General Compensation Question

[PEACHES1962]

This is my first time writing on this site even though I read it alot. I submitted a claim in July 2019 for sleep apnea secondary to chronic fatigue syndrome (Secondary), sleep disturbances (related to: Environmental Hazard in Gulf War) (New), sleep apnea (secondary to: sleep disturbances) (New). I have had my exam through LHI in August with the following remarks from my examiner:

Veteran was also diagnosed with OSA and is compliant with a CPAP machine therapy.

Concerning the contention of Sleep disturbances due to environmental hazards in Gulf War. Veteran has sleep
disturbances that are likely a result of PTSD type symptoms with nightmares, insomnia which are both hallmark symptoms of PTSD and trauma based
disorders. Her sleep disturbances are also a result of her diagnosis of Fibromyalgia and other Gulf War medical issues.

In fact, it is highly likely her sleep disturbances have incurred from both all stressor occurrences while she was in Army.

I also have a supplemental claim in progress for PTSD that was initially denied in 2008 and the examiner stated:

Veteran's previous C & PReview PTSD Examination was completed on MAY 13,
2008 by Cristina Gamez-Galka, Ph.D., of Houston, TX. Dr. Gamez-Galka diagnosed veteran with PTSD and Major Depressive Disorder. A C & P Initial
PTSD Examination completed on MAY 6, 2002 by Dunn, Ph.D. (Houston VAMC) also diagnosed veteran with PTSD and Major Depressive Disorder,
recurrent.

Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood

My question is, would this be enough to qualify me for compensation or is it a chance I will be denied?

I must add that I am currently seeing a VA psychologist for PTSD.

Thank you guys for your responses.

[vetquest]

There is always a chance of getting denied.  That said you should have a good chance of getting a 50% rating for PTSD if the C&P was well written and is positive.  If you are denied there are three levels of appeals.  Can you redact and post your C&P?

I assume you have an active case since you have had a C&P.  Is this correct?  I would also not wait and file a request for sleep apnea if you have not already.

[GeekySquid]

Hi peaches.

Do you currently have any SC ratings? I suspect you do, but I am asking so you will list them and their percent and year granted.

33 minutes ago, PEACHES1962 said:

I submitted a claim in July 2019 for sleep apnea

have you had a VA sleep study? do you have the results? will you redact and post them?

34 minutes ago, PEACHES1962 said:

In fact, it is highly likely her sleep disturbances have incurred from both all stressor occurrences while she was in Army.

are the magic words in that C&P examiners comments..." 50% more likely than not...."

35 minutes ago, PEACHES1962 said:

I also have a supplemental claim in progress for PTSD that was initially denied in 2008 and the examiner stated:

do you have the contents of the BBE from 2008 and the DBQ from the C&P? will you redact all the PII and post?

36 minutes ago, PEACHES1962 said:

Veteran's previous C & PReview PTSD Examination was completed on MAY 13,
2008 by Cristina Gamez-Galka, Ph.D., of Houston, TX. Dr. Gamez-Galka diagnosed veteran with PTSD and Major Depressive Disorder.

A C & P Initial PTSD Examination completed on MAY 6, 2002 by Dunn, Ph.D. (Houston VAMC) also diagnosed veteran with PTSD and Major Depressive Disorder,
recurrent.

This says you had a C&P exam in 2002 and 2008.

am I reading your post wrong and you DID get rated for PTSD in one of those? or were you denied on both?

Will you redact your PII from BBE letter and decision from 2002 and post them? the completed DBQ also.

39 minutes ago, PEACHES1962 said:

My question is, would this be enough to qualify me for compensation or is it a chance I will be denied?

this is why I ask you to post those documents with personal information redacted. post the whole documents,  not just snippets.

In the grand scheme of things it looks like you might have a continuing chain of claims/appeals since 2002. This is important since AMA started Feb 19, 2019. It affects getting an earlier effective date which might just be something you can qualify for.

----------

for discussion purposes:

If you were diagnosed in 2002 with PTSD and were denied a claim, we need to know that.

If you were diagnosed again in 2008 and denied a claim, we need to know that.

we need to know why they denied and what evidence they used to deny.

This information will help us offer you the best possible suggestions and answers based on the full facts not just snippets.

If you just give snippets from the requested documents all anyone can to is give out wild guesses.

if you have all the elements of the Caluza Triangle then you should be rated for your service connected harms.

https://hadit.com/caluza-triangle-defines-necessary-service-connection/

Why the dates are important from each of those past decisions/denials:

Prior to the AMA implementation, if a veteran was denied on some past C&P and did not appeal. Then years later applied again and got rated, an appeal for an Earlier Effective Date could be submitted. These would win or lose based on a bunch of individual facts.

