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63Charlie

Wrong C&P Exam For My Condition??

Question

Went for a C&P exam for PTSD.

I received a decision that I have PTSD...but it wasn't service connected.

After the PTSD claim denial, I filed a claim for anxiety and depression..

It was quickly approved at 50% rating ...without another C&P exam for anxiety and depression.

The C&P exam was for PTSD and didn't focus on my anxiety and depression. 

Questions were pertaining to PTSD.

My Gaf was 45 prior to the PTSD C&P exam.

Not able to hold down a job due to the severity of my depression and anxiety.

If I file a NOD, will the VA provide another C&P examination specifically based on ANXIETY and DEPRESSION?

 

Undecided if I should file a NOD.

Depression has increased in severity due to a stressor from a diagnostic test result obtained since the C&P exam..

The VA examination process heightens my anxiety level as I have a fear of not receiving a fair and unbiased C&P examination.

Edited by 63Charlie

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Do you have a PTSD SC rating now? if not file for PTSD  Because you have a rating for 

anxiety and depression.. & that's a part of  the symptoms for PTSD.

You would need medical evidence and VA Diagnose of PTSD/STRESSORS  with your STR's DD- 214, Unit reports ect,,ect,,'which you should have so they should redo the claim to PTSD. (just my opinion)

Remember the VA don't rate two separate MH Disability's  on the same claim.

But yes definitely file your NOD you have  12 months from the date of the denial to file it.

They probably will set you up a PTSD C&P  It's considered an Increase.

or this could be a CUE? rating you for  anxiety   and depression &then say you have PTSD???

 other more experienced Members like Ms berta broncovet , asknod,Gastone will chime in.

jmo

............Buck

Edited by Buck52

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I DO NOT  have a copy of my military service records, or C-file just yet.

Ebenefits say I'll get a copy some time between 2018 and 2019. 

How lovely.

Sent a FOIA request and time is running out, just as soon as the twenty business days are elapsed and no copy of my c-file,,, I'm appealing to the OGC.

If the OGC fails to timely respond in 20 business days I will seek an injunction in federal court to have a court order forcing them to comply with the rules/timelines.

I'm at a huge disadvantage without knowing what's in the file the VA is using to make decisions.

I think the C-file is going to shed some light about what medical opinions are in it are saying

i have begun to feel like I'm treated like a mushroom.

The VA feeds me crap..... and keeps me in the dark..

 

Edited by 63Charlie

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Take a breath, relax and try to get a grip on your situation, all is not lost. You got a 50% SC, based primarily on your PTSD DBQ from  your 1st claim, right. Not too shabby, not the SC you were looking for but it will do for now.

Did you get a copy of the C & P PTSD DBQ? If not, get it from your VMC Med Recds, if it was done by a VA Psychiatrist/Psychologist PhD. My Lay understanding of a Anxiety/Depression DX SC, you don't necessarily have to have a PTSD DX. On the other hand, Anxiety/Depression are both integral parts of a PTSD DX and as such, are addressed on the PTSD DBQ.

What to do now? Go ahead and NOD your PTSD Denial, don't let the claim die by missing the 12 month  window. Best you could expect to get, maybe a 70%, which would include the 50 you already have. If you don't have New & Material Medical Evidence, right now you don't, your headed for a 4+ year wait for the BVA.

You say your current verified actual MH DX, which is your 1 and only SC, keeps you from working. That MH employment issue, is probably addressed on the PTSD C & P DBQ. That's just you saying it, hasn't been verified or substantiated by anyone else, right?

I recommend that you go immediately  on your E-Ben site, start a Individual Unemployability "IU" FDC, just don't hit the SEND Button, just yet. Next, using E-Ben, file an application to the VARO Vocational Rehabilitation Program. You'll get an appointment within a couple weeks, trip down to your RO and see a Voc Rehab Councilor. After 1 or a couple of appointments, no more than a month total, the Councilor will be able to issue a Professional Employment Councilor's opinion as to your employment status for IU purposes. If the Councilor agrees that your currently IU, due to your SC conditions, he/she will write you a Voc Rehab Denial Letter indicating that your disqualified for Employment Rehab. This letter will be a piece of Gold as evidence for your IU claim. Scan & attach it to your IU FDC and hit the SEND Button. Next stop, Temporary IU Award, paid at the 100% SC rate. You'll probably be scheduled for a re-exam in 3 - 5 yrs, so what.

The above, Voc Rehab strategy worked for me and 3 other Nam PTSD Vets that I had to push, literally, after I got my DRO IU Award 6/14 from a 12 Denial. 3 of us were 70% and 1 rated at 50%. All 3 got their Denial letters within 3 weeks. 2 got their IU on the 1st try and 1 was awaiting a DRO Hearing, when he went to Voc Rehab for the letter. He had to wait for his Hearing due to the Retro situation, but the Letter got the Award and a Big ASS RETRO Deposit 05/16. His DRO, as well as mine, acknowledged that the "Denial Letter," was the determining piece of Evidence needed for the Award.

Semper Fi 

 

 

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I don't know if this will be of any help, but, I thought I would touch on this, since it recently happened to me with my claim.  Be careful with the change of diagnosis.  I was extremely lucky as my claim was still alive,  sort of.  In the middle of this last appeal my mental health rating went from 50% to 70% and had a change in diagnosis.  It went from adjustment disorder with anxiety and depressed mood, to PTSD and other.  I can't verify the exact medical coding or any part of the decision as the VA has ignored and played the shell game with my FOIA request for the mental C&P exam. They have been trying to lead me around Muskogee Regional Office and the Evidence Intake center.  Neither have produced my request for records.  

Also this last decision, I am still waiting on the decision letter.  I haven't pursued getting the decision just yet however, because my appeal according to Muskogee has been certified to the Board. BVA confirmed me of that fact as well.  I guess I'll find out more in a couple of years of waiting.  :blink:

My last trip to Muskogee was not very fruitful.  Gotta tell you though " sorry we can't help you" stated with a smile really burst my bubble.  I understand why folks do extreme things when treated like this.

I'm not stressing because I have the exam "unofficially documented" but I want those reports and exam.  Heck I want my last decision letter but that was a no go as well.  

I have to say, with my particulars, I had an approval for Voc Rehab but I didn't have to go through the regular process of getting the Voc Rehab exam and denial.  Heck I didn't even get to go to the Voc Rehab appointment, but got an approval for this benefit, a few months later after getting out of the hospital in 2014.

All this verifies is the VA regional office has a nice system of denial and run around.  They don't follow regulations at all and kind of make things up as they go along.  Such BS.

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8 hours ago, 63Charlie said:

I DO NOT  have a copy of my military service records, or C-file just yet.

Ebenefits say I'll get a copy some time between 2018 and 2019. 

How lovely.

Sent a FOIA request and time is running out, just as soon as the twenty business days are elapsed and no copy of my c-file,,, I'm appealing to the OGC.

If the OGC fails to timely respond in 20 business days I will seek an injunction in federal court to have a court order forcing them to comply with the rules/timelines.

I'm at a huge disadvantage without knowing what's in the file the VA is using to make decisions.

I think the C-file is going to shed some light about what medical opinions are in it are saying

i have begun to feel like I'm treated like a mushroom.

The VA feeds me crap..... and keeps me in the dark..

 

Heh keep at it, eventually the light will shine through.  Just keep pushing the right buttons like you are.  You having to go through the OGC has me at the very least curious. How long do you have on the 20 business day wait?  Has there been any correspondence as since you made the initial request for information? Or is it strictly relying on ebenefits?

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