Chuck75

The way things are, (and have been for decades) Congress has the authority and responsibility to "fix" the VA. Unfortunately, virtually everything that needs to be done will cost more money. This translates into less money available for other more popular uses. Since there is never enough money available, the VA has been shortchanged ever since the end of WWII. VA's use of what it has can also be questioned. Congress, for example might enact and impose time limits on the VA. Under current rules, this would require a "how much is this gonna cost excercise", and the results will not be to the liking of many. The time limit problem must be addressed in a way that points out the moral and real responsibility of Congress and the VA to correct things.

And at 80%, if you are not and have not worked for awhile, you should apply for TDIU, Then if approved, you would be paid at the 100% rate. If there is no evidence that the VA had considered you previously for TDIU, you may have a claim for retro as well. They "should" have considered you automatically, when you reach a percentage that requires them to do so. Ratings combined using VA "math" can only be rounded to 100%, as they will never equal 100%.

I'm afraid your problems are typical rather than an isolated case. E Benefits information is often so far behind that it's useless. Also, revisions to the various documents in E benefits over the last year or so have reduced claim related detail. As a personal example, (last time I looked earlier this year) SC'd conditions beyond the highest (100%) disappeared. Evidently the Nehmer review board entered them, and the area VARO removed them or altered the available information.

In may states, the divorce courts rulings side step federal law, and include VA compensation as income for purposes of establishing child support, and other divorce related items. It will take state law changes to stop the practice, and the changes aren't likely to occur. Other liens, etc. do fall under federal and state law. The most egregious violations seem to have been via VA Fiduciaries, appointed by the VA to handle a veteran's money when the VA rules (or even proposes) that a veteran is "incompetent". Banks are also at fault for turning over funds in excess of what the laws allow/require. It can be time consuming and difficult to get the funds returned when this occurs. It may become more of a problem when "direct deposit" is required, since the VA then has an easy way to obtain account details, etc.

This is part of the famous VA catch 22. I'd suggest that you start taking metformin as soon as possible. If you are already being treated by the VA or, wish to obtain metformin from them, do so, since this starts establishing a VA record of treatment. Your private doctor can also fill out a VA form that is used to document DMII for claim purposes. http://www.vba.va.gov/bln/21/Benefits/exams/index.htm and other fillable worksheets? for an independent medical opinion. The VA recently released specific forms for outside doctors to use, but my bookmark is no longer valid.

To David W Congratulations! 100% SC'd sort of trumps TDIU. But, is the basis of the 100% one or several combined disabilities? Remember that it's possible to be eligible for additional compensation beyond that granted for 100%. The gory details depend upon your exact case, and the VA prefers to ignore additional compensation beyond the 100% scheduler rate.

SSA can look at your tax records, such as a W-2, or tax return, and also see if you or your employer is making "contributions" to your SSA account. Another stupidity would be to apply for unemployment compensation.

The VA can "defer" a claim for seemingly almost any reason. At this point, the original TDIU claim has not been fully granted. You should NOT submit a new claim for TDIU, as the VA can say that this is a "new" claim, and screw around (improperly) with the EDD. A letter stating that the claim should be adjucated with the exisiting evidence may help speed things up, if you are sure that the evidence supports TDIU. Finding out exactly why the TDIU portion of the claim was deferred may be difficult. You might consider requesting an SOC, since the claim was not fully granted, and the VA has not sent one?. An SOC might show why things were deferred, although I doubt it. It's more of an informal notice to the VA that you haven't given up, and will persue things further if they don't do things as they should. "The DAV then proceeded to tell us that our State's VARO didn't accept Requests for Reconsideration" If so, The VARO is not following the law and regulations. It sounds more like the DAV rep doesn't want to mess with the request.

