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Showing content with the highest reputation on 11/21/2015 in all areas

  1. 2 points
    If the VA considers an NP qualified to do a C&P exam, then by their standards, any MD certainly is. The best way to challenge the C&P opinion is with an IMO from a specialist, board certified in an appropriate specialty.
  2. 1 point
    So after receiving my C-File and reading the doctors notes for my Knee, Back and Ankle exam two months ago and realizing something was off as her rationale make little sense given my record I looked into the doctors qualifications and found that she is gynecologist who apparently began with the VA Exam Contractor QTC Management after being losing a lawsuit for malpractice. My problem is this lady should not be doing exams on these issues when it is not her specialty. Her medical opinion and rationale is attached here but she says my back and ankles are less than likely secondary to my service connected knee and feet issues because of my weight but she obviously failed to consider that the weight gain has a lot to due with the physical limitations caused by the service connected feet and not being able to exercise which is noted in my service records. The VA has not made a decision yet. Is there any way to challenge her opinion?
  3. 1 point
    I haven't been here in a while.I just wanted to share my success story. In 2010 when I found this wonderful website I was rated at 10 percent and had almost given up.Using this site by reading tips, other peoples battles and using the CFR I successfully went from 10 percent to 100 percent .It took me a few years, first up to 70%, then 90% and finally up to 100%.... I am rated at 70 for PTSD with major Depressive Disorder, 10 for Degenerative Arthritis right wrist,50 for bilateral ples planus (flat feet), 10 for right knee, 10 for left knee, 10 for tinnitus, 30 for sleep apnea and 20 for Diabetes Melilitus ... I did this completely by myself using this site.. I do have the DAV as a representative but the only thing they have ever done for me is send me a letter telling me that I recieved a rating . I recieved it after I received the Official Notification Letter from the VA...I wholeheartedly endorse Hadit.com. in my honest opinion it is the best thing I have ever found.. So hang in there, read and research... Thank You , Hadit.com for a wonderful informative site....
  4. 1 point
    1st Acupuncture procedure completed 11/19 11:30am, so far, so good. It appears that this has really helped with lessening the pain and the return of sensations (other than just numbness) to my toes. The Procedure: The Acupuncture Dr advised me to close my eyes or look away, if I had problems with needles. I've never had a problem so kept an eye on what he was doing. The Acupuncture needles are long and very thin, can't say they caused any pain upon insertion. At 1st, it was a little disconcerting seeing the Dr start to insert the needles (7 in each foot) between my toes. After the 1st 2, no big deal. He also inserted 1 needle in each shin about midpoint to the knee. Total procedure took about 25 min. While the needles were inserted, the Dr would flick his finger on the top of the needle while rotating it, until I felt a vibration in the nerve that he had inserted the needle into. Very strange experience, haven't really felt anything but numbness and pain in the areas of insertion, for the past 5 years. After he removed all the needles, had me stand and walk. Still had the numbness in both feet but I actually experienced feelings in the toes on both feet and the pain (previously level 4) was gone. The Dr then inserted (3) snap-in ear lobe pins in my right lobe, after showing me a diagram of the nerves associated with the Ear Lobe and the feet. The pins fall out on their own after about 4 days. Usually at the end of the day, pain (7+) is really kicking in both feet, not as bad (3-4) since procedure. I message on the "Essential Oil" pain mixture and the pain is almost unnoticeable. Setting here this am, feet still numb, toes feel unusual (actually have feeling) and no pain as yet. Very Strange! Semper Fi
  5. 1 point
    If the doc offers a favorable exam, and VA accepts it fine. But, when its unfavorable you can challenge it, as Veterans attorney Chris Attig sugguests. The way I read it, VA will remand and give you a new exam (this is especially applicable if you can not afford an IME/IMO). Chris Attig: Like Ants at a Picnic, Junk Science Invades MOST C and P Exams.Chris Attig 7I’ve wrote about it on the Veterans Law Blog, but one of my biggest gripes with the VA is the crappy medical opinions that they provide. As any practitioner who works in the VA ratings system will tell you, the inadequate C and P exam has become the rule and not the exception. Source: http://www.veteranslawblog.org/c-and-p-exams/ A C and P exam (aka, C&P, or Comp and Pen) is where the VA Doctor – theoretically – reviews your C-File, conducts a physical exam and tests, studies the medical literature and then decides whether there is science to support your position that military service is related to your current disability. The VA administers hundreds, if not thousands, of C and P exams every day. And most of them are woefully inadequate. You know what I’m talking about…we’ve talked about it here before: * They send a nurse to do a doctor’s job * They have internists commenting on complex conditions they know nothing about * They use the opinion as a means to Develop the Record to Deny the Claim * In the case of many Veterans, they use Doctors that don’t even KNOW that certain medical conditions exist. This week I worked on several cases where the quality of the VA examiner’s opinion was the primary issue. In the case I looked at, an Occupational Therapist authored an opinion on the complex etiology of a lymphoma. That’s like asking a plumber to offer an opinion on what’s wrong with your tractor. Sure, plumbing and tractor repair both involve mechanical-y things, and both have metal parts, but that’s where the similarity ends. In the case I mentioned above, the Occupational Therapist missed the obvious cause for the lymphoma that even the “greenest” of Oncologists is going to spot. Why? * Because he hadn’t studied lymphomas in any detail in school. * Because he didn’t treat lymphoma as part of his daily practice. * Because he didn’t read about lymphomas in the medical literature to keep current on his knowledge. * Because he didn’t author any articles or journals on lymphoma. I’m not faulting him – he’s an Occupational Therapist. He has no place offering an opinion on the etiology of a lymphoma. Yet the VA assigns THIS person to do the medical opinion. And the BVA Rubber Stamps it. And – for now – OGC’s Group 7 puts a pretty red bow on it. Why? I’m at a loss to give a REASONABLE explanation. The Problem of Junk Science was Solved YEARS Ago in Other Federal Courts.Back in the 1970s, the Federal Rules of Evidence were introduced to Federal Courts, and one of them was Rule 702 on the Adequacy of Medical Examiner Expertise: “If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise.” (emphasis is mine). Back in 1993, the Supreme Court laid out several rules that dictates when a Court can even hear expert testimony – its called the Daubert Standard, and you can read about it here. The Veterans Court has no such rules. In the Veterans Court, here’s the general lay of the law: * VA employees are presumed to be qualified experts unless the Veteran objects. That’s it. You can point me to cases that suggest how a Veteran might challenge those so-called VA experts. You can point me to cases where the Court has questioned how the VA chooses experts. But the practical reality is that the issuance of a mere VA name-badge is the only legal standard used to rubber-stamp knowledge and expertise that often is not there. In fact, the Veterans Court is the only US Court I know of that does not have a black letter rule that regulates the quality of experts used to decide complex medical issues. In fact, the whole Veterans Benefits System, from top to bottom, is kinda like the lead character in the movie “Shaun of the Dead” when it comes to the danger of Junk Science invading Veterans Benefits law: [youtube id=”mqQ8Y9Sjp7o” width=”550″ height=”310″] Inadequate exams by unqualified doctors have no place in American jurisprudence – they quickly erode faith in the system. Veterans – who were taught in the military how to quickly sniff out bulls**t – walk away with a sense that the “game” is rigged for the VA And maybe it is. After 8 years doing this work, the phrase “Pro Veterans Benefits System” has a different meaning to me: it means: In the name of “clearing the never-ending backlog” we are going to deny you due process, access to remedy, and the right to discover the REAL facts about your case (arguably the 3 most important legal principles that have defined Western Jurisprudence since the Magna Carta). Starting Today – Here’s What I’m Going to Do to Challenge EVERY VA C and P Exam.Any time that a Veteran hires me to appeal their Ratings Decision, I’m going to challenge the adequacy of the medical exam and the credentials of the medical examiner. Any time that a Veteran hires me to represent them before the BVA, I’m going to challenge the adequacy of the medical exam and the credentials of the medical examiner. Any time that a Veteran hires me to represent them in the Veterans Court, I’m going to challenge the adequacy of the medical exam and the credentials of the medical examiner. And I’m going to ensure that the record contains the Examiner’s credentials (or lack thereof). I’ll stop when the Veterans Court applies a Rule that serves as a Gatekeeper against the flood of crappy “expert” opinions from unqualified medical examiners. How Can YOU Help – Is there Anything You Can Do to Battle Inadequate C and P Exams?Yes. When you file your Notice of Disagreement (NOD) or VA Form 9 – follow these steps. Or INSIST that your VSO or attorney does something very specific, like following these steps: 1) Add THIS Language to your Notice of Disagreement and VA Form 9’s.Using this language, ALWAYS challenge the adequacy of the examiner’s credentials at the NOD and VA Form 9 stages: The Code of Federal Regulations requires that to be competent, a medical opinion must be “provided by a person who is qualified through education, training or experience” to offer one. 38 C.F.R. § 3.159(a)(1). Competency requires some nexus between qualification and opinion. Dep’t. of Veterans Affairs Proposed Rules, 66 FR 17834-01, 17835 (Apr. 4, 2001) (citing Espiritu v. Derwinski, 2 Vet. App. 492 (1992) (stating that “opinions of witnesses skilled in that particular science, art or trade to which the