Filing Claims During Presumptive Period

[glashutte]

Can someone please clarify these concerns?

1. During the presumptive period after my ETS, do I file everything under one claim? Is it better to file everything under one claim or separately under multiple claims? I'm afraid of the doctors and staff looking over my claim and think I am 'malingering' even though they are all true. 

2. I do not have my actual medical record packet but do have a generalized medical data (still quite detailed) from Tricare Patient Portal via downloading from the Blue Button. Has anyoe had experience with this?

3. When do I submit my nexus? 

4. Do I need a nexus if I was seen during service by doctors and diagnosed for the condition I am claiming?

5. Do I submit proof (being seen by doctors during service, diagnosis during service) a long with my claim? Do you just send them the entire medical record or do you organize it so they can easily match up your medical history and each claim? It would be a pain for them to search through your whole medical history and at that point they may not even want to bother anymore...I assume.

 

 

Edited March 14, 2018 by glashutte
forgot something

[Berta]

Neither PTSD or flat feet are   "chronic" presumptives, as the link I posted here shows.....

I think you mean you want to preserve the day after your discharge as the potential EED (Earliest effective date) for any retro they might owe you if they grant these claims, by filing the claim within one year after your discharge.

Always a great idea. For this type of 'presumptive, the evidence must show the disability is at 10% or more during that period-VA can determine that with your medical evidence from your SMRS as well as any post service medical records.

You should search for the 2010 PTSD regs available here under a search.

If you do not fall into the "hostile fire-" and "close proximity to the enemy" criteria, you will probably definitely have to prove your stressor.

But if you are a combat vet with the CAB, CIB or PH on your DD214 ,they should  concede your stressor.(I say 'should because they did Not diagnose PTSD in a vet here , years ago, who had the CIB on his DD214..He never came back to hadit so there was more to that than we know.We have a current member who, as well had the CAR on his DD214 but the initial C & P doctor did not find him to have PTSD or any other mental disorder.He has re opened the claim for a new C & P exam.

PTSD has specific symptoms doctors look for....a vet does not have to have all of them but many of the symptoms are critical and unique to PTSD.

The VA will set you up for a PTSD C & P exam.

They will not accept a PTSD diagnosis unless it comes from a VA MH professional.

If your SMRs hold concrete diagnoses and inservice treatment for anything you claim, that is an established nexus but they will still order C & P exams because that is how they rate the disabilities.

 

 

Edited March 17, 2018 by Berta
added more info

[glashutte]

2 hours ago, Berta said:

Neither PTSD or flat feet are   "chronic" presumptives, as the link I posted here shows.....

I think you mean you want to preserve the day after your discharge as the potential EED (Earliest effective date) for any retro they might owe you if they grant these claims, by filing the claim within one year after your discharge.

Always a great idea. For this type of 'presumptive, the evidence must show the disability is at 10% or more during that period-VA can determine that with your medical evidence from your SMRS as well as any post service medical records.

You should search for the 2010 PTSD regs available here under a search.

If you do not fall into the "hostile fire-" and "close proximity to the enemy" criteria, you will probably definitely have to prove your stressor.

But if you are a combat vet with the CAB, CIB or PH on your DD214 ,they should  concede your stressor.(I say 'should because they did Not diagnose PTSD in a vet here , years ago, who had the CIB on his DD214..He never came back to hadit so there was more to that than we know.We have a current member who, as well had the CAR on his DD214 but the initial C & P doctor did not find him to have PTSD or any other mental disorder.He has re opened the claim for a new C & P exam.

PTSD has specific symptoms doctors look for....a vet does not have to have all of them but many of the symptoms are critical and unique to PTSD.

The VA will set you up for a PTSD C & P exam.

They will not accept a PTSD diagnosis unless it comes from a VA MH professional.

If your SMRs hold concrete diagnoses and inservice treatment for anything you claim, that is an established nexus but they will still order C & P exams because that is how they rate the disabilities.

 

 

Thank you. You're absolutely right it looks like PTSD is not on the presumptive list. Am I then out of luck since I never mentioned during service?

What you said here is correct:

I think you mean you want to preserve the day after your discharge as the potential EED (Earliest effective date) for any retro they might owe you if they grant these claims, by filing the claim within one year after your discharge.

I do want to preserve the date of my discharge because I have been told any diagnosis made 1 year following discharge will be service connected because it is during my 1 year presumptive period. Is this correct? I am not sure..

I do not have a history of being seen and never mentioned PTSD or anxiety within my medical records in service. Will this cause a problem? 

Also you mentioned PTSD must be diagnosed by a VA medical professional. I planned on going to a civilian doctor or even Dr. Bash or Levette. Would this work in my favor?

Edited March 17, 2018 by glashutte

[Berta]

If you claim PTSD, the VA will give you a PTSD C & P exam done by a VA MH professional.

If they diagnose you with PTSD, and the claim is filed within the first year after service, the EED for the retro will be back to the day after your discharge.

I think someone here in one of your other topics advised you to get a VSO to help you prepare the claim.

The VA will need bonafide proof of a inservice stressor.

I too feel that you need a VSO, and now is the time to think about the details of your inservice stressor and how you can prove it. You might need buddy statements .

We have articles here under a hadit search on buddy statements and also on what VA considers as a  stressor.

Dr Bash cannot opine on a PTSD claim, as he is a Neuroradiologist....and not a VA MH professional.