PTSD Years Later: Stopping Therapy (Or Taking A Break)

My question is this. 

I am 100% P&T for PTSD. I have been in therapy for 16 years with no real cure. I am fed up with therapy and want to stop. Will the VA reduce me if I stop therapy?  Yes I am P&T with no future exams scheduled. I have Champ VA for my wife and children and education benefits for them. I have been 100% for 9 years. I know that 20 years at 100% they can’t reduce me unless fraud is involved. But if for some reason I am called in for a review.....can they reduce me because I stopped treatment (therapy). 

Answer:

I stopped direct therapy about five years after my T&P rating. I had gone to therapy almost five years before I was service-connected for PTSD. I went back years later for the 12 week PTSD session outpatient. 

Like all the rest of it, it never did me any good. If you have been in group or individual for 16 years, they can’t say you are not accepting treatment. Tell them it’s not doing any good. They know there is no cure. Then just don’t make any appointments and tell them you want to take a break. Sometimes therapy can make you feel worse after a session than you did before a session. That’s why I stopped, and one time my therapist fell asleep so I said screw this. They can’t cut you, and if you are P&T with no future exams, they are not going to mess with you. Don’t worry about getting cut.

Working While Rated Unemployable

Marginal Employment 

Some veterans will argue that when you have reached unemployable status, you are supposed to stay at home and sit in your house, or spend all your time at the VA. They are terrified of doing anything that could be remotely related to work, but the Code of Federal Regulations does not require a veteran to stop functioning.

  4.17 Total disability ratings for pension based on unemployability.

All veterans who are basically eligible and who are unable to secure and follow a substantially gainful occupation by reason of disabilities which are likely to be permanent shall be rated as permanently and totally disabled. For the purpose of pension, the permanence of the percentage requirements of 4.16 is a requisite. (One disability at 60% or above, or a 70% combination of  two or more, with one being at least 40%.)   

When the percentage requirements are met, and the disabilities involved are of a permanent nature, a rating of permanent and total disability will be assigned if the veteran is found to be unable to secure and follow substantially gainful employment by reason of such disability. Prior employment or  unemployment status is immaterial if in the judgment of the rating board the veteran's disabilities render him or her unemployable. In making such determinations, the following guidelines will be used:

(a) Marginal employment, for example, as a self-employed farmer or other person, while employed in his or her own business, or at odd jobs or while employed at less than half the usual remuneration will not be considered incompatible with a determination of unemployability, if the restriction, as to securing or retaining better employment, is due to disability.

(from 4.16) Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination.

 (b) Claims of all veterans who fail to meet the percentage standards but who meet the basic entitlement criteria and are unemployable, will be referred by the rating board to the Adjudication Officer .

  What all this means is that you don’t have to stop trying to earn some money when you are considered unemployable. The VA will, according to a letter I received a few weeks ago, check Social Security and IRS records on you each year  when you are rated unemployable, even if self-employed. So, in theory, if you work a job involving taxes you will be hassled, if you make a ton of money. (The law doesn’t provide much incentive to improve yourself  if  you are declared unemployable.)

  In part b above, the law states that you can file for  unemployability at any percentage if you can’t work based on a service-connected condition. The VA and probably the service organizations will frown on this, but it is your  right to file for unemployability if you can’t work. Don’t ley anyone tell you that you can’t file. It is the law.

(From the S-2 Report Newsletter)

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The Trump Budget and Individual Uemployability

The Trump Budget and IU

There are rumors that the Trump budget will force everyone who is of retirement age (62) off of IU and on to Social Security alone to save money. This would mean a massive cut for seniors on  Individual Unemployability who need it the most. Most vets would lose over half their income.  

  This won't fly, and I will tell you why. If you are unemployable, you are considered 100%. Just because you lose the IU because of budget cuts does not mean you are suddenly employable.

  The VA would have to review every single case based on the level of disability, (even if they are eligible to collect Social Security because many people work past retirement age), and probably have to make everyone drawing IU before the budget cut 100% schedular.

  You are not suddenly employable once again just because they cut your funding. And if you are too old to work by then, they just can't cut your money and benefits to save funds. So you would switch from say 80% IU to 100% schedular. Same-same.

  I don’t think the cuts will ever happen, and if it does, I believe those already on IU will stay there based on their age.

  In my own case, I’m 70 years old. I'm 130% disabled (combined 90%) but next February I will have 20 years on IU rating. After 20 years of the same rating the VA is not supposed to be able to cut your percentage. You stay that way for life.

Diet Soda: Is It A Killer?

Diet Soda Killer?

I've seen two articles this morning on how bad a diet soda is for you. You have to be shitting me. All along they say you shouldn't have sugary drinks and now they are saying diet soda causes strokes and dementia...but when all the factors like smoking, age, weight, current medical problems, and health are figured in...the figures don't mean anything and are inconclusive. So in the end it's all bullcrap, probably promoted by the sugary drink manufacturers and the sugar growers.

They should be concentrating on the effects of mixing prescriptions and the many ingredients in the flu shots they now keep trying to push on people, who in nine out of ten cases get the flu anyway. Seems to me they would cause dementia and strokes more than any ingredient in diet soda.

