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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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JamesPT

Claim Remanded

Question

Hello everyone; just looking for opinions regarding claim for secondary issues as a result of primary service connected injury. Primary claim was for broken right foot, it was not treated properly in NAM, I was sent back to the bush too soon the foot was never the same; had to have reconstructive surgery 2 years ago; claim was approved last year. Along with claim I included secondary issues for damaged left foot which needs to be surgically repaired, damage for left foot came as result for compensating for right foot pain, also there's knee, hips and lower back pain. Secondary issues were denied. I submitted NOD, had support statements from my surgeon and 2 other podiatrists submitted as well. I had a BVA hearing 2 months ago, the claim was recently remanded and records were sent back to VARO, they made a C&P appointment for examination of secondary issues at the VA Hospital tomorrow June 29th. I am concerned about the upcoming examination tomorrow; I had an examination at the VA Hospital 2 years ago, the examiner's statement stated that in her opinion my right foot injury (broken foot) and secondary issues were not service connected. I perservered with my right foot claim and had it approved. Now I am struggling in getting the additional issues approved.

Since the examiner stated 2 years ago that none of my physical injuries were service connected, even with my broken foot and medical treatment recorded in my medical records, it baffles me how she came to that conclusion. Due to what I believe was an unfair opinion I have the premonition that VA examiners tend to not favor the Veteran, I may be wrong but do these individuals actually read the Doctor's support statements, do they actually review the medical records? Anyway, I think this C&P exam tomorrow will be useless, they will put more obstacles to delay the process, in the meantime we grow older, other health issues flare up and the stress with the claims process just adds to my PTSD condition. Has anyone one out there in the "HAD IT" world have satisfactory results with VA C&P examiners?. - If I get an unfavorable decision will it be the end of the claims process? I guess I'm just looking for a word of encouragement. Any replies are greatly appreciated. Thanks everyone.

Jim

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5 answers to this question

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I submitted NOD, had support statements from my surgeon and 2 other podiatrists submitted as well.

Jim

Jim,

I would take copies of the above and leave them with the C&P examiner.

jmho

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Carlie is right.

Have they considered your independent medical evidence at all yet?

"premonition that VA examiners tend to not favor the Veteran, I may be wrong but do these individuals actually read the Doctor's support statements, do they actually"

I would call that a fact ,in many cases, not all and not a premonition.

Remember- even if the VA doc goes against your claim- as long as you have independent medical support for the claim from a doctor with enough expertise to opine and the doc follows the IMO guidelines in our IMO forum then the VA should determine Relative Equipoise exists- basically the weight against the claim equals the weight for it and that should mean an award.

But it took me 7 years to even get the VA to acknowledge my independent medical opinions and additional medical evidence.The Buffalo VARO ignored my IMOs and other evidence completely but the BVA read it all and awarded.

If they do not consider your independent opinions at all nor list them as evidence, and if they again deny- tell them to CUE themselves as they have broken evidentiary VA case law regs 38 USC 4.3 and 4.6 and somewhere here is the M21-1MR evidentary scenario they are supposed to follow.

But maybe the VA C & P doc will give you a fair shake- Did the IMOs you sent them cover well a concise medical rationale as to how these foot problems caused the secondaries?

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Hello again everyone: Well, I had the C&P exam at the VA Hospital for secondary issues, (worned out left foot, needs to be surgically repaired, chronic knee, hip and lower back pain. All secondary issues are the result of a broken foot during ground operations in NAM; the broken foot was not treated properly, I was back in the bush from H.Q. Hospital after a month's treatment). Sorry, I'm summarizing my condition from previous post. Anyhow, the C&P exam lasted about an hour, it consisted of about 30 minutes of question\answer and concluding with a range of motion of the issues in question; no x-rays were taken. The Physician who examined me was a young man who was covering for the Physician who initially had the assignment, he was absentee that day. I didn't know what to make of it; it was all very casual, the young Doctor was very friendly, I did avoid being jovial with him, kind of hard to do anyway when your body hurts. I did take and submitted all my Doctor's support statements as suggested by a forum member, the VA doctor was glad I had brought them. I am a bit dumb founded as to the casualness of the exam; hard to tell whether it was favorable or unfavorable as far as approval or denial is concerned. Right now I have a 40% rating, 30% PTSD and 10% for service connected right foot injury. I am in the process of filing for a PTSD increase, 30% just seems very low as I was in small arms unit for 11 months. Just suppose the claim for secondary issues is approved, will the increase be 10%? I seem to recall that increases are done by 10% increments by law?.

