I was wondering if any one knew how likly it is to get your VA disabitly rating dropped lower? I was rated at 100% ptsd after Iraq, and now I got the infamous letter stating that I will be reevaluated. What all do they look at to determine if your better worse or the same?
Any exam...any claim..any request for an increase...can trigger an automatic review.
You were assigned a 100% Disability rating since coming home from Iraq...While WE ALL wish you the best and sincerely post that you will keep that rating, we would all be lying if we told you that you need not be concerned.
The VA will look at your treatment...they will access your treatment records..notes from your PCP etc., and then propose a C&P ..in your case, they did.
Not it is up to you to be open, honest with the C&P Doc...likely a Shrink...No matter what opinions you will read...my opinion is that his job is to find a reason to consider you improved...how much...can't tell, but stay at 100%/...unlikely. Get statements etc together.
Scenario of 1 known vet coming in for his PTSD C&P..He came into the VAMC..it was late afternoon..was made to sit in the waiting room for a rather long period of time..All the while, It came to be that he was being observed, he exchanged rather openly with other veterans..(a normal reaction....brotherhood) But not to the Shrink assigned to do the eval...To him and his subsequent report..It showed the vet as being sociaL, talkative, friendly..end result? a proposal to reduce to 70%
It took a hearing and an appeal to get it back on track
p/s as long as you have a treatment plan that you;re a participant in..and the Shrink you see knows you and about you..and you didn't take the money and quit treatment..it will count alot.
Look at the following VA web page:
If you are already receiving disability compensation from VA for a disability or disabilities and the VA wants to reduce those awards, the VA will send you a “proposal to reduce” letter showing the proposed action (Proposed rating they want to assign and the effective date of the reduction). This is just a proposal and cannot be appealed. Once you receive a “proposal to reduce,” you have 60 days from the date of that proposal to submit any additional evidence to the Regional Office stating why you think your evaluation shouldn’t be reduced. After the 60 day period is up, a RVSR will make a decision whether to actually reduce the award(s) or maintain the current rating as is. Once the Rating Officer makes a decision, they will send you a rating decision detailing their decision. If the Rating Officer decides to reduce the award(s), then the veteran has the one year period to submit a Notice of Disagreement (NOD) to start the appeals process.
If you want to make the VA hold off on reducing the monetary amount on the proposed date, you can file a request for a hearing. This must be done in writing within 30 days of receiving the “Proposal to Reduce.” Once you have submitted a request for a hearing (just a simple letter as there is no prescribed form) the VA cannot reduce the evaluation on the proposed date until the hearing is held, regardless of how long it takes to have that hearing.
Also, do a Search by typing-in your disability in to the BVA Cases:
thank you for the information. I was told that I would be getting the eval, and for that time I was still in serious "mental issue" status, but I feel that because I am fighting to make myself stay in the land of mentaly healthy, I am going to loose my rating. Mind you that if they find me better I guess I suck it up and drive on, it is just a scary part for me because the money I recieve is what is keeping my family afloat. I am not the the type, that if I am better, to say other wise just to ride benifits. I have consididerd many times just telling them to drop me so I can go back in.
Rather than the reasoning behind this post. Would it not be better for you..as well as your family to NOT PRETEND that you're fine? Because, likely you're not? PTSD is not something that just fades away with time. Rather it is a disorder that you may learn to cope with using various skills.
Now back to your C&P...YOU KNOW...you're seeing a Shrink outside of the VA...and that may have been a contributing factor in the C&P request they submitted...MAY IT NOT BE TIME FOR YOU NOW...to go to the VAMC and see an in house Shrink? I think that common sense will tell you that if you got yourself assigned a PCP at the VAMC, then you would be an open book, records and treatment all well documented..AND...It is LESS LIKELY that you'll be bothered with another C&P down the line..
Do yourself a favor and introduce yourself to the VAMC...DO IT FOR YOU..AND DO IT FOR YOUR FAMILY. There is nothing wrong with you seeking treatment from an outside source..THAT is fine!! But DO NOT make yourself a """Stranger""" to the VAMC..after all, It is the VA that awarded you the disability Comp payment every month, and they want to know your status..and they have that right to know.