question relates are admissible in evidence”), overruled on other grounds by King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012)). However, the VA Benefits from a presumption that it has properly chosen a person who is qualified to provide a medical opinion in a particular case. Sickels v. Shinseki, 643 F3d 1362, 1366 (Fed. Cir. 2011). Even though the law presumes the VA has selected a qualified person, the presumption is rebuttable. See Bastien v. Shinseki, 599 F.3d 1301, 1307 (Fed. Cir. 2010) (explaining that a veteran challenging the qualifications of a VA-selected physician must set forth specific reasons why the veteran believes the expert is not qualified to give a competent opinion). Given that one part of the presumption of regularity is that the person selected by the VA is qualified by training, education, or experience in the particular field, the presumption can be overcome by showing the lack of those presumed qualifications. I hereby request that a copy of the C&P Doc’s resume, CV, list of publications, list of specialties, etc., such that his/her experience and qualifications may be examined, reviewed, questioned, and/or challenged. I specifically request that any and all information stored in VetPort – or any other system of records – that pertains to the Examiners’ credentialing as a medical professional since the Examiner’s date of first employment and/or association with the VA – be included in my C-File and specifically examined by the BVA and CAVC to determine the adequacy of the Examiner’s so-called expertise. 38 U.S.C. 7402; 38 CFR Part 46;VHA Handbook 1100.19; VA Handbook 5005, Part II, Chapter 3; VHA DIRECTIVE 2012-030. Furthermore, I object to the following aspects of the VA Examiner’s opinion: a) The lack of support in the opinion with scientific, technical or other specialized knowledge, and how it relates to the conclusion being sought b) The lack of facts, tests, or data on which to base the opinion. c) The lack of evidence demonstrating the Examiner’s conclusion is the product of reliable principles and methods d) The Examiner’s failure to reliably applied medical, scientific, and or forensic principles and methods to the facts of the case. By challenging the adequacy of the exam and directing the VA to include that information in your appeal, the BVA cannot overlook that evidence without forcing a remand. By failing to get information that allows you to participate in your appeal, the BVA cannot fail to collect it without violating the Duty to Assist and – I would argue – violating Constitutional Due Process. Not to mention Veterans Advocates at the CAVC can make some pretty interesting arguments to start educating OGC Group 7 attorneys (the attorneys that represent the VA at the CAVC) and begin educating the Veterans Court on the very real problem of inadequate medical opinions – what many of us call “Junk Science” – and push for a rule to protect this area of law from being over-run by Junk Science. 2) Attach your Examiner’s credentials to your NOD or VA Form 9. Where do you find them? The first place is in the system referenced above…the second place is the link below. First you go to this: http://www.va.gov/directory/guide/division_flsh.asp?dnum=1 Then you click on the geographical area where you think the VA doctor is. Then you click on the particular HCS that you think he/she works in. Then you click on the Health Care Providers button on the left, and alphabetically find your doc. What you find there is the BARE MINIMUM that should be included in your C-File….. if you demand it. 3) Get an Attorney to help you at the Veterans Court. If the BVA has denied your appeal by relying – in part or whole – on Junk Science or an inadequate medical exam – get an attorney to represent you at the Court of Appeals for Veterans Claims (CAVC). Lawyers are trained – and practiced – how to challenge Junk Science, and with a bit of time and enough appeals, we can work with the Court to craft a rule that serves as a Gate Keeper against Junk Science. And I make this commitment to you – just like I spent years teaching Veterans Attorneys HOW to get their client’s C-File, I will start teaching attorneys how to challenge the qualifications of unqualified examiners at all levels of this system. In fact, right now, I’m going to go add this to my “This-Shit’s-Gotta-Change-in-the-Body-of-Veterans-Benefits-Law” List: “Get Court to Propound Rule Consistent with Federal Rule of Evidence 702 – Ensuring That all Experts are Qualified as Experts Before C and P Exams and Opinions are given any weight”. Source: Chris Attig Website: http://www.veteranslawblog.org/c-and-p-exams/
  6. 1 point
    Hi all...Just wanted to give you an update on my claim. It posted today in eBenefits at 70%. Overall I've had a positive experience with the VA...I know that's not always the case in some instances, but, I was treated fairly, and with great respect. I hope and pray other Vets get the same treatment, and the care they deserve. Also, thanks to Hadit and its members...Keep up the good fight! PEACE
  7. 1 point
    there are a few defenses against this, first your entrance pbysical, if no notations were made you were 100% good to go, secondly even if you had a preexisting condition that was noted the question becomes whether active service made that injury or disease worse in other words did service make it worse.
