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Chuck75
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Posts posted by Chuck75
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10 hours ago, Vync said:
I appreciate the friendly feedback. I just lurk around here from time to time to help out.
You are correct. The VA handled this badly. Up until the VA changed their policies to match the DEA policies, they would often tell veterans go ahead and request a refill as soon as your medication arrived. In those instances, veterans were at least one month ahead of the expiration. This cold turkey approach is a serious problem for some veterans.
I agree with you about the choice program, or as I more appropriately call it, the "lack of" choice program. Supposedly, you are supposed to be able to find an eligible provider at this link: http://www.va.gov/opa/apps/locator/
If you have doc you wish to see, try to look them up. If they are not listed, you can ask them to see if they are interested in getting listed by going to that link and clicking "for providers". It says they must accept Medicare, which is a real turn off for many providers.
The real problem with ""choice" from the provider's side is getting paid. The VA is failing to do so in any sort of reasonable manner.
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My original Vietnam Era DD214 showed in country service, and did not show combat awards. In order to prove combat veteran status needed for a couple of individual claims, a DD215 was necessary.
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3 hours ago, Steve G. said:
Long time reader, looking for advice/help -
I may have screwed up, but last Sept I filed what I was convinced was a slam-dunk CUE. In short, back in 1992 I was rated at 30% for -
"Hypertension was diagnosed from 1983 with persistently high blood pressure reading.... Continuous medication is required for control of blood pressure." ... "[Arthrosclerotic] cardiovascular disease with myocardial infarction, four vessel coronary artery bypass grafting and hypertension."
Later ratings in 2008 and 2012 used the same language "coronary artery bypass grafting and hypertension."
I included copies of my SMR showing several instances (5 shown) where I had multiple readings where I was above the levels authorizing both 10% and 20% ratings and also Note 3 from the VA's rating criteria where it states that "Evaluate hypertension separately from hypertensive heart disease and other types of heart disease."
Looked like a shoo-in.
In Mar of this year I received the following response -
"The Rating Criteria prior to 1998 prohibited granting a separate evaluation for hypertension and heart disease. Hypertension was part of the evaluation criteria for the heart. so it would have been pyramiding to give a separate for the heart and hypertension. While service treatment records show you had a compensable elevated blood pressure readings at the time of the 1992 Rating we were unable to grant a separate compensable evaluation for hypertension and heart disease. The law was changed in 1998 and a separate evaluation for hypertension and heart was allowed. Rating Decision dated January 5. 2012 explained that a separate evaluation for hypertension wasn't warranted unless your symptoms were compensable."
OK, I get it, HPT wasn't rated separately until 1998 so I couldn't receive any additional rating until after 1998. The part I don't get is the last sentence. I have to show current symptoms? I was always under the impression that while a rating could and would change due to on-going symptom changes/deteriorations, but that the intitlement had to originally show in the SMR. I definately had not only sufficient symptoms in my records, but also a diagnosis that "Continuous medication is required for control of blood pressure" (this alone should equal a 10% rating.)
I haven't been able to address this for the last couple of months due to on-going personal/family issues, but I would like to file a NOD as soon as possible if my reasoning is correct.
Am I missing something here? Or are there other factors that I'm missing?
Thanks for any help/advice.
Don't know about help, other than to tell you to get current evidence of the HBP.
What's interesting to me is that for quote some time, the VA often called HBP as "essential", and denied any relationship to other conditions, thus removing the secondary to option.
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"How is this company getting email and/or phone # contact for disabled veterans?"
Someone or some entity is selling the info? In the past, some of the veterans service orgs
sold data.
Anyway, there are public records that might also be used.
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I assume E Bennies shows no payment history. If this was a recent award, it's possible that the VA's mill is screwed up.
Something as simple as a "call Peggy" (the VA's 800-827-1000 number) may get you more insight into what is going on.
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On 6/3/2016 at 4:43 PM, Jeffrey Smith said:
Hi all,
I have two questions:
A) I was diagnosed with Prostate Cancer in early February 2016, filed a claim with the VA on February 16, 2016 and received the VA's 5/17/2016 notice of Original Award of 100% disability rating due to Agent Orange exposure in Vietnam (1968-1969). I've done quite a bit of research (including here on hadit.com) trying to understand the VA's back pay provisions to make sure I'm being properly compensated but most of what I've found seems to be a lot more complicated than what I think is my pretty simple issue. The VA's letter itself is a little confusing to me - excerpts follow:
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"Effective Date: 2/16/2016"
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"Payment Start Date: 3/1/2016"
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"Generally, payments begin the first day of the month following the effective date. When applicable, a retroactive payment, minus any withholdings, will be issued. Thereafter, payment will be made at the beginning of each month for the prior month. For example, benefits due for May are paid on or about June 1."
I received payment for 2 months retroactive around 5/17/2016 and payment on June 1 (for May 2016). But it seems to me that if my "Payment Start Date" was 3/1/2016 (presumably for February), I should have had 3 months of retroactive pay (not 2), for 3/1, 4/1 & 5/1 before normal monthly payments began on June 1. Am I correct here or am I misunderstanding something?
B) Maybe I'm looking in the wrong places, but I came across the following information from the " §3.114 Change of law or Department of Veterans Affairs issue", (a) Effective date of award that provides: " (3) If a claim is reviewed at the request of the claimant more than 1 year after the effective date of the law or VA issue, benefits may be authorized for a period of 1 year prior to the date of receipt of such request. (Authority: 38 U.S.C. 1805, 1815, 1821, 1832, 5110(g))" (this info was found at http://www.benefits.va.gov/WARMS/docs/regs/38cfr/bookb/part3/s3_114.doc which I was referred to from this link: http://www.veteranprograms.com/id1757.html ("Section 4. Other Claims"). Since I filed the claim more than a year after the effective date that the law recognizes prostate cancer as presumptive under the VA's Disability rules, should my retroactive pay be for 1 year prior to the 2/16/2016 date of my claim?
Thanks for any help anyone can provide - you all are providing a great service!
Jeff Smith
"benefits may be authorized ", not will be authorized! It's kinda like 54/40 or fight!
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"Effective Date: 2/16/2016"
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2 hours ago, Bugaboo said:
I am trying to figure out some information. Is it possible to have Special Monthly Compensation WITHOUT Disability pay? I was under the impression that you got both or you just got disability pay, but never SMC by itself.
The SMC Table rates include the Disability payment amount plus the SMC payment.
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The VA usually Interprets the 20 days to mean that they will acknowledge the request within the 20, and actually fill it when they please.
In the past they have also refused to send a copy until a claim in progress is completed, or used any other excuse that came to mind.
I'm sure that the electronic file bit has or will changes things, just don't know what to expect in the future.
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1 minute ago, Osccore9 said:
Usually, a PTSD C&P does not have as many positive markers. In addition, reserve service is involved/noted, and that can make the RO's a bit suspicious.
A maybe sort of example - - - One of my claims involves a back injury under awarded combat conditions. Little evidence exists in my service records.
The BVA judge directed the RO to obtain my post active duty records for any additional evidence. The Navy reserves physicals for those on inactive duty were a joke, and unless a really disabling condition existed, were almost always fit for service.
Just to add injury, the language in title 38 is extremely favorable to this type of claim, and the VA often tries to weasel out of the situation by trying to create negative evidence.
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Playing Devils advocate - - -
To me the C&P was a bit too positive, and the RO may use a final statement in it to schedule an additional C&P or so.
I suppose a great deal depends upon what is currently "in favor" at the VARO.
Single issue, make it happen, take the credit, or develop further in detail for a VARO "favored" rating.
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3 hours ago, rootbeer22 said:
Vets:
Unfortunately, I had to file my first NOD this week without the benefit of having my C-file after almost 11 months waiting for it? As you know, that puts us Vets at a distinct disadvantage because we cannot see the contractor CP Exams to see and question the opinions? At one point in my life, I was a FOIA Officer and know the rules very well. The government has 20 business days to fulfill a request for FOIA but can ask for another 10 days if they have cause and inform the requester? Ironically, I used the new form to request the FOIA/C-File so there's no issue there? But in my case, the e-benefits status this week says that it will be at least 2 more years before I may see my claims files for a total of 3 years from the initial request? In contrast, a Vet only has one year to file a NOD so this does not add up or it is not fair? The FOIA Laws also say that it's not a valid excuse that an agency is too busy or has a large case load which excuses the agency from fulfilling the law?
Anyway, I sent a letter to the Director, Office of Government Information Services (OGIS), to appeal the wait for my C-File? Their primary federal responsibility is to monitor other Government FOIA Agency Programs for Compliance, Operations and Training. I also sent a copy of that same letter to the VA General Counsel, Leigh Bradley, VA National FOIA Office Team and Director of the VA Intake Center in Janesville, WI. to advise them that I have asked for help from the OGIS. I was careful not to send a letter directly to the VA Secretary yet because like I told all of these VA Staffs that I've been trying to resolve this at the lowest level possible? However, there's something very wrong with a system that should have provided records in about three weeks that is now taking upwards of three years? Besides, from a legal perspective, an agency can't just ignore the FOIA regulations and if they need more resources then perhaps their senior leadership should be notified? At this point, I've tried to exhaust all of my administrative actions to obtain my C-file before I get to the point were I may have to eventually have to take legal action.
Right now, too many Vets are in the same predicament as I am in and some kind of overall resolution needs to be happen soon? Overall, It's probably just means that the VA Intake Center needs more staff and that may fix it? Consequently, yesterday I watched a congressional hearing about VBA records issues and a senior VBA representative said now that 98% of veterans records are now digitized, so they should be able to just make a disk and send the C-files right out?
Anyway, I'll report back to hadit.com what happens? Who knows, I could be pleasantly surprised in a few days or maybe nothing may happen at all -but at least I'm trying something?
Godspeed Rootbeer22
One of the problems with the digitization is that the original paper files seem to become inaccessible. In the process of preparing for the effort, The VA (around 2008) supposedly went through the files, and removed (redacted) extraneous information. No one knows what was actually removed. Earlier this year, I was told that my VARO still had the paper files. Last year they were supposedly not available for a BVA traveling board hearing ?? Copies the VA has sent in the past contained some blank pages, and some older claims records mysteriously vanished. It may be that a Writ will be the only way.
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I would look into an NOD for the Jan 1 2016 reduction. Further, it's possible that home bound status (SMC S) might be applicable,
since the veteran likely could not leave home for work.
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2 hours ago, Buck52 said:
Question for me to answer a Vets question? I met at my VAMC
Can a Vietnam Vet be rated for D.A. (Dengenerative Arthritis?
Under code DC 5003 10% OR 20%
This vet had a X-Ray from his PCP said Dr sent him a letter stating what the X ray showed. =D.A. in lower back area (I don't have many details) but he said he was not injured while in military or had combat action while in Nam.
He was ok after Vietnam but came down with this D.A. IN HIS Lower Back Area years later
He ask me if he could get a rating for it if its not S.C..??
I did give this vet a hadit card I printed off....don't know if he will chime in here or not? I told him I'd try to find out, he gave me his Number to call him when I find out.
Thanks.
.................Buck
Anybody have any suggestions?
IDK? he want to go on the A.O. Prsumption that A.O. cause the Dengenerative Arthritis
Is this possible ?
There would need to be at the minimum, some sort of record of an in or during service event that could be used as the basis for a nexus.
Are there any existing A.O. related awards for anything?
Otherwise, the VA (and most everyone else) will say that the condition is a fairy common problem, and the result of "normal" living, working, and aging. Exceptions relaxing the "rules" do exist, but, from the information given, it sounds like they are not applicable.
As a general comment, remember that the classical military retirement has been 20 and out. That in part is some recognition that military service can be quite wearing.
