donna68

Wings, Yes you are right and you are not confused. Infer is to invite and invite is to infer. Some staff use one term and other staff use the other term. Hoppy, Regarding the doctors, even though the motto is "One VA", VBA and VHA are not on the same page and there are many VA doctors that clearly are not pro-veteran, nor do they follow the work sheets or DBQ's. DeLuca is a big one that they fail to follow.

ammodad, This is late but if you are still waiting for your decision, Teac and jbasser are correct. All of those conditions; sleep apnea 6847, dyspnea (a symptom), asthma 6602 and chronic obstructive pulmonary disease 6604, will be rated together and you will get the highest from all conditions. Usually based on the results of a PTF pulmonary function test. So you are not maxed at 50% for sleap apnea, you may rate higher for your COPD.

Wings, Yes, there are some lazy workers in all organizations, however, San Diego RO actually has a policy to invite claims. Meaning if they review a veterans treatment records (newly discharged) and see that they were diagnosed with something permanent like arthritis of the knee and the veteran doesnt claim it, raters are required to invite the claim. Yes, some staff are lazy and dont invite the claim, but the majority, well 85% are veterans themselves and are likely to invite the knee arthritis.Does anyone check to make sure the staff invited a claim? No, but hundreds of claims do get invited each week. Captain Contaminate, I agree, upper management sets the bar, and is responsible for the results or lack there of and in VBA, standard operating procedures tend to be non existent, hence, no one is on the same page. jbasser, Unfortunately, we cant assume the staff are educated and intelligent, because they arent all fitting into one or both of thise categories. Nor or they well informed, and when staff arent informed and there are no standard operating procedures, confusion is inevitable. I think more pressure needs to be put on the top dogs and less blame on the worker bees.

Computer Tech, Sorry they dropped the ball. Was it a Nehmer Case. It may not be a denial based on the staff not being on board with the pro-veteran mentality, it may be an issue with the correct information being disseminated from the top management. Which hopefully, most people on this site undersatnd is a common occurrence with government employers. It is my understanding that the staff have a list of bases (non-vietnam) and ships and if the base your were stationed at or perimeter is not ont the list, they dont have the grounds to grant the claim so they to deny it. I think a new list of bases outside of Vietnam came out within the last 2 months, since VBA adds bases as cases like yours become more prevelant. R U aware of the list? If you have it or can access it, I suggest that you send it with a VA Form 21-4138. Hope it all turns out in your favor, but as I just mentioned to retiredat44, who is also in the San Deigo area, they are backed up in appelas 2 years....

retiredat44, Again, sorry for your suffering. I am aware that many jet mechanics and other mechanics were soaked in TCE solvents prior to the government pulling it from the shelves in the early 80's, and many folks that were exposed in extreme cases served in Vietnam so if they got sick, they can now connect it to Agent Orange, but unfortunately folks like you have to work harder at connecting it to service. R U sure VBA had all of your SMR's? What is the status of your case now? Appeals in the San Diego RO are 2 plus years behind, so basically they are just getting to appeals from February 2010 or older. My appeal is from 2008, sitting in LA. As far as TCE, I was never soaked in it, since I served from 1986, after it was pulled from the shelves. My exposure is from the various dump sites on the EPA list, and 3 of the bases I was stationed at, before the clean up took place. Mc Clellan AFB being the worst site on the current list, aside from Camp Lejune. Have you written your congressman to get your case listed as a congressional priority?

I think the statistics in this scenerio are based on two different things. One is actual service connection and the other is entitlement to medical care. In this case, they are referring to 1702 benefits. Veterans who have been diagnosed with a mental health condition within 2 years of discharge that are not granted service connection for whatever reason (condition resolved..), they are still entitled to chapter 1702, which is medical care, but not service connection. As far as BVA and appeals, the great thing about BVA is that they can manipulate the laws, but the staff who rate the cases do not have the same benefit. So with that being said, just because BVA grants an award that was denied by the RO, it doesnt necissarily mean the staff that originally rated the case was incorrect.

I hear progress is being made in speeding up the processing of claims. Some or all RO's have incorporated an new computer program to rate cases, called SNL which is text generated evaluation system. Yes, SNL which is a click the box type of system soley based on the C & P results. If the examiner clicks the box on the exam worksheet then the staff clicks the box in the computer and then the computer spits out an evaluation based on the boxes clicked. It is my understanding that raters that are using the system are able to work almost twice as many issues than before the system was incorporated. So progress on addressing the back log is in the works. Although, it seems as though the new system may speed up the process of claims it also create new issues. Also the VBA has imposed mandatory overtime for staff who work cases through the end of the year, and contrary to popular belief, the staff dont get credit for correcting their mistakes, nor do they get OT pay for doing the same work twice. So since thats the way it works, OT will be used to work cases back logged based on the oldest claim first, so hopefully this means the RO's will process twice as many cases as they have in the past years.

