Re- exam for PTSD

[coax59]

About 3 weeks ago I filed a new claim for Prostate cancer related to burn pit exposure in 90-91 Kuwait and 2003-2004 Iraq, I was scheduled for the exam related to the prostate cancer, this will be through VES, however they scheduled me for a teleconference with a Psychologist also the reason for the Psychologist visit was not stated, I am 100% service connected T&P for PTSD since 2014 Any ideas why this was scheduled ?

[El Train]

You filed a claim recently.  When you do that, they can reexamine all you conditions from what I understand.  Sucks that they do this.  It's almost like they want to punish you for opening a new claim.  Just go with the flow.  I think it would be hard for them to reduce you on your PTSD.  They might try.  If they do, others here can guide you on appealing that proposal.

[Dustoff1970]

Since you are P&T 100% for PTSD for well over 5 years, they would have to show you have sustained improvement and this usually requires more than 1 Rexam over a period of time of at least or usually one year.  As an example, in about 1987 with a 50% percent PTSD rating given to me in 85 I underwent another PTSD C&P exam and rating remained the same then in following year after another exam I was reduced to 30%. 

The key to remember is no improvement and you have same severe PTSD symptoms in your interview that gave you your 100% rating I assume.  It helps that you are still taking your PTSD medications as they look for this. A diagnosis of cancer would make my PTSD even worse, and I would tell the shrink that in no uncertain terms.

You have very little to worry about now.  The shrinks always like to ask how you are doing today and I always say terrible.

I have been 100% P&T for OSA, PTSD, GERD, IHD/CAD since 2021 and they cannot reduce or terminate my 70% PTSD/TDIU (since 1998) by law due to the 20-year rule.  After 5 years your condition is considered static.

My comment not legal advice as I not a lawyer, paralegal or VSO.

Edited September 22, 2022 by Dustoff1970

[Mr cue]

20 hours ago, coax59 said:

About 3 weeks ago I filed a new claim for Prostate cancer related to burn pit exposure in 90-91 Kuwait and 2003-2004 Iraq, I was scheduled for the exam related to the prostate cancer, this will be through VES, however they scheduled me for a teleconference with a Psychologist also the reason for the Psychologist visit was not stated, I am 100% service connected T&P for PTSD since 2014 Any ideas why this was scheduled ?

Well here is another one. Unnecessary exams been order.

Well I would be call the Whitehouse hotline an make a complaint explain that you didn't apply for an increase in your PTSD rating.

Tell them what you apply for a also upload a statement so it will be in your record.

If it was me I am cancelling the exam for PTSD.

But other will tell you you can't fight of they try to reduce you.

I am from the school Don't give them a chance to play with you.

Good luck 

 

 

 

[broncovet]

As explained in the past, and backed up by Veterans advocate professioanals, such as tbird and CCK law (and others), you should attend exams the VA calls for.  Here is another Veterans advocate who advises against refusing c and p exams:

https://www.statesidelegal.org/va-disability-step-4-c-p-exam

Quote

What if I don't want to go to the exam?

VA may require a C & P exam at any time. You may not refuse a C & P exam or re-exam. Although you may feel that you have provided more than adequate evidence from private physicians, VA will usually insist on a C & P exam by one of their own examiners. Your benefits can be interrupted or even terminated for failure to report for a VA exam.

 

Another advocate says you must have "good cause" to refuse an exam, this suggests if the timing is incredibly inconvenient, you can reschedule it, not refuse it.  

    These advocates are not making these recommendations lightly.  Personally, Im aware of Veterans who skipped exams, then wound up with denials, at least some of which were not "fixed" with appeals, especially if the Veteran continues on a path where they refuse to comply with VA's requests.  

    

Quote

§ 3.655 Failure to report for Department of Veterans Affairs examination.

(a) General. When entitlement or continued entitlement to a benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, or reexamination, action shall be taken in accordance with paragraph (b) or (c) of this section as appropriate. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, death of an immediate family member, etc. For purposes of this section, the terms examination and reexamination include periods of hospital observation when required by VA.

(b) Original or supplemental claim, or claim for increase. When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. When the examination was scheduled in conjunction with any other original claim, a supplemental claim for a benefit which was previously disallowed, or a claim for increase, the claim shall be denied.

(c) Running award.

(1) When a claimant fails to report for a reexamination and the issue is continuing entitlement, VA shall issue a pretermination notice advising the payee that payment for the disability or disabilities for which the reexamination was scheduled will be discontinued or, if a minimum evaluation is established in part 4 of this title or there is an evaluation protected under § 3.951(b) of this part, reduced to the lower evaluation. Such notice shall also include the prospective date of discontinuance or reduction, the reason therefor and a statement of the claimant's procedural and appellate rights. The claimant shall be allowed 60 days to indicate his or her willingness to report for a reexamination or to present evidence that payment for the disability or disabilities for which the reexamination was scheduled should not be discontinued or reduced.

