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Showing content with the highest reputation since 12/02/2019 in all areas

  1. 3 points
    Buck the big problem with that is civilian medical people won't have the time or inclination to "learn" about the problems we have, especially associated or "secondary" issues. For example, say Vietnam veteran; he has diabetes. Is the doc going to be on the lookout for other presumptives not only associated with that disease, like neuropathy, but other A.O. issues not related like heart issues or cancers? It's the same problem with Gilf War syndrome and Burn Pit diseases. It is too high a hill for many docs to climb. Too much work to put in for too few of a customer base. Too much of a learning curve. IMO the VA Medical side is way ahead of the civilian side in this area. Especially in the diagnosis and initial care. Maybe follow-up treatment is often lacking, but they are more likely to discover other issues up front. Of course I am only talking about the Health side, not benefits. That is a different cat all together. If they eliminate VA health care, they will be throwing out the baby with the bath water. Again, IMO.
  2. 3 points
    Just found out today that Huntington WV RO has my Remand. This is good news. I was hoping to avoid having my Remand going back to Philly. Anyway, Huntington has already requested a C&P Exam. I'm going Dec 13th. Pretty quick. Huntington did my hearing loss and tinnitus claim. Claim filed Jul 2019 and Granted Oct 2019. They seem to be quite efficient. Now let's get to the exam; they want another PFT (pulmonary function test) and then a medical exam. Here's the weird part; the medical exam may not be a Doc. They told me his first name. So, my Lawyer wants me to load up my paperwork and bring it with me. Every time that I read and reread the Remand Order, it clearly sets a very high bar for the VBA. For my case, it is a minor victory because the Judge ordered that the previous denial be reversed and the claim reopened. The most important part about this whole process is the amount of research that I had done. The Judge cited in his Order an article that I had sent to the Board about injuries that occur when a chest tube is inserted. Also, the Medical articles that I had sent in about Dyspnea and not being able to take a deep breath. It is so crucial that we get a copy of our C-File and educate ourselves about the process and what we are claiming. The idea that I had sought out a Medical Opinion on my own, on my dime with my own Pulmonologist, may get me to the finish line with a full Grant. Even if you have a Lawyer like me or a VSO; leave no stone unturned. Do your own research and leg work. I have all of the Federal Codes and all of Ratings criteria. Never stop. Never give up. I will let you all know the outcome of my Remand. Ray
  3. 2 points
    Valhalla0321 Not sure what your situation is, but If you have a C&P,scheduled, you must attend. If you have diagnosis from your doc, bring it with you. If this ia a follow up C&P for an already s-c condition then just tell them how things are. When asked, tell them about your most recent BAD day, not necessarily what you feel the day of the exam. I'm not sure what you mean when you say your claim is deferred, but if it is a claim you haven't yet been awarded for MH and/or PTSD, there are a lot of similar experiences posted here on Hadit. Do your research. Don't get mad at the examiner. If you're married, bring your spouse.
  4. 2 points
    Hi Alberti As Shrek pointed out, the RO is doing normal stuff. They don't have to have a C&P, but on most initial claims, they are going to do it to cover themselves. Read up on the dbq's and diagnostic codes for your disabilities, and you will feel more comfortable when you go to the exam.
  5. 2 points
    Wow...that is beyond scary. I am glad you asked for the second opinion. One should always ask for a second opinion no matter where they are seen when they want to cut you open.
  6. 2 points
    First I would suggest that you start a migraine diary asap. These are used by doctors to judge the seriousness of your migraines. It is a pain but it does help, you can find many on the internet. Be honest at your C&P but let them know what your worst day is like, do not say I am doing great. "I am good today but earlier this week I had a migraine that sent me to bed." The same for your feet and PTSD. I might also try to get some buddy letters from your manager at work if they are willing. This shows the seriousness and financial impact of your disability. I lost my job of 25 years over losing too much time off from work and not being my best while at the job due to my disabilities and the medications that were necessary. It took me ten years, this will hopefully not happen to you, to get my case through the BVA which granted TDIU and full benefits. The BVA cited employer letters as one of the highlights of evidence that showed I was not able to perform my job due to my disability. No you are not special but it is trying none the less. Loss of income and pain are not good for the mind or a good way of living. It creates it's own stress and this is something that you need to look after. If you were not depressed when you begin working with the VA, you will be when you get done. Good luck drawing good doctors for your C&P's and keep us apprised as to the results. Sometimes, many, you will get denied by the RO with a poorly done rating. Never quit at this point, always appeal if you are not given the full benefit that you deserve. Go to the BVA if necessary. It is a long process but the BVA reads your evidence and applies it much better than the RO.
