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rpowell01
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Posts posted by rpowell01
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Phillip and Navy04 thanks for information. I found what I needed in the Veterans Benefit Manual and the Federal Veterans Laws, Rules and Regulations. I think I got one from you Phillip? Anyway I ordered a newer version from Lexis Nexus and the CD they send helps also. I have issues focusing now becuase of the pain and the meds I take so its going to take a month to write claim or request up.
Again thanks for the information.
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Well I have 2 IMOs stating this and the RO has refused to give me P&T after they approved TDIU. So I am going to file a claim of P&T because I have this funny feeling that the RO has NOT seen my EMG on my legs showing bilateral radiculopathy. After dealing with the VA and them not doing a thing, treatment, on my back I decided to see a private surgeon. He setup for me to have facet joint blocks to tests if I can have a Rizhotomy. He sat down and told me that I had herniated a disc in my lumbar spine most likely at the L5-S1 but it had healed itself but it caused permanent nerve damage to the nerves going into my legs.
I already have 2 appeals at the RO each with other claims related to my spine plus each one has one leg secondary to my lumbar spine.
I am wondering does the RO actually retrieve the reports from their own databases? The reason I ask is when they were trying to reduce me they didn't even have none of the medical reports from James A. Haley where I was receiving my treatment. At the hearing I handed them 360+ pages of my treatment from James A. Haley for them since they were too lazy to retrieve the reports themselves.
I am going to file for P&T and once again show them in BOTH IMOs that Dr. Bash did where he stated that my issues were in fact permanent. Also SSDI's vocational specialists said I could not go to work because there was nothing that I could do, and vocational rehab sent me a letter stating they made a determination that I could not go back to work.
I understand there is a stabilization period at times before they grant P&T but geez this has been going on since January 2010!!!!!
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How would one go about filing a claim for P&T since this is not an actual disease or has a diagnostic code.
I am guessing I can just use the regulations and show how per the regulations that I am P&T?
I've been having a hard time focusing on just about everything lately but if it takes me a month to write this claim up then so be it.
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Anybody here take Cymbalta? I was approved by the VA, finally after begging my VA Primary Care Provider to send me to mental health after none of the other stuff helped me with pain.
Will it help with severe pain and what interactions should I be warned about with it as I also take Oxycodone? Mental Health also gave me Xanax but warned me of its addiction. I tried taking it with Oxycodone, noway Jose will I do that again, that combination causes me to sleep. I don't know how long it takes to get it in my system so I just might wait on the Cymbalta. I pray it helps with all this pain in my spine I have now.
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A few months ago I filed what I thought was a new claim for Bilateral Sciatica but the BP RO changed it to left leg pain due to sciatica (ILLEGAL!!!!) Yes I was denied because they changed it as a "Reopening" of a previous claim. This was my fault because I didn't have clear understanding of Sciatica and Radiculopathy. I thought they were two DIFFERENT components/causes. JBasser set me straight on this.
Anyway in their denial they stated nothing in the records shows it being from service and there is a diagnosis even though:
1. Dr. Bash's medical opinion (actually TWO opinions) NEXUS'd it as being from my service from a progression in my lumbar spine.
2. Pain Management Neurologist diagnosed the leg pain as RADICULOPATHY from my lumbar spine.
3. I have an EMG that was conducted AFTER Dr. Bash wrote his IMO and before PM Neurologist Diagnosed it.
4. Its WRITTEN in BLACK AND WHITE in all my Diagnosis "NERVE DAMAGE" which was written in there back in 2012 when my VA PCP wrote it in there, because he knew what was going on before all the testing was done.
In this denial letter it also reads they did make a decision based on Dr. Bash and the VAMC progress reports but did NOT say a word about the EMG!!!! Can I say CUE!!!
I am not asking for help but I am just writing this to show how the VA incompetence is to a degree of being contaminated with radiation!!!
I already have 2 NODs asking for reconsideration at the RO level and starting tomorrow I am going to write my SOC to show how everything is connected and how all these MDs have diagnosed it to my Lumbar Spine. BTW March of last year they did change my Lumbar Strain to Lumbar DDD...HUH you asked? Yep they changed it to Lumbar DDD per Dr. Bash's examination he did on me in 2013, after the C&P examiner stated there was no Osteoarthritis in my spine whatsoever, that went against all the XRAYS that showed PROGRESSION DJD...
