Chuck75

The whole VA compensation thing is a total disaster. That said, a lawyer that has requested a "C" file and hasn't gotten it 400 days later is in question as to what was actually done. The VA normally responds to lawyers in a much more timely fashion than to veterans direct requests. It can be argued that such a delay is denial of due process, if nothing else.

As a Vietnam (feet on ground) vet with IHD, and a fight with the VA between 2005 and 2011. (Until the Nehmer review board awarded just about everything the VARO had previously denied). - - - A board certified interventional cardiologist's written diagnosis of IHD, preferably using the VA's new forms, and including lab test results, is your best evidence. A heart cath with estimates of LVEF more or less is proof positive of IHD. If you are a Vietnam Vet with combat awards, these can substantiate your Vietnam service. They can be personal or even unit awards. A "CAR" (CR), or other awards that cite combat "conditions" are considered "combat awards", along with others, such as a bronze or silver star. If you were hospitalized in a VAMC, and the records show IHD related problems, You may be entitled to an earlier award date than the date of your "formal" claim". You also should, assuming you can get a doctor's written opinion on it, also claim "caused or at least aggravated by" the medicines you mention, assuming that they are for an already service connected condition.

The problem with the language that includes "multiple payments" is that it's left up to the VA to define the details. Naturally, the VA does NOT follow the "most advantageous" statement elsewhere in the mileage reimbursement regs, since they don't even follow it on a single payment. (Using crow flies from a calculated fixed point in a zip code instead of actual road mileage.)

You may see similar things here and there. It has to do with various DNS servers and, most likely, the changes needed to fully implement IPV6.

Bureaucrats believe in and practice in a system that is by design, intended to remove personal responsibility. What better way, when "stuff" hits the fan, than to "reorganize". Moving people, titles, functions, and changing organizational makeup removes those responsible from the line of fire, and most if not all of the consequences. Those that were unfortunate enough to be newly assigned to the areas under fire can truthfully (maybe, anyway) state that they know nothing, did nothing, and had no control. And they are working diligently to correct the problem, at least until they realize that the problem is well beyond anything they might be able to do.

Think about this - - The VA can order a C&P exam be accomplished by a VA treating doctor if they choose to do so. 1. VBA pays VHA when this is done. Ah Ha! 2. The treating doctor supposedly knows more about the veteran's medical problems in detail than a five to fifteen minute interview with a C&P examiner will disclose, and this information is usually favorable to the veteran's claim. In the past, I have had a few VA (real, licensed, etc.) treating doctors that were willing to fill out various forms that are useful during a claims process. It's worthy of note that those doctors invariably were transfered or left the VA completely within a year or so after filling out the forms. Documenting my claims properly involved several years of efforts, multiple non VA treatment records, and statements, including IOMs. I had one IMO summarily dismissed by the VA as "speculation", even though it met all the requirements to be valid when presented to the Court of Veteran's Appeals, and the originating doctor was considered and recognized as an "expert" in the appropriate field by the court.

