PTSD re eval experience after 10 years

[sox]

Hi Everyone!

     I recently filed for TDIU because of my tbi and ptsd symptoms getting worse. I am currently rated at 90%. The appointment was with an outside evaluator contracted by the VA. My experience was disappointing where they led me to an empty room to wait, the mh physician came into the room left the door open and started reading the disclaimer out loud. I was upset and firmly said to them "this is a private matter, and any appointment will be accomplished in the privacy of an office behind closed doors". Then after trying to fill out the multiple pages of paperwork in private with the door closed, they said i was taking too long and they would do the interview before the paperwork reflecting ptsd, depression symptoms etc was completed. Then the physician was asking the names of specific providers, which i had trouble remembering. After that they complained about my records having over 5,000 pages. I explained to them the treatment was from December 2022 forward at a particular va facility which they still said they couldn't find. Later I called their voice mail and left a message with the providers name after looking it up on mhv. This this a routine experience for contracted comp and pen evaluations, or should i be crying foul at this point?

Hopefully this isn't the new way the VA wants to treat our veterans...

Thanks in advance!

[sox]

Hi Everyone,

     Thank you for your kind words and insight! I just recieved my decision in the mail from my iu claim. They said my application was "moot" due to finding me 100% scheduler with t&p. This is a bitter sweet moment for us. Having a 6 year old little one I am now realizing the blessing of education benefits for them, but also know my limitations simply trying to be active as father. The money certainly helps the family and I can't thank everyone enough. I found out today after calling the social security administration office my initial claim for disability was approved as well. The social security claim took 14 months alltogether with a post 911 "expeditious preference" and the va claim took 5 months if anyone is interested. I'm still working on my fers opm claim. I have 21 years of  federal time and sending the va and social security decisions to opm once I have them. It's been a long and tough road for the family especially over Christmas and little ones birthday, but things are now looking up from a financial perspective...

Thank you hadit community!

[john999]

When you go for these exams keep your cool. You want to be "humble".  Do you have a doctor's statement that due solely to your SC conditions you are unable to work?  You have 90%. It is the job of the VA exam  to determine if you are unable to work.  In this regard I would trust them as far as I could throw them. With 90% you should be able to get TDIU, but maybe not based just on VA evidence.

[Tbird]

you may find this article helpful https://www.hadit.com/things-to-do-at-your-va-compensation-and-pension-exam/#gsc.tab=0

[sox]

I was using the voc rehab program graduated, and then had a head another head injury while doing my job search (already s/c for tbi). The whole situation is a huge slap in the face for the family. We were counting on the education to better our lives and help our little one succeed. The voc rehab program recommended ending the program due to the memory issues and forgetfulness. I have also filed for social security disability and their interview took an hour and a half surprisingly. They were even backing up on their schedule to provide the extra time for the eval. The va physician providing the evaluation took less than 30 minutes for some reason. I am completely disgusted after finding out after calling their phone number that they stopped taking private insurance and only provide evaluations for social security, workman's comp and veterans administration. Frankly I think this individual simply is practicing to provide lackluster evaluations and profit from volume of these types of claims. As a household we are completely disheartened by the experience...

Edited February 18, 2023 by sox

[broncovet]

My advice?  

Let it go.  The exam was what, 1 hour, 2hours?  Its not gonna change the rest of your life, "unless" you allow that to happen.  

Once you get the exam, you will be able to find out if its favorable, or not.  And, if its favorable, be glad, and look forward to an increase.  

If its unfavorable, you may just have to do something, but only if it results in a decrease.  It cant result in a decrease, because, the VA can not reduce you on a single exam unless it shows you have "actually improved under ordinary conditions of life", and, that single exam simply re states what is indicated by OTHER exams.  

In either case, relax.  Its over.  Dont dwell on it, you cant change your past.  Remember, your windshield has about 8 square feet of area, while your rear view mirror is just a few inches.  So, what lies ahead of you is about 50 times more important than what is behind you.  You get to choose, whether or not to worry about an exam, that is now in your past.  Choose wisely.  

Hadit can probably help you regardless of how the report goes.  Many times, a "bad exam", winds up to be favorable for you.  Of course, the reverse is also sometimes true.  You go into the exam..think, "Oh that lady was nice"....

....until you get the exam report, and you find out she trashed you.  

     I had an exam which was like the later.  She said TERRIBLE, terrible, terrible things about me, but, that, too, passed without incident.  I wound up getting my benefits anyway, because that one highly unfavorable exam report was inconsistent with the rest of my doctors exams.  Frankly, I mentioned it to my regular doc, who read it and refuted it, essentially saying it was BS, that "he had treated me for more than 10 years, and this lady knew nothing, and that at least 4 other doctors who treated me concurred with my findings (which are highly favorable)."

    The doctor went on to say that the examiner is supposed to read (my file) and he indicated, that the examiner could not have done so and came to those unfounded conclusions.  

(My paraphrase of what he said)   

    Source:  The regulation, posted below states:

Quote

It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history

Feel free to read it yourself, the complete regulation which protects your rating is here:

https://www.law.cornell.edu/cfr/text/38/3.344

Edited February 18, 2023 by broncovet

[broncovet]

Congratulations on your win.  Two things:

1.  Are you ok with the effective date?  Your effective date should be the later of "facts found" (this means the date the doc said you were disabled), or the date of claim.  Since most of the effective dates I got were wrong, and I had to appeal, you may need to do same.  

2.  When I was awarded 100 percent (they also said tdiu was moot), I appealed that.  Why?  TDIU, according to my bva decision "was not moot".   There are at least 2 reasons why you may consider appealing "tdiu is moot":

    a.  An award of tdiu can mean an earlier effective date and more retro.  That, of course depends on your situation, especially, when were you awarded PTSD, and when did you first become not able to work due to sc conditions.  

   b.  Again, I have not read your file, but an award of tdiu "may" result in SMC S, especially if this award results in a "single" 100 percent disability "plus additional combined disabilities" which combine to 60 percent or more.  This is the statuatory requirement for SMC S, housedbound.  Today, SMC S would get you about another $450 per month.  

      When I appealed (I disputed tdiu was moot), the board agreed with me, for reasons cited above, which can result in additional compensation, so its not moot.  

    If either of these apply (eligibility to smc S, or incorrect effective dates) be sure to appeal by filing a nod within a year.  (sooner is better).  But, of course, wait until the decision arrives, you will need information there to appeal.