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How to Get your VA C-File


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    • VA CUE Request
      I submitted new claims back in March 2016 and received partial decision for 30% increase for post traumatic vertigo as secondary to my 40% TBI. I was waiting on my ear and tinnitus claim to be completed and as those two claims closed out I received a notice to retract my previous partial rating of 30% increase for post traumatic vertigo. I'm little lost of what I should do and seeking advice from you all. Whether the evaluation assigned for post traumatic vertigo was clearly and unmistakably erroneous. Clear and unmistakable errors are errors that are debatable, so that it can be said that reasonable minds could only conclude that the previous decision was fatally flawed at the time it was made. a determination that there was a clear and unmistakable error must be based on the record and the law that existed at the time of the prior decision. once a determination is made that there was  a clear and unmistakable error in a prior decision that would change the outcome, then  that decision must be revised to conform to what the decision should have been. In this case, the disability evaluation is reduced because the previous decision was a clear and unmistakable error. The rating decision of April, 2016, contains clear and unmistakable error in the establishment of a separate 30 percent evaluation for post-traumatic vertigo. The decision in question established a separate evaluation using a symptom of traumatic brain injury (TBI) already evaluated under the faucets of TBI evaluation, as vertigo is a subjective symptom that is already considered in the faucet of the TBI criteria. The evaluation of the same disability under various diagnoses is impermissible under the laws governing service-connected compensation benefits (38 CFR 4.14). Evaluations concerning residuals of TBI require that a VA decision-maker evaluated each condition separately, as long as the same signs and symptoms are not used to support more than once evaluation, and combine the evaluations for each separately rated condition. remaining residuals that cannot be attributed to distinct diagnosed conditions as result of TBI are considered under the aforementioned facets and single evaluation is assigned (38 CFR 4.124a). As the etiology of your vertigo was noted to be symptomatic residual symptom of traumatic brain injury rather than an etiologically distinct diagnosis, there is no basis upon which to establish a separate disability evaluation for this condition. As such, the current evaluation is proposed to be discontinued effective Mary 2016, the date it was erroneously established; upon final discontinuance, this condition will be evaluated as a symptom of TIB and combined accordingly. Your overall evaluation is proposed to reduced from 80 percent to 70 percent as a result of this discontinuance. Please note, as this reduction is the result of VA error, no overpayment will be created as a result of discontinuance.  
    • Appeal Complete
      Thank you for the reply!  My retro pay amount is definitely going to be more than $25,000.  We figured it up, and it is going to be a little more than $30,000.
    • Appeal Complete
      Progression to the money should happen very quickly.  However, if your retro pay amount is greater than $25,000 you may have to wait a couple of weeks for additional funds approval signatures.
    • Medicare, yes or no? Not sure where to post this.
      I agree 100%, the guy I talked to last time said there is no penalty, I then again explained how I had opted in, then opted out and only had VA for healthcare, he had to go and ask someone.  Thanks for the info, I might just hold off and wait but will definitely confirm.
    • Appeal Complete
      On my Ebenefits account, it shows that my appeal was completed on 5/16/2016.  Just a few days ago, I received a letter from my representative (DAV) that reads: "Service connection for post traumatic stress disorder claimed as anxiety and insomnia is granted with an evaluation of 50 percent effective March 9, 2013.  Initially, I was denied because of a missed appointment, so I filed an NOD and was just scheduled for my C&P exam a few weeks ago.  Within what seemed like no time, I saw that my appeal was complete and I received the letter from the DAV stating that I was granted PTSD and increased from 40 to 70 percent (I am at 40 for IBS and Tinnitus).  My question is, does anyone know how long it will take me to receive the official decision letter from the VA?  I know it has only been a couple weeks since my appeal was completed, but you guys know how it is as far as waiting to get the official decision and the money.  Any info would be much appreciated.  Thank you so much!
    • Appeal Complete
      On my Ebenefits account, it shows that my appeal was completed on 5/16/2016.  Just a few days ago, I received a letter from my representative (DAV) that reads: "Service connection for post traumatic stress disorder claimed as anxiety and insomnia is granted with an evaluation of 50 percent effective March 9, 2013.  Initially, I was denied because of a missed appointment, so I filed an NOD and was just scheduled for my C&P exam a few weeks ago.  Within what seemed like no time, I saw that my appeal was complete and I received the letter from the DAV stating that I was granted PTSD and increased from 40 to 70 percent (I am at 40 for IBS and Tinnitus).  My question is, does anyone know how long it will take me to receive the official decision letter from the VA?  I know it has only been a couple weeks since my appeal was completed, but you guys know how it is as far as waiting to get the official decision and the money.  Any info would be much appreciated.  Thank you so much!
    • Medicare, yes or no? Not sure where to post this.
      Seminoles.  No.  There should be no penalty if you sign up EITHER:  1.  When you get disabled  OR 2.  At your age 65.   This is the way I understand it.  You get a second chance without penalty when you turn 65.  Check with Social Security website to make sure.   However, I learned something.  Dont trust the social security rep on the phone to "always" tell you the truth, just like you can not trust VA employees to tell you the truth.  Once Bill Clinton got caught lying, it seems like the whole government then thought it was okay for everyone else, too.  
    • IME and Physician conflict of interest
      Thanks for both of your replies broncovet and ArNG11. I do still intend to get the IME/IMO just don't want to start jumping from one thing to the next or wait to long; done both in the past and gotten bit in the backside (for both). Weird, I am  I.T. by trade tell people to be patient give it a chance.  What do I do, I start chomping at the bit. If he doesn't respond by the end of the week I will send another email to follow up and see if he responses to that.  If not, then I guess I start looking again....  (ARGH!!!!)
    • Is it possible to back date disability pay to time of injury?
      I wish the VA had paid me to the date of my claims, sometimes they don't even do that :(  I have never heard of being retro paid to the date of injury, date of claim yes but I am curious how that was awarded as well.

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Teac

Rating Coexisting Respiratory Conditions Any Ideas?

1 post in this topic

I was diagnosed with sleep apnea... I am already 100% due to asthma and COPD. My doctor indicated in writing that it is more likely than not that the Sleep apnea is secondary to my asthma/Copd because I have Chronic respiratory failure with carbon dioxide retention and need to use a CPAC machine. This is ratable at 100%.

Now If I understand the rating schedule, I cannot be awarded one rating for sleep apnea and another seperate rating for Asthma/Copd. In other words I only get one rating for all three medical problems. Am I correct. Also if I am correct will the va consider any extra schedular rating due to the severity of my lung problems?

4.96 Special provisions regarding evaluation of respiratory conditions:

Rating coexisting respiratory conditions. Ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other. Where there is lung or pleural involvement, ratings under diagnostic codes 6819 and 6820 will not be combined with each other or with diagnostic codes 6600 through 6817 or 6822 through 6847. A single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation

My asthma and COPD fall under 6602 and 6604 and are rated as one.... but apena will be rated under 6847.... so could this mean that I can get two seperate ratings? Or does it mean like I suspect that any respiratory conditions within 6604-6847 cannot be rated separately ...in other words I only get one rating for all three medical issues.

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