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Reopened Previously Denied PTSD due to MST claim

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Healingfor777

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Has anyone been successful in receiving retroactive back pay in a granted PTSD claim due to MST that was previously denied prior to 2011 based on the VA requesting you to resubmit your claim for re-evaluation due to almost half of the MST claims submitted prior to 2011 being denied in error?  If so, is that a CUE type of claim?  I also didn't complete the appeals process.  I filed a NOD, but didn't fight through the appeals process.  I refiled when a VSO told me of the changes to the law and VA OIG report.

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Since you filed a claim and did not follow through the appeals process I would think that you would have a hard time getting retroactive back pay.  But that does not say you cannot try.  See how your claim plays out and then proceed from there.  You might be pleasantly surprised with your rating or you might have to go to the BVA.  Only time will tell, if you get denied fight all the way to the BVA.

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I am hoping I have a chance since they erroneously denied the claims and had to re-evaluate them.  Common sense would say it's how it should have originally been adjudicated.  But we all know that common sense is not a pre-requisite for employment with the VA when it comes to taking care of veterans.

I had an IMO from Dr. Ellis with some other claims on there as well.  I claimed Sleep apnea and FSAD secondary to PTSD even though they had no SC'd the PTSD.  The VA hospital had diagnosed the PTSD in 2009.  They denied the sleep apnea and FSAD based on C&P exams from NPs over a MD.  This just happened this week.  What is your advice on the fastest way to contest it and get it overturned with the new RAMP process?

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Do you mean they have denied the re-open?

Your VSO is really on the ball. They (VA) had to  revamp  the way they handle these MST claims.

Can you scan and attach here the initial denial and what appears to be a recent denial?

We need to see the evidence list as well...

If they refused to consider Dr Ellis' IMO , as new and relevant evidence, that is a potential CUE....but we do need to see the decisions.

Cover your C file # ,name, prior to scanning it.

 

 

 

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I apologize for the confusion.  They didn't deny the re-open.  They denied the new sleep apnea and FSAD secondary to MST/PTSD.  I was diagnosed with PTSD back in 2009 by the VA docs before I filed the disability claim for PTSD due to MST.  When I filed the claim in 2009 for the PTSD/MST, they denied that one.  The new decision last week granted PTSD/MST at 70% but gave me a long sermon about how since the MST was not verified they had to use markers to decide my case.  It is very negative and demeaning almost.  They said the doctor confirmed that the PTSD was related to MST so they conceded.  You will see what I am talking about.  They never stop re-victimizing MST victims it seems like.

 

Also, in 2009 when they denied the PTSD, they granted Depression at 50%, so they have combined the PTSD/MST with MDD into one as I expected.  I know they consider MDD or PTSD one mental health disorder, but that does not help you heal when they misdiagnose or deny what is really wrong with you or what really caused all of the madness we experience due to PTSD.

I am attaching a copy of the recent decision from last week and the IMO from Dr. Ellis in April 2019.  Pay attention to the careful language they use about Dr. Ellis.  They never refer to it as an Independent Medical Opinion.  They keep referring to it as a statement by Dr. Ellis attempting to link.  I think that is problematic in and of itself.  They deferred the high blood pressure, GERD, IBS and migraines decisions maybe because I had in service treatment for those and a current diagnoses that I am on medication for those.  

They denied the new sleep apnea and FSAD claims because they said there was nothing in my in service records regarding those or I was never treated for either one.  My ex-husband submitted a buddy statement regarding episodes in my sleep while we were on active duty and they didn't mention reviewing that at all.  All they mention is the C&P and in service records that they say were more persuasive.  I thought his direct eye witness account had to be considered as well.  He also wrote about the FSAD contributing to the end of our marriage because of my intimacy issues that were unexplainable at the time.

Trying to figure out if I should go the supplemental claims route with a new medical opinion and bring up they didn't consider his lay statement.  Your thoughts on that one?  Also he corroborated the FSAD.  I will cut and paste his statement in another post rather than attaching it.  I am attaching a copy of Dr. Ellis' IMO and the decision for review and assistance.  

 

Standing by

Dr. Ellis redacted report-OSA excerpt.pdf VA Decision July 17, 2019 redacted.pdf

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I do not see any CUEs here.

They did consider the Sleep Apnea opinion from Dr. Ellis.

Perhaps you could get buddy statements as to your inservice snoring.

Others can advise you on the supplemental claims route. We have much info here on the RAMP program.

This is much different from what you originally posted - as to the PTSD-which they granted as depression, in  2009.

It is good that they defered some issues.They will all need an inservice nexus.

 

 

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I would recommend you get a copy of your C-File to see what what the VA medical actually says and who wrote it. Was it done by a PA or an actual doctor. I had wrote my own statement as well as a buddy letter from my NCOIC as well as my ex-spouse. Also have you looked at your SA as being secondary to your PTSD?

I won my SA but it went to the BVA to get the win.

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