PTSD Denied with a Not Service Connected but PTSD - Combat related description

[SHef]

I am currently at a 90% rating and have been fighting the appeal status for a PTSD rating for the last few years.  I just saw that my Higher Level Review was closed yesterday with no change to my E-Benefits.  What I am struggling with is that they have PTSD described in my disabilities and classify it as "Not service Related" but the "Related to" section it shows PTSD-Combat.  How can I have PTSD from COMBAT that came from incidents that happened while I was in COMBAT but its NOT service related!!!!  I have over 500 pages from my VA Psychologist showing that I have PTSD and they still denied it.  I haven't received my letter from the HLR to see what the appeal has stated but I don't see a change in EBenefits.  

Has anyone else had this issue?  If so, what have you done to prove your case?  

[Ddsr]

5 hours ago, SHef said:

I am currently at a 90% rating and have been fighting the appeal status for a PTSD rating for the last few years.  I just saw that my Higher Level Review was closed yesterday with no change to my E-Benefits.  What I am struggling with is that they have PTSD described in my disabilities and classify it as "Not service Related" but the "Related to" section it shows PTSD-Combat.  How can I have PTSD from COMBAT that came from incidents that happened while I was in COMBAT but its NOT service related!!!!  I have over 500 pages from my VA Psychologist showing that I have PTSD and they still denied it.  I haven't received my letter from the HLR to see what the appeal has stated but I don't see a change in EBenefits.  

Has anyone else had this issue?  If so, what have you done to prove your case?  

 

Are you trying for scheduler 100%? Or have you considered putting in for TDIU?

[Buck52]

Do you have a CIB  (COMBAT INFANTRY BADGE) AWARDED FROM YOUR UNIT  The norm on this  is if you have a CIB on your DD 214  They Concede your stressors.

but I am not understanding your question? You do have a PTSD Diagnose by the VA Correct? What percent of PTSD do you have service connected?

you  quoted

''they have PTSD described in my disabilities and classify it as "Not service Related" but the "Related to" section it shows PTSD-Combat.  How can I have PTSD from COMBAT that came from incidents that happened while I was in COMBAT but its NOT service related!!!!  '' 

your on appeal with  for an increase denial?

Veteran don't have to be in combat to have PTSD  if the Veteran was traumatized   and  that trauma caused the Veterans PTSD  it can be service connected and rated while in the military.

if your at 90% now  and you get an increase to 70% on another  seperate & disatink disability  you would make the 100% and qualify for the SMC -S 

 So you may not want the TDIU  but the TDIU would pay you at the 100% rate,  but your not supposed to be working if you accept the TDIU.

..IF YOUR AT 90% NOW AND FILING FOR INCREASE,  YOU NEED TO HOPE FOR AT LEAST A 50% INCREASE   FOR THE 100%  OR A 70%INCREASE FOR THE 100% PLUS SMC-S   AND WITH THAT RATING YOU CAN WORK.

but I am not sure I understand your question?  others may chimme in broncovet  ,GB Army ,Shrekthetank1,  Pac??

Edited June 14, 2020 by Buck52

[Berta]

Can you scan and attach the denial here to include the evidence list? Cover your C file and name prior to scanning it .

Do you presently have any MH rating at all that VA is compensating?

I sounds to me like you got a rater who can't read.

 

 

[SHef]

The PTSD was denied and has no rating.  I have 90% from other factors.  The denial showed that it was “less likely than not caused by an inService stressor event”.  However in all the documents given, it shows the events that led to this.  Because I didn’t want to lose my clearance when I was in the service, I didn’t start getting treated for night terrors or any of the many symptoms of PTSD until after I got out.

[broncovet]

I agree with Berta.  Do you have all 3 Caluza elements DOCUMENTED:

1.  Current diagnosis BY A VA DOC for PTSD.  Yes, PTSD has to be diagnosed by a VA doc.  You will have to ask VA why this is so.  

2.  In service event or aggravation documented.   With PTSD its called a stressor.    Now, since you are a combat Vet, the VA "should have " presumed your stressor.  I mean, gee, you dont serve in combat and not see some bad stuff...and most of the time you dont have anyone around to document it.  However, a buddy letter may help to document your stressor, especially if one of your buddies writes a letter that he was with you when (stressor..such as seeing someone shot, or even the fear of being shot, etc) occurred.  

3.  Nexus.  A doctor has to opine that your (stressor) at least as likely as not caused your current PTSD.  You see, its possible (but unlikely) that SOMETHING ELSE could have caused PTSD..after service.  An example might be if you were in a car wreck and trapped in your car without water for food for 2 days...that could be a stressor.  

      READ your c and p or medical exams.  Is it true your doctor said your ptsd was not caused by service?  Or that it was less likely than not caused by service?

You will likely need to appeal (or maybe file cue IF you have all 3 caluza elements docuemented in your file.  

Does VA have all your service records?  Do the service records show combat service?  Sometimes VA gets this wrong.  

[SHef]

9 hours ago, broncovet said:

I agree with Berta.  Do you have all 3 Caluza elements DOCUMENTED:

1.  Current diagnosis BY A VA DOC for PTSD.  Yes, PTSD has to be diagnosed by a VA doc.  You will have to ask VA why this is so.  

2.  In service event or aggravation documented.   With PTSD its called a stressor.    Now, since you are a combat Vet, the VA "should have " presumed your stressor.  I mean, gee, you dont serve in combat and not see some bad stuff...and most of the time you dont have anyone around to document it.  However, a buddy letter may help to document your stressor, especially if one of your buddies writes a letter that he was with you when (stressor..such as seeing someone shot, or even the fear of being shot, etc) occurred.  

3.  Nexus.  A doctor has to opine that your (stressor) at least as likely as not caused your current PTSD.  You see, its possible (but unlikely) that SOMETHING ELSE could have caused PTSD..after service.  An example might be if you were in a car wreck and trapped in your car without water for food for 2 days...that could be a stressor.  

      READ your c and p or medical exams.  Is it true your doctor said your ptsd was not caused by service?  Or that it was less likely than not caused by service?

You will likely need to appeal (or maybe file cue IF you have all 3 caluza elements docuemented in your file.  

Does VA have all your service records?  Do the service records show combat service?  Sometimes VA gets this wrong.  

The VA has my service records that show 3 tours in Afghanistan and Iraq.  During that time the base I was at was bombed and the convoy I was in ran over an IED.  These are documented but I don't have a buddy letter so that is my next step.  It just finished higher level appeal.  I haven't gotten that letter yet but I haven't seen a change in EBenefits so I am assuming it was denied again.