Vync

Congratulations @ShrekTheTank!

Welcome to Hadit! Possibly... Regarding worsening, check out the rating criteria first at https://www.law.cornell.edu/cfr/text/38/4.71a. There are a number of ways to increase a back rating based on worsening. I know from personal experience with back issues that falls can happen, especially if balance becomes compromised like during a spasm or acute pain. If he had an episode and fell and broke his arm, that injury might be able to be connected as secondary. Also consider secondary issues from a couple of approaches. The military and the VA loved giving motrin or naproxen for pain reduction. That and other NSAID meds can do a number on the digestive tract (i.e. side effects of meds used to treat a connected disability) which can lead to heartburn or GERD which the VA classifies as hiatal hernia. Even after surgery, it can come back if NSAID meds are in use. Also, long term NSAID use is not good for the heart and other other organs. Think of that old song "the hipbone is connected to the thighbone" in terms where a musculoskeletal issue can impact his walk and also nerves. A cane can change his gait. Flare ups can result in nerve pain like sciatica into the leg nerves. The VA treats the cervical spine (neck) as one segment and the rest as a separate segment that can be connected. What goes up may also come down in terms of impact. It is not unusual for vets who have lumbar issues to develop issues with other joints, even in to the neck, shoulders, knees, etc... It could also cause headaches, too. Also consider his mental health. It definitely stinks that a vet feels like they are falling apart, losing independence, and might have to avoid enjoyable activities to avoid pain. Depression is common. The VA or another mental health provider might prescribe antidepressant meds to help the vet cope. Those kind of meds can have a negative effect during intimacy, too... This is not exhaustive, but I hope it provides some level of benefit. Good luck!

@pacmanx1 No worries. Was just curious

@relatively happy camper Congratulations all the way around! That's a seriously long time to have to wait for them to get it right. You are correct though about vets rarely getting correct decisions. In my experiences, about 10% of my claims were properly rated and assigned the correct effective date. Everything else required numerous submissions, NODs, supplemental, HLR, and/or BVA appeals for them to get them corrected.

It seems to vary depending on the provider. I have one community care provider that will print the treatment records and hand them to me when I leave. However, another doesn't print any. I thought that those records would end up back in the VA's hands not long after the community care appointment, but honestly have no idea.

@relatively happy camper That's quite a win you received. Some kinds of SMC are supposed to be inferred where the VA automatically assesses and grant if the vet meets the criteria. However, it is tough enough for vets to be lucky enough to get SMC evaluated let alone vets properly understand that they can also ask for it if overlooked. From what I have read over the past few years, it is being examined more now, but I assume that is likely due to newer processes and computer programs that remind the raters to check for it under certain circumstances.

@pacmanx1 I agree. It was probably automatic for you because they are supposed to check on it for TDIU. I did have SMC-S housebound for a few months after getting a single 100% for heart attack and already having a separate unrelated 60% for something else. After I was well enough to return to work, they re-evaluated per the rating criteria, dropped the 100% to 60%, and then ended the SMC-S housebound status. The VA inferred the SMC-S evaluation based on the information in my medical records. I did not go out of my way to ask them to consider it.

@Spaceace1954 About how long did it take from the time the decision was made by the judge until you received the rating info? Based on the ratings, did they just grant the headaches and sinusitis? Also, even though the VA has separate ratings for sinusitis and rhinitis, they generally tend to grant the higher of the two due to pyramiding.

@Lemuel The VA has gone "redact happy". I find it kind of odd that around 14 years ago or so, I requested a copy of my cfile. It arrived in a giant box and contained no redactions at all. However, when I received a digital copy on CD, it was redacted to the moon and back. I know some things like SSN's in doctors' stamps/signatures contained their SSN, but the redaction logic was so dumb that it also overlapped visual content that should have never been redacted. And they even redacted stuff that that sent me that was previously unredacted.

Also ask them to avoid using the terms "possibly" or "probably".

@Spaceace1954 Congratulations! That's a step in the right direction. By chance, was yours a legacy appeal?

@FloridaNative I can definitely sympathize with your situation. Around 2011 was a big push to get marijuana legalized. The FDA suddenly changed their guidelines for prescribing opiates. Almost overnight, the VA docs began refusing to issue or renew opiate prescriptions without a lot of headache and outright refusals. The VA medical centers had a "VA patients bill of rights" posted all over their facilities. With it was a right to have your pain treated. That section seemed to disappear for a while. However, it is back as of checking this morning at https://www.va.gov/health/rights/patientrights.asp That sounds promising, but it has became increasingly more difficult to get effective pain treatment lately. And what works for one vet might not work for another.

I'm not an expert on SMC-S, but did have it for a few months and will try to describe my interpretation of it. Think of service connection (SC) as direct or secondary. Direct SC means it is not related to any other disability. Secondary is as a result of another disability or the side effects of treatment of another disability. Separate and distinct means the two percentages cannot be related to each other or one being secondary to another. Example 1: Vet has 100% for PTSD. Vet also has a separate 60% rating for something completely unrelated to their PTSD. These are separate and distinct. Example 2: Vet has 100% for PTSD, but secondary to that they have a 60% rating due a disability secondary to PTSD. These ARE NOT separate and distinct because the 60% is secondary to the 100% for PTSD. I hope this is helpful. I expect other members to comment, too.

Thank you for sharing this information. It's ok if you don't know all the terminology or jargon. Was yours a legacy claim, Higher Level Review, or formal appeal to the Board of Veterans Affairs? I don't want you to worry, but some of us (including myself) have been told they are siding in our favor, but when the decision letter arrives we find that we were denied to some extent. We all have our fingers crossed that they really will find in your favor. If you have a VSO who has access to the VA system (VBMS), they can look up decision letters and tell you what was decided before it arrives in the mail. In the end, it is a case where you really don't know for certain until the decision letter arrives. Additionally, even if they find in your favor, double-check everything. The VA is supposed to maximize benefits, but often misses things or low balls ratings. Trust, but verify.

@Freedom101 I just received an email from the VA giving the usual status update: