Chuck75

So are you 100% for IHD itself? AAA is not a ratable disability, if it's aid and attendance but rather due to the disabilities. On the other hand, an aortic aneurysm can be connected to HBP and CAD, as someone said, by a qualified physician. It's specifically (according to the VA) not part of IHD.

To oldranger821 IHD - If the medical records are good enough to show the current severity level of IHD a C&P is not really needed. That's not to say that the VA RO may schedule one anyway. One thing to watch for - if the severity is high, I.E. LVEF 30% or less, general medical advice and language in the VA regs advise against a stress test. A VA RO may schedule one anyway! If so, you may need to get a cardiologist to say that the stress test is "contraindicated" due to the severity or other details concerning or related to IHD, CAD, etc. A/O C&P - traditionally, there is an A/O medical exam, not used for rating purposes. This exam is basically the same exam as the VA exam given to veterans on entry to the VA system. There are exams for specific conditions related to/caused by A/O exposure. Compensation for IHD might/should be based upon the 2007 date, since evidence of the condition existed in your records when the DMII award was made. There are some date related limits that may or may not be applied correctly by the VA. The court ordered mandatory review of your A/O related DMII case should pick this up (an ideal world) I would suggest that you contact the Nehmer class action lawyers. The VA was required to furnish them with a list that "should" have your name on it, due to the 2007 DMII award. The following reference may be of some help http://www.nvlsp.org/Information/ArticleLibrary/AgentOrange/AO-VABeginsReview.htm I always kicked myself for not claiming various heart related problems prior to a DMII claim. The Ranch Hand study clearly showed that I should have. The VA would have denied it, but that would have established legal entitlement to a decades earlier EED, once IHD was added to the "list".

Navy related asbestos exposure should be presumptive for those that served on any of the older WWII and Korean era ships. Many of these ships were in service long after the Vietnam eara. Around the late 60's and early 70's, a lot of the older ships did have some level of asbestos removed and replaced with other insulation. Vibration broke down the fibers, caused dust, and generally resulted in exposure. A large number of the ships had air handling systems that did not prevent airborne particles from spreading throughout. WWII era barracks at Great Lakes and other Navy bases were built with a large amount of asbestos, (Insulation, tile, etc.) Many of these buildings were in use long after WWII, and were occupied by many Navy veterans during training and transit to other assignments. Shipboard exposure is not the only possible exposure.

The "study is generic" statement is enshrined in VA RO denial practice. I've seen this used in denials for A/O related conditions, that are not specifically called out by the VA as "presumptive". The "Ranch Hand Study" was often the A/O related study discounted by the VA. A similar statement may be used by the VA when non precedential court rulings or previous case awards were cited as being in favor of the claim. In my particular case, a condition "known" by the medical profession to be caused by or aggravated by an already SC'd condition, and even referred to in the VA/DOD treatment standards and guidelines as being related was denied using the "generic" based denial logic. The A/O review board reversed the denial, since it was for a condition specifically and recently added to the presumptive list. Somehow, I totally missed this thread, or would have commented on it in a more timely fashion.

The document referenced in the thread is dated in 2000. My experience with the VA and pill splitting began in 2002, and involved/involves tablets that are not scored, and have coatings that look to be "enteric"

"2) The October 2008 letter states that "Outpatient treatment records from Central Alabama VHCS were negative for PTSD" but I found a letter from the VA dated 8/18/2005 that shows screening for PTSD was positive during an examination for Knee pain which I now collect 30% for." You should submit any new evidence, etc. The VA will treat it as a new claim. If it is granted, then there is a possibility that NOD/CUE might be possible. Who knows, if you mention the 2005 letter, and provide a copy, along with the new evidence, the VA might CUE themselves. If not, (most likely) then you can request that they consider the earlier date. It might take a well qualified VA case lawyer to really look into the details, and determine if CUE is possible, and has a reasonable chance of success. It would seem that the VA failed to consider positive evidence of record.

The VA has been on the pill split kick for quite some time. In the past, they did not care if the pill was coated or not, scored or not. One medication I take fell into the coated and no score category. My private prescribing physician said OK, we'll fix that, and doubled the daily dosage. What griped me was that the VA got twice the copay for the number of pills, since 1/2 a pill was a "daily dosage", and actually paid the supplier about the same as they would have for the lower dosage. The VA's scheme may have actually violated "terms of use" that drug mfrs can impose. Since it's the government, I guess they think that they can getaway with such things. I once read that Medicade patients could not be required to "split" pills. A statement in the VA document "Tablet splitting saved $100,000 annually for all patients using Simvastatin at San Juan VAMC" is misleading and incomplete. What actually happens is that the VA pays 1/2 for a daily dosage, and charged the veterans co-pay for twice the normal amount of daily dosages. The VA collected twice the normal copay from veterans that pay copay.

