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    • Please pardon the length of my post, but I am looking for feedback.  I haven’t been on the board for awhile, and already miss the critique that Carlie and Stretch would have offered. I am 100% service-connected Permanent and Total for Bipolar Disorder.  I was awarded 100% in October 2009, backdated to September 2007.  Initially, I was in the VA system from 1994 to mid-1997, before they finally successfully diagnosed me as having a Bipolar Disorder.  I responded to medication treatment well for seven years (during which time I used the Vocational Rehabilitation and Employment (VR&E) program to obtain two computer-related degrees, until the medication stopped working overnight.  My Bipolar Disorder came back worse than ever, and nothing tried by VA and private psychiatrists worked in the least bit.  Finally after 2007, in which I missed half the year being hospitalized time and again, I listened to my psychiatrists telling me I was disabled and resigned.  After 8 years of failed attempts at controlling my Bipolar Disorder, the VA has finally given me the Veterans Choice program allowing me to see a psychiatrists and psychologists specializing in Bipolar Disorder. I have a rare form of Bipolar Disorder, which is why it took the VA so long to diagnose what was wrong with me.  I am hyper-manic, as a result, I have longer days than most people do, and look for things to fill up my time.  I do not suffer from depressive episodes like many others having Bipolar Disorder do.  The lack of depression, in itself, is a danger sign, and the VA has given me months of therapy to cope with depression if it should hit me.  There is a school of thought that people with my form of Bipolar Disorder cannot handle depression, and just spiral downwards until they commit suicide.  But I digress, sorry about that. I was recently talking to another veteran about MIT offering their entire course curriculum online for free.  You don’t get any credit, but you can study the subjects and I was playing around with that.  He informed me that the VA is required by law to retrain me into a different profession, since I cannot work at my previous one; due to not being able to work a regular full-time job in the field I was previously trained in through VR&E.  So I researched it and found: According to 38 USC Chapter 31 §3103. Periods of eligibility:  (c) In any case in which the Secretary determines that a veteran is in need of services to overcome a serious employment handicap, such veteran may be afforded a vocational rehabilitation program after the expiration of the period of eligibility otherwise applicable to such veteran if the Secretary also determines, on the basis of such veteran's current employment handicap and need for such services, that an extension of the applicable period of eligibility is necessary for such veteran and—(2) that such veteran had previously been rehabilitated to the point of employability but (A) the need for such services had arisen out of a worsening of such veteran's service-connected disability that precludes such veteran from performing the duties of the occupation for which such veteran was previously trained in a vocational rehabilitation program under this chapter, or (B) the occupation for which such veteran had been so trained is not suitable in view of such veteran's current employment handicap and capabilities. So, indeed I qualify, but there is a caveat.  I must have a feasible Rehabilitation Plan to present to the Vocation Rehabilitation counselor consisting of education needed, and employment plans.  The only option that would fit me is self-employment.  So I looked at self-employment careers, and found photography.  I researched further, and found that VR&E had even given someone $30,000 to start their own photography studio after they were trained.  I know I cannot be relied upon to work at the studio full-time, but I am not alone.  I have a wife who wants to use her Dependents Educational Assistance to obtain a degree in photography too.  The difference being is that mine would be a Masters of Fine Arts in Photography, while hers would be a Bachelors of Fine Arts in Photography.  While I would be the one to setup everything to run the studio on my own time, she would actually be the manager with a receptionist.  We would even hire local freelance photographers to shoot events, if need be. So basically, I would utilize project management skills to develop a business plan for the studio, and perform everything necessary for the start-up.  Having a Masters degree would give me the necessary knowledge to oversee the entire operation, but not have to be there 8 to 5; which I know I cannot do.  My wife will be the studio manager. I have researched 100% service connected Permanent and Total for Mental Disorders and going to college.  Most of what I have read is “why would you risk the Golden Apple?”.  First:  I cannot be absolutely sure I will achieve the Masters degree, although I am quite confident; because having a Bipolar Disorder has no impact on your Intelligence Quotient.  Second:  Each and every one of us is unique, and not one size fits all.  While some may consider 100% SC P&T the Golden Apple, I feel a need to do something other than exist and age.  Third:  I doubt that I will the studio will make enough after expenses for the initial couple of years for me to make more than Substantial Gainful Activity.  If the studio starts to succeed and grow, then I can put myself on the payroll.  Fourth:  With a Masters degree, I will be qualified to teach other photographers the finer arts of photography.  Fifth:  I can undertake subjects for photojournalism and submit my work in competitions.  Sixth:  I believe in helping others.  I live in a small rural town, and there are under-privileged Seniors who cannot afford to have Senior Pictures taken.  I would love to help them.  Seven:  There is a World of opportunities to be explored that I haven’t even thought of. I have not read anywhere that someone with a 100% SC P&T Mental cannot go to college.  I know “a 100 percent evaluation is warranted where there is total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of close relatives, own occupation, or own name.”. I know I cannot attend a traditional college with scheduled courses, but I have found an online University that is regionally accredited where I can take the classes at my own pace.  My social interactions would be online and not in person.  I can study at-home, even when I have locked myself away from the World.  There will be deadlines to meet, but I worry more about getting the work done too early, rather than late.  Going to college is different than having an occupational job, although obtaining an occupational job is the goal of attending college. I need to mention that my wife is my rock I cling to.  She tells me to go lay down, when I’m getting manic.  It is absolute torture to lay down and rest your body, when your mind is racing with all the things you could be doing, and the minutes go by ever so slowly.  She goes to all my appointments with me, and tattles about everything! The floor is open for comments, and thank you in advance.  
    • Sure its worth fighting for  you love your father..so fight to your last breath. I Would think you need to finds a good VA Attorney    someone like Dr Bash team  with Attorney John Dorle.  As for as the school tuition I'm not so sure?  but it sounds like your father could get some compensation for his condition   especially if he is a Vietnam Vet? Does he have a claim in appeals? Other members can chime in here  I am not that familiar with what you have mention. Ms Berta can sure give you some great Advice..she be on tomorrow Morning. good Luck .....................Buck
    • Check to see what he put in your C&P report, it should be in the EVet Bluebutton report. If the guy was doing you any favors, you would find it there, if not, you will find it there.    Point is, even if he did a halfassed job, wait to see what he put down in writing before you do anything.  He just might fool ya!
    • you need to wait for a decision   well actually you have to before you can file NOD. Was this was a C&P at the VA? I'd go see the C&P Director...take the CFR Reg's with you (found here on hadit) about what and how the exam is to be conducted how the scars are measured and ROM...Let the Director know what this examiner did by not measuring your scare's correctly  or using the correct tool  for  ROM and request another C&P with a different Dr....... & that if he/she can't help you with this? you will find someone who can. Also ask the Director  why did the examiner ask you what your rating was? why did he need to know that? JMO .................Buck
    • I had wrote a very long post previously but it did not send. To summarize I am a dependent and the son of two veterans my mother who is a disabled Veteran and my father who is a Veteran that had finished honorably. When I was 14 my father was diagnosed with kidney failure do to high blood pressure, and it quickly progressed to end stage kidney disease. I took care of my father the best I could given the circumstances He got a bit of disability  and was put on government healthcare I was in charge for all his health related care and taking care of him which I did so I got some benefits from my mothers disability as a dependent   which helped us scrape by throughout the years over and over again the insurance would request that he applied for VA health care because of his status income and inability to work originally he was told that he did not qualify when we went up to the office because he did not have a preexisting condition while enlisted we stated that he developed high blood pressure during which was the cause of his kidney failure now. He was even hospitalized when it was discovered despite this the man stated he did not qualify no matter how many times we told the insurance this they would stop his medical and state that he had to apply over and over again we took the form to the office throughout the years which they just pulled up the file from before we told them they said they had to sign something stating he didn't qualify this went on for a long time. When I turned 18 i decided to go to school via my education benefits on my mothers side. Everything was fine until my fathers health took another turn for the worst he was diagnosed with type two diabetes do to his home dialysis machine malfunctioning and pumping more of the l liquid that was highly glucose based into his body only draining half before pumping again while he slept. We found out the nurses were aware of this problem and even told the company but they did nothing. This was until people started to complain. I had to stop school to take care of him now that his health had gotten worst and  the company not returning my calls and said they would not talk to us without an attorney. I had told both the school and the local VA office that I had to stop going the VA office told me I had to feel out a form and due to the fact that it was an emergency I would not be charged because of my failure to complete and or attend classes I filled out the form that same day they sent it to my local regional office and I focused all my time taking care of him and trying to get a pro Bono lawyer to handle the case. I had contacted every single pro Bono and non profit lawyer in Arizona  none of them wanted to take on the case despite us having proof from a log we kept from the machine backing up our claims. I tried this up until my father got a transplant in 2015 in the mean time I started to receive letters from the VA stating that I owed them because I did not attend the classes and or failed. I contacted the VA who told me that had no such file I contacted the school who told me they did not work for the VA although they were a VA office and said that they sent it. I contacted the VA every chance I got while dealing with my fathers issues and his insurance constantly screwing things up. Until I got a letter stating if I did not repay or get on a payment plan I would be noted as an unpaid debt sent off into collections and I would lose all future educational benefits in the future. I tried again and again to get this resolved until I finally got to someone who knew who to send me to. They transferred me to some guy who I told him what had happened at first he told me I had to either get on a payment plan or lose my benefits at this point i was upset and I am a pretty calm guy. He than reluctantly said if I got a note from my fathers doctor and or his head dialysis nurse about his condition he would put it in the system and it would be as good as solved. He gave me a fax and said I had 7 days I got the letter from both within 3 and faxed it to him several times. I had contacted him afterwards letting him know that I had faxed it but didn't get a reply  but having dealt with the via for so long in this case wasn't that strange I was told after I had sent him the letter to look out for something in the mail. He was also meant to email me a few weeks past and I no longer got any lettings from the VA about the bills but I started getting some from the school I told them the situation and they said they would contact the VA and get back to me never happened. I ended up getting one final letter stating that I failed to make a payment and my education benefits would be halted and the bill would be sent to collections this made me so angry not just the VA the system itself insurance and all I called the VA knowing very well it was to late simply to vent my frustrations of course there was nothing that could be done and I was told there was nothing they could do I took what my dad told me and the fact that there was nothing that could be done right now. He was positive and regretted me having to take care of him which I love my father for he stood tall no matter what happened. Moving on and not being able to get any lawyer because they figured despite what we had it wouldn't be worth fighting a giant medical firm pro bono and most who were interested didn't even read my inquiry and assumed it was concerning a recall for the same device and not a new malfunction. 

