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  1. I have been on 100% TDIU for several years, and now I am coming up on age 65. I have a basic employee provided health insurance plan through Aetna from my Teachers Retirement System of Texas. This TRS-CARE1 program has informed me that after age 65, that they will become a "secondary payer". If I understand this correctly, what was once an 80/20 plan (TRS-CARE1) now becomes a 20/80 plan. I have a number of questions/concerns in how that works with VA 100% TDIU Disability. The VA has been billing Aetna (TRS-CARE1) for services I receive from the VA (contracted rate, 80%, etc). How does this change when I turn 65? I am receiving SS benefits at this time, so I assume that I will be auto-enrolled in Medicare A&B. Correct? Do/Will I need to up-grade my parts A&B? What about part "D"? I currently get all my meds from VA, wonder if having an outside option would be worth the cost? How much of a supplemental insurance plan do I NEED? Can I depend on the VA to continue to cover me at 100%? What if I have an auto accident and am taken to a non-VA hospital room? Do I get stuck with the out-of-pocket expenses? FWIW, hit deer on Harley a year ago, spent 32days in hospital and VA re-hab. Got lucky since I never lost consciousness and was able to direct EMS to take me to the VA designated/contracted hospital... THIS TIME. Bill was over $200k. Everything got covered between VA and Aetna... THIS TIME. Still ride Harley, so what will happen under "Medicare" in an out-of-network emergency in the future? (my biggest concern) I have attempted to talk with Aetna, but all I seem to get are sales-people who refuse/can't give any advise as to options. They only ask WHAT do I want... Not helpful to me at all. And when I watch the news that TrumpCare wants to 5X elder health rates, I get very depressed. BTW my major disability is TBI, so that may be factoring into my panic/depression about this as well. Not having fun... 8-(
  2. So, here's the thing. I got off active duty in 2012 after 6 years of AD. Since 2012, I was granted 40% for my dual knee replacement after getting injured in combat. Since I was only granted 40%, I had continuously submitted for PTSD disability as I'm treated for it and have been for 2 years now through a non VA psychiatrist. I've had numerous sessions within VA Mental Health regarding my mental state, issues, etc. Now, about 2 weeks (Nov 2016), I submitted another claim after being denied about 6 times since 2012. I gave as much detailed information as possible. My symptoms, issues, etc. This is the weird part. I've never seen such a quick turnaround. The claim is already in the "Preparation for Decision" phase, with an estimated completion of Feb 2017. Could anyone elaborate on why all of a sudden the process is much quicker? I haven't received any appointment to have an evaluation and I'm just stunned. Does this have anything to do with Trump making changes to the VA? Any input would be much appreciated. Thanks brothers!!
  3. Please, welcome new VET2VET podcast episode: https://youtu.be/waV5t0HPtbM Today we are joined by Thomas Wendel, DAV National area supervisor for West Cost Region. Thomas E. Wendel served in the U. S. Marine Corps from 1983 until 1997. Since 1999, Tom has worked assisting veterans in processing various entitlement claims on the local, state and federal levels; first in Clare County as a county service officer and then when he came to work for the Disabled American Veterans in 2000. In 2008 he was promoted to the position of supervisor of the DAV Service Office in Detroit and later he was promoted to the position of supervisor of the DAV National area for West Cost Region. DAV is America’s largest, most effective veterans service organizations dedicated to the needs of those injured, ill or wounded in service. We have more than 1,300 Chapters in communities nationwide to help make sure veterans from all generations and their families get the benefits and support they deserve. Today, nearly 1.3 million veterans belong to DAV, and we encourage you to add your voice to the cause. Our programs and free services help all veterans get the health, disability and financial benefits they earned. Take advantage of our benefits claims assistance, medical transportation and employment resources. Your local DAV Chapter is a great way to connect with fellow veterans in your area. ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/VETOVET2 ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/VETOVET2 ▶ youtube.com/c/VETOVET2 ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.
