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  1. 3 points
    As a veteran who fought for SC for almost 30 years, and now accredited, I would ask you to review any and all DBQs and show me where there is a box that says "Is the condition at least as likely as not SC?" This option is available on the ones used by VES/QTC/LHI occasionally. However, regardless of what the VBA says, the general rule is as it states in your attachment ( VHA Directive 1134) above: 1. Service connection and disability ratings for VA benefits are purely legal determinations belonging exclusively to the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure. Additionally, the issues of service connection and disability ratings are governed by statutory and regulatory provisions beyond the scope of VHA examination and/or primary care. Consequently, they are often not well suited to assess causality of a current condition in a manner helpful to inform the VBA adjudication process. VHA providers who wish to provide medical opinions that state causality must include clear and specific rationale citing evidence to support the conclusion reached, and should employ standard language appropriate for medical opinions (such as “at least as likely as not”, etc.) As for the second document (VHA Directive 2000-029), it is obsolete. It was issued prior to 2010. I don't wish to argue with you. I'm sure you feel I'm wrong. I litigate each and every day for Vets. I live and breathe VA law and study new techniques. I pay $3,000 a year to maintain that accreditation by taking the required CLEs. If I don't know the answer, I use Westlaw to confirm it. Westlaw costs $59 a minute to access. If I thought using VA doctors was a viable option, you would have heard about it years ago, sir. The CAVC and the Fed. Circuit would have tons of cites saying a VA doctor's word is gold. Now, if you are familiar with VA case law and precedence, you will know that a medical opinion is based on knowledge (the claims file and private medical records-or VA medical records). VHA doctors can fill out generic DBQs listed at the link above. If they do opine, it rarely has any bearing on a win. If they have not researched your case via the claims file, it isn't a probative nexus, sir. Try talking your VA doctor into reading a 2,000-page c-file and providing a IMO with supportive, peer-reviewed studies. I see hundreds of "nexus letters" by doctors. VA ignores them if they do not specifically note they have reviewed the claims file. You are welcome to believe what you will but speaking from experience, depending entirely on a VA doctor for a nexus is not advised. Here's a few from my file I find very much on point taken from Fed. Circuit and CAVC decisions: >The credibility and weight to be attached to medical opinions is within the providence of the Board as adjudicators. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Greater weight may be placed on one physician's opinion over another depending on factors such as reasoning employed by the physicians and the extent to which they reviewed prior clinical records and other evidence. Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994). >However, Dr. Bash did not address contemporaneous evidence, including VA and private treatment records from throughout the period under consideration, that note the Veteran was, in fact, ambulatory, albeit at times with the assistance of a walker or cane. His opinions are conclusory, inconsistent with contemporaneous clinically recorded data (which he does not acknowledge), and cannot be afforded any substantial probative value. >See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) (stating that a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (stating that a medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions). To begin, a VA medical examination report is entitled to no weight if it contains only data and conclusions. Nieves-Rodriguez v. Peake, 22 Vet. App. 304 (2008) Remember, we are here to help Veterans win. Each must tailor his defense to win using proven techniques. As an example, if you try to submit a psychiatric evaluation from a private doctor at the beginning of your claim, it will be rejected even if it's probative. VA's shrink must always opine first. It's the law. VA c&p doctors/nurses offer their assessment of a disease or injury for the VBA adjudicators to study. It is not binding on VA. I've had hundreds who said "Yep. It's due to AO. A month later I get the denial saying it isn't. I take no pleasure in arguing with any of you here. My desire is to teach you what you need to succeed. As they say, you can lead a horse to water but you cannot make him drink. You are free to ignore my advice and it will not hurt my feelings. I've helped thousands over several decades attain SC-usually IU or 100% +. It's a recipe-just like baking cookies. If you choose to substitute baking soda instead of the baking powder called for, you don't get what you desire. Many tell me I'm wrong here at Hadit. Considering I have never lost a claim or appeal yet (knock on wood), I take it with a grain of salt. I wish the best for all of you. VA screwed me in '89 & '94. Every win is a b*tchslap for that treatment I received. They should never have said I was not in Vietnam.
  2. 3 points
    My guess would be that yours is not a difficult claim to adjudicate so they were able to get it (almost) finished faster than expected. Based on the info you shared, there's no way they'll reduce your rating. Regarding the term "moderate to severe", it's important to put it in perspective. 90% to 95% of the country is not suffering from two serious debilitating mental disorders at the same time. Here's Dr. Mark's off-the-cuff, unscientific, for-illustrative-purposes only, 11-point "severity scale" that I just typed out as a "thought experiment" to give you a sense of where "moderate to severe" fits on the continuum. Rating - Description 0 - No symptoms, no history of disorder. 2 - Mild symptoms but frequency, intensity, & duration insufficient for DSM-5 diagnosis of disorder. 4 - Mild symptoms that satisfy DSM-5 diagnosis for the disorder. Experiencing symptoms more often and with more intensity - harder for him to say "it's just a bad week" or similar. Wife said he seems dejected, less energy, motivation flags. He'll bounce back for days or even a week or two but that's becoming less often. Calling in sick to work more often. Supervisor said management has commented on his declined productivity. 6 - Moderate symptoms that cause noticeable and significant social and occupational impairment; frequent distress, dispirited; interpersonal relationships strained, even with her children; school functioning has clearly declined. Got a "C" in one course and two Incomplete grades. Decided to hold off on continuing college coursework, even though she is close to earning all credits for bachelor's degree. 8 - Moderate to Severe - frequent painful symptoms much of the time despite assiduously seeking treatment and following his doctors' advice; significant social & occupational dysfunction; probably will need to seek medical leave, reduce work hours, or may end up not being able to work. Psychiatrist has discussed options for "treatment-resistant depression", e.g., ECT (electroconvulsive therapy); the new ketamine-like medication; Lithium; Abilify; etc.; psychologist recommended VA's 6-week residential treatment program for PTSD in Sheridan, WY. 10 - Severe - very frequent, soul-crushing painful symptoms most of the time despite assiduously seeking treatment and following his doctors' advice; substantial suffering is obvious; significant social impairment, and no longer able to work, at least for the next several months or longer. [The above is not an official, unofficial, actual, or real mental health scale. It's just a way to put symptom severity and functional impairment in perspective for illustrative purposes only.]
