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What Additional Evidence Do I Need For My Claim To Be Successful?


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22 replies to this topic

#1 willidx4

 
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Posted 09 October 2012 - 04:02 PM

What additional evidence do I need for my claim to be successful?

I was denied a PTSD claim back in 2005. I was in the Gulf and served in the grunts in a combat zone. I was diagnosed with PTSD by a Psychiatrist (private Doctor) in 2005 my GAF score was a 43. The VA needless to say stated I didn't have PTSD according to the VA Psychologist that did my 30 minute C&P exam I had a severe personality disorder and in her notes she gave me a GAF score of 38. I never filed a NOD at the time I just wanted to be done with the VA after reading the C&P examiners notes I was basically called a scam artist. I filed again for PTSD in August 2012 and was diagnosed again by the same private Doctor what other material evidence do I need to make sure my claim is successful

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#2 john999

 
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Posted 09 October 2012 - 04:27 PM

You need a DX from a VA doctor. Keep trying!

#3 vetswifeIndy

 
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Posted 09 October 2012 - 06:02 PM

Willidx4 you might try describing your symptoms to your PCP (assuming you go to a VA facility).

Try asking for a referral to see a MH DR. That may get the ball rolling. Good luck to you.

VetswifeIndy

#4 #1Cavtrooper

 
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Posted 09 October 2012 - 06:33 PM

I agree with both... Get scheduled to see a VA mental health physician. They will prescribe medications if need be and schedule you for appts. There are other programs and classes that I attend in my out-patient clinic that are very helpful also. The Va Medical center also offers programs like trauma recovery program (TRP), classes on anger mgmt etc. I also got a letter from my treating psychiatrist to submit on my claim. But just remember....DON't miss your appointments. Good Luck to You!

#5 willidx4

 
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Posted 09 October 2012 - 07:04 PM

Thanks folks I feel better about the direction Im going in now. I have a current Dx of PTSD and Major Depression from a private Psychiatrist and that evidence has been submitted to the VA. I still see my private Psychiatrist once a month and I have contacted a local vet center to make arrangements to attend some group counseling sessions once a week. I went to my Regional Office and requested to be seen by a MH doctor and was informed my income disqualified me from being seen. I have been prescribed Wellbutrin SR, Klonopin and Remeron by my private Psychiatrist

#6 john999

 
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Posted 09 October 2012 - 07:49 PM

I got a DX from a local Vet's Center "PTSD: chronic & severe" The VA just ignored that DX and went with a very old DX to grant TDIU. Since the VA has made themselves the sole power to DX PTSD in veterans if I could not get the VA to dx me with PTSD I would get an IMO to DX me with either depression,Panic or GAD. This way you side step the PTSD roadblock. It all boils down to the same thing.

#7 willidx4

 
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Posted 10 October 2012 - 02:37 PM

I got a DX from a local Vet's Center "PTSD: chronic & severe" The VA just ignored that DX and went with a very old DX to grant TDIU. Since the VA has made themselves the sole power to DX PTSD in veterans if I could not get the VA to dx me with PTSD I would get an IMO to DX me with either depression,Panic or GAD. This way you side step the PTSD roadblock. It all boils down to the same thing.


Thanks for the advice John999 are you saying rather than fight the VA on the PTSD issue I should get another Doc and get a dx of GAD? I had no idea they boiled down to the same thing in terms of compensation.

#8 Chuck75

 
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Posted 10 October 2012 - 02:57 PM

Thanks folks I feel better about the direction Im going in now. I have a current Dx of PTSD and Major Depression from a private Psychiatrist and that evidence has been submitted to the VA. I still see my private Psychiatrist once a month and I have contacted a local vet center to make arrangements to attend some group counseling sessions once a week. I went to my Regional Office and requested to be seen by a MH doctor and was informed my income disqualified me from being seen. I have been prescribed Wellbutrin SR, Klonopin and Remeron by my private Psychiatrist


If you are "enrolled" in VA health care, income or net worth has nothing to do with medical care. What I would do in your situation is to get something in writing denying the care. You might have to make a request for care in writing to the VAMC's director, in order to get a written reply. Then, there may be some further options available. I can think of other things as well, but I have no personal experience to go by in this area. I'd think that the current debacle concerning mental health care and PTSD can be made to work in your favor. It sounds like you currently have no service connected conditions.
In other words, it may be Lawyer time. Is the VA providing the drugs under the veterans drug act?

Edited by Chuck75, 10 October 2012 - 03:01 PM.


#9 willidx4

 
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Posted 11 October 2012 - 11:19 AM

If you are "enrolled" in VA health care, income or net worth has nothing to do with medical care. What I would do in your situation is to get something in writing denying the care. You might have to make a request for care in writing to the VAMC's director, in order to get a written reply. Then, there may be some further options available. I can think of other things as well, but I have no personal experience to go by in this area. I'd think that the current debacle concerning mental health care and PTSD can be made to work in your favor. It sounds like you currently have no service connected conditions.
In other words, it may be Lawyer time. Is the VA providing the drugs under the veterans drug act?