  4. To list the many many Tags would have been ludicrous. My case is relatively new. I joined here last year, this place has always been great to calm burned out nerves. I sometimes don't make sense to myself let alone anyone else. But when I got out, I went tearing away from anything and everything that even REMOTELY resembled authority. People being able to control my life terrified me to the point where it has literally affected every single part of my life. I came here seeking help and I got it. So, if my story can help anyone else, and my opinions on what you can do to help your own Battle, because that's what this REALLY is, then I will feel like I have done a small and meager effort to pay it forward. My C-File isn't stuffed to the gills with medical records because I didn't serve long enough to qualify for VA Medical. My Claims were handled fairly fast compared to the average. My Story is simple, I got kicked out of the US Army Infantry, after Basic, but I did not finish my A.I.T. We were OSUT. How and why is my business, and I have completely accepted that now. I wasn't even aware I had "issues" until about 9 years after I got out of there. And, a further 6 years before I swallowed my pride and went and finally asked for the help, that I had been convinced by every Veteran I knew, that I now have. I filed my initial claim for PTSD with Anger and Depression. 5 months later they denied me without a C&P, oh gosh gee wilikers was I disappointed. But, once again, fellow Veterans pointed me the way. I went to my Second VSO, and they filled for Depression, and I was scheduled for a VA C&P Exam. Why do I emphasize the VA part, well, I had learned from reading here at Hadit that C&P exams don't show up on your VA website thingy. Which, I thought to myself, that IS kind of important, you know, so no one can "lose" your record of that particular exam. I must admit that my best decisions I have made after getting my actual 50% Service Connected decision letter last year was to continuously educate myself. Not just about me, but the VA itself. IT IS IMPORTANT THAT YOU BRING YOUR COPYS OF YOUR PERTINENT INFORMATION WITH YOU. Sure that really friendly guy on the phone making your appointment is probably say it's not necessary to bring any documents, the Examiner will have ALL your evidence. Bullshit, don't ever leave your case DEPENDENT on ANYONE else' actions! Seriously, I took that advice from someone here, and it saved my ass. A actual Lt. Col. in the US Army Medical Hospital Diagnosed me with exactly what i was filing for. Match the Words, don't try to guess, don't try to infer. Take all your important verifying information with you. Don't leave out anything that you feel may hurt your case, if you think the VA is going to not use any excuse to take away what they give you, you are DEAD wrong. They will dig for it and hunt it down. Be honest, give them everything. But remember, you are literally not DEFENDING yourself to these Raters, you are pressing your case base on verified fact. They will work harder to rip your benefits away, than they are supposed to help you get them.Tell them something is wrong if you don't know exactly, and make them give you an examination, it is your right as a Veteran. I see too many Vets who are always asking others for help, guess what, it's up to US. DO YOUR HOMEWORK Seriously, you need to know more about your Disability's then the people who wrote the books and TREAT you for it. No one knows your Disability's like you. Because they are literally YOURS, not as a statistic or a Roster Number. Because remember, these are not minor discomforts or passing ailments. These damages are severe enough to make us DISABLED. You are LEGALLY entitled to the compensation for the damages done to you, maybe that's why the VA Denies us so consistently. No matter how many changes in Technology or public opinion, they have NEVER done it at a pace that allows most of us to barely maintain our composure and dignity. As far as the Law goes, if you have evidence, you're solid, it is not the RATER who is processing your claim wrong, it is YOU. Every "T" must be crossed, every "i" must be dotted. You have to make your case so solid,that it would literally be a breaking of the Law not to Service Connect you, or a fair Scheduler Rating, or TDIU. You have to SLAM THAT Claim DOWN ON THAT RO's desk, and CHALLENGE him to find flaw in every single interpretation of the Laws, Rules, Regulations....... Become your own greatest weapon, by realizing that you personally can't do that, you have to show it through your work, every page has to be meticulous, don't give them any reason to take the scalpel to your pages. I have a theory, based on how fast I was Denied the first Claim, how fast I was sent for a C&P for my second and winning Claim, and the fact that I was approved the DAY after my C&P exam. I personally feel, as if the moment a Rater can find a reason, and Literally the first reason, he denies and kicks out. Because I was denied without even a C&P exam. Then, when my second claim got sent up, they took one look at it, and knew they were caught out, so as soon as they got my results, they gave me 50% and expected me to be grateful for it. Never stop, always press on, continually advance, and when you can't advance, you bear down, shield up, and dig in. You are now in the Trenches of the VA, and we are literally all here because we are STILL Brothers and Sisters in Arms, against our own people. My OPINION of VSO's and LAWYERS A VSO, no matter where he works, is not gonna fight for you, oh they will file paperwork.....if you tell them what to file, you see, they just mostly don't have the balls for you, because they have balls for EVERYONE. A Lawyer, on the other hand, is motivated by Passion, and Profit. Think about it, if you were to Arm yourself with a Hypothetical Spear-like weapon, would you not want the one with the longest reach, sharpest point, and stopping power? A Lawyer, will fight, because he will look at your Claim, in whole, at ALL the FACTS, and take your case ONLY IF HE BELIEVES THE LAW IS ON YOUR SIDE AND HE CAN WIN IT! That alone, is a boost of confidence that will sustain your Hope, while unfortunately also being a two-edged sword. If he doesn't take your case, then do MORE HOMEWORK. If you can convince a VA registered Lawyer to take your case, you're fairly solid. ONCE AGAIN, MY OWN PERSONAL OPINION. Always Dig Deeper than the Surface Picture that the VA forces on you,If the Law is on your side, stand firm, and advance,Remember that you are right, and you need not defend against their No, but insist on your Yes. Good luck y'all
