Effective date on recent appeal

[firedog974]

Hi all,

            I recently won a RAMP appeal that originally started Jan 2016 when I put in a claim for PTSD.  I received my decision letter today, and the effective date is March 5, 2019.  Just wondering if anyone has any advice on where to go from here, as I feel the VA (as usual) screwed this one up.  In my decision letter it states the reasoning for the effective date as follows-"You were diagnosed with just alcohol use disorder on Aug 24, 2016 VA initial PTSD exam. Alcohol use disorder by itself is not a disability for VA purposes.  You now have a diagnosis of PTSD, therefore alcohol use disorder was included with it. We have assigned an effective date of March 5, 2019 which is the day the facts found show that you had a diagnosis of PTSD. An evaluation of 50% is assigned March 5, 2019"   So a little back story, when I initially filed, at the C&P exam, the shrink told me they could not find evidence of the stressor event, so he stated he could not diagnose me with PTSD (couldn't just take my word for it).  I filed an appeal when I received my denial letter, and submitted a report from my doctor with a diagnosis of PTSD, and began doing my own research to verify my stressor (The VA advised much of my personnel record was missing).  I submitted a lot of evidence during my appeal, and was finally granted it.  So is the VA essentially saying we know you filed for a PTSD rating over 3 years ago, but despite what your doctor said, the effective date is only when our doctor diagnosis you?   Is this correct, or is the VA wrong?  Any input for my next step (if there is one) would be appreciated.  

[ShrekTheTank]

I think you have a good shot at fighting this. I am sure there is someone here who has faought this issue. 

[vetquest]

What you are looking at is an appeal for EED.  If your case was before BVA there is not much chance of winning.  If your case was at the RO I would appeal to the BVA.  I will go out on a limb and say what the VA is stating is that your disability could not be verified until the date of your last C&P.  They did this to me on a claim for PTSD and I won on appeal to the BVA.

They can and do use this to avoid paying backpay when a claim has taken a considerable amount of time for them to get their act together.  It should not be right that they use the date of your last C&P and they can get away with this if you let them.

[firedog974]

20 minutes ago, vetquest said:

What you are looking at is an appeal for EED.  If your case was before BVA there is not much chance of winning.  If your case was at the RO I would appeal to the BVA.  I will go out on a limb and say what the VA is stating is that your disability could not be verified until the date of your last C&P.  They did this to me on a claim for PTSD and I won on appeal to the BVA.

They can and do use this to avoid paying backpay when a claim has taken a considerable amount of time for them to get their act together.  It should not be right that they use the date of your last C&P and they can get away with this if you let them.

Thanks vet quest.  Not sure what an EED appeal is, can you elaborate?  How long does something like that take?  This claim has been going on for over 3 years...

[ShrekTheTank]

5 minutes ago, firedog974 said:

Thanks vet quest.  Not sure what an EED appeal is, can you elaborate?  How long does something like that take?  This claim has been going on for over 3 years...

Earlier effective date.  And who knows. I have been 5 years+. 

Your brown envelope should have your next step to appeal to the BVA. 

[vetquest]

An EED (earlier effective date) appeal will usually go before the BVA.  You need to provide evidence to show that the EED is valid.  Usually the BVA provides much more weight to your case and evidence than the RO.  My appeal took five years but that is quick now a days.  A lot of veterans hire an attorney for their appeals, I did.  They get twenty percent of your award but that is better than 100% of nothing.

[broncovet]

You posted:

Quote

We have assigned an effective date of March 5, 2019 which is the day the facts found show that you had a diagnosis of PTSD.

When you appeal effective dates, understand the general rule is that your effective date is the later of the date of claim or "facts found".  

To appeal, you have to refute the statment I quoted.  Here is why this statement is wrong.  

Refer again to the caluza elements.  It says you have to have a "CURRENT" diagnosis.  You did not have to have a PTSD diagnosis in service...and, if you read the effective date rules, they do not say, your effective date is the date of your first diagnosis.  

The VA pays you for SYMPTOMS, not a diagnosis only.  If I were diagnosed with PTSD with no symptoms, then my rating would be zero percent if not denied.  

Sometimes docs change your diagnosis...medical science changes.  As an example, Alex has pointed out there was no such thing as a hep c diagnosis in the 1970's..That does not mean you could not have been infected, and it does not mean you had not symptoms, either.  YOU need a CURRENT diagnosis.  

Dont let VA pull that crapola.  Appeal.  You suffered with symptoms of PTSD, long before that doc diagnosed it.  Equally important, read your file to see if a doc previously diagnosed your ptsd.  Or, if he prescribed medications normally for PTSD.  Your doctor CAN prescribe PTSD meds for something else...say a hangnail...but he should state that he is prescribing this drug "off label"..in other words he is prescribing this med when you dont have ptsd, but he is prescribing it off label.  Off label means that its for a purpose other than what the drug company says its for.  

If you were prescribed a mental health drug..say prozac...and the doc did not say that was "off label" to treat your stomach issues, then its presumed you have a mental health disorder.  

"The date of diagnosis of PTSD" does not control here.  The date of the onset of your symptoms is controlling.  As I said, the Caluza element requires a "current" diagnosis.  You could well have been receiving treatment for this malady PRIOR to this doc finally documenting you have PTSD. 

If you break your leg, you still have symptoms of a broken leg BEFORE . you go to the doc and he tells you its broken.  (gives a diagnosis of a fractured leg).