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Question About PTSD Re-Eval

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USAF K9

Question

I'm sorry if I am posting in the wrong place.  I wasn't sure where this should go.  

I am prior Air Force, combat action medal from Iraq, blah, blah.  Lots of issues from Iraq and base football, and other stuff.

I am 100% SC schedular, non P&T.  I am 70% PTSD, 40% back, 20% for each leg bilateral radiculopathy, and a bunch of 10% ratings on my feet, knees, hands, etc.

I went to my first and only C&P for PTSD back in March 2019, so I have only been SC for PTSD for 4 months or so.  

I recently filed claims for several other conditions (Sleep Apnea secondary to wt gain from PTSD and other disabilities, Fibromyalgia for Gulf War, Migraines from Gulf War, ED secondary to PTSD meds).  I also provided a letter from a doctor saying I should be P&T.  I would have left well enough alone after getting 100%, but the rating said I would be re-evaluated for my PTSD and my back, so I figured I may as well go for the jugular and overwhelm them with the rest of my issues, so maybe they give me P&T.  I also THOUGHT I was safe from a re-eval since I had been rated so recently. 

Anyway, despite me providing  them records to fulfill all the necessary elements (favorable DBQs and nexus letters from Dr. Ellis, and diagnoses/sleep studies, etc. from my personal doctor) for all the new claims, they still sent me to a C&P for all the newly claimed conditions. Fine, I will play the game even though I sent you everything wrapped in a nice bow. But, then comes the part that threw me for a loop, and is my actual question:

I looked in ebenefits and see a request for a PTSD increase showing in the system, which I absolutely never asked for.  I didn't even think I could go for an increase since I had only been rated like 4 months ago at that time.  I also didn't think I rated 100%, based on the description in the CFR.  Anyway, I call a bunch of people to ask what is going on and nobody has an answer.  The VA acknowledged that they asked for the re-evaluation.  I understand the VA can and will re-evaluate anytime, but it is a bit ridiculous, even for the VA, to do another PTSD exam 4 months after the first one.  I would certainly understand if they re-evaluated my physical issues since I was seeing a primary care type C&P examiner for my new claims.  But, it doesn't make sense to generate a request to have PTSD added to the mix after only 4 months.  

Does anybody have any thoughts?  Some have told me that this may be part of their process to determine if I should get P&T, but I had a VA phone rep read me the correspondence between the VA and the Psych, and nothing was mentioned about "find out if this dude is going to be messed up for the rest of his life," and I know the C&P psych certainly didn't ask any questions about permanency, and she actually seemed mildly annoyed that they sent me again so soon, especially when I told her I never requested an increase.  BTW, the C&P seemed to go really well, so I am not super stressed about the outcome, but you never know.  Actually, scratch that.  I am pretty much constantly anxious about everything.  But, the exam did seem to go well.

Anyway, if anyone has any thoughts about why they sent me for another C&P exam for PTSD so soon, I am all ears.

Thanks everyone!

P.S.  This forum has been EXTREMELY helpful to me as I took myself from 20% up to 100% (and maybe back down again depending on what the VA says about my PTSD C&P exam).  So, I thank you all for that.

Edited by USAF K9
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2 minutes ago, USAF K9 said:

They awarded P&T!

Congratulations!

The SMC(s) means an additional 350 a month for you.

Just for your info. SMC(s) has two types if you will. Statutory and Actual. In your case, based on your posts, you have Statutory. You can continue to work, go out, do whatever you normally do.

There are no limits on your income from work and there will be no more evaluations based on your rated conditions. Be aware if you put in for other SC conditions your existing ratings will be looked at but absent strong indicators, really really really strong indicators, in your medical record there is no harm likely.

Once your rating hits 5 years another barrier to reversal goes up. 10 years another barrier. At 20 years the only way to reverse is if you committed fraud to get that rating.

Once you hit 55 you have another barrier to the VA trying to reverse a P&T Award.

Congrats again!

 

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11 minutes ago, USAF K9 said:

Fibromyalgia denied - I assume because it has not been six months since my diagnosis. The c&p examiner was pretty awesome so I doubt if she screwed me.

as I was thinking over your initial post, you may want to file a NOD on this. Order a new C-File copy, or get your VSO to print the DBQ and code sheet for all your stuff, but specifically the Fibro

IMO don't make the same mistake many of us have and just let it slide. The father away from your discharge date and or claim date you file the harder it is to overcome VA objections and denials.

you are on a roll. your situation must  be well documented and records very complete. Use that roll to your advantage and get the Fibro SC"d. even if at 0, do it NOW.

I am not being a downer or telling you something you don't already know at some level, but age will not make your conditions better; they will only get worse. Do the heavy lifting now to get the SC's so when they do worsen the path increased % is already laid.

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Thanks everyone for the replies!  I appreciate the info. I spoke to my VSO who has seen my letter (I still haven't gotten it yet in the mail).  She confirmed what I saw on ebenefits, so no worries about ebenefits being different from the letter.

Anyway, she reviewed the fibro decision and she seems to think the same as me, that it is because I haven't had it diagnosed for 6 months. I'm still unsure if I will try for it.  On one hand, I don't want to lose the automatic Gulf War service connection if VA doesn't extend it again.  But, I also am P&T, so I have won the war so to speak.  

I also wanted to mention that the VSO said that she can see that my DDD/radiculopothy is scheduled for a re-eval some time down the road, but no other conditions are.  I am curious, is there any chance the VA just cancels the back re-eval down the road when they see I am P&T?  The rating letter from a few months ago said my back has a chance of improving (DDD--LOL), so I will be re-evaluated. But, that was before the P&T rating.

Any thoughts, anyone?

Thanks!

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37 minutes ago, USAF K9 said:

Anyway, she reviewed the fibro decision and she seems to think the same as me, that it is because I haven't had it diagnosed for 6 months.

i wouldn't trust a VSO's offered medical opinion if it came spit shined and attached to a million dollars in gold bullion.

37 minutes ago, USAF K9 said:

I'm still unsure if I will try for it.  On one hand, I don't want to lose the automatic Gulf War service connection if VA doesn't extend it again.  But, I also am P&T, so I have won the war so to speak.  

1) that is totally your call

2) why give up something that is automatic?

3) no you have not won the war; you got in a couple luck skirmishes, but you have decades of war with the VA ahead of you

39 minutes ago, USAF K9 said:

I am curious, is there any chance the VA just cancels the back re-eval down the road when they see I am P&T? 

there is always a chance. just don't put any money on it.

39 minutes ago, USAF K9 said:

Any thoughts, anyone?

those are my thoughts. do as only you can decide you will but as I said to you  before. fight the fight while you are able instead of waiting until you need to have the fibro SC'd for medical reasons.

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