  5. Hello, This is my way of introducimg myself to the Hadit community as a whole. I only surf forums and give opinions and such to things that relate to me personally and my Battle with the VA I wanted to get not only all of these tags talked about, but i would hope to be able to at least get all of those abbrvs broken down for the people that come to this site in need I have noticed a lot of us old hats talk to each other in a comfortable, approachable, yet sometimes maybe even un-understandable to those who aren't in our War with the Rap-i um, mean Rating Officers Some of the people stopping by here for well deserved and needed help may not even be Vets, but their Spouses, their guardians, and most Unfittingly too often their Widows I hope to try to build a little list, where if someone came here, they would have, oh, lets say a nice rusty ass old anchor to grip on to, you know, to help them ride out this Hellacious Hurricane of a system we face Add any word, phrase, Article or Chaptet number of any Law, Rule, Regulation that you would like to help pass on, well, not only the cold logical definition, but tye way it helped you in YOUR Battle. i want this thread to be open and honest, but please, don't get lost and sidetracked trying to impress the community, if a discussion blooms from seeds planted here, take your conversation to the Mail system, and coax them to sproutlings on your own dime, and come back with your Harvest of Ideas. Only we have each other, as i have stood on my own for this last 2ish years, i have wanted something more Here, there be monsters, hide no truths, hedge no bets, the deaper we are able to cut on here, the finer and more powerful Claims we can make. Always remember, we should be advancing, and when i steped into Hadit, i started to feel something different on this Battlefield, ever so softly, in the muck, my arm tired from holding back the Tide of VA bullshit... I felt a small click on my shield, it was YOU! You and I, we began to share the load, gave us both second wind. And slowly, i realized what T-Bird has done, he has started a Cadence! my Shield-Brothers and ShieldSisters. Every one of you, whose words i read, eased my burden. The VA can only xxxx us as individuals. Remember, nearly a hundred years ago, when people REALLY figured out how democracy can work for the minority within the majority, Prohibition was passed, and that is because of Soldiers of Ideals. Our issue is, the VA makes us literally be the David to their Goliath. They demand that we beg for our scraps. Very few Vererans are in the position to demand their Just Compensation because first off, we are broken. Assailed by disabilitys they expect us to fight. Alone! They punish us horribly with Time, and indifference......they teach us to Hate the individuals in their system, Whistleblowers ignored except when it boosts Ratings yet never allowing us Veterans ourselves the ability or TOOLS to help OURSELVES. i dont want someone coddling me, i can repair my own engine given time and proper tools. No way in Hell am i gonna try to pull impacted lugnuts off with my teeth now am I? "that some small amount of moneys may be paid to the maimed, the crippled, his widow, his children...." -Abraham Lincoln (Maybe not exact words, but its from my xxxxxx up memory so go google for Knowledge)
  6. So here it is going on 4 years since I was honorably discharged from the military. Since I have been out, I seem to hit these depressing slumps of missing the military, wishing I could go back in (unable to go back in on account of a medical issue), having adjustment issues to not having the structure in my life as well as I am always "military minded" about how I deal with stress, people, other issues. I expect everyone have the same mentality from my family to my friends. I was treated once for anger issues while in the military, but this depression crap has me completely off the wall at times. I lose control when people make simple mistakes as well as ask me what I consider to be simply self explainable question. Am I even able to explain this to a VA Counselor or psychiatrist and have it service connected? Any input or advice is welcome positive or negative it is appreciated.
  7. Hello, This is my way of introducimg myself to the Hadit community as a whole. I only surf forums and give opinions and such to things that relate to me personally and my Battle with the VA I wanted to get not only all of these tags talked about, but i would hope to be able to at least get all of those abbrvs broken down for the people that come to this site in need I have noticed a lot of us old hats talk to each other in a comfortable, approachable, yet sometimes maybe even un-understandable to those who aren't in our War with the Rap-i um, mean Rating Officers Some of the people stopping by here for well deserved and needed help may not even be Vets, but their Spouses, their guardians, and most Unfittingly too often their Widows I hope to try to build a little Pist, wher if someone came here, they would have, oh, lets say a nice rusty ass old anchor to grip on to, you know, to help them ride out this Hellacious Hurricane of a system we face Add any word, phrase, Article or Chaptet number of any Law, Rule, Regulation that you would like to help pass on, well, not only the cold logical definition, but tye way it helped you in YOUR Battle. i want this thread to be open and honest, but please, don't get lost and sidetracked trying to impress the community, if a discussion blooms from seeds planted here, take your conversation to the Mail system, and coax them to sproutlings on your own dime, and come back with your Harvest of Ideas. Only we have each other, as i have stood on my own for this last 2ish years, i have wanted something more Here, there be monsters, hide no truths, hedge no bets, the deaper we are able to cut on here, the finer and more