You can get past this C&P and lose nothing...yet...but keep staying OUTSIDE of the system only serves to keep you on the VA's ACTIVE RADAR SCREEN...Tis time for you to get your treatment with a low profile..AT the VA..and then..still, if you so prefer, see an outside entity as well, but you cannot choose one and ignore the other, it's an invitation for information.
Wishing you the best my Friend.
|Sr. Benefits Liaison|
Former U.S. Army, SGT (Combat Infantry)
I second Freddy's reply, and so as to paraphrase, do not sell yourself short. If you do not have a representative to assist you, you may want to obtain one prior to the decision.
A representative would have the authority to review the decision prior to promulgation, and be able to advise you on the evidence requirements and assist in ensuring all aspects of your treatment both VA and private have been equally weighed by VA.
"Building better lives for America's disabled veterans and their families." Ne Desit Virtus-Let Valor not Fail
If you have been going to the Vet Center for Readjustment Counceling with a Social Worker or Psychologist, call your Vet Center and ask for a copy of your entire record of therapy. Take a copy of that to your C&P Re-evaluation and give it to the doctor that is conducting the re-evaluation.
Get copies of all therapy sessions and your VA medication records. If you're seeing a VA Psychiatrist, call his Nurse and ask for a copy of your current medication record. Give that to the C&P doctor, also.
If you are as I was at first, I didn't tell the whole story of my PTSD illness. THATS NOT GOOD. You must tell every bad fact regardless if you are ashamed of it or not. At first, I denied the truth about my suicidal thoughts, but later, I opened-up and told the truth. Make notes to take concerning the following issues:
•Impairment of thought process or communication.
•Delusions, hallucinations and their persistence.
•Eye contact, interaction in session, and inappropriate behavior cited with examples.
•Suicidal or homicidal thoughts, ideations or plans or intent.
•Ability to maintain minimal personal hygiene and other basic activities of daily living.
•Orientation to person, place and time.
•Memory loss, or impairment (both short and long-term).
•Obsessive or ritualistic behavior which interferes with routine activities and describe any found.
•Rate and flow of speech (note any irrelevant, illogical, or obscure speech patterns and whether constant or intermittent.)
•Panic attacks noting the severity, duration, frequency and effect on independent functioning and whether clinically observed or good evidence of prior clinical or equivalent observation is shown.
•Depression, depressed mood or anxiety.
•Impaired impulse control and its effect on motivation or mood.
•Sleep impairment and describe extent it interferes with daytime activities.
•Other disorders or symptoms and the extent they interfere with activities
E. Assessment of PTSD
•identify behavioral, cognitive, social, affective, or somatic symptoms veteran attributes to PTSD
•describe specific PTSD symptoms present (symptoms of trauma re-experiencing, avoidance/numbing, heightened physiological arousal, and associated features [e.g., disillusionment and demoralization])
•specify typical frequency and severity of symptoms
PS: tuffnutt: did your original Rating Decision state that you are Permanent and Totally Disabled? Did it say your family members are eligible for Chapter 35 benefits such as CHAMPVA and education assistance? Life insurance benefits? What is your age? The reason that I am asking is as follows:
In Disability Compensation cases, reexaminations are not deemed to be necessary under the following circumstances:
1. When the disability is established as static;
2. When the findings and symptoms are shown by examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;
3. Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;
4. In cases of veterans over 55 years of age, except under unusual circumstances;
5. When the rating is a prescribed scheduled minimum rating; or
6. Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions.
For veterans receiving Disability Pension benefits in which the permanent total disability has been confirmed by reexamination or by the history of the case, or with obviously static disabilities, further reexaminations will generally not be requested by the VA. In other cases further examination will not be requested routinely and will be accomplished only if considered necessary based upon the particular facts of the individual case. In the cases of veterans over 55 years of age, reexamination will be requested only under unusual circumstances.This message has been edited. Last edited by: RVN1968,
TO THE OP
While I am 99% neutral on representation of a VSO or NSO. I will go on record with RAKK...that anyone with PTSD, that have concentration problems etc., then by all means..DO SEEK the service from a VSO/NSO.
