100% PT and doing Reservist PHA

[glashutte]

My main concern is civilian or Army provider who does PHA contacting VA due to ‘undeserving’ VA disability.
Whether they have logical reasons or not, it can still trigger the VA sleeping bear to awaken and unnecessarily audit right? 
 

What are your thoughts? 
I’ve been documenting all disabilities and medications on my PHA for years (no change in PHA) but always do it with a civilian provider.

Now I must do it with an Army provider. 
 

What are your thoughts? It’s been 5 years since my VA claim was connected. 

Edited August 25, 2023 by glashutte

[brokensoldier244th]

Unless it has significantly improved over time then there is no reason to examine it. Its not 'protected' fully until 20yrs, just varying increasing levels of evidence required at 5-10-20 yrs. If it's being reported to OIG It doesn't matter if its protected or not - they are only investigating fraud. 

 

[glashutte]

Thank you. 
 

For certain conditions that are rated like mental health, I don’t see a doctor for them and it’s been a few years seeing a doctor for them.

could this be an issue? I do self therapy with meditation, herbs, etc and so it’s controlled but definitely still there and impairs me going back to my civilian career. 
 

Of course i plan on seeing a doctor soon for it (scared now of it messing up my VA) but assuming I will see a doctor soon - has there been any permenant damage to my VA claim for not seeking treatment for years on mental health?

[glashutte]

9 minutes ago, brokensoldier244th said:

Unless it has significantly improved over time then there is no reason to examine it. Its not 'protected' fully until 20yrs, just varying increasing levels of evidence required at 5-10-20 yrs. If it's being reported to OIG It doesn't matter if its protected or not - they are only investigating fraud. 

 

That makes sense. I meant to quote this but replied below without quoting 

[brokensoldier244th]

Not necessarily as long as you are forthcoming enough to provide whomever the information they ask for. You'd need documentation of how it impairs your civilian career from a doctor; self-diagnosis doesn't cut it for SSA or VA, though VA is less of a PITA than SSA.

If you need to see a doc, see a doc, if you need to see VA for a doc see VA for a doc. If your conditions haven't changed then stop worrying about them and focus on whatever it is that you ARE going to claim. The longer you don't the less time its potentially service connected. You're already at 100% so its up to you if you want to file for something or not. 

[Rattler]

I agree with broken. I would not worry about it until someone comes and asks you to sign a release to allow the VA  access to your records. (one of the VA forms) You are protected @ 5 years. It would hurt to do a MH appointment every month or two. (Do it tele-heakth) 

Or were you asking about the opt out of the VA automatically sharing you records that the deadline was I think a year or better ago? 

[broncovet]

It sounds like you are referencing a "fear of reduction".  Its a myth that Veterans can not be 100 percent P and T and working, else VA will reduce you.  

At least one example of this is Senator Tammy Duckworth.  https://www.duckworth.senate.gov/about-tammy/biography

She is a very very high profile 100 percent disabled Veteran who was a very high official at VA, and later became a senator.  Dont worry, tho.  VA loves this myth and does little to refute it.  

The reason is many Vets "dont apply for all the benefits" they deserve out of fear of reduction, and it saves VA time and money.  The VA wants you to "settle in for less than what you deserve".  This is a great reason why you need hadit.  

Here is how to beat fear of reduction:  Knowledge.   Notice, below, is 38 

CFR 3.344 C, which is the "5 year rule".  

Quote

38 CFR § 3.344 - Stabilization of disability evaluations.

• CFR

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§ 3.344 Stabilization of disability evaluations.

(a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. 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. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ______ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.