powerful Claims we can make. Always remember, we should be advancing, and when i steped into Hadit, i started to feel something different on this Battlefield, ever so softly, in the muck, my arm tired from holding back the Tide of VA bullshit... I felt a small click on my shield, it was YOU! You and I, we began to share the load, gave us both second wind. And slowly, i realized what T-Bird has done, he has started a Cadence! my Shield-Brothers and ShieldSisters. Every one of you, whose words i read, eased my burden. The VA can only xxxx us as individuals. Remember, nearly a hundred years ago, when people REALLY figured out how democracy can work for the minority within the majority, Prohibition was passed, and that is because of Soldiers of Ideals. Our issue is, the VA makes us literally be the David to their Goliath. They demand that we beg for our scraps. Very few Vererans are in the position to demand their Just Compensation because first off, we are broken. Assailed by disabilitys they expect us to fight. Alone! They punish us horribly with Time, and indifference......they teach us to Hate the individuals in their system, Whistleblowers ignored except when it boosts Ratings yet never allowing us Veterans ourselves the ability or TOOLS to help OURSELVES. i dont want someone coddling me, i can repair my own engine given time and proper tools. No way in Hell am i gonna try to pull impacted lugnuts off with my teeth now am I? "that some small amount of moneys may be paid to the maimed, the crippled, his widow, his children...." -Abraham Lincoln (Maybe not exact words, but its from my xxxxxx up memory so go google for Knowledge)
  8. Hello all, First, thank you all for your service! My claim was approved on some contentions and one deferred and two considered not service connected. I was increased from 60 to 70% while the other deferment is in development. My question deals with my award letter stating my increase from 60 to 70% is dated to Nov 1, 2015 and I received the letter today July 18, 2016. Will I receive a back payment for the difference of 60 to 70%(even though SOME of my claim is still in deferment) and if so when can I expect the retro to hit my account? Thank you for any information
  9. My husband( a Marine combat vet - infantry) received a call today that the VA is scheduling him an Independent Medical Exam. He is currently rated at 40% (Dec 2013) for back, knees, hip - service connected. When he only won 40% we appealed the decision and hired a lawyer. The lawyer immediately sent us to a specialist for my husband's specific disabilities which also cost us a small fortune, for an Independent medical exam. We found out after a battery of tests that my husband's condition was much worse than the VA's lousy exam expressed(big surprise there huh?). Our lawyer wrote up his case including this well documented evidence from our Independent Medical exam and documentation showing my husband's in service medical reports. First we had a de novo review with the help of our congressman where they didn't even read any of the paperwork because they didn't even put the right hip or knee on the report and basically said your exam doesn't mean squat and ours which didn't even include a specialist or the correct testing means more. So we are now waiting for a DRO review since November 2015. Questions: 1. Why do they want one of their hired "independent" companies to do yet another exam on my husband? It is to try and weasel out of giving him the disability he deserves? 2. Now I am so worried by the VA's actions that I'm concerned they will try and take his 40% away from him as well and this appointment for the Independent medical exam will do that. Is that a possibility? 3. Does the fact they are setting up an appointment for this Independent Medical exam mean we are getting close to his DRO hearing? The VA worries me to no end. I would appreciate any info or experience y'all have.
  10. I am trying to figure out some information. Is it possible to have Special Monthly Compensation WITHOUT Disability pay? I was under the impression that you got both or you just got disability pay, but never SMC by itself.
  11. I am currently rated at 50% for PTSD and just had my C&P exam for an increase. Below is my current C&P results. Any input would be appreciated on to what my outcome may be. Thank you SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran now have or has he/she ever been diagnosed with PTSD? [X] Yes[ ] No 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD, moderate to severe, chronic Comments, if any: The trauamtic event was learning that a close friend of his killed two older female civilians. PTSD also causes secondary panic attacks 2-3 times per week. b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes[X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes[ ] No[X] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with reduced reliability and productivity b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes[ ] No[X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes[ ] No[X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes[ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes[X] No If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [X] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: b. Was pertinent information from collateral sources reviewed? [X] Yes[ ] No If yes, describe: On 11/25/2014, Dr. XXX conducted a C&P Initial Evaluation for PTSD and diagnosed the veteran with PTSD with panic attacks. 