At age 70, I have a case of Type 2 diabetes, which they say is from exposure to Agent Orange during the Vietnam War. I was exposed to it...but I never got diabetes until I started taking blood pressure meds, some of which make your blood sugar go up and down. So I quit drinking regular soda and switched to diet. Now they are saying diet soda can kill you?

When I first got back from Vietnam, normal blood sugar levels at the VA were 140 or under. Then it went down to 130. When I was diagnosed it was 125, and that day my blood sugar was 126. Years later, it was an automatic service connection, but since I was already 100% service-connected, the extra 30% didn't matter in the long run. Pretty soon they will have blood sugar levels down to 100, and anything over will be diabetes and you will have to take meds...and the only people happy will be the ones who own the drug companies.

Live your life. If you like diet soda, drink it. They don't really know what causes anything, and sugar is a lot worse for you than no sugar.

PTSD: Temporary Improvement

PTSD: Temporary

Improvement

You’ve been fighting a long time with symptoms of PTSD, and after the VA grants your claim, you are told that your compensation may be cut in the near future due to a temporary improvement  or even just an improvement.

  I tell veterans not to worry about this. PTSD is a lot different than a physical disability. Certain physical conditions do show improvement, and the rating percentage can be reduced at some point. But with PTSD, any long term improvement is not likely to happen (at least improvement that would deserve a rating cut).

  When you are first service-connected for PTSD, you may be called in for the first couple of years for a Comp Exam, but this doesn’t mean you are going to lose your percentage.

  The VA is so swamped with claims right now from the new wars that an easily settled PTSD claim is not going to be called back in any time in the near future. That would just add another claim to the already full docket.

  Also, the VA cannot cut a veteran with PTSD for any short term improvement without considering the entire claim history.

  One veteran who is currently 100% for Individual Unemployability was told that he would be called in for a future exam because ‘improvement was anticipated with continued therapy’.

  Just because a veteran improves on a temporary basis (there is no permanent long-term improvement of PTSD) does not mean the veteran is all of a sudden capable of holding a job, or spending months or years in some Voc Rehab training program. Still, it would be best for the veteran to continue therapy, or start therapy again until the condition is made permanent.

  The VA must follow regulations in the CFR (Code of Federal Regulations) before reducing the percentages of any disabled veteran.

  Veterans who have held a rating for less than five years are protected under several rules. According to the CFR, the VA must find that there has been an improvement in the level of disability before reducing the percentage rating. The entire history of the disability must be reveiwed. The evidence must show that there has been some positive improvement in the veteran’s ability to live and work. (Improvement does not mean such silly things as your ability to walk your dog down a public street or playing cards once a year...such excuses have been used to cut veterans by saying their social interaction skills have improved).

  Any attempt at reduction must also include a current Compensation Exam covering the issue of the disability. A Comp Exam for PTSD which does not include the issues bothering the veteran is not valid.

  Veterans with PTSD can expect to keep their percentage without fear of reduction

CUE: When The VA Violates Their Own Laws

CUE

  CUE means the VA did something in your claim which is a clear violation of their own laws. One example can be when a veteran files a claim, the claim remains open until they adjudicate it.

  Many times, the claim will sit in a file for years before someone gets around to deciding the issues. Once in a great while, a veteran will submit a claim, and nothing will ever be done about it. Years later, the veteran may submit a new claim for the same disability. If the VA grants the claim, the effective date of the award should be the date of the old claim, not the new one.

  This applies only to claims that were never adjudicated. If the VA did anything in the way of rejecting the claim, then it has been adjudicated. I often suggest to every veteran to save every letter or piece of paper they receive from the VA. That way, if you do file for the same disability years after you haven’t heard about an original claim, you have the proof in hand. If you don’t save your paper work, the VA may say you never filed, and you wont be able to prove that you did.

  This situation is really not a mistake in the law, but a mistake in applying the law because they didn’t adjudicate your claim. In another case, a veteran was rated at 70% for PTSD and filed for unemployability based on the fact that he couldn’t work. Voc Rehab had turned him down for training, and he was on medication. The VA denied him the 100% rating because they said his isolation from society (typical among vets with PTSD) was self-imposed.

  The Code of Federal Regulations doesn’t say anything about self-imposed isolation, as far as I know. The only way you couldn’t have self-imposed isolation is if you were in prison in solitary confinement. The VA never mentioned anything about his inability to work or anything about his work history. The total isolation and withdrawal from society due to PTSD rates 100%.

  Not only did the VA violate the law by not examining him for his ability to work, they made up some fiction about his isolation. This is really grabbing at straws on their part, and is a clear violation of their own laws. This claim went to the Veterans Court of Appeals, and was remanded back to the Regional Office to be fixed. It had been going on since 1989. In the end, the veteran was granted 100% going back to 1989. He ended up getting somewhere around 60,000 in back pay.

  CUE can be hard to prove, but your service organization will probably be able to spot clear violations in the law, and follow up with you. If the service organization offers to take the case to the Veterans Court of Appeals, you probably have a good chance because they wont take a case they don’t think they can win.

  Any veteran rated at 70% for PTSD should file for unemployability when they can’t work.

   If you’re not sure about CUE in your claim, ask someone who knows the law. And never give up!


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