PTSD C&P (RFE) - VA requested (increase)

[19K2O]

Two weeks ago I got a call from my local VA Hospital notifying me that C&P has requested an examination for increase. I have set the appointment for tomorrow (8/20/18) and I have done A LOT of reading recently to prepare for it. I have a couple concerns that I hope anyone with some experience here can help me with. First, a few facts on my case:

- My original claim for compensation was received at the DVA on 8/11/2011

- On 08/01/2013 my original claim was closed and I was awarded service connection for PTSD at 50% and service connection for tinnitus at 10%.

- On eBenefits it shows that on 07/31/2018 a claim was opened by compensation (current status: Gathering of evidence)

- I exited service in 1997

- I have no record of treatment for PTSD before I started my claim and I have not sought treatment since I started my claim nor after the award

- The VA requested the examination

Since the original C&P examination I thought I could just get a handle on it now that I knew what my symptoms meant. Obviously I was wrong. Some symptoms have maintained, some have significantly worsened (rage, extremely short-fused, constant anxiety, severe memory loss, etc). Sadly, my family are the losers in my decision to just "try harder" to be better. So my question is this: how much weight is the absence of treatment on the examiner's report? Before I got the call for an examination I was succumbing to the fact that I need help and was interested in a couple of programs (fly fishing being one since I'm in Oregon). Can the VA determine that I'm "significantly improved" simply by no treatment in my medical records? I've obviously had my rating for just at 5 years (unless they go by their claim date which was 1 day under, sneaky devils). I'm just really worried about that rating since I and my family are dependent on by benefits.

Thanks for any help or advice anyone has.

EDIT: Follow up question: Can i bring my own  personal notes with me to the exam? My memory is garbage so I'm sure to forget something.

EDIT (8/20/18): Went to the appointment and had a panic attack in the waiting room. Thankfully my wife was with me. The doctor called me back and he was happy to talk with me; really great guy. He gladly allowed my wife to join the examination. I informed him I had written some notes and asked if it would be OK to refer to them if I needed. He asked if they had been uploaded into my file because if they had, he'd already seen them. I hadn't done that but he said if I needed to refer to them I could. The doc seemed almost excited to talk with me about what's been going on. The appointment ran about 1.25 hours and he and my wife chatted while I answered the screening tests. After that he suggested a specific counseling called 'Cognitive Processing Therapy' which is 12 meetings, one on one and proven to help. Looking forward to treatment regardless of what the outcome is. Thanks for the advice and support.

EDIT (8/27/18): Checked HealtheVet and saw that my C&P exam was posted on 8/23. Status still shows GoE. All there is to do now is be patient which, obviously, I have issues with.

EDIT (9/6/18): eBenefits now shows claim is in the "Preparation for Decision" phase and the decision time frame has been updated from 02/2019 as the latest date to 11/18. Anxiety is a mfer.

EDIT (9/7/18): eBenefits reporting 'Pending decision approval'

EDIT (9/11/19): eBenefits reporting letter and notification sent. VA determined my condition has worsened and increased the percentage from 50% to 70% for an increase of 10% for combined total.

Edited December 28, 2018 by 19K2O
Informational Update

[broncovet]

I have posted this before, but I will save you time by doing so again. 

When your examiner asks "How are you?"  ...have your answer prepared and thought out.   Never lie to an examiner, but dont tell him how you feel today, but how you felt on your worst day.  

If you respond the traditional "Fine, how are you?", that's not the right thing to say at a c and p exam.  Here is why:  If you are "fine", why do you need additional benefits?  You will be backpedaling and your credibility will be suspect.  

INSTEAD:  (How are you, Mr. Veteran?)

(Example only, use your own examples, not mine)   Last Thursday was terrible.  (Now proceed on telling what happened on "your worst day", not today as its still early and nothing bad has happened yet).  My wife called the police and I got thrown in jail............

[silverdollar22]

First hello and welcome to Hadit. Lots of great information here and some expert advice on many topics! Yes, your not seeking treatment for any condition that you have been rated on by the VA is not good. In there eyes you apparently can deal with life and work if you don’t have symptoms that are bad enough to seek treatment to improve them or help you cope with them. I really don’t know how to help you now but, I can tell you that they except you to seek treatment for your claimed disabilities. Someone else will chime in on this issue. 

[19K2O]

On 8/19/2018 at 7:48 PM, silverdollar22 said:

 In there eyes you apparently can deal with life and work if you don’t have symptoms that are bad enough to seek treatment to improve them or help you cope with them.

Thanks for the welcome Well, I just can't stress out about it any further. Appointment is tomorrow and then what ever happens, happens after that.

Edited December 28, 2018 by 19K2O

[Sgt. Wilky]

I too, am waiting on that shoe to drop. I am rated at 50% for PTSD, but I do have medical documentation of symptoms (Sleeplessness, RA, and other things that are symptomatic and secondary to it). I also have a good church that I stay pretty active in and the spiritual counseling that I get from my pastor is helpful. I understand religion may not be many people's thing, but I've found it very helpful. I was told years ago that the VA accepts this as a type of "treatment" and even my own neurologist agrees that those kinds of treatments are helpful to a lot of patients. Yes, my pastor has written a letter or two on my behalf when I first put the claim in, and I intend to use that as my reasoning for not seeking their "treatment" when my eventual CFE is ordered.

I happened to find this article ( https://www.pnj.com/story/news/military/2014/10/13/va-unwittingly-scares-ptsd-victims/17172265/ ) and there is one crucial sentence in which I cannot seem to verify and that is: "After PTSD sufferers are diagnosed and qualify for disability pay, the VA cannot compel them to seek treatment. As the number of cases has soared, up 42 percent between 2008 and 2012 to more than 500,000, the agency finds itself losing contact with many veterans. Paradoxically, a federal statute prohibits the VA from requiring treatment or examinations."

Perhaps others can chime in, but although the above statement may be true, how it effects the payment and disbursement of benefits can be disturbing. Good luck today and seek the help that you need!

Sgt. Wilky

[L. Chrastil]

RFE = routine future exam

Set in the record by VA to determine if improvement in your service connected disability has occurred.