2. Recent History (since prior exam) ------------------------------------ a. Relevant Social/Marital/Family history: Mr. XX is currently married to his wife of 10 years. He describes the quality of his current marriage as, "loving - but my wife puts up with me." He reports his irritability and anger can stress his wife. He adopted his wife's 14 year old daughter. He reports he has no friends of his own, but he reports he is friendly with many of his wife's friends. He tends to avoid crowds and group social activities. He is quite close with his parents. His main hobby is drumming and working on computers. Overall his social support is limited. He reports that the primary effect of his psychiatric symptoms on his social relationships are tension and distance caused by irritability, rage (including yelling, swearing, and very occasional violence towards inanimate objects - like punching a hole in the door), withdrawal, and emotional numbing. b. Relevant Occupational and Educational history: Mr. XXX highest level of education is some college. He served in the Airforce. He is currently employed as a cyber security analyst at XXX a telecommunications company called XXX. He has worked at XXX since 2011. In 2012, he was written up for "going off on a customer." He reports he works from home or calls in sick 4-5 days a month due to feeling stressed. He reports during times of stress he impulsively loses his temper when talking with customers or makes careless mistakes. He is a lead, and he has five other analysists who report to him. c. Relevant Mental Health history, to include prescribed medications and family mental health: Mr. XXX denied history of psychiatric hospitalization, receiving out-patient therapy, receiving any type of psychopharmacological treatment, or prior suicide attempts. He has been referred to a psychiatrist by his PCP but he is not currently engaged in therapy. He receives medication management from his private PCP, and he is currently maintained on a regimen of Zoloft, hydroxyzine, prazosin and diazepam. d. Relevant Legal and Behavioral history: No arrests. Received an article 15 in the military after he learned of the murders. e. Relevant Substance abuse history: No response provided. f. Other, if any: No response provided. 3. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors.) Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #6 - "Other symptoms". Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Witnessing, in person, the traumatic event(s) as they occurred to others [X] Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic events(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related. Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. [X] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] The duration of the symptoms described above in Criteria B, C, and D are more than 1 month. Criterion G: [X] The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. 4. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Anxiety [X] Panic attacks more than once a week [X] Chronic sleep impairment [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships 5. Behavioral Observations: --------------------------- Mr. XXX was casually dressed, and was cooperative throughout the examination. His speech was fluent. His psychomotor behavior was appropriate. His affect was constricted and his mood was anxious. His insight was intact. Thought process was linear, goal directed, and future oriented. No reported hallucinations or delusions. No reported homicidal or suicidal ideation. 6. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes[X] No 7. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes[ ] No 8. Remarks, (including any testing results) if any: --------------------------------------------------- Veteran's PTSD and panic attacks currently cause moderate socio-occupational impairment.
  12. Please, welcome new VET2VET podcast episode: https://youtu.be/9paX1-FyCaI Today we’re talking about SERVICE CONNECTION. When we talk about service-connecting a medical condition, disease, injury or illness to military service, we are talking about proving the relationship between the two. 1) Direct Service Connection 2) Service Connection by Aggravation 3) Presumptive Service Connection 4) Secondary Service Connection 5) Service Connection due to Injury Caused by Treatment in the VA Healthcare System 6) Special Service Connection Rules for Post-Traumatic Stress Disorder ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/VETOVET2 ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/VETOVET2 ▶ youtube.com/c/VETOVET2 ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.
  13. Please, welcome new VET2VET podcast episode: https://youtu.be/sTH3p-WwXn0 The way VA defines The word "permanent" slightly differently. For that matter, the word total doesn't mean total when discussing a disability. These are just terms to VA. There really isn't a protected rating. Any rating can be modified by VA at any time, depending on the circumstances. How do you know if your benefit is P & T? What is IU? What is substantially gainful employment? Are there any other eligibility requirements? How is the way VA decides total disability different from other agencies? TDIU awards may be permanent or they may be temporary. If I get a 100% rating, should I continue fighting the VA for benefits? SMC compensation Can you think of any other scenarios were a Veteran might want to keep filing to VA after they reach a 100% rating? ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/veterantoveteran/ ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/veterantovetera/lists/vet2vet ▶ youtube.com/channel/UCebXFpogeJ9r4EqRyxHriYQ ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.
  14. Hello all! I'm in the process of a claim for blood disorders. I'm actually in PFN stage as of yesterday so I've been a little bit nervous! The rating criteria state that if my levels are between 30-70, the rating will be 70% and if levels are between 70-100, the rating will be 30%. Over the past 2 years, my levels fell anywhere between 30-100, and over the past 6 months, my levels were under 70. My question is, will the VA take past levels into consideration or will my rating be based off of what my levels were at the time I had blood tests during my C&P exam?
  15. Hello! Excuse me if I posted this in the weong section but I have hit a hicup in my claim process. Yesterday my claim changed status to preperation for notification. Then today it changed again. It went to Review of Evidence but in the notes it says the notification letter was sent. Also under disabilities it now says I have a rated 90 percent. So my question is, do I just need to wait for it to update? Is it possible this is some famous ebenny glitch? Also my estimated completetion date changed from 3/29 to 6/06-10/20. Did it actually go back to review of evidence even though it says notification sent AND it now shows I have a rating on my profile? Any advice is appreciated! Thank you!
