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What should I do next.


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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  • HadIt.com Elder

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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