  7. 2 points
    I had a similar experience with SA, the VA used a PA to give an opinion and I had two MD opinions. The VA went with the PA opinion and ignored my two MD opinions, same at the HLR. It took the BVA to approve my SA, they actually read my medical opinions. Even though I prefer to go the HLR route (its faster) GB is right the BVA would probably be your better route. Now if you get the right senior rater who actually reads your evidence then they would approve it at the HLR level. I am assuming you are filing all this within one year of your decision. Good luck!
  8. 2 points
  9. 2 points
    The Remand is not a decision. It is the gathering of information to make the decision. It can really go any direction from there. From experience it can be for the better, but for sure it give you the information you need to fight it better!
  10. 2 points
  11. 1 point
    I filed an appeal when I got TDIU but was denied the Chapter than includes P&T. It took about a year for p&t to be granted. If you were explicitly denied P&T as part of your claim then appeal that denial. I think I have appealed just about every decision I ever got from the VA because they are almost always do not afford complete relief. A few years after I got TDIU I was granted another 60% for a separate condition. The VA did not immediately grant "S" like they should have done. I had to file a CUE to get that benefit. If you don't ask for it you often don't get it. The VA is sloppy and lazy. If they make a mistake that costs you thousands of buck they don't miss any sleep. The VA is just a machine. We hope to be the monkey wrench.
  12. 1 point
    Just a note, if you CUE them also file for an appeal. The CUE may not finish out in time for you to file your appeal, you have a year, and you would lose your ability to file an appeal. Keep both bases covered.
  13. 1 point
    If you are nervous about your exam, tell the examiner that you are nervous. What GB means about not getting mad at the examiner is right and sometimes hard to do. They will be poking around in your life and may want to talk about your stressors. They are not being jerks, just doing their job, sometimes they are jerks though. Do your best and remember that even this too shall pass. If you have your records, bring them as GB stated. They have an entire file to go through during the exam and most examiners appreciate someone who can point them to information they need. Do bring your spouse but do not be surprised if they do not allow them to come in. Be wary of the examiner if they do not though. Lastly tell the full truth and nothing but. If you exaggerate and they catch you it blows your entire credibility.
  14. 1 point
    Anharris, I was discharged COG from the military for a medical condition not considered a medical condition. I was first diagnosed as a hypochondriac by the VA. Thirty-five years later I am at 100%. With your situation I would hope that it does not take you that long, it sounds pretty clear cut to me. Always appeal. The VA will deny you hoping that you will go away. Fight them and you should have a good chance of winning, maybe at the BVA where all evidence is considered and many RO decisions are overturned. Is it worth it, well when you are my age and your disability makes it impossible to work it is worth it. You never know how serious the condition may become later in life.
  15. 1 point
    Hyrb is right on. When in doubt, and you have the evidence, list multiple causes. Let the RO sort it out. It sure helps if you can get an IMO from your doc that lists rationale and that any one or combination is more likely than not to have caused your disability. But making the RO rater having to deny all of them and their combinations is a tough thing to do sometime.
  16. 1 point
    I for one don't know the name of that site and, I do not want to know. Just based on witness statements from you guys is enough for me. Why would I want to get advise from a site that is one-sided and not open to differences of opinion. That is how you learn, by listening to what others have experienced. To be punished (banned) because you said something that goes against the brotherhood when proving your proof of the argument, kinda sounds what those despots in Iran do. No thanks. Besides, I'm beginning to like you guys. (Well, most of you:))
  17. 1 point
    Thanks Berta and Vetquest for your recent responses. I agree with you both 100% and I should never have followed some of their advice or I would be further along now. My last post on their forum was also dismissed and locked when former DRO Cruiser did not like my statement about my winning a CUE appeal as a pro se veteran before the CAVC vet court in 2005. I feel very sorry for younger and or newer vets seeking their advice on their one sided forum.
  18. 1 point
    I agree.... I would choose private if we could truly choose.... not those bogus choice we have now..
