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    • You are seeking Extraschedular Consideration. Extraschedular Considerations   “In exceptional cases an extraschedular rating may be provided.  38 C.F.R. § 3.321  (2015).  The threshold factor for extraschedular consideration is a finding that the evidence before VA presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate. Therefore, initially, there must be a comparison between the level of severity and symptomatology of the claimant's service-connected disability with the established criteria found in the rating schedule for that disability. “ Thun v. Peake, 22 Vet. App. 111 (2008).   But the VA will not act on any TDIU application from a veteran who is still employed.   I know two local people who have severe hearing loss yet also have severe communication problems because of the HL. They both get SSDI on that basis. They both wear hearing aids but it is very difficult to understand what they say sometimes, and one almost got hit by a pallet truck on her last job, because she could not hear it coming towards her. She was laid off and applied and received SSDI.   I suggest, when you do become unemployed, to apply for SSDI right away because, if the SSA awards solely for your SC conditions, then the VA would have evidence that would establish TDIU. The SSA has a SSDI web site that might have the criteria for Hearing loss claims and how they determine speech factors due to HL.    
    • A few months ago my service connected hearing loss  was increased from; 10% tinnitus
      20%  Bi-Lat hearing loss
      30% total to 10% tinnitus
      50%  Bi-Lat hearing loss
      60% total While I do not meet the single disability percent to apply normally needed to apply for IU, I do see a "Special Consideration"  which I believe applies in my case"  http://benefits.va.gov/benefits/factsheets/serviceconnected/iu.pdf Below is my letter asking for my increase.  I was wondering if anyone could give me some feedback on the content in order to determine of I should even bother to apply for UI ?   BTW, I will be 57 years old on December 1st, of that matters?  Thanks in advance, Mark   *********** 3/17/2016 Department of Veterans Affairs
        I am respectfully requesting consideration for an increase in my current Service Connected Bilateral Hearing Loss rating based on VA Autonomic re-evaluation dated 2/16/16, performed by XXX Snyder, MS, Audiology which included Maryland CNC word recognition testing, conducted at the VA Audiology Clinic, 760 XXXX Avenue, XXX Ca. 96001 (530) XXX-8830.       History:   I am currently rated at 20% Service Connected Bilateral Hearing Loss and 10% Service Connected Bilateral Tinnitus, dated 3/8/2011.  The details and evaluation of that service connection are documented in my VA file number XXX XX XXXX.     Continued and ongoing issues:   Based on my ongoing occupational, Retail Store Manager and non-occupational hearing problems, which include but not limited to;   Understanding and or comprehending spoken words
      Understanding and or comprehending telephone, conference call conversation and intercom announcements
      Understanding and or comprehending MIS helpdesk, police and other government or municipal telephone conversations.
      Understanding and or comprehending streaming television, computer, radio or other electronically produced broadcasts.
      Communicating in moderate to noisy environments, including retail store operations.
      Communicating with a group of individuals, including retail store operations, staff meetings and training.
      Communicating using retail store, company provided two way radio handsets.
          My service connected hearing problems, severely limits my ability to applicably react to audible occupational signals from:   Building alarm, emergency warning and other electronic security systems
      Fire and Loss prevention alarm / notification systems
      Point of Sale alarm / notifications and alert systems
      Point of Sale scanners; Symbol DS9808, Motorola LS2208,
      Inventory management scanner; Symbol MC3100
      EAS Loss prevention entry/exit scanners
      Refrigeration / Freezer malfunction notification systems
      Environmental systems (heating/cooling) notification systems
      Energy management systems NOVAR notification systems
      Freight delivery truck, backup warning notification systems
        My service connected hearing problems have resulted in:   My inability to efficiently communicate with friends, acquaintances, family, customers, vendors, subordinate employees, peers and supervisors.
      Frequent outsourcing or shifting of my normal and personally assigned managerial functions that require high amounts of communication, to my subordinate managers.
      Personal, occupational and social withdrawal due to reduced access to services and difficulties communicating with others.
      Experiencing significant emotional problems caused by a drop in my self-esteem and professional confidence.
      Exacerbation of my VA diagnosed PTSD, that I am currently being treated for at the VA XXX VA Behavioral Health Department.     Recent VA recommendations and action by XXX Snyder, MS, Audiology:   Since my recent VA Autonomic re-evaluation which included Maryland CNC word recognition testing, dated 2/16/16, I have been issued and subsequently fitted with updated VA issued hearing instruments: PHONAK AUDEO V90-13 RIC to replace my previous hearing instruments: AUDEO SPICE SMART IX UZ RIC.  I have also been issued and fitted with a Remote Control, ComPilot II and Remote Microphone in order to specifically assist with my occupational communication problems.  Mr. XXX Snyder explained to me that the new hearing instruments will provide a longer usable service life for my substantial and difficult to manage hearing loss.   ***************** Below is the actual examine results: 1. Objective Findings --------------------- a. Puretone thresholds in decibels (air conduction): RIGHT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 30 | 50 | 75 | 85 | 95 | 105+ | 100+ | 76 | +=======================================================================+ LEFT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 35 | 50 | 70 | 80 | 85 | 105+ | 100+ | 71 | +=======================================================================+ * The puretone threshold at 500 Hz is not used in determining the evaluation but is used in determining whether or not a ratable hearing loss exists. ** The average of B, C, D, and E. *** CNT - Could Not Test b. Were there one or more frequency(ies) that could not be tested: No c. Validity of puretone test results: Test results are valid for rating purposes. d. Speech Discrimination Score (Maryland CNC word list): +=======================+ | RIGHT EAR | 56% |   Thank you,   Mark Nicholson
                   