Adjustment disorder with anxiety and depressed mood - - The VA might try to use this to say that it's not service connected. Undifferentiated somatoform disorder with anxiety can be related to the physical injuries, based upon the general definition

Even A Pro Bono lawyer may get paid by the government under an "Equal Access to Justice" law. There are just a lot of hoops for the lawyer to go through.

Without the details, I'm only guessing - - On the surface, (obviously) it seems that you will need to find out why they didn't go back or reference the original award date. It looks like they just forgot about the original NOD and details. The lawyer may be hoping to distance himself from the rest of the case, perhaps due to little reward. If it turns out that this is the case, you may, if you can contact the VARO legal office, be able to do something in this area to make the lawyer more interested in taking the case to it's conclusion. Sorry I'm being so general, but the VA's legal section is perhaps a bit strange in what they want to or will get involved in. There are some circumstances that allow them to get involved with what lawyers get paid for representing a veteran. I don't know if this case might be one. If you manage to get in contact with them, they will at least look at the circumstances. Depending upon the VARO, they may have virtually instant access to your claim. (The last time I got involved with this side, it had to do with a possible reduction of a lawyer's fee, due to certain VA actions, resulting in less work for the lawyer than typical.) Seems there are guidelines of some sort. I really have no idea how being overseas complicates matters, except to think that it just aggravates the whole set of problems.

Assuming you were rated at 60% for things unrelated to the 30% - - VA math applies. 30% of the remaining 40% = 12% added to the 60% and rounded (down) to 70%

BigRed, it sounds like you need to at least talk to a lawyer qualified to practice in the area of VA claims. Your description of past events sounds to me like you may have legal recourse, but I'm far from a lawyer.

In short, yes.

To me, the problem is the 100% for PTSD. (If this is really the case in actual fact, without regard for the VA's regs, etc.) Remember that the VA's formal award letter is not yet in the veteran's hands. The formal award letter and accompanying documents may have something useful to say. There are two way to look at things. Teaching is in fact somewhat of a sheltered environment. Someone who would not succeed in the "rough and tumble" environment of "normal" employment and "normal" social interactions may still be able to function well in a teaching environment. Then there is an opposite view that has nothing to do with the functional requirements, rather it has everything to do with some of the more common PTSD symptoms. First and foremost - - some of the symptoms include a person with PTSD induced behavior that can possibly be a danger to those in close contact with the individual. Under this thinking, teaching might not be a good occupation. Yet, when someone is comfortable in a teaching environment, it may actually be beneficial to maintain it as long as possible. To me, it has to do with stress. The whole mental area is one of a great deal of subjective judgment, and there are extremes from one opinion to another. Although I never bothered to try and claim PTSD, I believe I and many other "war veterans" do have at least some relatively minor symptoms that are likely PTSD related. (Writing this a 4AM is one of them!) A diagnosis of PTSD would have been a death knell for any position in my field. Even the hint of counseling would have resulted in job loss.

An SSA SSDI rating, especially if it is for possible SC conditions, is often downplayed by RO's, and on review or appeal, positive evidence. After all, it's legal evidence of the inability to work, not just someone's opinion.

First, congratulations are in order. Perseverance can eventually pay off! This case and very late award reminded me of my late father's hassle with the VA. He was an Army pilot, and flew B-25s in the Pacific. Like many others of that era and locale, he eventually came down with Malaria. It was debilitating enough that he was eventually sent back to the states and medically discharged with a small amount of compensation. When the Korean war was on the horizon, the VA was directed to sever a large number of veterans with low compensation percentages, so that they might be subject to recall. Although my father suffered periodic bouts of malaria at that time, and into the late nineteen sixties, he was one of those severed, and the military attempted to recall him. The purpose of the VA actions was rather obvious, in that it reduced the governments payments to veterans, and made thousands subject to recall for service in Korea. Indeed, had my father been enlisted, he likely would have ended up in Korea, malaria and all. Instead, an obscure regulation (or law) came into play. Seems that the military could only force recall if they needed the specialty, and so forth. What they wanted to do with my father was make him an administrative officer, which is a far cry from a pilot. Things calmed down for quite a few years, although he and many others were transferred on paper to the USAF. Time went on, and the AF imposed a requirement that my father and his brother officers do correspondence courses. The ex army officers as a group decided that this was totally ridiculous, and declined. After threats of such things as court martial, the officers, as a group decided to tell the AF to "bring it on". At that point, the AF decided that court martial was not a very good idea, advanced all the officers one grade, and retired them without pay. It seems that the AF would have had to place the offices on active duty to court martial them, and that kicked in a whole bunch of things that the AF wanted nothing to do with. During the time my father was paid VA compensation, which was a very paltry sum of about $14 a month, the VA frequently required him to go to an exam in another city. The exam was a travesty, and actually cost him more in expenses and lost pay than his month's compensation payment. Anyway, to the best of my knowledge, the VA still has unresolved claims that have been around since WWII, Korea, and Vietnam. The number of claims resolved solely by a veteran's death and not by the VA's actions would be interesting to know, and is likely quite significant. Failure to figure inflation in the awards just encourages delay.