  16. I got a letter a week ago that the VA wants to reduce the rating I currently have for Degenerative Arthritis of the Spine from 20% to 10%. I have had the 20% rating for over 5 years. The disability is the result of an injury that occurred when I was in the military and is well documented. I have prepared a statement contesting the reduction, but I'd like someone to read through it to see if I could be messing anything up. This is my first post here, so I'm not sure if this is a valid request for these forums. Here is the statement I have so far. Any advice or information is appreciated. -------------------------------------------------------------------------------- This statement is in response to the proposed reduction of my disability rating for thoracic spine degenerative joint disease with kyphoscoliosis from 20% to 10%. As stated in §4.71a—Schedule of Ratings–Musculoskeletal System, The Spine, “muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis” are to be rated at 20%. The presence of kyphoscoliosis, caused by the muscle spasms and guarding which resulted from my injury, should continue to be rated at 20%, as indicated in the aforementioned Schedule of Ratings. Additionally, my current rating of 20% for thoracic spine degenerative joint disease with kyphoscoliosis has been in effect for over five years and is thus afforded ‘Protection of 5-year stabilized ratings’ as stated in 38 CFR Part 5, § 5.171. Under this protection, the rating cannot be reduced without showing Material improvement. For the following reasons, Material Improvement, as detailed in 38 CFR Part 5, § 5.171 (c), has not been shown: During the VA Examination, dated January 20, 2016, the VA examiner did not use any medical instrument to measure the combined range of motion of the thoracolumbar spine or the forward flexion of the thoracolumbar spine. Therefore, there is no evidence that the measurements taken during the VA Examination, dated November 28, 2014, represent a sustainable material improvement. I have discussed my incapacitating exacerbations with muscle spasms with my VA primary care doctor during every checkup and continue to receive medication to treat these episodes. There has been no sustained improvement in either the frequency or the severity of these incapacitating exacerbations and, due to recent restrictions on medications I can take (explained below), there has been an increase in the daily pain, inflammation, and muscle spasms that I experience. Between once and twice a month, an incapacitating exacerbation is triggered by events as common place as moving laundry from the washer into the dryer, putting a trash bag into the alley dumpster or picking up one of my kids, indicating that no improvement has been maintained under the ordinary conditions of life. I have daily pain, inflammation, and muscle spasms that are a direct result of the disability discussed here. I also experience incapacitating episodes which occur an average of once to twice a month. During these episodes, my movement, strength, and mobility is severely limited for at least a full day. These episodes can be triggered by events as common place as moving laundry from the washer into the dryer, putting a trash bag into the alley dumpster, or picking up one of my kids. In the past, to manage the daily aspects of my disability, my VA primary care doctor prescribed Etodolac, a nonsteroidal anti-inflammatory drug (NSAID), to minimize the inflammation and reduce muscle spasms. Within the last few years, I was diagnosed with Kidney disease and told by my VA Nephrologist that I am no longer able to take any NSAIDs. Since I have stopped taking Etodolac, my daily pain has increased making everyday tasks more difficult and increasing the number of debilitating episodes I experience. I have also been prescribed Cyclobenzaprine, a muscle relaxant, to manage the daily aspects of my disability as well as the debilitating episodes. When taking Cyclobenzaprine I always experience drowsiness and trouble concentrating, which are documented side effects to the medication. Because of these side effects, I am not able to take Cyclobenzaprine on a regular basis to manage the daily pain, inflammation, and muscle spasms. If, after the review of the information provided above, the reviewers still hold to the decision to reduce my current rating for thoracic spine degenerative joint disease with kyphoscoliosis from 20% to 10%, then I request a personal hearing.
  17. I filed for disability benefits in Jan/13. Went for c&p exam Dec/14. Was awarded benefits at 40% in Feb./15 with back pay only dating back to Jan/13. I have fellow vets and battle buddies telling me I can file for back pay for the same injuries incurred in 03 in Iraq. Is this true? The reason for the gap between separation and filing is simply because I did not know I could file for VA disability benefits until a school VA rep told me so in 2012. I just want to know if compensation is still owed me and how do I go about obtaining it. The DAV in Indiana helped me file the first time.
  18. Hello, I am a veteran, however, this post is in regards to my spouse, who is a retired veteran. He had been awarded 90% a couple of years ago. He made an attempt to have an increase for anxiety (was 30%) and another previously rated condition (20% I believe) re-evaluated. More than likely they would have been increased as I know that the anxiety had gotten worse with several panic attacks a day. There was a letter dated mid-2015 that stated he had missed his appointments for re-evaluation and so his ratings were reduced to 0% for both service related conditions. We are currently separated, so I was unaware of the disability compensation reduction until I found the VA letters when going through his things after his hospitalization. He was admitted to ICU for almost a week, remained in the hospital for 3 weeks, and was put in a skilled nursing facility about 5 days ago. He is still very sick. While in the hospital (regular), it was discovered that he had Hepatitis A and Cirrosis of the liver. We were told that he needs a liver transplant. I went online and conducted a chat with VA to find out how I could get the process restarted on the claims that had been reduced, but was told that I needed to have VA Form 21-0845 (Authorization to Disclose Personal Information to a Third Party) in order to do anything on his behalf. I currently have the form signed. Upon further reading, I discovered that it needed to be sent with a claim and it was recommended not to handle this through the online system because it could take a significant period of time. He currently works for the DOD as a federal worker and they are unwilling to grant any type of advanced leave. I am also thinking of seeing if I can get him moved to a VA hospital because the nursing facility are not providing the care (daily labs, close monitoring, IVs) that he requires. Any assistance that anyone can offer would be greatly appreciated.Thanking you in advance.