      The nurses who knew about this told my father when he was reporting issues previously before getting diagnosed they were aware but the company would not allow the techs to alter it they even knew how to fix it. But they didn't say it was dangerous eventually my father had to be taken via ambulance to the hospital and they told him his blood sugar was almost at lethal rates this was the only time my father had gotten upset about a medical problem only because he had no control over this one and he knew it could have been prevented and that lasted for one day and he went back to accepting it. I continued looking for lawyers up until he got his transplant at the end of 2015 thanks to a great doctor on the transplant bored of mayo clinic who heard from a social worker about my father. He was put on the transplant list right away and at the top because of the length of time he was on the list. This was the best news in years aside from the insurance once again messing up as he was doing to testing that was required before than. It is only because of the great people on the mayo clinic transplant team that talked to the insurance to fix the problems we couldn't that it got approved of course they also requested that we go back to the VA again and once again they said he did not qualify. We got him approved for the transplant and despite some other hiccups with the insurance refusing to cover his crazy high kidney medication which he needed so his body wouldn't reject it. Once again thank you mayo clinic for footing that bill. He got the transplant and as soon as he could work he did Me and my brothers and sisters who were in California put what we had together  to get my father a car which he used to start work. He is still disabled but is doing much better.  Today was the first day I could get time to request info about getting my educational benefits back I had talked to someone about getting it back and along the line my father being a Veteran popped up and she asked if I got my benefits from him I stated no he did not have any benefits which we talked for a bit I stated that we had his dd214 with honorable discharge and he didn't qualify for any medical because he didn't have any preexisting conditions while he was in which I told her that I told them about the high blood pressure the cause of his kidneys shutting down and how he even got cancer on his kidneys. She mentioned that he should of been entitled if not they should have looked into it because of the high blood pressure instead the guy took the form signed it for the insurance marked are reason for visit in the system and said he got nothing. 