  3. 3 points
    @acesup I was previously in the same boat. My DRO appeal was granted on July 31, 2018. I learned the hard way that White House phone calls and Congressional Inquiries don’t work. Last month (February), I called the VA 1-800 # like I did everyday, three times a day. And the representative said she would give me the number to the VA liaison for my regional office which is Baltimore. Long story short, her office was directly across from the person who oversees the entire appeals Dept. The liaison took action on my behalf and was quite upset about the whole ordeal. My claim was closed the very next day and money in my account three days later.
  4. 2 points
    I have hypogonadism as well, and receive testosterone from the VA. Im 42 (ugh). While its not had much effect on my depression over all in the last 2 yrs, it has helped my energy levels through the day so Im not completely exhausted from mundane tasks. Quality of life is important but its not a cure all. I self inject, incidentally, its not that difficult once you get the hang of it, and they provide the needles and syringes. I would recommend drawing your dose with a larger needle, like a 20 gauge (still pretty small), then switching needle tips on the syringe and using a 22 gauge to inject. Reason being is that piercing the top of the container to draw out your dose dulls the tip of the needle just a bit, and its noticable when you use the same needle to draw and then inject. Trust me on this. VA used to give me sets of both gauges, for awhile, then they stopped. Not sure why, but in any case you can, for about 20.00 a box of 100, get syringes and needles for self injecting from Amazon without a pharmaceutical license or anything like that. That way I am still able to draw with 1 needle and inject with another. Its pretty simple. I have not had benefits reduced, but depression is long term treatment resistant type so it depends on what yours is and its cause. If you go outside VA it will be at your cost and I don't know what that costs. I get my dosages 2 to a bottle, and I reorder from VA pharmacy online. I take shots once a week. If you have insurance that will cover it, why not, but if you can get it for free from the VA, I would. You'll have to go in every three months or so for the first year so they can monitor your doses and make sure you are compliant with injections (basically, that your levels are static) and that you aren't having any other issues. Keep in mind that if you start taking testosterone your testes will stop making it and it will basically render you sterile. Not 100%, but your S count will drop to the point of being unable to have kids if that is a concern. Your doc should fill you in on all this, too.
  5. 2 points
    SMC is a quality of life issue. You assemble it like Legos. Okay. There is no requirement to get to SMC S prior to ascending to SMC L. LOU (loss of use) of lower extremities is one SMC L. If you had LOU above the knees, It would be M. If the catheter causes you to need Aid and Attendance, that is another SMC L. Two Ls advance you to SMC O. If one of the Ls is for A&A, then you get R1. You could have two entitlements to A&A and get R1. The c&p for SMC is basic. You have to prove by medical records you have been dx'd with LOU of two extremities. VA does use the VAF 21-2680 for determinations. I've never heard of a SMC L c&p taking four hours. Generally, you medical records reveal the determination you have been dx'd with the LOU or the need for A&A- but not always. The M 21 states only a VA examiner can make a LOU/ A&A determination. Thus, even if a QTC/VES/LHI doctor says yes, VA can still say no. I am currently in that situation with one of our Hadit members right now. He deserves A&A and they refuse to grant. The good news is the Mariano v Principi decision. If you have a dr. saying yes and VA says no, that's equipoise and by operation of law, they have to grant it. Sadly, I almost always have to go to the BVA to achieve them.
  6. 2 points
    BroncoVet touches on an interesting precept with attys/agents. Most of us will never touch a new claim but will advise you to use a VSO to file it. The reason is simple. We are forbidden by law to charge you to file a claim. We only can enter in to the fray once a denial is issued. It also is a good experience to discover what "hands on" really means in claims development. I do not fault VSOs for their lack of ability. They are not trained to do this. They are glorified mailmen. They fill out your 526 and deliver it. I have learned to file an 8940 at the outset of a claim regardless of whether a client is working. I've won on a Vet being "marginally employed" in a sheltered work environment. He was a CPA working for himself and all but unemployed but for some of his oldest clients. The VR&E angle is good but time consuming if attempted after filing. With the new AMA, you want that in your file at the outset if possible. I advise you begin that asap and prepare it as a tool ahead of time. I never procure an IMO until I lose. Why waste the money? I'm an undying optimist that VA might be agreeable and give my client his due. Of course, I was convinced we were going to win in SEA in 70-72. As with all techniques, VA is learning to deny IMOs by sending out to get second opinions. This is called developing to deny and is forbidden by Mariano v Principi and §3.304. Thus, I always ask for a SOC asap and submit it to a VLJ. I just got back from a TB hearing in Oakland before VLJ Matt Blackwelder last Thursday. My client has Hep C and he admitted to snorting toot in 88. He has no medrecs. They burned up in 73 or so VA says. I had to explain to the judge that Stage 4 cirrhosis takes 50 years-not 30. 1988 doesn't fit the medical scenario. You could never accomplish a win like this without an extraordinary IMO presented in person to the judge. He read it while we sat there and nodded in agreement. I never forecast wins but I feel good on this one. Absent qualified counsel, he could never have won it on his own or with a VSO. A videoconference would never have conveyed my client's advanced debility from the cirrhosis. One thing I cannot impress on you folks here. There is no template for a claim. Each of you is unique as are your circumstances. There is some commonality in how it is done but each one must be produced based on the evidence you possess-and most especially- what you do not possess. I like to use this as the ultimate example of what you can create with absolutely nothing to work with but negative evidence-or worse- no evidence whatsoever. The gentleman was advised in 2015 by his VSO not to waste his time filing as he could never win it. We shall see.
  7. 2 points
    Hi Everyone I've learned so much from this site over the past 5 years. I was granted service connection for PTSD (02/28/2019) and I am in the same boat. My effective date is the date of my last C&P (01/31/2019) even though I had a diagnosis from a private doc from and never let my claim close. I just filed an appeal using the higher level review lane (03/28/2019) so I will try and post my timeline and eventual outcome.
  8. 2 points
    VA quit allowing their doctors to opine on Veterans' conditions and whether they are service connected back in 2010. You'll have to look to an outside source in the private sector to get the opinion [option]. You can use an PA-C, PA, or ARNP but an MD is the best. VA often uses registered nurses at the ROs to make the decisions. They are called "VA examiners". Good luck.
  9. 2 points
    I wouldn’t pay a lawyer for something you and a good service Officer can do for free. You’ve got a lot of options, but going it alone is a bad one. If you’ve got issues after a surgery by the VA look into the possibility of filing an 1151 Claim. It may be wise for legal counsel on that approach. Discuss it with a service officer first and any recommendation she/he may have. TDIU you can not be working if you file. Filing for SS is an option too. Their standards are different for rating conditions and based on your length of work history. A medical option by a VA doctor is the best option. She/he must state in the option that your condition is due to or more likely than not due to your d/x disability. Maybe even permanent and total in nature. Again, this needs to be an MD.
  10. 2 points
    Did you file for and get temporary 100% after your surgery? Depending on the surgery you had, and the results, I believe you could possibly be entitled for a temporary 100% benefit for 5 months, if you file a claim for it with the appropriate documentation (mainly the Surgery Report). Of course that is only if you're already SC for whatever caused the surgery. As far as the side effects of the medication, getting any compensation out of the VA for a temporary problem that is now resolved might be like pulling hen's teeth. VA disability compensation is not set up for what is considered "acute and transitory" symptoms, such as a short-term bout of depression or other temporary symptoms you're reporting here. There may be a slim possibility of filing an "1151" claim, it's not a subject that I pretend to know much about, but it might apply in your case. It is basically a claim for problems caused by improper treatment or malpractice, etc. It also seems unlikely that you'd have an 1151 claim, because treating nerve pain and depression with Cymbalta is common. (I take it for exactly those issues.) There is information about the 1151 approach in these forums, just have to see what you can find that might apply. However, reading over your post again, I have questions: Did you have a medical professional that evaluated the side effects you experienced, and evidence that they were caused by the Cymbalta? Did the doctor who prescribed it tell you to wean yourself, and why and how you should do that? Did a medical professional diagnose the depression and blame it on the Cymbalta? And do you have all of that in written opinions or in your medical records? Without diagnosis and nexus opinions from qualified medical professionals, there's not much for the VA claims folks to work with. Hopefully others will chime in with their knowledge about problems like yours. Hope your back and everything else is getting better. Two years ago, I had a 4-level lumbar fusion (TLIF with laminectomy and lots of titanium hardware), so I feel your pain. I filed for and received temporary 100% at the time, and got paid 5 months of it with SMS (S). (Since then, I've been granted TDIU and SMC (S) back to 2009, that's another story). Best of luck with your claim.
  11. 2 points
    I personally believe that a letter from your spouse or significant other is one of the most important pieces of evidence you can have inside your claim. I believe that many examiners and raters do not consider them important and tend to dismiss them and give them no credibility. However, on appeal it is something that seems to be a deciding factor in overturning a poor rating decisions by the BVA. There are two important pieces to this letter that I believe is critical. 1. Your spouse should only list symptoms they see. They should never state in the letter a diagnosis. If your letter has a diagnosis in it and your spouse is not qualified to render a diagnosis the rater will immediately ignore it. 2. Your spouse should state how your disabilities impact your day to day living. What things you could do in the past but cannot do now because of your disabilities. No one is more qualified to stated how your daily life is impacted than your spouse. I think anything else in the letter would be overkill but that is just one man's opinion.