The last thing I would want to see happen to any veteran is to see him sell himself short.
1) Did your original Rating Decision state that you are Permanent and Totally Disabled?
2) Did it say your family members are eligible for Chapter 35 benefits such as CHAMPVA and education assistance?
3) What is your age?
|Founding Member DVG|
First even P & T can be changed if a person improves. My recent decision says just that. I am to notify them if there is a substantial change in my status.
Second, a reevaluation has been scheduled. So discussing the VA and their ability to do such is a waste of space. We must help the OP with the process, not get off track.
i ahve been seeing a therpist for over a year. i moved to las vegas, and have not found a program yet. the primary doc at nellis sent me throw tri-care for out side help. that place was a zoo! i called backed a told them i would not be going there again! especillay after i had to pay a co-pay everytime of 25.00 dollars. checking into va now to see what they can do for me. freddy is right,ptsd "never" goes away. there are good days and then there are ones you want to forget. i finally retired and now i am on ssdi. i had really bad time working,took many meds to work and meds to sleep. i could not function in public with a job.so,after trying to stay in the work force and the recommendation of both my doc and therpist i retired.
freddy, i put in for for disability and got it on the first time. family life is better for both of us. freddy i finally bought a home in north las vegas. if you are ever in town how about a cup of joe? thank -you for your help.
friend for ever
It is possible that the re-evaluation is a mistake on the VARO's part. They do make mistakes; I know.
|Founding Member DVG|
He was rated 100% after Iraq. As such, it was probably within the last 5 years. Unlike after Vietnam, the VA is rating these cases on discharge. As such, all rating are temporary. The VA needs to see if time and treatment reduce the severity of the patients symptoms. Some patients with a high rating, reflecting a severe problem, do get better with time and treatment. The VA has the obligation to determine the residual disease after treatment and to rate it accordingly.
Members tend to focus too often on the rating and the money. The VA has two missions here. They are trying make the veterans whole and return him to normal life after the devastation of war. During the rehabilitation period, they should pay a high level of compensation. After a period of time, they need to evaluate the success of treatment, and determine the current level of disability.
DAVE_M is absolutely right !!
Especially his 2nd paragraph..Making the vet whole and return him hopefully to a normal life...and MEMBERS do...focus nearly 99.9% on ratings and money..INSTEAD of Treatment and subsequent assimilation into civilian life ABLE..not DIS-abled.
My oh my...how many would not trade a normal life for their comp?? Goodness, for myself, I prefer the life I had over the one I'm stuck with.
One vet I know would trade his comp for having his Normal healthy life back.... but we know we cant go back,but only forward. Do the best with what we have, ya know..
Be Well and God Bless
Ruptured Duck-Derelict Vets
Had my reevalution ysterday at the VA Hospital in Chicago. This was for a NOD I had put in last year in August. I was surprised at the different techniques used by this particular Dr. When explaining my feelings at the beginning, he cut me off. However after building rapor with him he continued the exam explaining to me how VA does not include pain in their decision. I let him go forwrd on his theory and then he did the "Range of movement exam" I then whipped out the meds I have. He stated that obviosely I have the need for a knee replacement as the size of the knee and the range of movement shows a major problem.
I will let all know the outcome of this particular exam. I sensed that their are many individuals trying for increases that are acting. He gave me that impression at the beginning with his abrubt comments until I showed him some of the documentation I had, which caused him to look deeper into my file. I left him feeling that had I not pursued the matter he would have classified me as one of those fakes.....My advice is bring all info...do not argue..however be strong and pursue your case with your doc with the facts....Remember...these guys hear numerouse stories fact and fiction...Just check the results on line from individuals who complain about joint problems, but have full range of movement.... Bottom line is....Do not go or apply for a NOD without getting all of your ducks in order!
