templar1231

Ok, I've finally heard back from VA. They've indicated they're going to proceed with my hearing...any advice on how to prepare and who to bring?

Berta, I never did have a hearing...yet. And no indication I'm going to - it appears they're going straight to making a decision. We'll see, I'll post the result when I get it.

Pending Decision approval on E-Benefits...we'll see. Interestingly, my AB8 has a date of Dec 1, 2014 for effective date of 80% combined rating. I believe it was Jan 1, 2014 before, is this just a coincidence with the COLA increase perhaps?

A huge thanks to Broncovet for getting me headed in the right direction for my response letter and assisting with editing. I'll let the group know what kind of response I get. See my letter attached. Response to VA CUE.pdf

Thanks for the advice so far, please see below what I plan to send through my VSO as a response and let me know any critique or suggestion: Dear Sir/Madam: I have received your letter dated . In that letter you have advised me that you propose to reduce my benefits. I disagree with your assessment to eliminate a separate 40 percent evaluation for TBI. This action isn’t warranted due to such documented symptoms as “subjective complaints of balance problems and vision changes”. Although the doctor did not feel that these symptoms warranted a higher facet level than 0, it’s not the symptoms but their effects on my work and everyday life that really are the impairment. As a consequence of these documented residuals, the problems/symptoms compound to negatively impact my life. The balance problems I have cause dizziness and give me problems while reading that interfere with my effectiveness at work and home (causing me to take breaks). My vision changes (light sensitivity and blurred vision) cause me to strain while performing computer work and hastens fatigue. I did not point this error out (during the 1 year appeal period) until now since I felt my evaluation was “accurate enough” and I didn’t feel it necessary to merely get one TBI facet marked in line with reality. With the pending reduction, my VSO advised me to address this in order to get everything sorted out. I request that you take no action to reduce or modify my monthly benefit amount at this time. I request a de novo review of my file and this proposed action by a Decision Review Officer. I guess I could send this and then wait for their response or send this and get an IMO or IME. I've been trying to get ahold of the neuro that did my TBI neuropsych to discuss. Suggestions please?

Not sure about who'll be going, I am having a hard time getting seen by a VA doctor to verify my residuals and provide documentation. Is it worthwhile to get that from my physician outside the VA? If so, do they need to be a specialist and what exactly should they document (eg a certain form?). I feel like if it can be shown I have a higher facet level for the subjective symptoms (blurred vision, balance, and hypersensitivity to light, etc) than was recorded in my C&P, then their decision should change, correct?

Berta, yes they did give me 30 days to request a hearing (my VSO suggested I do the hearing) and 60 days to provide additional evidence supporting my case. I have until the 24th of Oct for the hearing.

Thanks to you both, you're right in that I think I should focus on the symptoms that can't be attributable to PTSD or other awarded disabilities like blurred vision, balance, and hypersensitivity to light, etc that should be documented in my file. Only problem is I don't that facet level was rated accurately by the neuro - I think she was focused more on the psychological manifestations.

tbi reduction - Copy.pdf Sorry, meant to attach this before - see it

Last year, my claims were approved and I received a combined evaluation of 80% due to (PTSD - 50%, TBI - 40%, Migraines - 30%, Tinnitus - 10%). Recently, I received a letter stating that they had made a clear and unmistakable error and will reduce the TBI to 0% and my overall will go to 70% after an Admin Review. I understand their reasoning since they feel the symptoms are overlapping and they can't apply my TBI facet levels that are higher than 0 towards TBI since they've already supported the 50% evaluation for PTSD. Where I disagree (potentially) is that I have other residuals that aren't "psychological" and are attributable to my other evaluations (e.g. Migraines). The items/residuals that might still apply are subjective complaints of balance problems and vision changes (TBI residuals) that I don't think the doctor evaluated correctly at a 0 severity level. I have blurred vision, balance problems and hypersensitivity to light that do interfere with work, daily living, etc. I wasn't worried before when I got my evaluation because I thought what I had received was fair...but now they're attempting to reduce. My VSO suggested I show the letter to my Mental Health doctor and see their opinion (and see if they'd like to write up documented opinion for me) and then try to request a hearing or denial. Any suggestions?

I'm currently rated at 80% for multiple issues (TBI, PTSD, Tinnitus, etc). I was awarded around January 2014 and then an Admin Review was finished on EBenefits about a month later. Immediately, another claim opened that said Predetermination that same day. I've been trying to find out for the longest time what it was for. Today, I finally got ahold of someone that told me it was for Brain Thrombosis - it's confusing because on Ebenefits it says it's in the Gathering Evidence stage but it also says the Decision Notification has been sent. Not sure what to make of that, but it just changed to that within the last week. So, what is the criteria for Brain Thrombosis that they're looking for? I couldn't find anything on it and I assume it's a secondary to TBI? Anyone else seen this and can point me in the right direction?