  12. 2 points
    In addition to the excellent advice you've received from your fellow vets, I'll briefly share from an examiner's perspective. I learned from my friends who are veterans and from the many veterans I evaluated over the years that the "rules of the game" change dramatically when services members leave the military and enter the world of being a veteran. In the military, seeing the doc for anything that's serious or chronic will likely hurt your career and you'll go from "Awesome member of the team" to "Potential liability". Then, when you enter the world of being a veteran all of a sudden everyone is exclaims, "What?! You haven't sought treatment? You gotta do that man." I don't mean in any way to discount the advice you've received here--I totally agree with it. I'm simply highlighting the stark contrast between life in the military vs. life as a veteran. My main point is that decent C&P examiners know that there are many possible reasons why a veteran hasn't sought treatment before. When and if it seems appropriate (trust your gut) tell your examiners in a brief, matter-of-fact way (like you did here) why you put off treatment for so long. Don't belabor the point. Finally, as others have said, when you go for treatment appointments, try to put your disability claim out of your head. Ask yourself, "If I didn't have a pending claim, what would I say? How would I act?" I've had severe allergies since I was a teenager and they're awful. People who don't have them really don't understand (unless they're medical folks.) But over the years my doctors have found treatments that work for me and now the allergies are a nuisance, but tolerable. Allergies are just one of the ailments you're dealing with, but my point is that treatment is often quite helpful. All the best, Mark
  13. 2 points
    As a C&P examiner, I took letters from spouses seriously. And, if a vet was accompanied by his or her spouse and asked me to speak with him or her, I would always do so as it often helped me to better understand the frequency, intensity, and duration of mental disorder symptoms and associated functional impairment. Unfortunately, VA does not require examiners to interview family members, and there are not any specific requirements for examiners about how to regard letters from family members. Nonetheless, letters from "lay witnesses" could help, even help a lot, and they're unlikely to hurt a veteran's claim. Veterans law attorney Chris Attig recommends submitting lay witness statements as a "Declaration", which he explains in a blog post. Note that Mr. Attig calls it a "sworn declaration" whereas other legal websites, and the relevant U.S. Code, call it either an "unsworn declaration" or simply a "declaration". In my experience reading Mr. Attig's blog over the years, he offers well-written, important, accurate information for veterans and their representatives. I don't know Chris Attig personally, but I respect him and value his opinion. Although they don't mention using a Declaration, the law firm Chisholm, Chisholm, & Kilpatrick has a good article, accompanied by a question & answer video titled, How to Use Lay Evidence for VA Disability Claims. There's an easy-to-understand, informative article on the Martindale (legal publisher) website that discusses Declarations in general, i.e, the article is not specific to veterans law: When to Swear and When to Declare: Affidavit or Declaration? by Matthew J. Bakota (21 May 2012). Finally, here is the statute itself: 28 U.S. Code § 1746 - Unsworn declarations under penalty of per­jury. I'm not an attorney, but it looks pretty straightforward. If it were me I would write exactly what the law specifies at the bottom of a family member's letter, and ask them to date and sign it: Note this part: "... under penalty of perjury ...." Chris Attig offers important advice in the blog post I mentioned above: I hope all your exams go well SwiftSig! ~ Mark
  14. 2 points
    That evidence should carry the day.
  15. 2 points
    A claims file request made by the veteran is legally designated as a Privacy Act request, not a FOIA request.
  16. 2 points
    It’s been a long road 4 years and 7 months long but finally WON! Never thought at my age I would ever see P&T. Now on to SS. Thank you to everyone who has posted. This site has helped me along the way in so many ways!
  17. 2 points
    Which one of the following best describes your situation? This is a general idea of how they will rate it. They don't go off of one statement a doctor will place on there, it is more of a puzzle and finding out which once you fit into. After looking it over page 9 is where I would look to see how they will rate it. If I am reading this correctly the 70% seems to fit. But I am not a rater, so It will based on what they see.
  18. 2 points
    Winston Churchill once said “Never give up, never give up, never, never, never.” This holds true for those that have the invisible wounds of war. Sixteen years after my retirement I received a letter that outlined possible VA presumptions. The letter explained many challenges I experienced and encouraged me to apply for VA disability and the beginnings of denial. I received a 60% rating in 2017 with a service connection date of Aug 2014. However, my main challenge (PTSD) was denied. The denial was because I didn’t have a therapist confirming my condition; they agreed with the stressor. Since I am retired and use Tricare Prime, I went there for therapy and appealed. I was again denied because the therapist was not a certified therapist. How would I know? i was headed to an appeal with the BVA and my VSO (Virginia Department of Veteran Services), specifically Caleb Johnson, helped me get two independent evaluations from a university and a therapist. I entered the RAMP program and received a 50% PTSD rating in 2018 but with a service connection date of Dec 2017. I appealed the date and for an increase in Nov 2018 and yesterday (19 March 2019) received a 100% P&T with SMC (S-1) with a service connection date of Aug 2014. Below is my HLR Ramp timeline: 1.. 1/17/19 CR 26 Apr 19 - 10 Aug 19 2. 1/28/19 PFD 25 Feb 19 - 1 Apr 19 3. 2/6/19 PDA 6 Feb 19 - 10 Mar 19 4. 2/7/19 9 PFN Feb 19 - 11 Feb 19 5. 2/11/19 PDA 26 Feb 19 - 15 Mar 19 6. 2/19/19 PDA 6 Mar 19 - 23 Mar 19 7. 3/4/19 PFD 1 Apr 19 - 6 May 19 8. 3/5/19 PDA 20 Mar 19 - 6 Apr 19 9. 3/5/19 PFN 7 Mar 19 - 9 Mar 19 10. 3/6/19 PDA 21 Mar - 7 Apr 19 11. 3/8/19 PFD 5 Apr - 10 May 19 12. 3/11/19 PDA 26 Mar - 12 Apr 19 13. 3/13/19 UR 10 May - 23 Jul 19 14. 3/15/19 PDA 30 Mar - 16 Apr 19 15. 3/18/19 PFN 20 Mar - 22 Mar 19 16. 3/19/19 Complete As you can read above, there was a lot of bouncing back and forth. Yes, I watched eBenefits more than I should. This site was a source of support throughout my painful wait. This is what I learned: 1. Don’t quit! 2. EBenefits does not accurately demonstarate the RAMP stages. You may see the progress in EBenefits but the stages don’t apply correctly. 3. It is futile to tell a veteran to stop watching EBenefits. What else are they going to do? 4. If you feel like you must call EBenefits (Peggy), they cannot tell you everything they see but some will tell you more than others. I called several times till I at least got some type of information I thought was the most they could give. 5. While I had success with my VSO, it was with Caleb and not with the other people that worked there. So, sometimes you have to ensure your VSO cares. As a matter of fact, after receiving the 50% PTSD an idiot at that office told me to be happy with it. I submitted the HLR RAMP on my own. I didn’t bother to complain to Caleb but he found out and that person’s supervisor called me to apologize. The moral is that you are ultimately accountable for the outcome so don’t give up!