    • Thanks for the help!  I am happy to report that in less than 2 weeks from contacting the Secretary, my back pay was deposited into my account.  Still waiting on the back pay from the latest increase, but its only been a couple of months.  I will give them a little time.
    • There's  no known medical reason for tinnitus  but usually hearing loss and tinnitus goes hand in hand there are two types of tinnitus &. A medical Dr in this field of expertise will need to make that opinion & as for as a secondary to cause or aggravate tinnitus. I would recommend you request a Hearing test from the VA  and you need to let them know about the ringing in your head  not your ears this is the only way a Dr can know you may have tinnitus....the tinnitus is an unknow sounds that come from the middle of the head...and it bout drive a person batty, also if your wanting to get this S.C. AND Possibly rated   you need to  remember if you were around any loud noise while in the military  your mos AND what you did in the military,,,,you don't need combat to qualify for  S.C. Disability  as long as  any event that caused your condition/disability while in the military   if you can prove it  then you can get compensation for it.  but its on the veteran to prove that...you do this with medical reports hearing test  and your lay statement in detail as to how the even happen.  this is called bilateral noise induced hearing loss and it gets worse over the years.   with the exception of natural age progression. jmo ..................Buck
    • Is that your reply to my question here: "Is your inservice nexus to the anxiety/depression in your SMRs and/or established in any other way?" I guess I mean- is that surgical error the cause for the anxiety and depression? I found your past posts and this happened in a Military Hospital. That means it happened in service. I assume you have some Psyche treatment records in your SMRs? Did the SMRs reveal anything that confirms what actually happened ? There are still movements to get the Feres Doctrine abolished. The Feres Doctrine means a service person injured medically (or even killed) by Military malpractice has no way to really sue the Mil or get restitution. Except the way you might get it...via the claims process. I think the Military is better than the VA at covering up this stuff. Then again VA killed my husband and did a very good job of trying to cover it up. They failed however. You have anxiety and depression from a very traumatic inservice event. I just hope the VA sees it that way too,since they deferred that claim. Otherwise you might need an IMO/IME.            





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Teac

Rating Coexisting Respiratory Conditions Any Ideas?

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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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