Chuck 75 I am not enrolled in VA health care soley based on the fact that I have been denied multiple times for health care from the VA based on income alone. I have been told by the VA in Durham NC (twice) and the by the DAV that I must be service connected before they will issue me an ID card or helthcare of any kind. I have been pretty lucky I have private insurance so all of my MH care and drugs are taken care of by United Health Care. The last time I went to the VA I was basically informed that with 3 dependants, in Raleigh NC making over 68k a year made you richPosted Image so I could not be treated by the VA without being service connected. You mentioned getting an Attorney to help with my PTSD claim what can a Lawyer do for me concerning paper work that I can't do for myself. I thought about just handing the entire thing over to a Lawyer and letting them deal with the VA however what more access would they have to the VA that I don't. I would love to gets some answers so I can have an excuse to find a good lawyer and let him or her worry about this stuff.Posted Image

#10 Hollis

 
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Posted 11 October 2012 - 11:39 AM

well when I started going to the VA, they to asked me for my income infromation. I kindly told them that the Military did not ask me for my income infromation when I was drafted and sent to Viet Nam, so why is it a problem now. I do know that the VA will help veterans out that are not SC. my brother get his hearing aids and his glasses from the VA at no cost. But his meds do cost him more thru the VA than going to Walmart.,BTW I went thru 16 weeks of therapy for my PTSD and I to go to the MH hospital every 2 months to vet to vet meetings. I still see the head Doctor on a regular bases AND HAVE NOT BEEN RATED FOR PTSD as of yet, yes I have filed for it back last May . The Ebenefits is show 10/09/12 to 04/2013 for a decision. Oh well just waiting like most on here. Good luck

#11 carlie

 
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Posted 11 October 2012 - 01:02 PM

I went to my Regional Office and requested to be seen by a MH doctor and was informed my income disqualified me from being seen. I have been prescribed Wellbutrin SR, Klonopin and Remeron by my private Psychiatrist


Go back and tell them the above is BS.
Your income does not disqualify you from receiving VAMC health care.
It would most likely put you in Priority Group 7 or 8.

Give this a try.
http://www.va.gov/he...ility_check.asp

#12 carlie

 
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Posted 11 October 2012 - 01:45 PM

What additional evidence do I need for my claim to be successful?

I was denied a PTSD claim back in 2005. I was in the Gulf and served in the grunts in a combat zone. I was diagnosed with PTSD by a Psychiatrist (private Doctor) in 2005 my GAF score was a 43. The VA needless to say stated I didn't have PTSD according to the VA Psychologist that did my 30 minute C&P exam I had a severe personality disorder and in her notes she gave me a GAF score of 38. I never filed a NOD at the time I just wanted to be done with the VA after reading the C&P examiners notes I was basically called a scam artist. I filed again for PTSD in August 2012 and was diagnosed again by the same private Doctor what other material evidence do I need to make sure my claim is successful


will,

I believe if you were denied benefits due to a PD diagnosis versus a PTSD diagnosis,
during this period - your claim should be re-adjudicated.
Perhaps someone else has the link handy and will post it.
If not try doing a search on the web site.
Many claimants were denied for PTSD and stamped with a different label of Personality Disorder.
BTW - did you happen to have any TBI or mTBI while on active duty?

You might want to research through the links
at this link:
https://www.google.c...chrome&ie=UTF-8

This one is also informative.
http://www.vva.org/ppd-faq.html

#13 john999

 
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Posted 11 October 2012 - 02:20 PM

Willie

You tell the VA that you are suicidal and they will treat you in a hurry. If you have PTSD, depression, panic or gad this would be a very common feeling. When I was dx'ed with a major mental illness the VA did not even have a dx of PTSD. You can get 100% for any mental illness that has a valid DX. You can't get it for mental retardation or personality disorder. I was discharged from the Army on my return from Vietnam as a personality disorder. The VA reversed this and changed to a compensable mental illness and I got compensation. This is pretty unusual at this time, but I had evidence. Once the VA has got it into their heads you are a PD they will look for any sign that you are a PD and ignore other evidence that you have a real mental illness. You have to fight them with medical evidence.

#14 willidx4

 
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Posted 12 October 2012 - 08:10 PM

will,

I believe if you were denied benefits due to a PD diagnosis versus a PTSD diagnosis,
during this period - your claim should be re-adjudicated.
Perhaps someone else has the link handy and will post it.
If not try doing a search on the web site.
Many claimants were denied for PTSD and stamped with a different label of Personality Disorder.
BTW - did you happen to have any TBI or mTBI while on active duty?

You might want to research through the links
at this link:
https://www.google.c...chrome&ie=UTF-8

This one is also informative.
http://www.vva.org/ppd-faq.html


re-adjudicated ?????? I reopened the claim from 2005 when you say "re-adjudicated" are yor referancing some other avanue besides just reopening my old PTSD claim? I read the below links I very informative reading. As far as TBI no and I thank God for that.