      This made me think I am not after anything and I wont fight it if he wasn't entitled I will fight for my education given the circumstances but I would be so upset to think that he could of had VA medical or other benefits this whole time but was told no over and over again. Like I said personally I dont know but I wanted the opinion of others on the subject on what I should do I dont even care that my credit got ruined because of the VA and the school thing having my father healthy after beating so many things I am proud of my father regardless but the only reason I am fighting for my education is because my father told me that I should.    Sorry, for the long read for anyone that managed to read all that I has not planned on it being that long but this was my first chance to vent having my father recover enough to do things on his own up until recently. I know there are tons of stories about falling through the system and injustice so on and so on my real question is should i fight for any possible benefits for my father. I dont want to go through another long battle if the lady was wrong and the people at the local office was right. But having filed to get a lawyer and not being able to help my father aside from taking care of him. I now have to fight Arizona and request my certificate of birth Abroad so Arizona will recognize me as a us citizen because of a immigration law that was passed and being born overseas in England because of a military family and despite having duel citizenship I am getting a bit tired of falling through the cracks and want my father to get what he deserves if he does deserve it. I had talked to my father recently and we do know that he qualify for a home loan from the VA potentially we need to provide some kind of point sheet requirement. If i have to request that stuff for him I might as well do the same for any possible benefits. 

