Stan n Pam

I would like to add my 2 cents here........ huh...????????? say what....???????? who knows all this STUFF...???!!! :-) seriously now... I would like to say - that the respect level, for others on this site, is exceptional - and that speaks volumes about you all - thanks for what you do, p

Thank You! Thank You! Thank You!!! I know I must have already used this - at least 10 times today! p

I see that you havn't received any responses to this post - these are very good questions - and you will get help with them from the very knowledgeable folks on this board - but I think you have posted this in the wrong forum - not very many people will check this forum - I only checked it because I am still trying to find my way around - I am a newbie with lots of questions and needing lots of help - I have received so much already - I post my questions under the very first forum (VA Claims Reserarch) Veterans Affairs Claims and Benefits Research - try posting this there and see what happens

thought I'd post this again - have a few questions in here I need replies on- (would someone tell me if I am writing too much? do I need to cut down the lengths of my posts?)

This sounds wonderful! Good for you Robbi! Thank your husband for his service and sacrifice for this wonderful country! A couple of questions if you don't mind: I wonder why the diabetes was just given a rating in Dec 2006 and not back to the 2004 date when the claim process? started? I thought it was pretty much an automatic for a combat veteran. Don't know where I actually got that from but it has stuck in my mind. ...service connection for Post Traumatic Stress Disorder is granted as being 70 percent disabling effective December 16,2004 service connection for diabetes mellitus due to herbicide exposure is granted as being 20 percent disabling effective December 13, 2006; entitlement to individual unemployability is granted effective December 16, 2004... this is something that I had an earlier question about - he's rated right now at 40% plus 70% PTSD plus 20% diabetes - wouldn't that qualify him for the extra SMC benefit? Or is it that a veteran has to be 100% rated in one disability and then the additional ratings in other disabilities to qualify for the SMC?

HOLY S&%T !!!!!!!! WHO KNOWS ALL THIS STUFF!!! this is a knee jerk reaction and in 30 mins I'm sure I'll be sorry I hit "send" -

answers to: Post #14 By: Berta "Stan has severe hardening of the arteries" seems to me you have medical evidence to get a higher rating on the atherosclerosis. "0" is ridiculous- Pam’s reply: We have plenty of medical evidence and medical history to back up anything about his cardiovascular system – I think I have mentioned his surgeries and procedures – this all basically started after he was medically retired from the PO in 1984 – the stress of the whole thing was tremendous on our family. Nothing to prove that tho – all families have their stress and problems I guess. also did they Cure his cataracts with laser surgery? Pam’s reply: cure for his cataracts – no treatment was ever offered When is last time he had vision C & P or any vision test at all? Pam’s reply: His last vision exam was in April or May 2006 – he was given prescription glasses at that time – I have the prescription, but nothing else was ever mentioned You need to go over the diabetes regs-as well as the heart disease regs and the vision regs- Pam’s reply: I will do that this evening – is there anything that I am looking for, in particular? I am having problems here - and cannot take time to add links ---- these regs are all in 38 CFR--- I will attach the VA's DMII training letter- Did he claim HBP as secondary to his DMII? Pam’s reply: Not that I know of – I really haven’t seen any of the paperwork that was turned in to the VA for this appeal process – and I have decided not to request a copy of his c-file right now – since the appeal is now at the Rating Board/Office – I think I mentioned that it supposedly went there on Jan 17, 2007 Atherosclerosis is a progression of HBP- Pam’s reply: Absolutely! M21-1 Part !!! Subpart IV states the atherosclerosis manifestations of DMII- also there is cardio logical manifestations-(VA Training Letter #00-07) Pam’s reply: don’t understand this statement…….? The ECHO report will have an ejection fraction at the bottom of the medical report write up- it also will have arterial measurements- he probably had an ECHO because they determined his atherosclerosis is "severe". Pam’s reply: Let me state here that I don’t have any paperwork or don’t remember if Stan was ever seen for his heart – that is one thing that I absolutely put my foot down on – no VA intervention with any of his heart treatment or symptoms or medications That ECHO contains a lot of info- It seems to me that he has secondary conditions that they did not rate properly or maybe they were not formally claimed-such as the HBP and cardiac involvement. Pam’s reply: I think you are probably correct when you say that – they were not formally claimed – I’ll probably need help on pursuing that when we hear back from the Rating Board If you go to the BVA web site and search the cases regarding DMII and secondary you will find many regs there they use (I would stay with the 2005 and 2006 decisions) and how they should determine these conditions. Pam’s reply: WOW – don’t know if I could handle that much information at this point!! I have really done well so far – with my frustration level over my attention span problem – I am pacing myself – and I keep having to go over and over some things before they click – Note to Berta: I have really concentrated on organization – and I am making progress with that – and you are so right when you know that it is comforting to know that you can get something right at your finger tips ---- I’m far from that point, but I’m chuggin’ along - Manila folders are my favorite invention right now – The original VA DMII training letter -1997- I posted here long ago- It contains a more detailed account of the considerable complications of DMII- High glucose causes affect to pancreas, blood pressure, heart, brain, neuropathic system, systems involving sight, taste, sleep, ---the whole body system- the ramifications are endless and fortunately all preventable and treatable-if the glucose is well controlled- This isn’t the worse DMII decision I ever saw- it is typical -to some cases- of VA's failure to rate secondary conditions properly- You might know that I have a DMII claim at the VA - I only filed this at my daughter's insistence-and then began to study the disease- no one in the family had it-but Rod had been exposed to Agent Orange- If I had not spent a lot of time studying it Pam- I would have never known how the VA really killed my husband- I was astonished at what I read-but knowledge is power- Pam’s reply: This is the kind of thing that makes all this work all worth while – I’m so sorry to hear about Rod – but at least you are keeping his memory alive and well with all you are giving back to other veterans!! It is sinking in more and more each day… knowledge is power! (just wish I could remember it more easily) The ADA web site and many more sites have considerable info on this disease-and it might help you a lot to get a good picture of what it is. This will help you to identify whatever secondary conditions he has that the VA should rate- They do not award on something the vet has not formally claimed. well sometimes they do-but these cases are few and far between---- Pam’s reply: I’m still working here in Buford, GA (yes, Buford!) ……….. you will hear from me again …………….I’m not going anywhere ……………. DON’T YOU GUYS GO ANYWHERE either :)