  8. 1 point
    I have gone over my STR, trying to find any entries related to sleep issues. I found one on a health survey, where you check off the boxes "yes, no, or don't know" and then write on the back why you checked yes. I wrote trouble sleeping. I'm fairly certain that I mentioned problems sleeping during a visit to sick call. I have to go over my STR again, to find it. Cuz even tho there isn't any specific mention, beyond high levels of stress to SC my depression, those sleep issue entries may just be the thing to getting my SA and MDD SCd! Wish me luck, please!!!
  9. 1 point
    lots of answers today. if already stated apologize, but here's a couple additional pieces Had this in my file- for what it's worth> Independent Medical Opinions VA plays a war game called the War of the Words. The proper wording of an IMO is critical to VA's acceptance of it, as probative evidence. A Valid IMO must contain the following: The doctor must have all medical records available and refer to them directly in the opinion. In cases involving an in-service nexus- the doctor needs to read and refer to the SMRs. Also the doc needs to have all prior SOC decisions from VA ,particularly those referencing any VA medical opinions and a copy of the actual C & P results is even better. The SOC or SSOC could parse or manipulate critical statements in the actual C & P exam. The IMO doctor should define their medical expertise as to how their background makes their opinion valid. They should be willing to attach to the IMO their CV (Curriculum Vitae that contains their medical background and any other info pertinent ,such as any symposiums they attended, articles they had published etc etc,if possible, that show their expertise .) A psychiatrist cannot really opine on a cardiovascular disease. An internist cannot really opine on a depression claim. They need to have expertise in the field of the disability you have claimed to make their IMO valid. They should rule out any other potential etiology if they can-but for service as causing the disability. They should briefly quote from and cite any established medical principles or treatises that support their opinion. They should point out any discrepancies in any VA examiner’s opinion-such as the VA doctor not considering pertinent evidence of record in the veteran’s SMRs or Clinical record. They should fully provide medical rationale to rebutt anything that is not medically sound nor relevant or appropriate in the VA doctor’s opinion. They should then refer to specific medical evidence to support their conclusion. They must use these terms: (VA is familiar with these terms) "Is due to- 100% More likely than not- Greater than 50% At least as likely as not- 50% (Benefit of doubt goes to Vet) Not at least as likely as not- Less than 50% Is not due to- 0% from an post by carlie “ It helps considerably to identify pertinent documents in your SMRs and medical records with easily seen labels as well as to list and identify these specific documents in a cover letter that requests the medical opinion. A good IMO doctor reads everything you send but this makes it a little easier for them to prepare the IMO as to referencing specific records. Send the VA and your vet rep copies of the signed IMO. And make sure your rep sends them a 21-4138 in support of it- you also- can send this form (available at the VA web site) as a cover letter highlighting this evidence PS- Mental disabilities- make sure the doctor states that you are competent to handle your own funds- otherwise, if a big retro award is due-the VA might attempt to declare you incompetent and it takes times to find and have the VA approve of a payee. (unfortunately many PTSD claims these days depend on a VA MH professionals diagnosis of PTSD and an IMO diagnosing PTSD will not be accepted by the VA. See our PTSD forum for the 2010 regs on that. I need to add here that a secondary condition to an established SC condition wold not need the IMO doctor to read all of the SMRs. They just have to state with medical rationale why the second claimed disabilty is due to (secondary to) the initial SC disability. IMO docs must avoid words like 'maybe', 'possibly', 'could ' or 'might' be related to, or any other wording that VA could construe as speculative and then disregard the IMO for that reason. On the other hand the IMO doc should look for any purely speculative statements in the C & P exam report or in the C & P and overcome those statements by stating they are mere speculation and have no medical basis. 