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Cloudbuster

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Hi fellow Vets,

So last year during the pandemic I finally applied for a PTSD disability.

As I knew VA screw vets I found a Psychology that does DBQ and had one done via telehealth.

Initial Decision letter for Aug 2020 I got a 50%
I submitted a HLR and decision on Feb 2021 increased to 70%

and this is on the HLR Reason For Decision 

We are unable to use your submitted DBQ as initial PTSD examinations must be performed by a VA professional. A telemental health examination report is only acceptable and actionable for rating purposes when prepared by a VHA or VBA contracted examiner in response to a VA C&P request. Decision makers must not accept in lieu of VA examination any DBQ that has been prepared by a non-VA provider and completed by means of telephone or videoconference examination. 

Because we were not able to use your submitted DBQ by itself to determine service connection, we ordered a VA Examination.

Have a new DBQ completed via telehealth? And submit it via supplemental?

Have a new DBQ completed via in person? And submit via supplemental?

Or should I request a new increase and then submit a DBQ?

I do believe I meet the 100 criteria.

as explained to me by the Dr that did the DBQ.

 

the VA C&P exam was quick and did not ask questions.

 

Thanks.

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Cloudbuster The VA won't accept a tel-med eval for MH. You got an original decision of 50%; appealed thru HLR and got 70% To get to 100%, which is a VERY high bar, you need some additional evidence to what you already have, or you will be denied an increase. Compile more and resubmit if you wish but understand it is a very difficult level and I wouldn't just submit because i "deserve" it, no offense meant. Look up the criteria for 100% under the MH criteria and be objective in your self eval, as you can also be decreased back down from 70% depending on the next C&P.

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GB is correct- initial PTSD exams are not authorized for telehealth except under some specific circumstances, and none of them are "I want to have my own provider X do it....". You can supplemental it if you have new and relevant evidence that has NEVER been reviewed, or you can file for an increase, but if you have only recently received the decision I would not advise that unless you have a lot of treatment records to back up the request that show you meet the 100% requirements. 

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IMHO( IN MY HUMBLE OPINION) you can file an appeal to the BVA. You filed a claim, and it was rated at 50%. You then filed a HLR and was increased to 70% within a years’ time. Depending on the symptoms listed in your records, it's likely that you had these same symptoms when you were rated at the 50% rating. We are only speculating here (guessing), and we do not have all the evidence in front of us, so we do not know what is and what is not in your records. It is your call.   

1 hour ago, GBArmy said:

Look up the criteria for 100% under the MH criteria and be objective in your self eval, as you can also be decreased back down from 70% depending on the next C&P.

There are rules and regulations about reducing a veteran's rating and the VA cannot and I repeat cannot reduce your rating based on one C & P exam. Not trying to step on anyone's toes, just trying to get the best information out.  There are times when a veteran file a claim and is rated and lowballed. If and I say if the veteran symptoms meet a higher criterion, then the veteran can file an appeal and get the higher rating based on the original claim if the veteran files within one years’ time. 

Fear of Reduction Wait Read This - VA Disability Compensation Benefits Claims Research Forum - VA Disability Compensation Benefits Forums - HadIt.com Veterans.

 

Edited by pacmanx1
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Thats why GB  suggested he do an objective self eval of his conditions. He may or may not have symptoms over 70%. We don't know, only he does. 

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There are different questions here based on the OP (ORIGINAL POST)

Should the veteran file a claim for increase to 100% schedular depending on the symptoms already listed in his records?

AND

Should the veteran have been given a 70% rating on his initial claim?  Keep in mind that the VA did not use his submitted DBQ but requested their own C & P exam all within the claimant’s appeal time. This VA C & P exam should cover the initial rating period. His initial rating was August 2020, and he was increased in February 2021. Since that is less than a year, the VA should have considered the 70% rating for the effective date of August 2020 and that is totally separate from him filing a claim for 100% schedular. Still, he has until August 2021 to ask for a 100% rating and if granted that should also go back to August 2020 but as stated different questions. It all boils down to what symptoms already listed in the veterans' file.

Even still the veteran will not lose his already 70% service connected rating. The VA may not grant him the EED back to August 2020, but it should be addressed. 

Edited by pacmanx1
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Hi,

I just looked at the letter again and is Service effective Marc 2020 the 70% PTSD.

Quick recap:
March 2020 - Initial claim
Aug 2020 - 1st decision letter with 50% PTSD
Oct 2020 - send for HLR
Feb 2021 - 2nd letter with 70% PTSD effective for March 2020

Also on the letter it have:

After a review of your VA examination and VA medical records, we find that your symptoms support a higher evaluation. Some symptoms noted on your VA examination were not accounted for in your VA evaluation.

Im not sure if I should supplement and send my dental records I had like 3 crowns, root canals done in a short period I was not aware that was part of the rating until the Private Doc asked me.
But then the VA C&P did not ask anything I was surprised.

 

1-So the VA dont take private DBQ for MH only for initial claims?

2-Do they take them or give them more value for increase claims?
-If yes do they care if it in person or via telehealth?

I just want to be ready if I for some reason have to do another C&P and get a examiner like the prior one.

I have two clinic near me that can do MH DBQ but I been seen at the VA and currently taking medication.

Thanks.

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