      Will the VA fight us on this despite him being hospitalized with high blood pressure while in service and tested before joining? If so and you think we wont win I dont want to drag my father through another battle for a slim chance he is working and rebuilding his credit to try and get a home regardless so he is fine but he said he doesn't know what the VA would do. 


      Thanks for any and all feedback like i said this is mainly an inquire for if I Should fight for anything he should of have. 

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Charleese

Disability Rating For Cervical Spine

Question

Hi all,

My husband's BVA decision states residuals of a herniated cervical disc and discectomy are the result of service connected residuals of a left tibia fracture. It also states under ORDER that Entitlement to service connection for residuals of a cervical disc herniation and discectomy as secondary to srvice-connected residuals of a left tibia fracture is granted. They sent it back to RO to be rated.

? What %age do you think RO will give him for this.

My husband current rating is 60% and he has applied for TDIU and was denied by RO.

However, BVA states in their decision: "With respect to the Veteran's claim for TDIU,, the claim is inextricably intertwined with the grant of service connection for a cervical spine disability discussed above. After implkementing the Board's grant of service connection, the RO should readjudicate the claim for TDIU. The Board notes that the Veteran's residuals of a left tibia fracture, left knee recurrent subluxation, and left knee tender scar are disabilities of a common etiology, and therefore meet the schedular criteria for a grant of TDIU under 38 C.F.R. Section 4.16(a)."

? Do you think RO will now grant him TDIU PT. 3 doctors have given IMO's stating that he is unemployable because of these injuries.

Thanks in advance for your replies.

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7 answers to this question

They most likely (Or SHould) rate his neck as Traumatic Arthritis under the 4.71. Thee is a diagnostic code for Cervical Fusion. What levels did he have fused. It also applies another rating if he has radiculopathy issues in his shoulders, arms.

The ratings are based on his range of motion. Since he has been examined, you can compare his actual ROM from the exam to the listed ROM parameters in the title 38 cfr 4.71a.

I think this is enough to put him over the IU hump. especially if he has neuroligical invilvement.

J

Edited by jbasser

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Fusion and plating was done at the C3-C4 level His BVA decision states: "On July 30, 2008 the Veteran fell injuring his neck while getting out of a car. Over a three week period, he experienced progressive quadripaersis and in August 2008 was admitted to a private hospital and diagnosed with a severe cervical disc herniation. A cervical discectomy was performed nd the Veteran demonstrated improved leg, aqrm aand hand function. The most recent records from the Veteran's private physician included a December 2009 MRI report showing numerous central disc protrusions along the cervical spine with central canal narrowing. Therfore, the record establishes the presence of a current cervical spine disability."

