ptsd My Ssd Case.

[spike]

filed for ssd with the same disabilities on my va claim. The atty is working on it from the start of the claim. My last day at work was March 1. With my GAF of 40 he wants to start with that. I am pending I/U. I am hoping for an increase on my PTSD claim since it was a PTSD issue in which I was medically retiring my position from the employer. It has gotten worse with all this Iraq and Iran crap on the news......I am currently 50% PTSD, 40% Lumbar Disc (Herniation in L4/L5), Bilat knees 20% each, 10 % Scars, and a few other Sc's what do you think my chances are...for ssd approval?

[Philip Rogers]

Based on your age, I think they will try to deny you, however if your atty's any good he'll win at the ALJ level. SSD uses vocational rehab specialists to show that you can work. A couple of favorites are cashier at mini-mart, laundry sorter and security screen monitor. With the PTSD and disc problems you should win but you may have to go to the ALJ level. I'd also try to get the PTSD increased w/the VA, w/a 40GAF. jmo

pr

Edited March 30, 2007 by Philip Rogers (see edit history)

[Pete53]

For what it is worth the fact that a Lawyer took your case indicates a very good chance it will be approved. If you are unable to work and have PTSD you should win.

Good Luck

[robert51]

Based on your age, I think they will try to deny you, however if your atty's any good he'll win at the ALJ level. SSD uses vocational rehab specialists to show that you can work. A couple of favorites are cashier at mini-mart, laundry sorter and security screen monitor. With the PTSD and disc problems you should win but you may have to go to the ALJ level. I'd also try to get the PTSD increased w/the VA, w/a 40GAF. jmo

pr

you are 100% on my case they tried the sorter job as the reason ,, my IMO gave me the keys to a win by saying i could not work 8 hours a day and that was what the AJ said although i could do these type of jobs... greeter , sorter , etc i could not do them full time so i was granted...

[spike]

Here is a change. I was just granted I/U, in record time. About a month and a day. I gave a copy of all 400 pages of my medical records from the most recent VA hospital. I am 90%, I am at 100 % IU, and have my DOD military ID Card for bases. When I had my inital rating for PTSD last year they inicated a future exam in jan 1 2008, to re-evaluate (this is being addressed as I see it is the only reason why I am yet to be P&T). I am wondering if the I/U has any bearing on the SSD case having a greater chance of being granted. I was surprised that it was granted in one month...therefore I wonder about SSD thats been out there since 1 Mar 07.

[Guest Dataman]

Spike;

SSA disapproves most on 1st try. Best guess (hope I am wrong) is you get disapproved. Because "you can work some job they will say".

Hang in there! Will VA 100% TDIU help. Sure cannot hurt. I have similar to your case (40% Back, 20% wrist, some other stuff for 80%) got TDIU (with P&T) in 6 weeks. 2 years almost for SSA. I won in ALJ hearing.

I applied for Voc Rehab and got turned down in the 2 years. They gave me nice letter (Gave to SSA).

ALJ asked why I did not get my other arm fixed (one has had 5 operations and fused). I held up XRay and said I have had enough of surgery.

Who will hire someone who cannot wear shoes and has only limited use of one hand and 30 min on the other?

I won and he said he wouldl approve in the hearing. Got review last year. Approved again.

I was 42 (2000).

Later

[jbasser]

Data man thanks for that post. I too have lumbar issues, severe neck issues, COPD and pulmonary hypertension. I am also 42 and have an ALJ hearing soon. I also like the fact that an IMO stated a person can do things but cant do them in an 8 hoour day.

Ypou folks seeking advice about SSD should take this topic to heart. Know what you are going to get and a good IMO cannot hurt.

Edited May 8, 2007 by jbasser (see edit history)

[Berta]

Spike makes sure the SSA knows you were granted the TDIU.

TDIU is excellent evidence for SSA and Vice versa.

[Jay Johnson]

Few things:

1) Find a "good" civilian psychiatrist and get a detailed diagnosis. Most people with PTSD have other diagnosable problems such as massive depression, generalized anxiety disorder, obsessive compulsive disorder, bipolar, etc (my wife has all those and some). The SSD folks grant disability for bipolar all the time, so it's a favorable finding and it is commonly linked to PTSD (high and lows = bipolar type 1). So, find a psychiatrist that specializes in anxiety disorders and ask him/her to evaluate you in extensive detail (I would also suggest using the civilian psych full time over ANY VA psych.....we pay for ours out of pocket).

