PTSD Increase - Opinions Wanted

[anxiousinMD]

Hello all, first of all thank you to all who share your stories and advice. While this is my first post, I've been stalking the forum for months as something to do during my insomnia as I wait for my decision. I have found both comfort and education here. I was hoping for some opinions, advice, or even encouragement. I realize I'm not in the worst shape compared to others, but this process has my anxiety through the roof.

I am currently rated 30% SC PTSD-MST (total rating with other disabilities is 50%). My condition has progressively worsened, especially over the past few years. I submitted my FDC for PTSD increase and TDIU in May and it has been in Gathering of Evidence phase. All of my treatments have been with VA docs. My GAF scores average around 50. I obtained a favorable IMO to submit with my application. I haven't yet been scheduled for a C&P exam. Over the past several years I missed a lot of work, burned through my leave with sick days, was previously placed on both short and long term disability with my employer, all from my SC medical issues.

I would appreciate based on your experience and thoughts on whether I might have a good case for increase, what my rating might be, whether I might get TDIU or P&T, how long it might take for VA to get my medical records from VA hospitals, if I will have to do a C&P exam (the thought almost triggers a panic attack), or any advice on what I can do to pass the time as I wait besides chronically check eBenefits and read every single thread on this forum. I realize I have a much longer wait ahead of me, so I figured I'd start engaging here.

Thank you in advance for any help.

Edited August 26, 2016 by anxiousinMD

[Buck52]

Usually when Veteran is 70% to 100% for PTSD  From VA helps with SSDI.

However in my case it did not  because I had not worked in the last ten years..so they denied me SSDI  and my S.C. Disability did not meet S.S. A. Criteria..I only appealed  this twice  the second time I was denied for not enough work credits with SSA, I could no longer work because of my S.C. Disability  and just did odd jobs during my fight with the VA...Finally in 2002 I got TDIU P&T.

I was unable to work from the early 90's from my not then S.C. Disabilitys...If I had known then what I know now I would got a lot of retro  but they paid my retro back from when I first filed for  an increase for 50% in 2000...from 2002/2003 to the 100% rate IU 2 YEARS RETRO...When it could have been a lot more.

live and learn  eh!

so my Advice is every veteran should watch and pay close attention to his/her EED.

Don't let them beat ya out of your earned benefits  and EED is a part of that.

[anxiousinMD]

Sunny, Navy, Buck – thank you for your responses and advice.

I read the same about GAF scores but read somewhere that a series of GAF scores over time can help the reviewer see a general picture. Not sure what mine says, but thought I'd include it in case it ever actually mattered to anyone's claim. 

Question – Since I have my SSDI initial and PTSD increase going on at the same time, if I were to receive a positive outcome on either before the other is completed, do you think it would help to submit that result to the other agency before they make a final determination? If I were to miraculously be a first time go on my SSDI, would submitting that decision to VA kick me out of the FDC process (read that submitting additional info does that).

Thank you again for your time.

[Buck52]

I don't think it matters  VA &SSA are two completely Administrations, the sooner you file for SSDI the better  again if denied and you appeal you will get Back Pay...same with the VA....However VA don't care if you file for SSDI or not  or SSDI don't care if you file for VA.

its the Norm for a Veteran that can't work because of his/her S.C. Disability to file with SSDI  especially if they have the work credits with SSA.  (Every little bit of income helps greatly.)

JMO

......................BUCK 

[Berta]

"Since I have my SSDI initial and PTSD increase going on at the same time, if I were to receive a positive outcome on either before the other is completed, do you think it would help to submit that result to the other agency before they make a final determination? If I were to miraculously be a first time go on my SSDI, would submitting that decision to VA kick me out of the FDC process (read that submitting additional info does that). "

If the VA awards you Solely for the SC PTSD, then YES this will help your pending VA claim.

I assume the PTSD is your only SC disability?

Make sure the VA is aware of the SSA award.

When SSA awards for both SC and NSC conditions, then their findings really do not help a VA claim.

If VA awards TDIU or 100 for PTSD prior to any SSDI determination, then YES that info will help the PTSD  SSDI claim.

SSDI is ,in essense ,an independent medical opinion.And SSA has changed considerably in the way they consider PTSD.