  19. In 1972, while serving in USN, I landed on my head from a motorcycle accident and woke up in the Naval Hospital. LOC ~45min but at time diagnosed as "mild concussion", held 24hr, dismissed after being told I would be fine and sent back to ship to be deployed to Vietnam. Flash forward ~40yr. When my perpetual depression eventually went off the deep end I asked the VA for help. Started taking meds and asking questions about my life. Finally got directed to Poly-Trauma for full neuro-pysh and MRI. FWIW, I was wondering why I always had trouble remaining employed longer than ~2yr at-a-time over the past ~40yr. I earned three degrees including a PhD, plus three other professional certs, but just could NOT keep a job. MRI results showed past indications of "stroke" (ischemic insults in white matter where parts of brain died), but being UNRATED for TBI, the current doctors atributed this to current diabetes and age. At this point I filed for disability and 14 months later got my 50% rating for TBI. THAT is when I finaly realized my TBI was real AND just how bad I am disabled by it. The detailed list of symptoms/manifestations that the VA examiner provided read like a laundry list of my life's challenges, that until then I had never put together in conscious thought. I have my intelligence but what I lack are the higher level executive functions that would let me put my education to use. In other words, I can't play well with others at work or at home. I could p***-off the Pope given enough time together. I have no friends at this point, but do have ONE person I taught school with (a retired LTC) that seems to understand and gives me advice from across the country. My military performance records are bad, real bad... as in I do not understand why I wasn't kicked out, jailed, etc. They show manifestations of deprived sleep, anxiety, irratibility, lack of motivation, etc. My post-military civilian employment performance records show the SAME manifestations over a roughly ~27yr of the 40yr since TBI. I only kept THOSE records because I thought "they" were picking on me. But they are detailed records, and they seem to show that "they" were correct, and NOT me. This took me months to come to terms with, and only by viewing these things using a 3rd person analysis. Personally, I get too upset reading/thinking about them. My Depression Rating was denied, though the VA final rulling about depression being "secondary service connected" came through within a week of my TBI rating, so THAT will be reassessed in the appeal. I recieved a C-PAP for my sleep apnea, that was just diagnosed in 2013. I have a 1973 diagnosis for vaso-motor rhinitus, that also states/records such things a "trouble sleeping, mouth breathing, snoring, 30lb weight gain(BMI-31 = obese), anxiety, BP of 140/100/90, non-reactivity to know allergens, etc. Sleep apnea denied due to lack of nexus. BOTTOM LINE is that the military FAILED to do adequate testing in 1972-73 on my TBI, depression, sleep disordered breathing, etc. What is NOW considered as standard protocol following a TBI, was not even known in 1972-73. Shoot the C-PAP machine wasn't even invented until 1985, so the military would not even know what to look for. QUESTION: Isn't THIS where the VA's "benefit of the doubt" rule should kick in? After all they finally rated my TBI (lower rating than I have records to show degree of disability) going retro-active ~41yr. (i.e. Schrödinger's cat) CURRENT STATUS: My TBI/Depression appeal has been filed. My Sleep Apnea appeal is being developed AND THIS IS WHERE I COULD USE SOME HELP. I am focusing on the military's failure test me for sleep disorders when it was/is obvious that I had manifestations of sleep disordered behavior in my elisted performance records as well as in my vaso-motor rhinitus diagnosis in 1973. Any help/advice would be appreciated.
  20. I had a question and was wondering if any of you, who are more experienced with the VA claim process, can give some insight on my situation. I am rated at 90%; 1 year out from discharge I was having issues that corresponded with sleep apnea, I told my VA doctor and she ordered me a sleep study, lo and behold - I was diagnosed with OSA and was given a CPAP machine. I submitted a claim for sleep apnea and was denied a percentage because it was not SC'ed. I was a little perturbed because I knew I had MANY documented sleep issues while active duty, but the VA still did not SC me. I went through my SMR with my VSO and we highlighted everything that was related to sleep issues/disturbances, we reopened the claim with submission of new evidence plus really good lay evidence (buddy statements from my actual platoon DOC who admitted that I complained about sleep issues while deployed in Afghanistan, only to deny me special attention and gave me Benadryl as a solution to my problems) - and a few other buddy statements from my former superiors who also denied me medical attention. My original date of estimated completion after reopening the claim was December 2016, but after waiting a month then checking Ebennies's; they moved the date to 9/13-9/20 with a preparation for notification. My question is this: On my ebennies list of disabilities, it's still showing as "sleep apnea not service connected", would this remain this way until I receive the big brown envelope? I just get concerned that I am still not SC'ed because of that. Obviously, that could still be the end result, but I just want to know if the update wouldn't happen until the letter is received by me. Any guidance or help would be greatly appreciated!
