Jump to content

A Duty to Assist Error has been identified-Higher Level Review


Recommended Posts

Bare with me as I have done all this work myself, so if I don't have a specific answer or know an abbreviation. All I ask is you give me some time to look it up cause I am not well versed in VA lingo. 

I completed a Higher level review (This apparently means sometimes you get a more experienced person, I explained to her all the issues I have been having and she basically said, I will send this back down so they can fix it and she said she has everything she needs to increase my Bell's Palsy which was at 0% and she changed it to 10% She told me she would have to issue me a couple more exams. They are specifically for IBS and Mental Health. 

The exam package from QTC for the Psychology exam does not mention a specific condition. (This would be my third mental health exam) The initial application was in 2019 and included depression and anxiety. I submitted a 2900-0659 as my stressor.  The second exam from qtc came back and said "PTSD with ADHD" so my claim for "PTSD" was denied. On the latest Denial letter, I have the following line items.

Depression,anxiety and sleep problems (listed as one condition)

Post traumatic stress disorder with attention-deficit hyperactivity disorder, predominantly inattentive type. (VA Doctor thinks I must have seen a child psychologist cause he said and I quote "That's the most insane diagnosis I've ever heard of) 

The QTC package for IBS is with a nurse practitioner at a clinic in town. 

So is the duty to assist for all of my conditions   based on the fact that the previous examiners did not do there job? 

 

 

Link to comment
Share on other sites

  • Replies 10
  • Created
  • Last Reply

Top Posters In This Topic

Sounds like you may need an independent medical opinion or exam. You would have to have a nexus to get a rating for PTSD (in service event, current diagnosis, opinion linking the two). Not much info to go on, but it might be helpful if you could get a VSO to start the ball rolling. I think filing claims can be confusing and complicated and the VA is getting more and more requirements. It helps to have a strategy. Might even call a couple of VA attorneys and see what they say. I was a lot more confident about my claim after hiring an attorney.

Link to comment
Share on other sites

Any of these are possible. You can ask the C & P examiners what are the appointments for when you arrive, and they should tell you. If your medical records do not mention any childhood drama or childhood disorders than it should not be addressed/included in your C & P exam or your treatment. Some examiners try to say that you did not have a normal childhood and that should not be mentioned at all, just your service incident and how it affects your life and how severe it is.

Link to comment
Share on other sites

  • HadIt.com Elder

Can you scan and attach the PTSD denial here? Cover your C file # and name, address prior to scanning it.

MsRay is right- there must be a proven event, accident, etc. that caused the inservice PTSD.

With more info we can help more.

Do you have copies of your inservice Medical Records and also any 201 files ( aka personnel records?)

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Ads

  • Ads

  • Similar Content

    • By Nicofsu
      Anyone know of an individual whom I can speak to who can get more information about my claims? It’s being held up and no one knows why from the VA 1-800 number does anyone have an insider that can help?  Thank You 
    • By bionoce
      Has anyone ever tried the stellate ganglion block treatment for PTSD and how did you go about getting it through the VA? Pill medications and medical marijuana do not work for me and am looking for alternatives.
    • By FacingOdds
      Hello, I'm new here but have read through many posts. I posed this question under a different area not knowing there was a specific area for PTSD/MST cases. Anyway I put in several claims for increase & a new one for PTSD due to MST. I've had exams for everything but the PTSD. When I contacted the VA to inquire if I would be scheduled for one. They stated that reviewing chart records & other evidence no exam was needed. Has anyone had a good outcome without a C&P exam for PTSD? I'm currently at 50% for MDD & anxiety. However, recently VA doctors have said it's a misdiagnosis & changed it to PTSD. Any feedback would be helpful. Thanks 
    • By BionicVet
      I have attached my denied claim for migraines. I have many docs I can attach. I.e buddy letter from my mother ( fractured skull prior to military), and also squad leader that mentions bad landing on military jump service connection ( knocked out). Military entrance exam showing fractured skull. VA NEUROLOGIST stating service connection. Sick call slip headaches. There is more but
      post. But I’ll start with the ones attached. I don’t understand the reasoning for denial . They have rated me earlier with SSD. Aalso they show a history of risk factors … and if you look at my disabilities the denied me hypertension , musculosketal pathology of the cervical spine and chronic opioid use (because of my service connection disabilities) … is that not oxymoron.. no pun intended. Did I make a mistake filing as a secondary to ptsd? I could have filed for a Tbi service aggravation.. but if they won’t service connect me for this than who knows.
      Any input would be great. I won’t post everything I have but this seems to warrant service connection
      if I did not redact anything please let me know.
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
    • By Sgt. Wilky
      I had a C&P exam this morning that went two whole hours and then some, with a mental health professional via video conference from the Cheyenne VA. She was very nice and seemed to be thorough. She confirmed what I already knew, and that was that I had PTSD, for which I have been rated 50% since 2015. Anyway, I learned that although my symptoms have gotten worse, that since I struggled to keep my job of 18 years and having not been fired multiple times throughout my "career", and since I wasn't a complete turd to my employer and to their customers, and I rarely showed up late to work and since I didn't hassle my coworkers and behave inappropriately, and since I didn't get so angry that I hit my spouse or beat my kids (despite the fact I stated quite clearly [and my wife confirmed] that I've ruined my relationship with my oldest son), and since I can brush my teeth on my own that I "probably" wouldn't qualify for the 70% requested increase.
      So, I found out that if I had put my employer and my family through the proverbial wringer and I didn't cost them a bunch of money, and since that I haven't yet ruined my reputation in the neighborhood or at my church, and since that I was proactive to the point that the pain made it unbearable to work anymore, so I quit, rather than force them to fire me, I can't get the help that I need. I've been fighting the VA since 2008. I'm tired.
      Awesome.
      Sgt. Wilky
  • Ads

  • Our picks

    • I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently 
      • 20 replies
    • 5,10, 20 Rule
      The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
        • Like
      • 58 replies
    • Post in New BVA Grants
      While the BVA has some discretion here, often they "chop up claims".  For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.  

      I hate that its that way.  The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.  
        • Like
    • Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!

      My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.

      Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
      • 18 replies
    • I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,
  • Ads

  • Popular Contributors

  • Ad

  • Latest News


  • veteranscrisisline-badge-chat-1.gif

  • Fund HadIt.com

    406%
    $6,103.00 of $1,500.00 Donate Now
  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

×
×
  • Create New...

Important Information

{terms] and Guidelines