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    • Not sure what state your located in,  but I highly recommend piemonte law firm and also the ATTIG Law firm is excellent, Chris Attig is the main attorney I believe, and the first thing they do is request your complete cfile. 
    • VA will pay compensation for some disabilities that are proven to be directly due to ionizing radiation exposure.   Ionizing only Can you scan and post the Reasons and Bases part of the denial and the evidence list from it? It is always possible that you were exposed to ionizing radiation but VA considered it to be non ionizing,in order to deny the claim. Based on your post it does sound like ionizing radiation.(involved with the nuclear reactor). Perhaps VA did not have enough info to determine what type of radiation you were exposed to. This VA  link contains limited info on radiation claims: http://www.publichealth.va.gov/exposures/radiation/basics.asp We have more info here at hadit under Radiation than at the VA web site. Also there have been a few awards for Agent Orange exposure at Ft. Mc Clelland, also searchable here at hadit. Or you can search with google Radiation Berta hadit.com or Fort Mc Clelland AO Berta hadit.com and many of my posts as well as from others on these issues will pop up.I just suggest google with my name in it because I have had many posts on both of these issues here over the years and it is easy for me to use google to find them. Were you ever, while at Fort Mc Clelland, involved in any "Tiger Village" exercise? If so when? What disability(ies) are you attempting to gain service connection for? Cover your C file number,name, prior to scanning the denial.    
    • Its very hard to win a S.A. claim  if you don't have Medical Records about any type of Sleep Disturbance/OSA while in the military. it can be a secondary from another S.C. Disability ''Aggravated by''  but  a specialist sleep Dr would need to detail why it is aggravated by. A S.A. DX and using a C-PAP prescribe by the VA is not enough to win a S.A. Claim  Just saying ''It is more likely than not that the xanax that my patient takes contributes to the sleep apnea" would be sufficient.'' Is not enough! I agree with Lotz about the detail explanation of the med Xanax However its true the  VA raters are not Medical Dr's but they have been trained to  read medical evidence and have a medical manual for the claimed disability to  point out certain possibility's of the  causes /aggravated  by  ect,,,ect,,
    • Will get an attorney. Thanks for the advice. Anyone know of any good VA attorneys? 
    • Just my opinion, but I would suggest that your doctor also explain exactly how the Xanax that you take to treat PTSD causes YOUR sleep apnea, specifically.  What is it about that medication that leads to sleep apnea?  Add what clinical evidence exists to back him up, like in a journal or something like that, then have him attach his curriculum vital (aka resume).   VA raters who review these forms are not healthcare professionals and need things spelled out in plain English.





Detonator

Insomnia - Combined Rating

15 posts in this topic

I left the Army in 1995 with 20% lower back, 10% left knee meniscus, and 20% right knee PCL deficiency following surgery (50% total). Last year, I asked for an increase on my left knee, right knee and requested a secondary service connection for insomnia due to chronic pain.

Today, I received a letter stating that they denied any increase for my knees but did grant service connection for my insomnia (it dates back to 1998) and awarded 10%. However, the letter states the VA does a combined rating and will not increase past my 50%.

So what does the 10% service connection for my insomnia mean? I was hoping to get at least a 12 month back dated check for the 10% but it doesn't sound like I will get anything.

If someone could explain how this service connection for insomnia will help me....please let me know.

Also, the way they worded the decision, it makes it sound like I'm lucky they didn't decide to reduce my 50%. Amazing!

Any insight would be helpful!

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The letter states we do no add the individual percentages of each condition to determine your combined rating. Also under the insomnia decision, because apparently my doctor didn't put in there that insomnia effects my employment, it has some significance. Even though I only work one day a week (Part time job) and just recently began seeing a therapist for depression side effects.

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Also, if my insomnia condition continues to worsen....since it is service connected now....could I get that temporary total disability? Could my VA Sleep Doctor request that?

Sorry to keep adding questions...I'm just a bit frustrated with that letter. It didn't come at a good time! :rolleyes:

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Detonator, ratings are awarded in increments of 10% (10%, 20%, 30%, etc.). They are also combined with your other ratings, not parsed out and rated separately, or retroactively. What the VA appears to be stating is that even though they've added 10% for the insominia rating, when combined with your other ratings and compared to the Combined Ratings Table in 38 CFR Part 4, it wasn't enough to increase your ratings or payments. A higher rating might have done so, but again, everything is combined and measured through that Combined Ratings Table. There's a calculator on the home page of hadit. Plug in your ratings for your separate conditions and see what you get.

http://www.hadit.com/Service_Connected_Rating_Calculator

You can file a Notice of Disagreement, get the doctor to clarify his staement saying that you can't work, and while you're at it, file for TDIU (unemployability). Again, there's a lot of information mentioned on the home page here that should help direct you.

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I would try and work the insomnia and chronic pain into a depression claim. You can get a greater percentage rating for depression than insomnia alone. Are you seeing a psychiatrist about your chronic pain and insomnia. If you can't work file for TDIU. Just about eveyone who has chronic pain does suffer from some depression.

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Detonator, I received the same answer on 7-14-08. MY initial rating for DMI II was 40% and hypertinsion was defered on the initial rating pending an additional C&P exam. I was awarded 10% sc for the hypertinsion but my combined rating remained at 40% ( Quote from th rater. We do not add the indiviual percentages of each condition to determin your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions) The way I understand the rating calculator 50% plus 10% gives you a total rating of 55%. If it had been 55.5% it would have been rounded up to 60% total rating. In my case 40% plus 10% equals 46% rounded up to 50%. I am with you, I don't understand this and I am still looking for an explanation. I am sure someone on HADIT can handle that.

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