  19. 1 point
    There seems to be some continuing confusion here at Hadit on SMC requirements for Aid and Attendance. SMC L covers A&A. Look at §3.350(b) and you see: (b) Ratings under 38 U.S.C. 1114(l). The special monthly compensation provided by 38 U.S.C. 1114(l) is payable for anatomical loss or loss of use of both feet, one hand and one foot, blindness in both eyes with visual acuity of 5/200 or less or being permanently bedridden or so helpless as to be in need of regular aid and attendance. The only other rating for aid and attendance is R2 which is "a higher level" of A&A. It is covered in §3.352(b): (b) Basic criteria for the higher level aid and attendance allowance. (1) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met: (i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p). (ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section. (iii) The veteran needs a “higher level of care” (as defined in paragraph (b)(3) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care. (2) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(j) in lieu of the regular aid and attendance allowance when all of the following conditions are met: (i) As a result of service-connected residuals of traumatic brain injury, the veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section. (ii) As a result of service-connected residuals of traumatic brain injury, the veteran needs a “higher level of care” (as defined in paragraph (b)(3) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care. I think the problem arises with the VA Form 21-2680 which is a form used by a VA examiner to investigate qualifying for SMC S as being substantially housebound or the need for A&A. Note my use of the word "or". SMC S is essentially a two-part test for a) 100% + an additional 60% separate and distinct from the 100% or b) being substantially housebound in fact. There is no mention of a&a in SMC S under §3.350(i) nor would there be as it is rated as SMC L. As I like to point out, SMC is very complicated. Just when you think you have it figured out, you discover you don't. Imagine VA examiners. They need a M 21 calculator to figure it out and then cannot even accomplish that. I've had to fight for every SMC O leading to R1 or R2 except for one (R2) in Manila. It took a long fight at the local VARO level because they kept trying to use a PN DBQ to deny LOU of the lower extremities. Their view was if you could get out of bed, pivot and fall back into a wheelchair, you did not suffer LOU of the lower extremities. Jensen v. Shulkin (§3.809) put paid to that insanity.
  20. 1 point
    Vetquest is dead on here! Follow what he said and you will succeed! Trust me I started out here at 30% and am headed to the CAVC to get to 100% P&T
  21. 1 point
    JKWilliamsSr Appeal to BVA. Too much of a legal hurdle to try HLR; they won't change their decision. IMO.
  22. 1 point
    He obtained the IME from Ellis and the C&P likely saw it in the record and denied it. This happen to me as well, when I had the IMO from Dr. Anaise. File a complaint and get a new one.
  23. 1 point
    I assume the PA reviewed your records before the exam and may have pre-populated much of the report in advance. That is a normal practice. However, it sounds like a lousy exam to me. You have a C&P by a PA against SC and an IME (I assume by an MD) for SC. If that's the case, the VA should grant SC based on your IME. The PA failed to contest the more favorable findings from the IME or even entertain the possibility that your obesity was caused by pain limiting your ability to exercise. Additionally, these are the instructions for musculoskeletal exams. The part covering the goniometer requirement gives the VA free reign to assume it was used even if it wasn't (which is BS): https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014194/M21-1-Part-III-Subpart-iv-Chapter-4-Section-A-Musculoskeletal-Conditions?query=favorable exam These instructions tell them how to handle examination reports. There are a bunch of requirements listed. If any are missed, the report is deemed insufficient. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000015812/M21-1-Part-III-Subpart-iv-Chapter-3-Section-D-Examination-Reports#4 Might be worth waiting to see what the rating decision says. You might have been granted SC. If you are, then that would be great. The only thing left would be getting the correct rating.
  24. 1 point
    Free is good! But no, we don't have any Publix around here.
  25. 1 point
    VA care vs private care...... I would never trust the VA to do any surgeries....in fact I would never agree to be admitted to a VA Facility. Speaking to my Nurse just yesterday she indicated that private care is really messed up, she said she wish she were a veteran so she could get treatment in the VA. She indicated in the Temple Texas area that it took over a year to get a medical appointment for a condition she has. I don't know that anyone waits a year to get medical care at the VA. In most cases private facilities will run many test if for no other reason to cover their butts, but along the way they charge large fees. I worked in the computer room of a Hospital once, I saw first hand the cost of private medical care when I printed out patients bills. A good example was $20.00 for one aspirin .. and this was 27 years ago.. its worse now. The problem I see with the VA is that they hire to many Doctors right from Medical school, from any country, as long as they have a Medical License from one of the 50 States. Doctors trained in India, or Guam, or Burma ( yes even Burma) do not have the necessary education to treat me as far as I am concerned. Another issue with foreign doctors is the language barrier, especially for those of us with hearing loss. And still worse the VA employs PA's and NP's because they cannot find enough trained medical doctors to work at the VA. In fact according to my Nurse yesterday, there are over 50 thousand vacant medical positions at the VA yes she said 50 thousand a number that is hard to believe and makes me wonder if the government really cares about veterans. The nurse I spoke to indicated the biggest difference with private vs VA care is that when ever something bad happens at the VA its in the news... but when something bad happens at a