Another issue that may be an obstacle is the fact that I worked for 27 years for the federal government, I dealt with my PTSD condition and physical injuries on my own for many years since the VA would not have anything to do with me, I went for help multiple times, just to be sent out the door with their suggestion to go see a family Doctor. I did very well in school (GI Bill); since I was unable to sleep I would spend nights reading my textbooks which allowed me to concentrate in school subjects and temporarily alleviate my PTSD condition. Finally, dealing with the war issues on my own took its toll and I fell apart mentally and physically (reconstructive foot surgery) 2 years ago. I got a VSO rep. started the claims process and ended up at the Veteran's Mental Health Center for treatment. I was inmmediatly put on meds. The meds for PTSD and pain killers due to my war injuries became a big issue at work, I was relieved of my regular duties and relegated to do absolutely nothing for the past 3 years. I was now useless so when I turned 60 years old I decided to retire. My question, if someone has an idea, would it be possible to submit VA Form 21-8940 and be considered for the benefit, I can no longer work, PTSD condition and side effects to meds are an issue; reconstructive foot surgery and degenerative condition\chronic pain of both feet. Is filing for increased compensation due unemployability like starting the process all over again, in other words are we talking about Doctor's support statements, C&P exams; items which have already been submitted during my claims process?. Sorry for the lengthy statement, just navigating the system and looking for suggestions\opinions. Your answers are greatly appreciated in advance.

Jim

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You write you have 30% ptsd and 10% for foot...your avatar set up has 30% so anyway you can always file for an increase, anytime, but in order to be rated for it they will review everything, and yes most likely do current C&P exams too. What have you got to loose but not putting in for these tomorrow?? Call/fax your VSO and tell them you are puting in for increases...if you were inable to do your job and cannot work and be gainfully employed that is indicitive of reasons down the road for requests for TDIU if you meet the guidelines/criteria. What about application for SSDI if you no longer can work...have you applied for that too??

PTSD goes in increments of 20% ie 10-30-50-70-then if awarded next level is 100%.

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I will attach the TDIU form here.

Under # 18 check yes, and as Halos said, apply for SSDI. Under # 25 Remarks refer them to additional page, put your C file number, name and address on it and tell them anything they should consider to determine if you are eligible for TDIU.

I sounds to me like your performance appraisals from the job would definitely be good evidence for TDIU.

"The meds for PTSD and pain killers due to my war injuries became a big issue at work, I was relieved of my regular duties and relegated to do absolutely nothing for the past 3 years."

My husband was 30 % PTSD since 1984 and I used his work related performanace appraisals and even information from a US DOL and also an ADA complaint he had against former employers to support his claim for higher percentage.

"30% just seems very low as I was in small arms unit for 11 months"

What you did on combat or whatever does not impact on the PTSD %.

You need to familiar yourself with the PTSD rating schedule here but I assume you have fled a NOD on the past decision and you can apply for TDIU at any time even with a claim in appellate status.

As it happened the SSA awarded my husband solely for PTSD after he filed claim for higher rating.

He filed the TDIU form which the VA seemed to never acknowledge but he was awarded 100% P & T SC from VA.

He had died almost three years prior to that and asked me the day he died to make sure continued his claims- he had 2 pending.

SSA awarded his PTSD award within a few months.SSA awards are good evidence - if solely for SC condition-to prove TDIU.

Tell them of the side affects of your SC meds and you can send them medication side affect print outs that show the side affects they cause that impact on your employability.

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