2) As has been said, the SS people tend to go with the VA decisions, so the TDIU thing will be quite helpful. Get that to them ASAP.

3) I wouldn't go overboard on the 40 GAF thing. Although a 40 GAF is "supposed" to mean that you have severe occupational issues, it's not all that low for VA standards. Heck, they tried to lower my wife from 100% to 70% based on a admitting GAF of 10 and a current GAF of 15, which is darn near legal basis for permanent committal to an institution based on GAF criteria. My guess is that the civilian psych will give you a more favorable GAF.

4) Speaking of GAF - check your medical file and your recent paperwork from the VA hospital. The VA is "supposed" to use your admitting GAF and NOT your discharge GAF as a basis for evaluation because they are "supposed" to be evaluating you at a low point and not your best point (IE - after a lengthy hospital stay with 24 hr care and a heavy dose of meds to likely include the overkill of haldol). The VA did this to my wife in order to justify that lower rating...she was admitted with a 10 GAF, but was discharged with a 42 (and the current, as mentioned, of 15, which they ignored). So, see what that admitting GAF was and use it rather than any C&P or discharge GAF.

If you follow those things and present your case well you stand a good chance at SSD (and, perhaps, have more ammo for your next C&P).

P.S. - I'm not quite sure whether or not the SS folks use a schedule table like the VA, but I know the VA focuses very intently on those set rating's criteria. Everyone decision we've gotten from them cites the rating's criteria met, line for line. So you may want to take a look at that to properly word your case also (and to help your IMO word his/her's)

[spike]

I don't have P&T and I am wondering if the SSD will be what is needed to give to VA and stop this nonsense of future exams. I haven't heard from the SSA office in a very long time. I am having to check with the attorney. What do you guys & gals think?

[robert51]

I don't have P&T and I am wondering if the SSD will be what is needed to give to VA and stop this nonsense of future exams. I haven't heard from the SSA office in a very long time. I am having to check with the attorney. What do you guys & gals think?

i have PT and they still can and will call you in for an exam ... the letter claims its their duty to check on your status from time to time. and if they find your not as bad as you used to be they can and will lower your rating, So PT could mean dont relax the VA is still in the backround ready to step on your neck

[Ricky]

Robert is right. P&T with no future exams scheduled means just that - none scheduled. However, the VA does have the duty to keep a good eye on the taxpayer's money so they can recall to update your status. Now with their hands full that may never happen but it could.

[Jay Johnson]

The VA should not be calling any veteran in that is P&T without new and material evidence to warrant it. It says so clearly in the regs, it's been handed down that way by the BVA over and over and the VA's top brass has made it clear in senate hearings. The only reason a P&T vet should be called in is if there is some reason to do so.

If they do so, you need to fight it and get a senator involved...not only is it the regulation, but it's just common sense; if the medical evidence says that you are permanently disabled that doesn't mean you are permanently disabled but may get better. It means PERMANENT! Don't let them fool you with this nonsense...if they send you for a C&P for a P&T condition CUE it immediately and send them the reg saying they can't....if need be I'll dig up the senate notes in which several top VA folks said no future exams for P&T vets....this is a clear black and white issue!

[betrayed]

....if need be I'll dig up the senate notes in which several top VA folks said no future exams for P&T vets....this is a clear black and white issue!

PleaSE dO!

[Jay Johnson]

Well, keep in mind that what constitutes "new and material" evidence is very subjective from the VA's view point. I think folks with multiple rated problems have a much higher chance of being called in for a C&P after being found P&T because the VA can poke through medical records and/or use an appointment for something rated only 20% to justify opening a claim on a more severe, and permanent, 100% disorder.