  19. 2 points
    As I mentioned before, I used both Dr. Ellis and Dr. Anaise. Dr. Ellis performed an actual examination and provided an IME/IMO, and Dr. Anaise did a full records review of everything, including Dr. Ellis’ own IMO. Drive-out cost for a baker’s dozen, plus a couple of conditions: Dr. Ellis - $550 (It included a full blown exam. I had to mail off all of my documents to him in advance, which was no real problem thanks to the U.S.P.S. Great staff, and a free sucker (lollipop for those inquiring) when I checked out.) They maintained contact with me throughout the process until I received my final IME/IMO draft. Yes, they will correct mistakes or note something for you if you ask nicely. Dr. Anaise - $2K (I e-mailed most all of my documentation to his office, and only had maybe two phone calls. The staff there, consisting of at least one more doctor...maybe more, are efficient. They are pretty much business only, but he writes a great IMO.) They will also go back and forth with you via e-mail to proof your final draft. My Oncologist....$25 co-pay, rest covered by my health insurance. He did a short and sweet IMO based on records and his 20 years of treating me. A friendly East Texas Audiologist - $40 - She did a one-pager IMO after doing a round of audiology exams on me. Throught it all, the VA sent me to three different full blown C&P’s and two Audiology C&P’s. The process has been slow, and the VARO ignored everything they could ignore as I climbed up from 10, 20 and then 80% (The last big jump was due to a new condition that the VARO actually approved right out of the chute. I’m still amazed.) Now, reading the BVA’s recent decision, which granted 12 conditions and remanded two, I see that the Judge and the BVA attorney staff loved Dr. Ellis’ work and cited it in nearly every grant. They also cited Dr. Anaise quite often, and both served as a one-two punch against the negative C&P’s. They also loved the short IMO from my oncologist due to him being my treating doctor for over two decades, and even mentioned the audiologist IMO once in granting a hearing loss connection that I had all but given up on. In truth, I also had plenty of medical records and some recent VA treatment and x-ray reports that my representative shot over to them at the last minute, which they cited as well. Long story short, I think the BVA really liked that Dr. Ellis and his staff actually performed examinations instead of just records reviews, and Dr. Anaise served to bolster the evidence even more in my favor by providing medical basis for each claim with legal reasoning. (I did not use him as my attorney, although he does do that too, but he ensures that the language of each nexus conforms to legal standard at the BVA.) Now keep in mind that the costs probably have risen since I obtained mine three or four years ago. I’m still sitting in the waiting line back at the VARO to handle my granted conditions and work on my remands, but at least I have that BVA decision and I couldn’t have done it without those solid IME/IMO’s. Good luck! Mark
  20. 2 points
    And, depending on which RAMP path you chose, you are not allowed to submit any new evidence to the BVA that might mitigate in your favor once you start down that road. The problem with RAMP is simple. You trade in due process rights-in this case, the duty to assist you in developing your claim(s)- for a speedier decision and an expedited decision at the BVA. Since the new system BVA RAMP part doesn't kick in until February 2019 (we hope), you could never get it expedited in the truest sense. If you are not permitted to submit a new nexus/IMO at the BVA, what, pray tell, would be the purpose of appealing? The sole purpose of the BVA is to give you another bite of the claims apple. This is the stage where more claims denials are overturned-many due to introduction of new evidence. RAMP is a feel good panacea to give Vets the illusion of a faster decision. Unfortunately, it strips you of protections accorded you under the old legacy situation. All this will end up doing is overburdening the CAVC with a huge backlog. USB Allison Hickey promised us a streamlined system in 2013 with the advent of VBMS and electronic claims processing. That led to Fully Developed Claims (FDC) where you do all the work in collecting the evidence. With RAMP, in essence they effectively forbid your doing even that. So... FDC gets you a 125-day decision with a 75% error rate. Add in RAMP and you get a denied appeal with no added evidence permitted within a month after you get the appeal(s) certified. If it were just a pure law argument like CUE where you are not permitted to supplement the record with anything new, it (RAMP) would be advantageous. This poker game is already stacked against us. RAMP is just one more tool to be used against us. One thing I see in VA law is when I get in front of a VLJ literally face-to- face rather than video conferencing, I win. Granted, I submit a new IMO, too. You want that interpersonal relationship. You need to get the Judge to view you as a Veteran and not a number. It's one thing to see an ASPCA commercial showing a shivering dog. It's another thing entirely (and far more poignant) when you come across a shivering dog in the flesh. A VLJ's compassion level goes up immensely face-to-face and even more so if your appeal is justified.
  21. 1 point
    Kudos for bettering yourself. However, It’s a fact. When you complete VOC Rehab? They VA will deem you employable. You WILL lose your TDIU. I think you could argue the rental property issue, but that’s out of my lane.
  22. 1 point
    UPDATE: I saw a post on another thread with an email address for BVA inquiries. So I figured I'd give it a shot. So I sent an email explaining our appeal info (BVA grant for migraines and remand for TDIU on March 7 2018) and I asked for any information they could provide. I sent the email last night and got a response this morning. See below: Thank you for your inquiry. Your appeal was remanded by the Board of Veterans’ Appeals (Board) to the Appeals Resource Center (ARC) on March 7, 2018. In its decision the BVA granted issues (Headaches) and remanded another for development and adjudication(TDIU). Upon review of the electronic file a rating decision in reference to headaches has been completed. As such, the appeal status is currently listed as “Open”. Please note that after promulgation of this grant, development will be continued for the remaining remanded issues. An email has been sent to the Supervisor to initiate the grant for headaches. Thank you for your service to this country. I'm hoping that this is good news.....the part about sending an email to the supervisor to initiate the grant for headaches. Also today I received a response from IRIS from an earlier inquiry I made. Their response was DIFFERENT than any of the others.....it stated that they could not retrieve the appeal information and that they VARO would be contacting us directly regarding this info..........hmmm....could this mean someone might be working on it?
