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Initial PTSD C&P Exam found to have missing criterion

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Recondo@53

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Hi, I am currently on appeal for increase rating in excess of 50% PTSD (rated as Specified Trauma and Stressor Related Disorder) and the case was remanded by BVA back to the RO. The initial PTSD C&P was done in 2014. The original rating was not rated as PTSD, but Specified Trauma and Stressor Related Disorder. A new exam was requested and completed October of 2020 and I was awarded 100% PTSD. I contested the rating as VA denied a rating of excess of 50% prior to September 2020. The RO stated the following, "The evidence does not support a change in the prior decision. Therefore, entitlement to an evaluation in excess of 50 percent prior to September 2020 for post-traumatic stress disorder (previously rated as specified trauma and stressor related disorder) is denied. The rating decision noted that the examiner diagnosed me with PTSD and it was a correction to my prior examination. Here is where it gets odd. After I got the denial of excess of 50%, I started scrolling through my C-File. Well, I noticed on the initial C&P for claimed PTSD, the C&P examiner missed 2 criterion for  DSM-V. My understanding is that I am entitled to a complete exam and the medical opinion is based on the C&P, which if was incomplete that would warrant an incomplete medical opinion. Since the appeal up to date, my historical evidence and symptomology and social and occupational impairment has aligned to 70-100%. It is clear as day in my C-file. The mistakes on the exam were missed by VSO, attorney and BVA.

My question is what is my best course of action for this? Thank you kindly!

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I had a similar situation.  Increased from 50% to 100% PTSD P&T.  I personally would leave well enough alone.  Or let sleeping dogs lay.  The VA can get pissed and start looking at other things to decrease.  If you know what I mean.

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Well, they already are. But that isn’t a concern to me. My issues are what they are and have a historical pattern of not getting better. That’s a lot of back pay my family loses out on because of their error. I understand what your saying, but they are held to do the right thing, and need to in every event. That’s the square deal. Appreciate your time and insight. 

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On 11/16/2020 at 10:00 PM, Recondo@53 said:

Hi, I am currently on appeal for increase rating in excess of 50% PTSD (rated as Specified Trauma and Stressor Related Disorder) and the case was remanded by BVA back to the RO. The initial PTSD C&P was done in 2014. The original rating was not rated as PTSD, but Specified Trauma and Stressor Related Disorder. A new exam was requested and completed October of 2020 and I was awarded 100% PTSD. I contested the rating as VA denied a rating of excess of 50% prior to September 2020. The RO stated the following, "The evidence does not support a change in the prior decision. Therefore, entitlement to an evaluation in excess of 50 percent prior to September 2020 for post-traumatic stress disorder (previously rated as specified trauma and stressor related disorder) is denied. The rating decision noted that the examiner diagnosed me with PTSD and it was a correction to my prior examination. Here is where it gets odd. After I got the denial of excess of 50%, I started scrolling through my C-File. Well, I noticed on the initial C&P for claimed PTSD, the C&P examiner missed 2 criterion for  DSM-V. My understanding is that I am entitled to a complete exam and the medical opinion is based on the C&P, which if was incomplete that would warrant an incomplete medical opinion. Since the appeal up to date, my historical evidence and symptomology and social and occupational impairment has aligned to 70-100%. It is clear as day in my C-file. The mistakes on the exam were missed by VSO, attorney and BVA.

My question is what is my best course of action for this? Thank you kindly!

Recondo@53.

Do you really believe that the VSO, the Attorney, and the BVA with its dozens of attorneys, “ all missed it?”. Well I don’t. I do believe they all work together, and every one of them screwed you over. They gave you a fraction of what you deserved figuring you will take what they gave you, or have to go through tons of irritating events and finally give up anyway in the end.

Time and everything else is on their side, and you cannot trust anyone, even your own lawyer, because they will sell you out once the VA offers any settlement amount, or effective date he thinks he can get you to accept. They will tell you that you should accept the offer in their own professional opinion because they can’t do any better. What are you gonna do then? Get another attorney? No! If he wins “anything”, then you owe him 20% or whatever you agreed to. You can’t trust or believe anyone and I know this first hand. 
 

I was lied to and deceived since June 7, 1971 in Vietnam to present day, and it will be 50 years this coming June 2021. I have had my medical treatment records and all my C & P benefits intentionally withheld until 2015, finally getting “IU” in 2020, but still had my medical records withheld til present day. My children were all affected by my Agent Orange Exposure and my oldest son died last December 2019 at 47 years old. He’d be 49 this coming March 2021, and should have been compensated because he wasn’t ever quite right. Yes, I am bitter that I was deceived for 50 years, when I should have been medically retired and my kids compensated.

Believe what you want, but those three did not all miss all the mistakes on your exams in my opinion. Good luck regardless.

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I have enough bad experiences with VA to believe what you’re saying. With that, as I looked closer and investigated the C&P, how I think he got away with it is he wrote, “No response provided”. My argument now is shaping around the fact that the medical opinion provided was not based on the factual representation for PTSD as he should have questioned why there was no responses provided. I’ve requested credentials and the medical opinion to the the C&P exam. It should get interesting. 

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