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    • http://www.va.gov/vetapp16/Files3/1619696.txt ^^^^ That is my decision letter from the bva judge. On ebenefits it is rated 10% for brugada syndrome WITH AICD IMPLANT now they didnt rate it correctly i filed a notice of disagreement an idk if she sent it to the DRO or to the other option... how long do I have to wait for them to fix their mistake another 4-5 years!?
    • Hello everyone,
      It is VA clothing allowance time again. For those who do not know, some new rules were introduced last year.   http://www.benefits.va.gov/COMPENSATION/claims-special-clothing_allowance.asp Additional information about how to deliver clothing allowance claims may be found here: http://www.prosthetics.va.gov/psas/Clothing_Allowance.asp The PSAS handbooks can be found here: http://www.prosthetics.va.gov/psas/PSAS_Handbooks.asp The current version of the Clothing Allowance handbook (dated May 14, 2015) found here: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=3112   More restrictive claims This link was posted on Hadit recently, but here it is again with more details

        It is important to note that the first part of 6b appears to almost contradict itself. First, they state the treating physician "will re-evaluate", but then they turn around and state that an "annual re-evaluation...is recommended". If the VA denies your request because you did not have an annual re-eval for it, then it might be worth reminding them that the re-eval is recommended, but not required, per the handbook. It is also important to be aware of the "Note:" portion. If the VA asks you to bring in actual damaged clothing, then they are breaking their own rules. They state that "For unusual circumstances...submission of pictures is considered sufficient evidence". I guess this makes sense that it could generate a health hazard if a veteran hauls their damaged dirty laundry and dumps it out at the VAMC's prosthetics desk.     A while back, I found a topic here on Hadit where elcamino_77us posted a PDF VA letter stating off the shelf braces no longer qualify for CA because the manufacturers stated "they do not damage clothing". Others on that topic stated they had to bring in damaged clothing to prove it to the VA. Per the rules (6 b), this should NOT be required. The "do not tend to tear and wear clothing" part is important. From talking with the people at my VAMC prosthetics desk, all of the braces they issued have fabric covering the metal and plastic parts and clothing allowance would not be paid for them. Despite what the VA thinks they know about the braces they give us, I can indeed confirm that my wrist and lumbar braces damaged my clothing due to friction and velcro.
    • Also, before 2003 or 2004 all Mental Health was actually considered Behavioral Health. If you write to you NPRC(mine is St Louis), and you ask for medical records they may not show up, try for Behavioral Health Records.  Good Luck
    • One question--- ( I do not doubt you have PTSD , I just want your claim to be as solid as Buck's was) You stated:  " I admitted to behavioral health hospital and the VA inpatient PTSD program." If you mean the 21 day Inhouse program specifically for PTSD, did someone there apply for Temporary 100% comp for you? Did the VA diagnose you with PTSD in those inhouse records? As I recall my husband's PTSD inhouse records were not with his regular VA medical records. Neither were a battery of Psychologial tests he got when his VA psychologist was changed to a VA Psychiatrist. Someone at the Hospital (this was Buffalo VAMC) filed Temp Comp claims for all of the vets in the same inhouse  program with him.They all had PTSD diagnosis already but one didnt and my husband had 30% PTSD SC at that time. It took a few weeks or more  but they awarded all but one vet  the 100% Temp Comp, less any estabished SC for the 21 day stint. My point is that VA might have diagnosed your PTSD during these hospital stays.Did you get any one month  temp comp check for the PTSD program?
    • To add...I see you had 7 deployments but I did not see any specific nexus statement to your stressor in the DBQ. Maybe I missed it but VA will not accept this diagnosis anyhow. The stressor (s) must be as specific as possible, consistent with your MOS, and with a date as close to you can get so that if JSRRC has to attempt to verify the stressor they will be able to narrow it down. If a veteran does not fall into the 2010 criteria ,then VA will attempt to verify their stressor via Joint Services Records research Center (JSRRC) We have considerable info here on stressors and how to prove them. And what Buddy statements need to cover. Many vets have multiple stressors.You only need one verification of a stressor so best to give the one most easily verified. edited to add... the stressor boxes were checked off on the DBQ but nothing was specifically identified as a stressor from what I could see.You will need to expand on the stressor for the claim.  

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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.


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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