You do have the option of asking the VA to reduce the 100% rating. The VA may reduce the rating, and possibly even below the previous 50% rating, based upon current "evaluation" and rating. In other-words, you really don't want to do this without serious cause. If you are 100% "scheduler", and not "TDIU", you can legally continue to work. A 100% rating for PTSD often carries some repercussions. The VA may propose that they appoint a "fiduciary", who takes control of your VA payments, and possibly other income (not really according to the law, but it has been known to happen.) You may loose the right to own and carry a firearm. Reducing the rating will not automatically remove these repercussions. The VA seems to want to ignore the differences between suffering from PTSD and incompetent to manage, or sanity. The VA has the right to order a review and re-evaluation, and propose a reduction, based upon "new" or updated findings or exams. Even though the rating may become "protected" the VA still can order a re-evaluation Will the VA even look to see if you continue to be employed ? Usually not, unless you are rated 100% TDIU.

The heart of the VA problem seems to be that the PCPs are "too busy" with routine scheduled exams to worry about following up. You would think that the test techs could and should "flag" results that indicate further action is needed.

To me a prescription for Lipitor shows a primary concern for potential heart related problems. It is not usually considered a primary drug for control of HBP. The other issue is that the effectiveness of Lipitor can vary quite a bit from one to another, based upon genetics. I have taken this drug for quite a few years.

The appeals court ruling will undoubtedly end up back in court. A possible example might be a veteran diagnosed with PTSD, and awarded SSDI by SSA, and then denied for SC by the VA. This can easily invoke other sections of the "rules" and law.

A question that can only be answered with a written C&P copy - - What did the examiner actually write down about it? Based upon that - - The VA MAY automatically consider hypertension, and rate it. Or, the RO may IGNORE it completely. It seems to me that getting a copy of the C&P results (assuming you don't get into deadlines) will help deciding what to do next.

It's been my experience that the VAMC for my area is(or has been) quite slack about what "priority group" is assigned, and what it actually means. First there is the literal meaning, in that the priority group sets a priority for enrollment. Fine. Now what happens when a veteran is enrolled? Perhaps the veteran had a 10% or less SC'd condition, and that condition was A/O or SHAD related. The veteran is often placed in group 6, and may be improperly charged co-pay for presumptive conditions that have not been "adjudicated", contrary to VA written policy. Indeed, as various claims are processed, and hopefully approved at some SC level, it's not uncommon to find that no one bothered to change the "priority group" to the correct one. What are the consequences of an incorrect group rating? Possible incorrect co-pay charges, and an ensuing fight to get them corrected and refunded. Denial of entitled services, such as dental care (and others)

The SSA's requirements for disability are different that the VA's. For SSDI, it is "all or nothing". Anyway, there is a chance that a 50% VA rating for a condition might be rated differently by SSA. Having a doctor or two say in writing that you cannot work will certainly help. SSA will also consider any non service related conditions that contribute to the overall disability. Having said that, the SSA determination can be almost a "crap shoot", in that there is not much consistency in decisions.

Following other's advice, I'm trying the spell check functions with both US English and UK English downloads. It seems at this point that the UK version corrects the problem, and you can then use/select either the US or UK version, and it will work. Firefox 9.01, release version

I'd agree with anyone that posting a list of contaminated sites and the types of contamination can be quite useful. When I started researching contaminated sites several years ago, the "superfund" site listings were more detailed than they seem to be today. It's as if once a superfund site had some sort of major remedial action completed, the government hopes it will quietly go away, along with claims, be they VA or otherwise, and quietly removes information from websites and even closes them down. Another tactic seems to be to move the data to locations other than those referred to by other related references in EPA and DOD documents. This is also of concern to me, since I spent a couple of decades working at various bases under contracts. The majority of those bases are or were "superfund" sites.