ptsd Notified Of Rating

[RockyA1911]

I spoke with a VA service rep this am and was told my claim is in for authorization and rating was completed last Friday. I can't believe this crap. He told me that I have been increased from 10% to 60% with retro back to April 05. My effective date of my claim is 25 Mar 05.

The skull loss alone under diagnostic code 5296, inner and outer tables, for size exceeding 4.177cm or larger than a 50-cent piece at 50%. Both past and recent SMRs and VA medical records verified mine to be 4.5cm x 4.5cm. The skull loss was claimed in 1976 on the same claim form using the exact same medical evidence used when they awarded me 10% in 1976, for also claimed post concussion residuals the day after discharge from the Marine Corps. This is an open claim since Nov 1976 and I should get retro back to then according to the CFR. My entitlement arose in Nov 76 for the Skull Loss.

Since I was already getting 10% and if they awarded the 50% for skull loss but not retro, that is 60% combined right there.

That means they must have denied:

Post Traumatic Encephalopathy due to S/C TBI (C&P More likely than not)

Post Traumatic Stress Disorder (C&P More likely than not, IMO More likely than not, combat award)

Surgical Scar from TBI surgery and cranioplasty (C&P More likely than not)

Cognitive Disorder due to S/C TBI (C&P More likely than not)

Tinnitus (C&P more likely than not)

Skin Disorder (C&P more likely than not)

Unemployability (Psychiatrist and VA Neuropsychologist, both stated unemployable)

I guess I won't get the actual brown envelope to where I can figure out what they did wrong or what evidence they looked at. But, clearly they had to have not even looked or had a lot of it or were missing my claims.

Either way, after waiting almost two years this really sucks the big one.

I even made copies of the CFR reg on retro payments, the 1976 claim with their stamp on it, their 1977 VA

C&P and neurological exam report, and their 1977 rating decision rating decision form that even mentioned the skull defect and size in the narrative portion. At the bottom of the decision it had just "10% award for post concussion residuals due to head injury." I sent that two them almost two years ago with the statement in support of claim form and listed each document as an exhibit.

I just don't understand how they could have turned down seven of my claims as even just the Skull Loss and PTSD alone if at least 30% is 65 rounding to 70%.

I don't understand how the VA can service connect the TBI skull loss and the post concussion residuals due to TBI and deny service Encephalopathy, Surgical Scar, and cognitive disorder due to the same S/C TBI.

This IS FUBAR at it's best.

[sixthscents]

I've actually included a CUE within a NOD - when I was first starting... and the rater addressed it. Their SOC claimed that a CUE had not exsisted, so I just reiterated the CUE (after actually reading the procedures) spelling it out clearly with references standing alone and am still waiting a decision. If its negative then I'll just kick it up the chain.. I was suprised the rater even addressed it the first time to be honest. I thought it had to go to BVA, but hey who knows, I have seen the VA CUE themselves and reduce a rating after a NOD... and they aren't supposed to do that either. I often get the impression that they just make up the rules as they go along. They certainly dont follow CFR 38 quite often.

I would file the CUE and see what happened. Also, repeating what has already been said I would make sure that its understood is that its not a request for reconsideration etc.

[Michelle]

Hay 1968 Army VV:

Don't count on it though. I filed my claim for increase in Nov, 2005 and they just told me that a decisions has been made but it has to be signed off by a supervisor and no one would tell me at the 800# what the decision was but I kind of have an idea from my VSO but I'm going to wait and see.

Michelle