Re-evaluation of Disability Ratings

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Posted on: Wednesday, October 09, 2013
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Hello Jim,

I served in the Navy during the First Gulf War with the Seabees. I got out in 1992, in 2005 my friend saw the signs of PTSD and convinced me to go the VA. I was having a lot problems at work and failed relationships, plus nightmares, flashbacks, and difficulty dealing with people in my job as a customer service representative (both customers and management)

To make a long story short I was awarded 30% service connected for PTSD. I went to therapy at local Vets Center, things got worse at work, and personal life( been divorced three times and had 5 failed live in relationships since 1992)

I was told more then once to apply be reevaluated by doctors at the VA, as they thought my condition was bad enough I should not be working. I did that in 2010, and went though more counseling and group therapy. In 2011 my life fall apart when third wife left with a coworker and problems at work got worse. I spent majority of that year and 2012 in counseling at the VA. I was raised to 70% in 2011. Don't remember the month, and soon had to resign from my job due to all the stress and problems.

My psychologist suggested I apply for IU, which I did in august of 2012. May of this year, I got the award letter stating I was rated IU from November 2011 when left my job to August 28 2012. Then was rated 100% P&T by schedule for PTSD.

I just found out the permanent and total doesn't mean what it says and the VA can review me anytime and change it, and now really let downby a system I believed in.

My question is this, to keep the rating do I need to constantly be going to counseling? My doctor told in January this year, things seemed stable no need continue visits unless things get worse in further. Will it affect me negatively if I only make appointments when I need to? I am not taking any medications because they didn't really help and the side effects were awful. Was on Zoloft for two years and sleeping meds.I know I couldn't keep a job in the private sector and only only I was employed for so long is it was a civil service job and managers didn't want do the paperwork to document all the problems I had dealing with people, being absent, and just just plain hard to get along with.

I'm really worried now that there a chance I may lose my rating sometime in the future and don't know what I would in that case. By the way I am 46. Any advice or information you can provide me would be most helpful as I have been a nervous wreck since I found this out.

Reply:

I'm glad you took time to write to me. I hope I can settle your nerves just a bit for you. Keep in mind that the discussion that follows is exclusively about 100% ratings.

You are correct that VA can and will reexamine you at any time they wish. We hear a lot of talk about "protected ratings" but for the most part, there aren't any such things. If a veteran holds a P & T rating for 20 continuous years there is a bit of protection but even then, if VA suspects any fraud in the original application, they can and will reopen the claim and investigate the veteran.

We must accept that. It's how the system works and it's all based in laws promulgated by the Congress. Now that we know VA can reexamine us at any time, we have to consider the likelihood of that happening and what we should do to protect ourselves.

VA sees certain conditions as having a reasonable chance to improve. The 2 top conditions for that anticipated improvement are mental health issues and cancers. Both of those conditions are likely to show improvement with extensive treatment. Many veterans who suffer from PTSD get better with treatment. Many cancer patients can be cured of their disease. VA will usually rate either of these kinds of conditions as temporary rather than permanent. You probably hear a lot of talk about a P & T rating. There are significant differences in a P & T rating when compared to a temporary rating.

Please click http://www.vawatchdog.org/permanent-and-total---p---t-.html

Your relatively young age makes it all the more likely that VA would award you a temporary rating rather than a permanent one. That is because the VA, as well as many other agencies that deal in disability ratings, are loathe to call a young person (under age 55) permanently disabled.

The law requires that VA rate you for the condition as it is today. That doesn't work very well because VA is always so far behind. But the theory is that if your condition is worse today than when it was last rated, you are eligible to have the rating increased. The opposite is also true; If your condition improves, VA is required to rate you to reflect the improvement. That seems reasonable on the face of it.

Is it likely that you will be reexamined in the future to determine if there are improvements in your condition? I don't know what your award letter says about your P & T rating. I have a feeling you are probably rated as temporarily rather than permanently disabled. You say you were rated P & T but that would be unusual at your age and considering you have a mental health rating.

However, whether you have a permanent or a temporary rating isn't important if we're discussing how to protect the rating.

I advise all veterans who have any ratings to establish a steady record of follow-up sessions with their VA providers. This is very true of mental health conditions. In far too many cases a veteran will be in intensive therapy when he gets his 100% award and retro pay. Once he has the check in hand, suddenly he isn't so interested in therapy. A lot of guys drop off the VA radar completely once they get the award.

That can appear to VA as if you're cured. If you are doing so well that you don't need therapy or treatment, why is VA paying you? This is true whether you are seeing a psychiatrist for mental health or a urologist for prostate cancer. If you allow VA to believe that you're suddenly no longer in need of any treatment, that can raise a suspicion of just how disabled you really are.

Why take the risk? In your case, you probably don't need to make the schedule of appointments and sessions as often as you have been in the past. If your therapy has gotten you to a point where you're stable, you can reduce the numbers of visits safely. But you should not discontinue or ignore future visits because they may be inconvenient. A regular record of continuing therapy where you are reporting the problems you're still having is your best defense against any possible future examination.

Don't get complacent and give the VA the ammo they may want to shoot down your rating. Keep your medical records buffed and polished by using the services that are there for you. A steady, documented official medical record is the best possible evidnce you have to make or continue a claim.

If you will do that, I don't think you have a thing to worry about. You should be slightly concerned about this but certainly not the "nervous wreck" that you claim to be today. Now you know how to ward off any future attacks by VA and that makes it very unlikely that you'll have any problems.

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