I am going to write a SOC for the reconsideration and document everything for them, word for word with all the evidence I have.
If you are smart, get copies of ALL your progress reports and testing. Why? Whenever I had my SSDI hearing the VA sent copies of all my records EXCEPT the EMG. Without that EMG I wouldn't have won my case. THE VA is pissed off with me because the judge granted me SSDI based on Dr. Bash's opinions and the EMG. The EMG only gave Dr. Bash more credit than any VA Doctor. The VA had not choice but to award me TDIU because they were caught in huge lies and covering up the EMG with the SSDI Judge. Yep you heard it first right here, get all your progress reports and testing reports and file them in a box and scan them to an extra hard drive. I have everything neatly filed...
Anyway yes we are not allowed to pyramid and I wasn't trying to, I just didn't know the difference between the two and now I do, thanks JBasser!!!
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WVSERVER not taking away you wanting to go to school but to explain more in detail with TDIU and P&T; with TDIU even though you are 90% you can be paid at 100% if you cannot work. That is what TDIU is. P&T means your conditions are permanent and will not improve over time but most of the time get worse. There is a stabilize period, like I am in now. They will see how you condition stabilizes because some conditions get better while other conditions like mine won't. After the stabilization period you are most likely given P&T which basically means you are permanently and totally disabled. It doesn't mean you can't do nothing, it just means its permanent. Now, back to TDIU. There are thousands, hundreds of thousands of people who might have a rating of 80% but they cannot work. Ratings are not based on if you cannot work or not but the degree of your medical issue. A person can have a 50% rating the highest that they can go because that is the highest for that rating and they cannot work while there are others who are 100% and can work because their ratings, medical issues, have a higher rating. This is why TDIU was created, to help those who are not 100% or will never be able to reach 100% but cannot work.
TDIU is a rating in itself actually and so is P&T. You have PTSD, and I can tell you that PTSD doesn't heal. Have you ever watched Band of Brothers when they interviewed those WWII veterans? They will tell you PTSD never leaves you. We are the lucky ones because PTSD is not rated but with the WWII, Korean, and Vietnam Vets (Correct?) there was no PTSD rating and they suffered big time. My wife's uncles still has nightmares to this day. Her cousins has told me stories of him yelling screaming in the middle of the night because of the stuff he went through in Vietnam.
I would suggest you try TDIU and SSDI. Now, TDIU in itself won't allot you to get ChampVA for your kids but P&T will. TDIU with P&T will benfits NOT just you but your wife and kids. How? With P&T status your wife can go to college, paid tuition and a monthly stipend and your kids the same. So think about it, With P&T you get CHAMPVA, dependents can go to college paid by the VA or even the state, depending what state your in, and most states give you exemption on property taxes and most licenses like fishing license. TDIU alone will give you access to every military base to go to the PX and Commissary. Plus with TDIU you get a military retired ID and you can use certain lodges/hotels very very cheap...Just food for though for you.
- Buck52 and silverdollar22
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diver just curious I read that you are 40% for lumbar strain? Your case appears to be like mine in many ways. How long ago did you injured your back? You do know that with a high rating like that does how that lumbar strain will eventually turn into DDD or DJD or both like mine. I have more DJD than anything. A few years ago my lumbar gave out for no reason and now I live in a lot of lower extremity pain. The VA would not tell me why even though their EMG showed lower bilateral radiculopathy.
Finally after a few years I had enough of the VA and went to a private surgeon. Just last week he sat down with me and told me exactly why. I had herniated a disc in my lumbar spine that healed itself but it damaged my nerves permanently. I asked if they will heal and he said after 2 1/2 years they should have healed if they were going to heal, so he said NOPE. NOPE? Seriously!!! After he walked out I actually teared up in the room. But hey it is what it is.
If I was you I would try for TDIU and SSDI, I have both and well I can say I am doing a lot better now than before I was granted both. Yes you will get bored at home not working but look for projects to do around your house. Trust me I know, if you don't it will haunt you big time like it did me. This past summer in 2014 was one of the rainiest summers I can remember here in Florida. I was stuck in BED the whole summer because of the rain. Its like a bad dream when your in severe pain but you can't do anything and the meds I take doesn't touch it. Up late hours in the night to get myself so tired I have no choice but to go to sleep.
