Proposed Rating Reduction Questions

[ThomasGray]

First off, hello and thank you in advance for any help that can be provided. Also, I apologize if something is not clear, trying my best to keep things concise.

• On Friday, May 15, I received letter from the VA, dated May 11, proposing a rating reduction from 100% to 70% for PTSD. The only evidence for the change listed is Rating Decision - Narrative(17SEP18) and DBQ PSYCH PTSD Review(06MAY20), whereas on my initial decision letter there was an abundance of evidence used. The major takeaway appears that my medical records(both prior to and after the initial rating, also from VA facilities) were not considered in this proposal. Is this normal?

 

• I have yet to obtain the most recent C&P as I just received the proposal letter, but intend to attempt on Monday, May 18. Looking at the proposal letter though it seems that examiner didn't check a few specific boxes that were checked on my previous C&P. Other than that the differences appear to be minor. The two lists are as follows:
• Original C&P
  • Gross impairment in communication
  • Suspiciousness
  • Depressed mood
  • Suicidal ideation
  • Near-continuous depression affecting the ability to function independently, appropriately, and effectively
  • Disturbances of motivation and mood
  • Chronic sleep impairment
  • Near-continuous panic affecting the ability to function independently, appropriately, and effectively
  • Difficulty in understanding complex commands
  • Total occupational and social impairment
  • Panic attacks (weekly)
  • Difficulty in adapting to stressful circumstances
  • Neglect of personal appearance and hygiene
  • Difficulty in adapting to work
  • Inability to establish and maintain effective relationships
  • Flattened effect
  • Panic attacks (less than weekly)
  • Intermittent inability to perform maintenance of minimal personal hygiene
  • Difficulty in adapting to a worklike setting
  • Anxiety
  • Difficulty in establishing and maintaining effective work and social relationships
  • Intermittent inability to perform activities of daily living
  • Gross impairment in thought processes
• New C&P
  • Forgetting names
  • Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgement, thinking, and mood
  • Depressed mood
  • Suicidal Ideation
  • Near-continuous depression affecting the ability to function independently, appropriately, and effectively
  • Disturbances of motivation and mood
  • Mild memory loss
  • Forgetting recent events
  • Chronic sleep impairment
  • Near-continuous panic affecting the ability to function independently, appropriately, and effectively
  • Difficulty in understanding complex commands
  • Panic attacks more than once a week
  • Difficulty in adapting to stressful circumstances
  • Neglect of personal appearance and hygiene
  • Difficulty in adapting to work
  • Inability to establish and maintain effective relationships
  • Impairment of short- and long-term memory
  • Flattened effect
  • Difficulty in adapting to a worklike setting
  • Anxiety
  • Difficulty in establishing and maintaining effective work and social relationships
  • Forgetting directions
• I bolded the important items not that were not checked on the new c&p which led to the reduction proposal. It seems strange to me that new symptoms were added, however the very specific ones that would've caused the rating to remain the same all disappeared in just 1.5 years even though there is no noted improvement in my actual medical records.

 

• What exactly is my next step? I have written a few statements of disagreement contesting the proposed reduction and pulled my VA medical records and will be getting a copy of the new C&P shortly. I have no idea were send the items as it is unclear in the packet. It says I have 30 days for one option and 60 days for the other. I don't think I need a notice of disagreement or start the appeal process as the final decision hasn't been made(this is a poorly worded question)?

 

• Can I also request that they consider TDIU if the rating reduction is finalized or will I have to start a new claim for that? Should i send TDIU forms with my statements of disagreement and records?

 

• I have been avoiding poking the bear and not filing claims for other conditions, some of which are caused by the various medications they have me taking, should I start filing claims for those as well?

 

• And finally, if I do have to file for TDIU separately, should I start the claim now so that the date is saved? Do I submit the claim before or after I receive the final decision on the proposal?

Sorry for the long post. I'm lost as to what to do next. It took me over 5 years of being denied before they would actually service connect anything and now this. Thanks again for any help, it is appreciated.