private facility, they pay out malpractice claims, and require non-disclosure agreements before any payout... IN other words they both have the same issue but we almost never hear about a private facility malpractice or worse killing someone.... I use VA care because of my disabilities, and the cost associated with care.... I need the prosthetic services for my braces, wheelchair, auto adapted equipment, breathing issue supplies and many other things. This year I spent out of my pocket $10,000 for 2 portable oxygen concentrators, and two home oxygen concentrations, because the VA ( even with my 100% for COPD) will not issue portable concentrators, they are in the dark ages still issuing tanks. My Medicare provider, took my broken concentrator for repair, and tried to stick me with tanks, I never got the machine back and ended up canceling the service and purchased my own. Medicare was paying an astronomical amount of money for these machines that within a 5 year period the provider was getting enough funds to pay for the cost of three machines. And when I complained to Medicare about the provider, Medicare said as long as they provide any oxygen service they was nothing they could do. For me the Actual Medical care at the VA is good and bad....it depends on the doctor you see and the service they provide. Recently I was trying to receive treatment at Darnell Army Medical Center at Urology for a prostrate issue, for over a year the doctor gave me the run around about doing a biopsy, and other tests. This doctor did not even do the finger test, or check my private areas yet he wanted to send me off for a so called virtual biopsy, when no such test exist. I complained about burning constantly... and could not even get medication, I went to the VA urology clinic . this doctor ( PA actually) did more in that one visit to help my condition than a year of treatment at Darnell. The PA determined I had Prostatitis and placed me on Bactrum, which immediately cleared up the burning. This is just one example of VA doing a better job.. now I realize that Darnell is not considered private medical care, but I always was under the opinion that they provided better care than the VA. I was wrong. Another example, My pulmonary doctor at Darnell literally saved my life ( had Multiple PE's this past Feb) .. the pulmonary doctor at the VA almost never listed to my lungs, he would sit there and look at me for 5-8 minutes and refill my meds and that was that, until 6 months later when we would do it all over again. I had PE's for at least 3 weeks, and had made a visit to the VA and even after describing my issue I was ignored and sent home. The doctor at Darnell listen to what I had to say, he admitted me suspecting PE, ran test, and did MRI within three hours of my being admitted they confirmed I had PE's, I was told that I had one large PE with multiple smaller ones. This doctor told me if I had gone home he had no doubt I would have died within two days. No one can state for certain that Private care is any better of any worse than VA care. There are both good and bad doctors in each of the facilities. We always hear about the bad issues at the VA and almost never hear about the good outcomes. They each have there own problems but are just handled different ways. Oh and too throw into the mix.. for those of us that are retired military ... the Department of Defense had Incorporated all Military health Care under the Military Health system.. in other words the separate branches do not have control over their facilities anymore. The goal of the Military Heath system is to eliminate all care for retired military in a military facility. The reason is apparent, the Military Health care does not want to treat retirees at all but especially those of us over 65. They will refer you to health care outside the faculty, and then the Tricare office sends you a letter saying they are not responsible to find a place of treatment for those over 65 on Medicare. In the coming months we can expect that most retirees will receive nothing more than emergency medical treatment at military medical centers. Remember the days we were told stay and retire and get free health care for life, for you and your dependents. Yet the Government refused to provide care, and Col Bud Day sued the government for retiree medical care, and before a decision could be made the Government created Tricare for Life... so the courts never rendered a decision concerning life time care. Now we see that Tricare for retirees was not free, and even tricare for life has a price because they tied it to medicare that is if a retiree doesn't take part B Medicare he does not get to use tricare. This isn't free, if fact when we turn 65, (or younger in cases of those on SSD) our cost for medical care goes up, at an age when the income of most retirees is stagnant. We see and hear all this garbage about one payer systems its just never going to happen.. first such a system would cause delays in care, and many deaths but more important the Country cannot afford a one payer system, medical care would be rationed and the sickest would not get treatment.Overall Our Government wants to get out of the Medical Care business because of the cost.
  26. 1 point
    If you can show an additional 60% for another unrelated disability you can get Housebound which is another $300. Between the time you got TDIU and now did you get rated 60% or more for another unrelated condition.
  27. 1 point
    Maybe I am just the one to challenge the rule... since in my case its so apparent that the rules were designed to prohibit actually disability ratings and compensations....
  28. 1 point
    With what we've been put through, it couldn't hurt
  29. 1 point
    It has always been claimed as collapsed lungs with chest wall defects...since day one. Yes, a treatable collapsed lung in and of itself, is not disabling, but, if the treating Naval Hospital severed intercostal nerve and tore up rib cartilige, that is disabling. Chronic pain and splinting; yes but what is really kicking my ass is not being able to take deep breaths. As my lung doc said, it's mechanical, not so much mental. Thanks for checking in!!!
  30. 1 point
    I second that about IMO's. I had two IMO's in my last BVA award that refuted bad C&P's.
