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Finally got my 100% P&T rating

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Thomas54

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Hello everyone,

I have been on this forum from time to time, and I must admit usually when I was feeling hopeless about the process, or angry.  Hopefully I am not putting this post in the wrong place also.  Unfortunately, it's been a long time since I got on the forum, and totally forgot my login and password.  I got a new one, and here I am.  I wanted to post to give other veterans fighting this difficult process some hope.  I started in June 2008 to get rated, after my second neck fusion surgery.  The surgery went bad, and left me with permanent nerve damage down my left arm and hand, and permanent pain and fatigue in my neck and shoulders.  It got so debilitating that I ended up having to retire on disability from a great civil service career as a GS15, doing what I loved.  My problem was that I chose not to take the VA exam when I was retiring from the Army, because I felt like I was in better shape when I retired than when I enlisted.  If I could offer any advice to those active duty Service Members who are getting ready to retire, go to that VA exam.  Do not ignore it, as I did.  So I was initially rated at 40% back in 2008 and received an increase to 60% in 2009.  Eventually with the help of an Independent Medical Opinion, I was able to get to 90%, which was reduced to 70% for no reason or medical change, and then raised again on a DRO appeal back to 90%.  All the while my spine was beginning to show the wear and tear of having jumped out of airplanes.  While the pain in my neck and arm was diagnosed as CRPS by a Navy pain management doctor, and substantiated by an army doctor I was assigned to after the first one PCSed.  I must point out here that I am very lucky, because I live in the Metro Washington DC and I was enrolled into the Military Health system, and in a local Army off-site clinic feeding into Ft. Belvoir and Walter Reed hospitals, so all the while I was getting good health care.  As I mentioned, I had to retire on disability from the civil service much too quickly, it was in part because the CRPS had spread into my left and right extremities. It was so bad that in Sept 2012, that it caused me to fall and crush my right foot and severely sprain my left ankle.  It took me nearly a year to get over the initial surgeries, and after three surgeries I can at least walk.  SO I applied yet again for an increase. 

Along the way, my lower back was rated at 20%, and while it was worsening over the arc of my story, I was getting no support from the VA, as I was fighting back in forth with the VA to keep and/or restore the 90%.  This past summer my back had deteriorated to the point that I could barely walk.  I saw the spine surgeon at the Ft. Belvoir Community Hospital last July. Ironically, after I asked my orthopedic surgeon who was still following my aftercare post foot surgery #3, which she performed in January of 2015, to look at my back, because of the pain I was in.  I told her that I had prior x-rays taken where the radiologist report stated that all I had was some age related degenerative disk disease, but that the pain I was experiencing was much more than a little arthritis.   She ordered new x-rays and after reviewing she said that I had a right to be in so much pain.  From her point of view my back was in such bad shape that she wanted to refer me to the spine surgeon.  So I saw him and discussed that x-ray.  In his opinion I had serious instability at 6 levels, and scoliosis (which had been diagnosed while I was still active duty) in the lumbar area, and desiccated disks up and down that segment.  He ordered an MRI and a Myelogram of my lower back and both tests confirmed his concern.  So I had surgery to fuse my back from T12 to L5 last October, which my surgeon characterized as one of the most stressful surgeries for a human body.  It was also obvious that I my back was not normal, and clearly it had all come because of active duty service.  Still I didn't get an increase until I changed my VSO from the American Legion to the Disabled American Vets.  I met my new Service Rep in early December last year, after I received a letter from the VA once again proposing to reduce my rating yet again.