[pacmanx1]

My first thoughts are what does your current treatment records say about your condition and or your employment?  What does your current treating doctor say about your condition and or employment?  What does your current treating doctor say about this proposal of reduction? If you have other disabilities then you should file claims for them or at least file an intent to file and you have one year to complete your intent to file the claims. If you are unsure where to send your evidence, the proposal of reduction letter should have that information and if it doesn't contact 1 (800-827-1000) and ask for the information and they should assist you. It doesn't matter what type of claims or how many claims you have but you should always file for claims that could/should be service connected.  Make sure you don't miss any deadlines. According to VA regulations CFR 3.303(b):“Symptoms, not treatment, are the essence of any evidence of continuity of symptomatology.” Savage, 10 Vet.App. at 496. (1997)

 

Not sure why it has the line trough it.

 

Edited May 17, 2020 by pacmanx1

[broncovet]

ITS a bogus reduction proposal "hoping" you wont protest it or wont know how.    You have just proved my point, there is no such thing as "poking the bear" at VA, and "fear of reduction" is a bad reason to not seek all the benefits to which you deserve.  Instead, get all the benefits you deserve and read this over to see about reductions.  

This is why your reduction is bogus:

Quote

...Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. 

Source:  https://www.law.cornell.edu/cfr/text/38/3.344

Send in a 21:4138 disputing the "proposed reduction" on the bases which applies to you, above.  Since PTSD is a "psychotic reaction" the VA cant reduce this on any one exam.  Of course this assumes you have been rated with PTSD over 5 years or are P and T, as explained in 38 CFR 3.344 (c).  

As Berta says, the enemy has guns, but we have guns, too.  Use the regulations.  I have had 2 proposed reductions, the first was overturned, and the second is the same as the first!!!!!

The VA cant get it through their thick noggin that my dependents did not change, I did not get a divorce and dont have multiple wives!!!!!!!  Altho my wife watched the show "Sister Wives", not everyone who watches that show runs out and gets multiple wives.  My wife has "nixed" the idea of multiple wives, and its a mutually agreed upon idea.  I have difficulty enough keeping "one" wife happy, and dont need the challenge of trying to keep 5 or 6 wives happy.   My newest proposed reduction will also not fly.  Frankly, Im not even worried about it.  

If I need something to worry about, I have plenty already with corona virus.  However, I have taken to heart my pastor's sermon on "Pray more, Worry less".   As my father used to say, "Worry never robs tommorrow of its sorrow, only today of its happiness."  

Edited May 17, 2020 by broncovet

[Buck52]

I believe they  (your Dr  or VA Therapist) are overstepping their bounds in their after session reports saying things like this > Veteran shows improvement in today's session  saying things like this to think they got the Veteran condition to Improve

(veterans therapist notes in myhealthyvet  >) ''We did a breathing treatment today because I ask him on a scale form 1 to 10  how high would you say your Anxiety Level is right now? ''''

''The veteran responded back I am not sure but maybe its a 9 or 10  I am very nervous and  its got my anxiety level is up''   so his therapist ask the veteran  ''lets do some breathing treatments together   they do the breathing treatments and at every end of the treatment

  ''The therapist ask on a number from 1 to 10 how high is your anxiety level?''  veteran says well it seems a little better  its down to about a 7/8..''

''.The therapist says let do another breathing treatment ,  they do another one and the therapist ask ok now on a scale from 1 to 10 how high would you say your anxiety is? 

The veteran responds well its getting better its about a 4/5     then the therapist says  '' lets do another breathing treatment and get your anxiety level back to 0''

..So they do another breathing treatment and she again ask the veteran well how high is your anxiety level now?  veteran responds back well I think its a 0 now....

Anyway point is  if VA Regional gets or see these reports this is usually what causes a proposal to reduce benefits.

  They think your condition as improved because your therapist got your anxiety lever back down to 0...all veterans with PTSD be aware of this method it could cause you a lot of problems. 

[USMC_VET]

On 5/16/2020 at 5:43 PM, ThomasGray said:

First off, hello and thank you in advance for any help that can be provided. Also, I apologize if something is not clear, trying my best to keep things concise.