A problem with SSDI is that you must be incapable of holding a job that provides a certain level of income. In other-words, before the disabilities, you might have earned 100k a year, and after, you were only qualified and capable of being a Wal Mart greeter means that SSA will deny. A friend of ours was denied by a Chicago SSA office, not because his disabilities were not significant enough, but solely because he owned his small painting business. The SSA told him to hire someone to do what he was doing. (painting houses)

You will need to (preferably) go back to the same neurosurgeon with a copy of the C&P in hand, as well as the current VA form for specialists IMOs for your condition, It may make him quite unhappy with the VA, and he can, in detail, totally negate the C&P findings. He is a "specialist" and it's likely that the C&P examiner was not. The neurosurgeon can document your current level of problems, document your pain, and totally rebut the C&P results. (If he chooses to do so) In any event, the problem is that this is 2012, and your previous favorable evidence is dated in 2010. This gives the VA an out to claim that the C&P results properly show current conditions, and negate the 2010 evidence with the C&P. You have no choice but to counter the C&P with additional evidence. Even with the additional evidence, there is a possibility that the VA will call for another C&P. You can file a new IMO from the neurosurgeon, and claim that the C&P was incomplete and insufficient, and/or request another C&P from a different VA examiner. Once current favorable evidence is in your file, you can appeal, request reconsideration, etc. and state that you want to go with the evidence on file. You must have other SC'd conditions and this looks like an attempt to drop your % to below the % making you eligible for TDIU. Generally, it takes a qualified medical professional (Board Certified Specialist in the appropriate field) to fully counter C&P results such as those you mentioned.

Given the shortage of VA doctors, it looks like the administrators get the most benefit. Since the congress has not seen fit to place "reasonable" (to veterans with a medical problem) time limits, and mandatory VA action, such as fee paid, etc., the VA will continue on it's merry way. Blame Congress along with the VA.

"I live in the state of Georgia" usually equates to the Atlanta (Decatur GA) VARO for veterans. SSA is another can of worms. Generally, it is faster and perhaps overall more "fair" than the VA. SSA individual cases show the same lack of consistency across the country as VA decisions. Being "nice" to the SSA interviewer/ case worker can have a large positive impact. You will likely find that there is a great deal of difference from one case worker to another. (I had one senior case worker that would "bend over backwards" to help a claimant, and another junior worker that was just the opposite, in the same office, no less.) I had to appeal an EDD, and would likely not have been successful as quickly and simply without the help of the senior case worker. Past history of this VARO, as well as my experience with it - - - A "simple" claim goes through the system fairly quickly, although it may have been "low balled". Complex claims can result in deferrals, failure to read all the evidence, including service medical records, loss of records, Etc. Denials of claims with ignored evidence of in service treatment, military doctors statements saying "duty related", and so forth. Dismissal of expert IMOs as "speculation", even when the IMO is in accordance with the requirements of the appeals courts. Failure to notify NLSVP of Nehmer case members, even when the veteran already has adjucated claims that fall under Nehmer. Loss of records, and so forth, including "redaction" that destroyed documents that by law, are to be in the veteran's claim folder. (Records of such things as past denials that did not meet the requirements, regulations, practices, and law in effect at the time.) (It's hard even for lawyers to prove something happened when the records disappear!) Hopefully, all the current scrutiny, combined with outside review of Nehmer cases, has improved or will improve the Atlanta VARO's speed and accuracy. Deferrals can be a particular problem. I might suggest that the veteran consider a reply to a deferral stating to the effect that the VA should use "evidence of record", and decide the claim(s). At least this encourages the VA to make a decision, allowing the next step to be taken if the decision is a denial. Many of the conditions resulting in a VA claim are not "static". So ongoing evidence of changes (treatment, severity, etc.) can be assumed. The VA can use this (if they so choose) to delay/defer a claim while awaiting "current evidence". Naturally, the ridiculous time the VA takes on a deferred claim can render "current evidence" a never ending problem.

Don't Panic quite yet! Give things a couple of days, then go into panic mode if the check is still missing..

Print out the letters, etc. You can assume that P&T status exists. Another phrase indicating P&T status is "no future exams scheduled". It's also useful to understand that the VA CAN, sometime in the future, decide to review your status, pull you in for another C&P, and use the results to lower your ratings, at least until they become "protected" by time limits. This may happen shortly before the first limit is reached, usually just before the ten year mark, or even sooner, if some reviewing rater decides to do so. Reviewing cases is something that is done by new raters, as part of the training. With all the veterans coming back from the mideast, etc. and the high number of claims they generate, it's hard to say what the VA will do in the future.