I have tried to answer the questions, about Stan's situation, that Berta and others have requested - let me know if I need to clarify anything......... I noticed they did state chronic and severe-so there must be evidence there already beyond the 10%-that can be Nodded-(Notice of Disagreement)---then again could it be NOdded ?-hope Vike comes back-can you NOD part of a decision where no formal claim for increase was raised? ”Did he ever ask for higher PTSD rating?” <H1 style="MARGIN: 0in 0in 0pt">Pam’s reply--- </H1>Yes, but I haven’t actually got my hands on documentation – also, I just found out (today) that the PTSD part of the claim went to the Rating Board on Jan 17, 2007 – Stan has some pretty strong wording in his diagnosis report from his VA doctors… (I sure hope we don’t have to fight this) ”something here is really sticking out to me- DMII % was raised-but what was the rating for the nuclear cataracts- and how could a DMII vet have cataracts (I assume they are definitely due to the DMII) if they did not rate the atherosclerosis as service connected too at a ratable % beyond "0"? DMII can cause atherosclerosis that also can cause cataracts- I have vets who have this progression of their DMII. These are secondary conditions of their SC Diabetes. But their claims were specifically for the rating of these secondary conditions. Even the VBM makes the point of the nexus between these conditions and also the VA training letter on DMII does too.” Pam’s reply--- …Berta – I really have no clue what you just said….but this is what we received from the VA… This is the REASON FOR DECISION – copied right off the Entitlement letter from VA: (received around end of Dec) Evaluation of diabetes mellitus, type II with nuclear cataracts currently evaluated as 10% disabling. The evaluation of diabetes mellitus, type II with nuclear cataracts is increased to 20 percent disabling effective December 20, 2005. The evidence shows you have a requirement for insulin and restricted diet, or oral hypoglycemic agent and restricted diet to control your diabetes mellitus, allowing a higher evaluation. The most recent examination by Dr Beldick indicates that you have no diabetic retinopathy, however, you do have cataracts likely due to your diabetes mellitus. Your vision is 20/25 corrected in both eyes. Although the optometrist indicates that you should be followed up for diabetic retinopathy, the examination by the specialized eye doctor, Dr Beldick does not show that you have this complication. However your diabetes induced cataracts are included in this rating evaluation. Any noncompensable (I don’t know what this means, I don’t think that it’s a word) complications are considered a part of the diabetic process, and are considered within this rating decision. An evaluation of 20 percent is assigned from December 20, 2005. An evaluation of 20 percent is assigned if there is a requirement for insulin and restricted diet, or oral hypoglycemic agent and restricted diet. A higher evaluation of 40 Percent is not warranted unless insulin, restricted diet, and regulation of activities are required. Regulation of activities indicates avoidance of strenuous occupational and recreational activities, and is needed for diabetics who have a difficult time keeping their blood sugar within normal. You are likely to have difficulty with such symptoms as: episodes of hypoglycemia, frequent doctor visits and changes in insulin dosage. ”Is your husband unemployable due to his service-connected conditions?” Pam’s reply --- Not according to the VA (yet) We were very fortunate that Stan has not had to work, because for 25 years when we lived in Orlando, we owned a small Commercial Janitorial Business. The business was in my name and he showed no income. Stan was medically retired from the PO in 1984 – because he could not use his arm any longer to do his assigned position – this was due to the GSW from Viet Nam and also his right shoulder had developed a chronic problem after 11 years of repetition and stress. It had compensated for the weakness in his right arm and just basically wore out. He had surgery on it in ’83. The surgery was