I'm also currently fighting a back injury denial. There is minimal and possibly ambiguous reference to it in my service records. War zone service, awarded combat veteran status, and so forth that are applicable. The VA at the RO level, naturally denied, forcing an appeal. (Failure to apply combat veteran status rules and law) I'd likely not have appealed, but the rules for certain levels of SMC may be a factor for additional compensation.
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It looks to me like 100% single condition + 70% single condition more than justifies SMC S.
The others should entitle you to an SMC rating higher than SMC S.
Given the severity and mix of the conditions, I'd suggest that you don't dither in getting things corrected.
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A favorably filled out DBQ makes things a lot easier and hopefully faster. With or without one the VA is likely to call for a C&P.
(Standard RO CYA practices)
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On 6/9/2016 at 11:46 AM, OldJoe said:
I know we all go into "conspiracy mode" when the VA pulls lame brain stunts like this, but is there some reasoning to the logic?
I know this is the VA we are talking about they would send a Vulcan into an epileptic fit, probably would be considered inhuman and cruel punishment to even let one within 500 feet of a Vulcan.
Some reasoning to the logic?
What logic?
Anyway, It's likely that the VA's interests were best followed by just picking the next available C&P slot, regardless of other consideration.
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On 5/31/2016 at 1:01 PM, OldJoe said:
That said is there anything being done about IME/IMO this seems to be getting a bit ridiculous that in a "non-adversarial" system that a vet has to get a IME/IMO just to stand a chance of getting properly assessed (even low balled).
And the more I seem and hear it sounds like IME/IMOs will soon start to be discounted because all the vets are doing them just a standard practice when filing a claim.
Then where are we going to be?
"will soon start to be discounted " That's been going on for some time! The VA, unless forced to do otherwise, has often taken the less favorable opinion (usually from a VA examiner) even when the examiner is marginally qualified, over the favorable one from a fully qualified physician. (I.E. Board certified specialist, etc.) On appeal, the BVA usually catches this. But, it's occasionally necessary to have more than one favorable IME/IMO to counter an unfavorable in house opinion and C&P. One of the "reasons" the VA uses is calling an expert opinion "Speculation". After all, an opinion given decades after a nexus event is less probative than a more contemporary one. It's all in the evidence.
I really get upset when the VA calls for a C&P that is clearly not needed, due to sufficient medical records and test results. At one point, the VA RO was trying to make me take a treadmill stress test, even though the medical records, test results, etc. showed that such a test was extremely hazardous to me, and the VA's own regs and guidelines said that a stress test was not to be given. On appeal, via Nehmer (the VA failed to place my name on the Nehmer list, etc.) the appeal results politely said that the VARO screwed up, and that the existing medical evidence was conclusive without the C&P and stress test. The fact that the VA was trying to force me to drive over a hundred miles over snow covered two lane roads in Georgia to attend the C&P was not even mentioned. There were two other VAMC locations that were closer or easier to get to that had the ability to do the C&P, including the VAMC across the street from the VARO.
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1 hour ago, fiasco2g said:
Hello. I am new to this site and need a little info. I am trying to get my va primary care doctor to refer me for an MRI for my back and a Rheumatologist for the pain in my knees, hands, back, etc. He said he does not know why I am hurting but will not send me to a specialist. This was messaging response below:
I have reviewed your lumbar spine films and you have a mild L5-S1 disc disease. Without radiculopathy, an MRI is not warranted. I understand that you are applying for benefits, but it is not the VA providers responsibility to order all tests and exams that you want done. I have to justify all consults and exams. Your lab work is within normal limits so Rheumatology will not be consulted as they have rules as to who can be seen. You do not meet the criteria for Rheumatology consult.Well I did not want every test in the world just something to diagnosis the problem. I sent him a reply asking what the next step for treatment and diagnosis is then since he told me that he does not know what is wrong with me. I thought 30% of the time
blood work will not tell you anything for Rheumatoid arthritis, fibromylagia, gulf war syndrom, etc. I just need help. I paid for an MRI myself on one knee and it is expensive.