Actually, I doubt it, unless you can "prove" that it's aggravating things. Remember that there is an unstated assumption that active reserve status indicates that you are medically fit for active service, unless proven otherwise, and once proven, you shouldn't be in the active reserves.

Theory only - - The VARO decided to award, thus making the BVA moot. Or, alternately, the admin process found something that was left out.

The letter from an employer will most likely cite performance issues, and avoid any mention or relation to PTSD or TBI. It will take a doctor's opinion to connect the performance issues to either cause. Why? An employer (in general) cannot fire a person solely because they have a disability, or medical condition. Next, if the employer happens to be a government contractor, or receives grants from the government, firing a veteran can "kick them off" the "gravy train". Not to mention minor problems such as fines. A major problem with disabled veterans and the general disability/handicapped law environment is simply the VA's lack of promptness. The employment laws have a relatively short time (limitations statutes), often a year or less. The VA routinely takes so much time to service connect a disability that the time limits in the employment laws often have expired.

Using this, a common etiology (cause) could be used to limit a claim based upon A/O exposure to 100%, even though the claim may involve more than one "system", and have secondary conditions. This is not being done at present, at least to my knowledge, and the M21 contains language that directs that common etiology is not used to limit to 100%.

A single "Nexus" yes. I doubt that the VA will ever consider the example as a single disability, unless forced to by the court and/or congress. Using the example, A/O "presumptives" would become a single disability. I do have language in a C&P showing that the examiner considered multiple problems related to A/O exposures as a single disability. The Nexus was also single - - Vietnam, "Feet on Ground".

"So now I am at a total or 80%!" Did the VA consider TDIU? If not, have you applied for it?

Making COLA "automatic" has it's pitfalls. A biggie is "out of sight, out of mind" The current 100% compensation level is about 25% or even more low, if you consider that the "average income' numbers are higher than the 100% comp level. To stay with the present level before COLA says that congress thinks veterans have an average lower income that the general population. Remember that the compensation is to replace "lost income" due to the veteran's disability.

The VA's error rate is stated in a way that intentionally leads readers to think that it's better than it is. A conservative guess is 33% instead of the stated 16%. Part of the problem may be the old "apple, oranges, and fruit" bit.

The "rater" makes the decision. It seems from your stated information that you should be successful. However the VA's error rate is high enough that there is no telling. I'd say that there is at least a 30% chance that you will end up filing an appeal. On the other hand, you may have at least a 50% chance of a favorable decision. I assume that you have already filed for reconsideration, from your remarks.

It looks like VA treatment is available in Decatur GA (VAMC), or perhaps in Athens (Clinic). Given your situation, I'd certainly at least talk to a patient advocate and see what might be available. Distance is not a primary consideration of the VA's, when it comes to fee based treatment.

This gets into a contentious area. The VA looks at things their way, and that is not usually to the veteran's benefit. The statutory language can be interpreted more than one way. Even the VA has changed it's stance over time. One line of thinking is that the combination scheme used by the VA can only be used once, and the problem is that all disabilities present will only result in something less than 100%. (by VA design!) The VA may (and should) then award the closest percentage, which may be 100%. The key is what disabilities were "used up" in the 100% award. A severely disabled veteran with a 100% statutory disability and other disabilities falls into the contentious area concerning SMC ratings, because the language first states clearly that one of the additional disabilities should be 60% or greater. There is follow on language and language in other sections that can be read as allowing the additional disabilities beyond the 100% to be added to reach the 60%. The VA has, in past cases, used both additive and combinational methods, and also denied based upon the lack of an additional single 60% disability. A question is always did the VA use the combinational scheme up with the highest disability rating, which might be 100%. Or, is the VA free to use the combinational scheme on the lesser disabilities below the 100% single rating? In other words, cases like the one mentioned in this thread are a very good candidate for legal representation, and appeal actions. Generally, a skilled and experienced VA case lawyer will find errors in the VA's decisions that can be used in the veteran's favor, be they such things as under rated disabilities, or procedural and legal errors.