The only ROM that was done was done on his service connected left knee in June of 2010 boy his othropedic doctor and he states: The patient, on examination, has old well-healed scars over the left knee. Range of motion of the knee is about 10 degrees to about 80 degrees. He has good alignment. Both knees have crepitus. The right knee has more crepitus and pain on the medial side. Varus knee deformity on the right is noted. Sensory examination is intact. Reflexes are trace bilaterally. Dorsalis pedis pulse is 2+. What this means I do not know. He goes on to state that the patient had x-rays taken today in the office, standing films, show severe patellofemoral arthritis and milder femorotibial arthritis. He has also patellofemoral arthritis on the right knee and primarily medial joint arthritis on the right knee. Impression: The patient's pain is more severe in the left knee than the right.At the present time, the patient is unemployable since ambulation for any long periods of time bothers him and he cannot stand for a long period of time, anything longer than 20 minutes of the timeand also, when he sits in one position for a while, his legs start to cramp up and bother him as well as pain in the lower back, so he has got to get up and move.

He's in chronic pain from the hurting of both of his shoulders. He put claim in for them but they had not acted on it as of yet.

Also when you say: "I think this is enough to put him over the IU hump. especially if he has neuroligical involvement

WHAT RATING %AGE DO YOU THINK THAT RO WILL GIVE HIM WHICH WOULD MAKE HIM OVER IU HUMP.

Please all, continue to answer these questions.

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I MEANT HIS RANGE OF MOTION FOR THE CERVICAL SPINE IN COMPARISON TO THE CRITERIA LISTED BELOW?

General Rating Formula for Diseases and Injuries of the Spine

(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):

With or without symptoms such as pain (whther or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease

Unfavorable ankylosis of the entire spine 100

Unfavorable ankylosis of the entire thoracolumbar spine 50

Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine 40

Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine 30

Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis 20

Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height 10

Note (1):Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.

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When I went through my C&P the Doctor had me go through all these bending motions, and I did not do very well. He also noted that I had a problem dressing with just a chair. But, the funny thing is that he said he was not scheduled to examine my back. Was he checking for something else?

Papa

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I have an injury to that effected my left foot and ankle and has caused stress fractures in my Tibia, the injury occured from a parachute jump that did not land so well :unsure:. Well I also have cervical spine damage. I did not get a percentage for it when I started my first claim in 2005 because I had never complained about the injury while I was in the Army. So VA gave me 0% but gave me 10% for the acquired flat foot which was caused by damage to the ankle. I just figured what ever back pain I was having was do to me not being able to stand correctly or walk normally. I was told after my first C&P exam in 2005 that I definatley had damaged my spine. I was told that I would have to prove that the injury not only occured while in the Army, but that it was caused by a particular event and not just an added complication of the ankle. I do know that it seems no matter what the problem is the more you get treated for it and the more documentation you have for your treatments the better chance you have of getting considered for compensation. Paper trails seem to be the name of the game.

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I have an injury to that effected my left foot and ankle and has caused stress fractures in my Tibia, the injury occured from a parachute jump that did not land so well :unsure:. Well I also have cervical spine damage. I did not get a percentage for it when I started my first claim in 2005 because I had never complained about the injury while I was in the Army. So VA gave me 0% but gave me 10% for the acquired flat foot which was caused by damage to the ankle. I just figured what ever back pain I was having was do to me not being able to stand correctly or walk normally. I was told after my first C&P exam in 2005 that I definatley had damaged my spine. I was told that I would have to prove that the injury not only occured while in the Army, but that it was caused by a particular event and not just an added complication of the ankle. I do know that it seems no matter what the problem is the more you get treated for it and the more documentation you have for your treatments the better chance you have of getting considered for compensation. Paper trails seem to be the name of the game.

Stu, you may be looking at secondary conditions from an abnormal gait.

In order to prove this, one would need to put it together to make it feasable. First, one should gather all medical information. go seek an IMO and have the Doc to review the entire history, Xrays, Etc.

The Doc can write an opiion and a nexus to your secondaries and put them into a medical prespective.

There is one Doc who is really good at this that I am aware of.

Dr Craig Bash. He is a Neuro Radiologist and he can put it together for you. The only negative I have seen is that he is a little pricey, but I have witnessed his work for 12 years and he is effective at all VA levels.

J

Edited by jbasser

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