Filing for an increase for mental health service connected disability

[1454th Solider]

I'm service connect for MDD and I am currently virtually visiting the VA medical center, due to COVID. I was wondering if it is a good idea get more VA information added to my medical records before I apply for an increase? The VA doctor has already prescribed meds and they have no effect on my condition, I still have the same symptoms. My last award was in May 2020. 

[brokensoldier244th]

You've gotten worse in 4 months?  It takes well over a month in most cases for your medication to reach a level in your brain to start working, and with tweaks or increases more time on top of that. It took two months for my wellbutrin to kick in substantially, and about that long for my son's escitalopram. 

 

You can look up the symptomology that you are rated against on the schedule for mental health ratings- just find your percentage, then look at the next percentage up and its list of symptoms and see if your medical records have a majority of those symptoms. 

 

https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=9326662dc5925f175acd349f6883a4dd&mc=true&r=SECTION&n=se38.1.4_1130

[USMC_VET]

52 minutes ago, 1454th Solider said:

I'm service connect for MDD and I am currently virtually visiting the VA medical center, due to COVID. I was wondering if it is a good idea get more VA information added to my medical records before I apply for an increase? The VA doctor has already prescribed meds and they have no effect on my condition, I still have the same symptoms. My last award was in May 2020. 

to get better advice we need some more information like

what is your current rating, when were you prescribed these medications, what is in your medical file in relation to MDD already, etc.

Medication not working doesnt effect your compensation % level at all, however if you arent seeing a therapist and arent taking a Rx for it at the 50% + level it can effect you (I will say that this is anecdotal from people ive spoken with).  Also medication helping you also doesnt effect it either.  lets say that you had severe MDD (suicidal ideation, no friends, couldnt work, bad hygiene, trouble with the law, etc.) and after taking a medication you no longer had suicidal thoughts, patched up your marriage, still had emotional swings and overall werent as "normal" as the average worker bee but you were mutch better...the VA cant (USAVC Jones v. Shinseki, 2012) rate you based on your medicated state only on your unmedicated symptoms.  This doesnt mean they COULDNT do it, so just be aware if you do ever get a treatment that works.  I dont believe that most of the stuff we attribute to malice in the VA is actually that, it could be a rater that is rushing work, doesnt see all of it, see a list of symptoms on a C&P and goes off that, or whatever.

Back to your real question...

If you really want to do an increase, do it right.

Start to look at your va exam notes, last C&P, etc and see if it matches up with the next % level (or higher). if you only have 30% symptoms you arent going to get a 50%. they dont just give it to you because you are SC'd and want an increase.  If you do have those in your notes or you, like myself and alot of vets, dont want to go over the litany of feelings you have had over the last months, year, since your last checkup you need to get private physician notes if you go there or considered spending the money on a IMO.  never hold back in a C&P and describe your average/worst day, not how you feel that second, because that C&P isnt covering you that day, its covering how EVERYTHING has been from the last time you had one or since your life began.  

Personally when i ahve done increases or initial claims in the apst, Mental Health or otherwise, i create multiple Sworn Statements from myself and others.  I list EVERYTHING i have felt, how it affects me, how it affects my relationships, work, etc.  If you can get a spouse, family, friend, co worker, boss, etc to do one have them list out what they have seen, how they see it effects you, relationships, work, etc. Your're already SC'd so increases are all about how X affects you, and statements from family and friends carrys MUCH more weight in these cases then say getting a Service connection and them saying they saw symptoms in service, etc.

get all your VA medical records, private medical records, etc.  copy./print/scan the pages that support your case and name symptoms that match the symptoms listed in the increase % table.  highlight those symptoms and in a cover sheet for your evidence list the pages and what they contain.

Get an imo done by a psych and do your best to find (within your price range, and geography) the most accredited psychologist possible.  In my experience the VA is like the military and accredidations, education, etc are like rank.  If a VA psych with a PHD and 7 years experience does you C&P and your IMO is a PHD, with 30 years, multiple boards, associations, etc your person wins. If you get a exam note from a NP listing your symptoms and their VA psych disagrees you lose.  

Now is a good time for a MH claim since they can do virtual exams for MH while nothign is moving in terms of physical exams, so if your increase is only for MDD is shouldnt be stuck in limbo like alot of us are.  BUT dont pull the trigger too early, file online for the increase to save your spot and then put the evidence together.  

Seeing that your last award was in May, and going off of the assumption it was for MDD as well, you might consider looking back at the evidence you submitted then, your exam notes,etc and seeing if you met the criteria, or could make the argument you did along with a IMO to back you up and submit this as an appeal. 

 

[brokensoldier244th]

If you end up thinking you were rated too low, DON’T file again on a 526ez. That will get kicked back-appeals have to be in the right form. That’sa 21-0995 (if you want to submit more evidence use this one). 21-0996 is a review of the evidence of record with no additional evidence permitted. 

[broncovet]

Broken soldier read my mind.  It sounds like you were lowballed.  You should appeal for a higher disability rating, on the form suggesed by broken soldier.  

[1454th Solider]

Thanks everyone for your feedback, I am currently rated at 70% for MDD and just started getting service from the VA for about two months now. My meds were prescribed about a month ago. How do I get a copy of my last C&P exam and what information can I expect to find in myhealth in ebenefits?

[USMC_VET]

12 hours ago, 1454th Solider said:

Thanks everyone for your feedback, I am currently rated at 70% for MDD and just started getting service from the VA for about two months now. My meds were prescribed about a month ago. How do I get a copy of my last C&P exam and what information can I expect to find in myhealth in ebenefits?

for your C&P exam, who did it? were you at a VAMC (va medical center) or was it a third party like VES or QTC. if it was the latter you would have gotten a letter from them with a scheduled exam date/time, etc.  

If you went to a VAMC you would find it in your bluebutton report on ebenefits, if it was a third party youll need to...

1) contact your VSO/rep and ask them to print them for you

2) go to your VARO and get them in person (not all VARO's are allowing visitors due to COVID)

3) Request it via FOIA (i did this and it was marked closed but havent gotten the exam notes yet so i cant definitively say this works)

4) request your C-File.  You should after every claim is closed, request your C-File to get the most up to date version as well as make sure all your evidence was considered.  I request my C-File at the same time i make a claim.  they wont send the C-File until a claim is adjudicated so it usually works out to about 3 months after  a claim is closed.