I had to start laughing! The service orgs did not really want to "tweak" the VA's "beak", or even more important, place a good part of the "blame" where it should be. (Congress) Think a bit -- Title 38 (Law, Congress) VA Regulations and M-21 (In many places, they restrict the original meaning and intent of Congress, such that a small number of veterans are successful in claims VA Bureaucracy and practices Establish or promote a mind set that veterans are out to "game" the system. And regardless of VA disclaimers, make claim denial quicker and simpler than award. VA attitudes towards veteran's claims seem to be that if we delay long enough, it's likely the veteran will go away (die), or the veteran's claim succumbs to the "pitfalls" built into Title 38 and the VA regs, or the veteran will "just give up". The VSO's have a problem, in that fighting the VA tooth and nail, as Filner seems to favor, is often counter productive when having to deal with bureaucrats. Getting bureaucrats to do something is often difficult, and more so when you don't have their "goodwill". When it comes down to it, over the decades, blue ribbon panels, committees, funded and unfunded studies have made numerous recommendations. Virtually NONE have been implemented by changes in law or regulation. Many of the more recent changes have been examples of "give with one hand, take away with the other". One notable example, and "improvement" is a VA reg that deals with PTSD, and states that a VA C&P examiner's report is the only way that the VA will recognize a PTSD diagnosis for claim purposes. (This is contrary to past practice, and Title 38 language.) Not to mention that the VA C&P examiners qualifications are often such that the examiner's opinion is not accepted by a court of law as authoritative. Another one is shortening veteran's response times, and leaving the VA's side open ended for a useful response or decision. Perhaps another oddity worthy of mention. An SSA determination of total disability is valid for almost all courts and purposes, yet the VA does not acknowledge it's validity. In such cases, the VA should only be concerned about "Service Connection", not the level of disability. The present situation is not only absurd, it costs the government a great deal, in terms of extra administrative time and expense. A fair number of the VA problems can be cured by legislation and oversight, if penalties can be imposed for the VA's improper actions and lack of action. Possible examples 1. When a veteran is paid retroactive compensation, the compensation must be adjusted for the delay, inflation, etc. and perhaps a percentage (20%) added when the delay is significant. 2. Denials must go through a more complex process than they do now, and the process must take as long and be as or more complicated as the award process. 3. When a significant number of denied claims processed by a VARO are found to be in error, all denied claims in the same general time-frames must be reviewed for error. 4. Bonuses will not be given to management when a VARO takes over "X" days to process and complete claims. 5. Bonuses will not be given when the number of appeals is above "X" percentage. 6. Bonuses will not be given when claim error rates are above "X" percentage. 7. As time passes, the "X" number or percentage will be reduced significantly each year, until the VA's performance is "second to none". In other words. the VA's proclivity to deny rather than award must be reversed any way possible, if the stated intent of the veterans compensation laws is to be properly carried out. Ultimately, this places things back in Congresses lap.

The VA has been known to screw-up on more than one occasion. It sounds like your letter falls into that category. If you have access to E Benefits, I'd look there, knowing that there may or may not be something useful. You might consider asking "peggy" if there is any information that might shed some light on things. At this point, it's hard to say what the VA's "decision" was or was not, as you said.

Most of the lawyers agree on 20% plus any EAJA payments. (Actually, the EAJA payment "should" be used to offset the 20% that the VA deducts from retroactive awards.) Next, they should only be asking for a % of those appeals that they are actually involved with. A DRO hearing is not an appeal. You can file a NOD or even possibly a CUE on a DRO decision, at which point it becomes an appeal. There are some details involved in properly reducing or severing an existing SC'd condition. I haven't recently refreshed my memory on them, so I'll leave that to others. In essence, the VA supposedly has to do things in a certain way, and they have been known to not do so. This is where a lawyer comes in handy.

It would certainly be a stressful environment and give you feelings of helplessness, danger, and high stress due to possible hostile fire, etc. In principal, I believe this meets the requirements for a Nexus. Unfortunately, the VA often has it's own unique way of seeing things. To me, the biggest issue/difficulty might be documenting the facts and conditions of your service. At one point, in a group of Navy A/O related claims that included mine, the VA was ignoring a sworn written statement from a Navy Admiral verifying dates, and locations of in country presence and likely exposure to A/O. They also ignored "combat veteran" status as well. Several years ago, before the VA got serious about properly recognizing "brown water" service the same as "feet on ground", I had a problem documenting "feet on ground". It turned out that military medical records existed of treatment at a USAF hospital in Vietnam. I had to find documents listing APO/FPO addresses, showing that the hospital was physically located in Vietnam. (The state VSO assigned to the "local" VAMC had never seen the list, and didn't even know that it existed.) Another go around occurred, in that I was awarded a Combat Action Ribbon, then called a Combat Ribbon(CR) instead of today's CAR designation. This was not shown on my DD214, since it was generated before the award became a matter of record. (Time to ask for a DD215, which I did) Other "combat" awards were also not listed on the 214, and were picked up by the 215.

"Major Depressive Disorder and Generalized Anxiety Disorder." "Why is it showing up now as deferred?" Being a pessimist and a bit paranoid at heart, I'd be tempted to think that the RO wants a chance to see if there is an excuse to change (reduce) the previous depression rating. A "new" claim or decision is an opportunity to determine the appropriateness of existing ratings that are not covered by time limits.

