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Non Combat Ptsd Claim Changed To Combat Ptsd By Va


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9 replies to this topic

#1 DOCRVSR

 
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Posted 06 April 2012 - 07:10 PM

Let me start by saying that I am a newly retired navy surface force independent duty hospital corpsman (11/1/11) and new RVSR. I filed my initial claim on 8/1/11 and received a partial rating from VARO San Diego on 2/1/12. My non combat PTSD claim was denied for further development although I completed my VA PTSD examination on 8/25/11. The examiner diagnosed me with PTSD and provided me with a clear nexus relating my claimed stressor to my humanitarian missions in Senegal. I was diagnosed with a Major depressive disorder while on active duty by a deployment psychologist due to the same claimed stressor. I found out on 4/2/12 that VARO San Diego submitted a PIES request for my entire personnel file due to me not having a campaign medal on my DD 214. Here is the issue you do not need a campaign medal for a non combat PTSD claim. I provided them with 13 pages of evidence on 1 March 2012 which has yet to be included into my C-file. I submitted a IRIS request asking why my claim was changed from a non combat claim to combat and sent back to the development phase. The answer i received was from Mr. Patrick Zondervan the service center manager stating that I should no what evidence is needed to develop my claim since I am a RVSR. He never answered my question about why my evidence has not been looked at and he never answered why the claim was changed wihtout me claiming a combat stressor. To make matter's worse he stated that as far as he is concerned the inquiry is closed and stated DO NOT REPLY TO THIS INQUIRY. If this is happening to me as a RVSR I can only imagine what is happening to my fellow Veterans who are not as versed as I am due to my job. I left out a very important part of this story and it is the type of claim changed after a congressional inquiry. They can't seem to be able to wrap there minds around the fact that I was deployed onboard a Dutch ship supporting the Royal Marines. We are taught that if the evidence is in equipoise you are the grant the claim in Favor of the Veteran. I have a diagnosis of PTSD with clear nexus and stressor conceded, my military job is consistent with the claim stressor, evidence was submitted (TAD ORDERS and Performance information memorandum from Africa) yet there still seem to be some confusion with the sensitive 7 RVSR. Any thoughts.

#2 carlie

 
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Posted 06 April 2012 - 09:46 PM

Let me start by saying that I am a newly retired navy surface force independent duty hospital corpsman (11/1/11) and new RVSR. I filed my initial claim on 8/1/11 and received a partial rating from VARO San Diego on 2/1/12.
My non combat PTSD claim was denied for further development although I completed my VA PTSD examination on 8/25/11.
Welcome,
Are you sure the PTSD was"denied" versus deferred ? If it was actually "denied" the VA would not continue with any
additional action for further development on this issue. - carlie

The examiner diagnosed me with PTSD and provided me with a clear nexus relating my claimed stressor to my humanitarian missions in Senegal. I was diagnosed with a Major depressive disorder while on active duty by a deployment psychologist due to the same claimed stressor.
What Diagnostic Codes and conditions is your current 40 percent SC for ? - carlie

I found out on 4/2/12 that VARO San Diego submitted a PIES request for my entire personnel file due to me not having a campaign medal on my DD 214.
Here is the issue you do not need a campaign medal for a non combat PTSD claim.
A campaign medal is also not a necessity even in a combat situation. - carlie

I provided them with 13 pages of evidence on 1 March 2012 which has yet to be included into my C-file.
These 13 pages maybe beneficial when/if you file a NOD. - carlie

I submitted a IRIS request asking why my claim was changed from a non combat claim to combat and sent back to the development phase. The answer i received was from Mr. Patrick Zondervan the service center manager stating that I should no what evidence is needed to develop my claim since I am a RVSR. He never answered my question about why my evidence has not been looked at and he never answered why the claim was changed wihtout me claiming a combat stressor.
Did you submit a 21-0781 ? - carlie
http://www.vba.va.gov/pubs/forms/VBA-21-0781-ARE.PDF

To make matter's worse he stated that as far as he is concerned the inquiry is closed and stated DO NOT REPLY TO THIS INQUIRY. If this is happening to me as a RVSR I can only imagine what is happening to my fellow Veterans who are not as versed as I am due to my job. I left out a very important part of this story and it is the type of claim changed after a congressional inquiry. They can't seem to be able to wrap there minds around the fact that I was deployed onboard a Dutch ship supporting the Royal Marines. We are taught that if the evidence is in equipoise you are the grant the claim in Favor of the Veteran.
Well, first off you have to be sure the probable and credible evidence of record is actually in relative equipoise
and only the VA decision maker has the authority to assign the weight to the evidence - (so this can actually
give them the upper hand). This has to be decided prior to even consideration of application of the BOD. - carlie

I have a diagnosis of PTSD with clear nexus and stressor conceded, my military job is consistent with the claim stressor, evidence was submitted (TAD ORDERS and Performance information memorandum from Africa) yet there still seem to be some confusion with the sensitive 7 RVSR. Any thoughts.

