Now there are 4 opinions/DBQs

[spirit_grt]

Doctors treating me for years say PTSD, MDD, GAD and Social Phobia.  Filed DBQ saying such.  Primary, PTSD.

1st C&P, all was confirmed, PTSD as primary, doctor put at 100%.

2nd C&P, talked to me for 10 mins, filed DBQ saying nothing wrong with me.  VA rejected saying basically,  bullshit.

3rd C&P, done by just review of records./files, DBQ says MDD.  

My question, and I know it will just be opinions, how do you think it will be ruled?  Granted, benefit of doubt "should" go to me, but how often does it?  Will they grant, or punt and I have to go back to judge?  How often, in this situation, do you think they grant without having to appeal again?

Yeah, I'm just burning off anxiety by asking, but I'm hoping someone might have a solid opinion.  

Thanks to all.

Gene

[relatively happy camper]

Not to discourage you but I filed in '89, and it took me 10yrs to win 100% schedular.  They awarded me 30%, then 50%, then 70%, then TDIU and finally 100% P&T, retro to original claim date, with the evidence from original claim, in '89.  3 trips to BVA and one to the COVA/CAVC (nice check).  HB was awarded 31yrs later, retro to '89.  (Again, nice check but it really made my life hell, and they don't pay any interest.)  I appealed all decisions!!!  2 or 3 more BVA trips and another to the CAVC but won.  They can drag it out but for your sake I hope they don't.  Don't get discouraged!!  And IMHO, never accept their ratings or denials.  Many accept what they award and then file for an increase, costing the claimant, many dollars that could have been won.  Again IMHO.

[john999]

Yeah, I started at 10% in 1973.  Over the years I went to 30% then 70% TDIU and finally 100% with "S" . This took almost 50 years to get to this point.  I made a horrible mistake when I did not appeal the 10% rating. I did appeal all the rest.  I worked for 30 years up until the time I lost my job and filed for TDIU.  That was 23 years ago.  I really had no idea what I was doing and VFW and DAV did not help one bit.   I got smarter when I dialed into Hadit in 2002 and heard about TDIU for the first time.

[Rattler]

On 8/15/2024 at 1:59 PM, spirit_grt said:

Here I go again.  Another exam.  This time with Optum.  First VES, then QTC twice and  now Optum.  It never ends.

Am I getting this right?

1st C&P, all was confirmed, PTSD as primary, doctor put at 100%. (This is the good one PTSD)

2nd C&P, talked to me for 10 mins, filed DBQ saying nothing wrong with me.  VA rejected saying basically,  bullshit. (My question is why did they do this? Is it because you went to the BVA and it was remaned back to RO because the BVA said it was bullshit. My experance is they will only do a second one if there is a major question. I had this happen to me.)

3rd C&P, done by just review of records./files, DBQ says MDD.  (They generaly do this if they have one or two question on an exam for clearifcation)

4th (Here I go again.) Is this for the SAME PTSD or? See if you can get clearifcation on what the exam if for and why you are having a 4th one. 

I would ask your attorney about this because;

It would not be permissible for VA to undertake such additional development if a purpose was to obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for its decision to pursue further development where such development reasonably could be construed as obtaining additional evidence for that purpose" (Mariano v Frincipi, 17 Vet. App. 312 (2003))."

[spirit_grt]

9 hours ago, Rattler said:

Am I getting this right?

1st C&P, all was confirmed, PTSD as primary, doctor put at 100%. (This is the good one PTSD)  The 1st c&p was after a remand from BVA because one had not been done-even tho lawyer had asked for it at time of appeal filing.  

2nd C&P, talked to me for 10 mins, filed DBQ saying nothing wrong with me.  VA rejected saying basically,  bullshit. (My question is why did they do this? Is it because you went to the BVA and it was remaned back to RO because the BVA said it was bullshit. My experance is they will only do a second one if there is a major question. I had this happen to me.)    They did it because only 10 mins was spent and DBQ said nothing wrong-yet I've been in treatment for many years.  Was rejected as inadequate c&p.

3rd C&P, done by just review of records./files, DBQ says MDD.  (They generaly do this if they have one or two question on an exam for clearifcation)  At first they wanted a full c&p exam, in person.  Same doc they rejected the 2nd c&p from.  She only did a record review tho and filed it as MDD.  

4th (Here I go again.) Is this for the SAME PTSD or? See if you can get clearifcation on what the exam if for and why you are having a 4th one.   This is still the same PTSD, all same as first one, same appeal that was remanded by BVA.  The packet I got from Optum(downloaded) and this is what they list as what is wanted:

Services requested
DBQ Initial PTSD DSMV
DBQ Medical Opinion
DBQ Medical Opinion
CPT 96156 Health behavior assessment, or re-assessment
CPT 90791 - PSYC DX INTERVIEW XM
CPT LHI 1150 VA health behavior assessment prolonged time, each additional 15 minutes

Not sure what the LHI 1150 is but rest I know.  From what I understand, the RO claims no etiology has been stated, by my VA docs nor first c&p doc and this is what the RO is wanting(whoever is reviewing file).  I say bullshit because it is all thru my va records, in dbq my va doc filed in 2019 and in first c&p dbq.  I don't know how anyone can claim it isn't there.  

Lawyer says we will do this last one.  He is worried I will get denied if I refuse and he is hoping to get it granted without going back to the board.  If denied again, he is ready to deal with it, just doesn't want me waiting any longer if possible.  He has the experience with this so I follow his advice.  He is (almost) as pissed as I am about this but we will play the game while we have to.  I still think someone is looking for a way to deny but have to let it happen to do anything about it.  Monday is the c&p.  Hopefully they get the dbq in fast so I know what is next.  Still flagged as expedited, for whatever good that does. 

I would ask your attorney about this because;

It would not be permissible for VA to undertake such additional development if a purpose was to obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for its decision to pursue further development where such development reasonably could be construed as obtaining additional evidence for that purpose" (Mariano v Frincipi, 17 Vet. App. 312 (2003))."    Etiology is what is claimed as needed.  

 

[Rattler]

Who is your attorney?

[spirit_grt]

2 hours ago, Rattler said:

Who is your attorney?

Peter Cameron, San Diego.  

I logged in for my C&P this morning...no one showed up.  Tired of this shit.