I have a BVA ordered C&P scheduled for this Tuesday (Dec 22nd) on numerous issues previously denied by the RO, without exams, and have one major concern.
In the order by the BVA, the examiner has been restricted during the exam and mandated record review to make thier decision based solely upon "existing" evidence in my file.
My case is a safe I was moving with my supervisors tilted off of a step, and ended up falling on top of me. When I went to the clinic, my arm was x-rayed, and it was noted that it was contused-not fractured.
The only saving grace in the whole matter is that on the request for x-ray, the doctor did write "1500 lb safe fell on arm".
Letters from the supervisors (and our OIC) were not favorably considered by the BVA, as there is no mention of my complaining about back pain on the medical report, and the issue of my lumbar spine was denied, even though there is now, noted impact to the spine and coccyx, because no record of my complaints of back pain were ever recorded. (I was an MP- I was told (constantly) that it was due to the weight and location of the police gear (handcuffs in small of my back)on the job) but there was never an x-ray done to clarify the issue.
The very first X-ray of lumbar was done (in 2007) due to error on my VA doc asking for a back x-ray, should have been specified as thoracic, but lumbar was ordered. This x-ray found the damage to lumbar, and I returned for the thoracic, which found I had moderate scoliosis. I then went through a series of MRI's for both, which found nerve damage at C5-6-7 and T-3-4, and again at L4-5-6. Also noted was DJD and DDD in the same areas.
I recently contacted, and received a letter from, a physician (Cpt/0-3) who was assigned to the clininc at the time that I was initially injured and treated. He addressed the failure of the doctor ( now determined to be a Host Nation (GN) on temporary assignment) to record my complaint of back pain (especially considering the letters of my supervisors who were helping at the time) and that there is NO MENTION on the report why I reported to emergency sick call. The only item on the report is the order for x-ray to rule out a fracture to forearm, and advice on treatment for the contused tissue.
He reviewed his own treatment notes from years ago that I provided to him,(he had manipulated a disc 6 months after the injury), and sent me to a Krankenhaus for treatments. A few years later, (after I spent a 3 year tour on recruiting duty in Tucson Arizona), I went to the ER on sick call due to pain between my shoulders; he had my cervical area x-rayed and found reverse curvature of my neck. His report of that day was missing from my file, but again, the x-ray slip was in my copy of my Military Service Records, and it clearly noted the damage.
The BVA had denied another issue related to my neck, due to the lack of a 'diagnosis' concerning the reverse curvature. The physician concurred with the existing (and current) diagnosis, from my civilian Primary Care Physician, orthopedic surgeon, and Pain Management Physician.
My question is:
Beside presenting this letter to the examiner, how can I expiditiously (if possible) get the throracic and lumbar (which was denied) to be medically evaluated at this time (or within reason), before my case is acted upon by the RO, and then we get to do that appeal shuffle again, before this gets returned to the AMC/BVA for final disposition.
I was told that the last course of action should be the Court of Appeals. I don't want to wait that long, and I have been putting off any surgeries until this get decided upon. I am currently on Morphine and Vicodine, with increasing dosages, and have recieved over 20 Epidurals.
I also recieved notice from the VA Hospital today, rather than seeing the LPN who has done all of my other C&P's, I am now scheduled to see a physician, whom I have never met or heard of.
Thank you for all you do, I need an answer fast (if there is one) as my NSO at DAV has been out of area on business to outlaying areas. I have read all the previous entries, but none come close to this mess.
Thanks, and Merry Christmas...
|Founding Member DVG|
If they are restricting it to information in your file, you are not allowed to introduce any new evidence. You can bring a copy of the letter, but the examiner is supposed to reject it. I would send a copy of the letter to the RO for addition to the case file.
If you do not win this pass, you have new evidence, and can ask them to reopen the case for new and material evidence. You also can do the DRO/BVA again based on the decision if it is by a rating officer.
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