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PTSD IMO Questions

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McRay

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I checked VA.gov this morning and see there sending me a SOC for the appeal I submitted on Nov 27, 2018. No fun to get appeal turned down, but I guess it's good things are progressing to the next phase. And I suppose this is more of the denial to eliminate case backlogs. 

There are a couple of questions that come up so I'll post them here. I know ebenefits.com/VA.gov is notoriously bad for putting up the wrong information... When I look at the page for tracking claims, it says that my appeal for PTSD claim filed on March 22, 2016 was granted, also granted was an appeal for PTSD, generalized anxiety disorder and major depressive disorder filed on Feb 23, 2016. I was granted 50%. Recently, I got a copy of the C&P exam I took August 13 of 2018. In that exam the psychologist specifically stated I don't have a PTSD diagnosis, but checked all the other boxes eg., I had experienced an event first hand and it was at least 50% likely that I my condition was caused by events in the service. I was surprised so I called my atty and the case manager told me I don't have a PTSD dx. ?? I believe I've read on here that Mental Health claims are combined and that's what I'd 'assumed' had taken place until I read the C&P exam. Now, I'm curious as to how they separate out the PTSD claim and why? Is there a specific reason they wouldn't want to SC the PTSD? I had 2 IMO's stating I have PTSD, one from a psychiatrist at the VET Center in Florida and another from a psychiatrist in Venice, FL.

So now it's the form 9. I see if I don't submit new evidence it goes to BVA and I can have a Vet Law Judge look at it or if I submit new evidence I go back to the DRO Review? I was thinking of getting another IMO but that might just slow things down more.

 

Thanks!

 

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Your first issue is that only the VA can diagnose PTSD.  If an outside doctor says you have a disability they can go by this but unlike other claims PTSD is different.  If you got 50% for anxiety and depressive disorder, I personally cannot see where a diagnosis of PTSD is required since all mental disabilities are rolled together.  Are you a combat vet?  That might change things.  You could file an HLR or go straight to the BVA if you think this rating is low.  If you go to the BVA you can submit more evidence.

Edited by vetquest
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Thanks vetquest. I did not know that only the VA can issue a diagnosis of PTSD. I do think the rating is low and my appeal was for increased rating and EED. I first applied in 1978 and I suppose that almost guarantees a denial.

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If you do not think the decision was correct read the C&P from the VA and compare it to the VA rating chart.  At this point you must relate your C&P and the IMO's to the rating chart to show were you most likely fall.  It is a tough climb but you can make it.  You need to get your ducks in a row and tell them why you deserve the rating.  You must take you out of the letter and write it the way a third party would write it.  If you are going for a backdated EED you may want to consider a lawyer as these cases are difficult.  I have one I am appealing right now but it is a slam dunk, well maybe not after the VA gets a hold of it.

 

va rating mental health.jpg

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On 8/8/2019 at 11:31 AM, McRay said:

I did not know that only the VA can issue a diagnosis of PTSD.

Vetquest is absolutely on point. Only VA can diagnose PTSD for rating purposes.

13 hours ago, vetquest said:

ou want some help post a redacted version of your C&P and decision here so we can take a look at what you are up against.

again he is on point. Many of us have lots of PTSD experience. personal and reviewing DBQ's

On 8/8/2019 at 9:06 AM, McRay said:

it says that my appeal for PTSD claim filed on March 22, 2016 was granted, also granted was an appeal for PTSD, generalized anxiety disorder and major depressive disorder filed on Feb 23, 2016. I was granted 50%.

this seems to say you got an award of 50% for PTSD, MDD and Generalized AD.

On 8/8/2019 at 9:06 AM, McRay said:

Recently, I got a copy of the C&P exam I took August 13 of 2018. In that exam the psychologist specifically stated I don't have a PTSD diagnosis, but checked all the other boxes eg., I had experienced an event first hand and it was at least 50% likely that I my condition was caused by events in the service. I was surprised so I called my atty and the case manager told me I don't have a PTSD dx.

This is exactly opposite the previous quote.

so my question is, are you currently receiving 50% compensation pay (or any compensation pay for that matter)? if so do you have that award letter? what does it say you are rated for ?

or were you denied on your initial claim and the above is the VA posted result of your appeal? and if true I assume you don't have the letter yet.

To Vetquests point

On 8/8/2019 at 10:10 AM, vetquest said:

If you got 50% for anxiety and depressive disorder, I personally cannot see where a diagnosis of PTSD is required since all mental disabilities are rolled together

this is correct, but at the same time whatever your in-service event was that would cause MDD and AD at such a severe level to rate 50% seems, on the surface, to be equally likely to be diagnosable as PTSD.

Now while a the VA requires that only a VA Doctor can say you are rateable for PTSD and IMO/IME can be used at the BVA to challenge that diagnosis, or lack of one, and force a remand.

I may just be in a CUE mindset these days, but I smell an error, but as vetquest said reading the actual documents is required to better opine on that issue or anything else about your potential appeal.

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I will post the C&P exam as soon as I figure out how to redact it. Don't think my pdf program will allow me to black stuff out, so will probably have to use a scanner and marking pen. Having some leak problems with new roof, so it might take a while.

edit:

I did check on ebenefits and this is what it says about my disabilities:

Quote
unspecified depressive disorder, claimed as chronic psychiatric disability and as post traumatic stress disorder 50% Service Connected   09/23/2015

Letters didn't give any information other than I was 50% and amount I'm receiving.

Edited by McRay
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