  23. 1 point
    Thank you , Tbird for sharing this site. You probably have done it many times before but I just saw it. Great resource!
  24. 1 point
    Buffalo- when I was in ebenefits it said I had 53 historic issues with them. They gave me a lot of crap, I got a double DRO review under a IRIS CUE I filed. My useless state vet rep went to the second review- they had not considered 4,000 bucks of my IMos. The double DRO review got me the same DRO who did the denial and she handed the IMos back to my rep saying she could not read them. I asked the rep if he got them into the record but he didn't answer- he said at least I got you another posthumous C & P exam. I asked him if the DRO could not read the IMOs how can she possibly read the results of a C & P exam. I could have cued them again but had enrolled into AMU to finish my degree and I KNEW the BVA would award the claim and they did. I have named their Director and another person in my OAWB complaint and someone else , a veteran who deals with them, has written to the IG and is filing a WH complaint against their director. She called me twice to believe something that was ridiculous and it proved to me she does not know basis VA case law. Buffalo also tried to make up a regulations to deny my SMC CUE, and when I asked them to produce it they didn't respond.They withheld probative evidence I had for my wrongful death case, withheld it from a C & P doctor as well as the Office of General Counsel. The last C &P I got was so ludicrous, (I won with a CUE 3 weeks later)that I am waiting for a copy of the actual signed exam. I got a call from the local VAMC the other day asking me about the Exam, from info he got from Buffalo. He said why do you need the exam? I said because I do not believe anyone with a medical background wrote-I think the director's VSO shill wrote it. The Buffalo VARO made so many errors on my dead husband's issue ( not to mention that they killed him as well(FTCA.1151) that I told the OAWB I consider myself as having been targeted by them for the past 25 years. It was never a question of not having the evidence- and I finally won all those claims. Remember, anytime you get something from them, if there is an alphanumeric on the letter, that holds the initials of the last person who signed off on your claim decision. I always make sure I used those initials in my past more recent CUEs.As Attention to. That is one reason why my last denial became an award under CUE in 3 weeks. You WON a CUE in the past- so be confident that you can do that again.
  25. 1 point
    I am so sorry for your loss. Some of this does not make sense to me: "She is getting SS for him, DIC and SBP and part of my benefits as well. I just need someone to put me in the right direction" How do you know that? It would be possible that she gets SSA for the child and maybe for herself ,until the child is 16.fully legit. It would also be possible that he signed up for the SBP program ( I assume he was a Military lifer ) and that would make some sense-if he continued to pay it for her. I do not see how she could get DIC and you do as well....??? that definitely does not make sense. Also ( I am a Gold Star wife) and the GSWs fight aggressively to try to get SBP without the DIC offset or vice versa- she is qualified to be a Gold Star wife- so are you. You also would be eligible for SSA for the child you have and possibly a Mother's Benefit, as I was before my daughter joined the Military. " I am receiving VA benefits from him." What benefits, do you get a DIC monthly benefit? It should be more than mine is because you have a child . I get $ 1,319.04 p/m as the unmarried surviving spouse of my husband. Have you app;lied for SSA benefits for the child you had with him? But still...... can you scan and attach whatever the VA sent to you regarding the "apportionment" Before you scan and attach it here , cover your name, address, and C file number. He might surely have had Military insurance. My daughter still has hers ( $200,000) maybe more by now but that goes to the beneficiary he listed when he purchased it. We need more info. His child with the former wife would be eligible for DIC. I dont see how the former wife could eligible for it.
  26. 1 point
    That child was HIS child and is also entitled to HIS benefits after his death, also that child was his FIRST child and in many States that child's financial needs come before any subsequent children (which often is the case for child support purposes, also not relevant in the situation). It matters not whether the child's father was active in his life. That child had no choice in the matter. The child should also be receiving part of his social security benefits and I hope the child's mother has also applied for them as well. You said you have children (plural) but one child with your spouse who was killed while serving. You either have children from a previous relationship or subsequent children, do you not think their father should support them in life and death? This isn't about you, this is about the child.
  27. 1 point
    Only the VA can diagnosis PTSD. Until they do you do not have a leg to stand on. In your treatment you need to tell the doctor exactly what happened, even if you do not want to. If the doctor is not putting in your records what you are saying you need to speak to the doctor in a mild mannered way and ask them why. Never raise your voice or become frustrated, it is a losing proposition. I know this because I have been there, frustrated and angry. I had a doctor walk out of a session and say I threatened him. It was not a happy experience. It all goes into your records forever.
  28. 1 point
    I guess I should chime in. I went with Dr Bash, who first reviewed all my records then a year later I flew to DC, I think JFK, and Dr Bash did a full head to toe exam, clothed, on me in the airport, right inside Starbucks!!!!!!! Today im 90% IU and P&T!! I should be SMC but decided to stop other claims and now new stuff arising from SCd issues. May e in the future I may file but for now I just done with everything VA.. Dr Bash knows his stuff and the SSDI Judge said in her own decision hismedical opinion held more weight than any VA MD becausethe VA hid th eir own EMG reports from her!!!!!!!!!I had to give her the reports at the hearing in 2014!!! Bestof luck on who you choose… Hes been 100% correct on my diagnosis every single one of them...