2d item that I believe needs to be included with an IME is a "credentialing piece." My 2 IME's done by Dr Bash included following. (provided as an example) would suggest optometrist/opthamologist include appropriate verbiage citing their own expertise- Expertise-Special Knowledge: I have special knowledge in the areas of neurological-spine, sleep apnea, epigastritis-GERD/Lung fibrosis, right knee (10%), hypertension (HTN), nephropathy, hearing loss, scars right/left lower legs and cervical spine diseases, as I have radiology sub-subsection training and testing in these organ system areas as of my comprehensive 1990 boards. I have attended the US Naval course on medical effects of Ionizing radiation in 1989, which at that time was a 2-week in-person course on the campus of the National Navy Medical Center (NNMC) in Bethesda Maryland. (Now it is called MEIR and is a shortened 2.5-day course concerning the biomedical consequences of radiation exposure, how the effects can be reduced, and how to medically manage casualties. The training includes nuclear incidents that can occur on or off the battlefield and that go beyond nuclear weapons events. It covers thoroughly all four of the key subjects: health physics, biological effects of radiation, medical/health effects, and psychological effects.) I am double board certified specialist (national board of medical examiners and American Board of Radiology with an 4 month internship followed by a 4 year residency and a 3 year Neuroradiology Fellowship (2 years at NIH) for a post graduate total of year-7+ [PGY-7+] level of training, which is similar to the number of PGYs required for Neurosurgical training, am a Senior Member of the American Society of Neuro-Radiology (ASNR), and am an attending level school of medicine Associate Professor. It is important to note that vast majority physicians in America are trained only at the PGY level of 3. For example, almost all the primary care physicians in internal medicine, neurology, pediatrics and family practice are all trained at the PGY-3 level. For the benefit of VA raters it is important to note that by comparison for example orthopedic surgeons are trained at the PGY-4 and most general surgeons have PGY 5 levels of training and other specialty-trained surgeons are trained at the PGY 6 and 7 levels. I have completed a fellowship in Neuro-Radiology at the NIH (National Institutes of Health) and as such I am one of about 3000 neuro-radiologists in America at the PGY-7 level of training and one of less than a dozen who have completed a 2 year NIH experimental neuro-imaging research fellowship in the laboratory of diagnostic radiology research (please note that there are about 700,000 physicians in the US). I am a 100% disabled veteran and I have a Masters degree in Business Administration (MBA--Golden Gate University 1981) and have been employed as a Medical Director of a large ($1-200 million annual revenue) philanthropic disabled veterans organization and part of my duties involved reviewing medical records for the employment of disabled personnel and perform site visits to review quality of care at VA’s largest tertiary care hospitals and nursing/domiciliary/state homes. I therefore have both practical and theoretical experience/training in the issues surrounding the employment of disabled workers (TDIU) and needs of patients for long term care. (Please see my attached C.V.) Additionally, I have performed and/or interpreted plain x-rays, CT scans, ultrasounds, angiograms, arthrograms, barium studies, contrast studies, PET, nuclear medicine scans, and MRI (basic and research/experimental) scans as appropriate on thousands of patients with this patient’s type of primary and secondary disorders, and I have correlated my findings with the clinical record/physical exam. Please note that this patient’s claim hinges on the imaging findings. Competency, credible and professional opinions: I am highly competent and credible to make the professional medical opinion/s herewith because I am an actively licensed physician (Maryland) with extensive specialized training and experience (22 years of IME production) in the areas of interest (as described above). I have performed several hundred VA IMEs and I am familiar with the VA rating schedule as published in the CFRs/U.S. Codes. In fact, I have worked as a VA accredited Veteran Service Organization (VSO) representative for 8 years with two different VSO groups (PVA and DAV). I have reviewed the medical record and the patient’s lay statements, I have conducted a clinical historical interview, I have referenced current applicable publications (explained how they apply to this patient’s