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

[SteakNCheese]

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? 

 

 

[McRay]

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.

[pacmanx1]

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.

[Berta]

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?)

[SteakNCheese]

On 8/19/2021 at 3:51 PM, Berta said:

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?)
 

I can attach it, not a problem. 

I did just finish the second exam that was issued after the Higher Level Review. The PTSD one was easy, He asked me if I was diagnosed by the VA, and I said yes and he asked if I was assaulted while I was in the service and I said yes and he said are you still being treated for it and I said yes. 

Today's exam for IBS and Chest pains was horrible. She was a royal bitch and had such a shitty attitude. I have never been kicked out of an exam office by someone telling me "Times up" 

 

[pwrslm]

" (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) "

 

Ask your VA MD to provide you with a proper diagnosis.