for: chronic impingement syndrome, namely a Neer acromioplasty and AC arthroplasty of the right shoulder. …….so to make a long story short… instead of transferring Stan to a job in the PO that he could do within his limitations, the Postmaster, in all his wisdom, decided to medically retire Stan at that point. We were scared to death! At that time (and probably still is) PO pay was pretty darn good, especially compared to E-5 pay in the Army. Because he was medically retired we had the opportunity to keep the medical insurance that we had at the PO. But in order to keep the health insurance, Stan could not make over $600 a year. Hence the business and most everything else was put in my name. Because of that restriction - Stan going to try to find a “real job” was absolutely out of the question! I spent last night reading some of the old medical records from way back then – sure do wish I knew then what I know now….. oh well – we’ll just take it from here ”Does he get SSA for his service-connected conditions?” <H1 style="MARGIN: 0in 0in 0pt">Pam’s reply ---</H1>Stan is not eligible for SSA because he does not have enough work credits (he only has 35 or 37, I think) and hasn’t worked in the last 10 years. He can not draw on mine because I am not retired (62) and I’m not dead yet I’ve checked this out pretty well – I even called and talked to a representative at allsupinc.com and he told me the same thing that the SS office did ”Did he ever have an ECHO test to determine what level of atherosclerosis he really has?” Pam’s reply --- I don’t have VA documentation of that right now – but I’m sure he would have had the ECHO test. I can tell you that we have plenty of results from tests to verify just about any level of atherosclerosis – Stan has severe hardening of the arteries. He has had 2 separate open-heart surgeries, 3 carotid bypass surgeries (1 carotid was bypassed twice), kidney stints etc. Just today he had a full body cat scan because he is having head aches and pain in his legs again – the tech told him (off the record, of course) that there was some more plaque building up in one of the carotids). We’ll have to wait for the radiologist report for fill details. We would love for him to be able to have an MRI instead of a cat scan, the MRI has such a clearer picture than a scan – but that is impossible because he has shrapnel behind his left eye, and the doctors say that a MRI would most likely cause the shrapnel to come out right thru his eye. So there again, he cannot get the medical treatment he really needs because of remnants of the war. (FYI – the scan today and all of his surgeries have been in private hospitals – he has had only one major procedure at a VA Hosp and that was in Boise, ID, around 1976. He had an ulner nerve transplant due to the GSW in Viet Nam – I can’t tell you how thankful we are and fortunate we feel to have private insurance – I won’t even go into the experience we had there!) ”Did he in fact ask for increase in the % for atherosclerosis?” Pam’s reply --- I don’t know that ”Has any doctor said he was unemployable due to his service connected conditions-” Pam’s reply --- Yes – both doctors at the VA have stated that very clearly in their diagnosis letters I will attach a TDIU form- if he believes and can prove with medical evidence, that his service connected conditions render him unemployable. TDIU is the same $ as the 100% rate. Interesting- they considered 100% but did not infer TDIU----- ”Did the initial claim request 100%?” Pam’s reply --- The initial claim – I’m not sure about that one, but I know this last appeal did “1 thing I did notice was you stated there was two 10% ratings for the sciatic nerve. Was this just a typo? The reason why I ask is normally that isn't allowed under "pyramiding," meaning two disability ratings for the same disability. Could you clarify that?” Pam’s reply --- The 2 - 10% ratings were actually on the decision from the VA that was dated 2004 and that was repeated on several other papers – however on the latest thing we received from them, the duplication was not there – so I have to assume that it was a typo that the VA made