Trust me, TDIU and SSDI are good financially but you best prepare yourself and really find projects you can do.
BTW I never met anybody with 40% rating for a lumbar strain, lumbar DDD yes but not for lumbar strain. If its that bad you better prepare yourself for the Osteoarthritis (DJD). Trust me bud it doesn't play games with you.
With you the best and hope you get approved for both.
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Dont worry about ebenefits showing you need to upload more documents. Its just there JUST IN CASE YOU WANT TO UPLOAD DOCUMENTS. Also the VA MUST gather ALL records in their possession to include any records that are with the DOD or at the archives. If they don't the decision can be CUE'd.
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If they happened in the military and they are in his records then yes.
If any of these issues are a progression or secondary of the primary issues you listed then Buck is right you will most likely need a medical opinion (NEXUS). First you two need to research this website: http://www.benefits.va.gov/warms/bookc.asp
this is where you will find the 38 CFR Book C, Schedule for Rating Disabilities. Understand that the VA can't list every single medical issue as a rating because there would be too much so they try to find the one that is closely related.
Now, if you two want to know the ins and outs of the VA and how they do things and how you file your claims and what you should do you need to get this book:
Trust me, with advice from people here at Hadit I did everything myself and in the end I realized how the VA lies on C&P Exams, try to divert the truth when they rate veterans.
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Well it was confirmed I have Graves' Disease of my Thyroid!!!!
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Start digging your treasure holes in your back yard. Use canning jars with METAL lids so you can find them with a metal detector..
Best of luck...
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You know after searching BVA cases they have denied 100% everyone of them even though the veteran showed symptoms but the blood levels were normal. My Private MD believes I have Hashimoto's Disease which is an autoimmune causing my own antibodies to attack the Thyroid.
I was stationed at Ft McClellan and a lot of people that was stationed there has all kinds of problems. Congress has yet to act on the Ft McClellan issues even though the water on the base and in Anniston was found to be contaminated with all kinds of stuff. The company that disposed toxic chemicals got caught dumping. I can't remember the company's name but they are known throughout the USA of doing things like this. Anniston sued them and won their case. Why hasn't Congress Acted on this for all the veterans who have these autoimmune diseases that we know was causes by toxic agents in the drinking water?
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You are eligible to file for SSDI. I would do as others say and just wait until you get the award letter. If you are 100% with Chapter 35 Benefits (P&T) unless you are TDIU you might be able to continue to work. Would VA money replace you working income? If you become 100% for PTSD then working is probably not such a good idea since that DX at that level of disability usually precludes working. If you are self-employed you can often keep working just never mention it to the VA. If you apply for SSDI then working becomes even more of a "No, No". Of course you can do a little work under SSDI but poverty level stuff and they will look at you. Just read you award letter carefully and post results with name and any identifying numbers blacked out.
John
This is a biggy. Wait until your award letter then if its 100% then go file SSDI.
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The above statement is not true.
If the veteran is working VA will reduce his/her combine rating and he/she would be rated at 80% without the TDIU. ( 30% and what ever they rate his/her PTSD).
Veterans awarded TDIU can get a MWR ID card for commissary and PX privileges and still not be P & T.
VA rarely grants P & T for a mental health issue. It happens but VA looks a depression/PTSD as a curable disability.
Pete is correct, I am rated at 80% but award TDIU. I am awaiting P&T because the VA has to wait and see if my issues stabilizes. We all know that spine issues only progresses mainly if there is nerve damage.
I can go the any military base and go the commissary and PX. I just haven't been over to MacDill AFB to get my military ID card. Thanks for reminding me Pete I need to take a trip over there next week sometime.
My award letter stated I had a future exam in Feb 2016. What the VA is doing is going by what SSDI is doing. They thought I was going to be able to have surgery but I was told No surgery will help because there is no way to fix the joints in the spine.
Anyway yes you can get an ID card from any military base. You need your DD214, VA Letter that reads your entitled to commissary priviledges. Now, if you are in the DEERS system then you are good because they know your entitled. They will see your rating and TDIU award.
