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    • The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
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    • https://community.hadit.com/searching-for-va-claims-information-on-hadit.com/

       

      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
      • 3 replies
    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
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flow1972

PTSD for MST Do I have to give access to private med records?

Question

My claim is currently in Evidence Gathering.  My MST Coordinator has a DBQ that my VSO sent me to have my Dr (Private/Non VA) fill out.  It was filed with my claim.  She also has the AF OSI Report concerning the incident in question.  Two things:

1.  The FOIA Request I did to retrieve the AF OSI Report gave me the report summary and my hand-written statement of account.  The report summary discusses all statements, but they are redacted in my copy.  The report status shows Closed.  Recommended for action.  The MST Coordinator said she had the report but it didn't show what action was taken.  I told her that I was never "sent" anything explaining the action taken.  All I ever got was some generic phone call from some JAG person months later letting me know the case had been closed and that the subject had been "offered" CC but refused and was subsequently being discharged from service.  (I won't get into how crazy it makes me that someone can be "offered" jail time and "refuse")  MST Coordinator said she was going to see if she could obtain the action report.  I don't understand why they need that.  Any ideas?  I have since submitted a second FOIA Request (after learning that even though the Action Report is required to be given to OSI they "can't" release it to me without a FOIA Request being submitted and approved by the owners of that report which is AFLOA.  (Freaking ridiculous)

2.  She sent out a release letter to sign that will give them the ability to get my records from my private Dr.  Should I sign it?  Or should I get those records and send them only what they need?  My fear is that I talk about lots of things with my Dr.  Some aren't specifically about this.  Will they get that info and try to use it against me?

The stress of this, is literally about to do me in.  One of my "triggers" is being put in front of some person in charge and having them judge me while forcing me to recount every detail I've already written in my statement.  I am literally stretched thin thinking of being put back in that same situation.  It's unfathomable to me that the VA should be allowed to literally put an MST Survivor through the EXACT situations that caused a lot of the issues we suffer from.  They wouldn't stick a person with Combat PTSD back in Combat for their claim.  Before I go off on a tangent...thanks in advance for advice.

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And, yes, the VA will use any applicable evidence against you, if they get the chance.  Count on that.  

Again, my advice hinges on what evidence your private docs have.  I dont know that.  I suggest you get those records, and read them.  If you think these provide favorable evidence, send them to VA.  If not, dont send them.  

We get to choose what evidence to send to VA.  However, if they have insufficient, or negative evidence, they will deny.  

 

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No, you are not required to release private medical records.  However, the VA requires medical documentation to establish that you meet the Caluza elements.  So, if you fail to provide all 3 Caluza elements, expect to be denied.  

My advice:  Check those private party records.  If those records reveal favorable information, then sign the release form.  Favorable information would be evidence which documents symptoms, a nexus, in service event, or diagnosis.  Unfavorable evidence, for example, would be if that doctor said he did not think your condition was related to military service.  

You are not required to provide all private records, but, if you lack the evidence you will likely be denied.  

 

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You should also get your VA medical evidence.  See if it has the Caluza elements, and your symptoms adequately documented.  You may/or may not need private evidence depending on what VA evidence you have.  

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Thanks, everyone!  So, I spoke to my private doc (I really do love her).  She fully understands the adversarial relationship the VA tends to have and will provide me only the notes and records she feels they need to see that directly relate to the PTSD due to MST. 

I have chosen NOT to sign the VA's form.  I will submit my own records to them.  I actually just found out today that somehow I was scheduled for a C&P exam on November 18th.  I was never contacted to schedule it.  I only know because I called the local MST Coordinator trying to find out what exactly is needed from my private provider.  The local MST Coordinator (whom I've never spoken to before today) told me she isn't the one who requested the records.  It's the "Regional" MST Coordinator from the Claims side of the house.  The local one only deals with the treatment side of things, apparently.  I"m so new to all of this...it's just crazy confusing.  The local one kept apologizing for the fact that when I'd originally called to try to seek treatment through the VA, they didn't handle my request correctly.  They told me they couldn't see me for over a month, so I went ahead and found my own provider.  They also were supposed to notify her of my call...they didn't.  She said she will assist in trying to continue care with my current provider through the VA as much as she can since they totally hosed all of that up.

 

 

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  • Our picks

    • The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
        • Thanks
      • 3 replies
    • Wonderful news way to hang in. I hope this gives you some well deserved peace. 
    • If HadIt.com has helped you or you believe in it’s mission then please donate even $1 helps. I hope HadIt.com has provided $1’s worth of help to you. Imagine waking up and there is no HadIt.com it could happen and that is why I’m asking for your help now.



       



      Our traffic is going up and so are our expenses, however revenues have gone down and so I am reaching out to you to see if you can help me keep Hadit.com up and running.
      • 4 replies
    • https://community.hadit.com/searching-for-va-claims-information-on-hadit.com/

       

      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
      • 3 replies
    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 2 replies
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