how do I look this up?? 38 USC 1114 I've looked on this site and searched on this site to no avail - I need direction (in layman terms, please) ======================== GPO Access <H3 align=center>Electronic Code of Federal Regulations (e-CFR) </H3><H4 align=center>BETA TEST SITE</H4> e-CFR Data is current as of January 29, 2007 TITLE 38--Pensions, Bonuses, and Veterans' Relief CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS PART 4--SCHEDULE FOR RATING DISABILITIES

trying to navigate that site and can't find this out - thanks, p

Hey Berta - just read your profile...sounds like you must sit around all day and eat bon bons..... on top of that - 40 posts a day??? when do you sleep??? I have to round up some records from the VA because it looks like Stan didn't keep most of what I need to answer your questions - I am a little frustrated that I have very little correspondense from the VA for the last 4-5 years - seems to be missing since 2002 - not sure why he threw this stuff away I do have something from 2002 that does show that he requested compensation for PTSD along with about 10 other things - I guess that is when he received the 10% rating - however I don't have any paperwork at this time that actually shows/says that I think I need to work on getting "my ducks in a row" before I bother you all too much with this stuff It's just that this stuff is so confusing to me! (that's the 'ole ADD kicking in) But I know that I have to do this - Stan just can't. It may just take a while - so thanks for the help so far and I so appreciate the time and knowledge that you all are so willing to share with so many. Pam ps...the 2002 correspondense from the VA - DOES show the syatic nerve damage only ONE time - it was a VA typo on the later correspondense ppss... a little note to Berta - since I see you are also a fan...I have to tell you that I do have one (probably only one) claim to fame! While my dad was stationed at Ramstein in the last 60's - I went on a teen club trip and I got to see and hear Hentrix's in concert!! - I really didn't pay too much attention to who he was then - but at least now I get to say I saw him........ :) my kids were even impressed - and that doesn't happen much! :)

Allen First - I am not a doctor and I have never worked in the medical field - but we have had our share of exposure over the years - that is my disclaimer :) I would think that if you had an aortic anurysm it would not feel like a hernia - actually an aortic anurysm doesn't feel like anything - it just is there A lot of folks don't know they have this problem until it's too late or until they are discovered while doing testing for other problems. As far as I know - The best test for this is the procedure that they do for the heart cath. It shows most everything. We have been thru this many times - In 85 Stan had his first open heart bypass, 35 years old. Since then he has had numerous heart caths and several stints put in. He had his second bypass about 10 years later. Then in 2000 during a rather routine cath to check out circulation in his legs (he was having pain in them) it was discovered that he needed kidney stints. Well when he went back to have the stints put in a few days later, he was on the table and told the Dr that since he was already in there he might as well take a look at the heart, the Dr said that was not a normal procedure - but by this time Stan and Dr Schwartz were pretty in tune to each other and Dr asked Stan if he thougt he could handle it (they use the same entrance in the groin but they thread the scope to the heart instead of the kidney or legs) Stan said sure so they proceeded. By the way - the patient is conscience through out the cath, because they have to talk to you and ask you questions along the way - but let me tell you that they give pain medication and lots of valium so it's not a scary or hurtful procedure - so don't stress if you ever have to have one. Anyway they did the cath and that is when they found the anurysm on his aorta. It was huge and the Dr said he was a walking time bomb. He had the surgery and is fine today. So what I am saying here is......it really doesn't matter how you pay the bill or where they take the money from - if you have an aortic anurysm and the doctors tell you that surgery is needed - get a second opinion and then have the surgery. Our medical bills have been tremendous over the years - in fact I don't even open them anymore - I just have a basket (a big basket) that I toss them in. We are very fortunate that we do have insurance that we got to keep when the Post Office medically retired Stan '83. Unfortunately our co-pays can easily be $10,000 in some years. Bottom Line, Allen - don't mess around with this - it's a biggie. p

I know how thankful you and your family must be that your son is home!!! Thank him for all of us!!!!