In regards to "I have a diagnosis of PTSD with clear nexus and stressor conceded", from what you've posted,
IF the PTSD has actually been denied (versus deferred for further development) , it appears to me that VBA
has not conceded your stressor at this point.
As you being a RVSR, I question as to why you would bother filing a claim for PTSD when you have documentation
that would get a claim for MH granted as SC'd MUCH MORE EASILY.
"I was diagnosed with a Major depressive disorder while on active duty by a deployment psychologist due to the same claimed stressor".
Sensitive 7 file is probably because you are a worker-bee.
It would be best to post the Reasons and Bases Section from your Rating Decision with redaction of personal
information like name, claim #, address, etc...- carlie
JMHO



#3 Berta

 
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Posted 07 April 2012 - 05:58 AM

I agree with Carlie----

"I was diagnosed with a Major depressive disorder while on active duty by a deployment psychologist due to the same claimed stressor".

Sensitive 7 file is probably because you are a worker-bee. "

That is positive evidence to support a MDD claim.

Did you leave the Mil with your comlete 201 file and SMRs from the Military? It sounds like it could all be in transit to your VARO.

."newly retired"

It might pay to see ,if you attain the level of SC needed, to look into the CRDP and CRSC programs. They can be searched here at hadit for discussions on these beneits. A vet can only be granted one of these benefits, and they are explained in the transition programs for all military personnel with a discharge pending.

http://www.military....mpensation.html

Then again in your case ,if the disability is deemed as "combat related" by VA , this would impact on whether you are eligible for CRSC.(Combat Related Special Compensation)

Edited by Berta, 07 April 2012 - 06:00 AM.


#4 DOCRVSR

 
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Posted 07 April 2012 - 12:44 PM

The claim was deferred as non combat ptsd and then sent back to development for combat ptsd. I never claimed a combat stressor so feeling out 0781 was not necessary. On my original 21-526 I claimed major depression but the VA examiner changed the diagnosis to PTSD. My concern is the legality behind changing a claim without first talking to the claimant. I forwarded all evidence and examinations(VA and Navy) to a friend of mine at VARO Buffalo who is an Appeals Decision Review Officer and she stated the claim should have never been deferred. According to her the with the diagnosis of PTSD by a VA examiner with nexus, evidence that I was in Africa doing humanitarian missions, and military job consistent with the claimed stressor the claim should have been granted. And if there was still doubt it would be a case of relative equipoise and favor going to the Veteran.

#5 carlie

 
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Posted 07 April 2012 - 12:54 PM

The claim was deferred as non combat ptsd and then sent back to development for combat ptsd. I never claimed a combat stressor so feeling out 0781 was not necessary. On my original 21-526 I claimed major depression but the VA examiner changed the diagnosis to PTSD. My concern is the legality behind changing a claim without first talking to the claimant. I forwarded all evidence and examinations(VA and Navy) to a friend of mine at VARO Buffalo who is an Appeals Decision Review Officer and she stated the claim should have never been deferred. According to her the with the diagnosis of PTSD by a VA examiner with nexus, evidence that I was in Africa doing humanitarian missions, and military job consistent with the claimed stressor the claim should have been granted. And if there was still doubt it would be a case of relative equipoise and favor going to the Veteran.


What you post that she has said - I would agree is the way the claim SHOULD HAVE BEEN adjudicated
BUT
with you being a RVSR - I feel sure that you are aware of the lack of consistency in adjudication of claim issues,
from one decision maker at one VARO versus one decision maker at a different VARO.

Simply stated as an example - say a RO has 25 raters (decision makers).
They are all to fully adjudicate the same exact claim.
This test would not provide consistent adjudicative actions nor consistent decisions.

This is just another issue to factor into the reasons, for the backlog.
JMHO

#6 derickwade

 
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Posted 19 June 2013 - 08:04 AM

I, too, have had similar correspondence with Mr. Zondervan. He has refused to answer questions about my claim, has denied numerous times that certain files, responses and phone calls were received and has been anything but helpful. Currently i have filed a complaint with the OIG and obtained a lawyer. I refuse to go through another THREE years of this vague or no reply nonsense.



#7 broncovet

 
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Posted 20 June 2013 - 05:10 AM

Getting "no answer" from IRIS is par for the course, as I dont get an answer to my iris inquires either.  

 

I agree with the others, but would add my 2 cents.  As far as changing the claim goes, this is a good thing in my view.    

You see, Veterans are not competent to make their own mental health disorder diagnosis..the doc does that.  The Vet reports symptoms, and the VA doc makes the diagnosis, which would include changing the diagnosis if the doc thought it was warranted.    

 

I read a case where the Vet applied for depression and the doc diagnosed schizo.  They denied depression as there was no current diagnosis, and suggested he re apply for schizo.   If I recall the court said no, that the Vet need not make a diagnosis, he need only report symptoms.   Maybe someone else can recall the case name.  In the schedule of rating disabilities, mental disorders are rated on symptoms, not on the name of the disorder, be it schizo, depression, bi polar, PTSD etc.  