I am not service connect yet but filed an intent to file in January 2016. So I need to get the ball rolling on diagnosis and will go the civilian route if required. But is the VA responsible for at least attempting to diagnosis the problem or just continuing to push me six months down
the road to the next appointment. Thank you for you help.
Your problem is not an infrequent one. Even insurance companies are trying to get out of paying for such things as MRI's.
Personally, I do not trust VA PCP's to make decisions based upon the best interest and outcomes for individual veterans. Instead, the "party line" often seems to be as or more important. While I use the VA for no cost prescriptions, the majority of those are originated by non VA doctors. In the not so distant past, I had examples of the VA supplying prescriptions using generics that were not intended for the US market.
In short, if I were you, I'd get an opinion and evidence from outside VA, then proceed.
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On 6/7/2016 at 10:36 AM, SFOB said:
Is there a published list of disabilities considered permanent?
Not that I know of. But, certain disabilities/conditions are considered permanent, due to the very nature of them.For instance, IHD with LVEF % below 30%. (SC'd @ 100%) The only "cure" is heart transplant, which then gets into another set of disabilities and associated conditions. There are mechanical "helpers" that can be implanted, on a temporary or permanent basis, but they have serious limitations as well. A rule of thumb guide I'd consider is if the condition is likely to eventually be terminal. The VA disability schedule, in many cases, also shows hints as to P&T or not.
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There are fairly strict limits about holding/having a job and TDIU.
Obviously if you are able to work, then you are not in reality TDIU. (Although it's possible to meet the VA TDIU requirements.)
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That's a bit much. But, a complex IMO can get expensive, due to the time required to properly support the opinion with valid references and s forth.
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I'd likely see about voiding the NG enlistment. Can't have both. I'd think that you would not be deployable with the problems you mentioned.
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On 3/28/2011 at 3:07 PM, walt said:
Thank you Berta or Carrie.
For an IMO, I am sure a specialist for each condition would probably be best but would one from a GP DR. and PHY. assistant be of any benefit?
Also, isn't there something in VA rules or Federal rules that states if a veteran request it, the primary care giver MUST give a statement of patients' condition overall and place it in his medical folder,or something to that effect? I asked mine for a statement that I was totally disadled and she refused.Told me to go down the hall to C&P.Thank you in advance. Walt
There is such a requirement with caveats. But, do you really want someone to fill out such a form when they don't want to?
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On 5/21/2016 at 2:46 PM, Berta said:
Interesting...about the Korea problem.I will check that out.
My daughter told me her M16 jammed when she was in BT, 'just like Dad's did a few times in Vietnam", she added.
I suggested maybe she was trained on the same M 16 he had in Vietnam.
One point my AMU courses sure taught me was ,in battle, there is always confusion and panic. Mistakes happen.
And I bet our AD are still using old materiale , and such....In Vietnam they probable ate C Rats left over from WW2.
I learned that our best weapons as claimants are two fold.....the regulations themselves and the Internet.
And of course Hadit.com! This site should be a training program for the ROs.
"Having covered some of the potential issues with getting my IME is there anything I can bring to the Dr.'s attention so I don't fall into the trap that the nexus itself is considered not "new and material" .
A Good IMO/IME doc will follow to the letter the advise here at hadit on getting an IMO.
It holds the key words the doc needs to state, along with a full medical rationale.
They will need copies of your SMRs, all medical records, VA and private,and a copy of any C & Ps the VA used to deny you with.
I would give the IMO doc a copy of their actual decisions too.
VA honed in on a finding that this was not 'chronic' in service.His IMO will have to give a medical rationale that it was, and that it remains chronic.
"In Vietnam they probable ate C Rats left over from WW2 "
Actually those that i saw were from the Korean war!
At times, even those were preferable to the slop served up in the mess decks.
100% SC P&T Mental going to college
in VA Disability Claims Research
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