• On Friday, May 15, I received letter from the VA, dated May 11, proposing a rating reduction from 100% to 70% for PTSD. The only evidence for the change listed is Rating Decision - Narrative(17SEP18) and DBQ PSYCH PTSD Review(06MAY20), whereas on my initial decision letter there was an abundance of evidence used. The major takeaway appears that my medical records(both prior to and after the initial rating, also from VA facilities) were not considered in this proposal. Is this normal?

 

• I have yet to obtain the most recent C&P as I just received the proposal letter, but intend to attempt on Monday, May 18. Looking at the proposal letter though it seems that examiner didn't check a few specific boxes that were checked on my previous C&P. Other than that the differences appear to be minor. The two lists are as follows:
• Original C&P
  • Gross impairment in communication
  • Suspiciousness
  • Depressed mood
  • Suicidal ideation
  • Near-continuous depression affecting the ability to function independently, appropriately, and effectively
  • Disturbances of motivation and mood
  • Chronic sleep impairment
  • Near-continuous panic affecting the ability to function independently, appropriately, and effectively
  • Difficulty in understanding complex commands
  • Total occupational and social impairment
  • Panic attacks (weekly)
  • Difficulty in adapting to stressful circumstances
  • Neglect of personal appearance and hygiene
  • Difficulty in adapting to work
  • Inability to establish and maintain effective relationships
  • Flattened effect
  • Panic attacks (less than weekly)
  • Intermittent inability to perform maintenance of minimal personal hygiene
  • Difficulty in adapting to a worklike setting
  • Anxiety
  • Difficulty in establishing and maintaining effective work and social relationships
  • Intermittent inability to perform activities of daily living
  • Gross impairment in thought processes
• New C&P
  • Forgetting names
  • Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgement, thinking, and mood
  • Depressed mood
  • Suicidal Ideation
  • Near-continuous depression affecting the ability to function independently, appropriately, and effectively
  • Disturbances of motivation and mood
  • Mild memory loss
  • Forgetting recent events
  • Chronic sleep impairment
  • Near-continuous panic affecting the ability to function independently, appropriately, and effectively
  • Difficulty in understanding complex commands
  • Panic attacks more than once a week
  • Difficulty in adapting to stressful circumstances
  • Neglect of personal appearance and hygiene
  • Difficulty in adapting to work
  • Inability to establish and maintain effective relationships
  • Impairment of short- and long-term memory
  • Flattened effect
  • Difficulty in adapting to a worklike setting
  • Anxiety
  • Difficulty in establishing and maintaining effective work and social relationships
  • Forgetting directions
• I bolded the important items not that were not checked on the new c&p which led to the reduction proposal. It seems strange to me that new symptoms were added, however the very specific ones that would've caused the rating to remain the same all disappeared in just 1.5 years even though there is no noted improvement in my actual medical records.

 

• What exactly is my next step? I have written a few statements of disagreement contesting the proposed reduction and pulled my VA medical records and will be getting a copy of the new C&P shortly. I have no idea were send the items as it is unclear in the packet. It says I have 30 days for one option and 60 days for the other. I don't think I need a notice of disagreement or start the appeal process as the final decision hasn't been made(this is a poorly worded question)?

 

• Can I also request that they consider TDIU if the rating reduction is finalized or will I have to start a new claim for that? Should i send TDIU forms with my statements of disagreement and records?

 

• I have been avoiding poking the bear and not filing claims for other conditions, some of which are caused by the various medications they have me taking, should I start filing claims for those as well?

 

• And finally, if I do have to file for TDIU separately, should I start the claim now so that the date is saved? Do I submit the claim before or after I receive the final decision on the proposal?

Sorry for the long post. I'm lost as to what to do next. It took me over 5 years of being denied before they would actually service connect anything and now this. Thanks again for any help, it is appreciated.