  29. 1 point
    Just to make sure I understand correctly, you are currently receiving disability compensation for PTSD at the 70% level. Is that correct? If so, I am wondering if the letter asking you for more details on your stressors might be a mistake. Verifying stressors is something that happens before a veteran is service connected for PTSD. Once you are service connected why would they go back to the service connection question? It's like them saying, "You are service connected for PTSD, so we want to confirm that you have PTSD." As Spock would say, "that does not compute."
  30. 1 point
    You are now in a catch 22 area. You are working to make money but your disability is making it near impossible. You cannot get SS or TDIU because you are still working. Follow broncovets advise and get a voc rehab letter if you can. Then approach the situation with the full knowledge that it is a difficult road. Can your long term disability insurance keep you afloat if everything falls apart? Only you can make this decision. I was ready to be fired due to not being able to perform my duties any more and the constant late and absent days. Can you talk to HR or your manager about what is happening? Don't get fired due to this, get your doctor to write a letter for you, then you should be able to collect long term disability. With a doctor's letter the company will terminate you. You just want to leave on good terms. After you lose your employment get your supervisor and/or manager to write a lay letter for you explaining why you can no longer be employed there. This carries weight at the BVA level, the RO's sometimes neglect to consider lay letters. employer letter 2.pdf
  31. 1 point
    Thank you Shrek. It may not have been said, but I got the gist of what he meant. Thank you for clarifying though!
  32. 1 point
    You'll need to obtain your service medical record to confirm that your complaint during your May 2008 physical exam was clearly and unmistakably documented. Here is one way to request a copy of your service medical record. You will be making a FOIA/PRIVACY ACT request for a copy of your service medical record only. Be advised it will take approximately 5-6 months, but in the meantime you can file an intent to file to start your effective date; and still be getting treatment to build more medical evidence. va3288.pdf2017-01-18+Claims+Intake+Fax+Coversheet-1.pdf So let me see if I understand. 1. According to your post, the in-service event/injury was first mentioned May 2008 2. You have been treated for your shoulder in 2017 and 2018 . You might have a diagnosis, but you'll need to check your treatment notes. What you will need is lay evidence(buddy statement...same difference) from a buddy (in-service), family, friends that knew that you had hurt your shoulder and they will need to report what symptoms they witnessed from you after you hurt your shoulder, such as; guarding, wincing in pain, limited range of motion, decreased strength. But, it has to only be what they have seen; they can't make a diagnosis. You need to have what's called "continuity of symptoms or chronicity of symptoms" to fill in the gap from 2008 to the present day. If you have treatment notes ,submit that with your evidence. You will need a Nexus of opinion stating the minimum threshold of "at least as likely as not" your shoulder condition is due to or the direct result of military service. I hope this helps you get the ball rolling. Best wishes.
  33. 1 point
    The Calusa triangle is to have a condition noted in your service records, evidence of a chronic condition, and a doctor's statement that the condition is as likely as not incurred due to service. You appear to have the first one but lack the second two. I am most concerned with the fact that you have been medicating with alcohol. Do you have combat in your service records? You may be suffering from a mental condition also. As brokensoldier noted you need to get in and get treatment.
  34. 1 point
    Has nothing to do with that. I am 314516 in line according to va.gov. My appeal is from 2014. I would be happy they are working on it. I am now 10 months after remand was issued and they have just scheduled me for another c&p. You should be happy it is moving!
  35. 1 point
    Look here: https://www.benefits.va.gov/WARMS/bookc.asp Find knee (probably under muscular skeletal) and compare your symptoms and diagnosis from your doc notes to whats listed. Each percentage rating has criteria you have to meet, primarily range of motion, though pain can be rated as well. Make sure you have a relatively regular attendance to doctor appointments so you have a good record of how the condition affects you, then file.
  36. 1 point
    Mark D Worthen PsyD is also top notch and has helped my husband and me. very nice guy with extensive VA knowledge https://www.drworthen.net/
  37. 1 point
    Wow, this is a great thread. Nothing like the voices of experience to get a good sense of what's available in terms of an IMO/IME/Nexus Opinion. I don't know any of the physicians personally, but similar to what y'all have written, I have been impressed with Drs. Bash and Anise with regard to their breadth and depth of knowledge and ability to communicate effectively in writing. I have also enjoyed listening to Dr. Bash on the HadIt radio hour. I don't know as much about Dr. Ellis but I have read numerous positive reports here and on other forums. I have never read anything negative. Setting one's fees as an expert witness (which is how the federal courts refer to doctors like Ellis, Bash, & Anise) is interesting. I suspect a lot of it has to do with the stage of one's career, overall financial situation, and staff resources. If you're still in the midst of your career and you've got kids in college or grad/med school, then you should run your practice like a good small business and make some money. If you're approaching retirement and are financially secure then you might charge less as a community service. I am guessing, but Dr. Bash is probably following sound business principles for consultants of all kinds: If you have done good work, built up a solid reputation, and are swamped with referrals, you should raise your rates until you have a manageable number of referrals. Basic supply and demand in a free market economy (capitalism). Some people complain about such professionals, saying they are "too expensive". My usual response to such judgments is something like: "Well, if you want an economic system based on the principle, from each according to his ability, to each according to his needs, such a system has been proposed."
  38. 1 point
    Yea he's good at what he does. He went through my smr and found I had stomach issues that started in-service and they've gotten worse over the years but I have a claim pending. So, I'm gonna hold off on that.
  39. 1 point
    Hi Everyone- I obtained an IMO from Dr. David Anaise and eventually sought him as my attorney to represent me in my BVA Appeal for rhinitis and sleep apnea. He has impressed me with his professionalism and has answered my emails should I have a question. This is my first post in this forum and I Have learned a lot from my fellow vets. I will keep this forum updated as to my disposition of my case. Dave
  40. 1 point
    That’s a positive TBI exam glad they didn’t sweep under the rug...
