ptsd A few questions

[blakemc]

So I received a letter a couple days ago that I have a reevale appointment tomorrow.  I am panicking inside.  I am currently rated at 80% but I am unemployable due to PTSD so I get paid at 100%.  What do I need to do to make sure my rating stays where it is?  I haven't been able to see a VA doc in about a year.  I have tried and tried to no avail.  Any help is appreciated.  

[Vync]

12 minutes ago, blakemc said:

So I received a letter a couple days ago that I have a reevale appointment tomorrow.  I am panicking inside.  I am currently rated at 80% but I am unemployable due to PTSD so I get paid at 100%.  What do I need to do to make sure my rating stays where it is?  I haven't been able to see a VA doc in about a year.  I have tried and tried to no avail.  Any help is appreciated.  

Welcome to Hadit!

First, realize there is a difference between Individually Unemployable (IU) and Totally Disabled Individually Unemployable (TDIU).
- IU means future exams may be scheduled as you may be expected to improve.
- TDIU is were no improvement is expected, but they could still roll you back in for a re-eval.

Second, expect the C&P examiner to ask why you haven't seen a VA doc in the past year. Although there is not a requirement that you seek treatment for SC issues from the VA, if you have been treated elsewhere it is good for them to know. For example, some veterans with PTSD get counseling from a local vet center, church, etc...

Third, in my opinion, I recommend you do these things:
1. Go back over your original C&P exam results, if you have them

2. Review any mental health records where your psych doc indicated that you have not improved or are not expected to improve

3. If your PTSD still prevents you from being gainfully employed, let them know that

4. If you have been approved for SSDI, bring those records. If you have not filed for SSDI, file for it and let them know you filed for it.

5. Consider asking your spouse to write a buddy letter on your behalf. If necessary, see if they will go with you to the exam. Just keep in mind that some C&P doctors may want to see you by yourself.

6. If you have an official service animal, bring it with you.

7. Don't skip the exam! If you are sick or are unable to attend, contact the C&P clinic or QTC about rescheduling ASAP. If you miss the exam, they are very likely to hold it against you.

8. If you are SC for more than one disability, keep in mind that the VA might be bringing you back in for re-eval for any or all of them. Sometimes the VA is nice enough to tell you that you are coming in for a specific exam, but just be prepared. I was brought in for a re-eval, but the letter was generic. I had a claim in for my lower back, but it turned out they were just doing a re-eval for asthma.

9. Familiarize yourself with the disability questionnaire DBQ. This is the basic template of questions the VA will use.
http://www.vba.va.gov/pubs/forms/VBA-21-0960P-3-ARE.pdf

10. Familiarize yourself with the VA's mental health ratings schedule. This table matches up with check boxes on the DBQ. It shows you what your rating % is based on your situation.
http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#se38.1.4_1130

General Rating Formula for Mental Disorders

	Rating
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.	100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.	70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.	50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).	30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.	10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.	0

 

Good luck!

[Berta]

" I haven't been able to see a VA doc in about a year.  I have tried and tried to no avail.  "

That concerns me. Why could you not see a doctor at the VA?

I have an opinion on this that met with lots of negativity here over the years but I will state it again.

When a veteran has a PTSD rating, they need to continue to be treated for it , with either meds, or shrink care ,or at least get to a vet center often. The reason I say that is that VA needs to justify ratings with proof that the disability in fact is still one that the veteran has and it still remains at the same level, or gets better , or ( in many cases) gets worse and that is where those continous treatment records and the proper  ratings, due to the VA documentation ,can come into play.

However if anyone disagrees with me that is OK too.

When my husband was DXed with PTSD he didnt know what they were talking about. He had gone to the VA for a business loan and came out the same day with a PTSD DX and also a buddy statement from the head shrink at Newark VA who was incountry treating many from his Marine Unit after a horrific volunteer job they did.Someone at the VA  filed the claim right away. He was told to go to the closest vet center where he lived to find out what PTSD was. They awarded him 30%  at that time. When we moved to NY he began seeing a VA psychologist, and then the VA psychiatrist, for the next 6 years until he died.He was rated at 100% P & T posthumously, and granted SSDI solely for PTSD.His VA med recs, psychologist recs, Vet center records, Voc rehab rec, additional psychiatrist records and test results, VA employment records etc etc., 2 PTSD hospitalizations and his med records for PTSD all justified his 100% award.Unfortunately he died before he even saw that award.

Vync gave you very excellent advise.

Maybe I misunderstood and maybe you get private PTSD care.If so make sure VA knows that .