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PTSD c&p what next

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Cole23

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I'm sorry this is so long. I just wanted to give all info:

My entire situation is my husbands ptsd back in 2016 he recieved a proposal to reduce on his ptsd from 70 to 50. I asked for a hearing and sent in a bunch of evidence with it including a letter from his va therapist. The case was closed within 1-2 months and he remained at 70.  He is 100 overall but going from 70-50ptsd takes him down to 90. 

Fast forward to April  2018 he receives a phone call from a hearing judge saying we missed his hearing can he do it right now over the phone (we NEVER got the letter I open everything from the VA immediately).  He tells the judge he thought the case was closed (which in ebennies it was) but goes on to answer the questions. About a week afterward he gets a call from the local VA saying he has an appt scheduled for May 1st (10 days from the date of call) for a c&p for PTSD but they had an opening that afternoon if he wanted to come in then, he declined and they kept the appt for May 1st.  Again we didn't get a letter from the VA for the c&p yet so I call the va benefits coordinator at our local va and he says the letters are showing in the system. After calling him I finally receive the c&p appt letter on APRIL 30TH and for the first time ever there is no post mark date on the outside of the envelope. Ok no problem he knew about the appt from the phone call. 

So he goes to the appt comes home and says he was with the examiner for 10-15 minutes. He said I just don't feel good about it he only asked me a few questions and kept asking "anything else?"  Part of my husband's issue is memory loss. He doesn't know what they're looking for if they're not asking specific questions. So anyway I tell him it's ok they don't go just based on the c&p they look at your therapy notes too (he's been in therapy at the VA for 3 years basically 2x a month).  

Well now on the 15th I go into ebennies and there is no open claims or open appeals or any notification letter sent but when I go to disabilities it's showing 90% overall and 50 ptsd date 8/1/2018. So I go look at the c&p and the examiner states this is not a mistake this is progression. I would be fine with that if it were true. However his therapist (that he sees twice a month) says his progress is poor.

So my questions are:

How do they give more weight to a single exam than 3+ years of therapy? I was under the impression that they weigh all factors?

I don't know if I should call them bc I haven't received the letter yet or wait another week? but I don't know how long ago they made this decision, I just happened to see it on the 15th and now we're at the 21st and haven't gotten anything. I just don't want it to cut into my 30 days to appeal. And should I appeal or is there something else I can do?

Thanks for any help

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If his PTSD Rating was held for less than (5) years, ONE negative C & P showing Improvement is sufficient for the Rater to Issue an Intent to Reduce his Rating. Appeal the Reduction Immediately, you only have 69 Days from the Reduction Letter Date. His Comp will continue until the Appeal is adjudicated. If it goes against him, you can expect the VA to Clawback the Comp overpayments.

Does he have a POA-VSO Representing him, if not, sounds like he needs one, yesterday?

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I agree with gastone APPEAL this ASAP THE SOONER THE BETTER.

i would also get a transcript of the hearing he had with the judge over the phone  they should be a recording of it and transcribe on paper,( Need to see what questions was ask and your hubby answers) 

Also a copy of the C&P EXAM on April 30th

File the NOD 21 0958  Request a DRO Hearing to help get this mess straighten out (do so within 60 days) of receipt from the proposal to reduce letter.

DRO should contact you and let you know he got your request for the hearing and let you know when your request is accepted and give you a time and date to report for the hearing (do not miss this hearing) when you guys get there request a informal hearing, this is better b/c you both can be present at the hearing and face the DRO ONE ON ONE  & present your case have any favorable evidence with you at this time  Therapy notes is good lay statements from you to let them know about your hubby behavior and hopefully a rating specialist will be at your hearing also, if you use a vso or attorney they need to be there with you.

Request his C-FILE asap

Request the transcript & his last C&P Report on April 30th from the VBA (Veterans benefit Administration ) go to the medical records release of information, request all his medical records from the last 3 years or so  dig deep into them...find any favorable records  ect,,,ect,,

You need to know what evidence they have to reduce your hubby.

Dig deep for medical evidence favorable to your hubbys case , get (notarized) lay statements from family and friends  people that know your hubby and can attest to his behavior, his anxiety attacks, his fear being around others  his non social life  things that describe his life style and behavior  ect,,ect,,,

A good lay statment from you describing his behavior at home and some of the things he fears.

At night Describe his sleep pattern does he have night sweats wake up with nightmares does he say things like I wish I would die  or talk about killing himself , All these things need to be mention if they are true and  mention that your hubby attends therapy twice a month \  to address his emotional state and help him cope with his everyday struggles.

Mostly you need Dr opinion on his behavior  ask his VA Phyistrist to write a letter and give an opinion on his Assessment   to his PTSD...give the medications the psychiatrist prescribes for your hubby.

If the VA Physiatrist refuse to help , your only alternative would be seek a private One (they are expensive but an opinion letter for maybe 300/500 dollars to read your hubbys pertaint medical records and to examine him  to give his/her professional opinion about your hubbys present M.H. Condition would be well worth it. (jmo)

   if you can't then all the above would be proper way to prepare for this type of case.

or maybe hire an experienced attorney Attorney  Chris Attig would be a good one  or Alex Graham both  a members here on hadit and  Alex is a certified VA Claims Agent. (AKA (Asknod)

Or just stay here on hadit and get some great advice from some of our fantastic elder members  Ms berta , Tbird, broncovet ,gastone ,vetquest, Vync, Hamslice , L, prwslem, jerfri, so many others too that give there time free of charge for some well needed advice and information!

Don't be shy or afraid of the DRO  he /she is there to help you get this resolved & usually the DRO wants it to go in your hubbys favor.

   Just remember the DRO goes by what all evidence you have to refute this proposal to reduce and sometimes an increase is warranted instead of a reduction or your hubbys % stays as is.

if you have to and need more time to prepare for your case  you can request an extension.*(with good reason)*

Edited by Buck52
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Yes, you sure might need an IMO/IME-

Dr.Bash recommend a good shrink about a month ago here----maybe I can find that post.

The wife contacted Dr. Bash......and replied here with what he said........anyone recall that post?

Also Dr Valette's contact info should be here.

 

 

 

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  • HadIt.com Elder

______________________

Craig N. Bash M.D., M.B.A.

Neuro-Radiologist and Associate Professor

Uniformed Services School of Medicine

NPI/UPIN-1225123318

4938 Hampden Lane
Bethesda, Md 20814

Cell/Text 240-506-1556
Fax 301-951-9106

drbash@doctor.com


 

 

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Thank you all so much. I downloaded his mental health notes from his therapist and we do have a local psychologist that he has used before andis familiar with ptsd so I am going to see if he'd be willing to complete the dbq.  I will be calling him tomorrow.

In his c&p the doctor noted that my husband had passing thoughts of self harm but denies active suicidal ideation. And he quoted my husband as saying his age (40) is catching up with him. But didn't put that it was in regards to his nightmares and the way he wakes up. 

I just don't know how long I should wait to receive the letter or should I call them since the effective date shows 8/1/2018 maybe they're not mailing it out until June 1?

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