  31. 1 point
    I did not read your whole post but if you have not then find an experienced accredited VSO such as DAV, VFW, Legion, etc located at nearest VA regional office and they can be big help to you in finding military and service medical records in addition to providing you additional advice and filing claims, etc. You do not have be a dues paying member for them to assist you by their own rules/laws, etc. They can also help you to upgrade your discharge if it is needed. Interview them in person or by telephone and pick the one that seems motivated and most interested in your case. Avoid those with hostile or indifferent attitude or do a lot of sighing in your presence as if you are too much bother. You have to pick out the good apples from the bad in the barrell. The other vets here have given you good advice also. Many of us know how just unfair military leadership was and still is. Just like civilian life the cream does not always rise to the top in the service. There is another veterans benefit forum I refer to as VB* that spends a great deal of their daily post to vets bad mouthing lawyers and private doctors who provide medical opinions for a fee to assist vets with their claims. These former and present VA raters, and VSO lifer officers tell out right lies and falsely imply to new vets that the lawyers and IMO doctors are charlatans. Which is BS as I have read their many statements in BVA decisions winning benefits for vets.
  32. 1 point
    I think your case may end up in the Court of Veterans Appeals. Although with luck the BVA may decide in your favor. I think you can win the case because you indicated this started in service, and you have medical records showing treatment. In addition, you continue to receive treatment. I don't think I can advise you based on my eye damage because my situation was rated secondary to my lung disease. However.... My Asthmatic condition existed when I entered service although I had not had problems for years , by 1986 my condition had worsened with secondary COPD, and I was medically retired. The VA initially denied my claim, and I then claimed CUE, providing a copy of my medical board records which indicated the reasons for my medical retirement. After receiving the documents the VA granted me 30%. However, the VA had all of my medical records, and in no less than 7 places it indicated Asthma with secondary COPD. The retirement board indicated that my asthma condition was worsened by active duty. I think you can fight this denial and win. You already have an IMO which apparently was not considered or was considered to not carry enough weight with the rater Generally speaking when there exists two separate opinions the tie goes to the veteran. So first you need a copy of the C/P exam to see what the examiner stated that caused the denial. You need to tear his examination report up as part of your appeal. You need to show where the examiner is wrong. You also need to question why the IMO was ignored. Many cases of pigmentary dispersion and pigmentary glaucoma are not congenital or developmental defects. If your c/p exam was conducted at a va facility you should be able to download a copy from my Healthvet web site. If it was conducted by a contractor, you will have to request a copy from the folks in Janesville , Wi Intake center. They will handle the request under the freedom of information act. It could take 6 months or more to get a copy from them so you need to do this as quickly as possible as you only have a yar to appeal. Best of luck
  33. 1 point
  34. 1 point
    It sounds to me as if the Military did more harm to your shoulder , if your still having problems because of what Military medical personal did you should be able to get a service connected rating. But before you do anything with the VA.. you really should check on getting your discharge upgraded to a medical discharge, since the military made the condition worse. They should not have been able to just toss you out without consideration of a medical discharge. You could have a real fight on your hands, but one worth fighting. And yes you can get a medical discharge for conditions you had before service occurred or if the condition was aggravated by military service - ( aggravated means you went in with a condition and your military service made it worse.)
  35. 1 point
    Yes... in my case I was at 60% for Asthma and 30% for secondary COPD, which never made sense because both were rated based on the Pulmonary Functions test... so both should have been 60%.. So when I did the CUE, the VA severed the rating for COPD, but by the time they severed the rating I was already on Oxygen so they increased me to 100% for do to home oxygen use under 6602 Asthma. However, Asthma rating do not include a 100% rating for oxygen use. Technically, I still hold the 30% for COPD ( and sleep apnea for 50% ) but they are all lumped in together with one rating. Ironically while they severed the separate 30% rating for the COPD they did not sever the rating for sleep apnea. To have 1 rating for 3 issues really suck. While Asthma and COPD overlap, sleep apnea is not a pulmonary disease it is a sleep disorder. Even though Asthma & COPD do overlap they are completely different diseases. In Asthma after an attack lungs return to normal, in COPD lungs just continue to go downhill, so technically they should not lump any of the three into one rating. But the VA is going to do what they want to do. What really gets me upset about this is that the VA doesn't give any consideration to special compensation and that doesn't seem right. Many people with COPD have a 100% rating due to oxygen use, and that is bad enough, but to have 3 conditions really makes my life harder. The point I am trying to make is that they all have individual challenges yet the VA treats them as one disease. It just isn't right..... anyway sorry for the dissertation.