Berta and Vike17 - I read your responses and I soooo appreciate the time you take to share your expertise and knowledge!!! I will get back to you on the answers as soon as I can take time to figure them out :P I told you I'm ADD and boy what a bummer when I have to sort this kind of stuff out - the good thing is that when it finally sinks in I actually do 'get it' B) just takes me a little longer than most My kids are going to be here in a few mins for the afternoon so I'll work on this tonight - one thing I can answer - the duplication on the syatic nerve was not a typo on my part - it may have been on the VA's part, but it was on the document - and was repeated in several other areas But pretty much the info that I did give was taken directly off of the official documents from the VA - wish I could just scan them and send it to you - I spent hours last night composing and retyping things for this request and then I go to cut and paste it to the message board and it gets all jumbled up - I thought it might even be hard for anyone to read it - Should I ask the 'geeks' how to transfer info? or is it something simple that I'm missing? Thanks!!!! Pam

I'll try to explain this – I feel like I need to tell you all that have responded that I have a pretty healthy case of good 'ole ADD. I really struggle reading, especially instructions – so keep that in mind when I don't seem to click right a way on something – I'm a visual learner….so if you guys wouldn't mind drawing a few pictures now and then, that would probably help a lot……. Just kidding J …but if they could be in color…….. In going thru the ROI packet that was printed on 10.10.06 – there are some discrepancies that I need help understanding – It shows Stan as having a 60% disability rating. It is broken down like this: "CONSULT REQUEST" (is the title on the top of the page) page 53 Provisional Diagnosis: PTSD CHRONIC SEVERE Eligibility: SERVICE CONNECT ED 50% to 100% VERIFIED Total S/C %: 60 FOREARM MUSCEL INJURY 30% S/C FACIAL SCARS 0% S/C DIABETES MELLITUS 10% S/C POST-TRAUMATIC STRESS DISORDER 10% S/C ARTERIOSCLEROSIS 0% S/C ARTERIOSCLEROSIS 0% S/C PARALYSIS OF SCIATIC NERVE 10% S/C PARALYSIS OF SCIATIC NERVE 10% S/C Then…………………….. On October 12, 2006 Stan received notice that his disability had been increased to 70% - and that breaks down like this: ….decision on your claim for service-connected compensation received on December 29, 2005…. ….Payment start date: Jan 1, 2006 for increased service-connected compensation evaluation; monthly entitlement amount $1,280.00 this includes an additional amount for your spouse, Pamela….. ….We determined that the following conditions were related to your military service, so service-connected has been granted… <H1 style="MARGIN: 0in 0in 0pt">Medical Description percent assigned effective date</H1>Bilateral hearing loss 0% May 19, 2006 Tinnitus 10% May 19, 2006 …..we determined that the following service-connected conditions have worsened, so we granted an increase in your assigned percentage:….. <H1 style="MARGIN: 0in 0in 0pt">Medical Description old % new% assigned effective date</H1>Diabetes mellitus, type 10% 20% Dec 20, 2005 II w/nuclear cataracts Residuals, shell fragment 30% 40% Dec 20, 2005 Wound, right arm Scar, fragment wound, right and left periorbital areas 0% assigned …….we denied entitlement to the 100% rate because it wasn't shown that you are unable to work as a result of your service-connect disabilities…… My question here is: What happened to the previous ratings on these: POST-TRAUMATIC STRESS DISORDER 10% S/C PARALYSIS OF SCIATIC NERVE 10% S/C PARALYSIS OF SCIATIC NERVE 10% S/C Another question is: I wonder where the heck that 10% rating on the PTSD came from in the first place? I'm still in the process of going thru papers so I may find that out – Stan is hoping to be rated 100% on PTSD (his VA doctors seem to think that is a distinct possibility, we'll see) – if that happens will he lose the ratings on everything else? Will they all be absorbed into one single diagnosis of PTSD? I have a problem with that! He was shot serving his country before he developed PTSD! To me everything should be absorbed into that rating. Maybe I'm being too emotional here and I probably haven't thought this thru enough, but most of the time my first instincts seem to be the right ones. ….BUT… then on the other hand – I do have to realize who we are dealing with here!!!! The VA and The Government…….. 'nough said. Thanks for any direction anyone can give me on this, Pam If you need any more background – I'd be happy to supply it – one thing about this board that is so cool, is, that everyone has their own dirty laundry, and we all have to hang it out to dry sometime – and this seems to be the best place to do that.