Reduction in VA disability benefits - 100% to 0%

[Armyvet1987]

Hello everyone, 
Today I received a letter stating I will be getting a reduction of benefits from 100% to 0% for PTSD. I was awarded this amount in October 2010 and maintained the 100% rating until now. In November 2017 I had reexamination for PTSD, the results came back in December 2017 and I was again awarded 100%. Fast forward to February 2018, I received a letter in the mail saying I needed to go to a out of the VA doctor for them to fill out a DBQ form, I called the VA that day and stated I was not comfortable with speaking to another doctor about my PTSD, the women told me I could have my metal health doctor fill it out and send it back to them. I have an email from her with the attached document. My next appointment for the mental health doctor is in late April. The letter states that there is proof in my medical files and since I “missed” the DBQ appointment that they want to reduce my rating from 100% to 0%. 

So here is my question, how did my PTSD change significantly from December 2017 (when I was re-envaulted) to February 2018?
Next, should I hire a lawyer? VSO? I have never used the VSO or disabled veteran’s reps.
Finally, what should be my next step?


Thanks.

[Berta]

Vetquest said:

" Sometimes I wonder if they do this just to see if they can get away with it."

As a personal victim of MANY VA Errors, I have often felt that way too.

There is a time limit on the response to the proposal letter you need to adhere to but I sure would have IRISed them as a complaint or called the WH Vets hot line-by now. 

I have had success doing that with IRIS  when they made some ridiculous decisions in my claims

and I have called the WH Hot line as well..but as an advocate. I write to them now on veteran's issues.

Long ago VA tried to reduce my husband's PTSD comp.They gave 2 reasons for that.

I used their own reasons, and the regs that were in the decision, and plain old common sense and prepared the NOD. 

About 8 months later the POA called and said they had dropped the reduction idea based on my NOD.

But my husand worked at VA then and the proposed reduction amount was something that we could handle.

They want to take you from the 100% rate down to Zero -maybe you can deal with that for the year or so it will take them to handle your NOD...or longer if you request a DRO review.

 

 

 

 

[Berta]

There is more to this than meets the eye::

. "In November 2017 I had reexamination for PTSD, the results came back in December 2017 and I was again awarded 100%. Fast forward to February 2018, I received a letter in the mail saying I needed to go to a out of the VA doctor for them to fill out a DBQ form, I called the VA that day and stated I was not comfortable with speaking to another doctor about my PTSD, the women told me I could have my metal health doctor fill it out and send it back to them."

December 2017- less than 4 months ago .......

Why would this vet even need a DBQ? Is this some new Practice? and as this vet stated- it needs to come from 'a out of VA doctor'- who pays for that?

Do you all expect ,if you get a re-evaluation, to have to get a DBQ filled out too? From what appears to me they mean an Independent medical opinion on a DBQ form?

I am assuming it is for the same SC disability-PTSD

Please tell me the new regulation on that, anyone .....

I received a letter in the mail saying I needed to go to a out of the VA doctor for them to fill out a DBQ form

Army Vet 1987- do you have a copy of the initial C & P exam that was done  in November 2017?

I think the VA probably lost it and to CTA, they want the DBQ.Make sure if you get a VSO or however you handle this that you let them know exactly what this letter says.

I think they really screwed up here based on what this vet has told us.

 

 

 

[Buck52]

I once had a DRO to say'' the VA Dr overstepped his bounds and was not authorized to take my C-FILE to his home .

 BECAUSE OF THIS As to  what he (The VA Dr) Mention me  During a  C & P  Exam and that he would get with another Dr that was in New York on Vacation and had to wait for him to return and get with him to make an assessment/opinion.eh!

 he did and have it open (my c-file) at his VA Clinic for public viewing.'' in other words this VA DR HAD MY C-file open on the counter for anyone to walk up and start reading.

As this is what he did during My C&P at his clinic with me  about 17/18 years ago AS MY SPOUSE WAS WITH ME TO WITNESS AND SHE ALSO ACCOMPANY ME TO MY  R.O.  DRO HEARING.

This discredited the VA Dr with the DRO.

I mention All  this to the DRO at my  R.O.Hearing 

That is an absolutely NO/NO to a DRO.

Although I had a GREAT Detailed IMO from a private specialist  to give his professional opinion using the VA Guidlines and the DRO took his word over the VA Dr's

DRO-= (DECISION REVIEW OFFICER)

I won my claim.

Edited April 3, 2018 by Buck52

[Tyr]

If you miss a routine future exam, its mandatory for the VA to propose to reduce.

It doesn't sound like you should have had an RFE, but I can't say for sure without seeing your file.  My gut feeling is that someone got all sorts of stupid and inadvertently put an RFE on your PTSD.  If nothing else, the time frame is wrong - it should (generally) be at 18 months, 24, or 30.  Not freaking 4.  

 

Get another exam scheduled and go to it.  File a claim for DEA.  Make them make a decision as to if your disability is static or not.  

[broncovet]

This sounds like some type of retaliation by one or more VA employees.  Read the regulations..VA can not reduce you "on any one exam", because you are "over 5 years" or P and T:

 

Quote

 

3.344 Stabilization of disability evaluations.

(a)Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b)Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c)Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

 

 

[Gastone]

Upon receipt of the VA Intent to Reduce Letter, did you immediately File a NOD Requesting a Hearing, 2 Month Appeal Clock still Ticking?          One would believe that any Vet with a Single        SC Rating for PTSD @ 100% SC, would require constant VA MH Dept Treatment by a VA Psychiatrist.  Do you believe this VA Letter of Intent to Reduce is based on you missing the Scheduled PTSD C & P or do your MH Treatment Records actually show significant sustained Improvement?         Any VA PTSD C & P is Forensic in nature, Treating VA Psychiatrists or Psychologists are precluded from completing the PTSD DBQ of any Vet under their direct Care/Treatment.    Who completed the Re-Exam DBQ? Can you post a Redacted copy of the DBQ from 17 & 18?