  41. 1 point
    Hi all, My Husband is the disabled veteran with TBI, PTSD and other problems. He doesn't read or understand a lot of this. we have been married for about three years and I am trying to help him. My native language is not English and I have some friends help me with editing what I write before I post them. I was a social worker in Europe for several years, but this VA stuff is over my head. My husband told me that Berta, Dr Bash, and others on hadit had helped his wife before and she was in the process of getting his PTSD and TBI separated, Getting his migraines service connected and CUEs but she died of cancer before she could finish. we wanted to have Dr. Bash do an IMO, but my husband's fiduciary would not pay for it. we are living out of the country now waiting for my son and I to acquire our US visas. I have gotten a lot of help here from all of you and really truly appreciate it, but I am completely lost without the help you have given me. My husband always gets stressed when I have to post his personal information on the site, but he tries to stay calm. I am going to post his old C&P exam and other VA claim info over the next few days. Thank you for helping my disabled veteran husband "all hadit members"
  42. 1 point
    It sounds like you need a forensic IMO. They would need to review your service records and VA records and state that they did than and then provide a nexus between your service and current chronic condition. This is a high hurdle to make but it sounds like your only option. I looked for local doctors that did IMO's and found a neurologist that performed two IMO's for me. It is expensive unless @Buck52 or @broncovet can offer something else it looks like that is your only route.
  43. 1 point
    What you are looking at is an appeal for EED. If your case was before BVA there is not much chance of winning. If your case was at the RO I would appeal to the BVA. I will go out on a limb and say what the VA is stating is that your disability could not be verified until the date of your last C&P. They did this to me on a claim for PTSD and I won on appeal to the BVA. They can and do use this to avoid paying backpay when a claim has taken a considerable amount of time for them to get their act together. It should not be right that they use the date of your last C&P and they can get away with this if you let them.
  44. 1 point
    I understand your frustration. My claim was slotted to be complete on March 7. My estimated completion date went from March 29 to April 29 to May 5 within 5 business days. On Friday, my new estimated completion date is April 4. Broncovet must be right, it’s generated automatically off some algorithm. I’ve called up to the VA’s 1800 number and asked them for more information. It’s hit or miss but 1 out of 2 people up there have been helpful and provided me with information that I couldn’t see on va.gov. Nothing wrong with paying attention to your claim but just know you have no control over the VA. You can only drive yourself crazy and many of us can not afford any further stress.
  45. 1 point
    You're not less of a man for having PTSD. You're more of a man for admitting your problems and facing them. No one else has walked in your shoes. No reason to feel guilt anymore Buck. Forget everyone else's opinions. You have no need for their approval.
  46. 1 point
    I always use the regulations themelves because BVA does : "The general rule regarding effective dates is that the effective date of an evaluation and award of compensation based on an original claim, a claim re-opened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, or the date of increase if the increase is shown within one year prior to filing the claim, whichever is the later. 38 C.F.R. § 3.400. " https://www.va.gov/vetapp18/files9/18138958.txt EED and 'date entitlement arose' can be used in the BVA search feature. This is how it works- My deceased husband had two claims pending at his death- one under 1151 and one for a higher rating of his 30% SC PTSD. He was awarded SSDI solely for PTSD soon after filing the claim with VA for higher rating. Along with copy of the SSA award, he also sent a VA a TDIU application. Almost three years after he died ( VA told our Congressman and senators SSA refused to release his SSDI info- it was a lie) they received the SSDI info and awarded 100% P & T for SC PTSD. The date of the claim was in 1992. In an accrued award to me, as his survivor, they gave him an EED of Nov 1991 of 100% P & T PTSD, because the date his entitlement arose ( via medical evidence from the SSA) -as the last day he worked was Nov 1, 1991. However, to add, the SSDI used his VA medical records to determine the 100%.He had been treated for PTSD by the VA in two states, since 1983. VA could have awarded that claim in his lifetime. They also could have awarded the 1151 in his lifetime as well. Another example is found here: https://community.hadit.com/topic/52876-bva-cue-granted-eed-of-8-years/
  47. 1 point
    Victor, Even if the raters weren't trained, but told to apply the regs to the best of their ability, we'd all be in so much better shape SCD % wise. At least the raters could read the evidence, the examiner's opinion, and the CFR regs, and more often than not, make the right decision. But...that's not the case, they are trained, and told to deny most claims, at least the first time around. And if that's not the case, then how do you explain why we're even here, on Hadit, in the first place? Much less why Hadit even exists? As for being kept in the dark, if I didn't know better, Victor, I'd say you have got to be the single oldest living mushroom! All those years being fed bs and kept in the dark! Makes you quite the fun guy!!! But hey, I love mushrooms! Lol! Semper Fi
  48. 1 point
    That is part of the problem. The VA is vindictive against anyone who complains about the process! There needs to be a better whistleblower policy for veterans who are being abused in their attempts to obtain their benefits.
  49. 1 point
    Good to see your claim is picking up speed bud. Have a safe weekend and one day soon you will be posting some good news on here.
  50. 1 point
    Right on Proudvet, I agree., and thanks! It was hard at first and I was really nervous, but she was pretty empathetic and it was easier to open up to her once it got started. I was a little worried too about the work thing and how it may affect my PTSD claim...I've got to stay busy, it has always helped to keep my mind off of things. It's easier when I stay busy to avoid thinking about other things. Plus...the courts wouldn't really listen to any claims of PTSD if I wasnt paying child support. I even told the lady that at my exam...She asked about work, and I told her I had to work no matter how hard it was because if I didnt, I wouldnt have been able to make it to the exam because I would be in jail, LOL. It's just a wait and see now!
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