  36. 1 point
    Yep, 38 CFR 3.156(c)(1) and 38 CFR 3.156(c)(3) can be really helpful for EEDs, but applies for records not associated with the claims file when the original decision was made. I used this once some years back when the VA said my STRs were silent for a condition during service. I got my claims file and the records were not there. However, I found the specific document in the original copy of my STRs. My VSO sent in a copy of my STRs, but apparently missed a page or two. Once I sent it in, they conceded 38 CFR 3.156(c), awarded, and backdated the EED. However, for records which were present in the claims file, but overlooked by the VA, CUE is the other option (if final) per $20.1403 Rule 1403.
  37. 1 point
    Off the top of my head I don't have the case law if SMR's come available and were not used to adjudicate a claim the VA is required to give the effective date of the original file date no matter how many years ago it has been. This is binding by a CAVC decision and you do not have to prove the VA had the records in hand at the time the claim was decided. I will try to find this case law. Edit: I found the Case Law. It is Stowers v. Shinseki - Decided May 2014 https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000015778/Stowers-v.-Shinseki,-May-16,-2014,-26-Vet.App.-550
  38. 1 point
    A rater (properly referred to as a VA examiner, but not a medical examiner) is the individual who is processing your claim. They work in a VA Regional Office (VARO), review the evidence, and determines if it is sufficient to make a decision. If something is missing or insufficient, they may either ask you for more evidence or send you to a C&P exam. I had a situation where I had to go to another C&P exam just a few weeks after the first one for the same issue. This can happen if the examination is inadequate or not thorough. The rater will issue instructions to the C&P doc explaining what they need. If the C&P examiner is not certain which symptoms belong to each claimed disability, that can often cause additional C&P exams, but sometimes they can award a win based on benefit of the doubt. It sounds plausible that PTSD/TBI claims might require more clarification. The criteria for each rating is a bit odd and can overlap. It does stink that it is taking a long time, but it sounds like the rater may be trying to issue a fair decision. That's better than them issuing a rubber stamp denial and getting put in the appeal lanes.
  39. 1 point
    Waiting for two CUE/HLR claims to be completed. The VARO requested old medical records from the VAMC. VAMC sent paper copies to Janesville WI intake facility which arrived one business day ago.
  40. 1 point
    So Broncovet is right on! And how would you not have stressors from driving around Iraq??? For me every time I see a trash back or a pile of trash or something out of the ordinary on the side of the road I am thinking is that a roadside bomb? Is someone holding a trigger waiting for me to get close enough? Am I going to get boxed in today and an RPG fired at my head? Trust me there were tons of stressors out there, and we try to block them out, we typically become hyper aware of things and the normal person does not get their mind set on things like this. This is why therapy is good to find out what stressors you have and how to deal with them.
  41. 1 point
    You only get 10% for multiple 0's if you DO NOT have any rated disabilities. In other words, if you have a current rated disability, like tinnitus at 10%, for example, you can not get an additional 10% for having 3 non-rated disabilities. I have at least 5 disabilities rated at 0%, but they mean squat since I am rated at 90 already. Your best shot is to file increases for the zero's when they get worse. ** I believe the intent is to get the Veteran wtih multiple zero's into the VA medical system by giving them a 10 percent rating.** My thoughts, Hamslice
  42. 1 point
    Buck, you are correct, however, I made the claim without any new evidence, just my opinion that my issue had gotten worse. Then, the C&P produced the new evidence. But, you have make the claim or nothing will happen, Hamslice
  43. 1 point
    Phild523 It means you are on the hamster wheel. Some call it the VA. Aug 2018 isn't too bad. It sounds you have a complicated group of disabilities and, rightfully so, the VA is trying (I think) to develop them. There are crossover symptoms, for example, on symptoms for PTSD and TBI and you want to be rated the highest possible way. I would say it was promising that the VA sent you to 3 additional C&P's. ebenefits status doesn't really reflect what is currently going on. It could be at a rater. It also could be kicked back for further development again. Calling Peggy isn't going to get you any better insight either in my opinion. You just have to wait a while. Hang in there.
  44. 1 point
    They don't read your records but claimed they did. They know and denied because like most we all went in there blind and pretty much signed our name to a generic form. Dr. L can help you with a real IMEO. I posted in the IMO section.