By the time I saw the VSO, it was obvious that there were major changes in my lower back, and not only did I not deserve a reduction in my 90% rating, he felt very strongly that I had cause to get bumped up to 100%.  So he submitted for TDIU, because I was still just into my recovery from the back fusion surgery, and that it didn't look to him that I would ever improve; and an increase to 100% post-op recovery.  Luckily the VA finally agreed with something pertaining to my health, without a year's long back and forth battle.  I was asked to come into the Washington VA hospital for another P&C in April of this year.  I also ended up going back for a second exam a few months later.  Both examiners were sympathetic to my plight.  And here I would recommend anyone requiring a P&C exam that if you are sent to a QTC contractor exam (or a different company performing P&C exams) to try and get the exam switched to a government facility, even if it takes a little longer.  Every time I was examined (and I use that word lightly) by QTC, it ended up in either an actual reduction in my disability rating, or a proposed one that I had to fight off.  Finally, in July, I returned home from my second lower back fusion surgery and hospitalization to find that big brown envelop that we're all familiar with.  I had to have this second fusion, because the first one refused to fuse into my sacrum.  So the surgeon had to remove the L4-L5, L5-S1 screws, and re-anchor the L4-L5 screws and extend the rods down to my pelvis, where he had to add 5 inch screws in each side of my pelvis to anchor the entire fusion.  Back to the envelop.  I opened it to find a new rating.  Finally, I was awarded 100% Permanent and Total starting in April, with a 5 months of TDIU during my immediate recovery from the 1st lumbar operation. 

So now after fighting for 8 years, I am finally rated at 100%.  In my mind, I should have been awarded that years ago.  Here is where I tell all of you to never give up.  There have been times when opening those envelopes that I was disconsolate and angry, but I never gave up.  I have had assistance in tough times to get my journey on track, and I am so grateful to the DAV for taking my case and following it through to completion.  Pick your VSO carefully.  My first stab at this was with the American Legion.  Initially, I had success with the officer assigned to my case, but once she retired, I received no useful support, and the VSO assigned to me was as a ghost, never returning my calls.  So for years I was left to work my case alone.  It was only after the DAV started helping me did I see any increase.  So this is my story.  I appreciate those who have read it through to the end.

TCK

 

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Congratulations! It took me more than 25 years of fighting to get VA to rate me 100%, so I know how it feels! You are a inspiration to other veterans!

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On the subject of 100%.  So can you be "permanently and totally disabled" (for Chapter 35) at 100% and still be able to work?  While I expect my 90% to be bumped up to 100% once the deferred ailments are approved I feel I can still work.  I mean maybe not physical work like when I was younger, but certainly, most of my mind is in tact.  I still have to put one kid through school, and I would like to go back to school.

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  • HadIt.com Elder

Congratulations Thomas54  way to go buddy!

Victor82  it depends on what they rated you for?

If its TDIU P&T Then no you are not suppose to be doing any kind of work.

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With the 100% P & T decision the VA should have mentioned or enclosed the Chapter 35 applications for your dependents.They usually send the Chapter 35 pamphlet as well, which is linked below.

 

The dependents are also eligible for CHAMPVA  which also can be searched for here.I dont know how VA informs vets these days of their dependent's potential for CHAMPVA  in 100% P & T awards.

As I recall I received a VA letter advising me on CHAMPVA and that has to be applied for.The letter was separate from the 100% P & T posthumous award that included Chap 35 apps for me and my daughter.More info here.

http://www.benefits.va.gov/gibill/docs/pamphlets/ch35_pamphlet_2.pdf

 

http://www.va.gov/vaforms/medical/pdf/vha-10-10d-fill.pdf

http://www.va.gov/purchasedcare/programs/dependents/champva/

 

 

 

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  • HadIt.com Elder

Yes  the forms should be in the award packet  but you do have to file for the champva benefits  for you and your dependents.  mail in the forms and champva/chapter 35 educational allowances   they will get back to you.

also don't forget to fill out your free 10.000 life Insurance policy. or add to it  now is the time to do this  if you wait to long  the time line for filling will disqualify you.

and take your award letter that states your 100% P&T to your local property tax office and file for your property tax exception ,  if your a home owner  with a mortgage  this will help lower your payments,  if you own your home out right  then you don't have pay property tax  which makes a huge difference.

Edited by Buck52
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