Mental health CP exam

[wood78221]

Hello everyone,

So my story is that I filed for an increase, ended up getting reduced from 50 to 30. Overall rating wasn't effected. I filed a supplemental with a DBQ from my private doctor so now I have an upcoming CP exam with QTC. I have read that some people on the forums say " tell them about all your mental health issues (PTSD, anxiety, etc..). However, I am only S/C for depression secondary to tinnitus. So should I just only talk about depression? For my last exam in May I elaborated on all my mental health issues and it got me reduced. Thanks 

[Vync]

What was their justification for the reduction? As far as the reduction, they should have sent you a proposal to reduce letter saying you have about 60 days to provide evidence to justify a continued rating. If you don't reply or the evidence doesn't suffice, can can move forward with the reduction.

Requesting an increase can be tricky. In my opinion, the best approach is to always examine copies of your treatment records after they are made available. Compare them to the rating criteria. If you qualify for a higher rating, then file for the increase. In some cases you may win an increase based on the C&P exam findings, but it's easier to show you already qualified for the increase through the evidence of record.

I can personally agree that depression secondary to tinnitus is a real downer. They are supposed to rate you based on the MH diagnosis' social and occupational impact on you. If you have a PTSD or other diagnosis, there's still a chance it may be related, but even if you try to get SC for it, they will still give a single MH rating. If you served in combat, that should be relatively automatic with the VA needing confirmation of diagnosis and in-theater presence, otherwise a VA C&P examiner would need to make that determination.

 

 

[wood78221]

13 minutes ago, Vync said:

What was their justification for the reduction? As far as the reduction, they should have sent you a proposal to reduce letter saying you have about 60 days to provide evidence to justify a continued rating. If you don't reply or the evidence doesn't suffice, can can move forward with the reduction.

Requesting an increase can be tricky. In my opinion, the best approach is to always examine copies of your treatment records after they are made available. Compare them to the rating criteria. If you qualify for a higher rating, then file for the increase. In some cases you may win an increase based on the C&P exam findings, but it's easier to show you already qualified for the increase through the evidence of record.

I can personally agree that depression secondary to tinnitus is a real downer. They are supposed to rate you based on the MH diagnosis' social and occupational impact on you. If you have a PTSD or other diagnosis, there's still a chance it may be related, but even if you try to get SC for it, they will still give a single MH rating. If you served in combat, that should be relatively automatic with the VA needing confirmation of diagnosis and in-theater presence, otherwise a VA C&P examiner would need to make that determination.

 

If the reduction doesn't change the overall rating, you are not entitled to that 60 day period. In my case, it did not effect my payments. However,  I filed for PTSD originally and ended up with Depression 2nd to Tinnitus. 

I filed an increased and I really don't even think the examiner or maybe even the rater looked at my treatment records. So many things were left out that could of raised my rating. I keep hearing that medical records hold a lot of weight..however in my experience with the VBA, they don't mean much. That is my experience. CP exam is 99 percent. My VSO only said to hammer home depression and nothing else. 

Edited July 27, 2020 by wood78221

[Vync]

Interesting, I didn't realize that, but you are definitely doing the right thing by contesting the decision.

I have found that if I go out of my way to specifically tell the VA which medical record findings were in my favor, they more often than not looked at them to verify. From what I have heard, they may search for specific words or diagnosed conditions, but generally do not read every word on every page of your records (although that violated 38 CFR 4.2 and 4.6 by overlooking potentially favorable evidence). That's why I tell people to spoon feed the VA exactly what they need. Don't rely on them to be thorough. Although it's required, it's not realistic.

That sounds like my situation. I filed for PTSD and they diagnosed me with depression, despite already having a PTSD diagnosis in my records. If your VSO said to focus on depression, then that sounds reasonable. I'd keep a log of social and occupational impact tinnitus has on your situations. For me, I have trouble hearing people at work, people over the phone, my wife, my kids, the TV, people at the store, anything when in a crowd, and worst of all, I can't get that buzzing to stop when I try to sleep. Ironically, they did a hearing test and only found minimal hearing loss. Lost sleep is the big one for me. The VA gave me a Marsona sound machine to help cover it up. It's helpful, but doesn't always work. Hope this helps you out.

[wood78221]

1 hour ago, Vync said:

Interesting, I didn't realize that, but you are definitely doing the right thing by contesting the decision.

I have found that if I go out of my way to specifically tell the VA which medical record findings were in my favor, they more often than not looked at them to verify. From what I have heard, they may search for specific words or diagnosed conditions, but generally do not read every word on every page of your records (although that violated 38 CFR 4.2 and 4.6 by overlooking potentially favorable evidence). That's why I tell people to spoon feed the VA exactly what they need. Don't rely on them to be thorough. Although it's required, it's not realistic.

That sounds like my situation. I filed for PTSD and they diagnosed me with depression, despite already having a PTSD diagnosis in my records. If your VSO said to focus on depression, then that sounds reasonable. I'd keep a log of social and occupational impact tinnitus has on your situations. For me, I have trouble hearing people at work, people over the phone, my wife, my kids, the TV, people at the store, anything when in a crowd, and worst of all, I can't get that buzzing to stop when I try to sleep. Ironically, they did a hearing test and only found minimal hearing loss. Lost sleep is the big one for me. The VA gave me a Marsona sound machine to help cover it up. It's helpful, but doesn't always work. Hope this helps you out.

I had 2 PhD's saying I met DSM5 PTSD and they wouldn't give it to me for my initial claim (verified stressor also). Oh well. I'll respond in a few weeks and let you know how this supplemental goes. 

Edited July 27, 2020 by wood78221

[Buck52]

I  personally think they need to diagnose you with both Depression and PTSD

Most veterans I know who had PTSD also has depression  they are suppose to go by the one most severe   usually that is PTSD.

I Was service connected for PTSD also had a Depression diagnose.  in my case they went with the PTSD  what I should have did was NOD the depression and be service connected for both,  but they only rate one of the two  which is usually the one with the most symptoms and the severity.

WE CAN'T HAVE TWO MENTAL DISORDERS AT THE SAME TIME  DEPRESSION IS CLASSED AS A MENTAL DISORDER 

with the exception of a TBI

Edited July 28, 2020 by Buck52

[wood78221]

2 hours ago, Buck52 said:

I  personally think they need to diagnose you with both Depression and PTSD

Most veterans I know who had PTSD also has depression  they are suppose to go by the one most severe   usually that is PTSD.

I Was service connected for PTSD also had a Depression diagnose.  in my case they went with the PTSD  what I should have did was NOD the depression and be service connected for both,  but they only rate one of the two  which is usually the one with the most symptoms and the severity.

WE CAN'T HAVE TWO MENTAL DISORDERS AT THE SAME TIME  DEPRESSION IS CLASSED AS A MENTAL DISORDER 

with the exception of a TBI

The DBQ my doc filled out actually stated also that I meet DSM5 for PTSD. I am wondering would that actually award it from that? However, my original claim was over a year old for PTSD. I might not even be able to file for PTSD anymore. Thanks