Remember to breathe.  I had a terrible experience in 2015.  I went into the VA and they took me to the MH wing for the C&P, they had to badge in to get in since it was part of the psych ward which freaked me out, took me down a unlit silent hallway and put me in a room with a computer, a telehealth C&P before it was cool! well i get really nervous, was thinking that i wouldnt be let out if i was seen as "too crazy" so i did a "yeah im fine" with the doc, i just wanted to get out.  A few months later i get a proposed reduction letter and freaked out more. I wrote a letter stating what had happened and then after talking to some vet friends and dsicovered hadit, i got an IMO. the VA contacted my VSO off the books and said if i dropped my proposed increase claim they would drop the reduction, at the time i was relieved because i was in the middle of buying a home so a reduction woudl have really hurt and i jumped at it.  After looking more deeply i realize that they made the offer off the books because the IMO would have granted me the increase, but thats my issue.

 

What you need to do now...

1) You need to scrape together ALL of your relevant MH docs from VA doctor notes, to private physicians

2) I would recommend you get an IMO.  I have gone to Dr. Elaine Tripi who lives in Michigan for mine. She was the one who got the reduction thrown out as well as helped along with Dr. Anaise to get my OSA secondary to PTSD. The VA's not having the best and brightest actually works in your favor here. my experience has been that they are, not suprisingly, very militaryish in how they handle competing evaluations. The higher rank wins.  If the VA doctor has 5 years in psychology and is board certified but your person has 25 years experience, multiple boards and awards then guess what yours has more weight than theirs.  

3) If you have had to take any sick days from work for PTSD related stuff print out the emails asking for leave, statements from work showing sick leave taken during past months/years (if its just a X hours on a statement in your sworn declaration write out the specific days/amount of time used, more on that in part 4).  whatever evidence you can dig up that shows work performance or time off taken. If youve been reprimanded for issues relating to symptoms such as angry outbursts, daydreaming, etc get copies of those.

4) You need to get as many people in your life to fill out a "sworn declaration" as possible regarding your symptoms and how it impacts your life.  You need to write one, listing ALL of your symptoms and its impacts. Dont just write "i have anxiety all day" be VERY DETAILED AND DESCRIPTIVE. instead write "my anxiety starts within a few minutes of waking up, i have increased heart rate and worries about everything from my spouses loyalty to whether my boss will fire me to can i even make it through the day. within a few hours it goes from feeling like a heaviness in my chest to a full blown panic attaack that feels like a heart attack and requires me to sit in a quiet cool room to calm down. These attacks can last from 5 minutes to over an hour. normally i get this level of panic attack once or twice a day, every day.  my anxiety can also be triggered by specific events and smells like something on the side or the road or burning trash.  It causes issues in my life because i have to leave work to deal with them, leave family events and while my wife understands it strains my relationship with her and the kids."

Get these sworn declarations from yourself, wife, adult children, parents, friends, co workers, boss, etc.  anyone who would be willing. make sure they are descriptive as well and feel free to ask them to write it out and send it to you for review and make suggestions to them. Dont tell them WHAT to say, but you can ask them "you wrote i get depressed often, can you write how often you see me like this and how it hurts our relationship/work performance?"

Sworn declarations are not the same as affidavits, no notary required HOWEVER i prefer them over "buddy statements" because they are legally binding in a way a statement is not.  A friend or you could lie on a buddy statement and theres no legal penalty, you could be reduce or SC could be revoked if they found out, but hes not going to a judge. a Sworn declaration holds you to perjury for every word which makes it more impactful than just a statement. 

This is the template i use
 

SWORN DECLARATION OF FIRST/LAST

 

STATE OF  XXXX  §

COUNTY OF XXXX  §

Pursuant to 28 U.S.C. 1746, I, FIRST/LAST, declare under penalty of perjury that the foregoing statement is true and correct:

1. "My name is FIRST/LAST. I am more than eighteen years of age, of sound mind, and fully competent to make this affidavit. I have personal knowledge of the matters set forth below.:

2. asdfgh

 

Executed on 1/01/2019

Signed:

 

___________________________________________

FIRST/LAST