lumbosacral Head injury in service I just remembered, ironically....

[armyvet89]

Hello all you wonderful folks! 

I just found some of my service medical records the other day and in it was a LOD from where I suffered a head injury while training. I had (no pun intended) completely forgot about it. I dont feel that there was ever a diagnosis provided but it did knock me out and I was out for quite some time, so I'm told. I dont really remember much after that. I was told that the doc that was seeing me said that I was out for a while ordered bed rest WITHOUT sleep and to follow up the next morning. I did not go to the hospital but I guess she was asking me several questions to which I had inconsistent responses for like what is todays date? President Obama was my response. I still get jabbed about this from my buddies that were there. It took a good day or 2 before I came around to being close to normal. I was also involved in several explosions in iraq (rockets and mortars and a parachute grenade). The parachute grenade hit next to my truck and it knocked my gunner out. We were all pretty stunned. Since all of this I have had some serious issues with MH also headaches/migraines, balance and dizziness problems, tinnitus (SC'ed), blurred vision and a twitch in my left eye that is also documented on the LOD. One of the mortar blasts forced me off the top of the MRAP and I hurt my left knee. When I came back to the states I was put on pain meds most with tylenol in them and when I would complain about headaches it never made its way into my VA records because I was told that its likely do to the high blood pressure and the knee pain. So what I am getting at is that I think I may have covered up some of the headaches with the pain meds I was on and I think this is going to make it look like they arent bad at all when in fact they are. I am not taking the pain meds anymore and this migraine stuff is for the birds. In 2011 I was also diagnosed with PTSD and depression NOS by a VA doc and have continued treatment and medication ever since but last year I was denied PTSD from the RO because my c&p doc was a xxxxxx xxx. The exam doc works for another company on the side where they fight against people going for social security based on MH contentions. I feel like he is completely inadequate at his job and isnt deserving of the position he holds so I wrote the VA and told them about it.

So now I have recently submitted a claim for headaches, migraines, TBI, residuals of TBI and PTSD. I feel like if i can get them to SC me for the TBI that it would help with my PTSD claim. What are your thoughts? How should I approach this? What should I prepare for? Since there was never a diagnosis given for the head injury will the VA not provide a TBI diagnosis?

Not sure if it matters but I am currently connects for left knee 20%, Right knee 10%, Radiculopalthy right side 10%, lumbosacral strain 20% and tinnitus 10% totaling 60%.

[armyvet89]

Buck52, 

So if I send in a NOD on the decision what is the process like from there? This is what initiates the appeal correct? So this could take years to complete? What happens next? I am not familiar with the appeal process.

[Buck52]

Yes your correct  the 21-0958 NOD Form which you should get in the denial letter, you let the VA Know you do not agree with the decision.

We can't speculate on how long this process will be  it all depends on your ''concrete'' evidence  and hope you get a very good rater that will read all and not just part of your evidence before he /she makes a unwise decision.  usually if things go right you will have a decision within 3 to 6 months.(depending on the back-log)

You may need to request other records such as your DD-214, C-File  and your SMR'S ..And all medical records the VA has including Active Military Medical records  these are crucial  for evidence .

If you have all or most of your evidence to prove your claim and why you think they made the wrong decision  you can request a D.R.O. Hearing  at your R.O. (Decision Review Officer) and discuss this with a D.R.O. to hopefully get your claim adjudicated to your expectations. (this is what I did) for my initial first claim)  you request this in your NOD, & your R.O. will send you a letter letting you know the date and time of the Hearing

There maybe other records to request later on as you go through the process but these will get you on the right track

Unfortunately  VA don't take our word on anything  they need proof  with medical documentation  and sometimes lots of it .

Always make extra copies for your self and keep them in a safe place  and anything you send the VA from now ON make sure you get certified return receipts from the Post Office  to confirm they get what you send...and keep your receipts in a safe place  keep everything the VA Sends you no matter what it is

You may need something a year or two down the road  and it makes it so much less stressful if you have the copy of a document you need & to use as evidence in your claim obviously.

NOD is hopefully to get your decision of what you ask for or expected to get...after the NOD And your denied  then its I-9 that is the form for the BVA to decide and that my friend can take years.  so its always best to have your decision decided at the RO level.

Note:I Recommend you start a folder for your claim or claims and place in alphabetical order  to make it easier to finds things when you need it and also to take to your D.R.O. Hearing ( they can make copies) if needed.

 and remember to make copies of everything& they send and everything you send them.