  45. 1 point
    I have been through something similar to this. Keep in mind the way proposals to reduce work. They have multiple stages: 1. VA sends you a letter proposing to reduce your rating. This could be due to a recent C&P exam or the time limit expiring on a rating they deemed temporary. They will indicate that you have X days (can't recall, may be 30 or 60 days) to respond with evidence proving the rating should be continued. If you do not respond, they will move forward with the reduction. If you respond with evidence, they will review it. 2a. If they moved forward with the reduction, you'll get a decision letter explaining why and the usual appeal timeframe forms. 2b. If you submitted evidence, the VA will review it and/or request a new C&P exam. When that's done, they send you a decision letter explaining why and the usual appeal timeframe forms. 3. At this point, if you do nothing they consider that as being you agreeing with their findings and the decision will become final when the appeal window expires. However, if you appeal before the appeal window expires, your claim would still be considered alive. That brings us to the next question. Do you still have all the forms that came with the in October 2018 rating decision? If you do, check those first. One of them indicates your rights to appeal their decision and the duration of your appeal window. Normally it is one year for regular appeals with the VARO, but it could differ for a reduction. It is important that you do not throw away the pages that come with your decision letters. In April 2019, you submitted an Intent to File. That gives you a one year window to collect evidence and formally open your claim. In November 2019, the C&P exam found incomplete/moderate severity. Now for the tricky part. If your October 2018 claim had a one year appeal window, technically your claim may still be open. In April 2019, the VA began using the new appeals process. They are sticklers for filing the proper form depending on your situation. Many of us learned this the hard way. However, I could be wrong, but for claims which were not finalized by April 2019, your appeal window may have still been open from the October 2018 decision. Probably the best way to find out is to call the 1-800 number or check with a VSO to see what they say. Why is it important if the October 2018 decision was still appealable? Effective dates. This goes to what Broncovet said and their reasoning for reducing the rating last year. If they reduced it because evidence showed you no longer met the criteria for the 10% rating, the reduction would be justified. However, if they reduced it because you missed a C&P exam, you can look in medical records from the prior 12 months to see if you have evidence to help justify the continued rating. The decision letters from last year and this year hold the information you need. Here's something else you need to know. Once you are SC for a disability, even if you are at 0%, all you need to do is provide evidence showing you meet the criteria for a higher rating tier. This evidence can be from the prior 12 months (cannot go back prior to the date you were SC). The VA may or may not send you for a C&P depending on the situation. If they grant the increase, the effective date of the increase would be the date you met the criteria for the higher rating. I had a situation like this some years back. I was rated 30% for asthma and it was treated frequently with prednisone. I learned that if you got 3+ per year, that would warrant an increase to 60%. I filed the increase and won. The decision letter said it was a temporary increase because they expected me to improve. A year later, I got a proposal to reduce and sent in medical evidence proving the rating could be continued. Soon after, I got a decision letter reducing me back to 30% because they said the evidence did not show it warranted a continued rating of 60%. I filed a reconsideration along with the evidence and they still denied, so I filed a NOD and requested an in-person DRO review. A couple of years later, I met with the DRO and showed my evidence. Everything I sent in was present in the claims file. The DRO reviewed and said the VARO made a stupid decision. About five or six weeks later, a decision letter arrived which reversed the reduction, continued the 60% rating, and indicated how much retro I would get. Because I had been receiving the prednisone treatments for asthma for about six years total, they considered the rating stabilized and indicated it was not expected to improve. Below is an article which can help you understand how increases work. Check my blog for other articles which might be beneficial.
  46. 1 point
    Many years ago ( 20 to be exact) i was forced into a medical retirement by the Federal Government , due to continued problems caused by a service connected medical condition. Under the FERS retirement system I literally lost a portion of federal retirement when I was granted SSDI. The law actually requires all FERS retirees to file for Social Security so it is not like we have a choice. In my case I was denied SSDI the first time around. I was not yet rated 100%, but I had been medically retired from the Army and then Civil Service. At that time I started to volunteer for the DAV as a service officer and I learned that a veteran who has a hardship can request expedited claims service. ( I did this and I had my claim approved within 3 months) So that is the first thing I am going to recommend you do. I looked around for a lawyer to get me my SSDI, but they all wanted a portion of my back pay if they won the claim, in my case that was not an option because I was also going to have to repay the Government ( civil Service ) part of the SSDI that was offset by my civil service retirement. In my case this came to over $22000.00 that I had to repay. So when I finally did appear before the SSDI Law Judge, I appeared alone, and was asked why I should be granted benefits. and I explained that I was already medically retired by two government agencies and ( at that time) I was rated 70% disabled from the VA. I explained to the law judge that no one was going to hire me because I was an insurance risk with loss of use of my left foot requiring me to wear a brace to walk, and could not climb stairs. I was awarded SSDI about a month later. The whole point of my story is to say.. a veteran does not have to be rated 100% by the VA to get SSDI. In fact., more people than not, get SSDI without any rating from the Department of Veterans affairs, so don't let this be a reason to stop you from submitting paperwork for SSDI. The award of Social Security disability is based on two things , first the job experience of the person, and if it is possible to retrain into a different job, second the age of the person those over 55 generally will be awarded SSDI if it is impossible to retrain or impractical to start a new career field. I cannot recommend any specific service officer or organization to assist you because personally I don't think they have your best interest in mind. I think the best think to do is to ask around your community who goes above and beyond to help veterans with their claims issues... and I am sure someone will be recommended. Also, most states offer veterans assistance with claims. You may also be able to obtain financial assistance from Veterans organizations to help pay a monthly mortgage or utilities. The DAV I worked it gave donations to many veterans for these types of issues. There really isn't much more anyone can recommend, since your question does not really address a claim issue, what it is and how to win the claim.
