20% Disability Raised To 60% On Ab8 Before Receiving Disability Decision

[Absolute]

I filed for an increase in my allerghic rhinitis (0% SC), re-opened claim for sleep apnea w/CPAP in April 2012. Both were claimed on my initial claim in 2007 (received 10% for an tear in a disc in my back and 10% for a badly strained rt shoulder). Sleep apnea was denied 2 times previously. The claim process got all the way to decision notification phase and was sent back to review of evidence but the letter was updated. It seems like I won my claim but I am wondering as well, how far back would the retro pay go since the effective date of my AB8 states May 1, 2012 which is the month after my claim was filed. Would I get paid from the date of my medical evidence (2007) or the effective date and is that why it possibly was sent back for additional review? Any help would be greatly appreciated. Thank you in advance.

[Absolute]

I provided allergy tests, shots, more statements from co-workers as well as evidence that I use the CPAP every night and receipt of new equipment this year.

They also got the data off of the chip from my CPAP.

Edited November 27, 2012 by Absolute

[Absolute]

50% OSA

10% back

10% Shoulder

starting at 100%

100% X .5 for OSA = 50% rating and leaves 50% still ok

50% X .1 for back = 5% rating and leaves 45% still ok

45% X .1 for shoulder = 4.5% rating and leaves 41.5% still ok

total rating 59.5 rounded to 60% leaves 41.5% still ok

You may have recieved a rating for rhinitis but it can't be more than 10% and still be combined rating of 60%.

If you got 20% for rhinitis then you would be 70% total.

your remaning 41.5% X .2 = 8.3 + 59.5 = 67.8 rounded to 70%

There is a calculator here on hadit that worke really well. It would help further explain VA Math:)

Thanks for the breakdown. I think I have used that calculator before but it was a while ago.

[rdawg]

what were the reasons for the original denials of OSA?

[Absolute]

It was not presumptive...since it was not diagnosed in service. I was diagnosed less than a year after separating from service. The rhinitis has been in my records for many years...so I am assuming (I know what that does - lol) that they connected the two and approved me for OSA w/CPAP.

[rdawg]

I am changing my earlier guess from

The OSA will go back to the date of new and material

to

you may be able to go back to the original filing.

I was diagnosed less than a year after separating from service

That DOES make it presumptive and they missed it the first two times. If you were diagnosed more than a year after service then it is NOT presumptive. Look up the CFR as it relates to diseases diagnosed within a year of discharge.

Did you have CPAP less than 1 year after discharge?

[rdawg]

http://www.ecfr.gov/....1.1.4.1.66.115

3.307 Number 3 applies to you if you had CPAP within a year of discharge and you submitted the medical evidence the first two times 2007 and 2009.

Edited November 27, 2012 by rdawg