claim Reopening a PTSD claim

[bc0311]

I'm new to this site, and somewhat novice with claims as I've ignored them since my discharge in 2012, but I have some questions that I've yet to find answers for that hopefully someone can help me with:

In a nutshell, my story is I did my four years, two hellish combat tours to Afghan, got out in 2012, immediately filed my claims for a few disabilities like back and shoulder issues and got a 40% rating total. I've since not looked back as none of that concerns me. My issue now is that I was sent to a mandatory PTSD screening during one of my visits that year, and the examiner kind of went about the thing blase, and although I did tell her most of my traumatic experiences, she gave me 0% for "Combat PTSD not related to military service" as it says in their justification, whatever that means. I don't think they even attempted to listen to me as my experiences were extraordinarily traumatic and have been a detriment to my mental health and quality of life since. And yet I now have an effective date of a PTSD claim from day of discharge 6 years ago for 0%, says it right on eBenefits. I think you know where I'm going with this...

After 6 years of dealing with a slew of issues related to PTSD, I decided this week to start looking into trying to re open the case. My questions for you are.... Would I be entitled to any back pay if I could prove that I've suffered from PTSD since then, and that they made their original decision in error? And if so, how could I go about receiving the exact paper work / medical records from that one specific screening I had in 2012? I've looked everywhere and I don't really know how to navigate either of these situations... 

Thanks a lot!

[bc0311]

But is what I mentioned grounds for a CUE? That they missed all of my evidence from my hospital visit?

[Berta]

I think you are putting the cart before the horse.

A CUE can only be filed on a decision.

We have not seen the past denial decision and  will need to see the next decision.

If you do get a SC PTSD diagnosis from a VA MH professional due to the recent C & P,than the older denial might be  a basis for filing of CUE.

You need to see if the past evidence list ion the past denial (and the next evidence list )contains those hospital records....meaning they did consider them.

If they didnt you might have a 38 CFR 3.156 potential....might, maybe, ......

it all depends on the recent C & P exam results as to whether the VA finds that you have PTSD from your service.

 

 

 

 

 

[bc0311]

Right, I'm still waiting on their decision. I gave them about 25 pieces of evidence to go along with my 8 stressors, so I at least have a better chance now I think. 

My question about CUE remains, for the moment, hypothetical. I just need to prepare for it. 

As far as whether they looked at the evidence in 2012, they KIND of did. What I mean is, I told them that those documented symptoms may have been related to the IED blast ( I had no idea). So that's how the examiner interpreted it, as possible TBI. The only reference to my files from Afghanistan, in the initial C&P, are that she recorded that I said they may have been related to the IED blast. However, I think a reasonable person, having looked at that evidence, could deduce nothing other than that they were symptoms consistent with PTSD. The Doctors even wrote that. I was bedridden in the hospital for two weeks and they gave me a foot of paperwork documenting how I had no physical illnesses whatsoever, and that their decision was purely that I was suffering from severe combat stress, and their recommendation was to never go on missions again. That's all documented in my record. It would appear the examiner or rater did not look at this evidence. Had they done so, more of the criteria would have been checked off for PTSD, and undoubtedly been service connected with at least 0%. At the very least. 

All the explanations of CUE that I have read about online for the last few months is that they need to have overlooked material / medical evidence connecting your disability to service. It appears to me that they did this....

So hypothetically speaking, if they SC me now, I need to know if what I have is enough to file a CUE on the original denial. 

 

[Berta]

In some cases that would be true- meaning they completely ignored probative evidence they had.

In other cases the CUE lies within the rating sheet as well as their rationale in the decision.

If they overlook probative and compelling evidence to your detriment, that is a CUE under 38 CFR 4.6.

Hypothetically if they SC you now, you would possibly have a basis for CUE in the past denial.

But the Past denial stated a Zero----you would have to prove that the PTSD, at time of that denial, warranted at least a 10% rating, based on all evidence in their possession, when they made the "0" rating.... because their error cost you SC comp if that rating should have been higher than "0".

 

 

 

 

Edited March 16, 2018 by Berta