A SSA lawyer would not help us with a SSDI reconsideration many many years ago. The SSA had awarded SSDI for a stroke but never considered my husband's PTSD.(he was 30% at that time with a claim pending) I found a SSA regulation that said they had to consider all disabilities claimed. The SSA even tried to get my husband to drop the reconsideration idea.BS to that.

I called the lawyer up a few months later to tell him he had just  lost over 4 thousand bucks ( the SSA retro was about 17 thousand when the reconsideration request was awarded.)He remembered us being there and we had quite a discussion and he told me he would never look at a PTSD claim again the same way he did when we tried to get his help. (I wonder how many PTSD vets he had already refused to help with an SSDI matter)

A few years later I overheard my former vet rep say...'hm that is very interesting' to a vet who I had heard tell him he just got a SSA award solely for PTSD.

I managed to catch the vet going to his car at the local VAMC and asked him ,since we both had the same POA, if the rep told him to make sure the VA knew of the PTSD award from SSA.I couldnt help but over hear them as the office door was open.

The vet said "No, he just said it was 'interesting.' I thought it would help my TDIU claim. I told him it is more than 'interesting' and to make sure VA knew of this SSA award.I said my husband had been granted 100% P & T, based on his SSA award. The vet said I have a TDIU claim pending.... is that different than 100%?.

I said not really , so did he have a TDIU claim filed, , but they cant award TDIU to a dead veteran.

The VA lied about this SSA award and dragged this claim out for almost 3 years. They could have made the TDIU or 100% award in his lifetime.

Make sure if you get SSDI solely for a SC condition and apply for TDIU, that you sign an authorization form if they are still required by VA ,for these records from SSA,  and keep copy of the form and try to  seek the status of the SSA request from the VA, from time to time...

VA still tries to avoid getting probative SSDI records if they think they can get away with it as this 2015 Remand shows:

When VA has actual notice of the existence of relevant SSA records, the duty to assist includes requesting those records from the SSA.  See Golz v. Shinseki, 590 F.3d 1317, 1323 (Fed. Cir. 2010) (finding that VA must seek to obtain relevant records under 38 U.S.C. § 5103A when "there exists a reasonable possibility that the records could help the veteran substantiate his claim for benefits"); see also Murincsak v. Derwinski, 2 Vet. App. 363, 370 (1992) (finding VA's duty to assist specifically includes requesting information from other Federal departments).  This duty extends to obtaining a copy of the SSA decision awarding or denying benefits.  Id. at 371; Baker v. West, 11 Vet. App. 163, 169 (1998); Hayes v. Brown, 9 Vet. App. 67, 73-74 (1996).  

 

2.  Obtain and associate with the claims file any records in the possession of SSA pertinent to the Veteran's award of disability benefits.  Make a notation in the claims file of all attempts to obtain these records and all responses received. 

 

 

 

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp15/Files3/1525818.txt

A SSDI award solely for a SC condition is prime facie evidence of unemployability due to a SC condition.

 

 

.

 

 

Edited August 1, 2016 by Berta

[sunnyh]

Not sure if SSD helps at VA since it didn't in my case and I only get SSD for PTSD.

I got SSD for PTSD in 2008.

I had it when I was rated 50% in 2013 at VA.

I have SSD for PTSD now and during the July 2016 - 2nd C&P exam.

My claim is over 10 years old.

Edited August 4, 2016 by sunnyh

[PCW]

If you haven't done so already, document your workplace problems - and if possible get backup documentation from the HR department showing your absences and submit it (with/in addition to) your claim. It's always better to give the VA cold hard verifiable facts to help build your case. I wouldn't worry about dropping out of the FDC program - the turnaround on all types of claims is pretty quick these days. I started an FDC claim 2/29/16 for TDIU and/or an increase in PTSD (rated at 70% at the time). It dropped out the FDC program because I neglected to include an employer form. My decision was received on 7/8/16 - still a pretty quick turnaround.

You are most likely going to have a C&P for the PTSD increase part. Don't stress out about it if and when it gets scheduled. Look at it as an opportunity to bolster your case. Take the employer documentation with you and if the doc takes it so much the better. Make sure that that you verbally go over your workplace problems and any worsening symptoms. Be honest and forthright and don't hold anything back.

If you have documented your workplace problems adequately, and backed them up verbally during your C&P, and have treatment records documenting worsening symptoms, you should be happy with the outcome.

Good luck!