Sort of on and off topic at the same time! I received an envelope the other day from the NVLSP. It contained a copy of the Nehmer review decision. The decision was correct in the overall EDD date, and award for IHD, but obviously erred in some secondary decisions. One was a later EDD assigned than the overall EDD, even though evidence showed treatment well before the overall EDD (set by claim date). Another decision used current law instead of the law that was in place on and well after the overall EDD. This resulted in 0% rating instead of 10% for the secondary. When queried, the NVLSP stated that they did not have the time or manpower to deal with secondaries, and were just concentrating on IHD awards. So, if you have secondary conditions related to IHD, don't depend on the NVLSP to help when/if the VA does not properly deal with them..

And you never heard of paper coffins? They do exist, and are often used for cremation. The coffin typically looks like a standard coffin. they are/were used in Florida. Not to long ago, when cremation was involved, metal coffins were used for the funeral process, and the body was removed for cremation. The metal coffin was then "refurbished" and re used. The price of the "paper" coffin was slightly lower than a refurbished one. (And much less of a hassle for everyone concerned.) A "Fancy" cardboard box can also be used for cremated remains.

METS level assignments can be very subjective, and may not agree with medical evidence. (especially when made at a VA C&P exam) Private physicians are often uncomfortable with METS and another method used by many states in assigning handicap levels. Actual medical test results are usually better. An example might be measurements of blood pressures, volumes etc. taken via a heart cath sensor. Heart damage(IHD,etc) can change high blood pressure to a more normal pressure. One indicator of this possibility is a "slow" heartbeat. The measured "pressure waves" inside the heart are a diagnostic tool that can be used to fairly accurately estimate total heart damage.

You will likely end up fighting the VA for benefits. (Most veteran's have this problem!) I assume that you have your service records, including medical, and they have records of assignments (duty station, commands, etc) and your specialty. The next problem is proving that you were exposed to the microwave radiation, and at what levels. This is often a problem, due to extremely poor monitoring practices of the military. (Such things as taking microwave radiation surveys when everything is turned off or in standby come to mind, and a lack of functioning or correct monitoring equipment.) Although various things (documents, studies, etc.) show a high probability of being exposed to RF, the VA's attitude is that you will need to "prove" such exposure, even when it's likely. Buddy statements may be needed, with reference to specific dates, times, and locations. Were you ever "treated" for RF burns? Do you have medical opinions, etc. that associate RF exposure with your medical condition(s)? Your problems are of interest to me, simply because I worked as an electronics tech on active duty (shipboard navy) and maintained radar equipment as well as all the other on board electronic systems. If that wasn't enough, I spend decades working on or with airborne microwave transmitters as a factory "tech rep". From the late 1970's to about 1990, the USAF had problems obtaining, calibrating, and properly using microwave monitoring equipment in not a few of it's various repair shops. Often, the calibration facilities did not have the ability to properly calibrate the equipment, and even if they did, the equipment was in such demand that it might be sent to another user with a higher "priority" than the actual owner. We ended up having to send this type of equipment back to the microwave systems OEM, (I worked for them), so that the monitoring equipment didn't get "lost" in the AF supply system.

You may need an IMO if you think - - The C&P minimized your medical condition. The C&P was not complete in addressing all the "issues" contained in your claim. You believe the C&P is not accurate, or contains false information.

CAD (coronary artery disease), IHD, and bradycardia can be related. CAD can cause IHD. High blood pressure can be related to both IHD and CAD. Actually, cause and effect of these are intertwined. Bradycardia can be the result of a silent heart attack, or when it is very mild, normal under certain conditions. Since my at rest pulse rate is about 57, I technically have Bradycardia. It's really a minor issue, in comparison to other's, such as CAD. CAD can be the direct cause of IHD. The big question is what is your left ventricle efficiency, since you do have evidence of damage to your heart. An LVEF of less than 30% can result in a 100% schedular rating. I assume you fall under the A/O exposure rules.

And you expected something different from the VA. Remember that they have a history of interpreting the laws in ways that tend to not be veteran "frendly". At various times, Congress has "clarified" the laws by trying to modify some of the more onerous VA practices. Usually just enough to reduce the complaints to a level that allows them to fall off the news media's radar. Currently, things are a lot different, thanks to large numbers of newer veterans that are more internet savvy, better educated, and more likely to take on dealing with the VA. Unfortunately, those veterans in the most need and least able to deal with the VA still have many road blocks to surmount.