(2) If there is no response within 60 days, or if the evidence submitted does not establish continued entitlement, payment for such disability or disabilities shall be discontinued or reduced as of the date indicated in the pretermination notice or the date of last payment, whichever is later.

(3) If notice is received that the claimant is willing to report for a reexamination before payment has been discontinued or reduced, action to adjust payment shall be deferred. The reexamination shall be rescheduled and the claimant notified that failure to report for the rescheduled examination shall be cause for immediate discontinuance or reduction of payment. When a claimant fails to report for such rescheduled examination, payment shall be reduced or discontinued as of the date of last payment and shall not be further adjusted until a VA examination has been conducted and the report reviewed.

(4) If within 30 days of a pretermination notice issued under paragraph (c)(1) of this section the claimant requests a hearing, action to adjust payment shall be deferred as set forth in § 3.105(i)(1) of this part. If a hearing is requested more than 30 days after such pretermination notice but before the proposed date of discontinuance or reduction, a hearing shall be scheduled, but payment shall nevertheless be discontinued or reduced as of the date proposed in the pretermination notice or date of last payment, whichever is later, unless information is presented which warrants a different determination. When the claimant has also expressed willingness to report for an examination, however, the provisions of paragraph (c)(3) of this section shall apply.

(Authority: 38 U.S.C. 501)

 

[pacmanx1]

Quote

About 3 weeks ago I filed a new claim for Prostate cancer related to burn pit exposure in 90-91 Kuwait and 2003-2004 Iraq, I was scheduled for the exam related to the prostate cancer, this will be through VES, however they scheduled me for a teleconference with a Psychologist also the reason for the Psychologist visit was not stated, I am 100% service-connected T&P for PTSD since 2014 Any ideas why this was scheduled ?

NEWS FLASH

This is my experience and what happened to me and how I handled it. I am on the record for stating that a veteran should never refuse to go to a scheduled C & P exam and my opinion is not changing but a veteran can inquire and or challenge an exam.

I have been posting that I filed two separate claims for EEDs, and the VA sent me to two separate LHI exams and the examiners wrote very favorable medical opinions. I really didn’t even remember this until this very morning, but I found out that during this time I was also scheduled an exam for my already service-connected mental health disorder. When I found out that I was scheduled for this third exam I contacted the LHI scheduling office and the VA to inquire why was this exam scheduled, I found out that certain exams may trigger a secondary mental health exam. I did not refuse to go to the exam I just called to find out who and why the exam was scheduled.

I told the LHI scheduling office and the VA that I did not file for an increase for my mental health disorder and that my claims for EEDs could possibly affect my combined rating due to the medical evidence is dated prior to my 100% scheduler P & T rating but since my mental health rating was already static for well over a decade and a half that it would not affect my combined rating in any way, shape or form.

I found out that one of the examiners scheduled me a mental health examination due to my service-connected disability because they are/were so close in proximity. The VA finally informed me that they did not order the mental health exam and the LHI scheduling office told me that one of the examiners did, but the mental health exam was cancelled, and I did not have to report to it. So, it could be that the exam could have been scheduled by either the VA or the contracting examination office.

IMHO, going through prostate cancer could very much affect your PTSD and either the VA and or the VES scheduling office could be trying to examine how your prostate cancer affects your PTSD.

 

Edited September 23, 2022 by pacmanx1

[blahsaysme2u]

2 hours ago, broncovet said:

As explained in the past, and backed up by Veterans advocate professioanals, such as tbird and CCK law (and others), you should attend exams the VA calls for.  Here is another Veterans advocate who advises against refusing c and p exams:

https://www.statesidelegal.org/va-disability-step-4-c-p-exam

Another advocate says you must have "good cause" to refuse an exam, this suggests if the timing is incredibly inconvenient, you can reschedule it, not refuse it.  

    These advocates are not making these recommendations lightly.  Personally, Im aware of Veterans who skipped exams, then wound up with denials, at least some of which were not "fixed" with appeals, especially if the Veteran continues on a path where they refuse to comply with VA's requests.  

    

 

just as a comment on this particular- when i didnt "attend" the last exam that was scheduled for my right leg(my claim was for my left leg- please see other posts i have made on the subject) i was not denied SC that i had already received for my right leg...as @pacmanx1 makes clear, contacting the VA and the scheduling office to explain what is happening is your best option. i also should have contacted the Whitehouse line, but at the time wasnt something that came to mind. 

DO NOT JUST SIMPLY NOT ATTEND AN EXAM....but then i dont think anyone is advocating for just ignoring exams...even Mr C is advising to make waves about erroneous scheduled exams by reporting...i did show up for my exam but simply explained the exam was unnecessary since my claim was not for my right leg...