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Yes I ONLY secure message through myhealthevet. Heck the PCP told his nurses he was impressed with me using the secure messaging. But, I am betting he is really telling his nurses "Geez I wish that guy would quit messaging me. This secure messaging has to go." LOL
Well I kind of stuck my foot in my mouth with this topic in a way. The labs I just had last Friday only showed my Thyroid levels at around 2 so its NOT the VAs nor my PCP's fault. Its my Thyroid's fault for playing these stupid games on the level it outputs.
Its all good I have a private doctor working on it and next Tuesday I go for some type of ultra sound that they test with some kind of radioactive material to see what the Thyroid is doing.
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If your PTSD doctor stated you can't work because of the PTSD and the VA finds out your working they will most likely lower your rating like Chuck stated above...
Sorry I missed reading you had PTSD. Now if your PTSD is rated that much because of nightmares and such things like that then yea you can work. If I was you, I would get a boat and go fishing or hunting for awhile. Relax and enjoy life for a bit.
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Well for the past 6 months I have been having some horrible issues going on that I have been telling my VA PCP over and over. First it started with me feeling sick and really, really fatigued. I thought it was the Percocet so I asked my VA PCP if he could switch me to something else. So, he switched me to Morphine. Well that didn't work either as I was still fatigued. My sleep pattern was all out of whack and it was crazy. So, I asked to be switched again and he precribed Oxycodone. I found it better than the other ones. I wasn't getting sick but I was still fatigued and my sleep patters were still messed up. Example: I would sleep from 10pm-7am. That should be plenty of sleep right? At 9am I would get really fatigued and I would have to sleep another 3-4 hours. Then by 6pm I would be sleep again, so I would try to stay awake until 7pm and then I would get up at 2am and stay up for 5 hours. This went on and on and on for a few months.
Three weeks ago I had to go to the ER because my heart rate and blood pressure went sky high and I thought that was it I was having a heart attack. Diagnosis from the ER, Panic Attacks!!! One week later I had to go back to the ER for the same exact thing. Diagnosis: Panic Attacks!!! Nine days later boom I am back in the ER for the same thing. This time there was a nurse in the room and when I explained all the symptoms I have been having she said "Have you have had your Thyroid checked?" I told her that I just had a full blood work done at the VA and they said everything was "Okay", per my VA PCP. She asked the ER MD if he would approve they test the Thyroid. 15 minutes later boom the answer was THYROID problems causing the fatigue, heart racing, elavated blood pressure and just being sick.
I have explained all my symptoms to my VA PCP and I have secure messages to prove it. Instead of gathering all the evidence what does he do, he calls Cardiology to get them to send me a heart monitor I had to wear for 21 days. Funny thing is I just received it yesterday. After I found out all the problems was because of the Thyroid because I must have had at least 5 EKGs in the past month and they were all normal. So tomorrow I am packing that monitor back up and sending it back to Cardionet (company contractor with the VA).
Since I have been dealing with this for at least 6 months, maybe longer, and my VA PCP just hung me out to dry, and, with all the blood I gave last week that should have shown bad Thyroid levels (I dont' know if they checked them on the yearly appointment), can I file a 1151 claim since it appears the VA and my VA PCP didn't have a clue? I suffered 6+ months with this crap and my VA PCP threw me under the bus and waited months and months before he did anything. He waited until I had to go to the ER with a 160 heart rate and blood pressure that I could have stroked out with.
Advice please...
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Yes!!! Because you are 100% with the VA doesn't mean you can't work. Now, if you were 80% and then awarded TDIU then they would question if your working. Being 100% means your service-connected injuries are that much, it has nothing to do if you can work or not. There are A LOT of folks who are 100% and work at the VA doing claims.
BTW Congrats...
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I was able to drop Humana Medicare Advantage and now I am back on straight medicare. I didn't know that doctors that have a contract with medicare are paid per medicare payouts meaning if an epidural injection would normally cost $700 with insurance medicare might only pay $400 and the doctor has to accept this payment and they are NOT allow to charge you for the difference. Then only thing I have to pay is the 20% which IMO is better than waiting 3 months to get preapproved for a procedure using the Advantage medicare.