[armyvet89]

Buck52, 

Now let me ask this, I submitted a claim after I was denied PTSD. Because I was second guessing my treatment team and current diagnosis I claimed depression NOS, anxiety NOS and adjustment disorder because I was diagnosed with all of these in addition to the PTSD. When the VA received my claim they changed it from the disabilities I claimed and reopened my PTSD claim because they said that those are symptoms of PTSD. At the time I did not have any new evidence to submit so they ultimately denied the claim again even though I did NOT intend for PTSD to be reopened. Knowing this, does that change my EED to the current denial of PTSD? The VA has received my claim and yet again reopened it with new evidence so I am assuming I just ride this claim out and if denied I can appeal this decision. Thoughts are appreciated!

[jfrei]

Actually the other way around they say and lumped it with my sTBI. Since the psychiatrist couldn't tell my symptoms from my TBI even though she actually said I showed symptoms prior to my accident with the death of my friend and reckless behavior. But my accident was a car manufacturer defect that was then recalled ten years after my accident. I got the call 2 years ago and then got my service connection last year for my TBI and then my ptsd SC followed along with headaches and dizziness scars and shoulder injury. But I don't have years to fight for a separate rating i will keep fighting for it it's just not a priority at the moment I hope it will all be worked out with this presidency.

Edited April 19, 2017 by jfrei

[armyvet89]

Jfrei,

Glad things are working out for you now and best of luck in the future. What can I expect with the TBI C&P? what all happens and is covered?

[Buck52]

On 4/19/2017 at 11:46 AM, armyvet89 said:

Buck52, 

Now let me ask this, I submitted a claim after I was denied PTSD. Because I was second guessing my treatment team and current diagnosis I claimed depression NOS, anxiety NOS and adjustment disorder because I was diagnosed with all of these in addition to the PTSD. When the VA received my claim they changed it from the disabilities I claimed and reopened my PTSD claim because they said that those are symptoms of PTSD. At the time I did not have any new evidence to submit so they ultimately denied the claim again even though I did NOT intend for PTSD to be reopened. Knowing this, does that change my EED to the current denial of PTSD? The VA has received my claim and yet again reopened it with new evidence so I am assuming I just ride this claim out and if denied I can appeal this decision. Thoughts are appreciated!

First, if you reopen a claim instead of appealing it, and you are eventually given an award, it may only go back to the date you reopened the claim, and not the date you filed the original claim.
Second, asking for a claim to be reopened after a denial requires a showing of “new and material” evidence. If you don’t have something new and material that you didn’t show them before, you could be out of luck.

It can be a tricky decision on how to handle a denied claim. This is the time you should consider getting experienced opinions to fully review your options.  (ask questions on hadit)

Final decisions

Once a decision is made on VA disability claims, you have one year to appeal. If an appeal is not filed within that time, the decision becomes final. The only way to receive reconsideration of a final decision is with Clear and Unmistakable Error, or to reopen the claim presenting new and material evidence.

It may help to understand that, from the VA’s point of view, there are only three types of claims:

A new or original claim

A claim for revision of a previous final decision based on CUE (Clear and Unmistakable Error)

A reopened claim with new and material evidence

So, if you are still within the one-year window to appeal and you believe your claim should be approved as is, in theory an appeal is the appropriate route. The VA has admitted to having a high error rate, and errors and other issues often can turn your way on appeal.

If you wonder whether you might not appeal and instead try one of the other routes, in theory, this means either (1) there is clear and unmistakable error (this is a very high standard and something you should discuss with an experienced attorney or representative) or (2) you have new and material evidence that was not reviewed before which should therefore be grounds to reopen the claim. If you want to reopen a claim simply because you think you might save time from the appeals process, you are on shakier ground.

Effective dates – When considering your options with reopening and/or appeal, it is vital that you know the impact of all options on the effective date of your claim. If you eventually win an award, or an increase in your award, the award will be backdated to the effective date of your claim. The effective date is usually the date you filed the current claim (with some exceptions that allow the award to go back further). The distinction could cost you tens of thousands of dollars, depending on the award and the time different from your original claim to the reopened claim.

Reopening a claim that was denied

In general, when VA disability claims are denied, a veteran can always reopen a claim with “new and material” evidence. This applies when you are addressing the same condition.

“New” evidence is information not previously considered by the VA. “Material” evidence relates to an unestablished fact necessary to the claim. If the denial was based on lack of a service connection, then witness statements or other evidence can help resolve that question; of the denial was based on your condition, then new medical evidence or opinions may help.

There is little evidence that, given the choice, reopening a case rather than appealing it will improve your chances of approval, or your level of award. However, each case is unique and the distinctions can be highly confusing. You can often request a free consultation with an experienced attorney to help you understand the options.