The EAJA payments (when and if any) are based upon "approved" hourly rates for legal services. The process often reduces both the hours claimed and the per hour billing amounts from the lawyers. Lawyers and legal assistants, office administrative help, etc. have different rates. Basic eligibility (as I remember) is based upon net worth, and I think the limit is 2Mil. net worth. Remember that the VA will pay 20%, and lawyers in principal can charge up to 30%. "Expenses" can be charged on top of the VA paid 20%. Some lawyer will agree to the 20%, others want more. I have seen lawyer client agreements that allow the lawyer to keep the EAJA payment on top of the 20%. Remember that civil (non VA) cases may allow the lawyer to collect up to 50%.

The problem I see with "non VA" care is that the VA does not pay promptly, and the VA bureaucratic process ends up consuming (according to medical providers) more administrative time than it's worth. Besides that the VA often uses "not pre-approved" to evade payment, even when the VA was contacted per the regs. An example of this might be that the person that answered the call was "not authorized", to make the decision. (And, there was no one there that was) Or, (And very important), The regs call for payment first by anyone else, such as Medicare or private insurance. The last time I actually read the regs, there was a clause that (summarized) basically said that if anyone else paid anything, the VA would not pay, even when the payments did not satisfy full payment, or the veteran owed any differences. Getting ambulance costs paid has also been a real problem. In other-words, the VA can be expected to evade payment when it thinks it can get away with it, again leaving the veteran to deal with the aftermath.

The VA has a form for almost everything, including www.vba.va.gov/pubs/forms/VBA-21-22A-ARE.pdf When properly filled out, the form appoints you as your fathers VA representative. The law, in general, allows you to represent your father to the VA on a one time or one claim basis. Most state law allows you as next of kin to go beyone that in a non VA situation. It's worthy of note that a VA plus nursing home situation will likely impact your father's VA pension.

The problem is that the VA often takes quite a long time to do much of anything. That aside, a treating doctors medical opinion (IMO) that your in service injuries caused/contributed to your fall, and subsequent further injury would be quite helpful. I'd apply for TDIU, and SSDI as soon as possible if I were you. Even though you may not have (at your age) paid enough quarters into SSA, it's possible that you might have benefits available from your parents accounts. The VA seems to not care if a veteran is or is about to become "homeless", unless you are at the right place and time. It's remotely possible that a VA residence program might be available and appropriate, at least until you recover. If you can possibly get to a VAMC and or a VARO in your vicinity, It might be worth your while to apply personally for benefits. Since you are a recent veteran, (from your age) there are possibly some benefits available to you that us older veterans do not have.

In short, no, since you are around to tell about it. Too much insulin can cause problems, but a relatively small amount should not. I might speculate as to why you were given the insulin, but why bother. Things like utter mistake, or perhaps a higher than normal blood sugar count, due to a "drip" with glucose come to mind. I am a diabetic and recently ended up with a couple of insulin shots while I was in the hospital. The problem was related to iodine based dye, and the need to not take metformin for several days prior and post dye use.

Consider this - - - A higher dosage (double) pill has only a small if any price increase. In some cases, it may actually be cheaper. If a veteran must pay "co-pay", the rate is based upon a 30 day supply. So, the VA can collect twice the co-pay for the same number of pills. To the best of my knowledge, the VA has never implemented provisions that allow for "reduced co-pay" in the pill splitting area. The VA also doesn't let such things as pill coatings, extended release, approved use, drug licensing, etc. stand in the way. I recently tried to get the local VAMC to provide some light on the matter. What I found was that the pill splitting bit is based upon local "initiative" policy, whatever that is, and there were supposedly no documents defining a "standard policy". Evidently, the VAMC chief pharmacist calls the shots. What I'd bet is that getting my hands on a written list, and making it public is not considered in the VAMCs best interest.

After getting a "live" flu shot for what was then called a variant of "Hong Kong flu" while I was in the Navy, and watching the entire ships crew, including myself have a reaction -- (high temperatures just below danger levels, and most of the symptoms of a good flu case), I don't take flu shots. That has, so far, for more than forty years, been a good decision. (The flu vaccine was based upon flu strains then prevalent in Hong Kong and the far east.) Seems that if I do get something "like" the flu, its annoying, very mild, and usually mostly gone in a few days. I don't really want to get into a VA "treatment" discussion, as it increases my angst and blood pressure.