#8 john999

 
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Posted 20 June 2013 - 08:38 AM

One of my best friends in Vietnam was granted 30% for PTSD recently while I was granted 10% for schizophrenia back in the day. We had the exact same job.  I was much worse off than he was then, and now he is worse off than I was. I have 70% for mental disorder and he has just 30%.  The VA reasoning on mental health DX and severity are just a throw of the dice.  If they said I had major depression in service that is the claim I would go with and not try for PTSD unless you are trying to get the special combat compensation.



#9 Berta

 
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Posted 13 July 2013 - 06:33 AM

Welcome aboard!~

 

“If this is happening to me as a RVSR I can only imagine what is happening to my fellow Veterans who are not as versed as I am due to my job. “

 

This kind of VA crapola goes on all the time , as we at hadit, well know.

 

Lots of hardcore VA claimants here.

 

“We are taught that if the evidence is in equipoise you are the grant the claim in Favor of the Veteran. I have a diagnosis of PTSD with clear nexus and stressor conceded, my military job is consistent with the claim stressor, evidence was submitted (TAD ORDERS and Performance information memorandum from Africa) yet there still seem to be some confusion with the sensitive 7 RVSR. Any thoughts. “

 

Within weeks of my husband gaining employment at the local VA ( a Sensitive 7-they screwed around with his 30% PTSD rating.He had started Voc Rehab too.

 

The VA stated that this former Nuke , who never had a PT job in his life, had sustained gainful employment at the VA in a part time job, and they considered his , at that time, one semester of college, had turned him into a rocket scientist. I wrote a scathing NOD when they proposed to drop him from 30 % to 10, using common sense and the regulations themselves and they dropped that idea in a few months.

 

You are right on the Relative Equipoise concept of weighing the evidence but VA owns that scale and kicks Blind Justice in the knee sometimes to make sure their side of the scale tips against the veteran.

 

I worked for the VA too as a Vet center Volunteer. Although I have griped about VA a lot, and even have given H VAC testimony against them , I love the VA in many ways. Some of the best people I met when I moved to NY work ,with true dedication, at the local VA and are good friends of mine.

 

But VA crap in the claims process happens. The recent court order against the ROs due to the unconscionable backlog shows what I mean.

 

Carlie made a good point as to what you were diagnosed with inservice. The MDD.

 

“I claimed major depression but the VA examiner changed the diagnosis to PTSD. My concern is the legality behind changing a claim without first talking to the claimant “

 

They don't care about talking to us claimants.I need to think about that.... I wonder if that diagnosis change also rendered the wrong meds and wrong therapy to you....

 

With all due respect, and I sure appreciate you service, not only in the Military, but now with the VA,

your education in the VA claims process will be vastly enhanced by your continued presence at hadit.

 

As I understand this, the claim has been deferred and not denied.

 

If it is denied, and if you can scan and attach the decision here at that time (cover the personal C file number, name, address stuff) we can go over it with a fine tooth comb, and with our cumulative expertise here in VA regs and VA case law, as well as our own claims experiences, we will do all we can to help you get the correct decision that you deserve.

 

Do you have one of the VSOs or NSOs helping you? Many of the main vet orgs have some vet reps in offices right in the same RO buildings. ( Like DAV, AL, VFW, etc.)

 

Also, are you sure your DD 214 is correct?

 

It does not hurt to file a DD 149 (the form is here...I can post a link if needed and expalin how to file it out.) and ask DOD to make sure your DD 214 reflects everything it should.

 

I have a DD 215 right here.... it was the DOD correction on my husband';s DD 214.....more decorations and ribbons that he though he had in 1968 when he was discharged.( USMC 64- 68) .The DD 215 came mere months before he died, decades after his service.


Edited by Berta, 13 July 2013 - 06:36 AM.


#10 Berta

 
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Posted 13 July 2013 - 06:52 AM

Forgot to ask.. did you file the MDD claim within one year after your discharge?

 

SOunds like the diagnosis change was due to manipulating the future  EED.

 

Claims filed within that year can receive the day after discharge as the most favorable EED , as you know.

 

If the PTSD is awarded, I wonder if they would use the diagnosis cange date for the EED.

 

Buffalo ???? I deal with the Buffalo VARO. I didnt catch that at first reading.....

 

Over the past 18 plus years (as a survivor claimant) they have NEVER sent me a proper award from the git go.

 

And messed up my daughters Chap 35 claim by failing to add her 7 years Military  service to the Chapter 35  EED.

 

I named Buffalo VARO, and their Director ,  with evidence, in my H VAC testimony years ago to support my legit gripe as to how they can hinder and impede any vet or widows valid VA  claims.

 

I know they have some real good people there, but those employees work side by side with some  idiots, in my opinion.


Edited by Berta, 13 July 2013 - 06:53 AM.





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