New Claim?

[bmiddleton]

I received a random call from Topeka VA to schedule a reevaluation for PTSD. I checked my Ebenefits when I got home, there is an entirely new pending claim for PTSD as of May 4. I still have my rated disabilities since Feb 2012 as follows:

back strain- 10%

bursitis right hip-10%

GERD-0%

psoriasis-10%

panic disorder without agoraphobia- 70%

I did not start the new claim, but it is in the gathering evidence stage. I do see a psychiatrist for my medications and short psychotherapy sessions every 3 months through the VA. He has not stated any change in my diagnoses to me. I went through the notes my psych has put in and the only thing I have seen diagnoses wise is panic disorder with agoraphobia r/o PTSD in his notes. What could be the reason for all this in my claim? Is it an attempt to decrease my percentage, change my diagnoses, or just add to my claims? This will be the only other C&P exam I have had since my initial C&P exam.

Thank you for your help. 

 

 

[broncovet]

Of course, I dont know what VA is thinking.  Are you currently SC for PTSD?  If you are not, this could be a good thing and could result in an increase.  

To find out if your condition has "actually improved", go to your exam where you were rated for panic disorder and check out those symptoms.  Did they get better, worse, or stay the same?  

If you have a new PTSD diagnosis and its service connected, then it could result in an increase if your symptoms worsened.  

How long have you been service connected for panic disorder?   If this has been at least 5 years, its tough for VA to reduce you.  (Or if you are p and T).  

Are you working?  Its especially tough for VA to say you actually improved unless you got better enough to go back to work.  

Read the regulations and see if you meet these reduction criteria:

(Probably not):

https://www.law.cornell.edu/cfr/text/38/3.344

[Buck52]

bmiddleton

I agree with broncovet 

My observation or opinion on this

I would think that if you never filed a claim for this  and your Psyc Dr filed out a DBQ HE/SHE PROBABLY SUBMITTED IT TO YOUR R.O.  (Regional Office) AND R.O. took that as FDC.

Just keep your eye on ebenefits for the status change and update  and see how it plays out.

if you have been S.C. FOR PTSD  70%and now this new condition  THAT would be a separate claim and could possibly render you an SMC S H.B. Award,   which means your % would change to 100% plus 60 % for the new rating (if your s.c. for PTSD?

it all depends on what they rate you.

Edited June 15, 2018 by Buck52

[bmiddleton]

I am currently only SC for Panic Disorder without agoraphobia. I was never diagnosed or rated for PTSD prior to this new claim. My condition has worsened and was recently prescribed for a service animal.

I go to school full time and have for the past 4 years, more so for just the BAH to help pay some bills since I struggle to work. When I called the DAV, they are my assigned representative, they have no record of starting the claim. They said I would have needed to sign off on a new claim being started. 

Edited June 18, 2018 by bmiddleton

[broncovet]

Your VSO is not correct.  The VA can/does "infer" claims in some circumstances.  I wont go into those here.  

This applies to "increases", not an initial claim.  Initial claims have to be in writing.  Increases can be formal, informal, inferred, etc.   Nowadays, everyone needs a form each time.  

[Navy4life]

Are you due for an evaluation for your MH?  Most MH ratings have reviews unless you are P&T.  It is possible you are up for a review.  I just had my review and I was increased from 50% to 70% for PTSD.  The only way this would be a "new" or "increase" claim, is if you initiated it and if you did not, then most likely you are up for a review.  MH doctor's don't submit to the RO, they just add notes in your file, to include your sessions, recent tests for your MH issues, etc.  Your DAV rep should be able to see how the claim was initiated.

[bmiddleton]

The DAV happen to be in town today with their mobile assistance unit, so I made a short trip to see them. They got me in contact with a representative that could see my file in Topeka. She could not find any documents initiating a new claim, but a C&P exam is scheduled. So to my best guess, there is a communication error on whether its a new claim or a reexamination. I plan to just attend the appointment and see where it goes from there.