  47. 1 point
    Glad to help! If you were denied on an initial claim, going to the board next may not make much sense. Usually veterans go for a supplemental first, then an HLR or BVA if they do not succeed. Yeah, the BVA tends to offer much better results for many veterans because they take the time to supposedly read everything. The drawback is you could be tied up in that lane for years. My initial claim in 1995 got denied quick and my VSO told me to appeal to the board. They never told me I could file for a reconsideration (not available any longer). It took about two years for my board hearing. Then it took them about two more years before I got new C&P exams. After that, it took about two to three months to get everything finalized and approved. BVA might not take that long today, but you need to talk with your VSO and ask them why they feel that way. It never hurts to get a second opinion either. It might be a good idea to ask the VSO if they reviewed the NP's opinion before they sent it off? If they had, they could have seen the medical rationale was sketchy. When I had DAV, I would work up everything on my own and present it to them for their guidance, but I started out very green and didn't engage DAV until around 2008 or so when I learned more about the way things work.
  48. 1 point
    Retro finally hit the bank. Nothing on Ebenefits or no letter yet. Good 3 signature amount even after attorney got his score. 4 decades of retro. Now CAVC wait begins in earnest. 7 1/2 months from BVA decision to implementation.
  49. 0 points
    Great physical and mental harm was done to me and some other Vietnam and Korean veterans at the Temple, Texas VA hospital in 1985 to 1991 as we were used as drug guinea pigs and embarrassing to us training aids in a room full of medical students by a good German VA doctor (without our permission as they were sneaky how they did this). One veteran hung himself in a tree outside our ward the night after he witnessed my ordeal that day and he had been thru this himself. On another occasion in 2000 an Austin Texas VA clinic psychiatrist was found guilty in district court of sexual assault on veteran patients and staff. I was one of his almost victims but left his office abruptly when he tried his hanky panky with me about 6 months before he was indicted for his sex crimes against others. His name was Vagashian (SP??) and his wife then divorced him and his son drove a sports car off a cliff in Colorado after the trial. The Temple Texas VA doctor was eventually transferred to Arizona where he then died at young age of 63 and I am so happy happy. I filed a VA injury section 1151 claim over those incidents in 2000 and received a TDIU P&T award with several years back pay. Because of all that BS I use private medical care (medicare and AARP) for more than half of my health care needs and would never use VA for major anything. One of my nam vet friends died on their operating tables for heart surgery at the Temple, Texas VA hospital. Many years later (after 1991) 7 VA patients died at Temple VA due to breathing tainted oxygen and local crooked JP gave the VA a white wash. There have also been other negetlient deaths at same hospital over the years from 85 to at least 2009. I moved from Texas many years ago. I don't give a F***** damn if they privatize the VA medical system for many reasons.
  50. 0 points
    I am dealing with something similar but it is a supplemental claim. I had my C&P exam on November 5th and the Regional VA Hospital and the results were uploaded that same day. In fact Blue Button shows that the exam results were uploaded at 1:15 pm on that day. My appointment was at 1 pm. Monday I called to checked on the status of my claims since it has been 3 weeks since the exam. The call was because I found it odd that it is taking so long. On my new claim I had results 8 days after the exam and that exam was not at VA hospital but with LHI. So I was surprised there was not a decision yet on my supplemental claim. So I called the 800-827-1000 number and spoke to someone to inquire about it. At first he told me that it is held up because they are waiting on exam results. So I told him that I am having a hard time understanding how that is the case because when I pull my blue button report it shows the results were uploaded the very same day of my appointment. So he guy I spoke to changed his story to saying that they have the results but there is a very high backlog and that is why my claim is still pending. For lack of a better word I am now pissed off because the guy I spoke to lied to me first about waiting for my exam results. Then he gave a crap answer of a backlog. That is one of the biggest crocks I have ever heard. While there is a backlog as of September there was only 66k of pending claims and that was down from 611k in March of this year. So if they can adjudicate 100k claims a month surely the 66k in September (which is when my supplemental claim was filed by the way) is only a drop in the bucket. I maintained my composure and did not call him out on it. I will wait and see if there is some movement by next week. I wlll call the 800 number next week and if I do not like the answer I get I will call the white house line and complain.
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