ptsd Diagnosed housebound in 2008 by VA; is med diagnosis binding?

[Cannabis]

Hi everyone!

I started going to VA in 2008. I just discovered in my medical file that psychiatrist resident, as well as the head psychiatrist approved her diagnosis that I am housebound. That's 2 doctors. Then, over the next 2 years or so, many details in med record support housebound.

Sep 09, filed disability. 50% granted. (ptsd, depression, cannabis dependence)

Approx. May 2015, filed for increase. 100% granted, same as above.

I filed NOD.

My question regards this newly discovered evidence of record that shows since 2008, i was diagnosed housebound.  I also have current evidence of housebound, it's no mystery around here that I don't go anywhere. And haven't for years.

Is the disability examiner bound by this diagnosis in 2008?  If so, then

1. if I am housebound per physician diagnosis in VA medical notes, then how can I be 50%? Wouldn't that defacto be 100%

2. any ideas on approach for this?  NOD with SMC S claim to date back to Sep 09?  Or CUE?  Help!?

Thank you and bless.

 

Edited March 26, 2017 by Cannabis

[Buck52]

Asknod is right I stand corrected.

YOU NEED TO FILE FOR EVERY CONDITION THAT COULD BE SERVICE CONNECTED AT ONE TIME  FILE ON E BENEFITS  THAT'S THE FASTEST WAY AND SURE WAY THEY GET IT.

 I'M SORRY I thought you were already 100%...but say you file for the increase as to your new evidence you have now   if they did not have that back in 2009 ?...they can use it as new evidence now  unless you submitted it in 2009?

going from 50% to 100 %  you will need another separate rating of 90% to be 100% and the Dr letter that said you were House Bound in fact in 2009 (this would be special circumstances) because your still not 100%plus 60%   They do rate the SMC some times when the veteran is not 100%plus 60% under the special circumstance  and back then 2009 they rating you wrong in my opinion. And you  should have ask them to CUE them self....

if you have not used that as evidence then do so....if they give you a 90% rating or higher  along with your 50% that should qualify you for the HB infact ,However I would request the SMC -S  Because they never do what there suppose to do  and you have to file NOD to make your point...so if you let them know then its a possibility you will be referred to the H.B. infact....by reason of your new  evidence.under the special circumstances rule.

[Buck52]

If your at 100% currently and you feel you should have been given the SMC H.B. in fact back in 09 If your still in Appeal limit or kept your appeal ongoing  you can file a CUE on them for not rating you correct back in 2009...use the Dr's letter  that said you were infact house bound..other wise you need a new condition new claim to file seperate and hope it gets a 60% or higher rating  if you get that  that will automatically qualify you for SMC S H..B.

As Asknod mention you only got the 100% in 2015  this is why they never gave you the SMC back in 2009...You were 50%...had you presented the letters you have now  as evidence back then  then maybe things would have turn out different.

[Cannabis]

1 hour ago, Gastone said:

I take it that neither of your VA Psychiatrists from 08 to present ever actually completed the Dr's Statement for Housebound status, right?

You listed (3) issues resulting in the 50% back in 09, wasn't the 50% just for PTSD? Depression & the Weed Problem are covered in the PTSD Rating, they're not separate SC's.

You were 50% SC, you're now 100% as of mid 2015. Is that a Scheduler 100% from the Combined SC Ratings or is it an IU Award?

Semper Fi

No doctor filled out the dr statement for housebound.

I just recently found the notation in my medical record.

Yes, schedular, P&T.  All 3 combined into one rating (they considered as mental health, which is just one rating).

What I believe happened is this: I was discharged with 10% disability for depression. Statute says if discharged with 10%, then automatically it's 50% disability.  So, I think they just did an automatic on me and did not read my medical record.  I was housebound in 2008, they knew it, my record clearly indicates severe trouble and homeless as well.  I should have been 100% + SMC S in 2009. 

Then in 2015, I especially should have been 100% + SMCs. They did find the 100% but not SMCs.

If they are bound to the medical record as prima facie evidence, then it (housebound) is established in the record (VA med rec) in 2008, continuous until I quit going to VA.  (which is another story and another claim, 1151, for aggravating ptsd to the point where i no longer leave for medical or food (my only 2 reasons to leave) due to abuse from va doc.)

So in my mind it looks like the questions are:

1. does that notation of "housebound" in my medical chart constitute viable claim for CUE error that would then increase the 09 rating to 100% ... CUE?

 

Edited March 26, 2017 by Cannabis

[Buck52]

''Then in 2015, I especially should have been 100% + SMCs. They did find the 100% but not SMCs''.

the reason they didn't infer the SMC was because you was only 100% at that time,  they give the SMC on percentage ratings and you have to meet the critier for the SMC...in this case you were 100% p&t but you needed another ''separate'' rating of 60% or higher ..Now back to the Dr letters that you found  if they had used them as your evidence back then  maybe the out come would have been different.

The thing you can do if this claim is closed  you can request to reopen it and submit your new and material evidence  and get a  Dr Opinion in an IMO that you are infact House Bound along with the old letter that the Dr mention that...this may not be a CUE because no record of it back when they gave you the 100%  or you didn't find it in time to submit it.

My Advise is seek a good VA experienced attorney and reopen the 2009 claim.

[Buck52]

Cannabis

Maybe this will explain it better

The percentages assigned for each of your conditions may not always add up to your combined rating evaluation, they do not add the individual percentages of each condition to determine your combined rating.

Instead , they use a combined rating table  that considers the effect from the most serious to the least serious condition..the rating table there meaning is the special SMC Rating table.

 

To give you an example on how they have my combined ratings they are like this!

Keep in mind I served in Vietnam 69-71  47/48 years ago.

My first claims for S.C.compensation

My Effective dates are as follow

50%=April 1998 S.C Vietnam Incurred.

60% =Dec 10, 2002 S.C. Vietnam Incurred.

90%= March 17 2003 COMBINED RATING AND TDIU P&T Awarded  S.C.Vietnam Incurred.

100% =Oct 2 2015  S.C.Vietnam Incurred.  70% PTSD Awarded.

Note : Two claims since the 100% ,1 claim is a Separate S.C.Condition Above the 100%  It's 70% PTSD so  that qualified me to  get SMC S...AND K   K is consider to be 0% service connected  so the percentage don't count. 38 CFR 3.359 (a) loss of creative organ

Some say when a veteran is rated IU he should get the SMC S-H.B.in fact, because he can't leave home for work, I never got the SMC Referred to me when I got TDIU P&T and I could not leave home for work, and I never NOD the decision.

 I think I could reopen that old claim  but I'm Ok with what I get. so I just leave it alone. because the 70%  S.C. PTSD Rating got me the SMC S H.B.

I'm not sure veterans are getting the SMC S when first rated the TDIU P&T or not? I been checking out the success stories here on Hadit...so for I come up empty on the SMC S Referred .

Its really hard to figure it all out.

[Cannabis]

Thank you Buck.

My question about the SMCs is answered.

I do have one disability that is 100%. And I am housebound in fact, as per my medical record notation by doctors.

So, this convo needs to move to CUE forum as that is what I am looking at here, CUE in the first decision.

I need to know how to do that.  I'll copy and paste over there in a little while. Thanks again.