ptsd Another Question . . .

[Philip Rogers]

In reviewing my friend's c-file, I found he was hospitalized, back in 1983, complaining of a drinking problem and marital discord. His discharge summary lists 2 diagnoses: 1) Mixed character disorder, 2) Partial PTSD with depression. Now my question - if I recall correctly a VA hospital stay is supposed to be considered a "claim for increase." Since he was already receiving 50% for wound residuals, should the VA have rated these 2 diagnoses?? I think we should pursue it.

pr

[john999]

Phil

I know that my IU was made retro to my hopital stay. The VA used that date as the beginning of my IU and not the fact that SSA made that same date the beginning of my disability for their purposes. I know I have read in the VBM that a hospital stay can be used as in informal claim for increase.

[Ricky]

If it is to be rated as a "claim for increase" why would the VA take action on this. As I read it the Vet was not SC'ed for these conditions so what would they increase. Would he not have had to had a claim pending or approved. I understand the combat/wound claim relationship, however, martial problems nor partial PTSD is a disability. Just asking cause I don't really know myself - not questioning your thought process just seeking personal knowledge.

Ricky

[SLEDGE]

PTSD causes drinking problems and subsequently many other social problems.

Back in the late 80's the medical community was largely ignorant of PTSD.

The fact that it was mentioned at all is profoundly significant.

sledge

[john999]

It seems if the vet was not SC'ed for these conditions it could be an inferred claim since the VA was aware fo the conditions.

[Vike17]

Philip,

This would only apply to veterans that are hospitalized due to their already service-connected disability. I think this is what Ricky was trying to say. If he was hospitalized due to his "wound residuals," then, yes, the hospitalization may be taken as a claim for an increase.

Furthermore, does your friend have a an inservice stressor that caused PTSD. The mere fact that he has a drinking problem with partial PTSD doesn't mean that it was due to his military service. Hell, your friend might have been involved in a car accident after his discharge that is the cause of his partial PTSD. Ask your friend if something that happened to him while he was in the service that might be the cause. Also, was "Mixed character disorder" the Axis 1 diagnosis and "Partial PTSD with depression" the Axis II diagnosis. This is pretty important in regards to a PTSD claim.

Vike 17

Edited January 9, 2007 by Vike17

[carlie]

Philip,

I'm thinking this is what your referring to.

§ 3.157 Report of examination or hospitalization as claim for increase or to reopen.

(a) General. Effective date of pension or compensation benefits, if otherwise in order, will be the date of receipt of a claim or the date when entitlement arose, whichever is the later. A report of examination or hospitalization which meets the requirements of this section will be accepted as an informal claim for benefits under an existing law or for benefits under a liberalizing law or Department of Veterans Affairs issue, if the report relates to a disability which may establish entitlement. Acceptance of a report of examination or treatment as a claim for increase or to reopen is subject to the requirements of §3.114 with respect to action on Department of Veterans Affairs initiative or at the request of the claimant and the payment of retroactive benefits from the date of the report or for a period of 1 year prior to the date of receipt of the report.

(Authority: 38 U.S.C. 5110(a))

(This part is very confusing to me)

(b) Claim. Once a formal claim for pension or compensation has been allowed or a formal claim for compensation disallowed for the reason that the service-connected disability is not compensable in degree, receipt of one of the following will be accepted as an informal claim for increased benefits or an informal claim to reopen. In addition, receipt of one of the following will be accepted as an informal claim in the case of a retired member of a uniformed service whose formal claim for pension or compensation has been disallowed because of receipt of retirement pay. The evidence listed will also be accepted as an informal claim for pension previously denied for the reason the disability was not permanently and totally disabling.

(1) Report of examination or hospitalization by Department of Veterans Affairs or uniformed services. The date of outpatient or hospital examination or date of admission to a VA or uniformed services hospital will be accepted as the date of receipt of a claim. The date of a uniformed service examination which is the basis for granting severance pay to a former member of the Armed Forces on the temporary disability retired list will be accepted as the date of receipt of claim. The date of admission to a non-VA hospital where a veteran was maintained at VA expense will be accepted as the date of receipt of a claim, if VA maintenance was previously authorized; but if VA maintenance was authorized subsequent to admission, the date VA received notice of admission will be accepted. The provisions of this paragraph apply only when such reports relate to examination or treatment of a disability for which service-connection has previously been established or when a claim specifying the benefit sought is received within one year from the date of such examination, treatment or hospital admission.

(Authority: 38 U.S.C. 501)

(2) Evidence from a private physician or layman. The date of receipt of such evidence will be accepted when the evidence furnished by or in behalf of the claimant is within the competence of the physician or lay person and shows the reasonable probability of entitlement to benefits.

(3) State and other institutions. When submitted by or on behalf of the veteran and entitlement is shown, date of receipt by the Department of Veterans Affairs of examination reports, clinical records, and transcripts of records will be accepted as the date of receipt of a claim if received from State, county, municipal, recognized private institutions, or other Government hospitals (except those described in paragraph (b)(1) of this section). These records must be authenticated by an appropriate official of the institution. Benefits will be granted if the records are adequate for rating purposes; otherwise findings will be verified by official examination. Reports received from private institutions not listed by the American Hospital Association must be certified by the Chief Medical Officer of the Department of Veterans Affairs or physician designee.

[26 FR 1571, Feb. 24, 1961, as amended at 27 FR 4421, May 9, 1962; 31 FR 12055, Sept. 15, 1966; 40 FR 56434, Dec. 3, 1975; 52 FR 27340, July 21, 1987; 60 FR 27409, May 24, 1995]

Hope this helps someone, also perhaps someone can explain the first part

of section (b) in a way that I can understand.

Thanks,

carlie

Edited January 9, 2007 by carlie