#15 willidx4

 
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Posted 12 October 2012 - 08:12 PM

Go back and tell them the above is BS.
Your income does not disqualify you from receiving VAMC health care.
It would most likely put you in Priority Group 7 or 8.

Give this a try.
http://www.va.gov/he...ility_check.asp

Thanks for the link I applied however they did ask for my income/network but I read nothing stating I would be axed becuse of income. Thank You

#16 willidx4

 
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Posted 12 October 2012 - 08:21 PM

Willie

You tell the VA that you are suicidal and they will treat you in a hurry. If you have PTSD, depression, panic or gad this would be a very common feeling. When I was dx'ed with a major mental illness the VA did not even have a dx of PTSD. You can get 100% for any mental illness that has a valid DX. You can't get it for mental retardation or personality disorder. I was discharged from the Army on my return from Vietnam as a personality disorder. The VA reversed this and changed to a compensable mental illness and I got compensation. This is pretty unusual at this time, but I had evidence. Once the VA has got it into their heads you are a PD they will look for any sign that you are a PD and ignore other evidence that you have a real mental illness. You have to fight them with medical evidence.


Suicidal I'm not I have a security clearance and a job I really need to keep so I don't want to go that route with those folks.. I did make arrangments to see another Doc to get a Dx

#17 willidx4

 
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Posted 15 October 2012 - 02:13 PM

I got a DX from a local Vet's Center "PTSD: chronic & severe" The VA just ignored that DX and went with a very old DX to grant TDIU. Since the VA has made themselves the sole power to DX PTSD in veterans if I could not get the VA to dx me with PTSD I would get an IMO to DX me with either depression,Panic or GAD. This way you side step the PTSD roadblock. It all boils down to the same thing.


Thanks John I have an appointment with the local Vet Center on 10/16 to get me setup for some outpatient treatment. Now how that is going to work because I was denied for health care in the VA system is a mystery to me?

#18 willidx4

 
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Posted 15 October 2012 - 02:14 PM

re-adjudicated ?????? I reopened the claim from 2005 when you say "re-adjudicated" are yor referancing some other avanue besides just reopening my old PTSD claim? I read the below links I very informative reading. As far as TBI no and I thank God for that.


searched the term "re-adjudicated" is there a link some place that will tell me how to make the request

#19 cham1968

 
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Posted 31 October 2012 - 04:20 PM

Williedx4

they will give you treatment regardless of how much you make. Since your income is above their threshold what they will do is charge you a specific amount each time you visit the Hospital. Your insurance will still pay as though you were using your primary care Dr. However, if you are sent to a Vet Center that treatment is free regardless of how much you use it. Your pamplet or brochure they gave you at intake should give you an idea of the pharmacy charge. Your insurance carrier may have the VA listed under it's hospitals to get an idea of other costs.

Good luck and God Bless

#20 broncovet

 
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Posted 31 October 2012 - 05:52 PM

You need 3 things to get compensated for PTSD:

1. Medical evidence of a current disability, that is a diagnosis of PTSD.

2. Verification of a "stressor" event in service. If you served in combat, the VA is supposed to make the verification of a PTSD stressor easier. Note: YOu do NOT have to be present at the stressor event. Example: Your close friend gets his head blown off in service. You did not have to actually witness his decapitation...hearing about it afterwords is enough to be a PTSD stressor.

3. A doctors statement linking the above together. This is a nexus statement and it should be similar to "the Veterans PTSD is at least as likely as not due to (event that happened in military service) while in the service.


If you are missing ANY of these three, you will need these before you can expect to be service connected for PTSD.

#21 deanbrt

 
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Posted 31 October 2012 - 07:04 PM

"well when I started going to the VA, they to asked me for my income infromation. I kindly told them that the Military did not ask me for my income infromation when I was drafted and sent to Viet Nam, so why is it a problem now. I do know that the VA will help veterans out that are not SC. my brother get his hearing aids and his glasses from the VA at no cost.

During Pres. Bush's administration VA eligibility was changed to means tested, unless you had a service connected injury with a rating of 30% or more. In Iowa a few years ago it was around $33-35,000 a year. It is actually county by county for the threshhold.

#22 broncovet

 
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Posted 31 October 2012 - 08:13 PM

Deanbrt
Your blaming President Bush for the means test is inaccurate.
President Bush was president from 20 Jan. 2001 through Jan. 20,2009.
Clinton was president from 1993 to 2001.

Public law 107-135 implemented from earlier passed laws in 2001. It was actually under the Clinton administration when the means test legislation was passed, not Bush.
http://www1.va.gov/v...asp?pub_ID=2466

If politiciking is allowed, then it at least needs to be accurate, adding that the backlog under President Obama went from 390,000 claims to 900,000 so Obama has not been good for Veterans at all.

#23 willidx4

 
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Posted 03 December 2012 - 02:20 PM

Thanks for the info guys I’m currently being treated by Vet center at no cost to me. I'm also working with a private consular and a new Psychiatrist





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