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C&P question


dlpaul
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Question

I had my c&p for increase from 10% for PTSD.....the symptoms don’t seem to match the opinion to me.... any comments?

Opinion matches 30%


but in symptoms ......

depressed mood

anxiety

panic attacks 1 or less per week

chronic sleep impairment 

disturbances of motivation and mood

difficulties in work and social relationships

difficulty adapting to stressful situation including work

impaired impulse control irritability violence 

do you think she made a mistake with box she selected as her summery ?

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  • Content Curator/HadIt.com Elder

Welcome to Hadit!

Based on comparing the symptoms against the rating criteria, you have two that match the 70% criteria and three that match the 50% criteria. It is possible that a mistake might have been made. You could submit a request explaining your findings. If the VA doesn't grant you 50% or 70%, definitely consider appealing it.

These symptoms match 30%

Quote

depressed mood

anxiety

panic attacks 1 or less per week

These symptoms match 50%

Quote

chronic sleep impairment 

disturbances of motivation and mood

difficulties in work and social relationships

These symptoms 70%

Quote

difficulty adapting to stressful situation including work

impaired impulse control irritability violence 

 

§4.130   Schedule of ratings—Mental disorders.

Quote

General Rating Formula for Mental Disorders

    Rating
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0

 

 

 

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dipaul Great advise by Vync. If you feel that you have symptoms  that put you in the next level and some that put you say in the 30% bracket, it may result in a low ball rating. Maybe not. Your rating isn't going to necessarily be based on how many symptoms they find as much as which rating actually gives you the correct picture of where you are. If you have some in the next bracket and you think they are severe, appeal. Add more evidence; more buddy letters from family, etc. that talk to the severity of the symptoms in the higher bracket especially. Continue your treatment and meds. Just keep at it.

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  • Content Curator/HadIt.com Elder

I agree with @GBArmy. Based on what you posted, it sounds like you would qualify for an increase to at least 30%. Keep in mind that just because the VA sends you a rating decision approving an increase, it very well could contain errors (i.e. not increasing you to the correct percentage level). If you win the increase, they will pay you the retro, but you can still go ahead and submit a supplemental or higher level review appeal to get you where you need to be. Just don't wait too long. You should have a year to appeal (be sure to read the documents that come with your rating decision). Also, check the rating decision against the rating criteria to ensure they got it right. It can be tough to get through situations like this, but you did the right thing by asking if the VA rated you correctly. We're all here to try and help and offer our nonprofessional opinions.

If the MH disability ends up preventing you from working, you can also consider filing for individual unemployability (IU) and/or SSDI.

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Thank you all,

the 10% was from back in 2007 when there was no treatment for ptsd as a result of mst. Things have have now progressed to the point that I am unable to leave my house or continue working as a nurse (due to concentration problems) so had to retire early. 

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  • Content Curator/HadIt.com Elder

@dlpaul I'm so sorry to hear about that. You did the right thing to file an increase request.

I also recommend you go back through your medical treatment records. Claims for increase are special because you can use evidence from 12 months prior to filing to justify a higher rating. For example, if you filed the increase on March 1st, but your evidence shows you qualified for a higher rating as of October 10th, they are supposed to make the effective date of the increase back to when you qualified. You might just get granted the March 1st (example) effective date, but digging back through your records you might be able to even justify a better effective date which would mean more retro. 

 

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