My husband was at tier 2 and during the time his ptsd improve. however it reverted back to severe and the va caregiver program reduce him to minimum tier. They is evident in his psy medical note that he has worsen but his psy doctor wrote a very different self assessment without even talking to him nor me his wife of his current condition. Can I put in an appeal and add on the va notes supporting documents as proof. Also he increase his medication for night mire and mood swing.