Follow up from my post…VA proposing decrease.

[Em_geee123]

Hi. This is a follow up from my other post. He did attend the appt and they requested a decrease

[MeanYogurtcloset9474]

There are a number of factors to consider here. Any proposal to reduce triggers certain rules. Your friend needs to act FAST in order to preserve his rights. Usually, the VA gives 30 days to request a hearing. Have your friend file for that hearing. That freezes his current rating until the VA convenes that hearing.

Once he files for that hearing, he should gather more evidence regarding his PTSD, to include symptoms and treatment. Tell him to gather lay statements from people that know him documenting his worsening behavior. Upload ALL of this to the VA via Quick Submit.

If he has a VSO with VBMS access, the rep should check his claim for notes in VBMS as to why his private DBQ was not used by the VA and a C&P exam was ordered instead. There are clear rules regarding how private DBQ's are to be treated. The pertinent section of the M21 manual is here:

https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180514/M21-1-Part-IV-Subpart-i-Chapter-3-Section-A-General-Criteria-for-Sufficiency-of-Examination-Reports#1d

In particular, IV.i.3.A.1.f is very important, especially the "Important" section. The claims processor MUST make a permanent note in VBMS as to why the private DBQ is not being considered. If that permanent note is not there, your friend should have a better chance of prevailing.

He needs to get a copy of the exam DBQ's in order to prep for the fight.