In my wife's case, when I pressed this issue because they reopened her P&T PTSD case, they said that they had new and material evidence because I sent in a letter from her primary care doc stating that she could handle her own finances (to get her off of that god-awful fiduciary program)....the letter stated ONLY that the doctor asked her questions regarding her finances and that she seemed capable of handling them (I made the doctor be VERY specific not to mention a single word about her PTSD). But, the VA had "something" and, therefore, covered their butts, but only AFTER I had complained about them rerating a P&T case did they mention this evidence (after we got the new rating). Perhaps the letter got their attention, but it certainly wasn't their real basis for lowering her and, eventually, sending her to another C&P.

So, now I don't go within 10 miles of a VA facility. I pay for her psychiatrist out of pocket (because tricare sucks) and she will never talk to another VA employee again for the rest of her life. If they want "new and material evidence" they better get a subpoena:-)

P.S. - The info was in regards to senate hearings about IU. I actually got the info from someone who had posted it to hadit awhile back (and used it in my CUE at the time). Here's the post(s) - http://www.hadit.com/forums/index.php?showtopic=1869&hl=

Edited May 17, 2007 by Jay Johnson (see edit history)

[Jay Johnson]

One more note on this - I know some folks will say, "but the VA says it cannot be limited under 3.327, so they can send P&T vets to a C&P"....this is wrong in my opinion. That discretion, on the VA's part, is limited to new and material evidence and/or CUE type claims...they cannot simply send a P&T vet to a C&P because they feel like "checking in on them". The reg states as much, it has been said many times in BVA decisions and the VA top brass has expressed it to congress, but, despite all of that, it's the spirit of the designation and simple common sense. If a disorder will not likely improve, than it's a waste of time/resources to keep investigating it and once someone is deemed "P&T" they should never lose that designation unless new and material shows a clear improvement or there was fraud in determining the original status.

SO's should be all over the VA if they try to pull this nonsense, but they don't seem to care and most vets just accept it without question....this has to stop.

[Pete53]

Jay thank you for your post. Its the best one I have seen on this Board lately where a member actually credits another member Railroader for a post that helped win a favorable decision.

For the people who are still working their claims this is a great lesson. Hadit is the best resource that you can find to help you with your claims its a goldmine in my opinion.

[Jay Johnson]

It's the least I can do and that quote I highlighted seems to be very powerful to me:-) "Required" is a very strong and blunt statement that really leaves no room for interpretation and being that it was made by the VA top brass to congress (likely under oath), I don't see how the VA can ignore it or try to skirt around it.

Simply put, if you are P&T and the VA is scheduling C&Ps for you, they are breaking the law.

[betrayed]

Thanks Bro, will keep in my ammo locker incase of future skirmishes

[tssnave]

Jay,

Thanks for the post.

Given how the VA changes their regulations after BVA rulings and the Congressional testimony you quote is from 2005, do you have a current regulatory reference for no more C&P exams after P&T is given? How about listing those BVA cases.

Thanks,

ts

[robert51]

The VA should not be calling any veteran in that is P&T without new and material evidence to warrant it. It says so clearly in the regs, it's been handed down that way by the BVA over and over and the VA's top brass has made it clear in senate hearings. The only reason a P&T vet should be called in is if there is some reason to do so.

If they do so, you need to fight it and get a senator involved...not only is it the regulation, but it's just common sense; if the medical evidence says that you are permanently disabled that doesn't mean you are permanently disabled but may get better. It means PERMANENT! Don't let them fool you with this nonsense...if they send you for a C&P for a P&T condition CUE it immediately and send them the reg saying they can't....if need be I'll dig up the senate notes in which several top VA folks said no future exams for P&T vets....this is a clear black and white issue!

I think what triggered my CP even though i am 70 IU PT from 2002 and over 55 is when i came to the Philippines i wanted to be seen by a doctor for service connected PTSD and they gave me a real clown and the reason they gave me a clown is they the VA were only willing to pay 10$ a visit even though the going rate is $20 per hour so i started seeing a doctor on my own twice a month...The VA waited 7 months and then hit with the CP i am sure they were thinking ... ha ha ha he stoped going to the doctor must be cured now... Well i turned in my report from my IMO and so there was no problem with my rate but i still see the doctor IMO and expect the VA every year to try to catch me as they think self cured

Edited May 19, 2007 by robert51 (see edit history)