After the AMA was implemented one of the new rules is that if you let a claim die by not appealing it for a year, you lose all opportunity for an earlier date at the RO level. Higher levels like the BVA can have different arguments that might succeed for an EED, but that is not for discussion right now. 

It is possible, depending on your dates and the outcomes you might get an EED.

It is possible that if you get awarded this time, you may have a CUE on either or both of the earlier denials, which could step around the limits of the AMA.

 

 

 

 

 

[PEACHES1962]

Let me see if I can answer all of your questions:

Do you currently have any SC ratings? I suspect you do, but I am asking so you will list them and their percent and year granted.

My current disability rating is 40% Fibromyalgia and 0% Onychomycosis. Both were granted in Nov 2018.

have you had a VA sleep study? do you have the results? will you redact and post them?

My sleep study was at the VA-Houston location and the results stated that I have obstructive sleep apnea and of course I was issued a CPAP machine.

I am attempting to request both C&P exams from both 2002 and 2008.  Did not know I could request those at the time. Now I know, thanks.

I did get denied in both cases because I did not submit a statement in support of claim. Basically, I did not want to talk about it let alone write about it and I didn't know who to turn to to help me submit the correct documents.  Both were denied because I did not submit the paperwork before the deadline. They were both denied based on my not submitting proof of stressors proving a connection to the service. However, they did receive my medical documents showing that I had been hospitalized a couple of times for attempted suicide while in and out of the service. In both cases I was diagnosed with PTSD and MDD. 

 

Edited September 16, 2019 by PEACHES1962
Shortened response

[PEACHES1962]

Let me see if I can answer all of your questions:

Do you currently have any SC ratings? I suspect you do, but I am asking so you will list them and their percent and year granted.

My current disability rating is 40% Fibromyalgia and 0% Onychomycosis. Both were granted in Nov 2018.

have you had a VA sleep study? do you have the results? will you redact and post them?

My sleep study was at the VA-Houston location and the results stated that I have obstructive sleep apnea and of course I was issued a CPAP machine.

I am attempting to request both C&P exams from both 2002 and 2008.  Did not know I could request those at the time. Now I know, thanks.

I did get denied in both cases because I did not submit a statement in support of claim. Basically, I did not want to talk about it let alone write about it and I didn't know who to turn to to help me submit the correct documents.  Both were denied because I did not submit the paperwork before the deadline. They were both denied based on my not submitting proof of stressors proving a connection to the service. However, they did receive my medical documents showing that I had been hospitalized a couple of times for attempted suicide while in and out of the service. In both cases I was diagnosed with PTSD and MDD. 

 

[PEACHES1962]

Update: As of 09/13/2019 my supplemental claim for PTSD is now in decision status after I called the VA number. However, my others are still gathering evidence.

[GeekySquid]

6 minutes ago, PEACHES1962 said:

Let me see if I can answer all of your questions:

I am attempting to request both C&P exams from both 2002 and 2008.  Did not know I could request those at the time. Now I know, thanks.

 They were both denied based on my not submitting proof of stressors proving a connection to the service. However, they did receive my medical documents showing that I had been hospitalized a couple of times for attempted suicide while in and out of the service. In both cases I was diagnosed with PTSD and MDD. 

 

 

then to get back to your original question. With an in-service diagnosis of PTSD it is likely you can be rated on that claim. How high is unknown by any one here.

The statement you submitted, plus the evidence, and the C&P exam results are all factors we don't have and even then could not do more than guess at the way the rater will view your case.

By not submitting evidence in the previous claims you have closed off any reasonable path to retro pay. That said, if your military record is so clear that the rater should have just signed off on it, then you might be able to work an Earlier Effective Date. I am not saying you do, I am saying if your record is that clear, something I cannot know.

For SA, if you have evidence of in service problems you are halfway there. SA can be a difficult claim to service connect. It is one of those the VA does not like to pay out on.

Get your C-file they should be in there.

If they were done at the VAMC or through a contractor for the VAMC, the hospital office of records should be able to print them for you. If it was done by an outside contractor like VES or LHI as part of a claim it will not be at the VAMC so your c-file is the path to get them.

If it was done int eh last 3 years at the VAMC or by a VAMC contracted facility those records should also be found under Blue Button on My Healthy Vet.