medical data set), I have examined the patient by way of reviewing his pivotal imaging study reports, I have reviewed pertinent positive and negative medical data, and I have reviewed/referenced other physicians professional medical opinions1. Medical examination: In this case a face-to-face hands-on medical examination was done. The crux of this issue involves causation and etiology and this involves time line diagnoses for which I am exquisitely well trained as a Diagnostician. Depth of knowledge: The VA has recently started to extensively use non-credentialed Nurses/Nurse Practitioners (NPs) and Physician Assistants (PAs), so-called “On-Site Providers” (OSP) or VA examiners, to provide medical opinions in complex cases that often involve the review of medical records that extend over decades. These non-MD’s do not have the depth of knowledge needed to accurately evaluate the veteran-patient’s primary and secondary medical problems nor diagnose subtle or rare diseases; therefore the quality of these important medical exams is diminished by using these non-licensed practitioners (AKA Dumbing Down). These reviewers provide sub-optimal reviews simply because they do not have extensive training or experience as compared to a physician. The axiom “...You see what you look for and you look for what you know...” applies to these complex veteran cases, which involve multiple organ systems and which involve pathologic processes that extend over decades. These sub-optimally trained reviewers do not know because of limited training many subtle aspects of medicine and therefore are unable to see or look for the linkages necessary to create a fair nexus or analysis of any veterans’ medical issues. Thus these supervised only/novice practitioners are not able to consider every possible sound medical etiology/principle as is required by VA mandate for assignment of medical diagnostic codes. MD expertise is required for these complex cases as is well-recognized by the VA, which has recommend specialists analysis for medical diagnostic code assignments via the VA court decision in Hyder v. Derwinski, 1 Vet. App. 221 (1991). My review on the other hand is based on a deep body of knowledge and training acquired over almost 30 years as is illustrated in my C.V. contained in the file and this CV is compared to the C.V.’s of a standard support staff nurse/PA/health technician (HT)/nurse practitioner (NP) below: Dr. Bash Support Staff PA/nurse/HT/NP/OSP College/University 4 years 2-4 years Masters degree in Business (2 years) yes none Medical school MD degree 4 years none Licensed Physician Yes no Nurse school/PA none 2-3 years Internship/OJT 1 year none-1 Residency 4 years none Fellowship clinical 1 year none Fellowship-research at NIH 2 years (PGY7) none Practice only under supervision No Yes- Required limited skill/training Medical director 3 years none Radiology department director 2 years none MS/Brain--MRI research Yes since 1992 none Associate professor Medical school yes-10 years none Peer reviewed articles 22 none Paper H-index (14 Oct 2012) 24 none http://code.google.com/p/citations-gadget/ Most number of times paper cited 230 none The effect of interferon‐β on blood—brain barrier disruptions demonstrated by constrast‐enhanced magnetic resonance imaging in relapsing—remitting multiple …LA Stone, JA Frank, PS Albert, C Bash… - Annals of …, 2004 - Wiley Online Library Abstract Magnetic resonance imaging (MRI) has been a valuable tool to understand the pathophysiology and natural history of multiple sclerosis (MS), and increasing attention is focusing on the use of MRI findings as outcome measures in treatment trials in MS. The ... Cited by 230 Number of paper citations 348 none Spinal Cord MRI research experience yes none NIH Senior Fellow/staff experience yes-18 years no Several thousand VA IME’s yes no 50+ site visits for VA Quality of Care yes no Years experience as MD 26+ none Years accredited VA service rep 8 none Review of C-File if available yes +/- Review x-ray/CT/MRI if available yes no Number of years doing VA cases 26 ? Number of VA Patients done 4000+ ? Number of VA organ system claims 40,000 est. ? Success rate of cases 80-90% ? Total Formal Post-Grad training years 13 years 2-3 years
  10. 1 point
    Hello everyone, I haven't posted in a while. I just got awarded 80%. 3 years ago I stared this journey and didn't know anything about claims. I have done all the work myself from reading on this site and others. 70% PTSD 30% Chronic Bronchitis 10% shaving . I have several I'm about to appeal with sleep apena being one. Thanks for all the support.