At this time I cannot afford getting medigap because its just too darn expensive. I am hoping the VA goes ahead and gives me P&T so I can get ChampVA. This way medicare will pay the 80% and ChampVA will pay the 20%. My issues have stabilized and is not expecting to get worse or better even with conservative treatments. I am willing to find a doctor who is willing to use me as a guinee pig to test new things. I am willing to do this instead of living in the condition I am in. I have my facet block schedule for 2/17 so I a hoping it helps. If it does then they will do the rhizotomy that I told them I needed.
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My VA PCP is not help whatsoever. I seen me Friday and didn't have any explanation for the feet turning blue/purple when I sit down. I emailed Dr. Bash and asked him if L5-S1 radiculopathy would cause this and he replied YES but with not explanation.
I finally was able to drop the Humana Advantage medicare crap and was schedule for the facet blocks on 2/17. I am praying these will work because I am sick and tired of living like this (NO LIFE WHATSOEVER) and I am tired of taking these pain killers. I've been thinking of replacing the pain killers at night before I go to bed with a bottle of wine cooler. I don't drink and may have a wine cooler every 2 years or every year on my anniversary. But I think this may help my sleeping issues. I believe wine can be a good medicine if used properly and not used to just get drunk.
I also purchased me a testosterone booster (supplement) to see if I can gain some energy so I pray this helps.
ARNG the procedure your talking about just checks for disc herniations and I can't even think of the name right now. But, the VA doesn't do these anymore per my VA PCP.
After these facet joint blocks they want to try a rhizotomy if the blocks do not work. Right now I am willing to be used a guinee pig just to get treatment. If you know a doctor who is a test doctor let me know because I am willing to do anything right now!!!
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Sorry for such a late, late reply, I forgot that I posted this. I had another lumbar MRI (probably 5th one in 10 years) and they checked to see if I had any clots in my legs. The MRI was negative for anything compressing my spinal cord, I do have the dried up disc at L5 and I do have progression of Osteoearthritis throughout my thoracic and lumbar. I told the surgeon's PA that my mid back and neck are in bad shape and she said she wants to work on one thing at a time. I've been waiting and waiting to get some shots in the joints because the PA said they are inflammed pretty bad. I am not diabetic.
Since my last post nothing has changed, feet still turn purple and get cold and they stay numb all the time. When low pressures/rain comes my toes start hurting really bad and the pain gets worse in the back of my legs and buttocks.
The pain I have accepted but my feet turning blue/purple is bothering me. I have a friend who has the same issues he got from a car wreck. He says his feet and toes get "ice cold" but his doesn't turn color like this. I just took photos of my feet to show my VA PCP so hopefully we can get some test done on this.
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I dropped Humana Medicare effective January 31st. and the plan I had was a medicare PPO but everything had to get preapproved. I called them and they said I needed to send them a letter. So I wrote on the letter why I am dropping them because with regular medicare patients don't need preapproval but their plan does. I told them that I find it unfair and unprofessional that patients have to wait that long for preapproval.
IMO if medicare is going to allow corporation like Humana to supply insurance to medicare patients then I think corporations like Humana MUST follow the same exact rules as regular medicare.
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So, what is going to happen or what has happened to those veterans who received all that backpay? She lied to them and they gave her a fee amount. Do these veterans she lied to have to pay all that money back? This story is not finished IMHO.
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I have medicare and originally I switched to Humana Medicare Advantage to take advantage to the lower co payments and out of pocket costs. But, the one thing I dislike very much is I have been waiting approximately TWO months to get approval to have shots done in the joints of my lumbar spine.
I did originally get approved in December but the pain management doctor was so booked he couldn't schedule the shot until after the new year. But Humana only approved the shots to be done by the end of December. A few minutes ago I called the Doctors office and they told me they did resend to get approval and so I have been waiting and waiting. Tired of waiting..
My question is has anybody had Humana Medicare and dropped it and went back to straight medicare? Its my understanding that with regular medical you don't have to get approved.
Thanks for the answer because I am about to drop Humana in the next week.
P&t Claim
in Eligibility - Veterans Compensation Benefit Claims
Posted
Okay thanks Georgiapapa