  21. 50%

    I checked my claim status on Ebenefits this morning. i had my my C&P yesterday, case is closed, Ebenefits shows me at 50% for persistent depressive disorder (claimed as adjustment disorder with depressed mood). i feel its a start. just wanted to say thanks to all of those who answered my original post. and that i am still going to fight the good fight, but now i can do it within the system. Thanks
  22. I need help filing an appeal. I am on 100% health coverage and had VA pre-approved brain surgery which I recovered from quickly. VA then refused to fill my post op scripts resulting in a stroke 2 weeks later. I have a statement from my neurosurgeon (referred to by VA) that states this was the cause. The VA commission (federal) flatly told me that I cannot appeal when my letter says I can. Advocates have been worthless and even my Congressman is frustrated. How can I find someone to help me sort things out and get things done? Since my stroke I am very limited on what I can do. It is also concern that being knocked out in basic training, then later going to sick duty, being returned to duty with no care, and then ordered back to sick bay by my CO when my ear was draining blood and requiring hospitalization that this was beginning of my aneurysm. My stroke and my 30 day stay is NOT covered by VA and they state that it was not approved by the VA yet my neurosurgeon says I did the right thing by calling 911.........been fighting since my hospital discharge on 21 Dec 14
  23. Hello, I am new to this site and am happy to see that there are a lot of folks on here who know the ins and outs of filing claims with the VA. Hopefully someone will be able to offer me advice on how I should proceed. I did not know until recently the issues I've been dealing with were covered by the VA, otherwise I would've started this years ago. I'll try to provide adequate detail. Background: Navy; Honorable discharge in 2003; Persian Gulf; did just about every job imaginable on the boat. Claims and questions: Scarring/pain: service medical record contains detailed record of surgery for removal of Basal Cell skin cancer on my face, including drawing, measurement and procedure details. The nexus seems very clear. Question: How does the VA actually measure scars, and what rating should apply? My t-shaped scar runs from the inside of my right eye down the side of my nose (about 2 inches), and across under my eye (about 1 inch). My right nostril is now asymmetrical as a result of the skin pulling and settling after the surgery, and there is a small scar "pocket" on the side of my nostril. Also, the skin changes color with hot/cold, becomes irritated by sweat, tingles/throbs and is prone to sores and infections. Functional Gastrointestinal Disorder: Nexus: Record contains one instance of gastroenteritis (vomiting/diarrhea), along with "sea sickness". I have civilian medical records for multiple gastro events after leaving service, including hospitalization and surgery (the doc mistakenly diagnosed appendicitis) for gastro and non-specific gastro problems. Not in my records is that I constantly have gastro issues including dyspepsia, frequent vomiting, and bouts of constipation and diarrhea. Also, I am by definition a Gulf War vet, and I understand that this condition falls under "Special Gulf War Rules" as a "Qualifying Chronic Disability". Question: Is this adequate for nexus, or do I need an IMO? How do "Special Gulf War Rules" come into play vs. a standard claim for gastro issues? And, what rating does this condition entail? Tinnitus/hearing loss: my service record contains evidence that I was qualified in multiple weapons, and was a sonar tech. The sonar I worked on was I believe one of the loudest man-made noises on earth, and I had my bell rung more than few times when that thing went active. Question: There is no mention of tinnitus in my medical records, but is there enough evidence to establish nexus? My ears ring 24/7 and it drives me nuts to be in silence. Question: Will the VA most likely require me to take more tests? What if I'm in good shape the day of the tests? Do they understand the "flare up" nature of certain illnesses? I've obtained copies of all of my military and civilian medical records (and made more copies), and plan to meet with a VSO before submitting. I hope I have enough documentation and evidence to satisfy what the VA is looking for. I have a few other claims as well, but didn't want to post too much. I greatly appreciate any feedback on the items above, as well as any other advice that can help make my claims as painless as possible. Thank you all for your service.
  24. Long story short...In May 2013 I had a cervical compensation pending but at my C/P exam in July 2013 I signed off to dismiss the claim due to the fact that I have had normal pap's for years.... History: 1990 I had cervical cancer while on AD - had surgery and since then I have been okay... Today: I had an ultrasound last month due to pain in my tummy...Conclusion - I have cyst on ovaries and they need to be removed. I go in for surgery consult on Wednesday. Is this something I should look into getting S/C? Did I lose the opportunity by denying my claim in 2013? Should I even worry about submitting a claim? Please help! Thanks, Steph