  11. 1 point
    SemperFiGeek, Just as easy to say your weight gain was caused by your service connected knee, etc. My fighting weight when I left service in 08 was 226 with a passing PT score and made weight with the tape test, 25% body fat. 8 years later I'm 241. 15 pounds, not too bad. I still had a VA doc poke me in the belly when I told him by back hurt. So, did my plantar ficitis, DDD DJD of the cervical, DDD DJD of the lumbar, arthritis of shoulder bi-lateral, arthritis of elbow and high blood pressure cause me to gain 15 pounds. I think an argument could be made that it did. Ask for a re-do, and if that fails, then get a IMO and maybe legal help. And if you are in a hurry, youre screwed, sorry, Hamslice
  12. 1 point
    "This my first appt with them" I'd ask what led to the appointment. Beyond that, the first appointment usually involves a long questionnaire, probable lab tests, and beyond a basic medical exam, additional areas to look at based upon your answers to the questionnaire and any medical history or information you have, The initial exam is an interesting combination of the things that you would expect any "new" doctor to look at, plus things that are more or less specific to veterans. A great deal depends upon the person conducting the appointment/exam. Assuming you have not dealt with the VA before, you may need to take proof of military service, such as a DD214. Service medical records, and other medical records concerning any conditions that may be service related and of concern can also be helpful.
  13. 1 point
    I had NOTHING in my medical records!!!!! Because of my service connected injuries I was able to show excessive weight gain during service, numerous complaints from roommates with loud snoring, gasping for air during my sleep habits, able to show I had requested numerous sleep studies from the VA but was denied during my 1st year out(important you make sure you have them DATE STAMP ALL CORRESPONDENCE BETWEEN YOU AND THE VA). I had an IME from Dr Bash(don't listen to the rumors...call him because each case is different!!!!! His IME along with my Dr. Riad Dahkell Board Certified Pulmonary disease and Sleep Medicine EXPERT here in Maryland did it for me and I am grateful!!!!! Dr. Bash was able to use Dr. Dahkell write up and link the 'in service' connection which gave me 12yrs of retro!!!!!!
  14. 1 point
    I filed sleep apnea as secondary to PTSD. Originally I filed SA separately, denied. Went back and filed as secondary to PTSD. Approval was quicker than a recruit platoon getting into the barracks after the Drill Instructor says "move."
  15. 1 point
    the problem with VSO's is that there is no incentive for doing a good job, this is how the free market works. These guys are not volunteers, this is a job. While many may be motivated to help their fellow vets, for a chunk its also a job. A job where they have no incentive to do it well. That why i would prefer a good lawyer. I know there are bad lawyers out there who dont know much about VA law and regs, etc. However I feel that this would be a better solution. VFW/DAV/ETC has VSO's not as reps, but as just information folks, they run seminars for vets to teach them how to read the 38 CFR for themselves, they assist them in how to fill out these forms, basically be information people. focus on that instead of filing and talking to VSR's. Then each organization can have actual lawyer like claims agents that get say 10% of the retro as a financial incentive to win and to push for a higher rating. I bet that if that VSO was to say get paid like a waiter/salesman, extremely low hourly wage but work mostly off commissions they would not be just scrawling "he dun gots the mental ouchies" on your sheet and calling it a day. I do recognize most of these guys are overworked. Shit though its the 21st century, you dont even need these guys locally. The VFW/DAV/AMVETS/ETC should just have a central hub St. Lous, DC, wherever. of 150 folks like this and then in each VSO office at the VA have 1 person to greet and show vets to a room with a VTC line to Skype call with a agent centrally located.
  16. 1 point
    Chronic fatigue syndrome is a rateable disease. My wife was awarded 40% after she was medically retired and then 7 years later increased to 100% p/t. Document your symptoms. Go to the doctor weekly if needed. Keep a journal of your symptoms. And don't let anybody tell you it isn't real.
  17. 1 point
    you need to ask yourself what you're really trying to accomplish man. You're spinning your wheels by staying on a job that's causing nothing but aggravation. Again, YOU CANNOT be awarded TDIU while employed in any capacity. You may or may not receive OPM disability retirement. You staying on that job isn't helping you in any way.
  18. 1 point
    That's too much man. If you can't do it anymore, it's time to call it quits. I got to the point where I was walking out of the job due to panic attacks (sometimes 2-3 a day), furious outbursts, detachment issues, poor to no sleep, thoughts of suicide and being attacked. At some point you have to say enough is enough and lay things out to the VA in a way that they hear you loud and clear. I'm not a soldier anymore and am not required to "suck it up and drive on".
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