Effective Date Issues

[Freedom101]

I filed for PTSD 9/2017 and battling the VA and today I received my 70% PTSD bringing my total to 80%! I have filed every appeal on time after being denied and for some reason they made my effective date for 9/2020 on the day that I had my C&P Exam. My rep is telling me that they rated me at 0% from 9/2017 til 9/2020 and 70% after 9/2020 and now we must appeal the date again. 

Is the appeals process last long as the regular appeal time and what are the odds that they actually correct the issue at the end of this?

 

Thanks for your help in advance. 

[Fat]

I would appeal the issue.

It seems the effective date is the date PTSD was formally diagnosed.

However; I would attempt to show symptoms of PTSD or PTSD like behavior earlier.

Did you have any diagnosis before Sept 2020?

[Freedom101]

Just now, Fat said:

I would appeal the issue.

It seems the effective date is the date PTSD was formally diagnosed.

However; I would attempt to show symptoms of PTSD or PTSD like behavior earlier.

Did you have any diagnosis before Sept 2020?

Exactly what happened. Yes, my mental VA doc is the one who told me to file for PTSD before the 9/2017 original filing. I also got diagnosed in 2006 a month after ETS but never filed anything. In total I have been diagnosed 4 times with PTSD. The problem is that on my C&P Exam on my original appeal in 2019 the VES exam person diagnosed me with a Drinking Disorder and they ran with it. 

[Buck52]

1 hour ago, Freedom101 said:

Exactly what happened. Yes, my mental VA doc is the one who told me to file for PTSD before the 9/2017 original filing. I also got diagnosed in 2006 a month after ETS but never filed anything. In total I have been diagnosed 4 times with PTSD. The problem is that on my C&P Exam on my original appeal in 2019 the VES exam person diagnosed me with a Drinking Disorder and they ran with it. 

If  VA Dr's Diagnose you in 2006  but you failed to file a claim  they more than likely go by your 9-2017  the date you first filed the claim,   we have to file a claim to get a early effective date   other wise the 2006 date of diagnose is just that a diagnosis.

you can try to get this back to 2006  as facts first found but without filing the claim back then  it will be very hard to win that.

Check with Moderator broncovet he is pretty good on these  EED (earlier effective dates.)

I just think we have to file a Claim first  on anything we claim. 

[USMC_VET]

21 hours ago, Freedom101 said:

I filed for PTSD 9/2017 and battling the VA and today I received my 70% PTSD bringing my total to 80%! I have filed every appeal on time after being denied and for some reason they made my effective date for 9/2020 on the day that I had my C&P Exam. My rep is telling me that they rated me at 0% from 9/2017 til 9/2020 and 70% after 9/2020 and now we must appeal the date again. 

Is the appeals process last long as the regular appeal time and what are the odds that they actually correct the issue at the end of this?

+

Thanks for your help in advance. 

Im not a EED expert but without a claim in 06, 2017 seems to be the most likely ED.

that being said as long as you had not missed appeals (over a year) then this is likely an issue of a raters oversight or purposefully done hoping youll take the win and move on.

I would work with your rep to file for an EED (you have one year so dont rush it).

Do the following.

1) Request your CFile

2) gather up all the letters, decisions, appeals, etc since your first claim in 2017.  If it were me i would lay them all out in a timeline on the floor to make sure everything matches up.  I dont know how you keep records of your VA stuff, but if you have copies of your appeals & claims i would line those up as well.  Then i would write a sworn statement that illustrates this from start to finish....

ex:

"Intial PTSD Claim: September, 2017

Decision letter received: June, 2018 granting me Service Connection at a 0% compensable rate

NOD: Filed August 2018 (2 months after grant) disagreeing with disability compensable percentage

Decision letter received: January, 2020 granting me Service Connection at a 50% compensable rate

NOD: Filed April 2020 (3 months after grant)disagreeing with disability compensable percentage

Decision letter received: September, 2020 granting me Service Connection at a 70% compensable rate

 

As can be seen in your own files as well as the attached copies of claims, NOD's, accompanying certified mail receipts & VA decision letters my claim meets the criterion for a "continuously pursued" claim as all claims & appeals were filed, received and ruled on within the required time limits. The last decision letter i received, dated September 14, 2020 grants me PTSD at a 70% compensable rate but a effective date of 0% from 9/2017 to 8/2020 and 70% from 9/2020 onward.  This is incorrect and the evidence shows that a earlier effective date of 9/2017 is correct."

Something along those lines.  Never leave things up to "theyll see their own records" or "its in my VA medical record so theyll see it there". Always include everything you need them to see whether is military, medical or decision letters, highlight if necessary and if they want to go back and confirm what youre already showing them, let them do that, but they cant not see it.

 

Now i do want to ask in all those years were your symptoms the same the entire time? did your C&P in 2017 meet the 70% or was there a later C&P that got you there? Did you have private psych records or statements/buddy letters that were given as evidence in the appeals they didnt have in 2017?

 

Reason i ask is that if you had a C&P that gave youa  PTSD diagnosis but not enough for a 30% rate but last year you had a Psych IMO that showed a 70% rate you could be looking at a EED but not until the evidence supported it last year (or whenever) but not in 2017, or the 2017 showed a 30% rate and the 70% was only after a new C&P in 2020, see what i mean? all i can do is speculate at this point.  If the evidence was the same from 2017 on this should be easy (not fast but pretty easy).

[broncovet]

Effective dates are some of the most complex in Veterans law.  So complex, some attorneys dont even like Effective date appeals.  

However, your's is a "classic" error.  Think about what they are saying.  You apply for PTSD..they do a C and P exam.  Your effective date is the later of the date of claim or facts found (the date the doc said you were disabled).  

When the doc "doesnt list" a date, they use the C and P exam date.  That is NEVER correct.  What that suggests is you went into the exam room, with "no" PTSD.  You go to the doc, and "poof", you get out of the exam you have PTSD.  Well that cant or shouldnt happen.  Instead, the doctor should have said "when" you became first diagnosed with PTSD.  

When the doc does not do that, its not a good exam, and the VA should have sent you for another one.  

Here is how you fix this:

1.  Get a copy of your cfile.  Best is the VBMS file, which is your cfile in real time, available ONLY at your VSO, or attorney, or non attorney practioner.  Review it to see if "a doctor" listed a date of diagnosis.  Its likely its there..probably much before the c and p exam.  

2.  File a NOD and appeal the effective date, probably to the BVA.  "If" you need an IMO then you need to make sure you submit it, or at least leave the door open so you can submit new evidence.  

3.  When you file the NOD, have your decision, as well as your documents handy.  Then, use evidence to refute their effective date.  Example:

"According to the VARO decision dated 11-13-2019, the effective date is Sep. 2020, the date of the exam.  However, in a medical exam dated 07-02-2004, Dr. P at the VAMC in my city diagnosed me with PTSD.  The VARO should accept this diagnosis, as well as the symptoms listed, as the "facts found" and award an earlier effective date. "

Signed.  John P Veteran