retiredat44, sorry to hear you are going through so much. I wish you success in your journey. Exposure claims for non-Vietnam and non-Gulf War veterans is definitly not clear cut. I am in similar shoes, I served from 86 to 90, got out before the GW, was in the reserves from 90-98, but was not sent over to the gulf, though I was prepared (vaccinations...), I have been dealing with neurological symptoms for many years (not in service) but did not get diagnosed with PD until 43. I dont fit the risk factors for PD except for one, TCE exposure. I submitted a claim and dont expect to win, but I though that it wouldnt hurt to put in a claim because TCE exposure just may become an Agent Orange like case one day. I also have an appeal pending from 2008 for DDD of the back and neck that incurred on active duty orders as a reservist. My case is in LA.

justrluk, regarding the strong, mission driven justification you recommend for denials is the same for grants and it is called a law or regulation and in this case it is the 38 CFR. Check it out, I think there is a link on this site. Hearing loss this is an example that I see on this site a lot, veterans are upset because of a denial for hearing loss. The law says the veteran must have 1 frequency from 500 to 4000 hertz at 40 decibles or higher or 3 frequencies at 26 decibles or higher or a speech recognition score of 94% or lower . Thats the law. So if the veterans test dont show any of the above, the staff must deny the claim for hearing loss. Its that simple. Even though the the fact is the veteran may actually have difficulty hearing or have "hearing loss", but for the VA the numbers have to meet the criteria. Knees-I see alot of veterans upset because they only got 0% for knee or back conditions. The law says that during the C&P examintion, if the examiner observes and notes evidence of pain with range of motion, then that warrants 10%, but if the examiner doesnt note pain or if the veteran doesnt state the range of motion exam was painful and their range of motion is not greatly decreased the staff can only grant 0% and if the examiner doesnt give a diagnosis, the staff has to deny the claim.

Chuck75, I agree with your comment that pushing OT creates issues like burn out.... As far as denials, It is my understanding that San Diego's motto is "grant if you can, deny if you have to". They tend to take a pro-veteran approach. Though some staff may not be on board with that approach, there is a law that must support their denial As far as taking credit for denials, prior to the new SNL Rating Decisions, a write up for a denial required much more supporting information than a grant, hence more work! With the new SNL system, it looks like unfortunately there may be more denials based on inadequate examinations, but grants will be granted at a higher percentage for many conditions or issues, like migraines and mental conditions. As for taking credit or earning points, staff get points based on issues rated or developed, not the amount of claims or cases, ie asthma is 1 issues, tinnitus is another issues, so if a veteran claims asthma, tinnitus and lumbar spine strain thats 3 issues or 1 point. It takes 8 issues to earn 2 points, 16 issues to earn 3 points and each day a staff must earn about 3.5 points depending on thier pay grade.What alot of people on this site fail to understand is that there are laws or regulations that staff must follow (links are on this site) and if the staff fails to follow the law or interpretates it incorrectly, the veteran can appeal. Yes, appeals are backed up 2 to 5 years depending on the city. I know first hand, my appeal is from 2008, and Im still waiting. Notorious Kelly, u r welcome!

How many post Vietnam veterans are out there dealing with Parkinson’s disease or symptoms similar to Parkinson’s? Facts are: Parkinson's disease (PD) is one of the most common neurologic disorders. It affects roughly 1.5 million Americans. The Veterans Health Administration treats an estimated 40,000 veterans with PD each year. Recent studies link Parkinson’s to TCE which is a chemical that was common on military bases. Multiple military bases are on the EPA and ATSDR list. Parkinson's Disease Risk Greater in Those Exposed to Common Chemical, Trichloroethylene, Study ShowsScienceDaily (Nov. 29, 2011) — A University of Kentucky faculty member is a contributing author on a new study demonstrating a connection between a common solvent chemical and Parkinson's disease. Dr. Franca Cambi of the UK Kentucky Neuroscience Institute collaborated with researchers from across the U.S. on a paper recently published in the Annals of Neurology. Occupational or environmental exposure to TCE, PERC and CCI4 is common due to the extensive use of the chemicals in dry-cleaning solutions, adhesives, paints, and carpet cleaners. Despite the Food and Drug Administration (FDA) banning the use of TCE as a general anesthetic, skin disinfectant, and coffee decaffeinating agent in 1977, it is still widely used today as a degreasing agent. In the U.S., millions of pounds of TCE are still released into the environment each year and it is the most common organic contaminant found in ground water, detected in up to 30 percent of drinking water supplies in the country. While prior research has indicated a link between TCE exposure and Parkinson's disease, the current findings are the first to report a statistically significant association -- a more than six-fold increased risk. Researchers also found that exposure to PERC and CCI4 tended toward significant risk of developing the disease. Also note that the ATSDR has identified three completed exposure pathways for (Mc Clellean AFB) on-site military and civilian populations: past exposure via ingestion of TCE-contaminated water from the base's water production wells; inhalation of ambient air (past, current, and future) contaminated with TCE, PCE, 1,1-DCE, MC, benzene, and mercury; and ingestion of PCB-contaminated surface soil (past, current, and future). On-site residents, civilian and military personnel, and off-site residents living west on the base have been exposed to TCE in groundwater and ambient air. On- and off-site exposure at McClellan Air Force Base resulted from long-term (more than a year) ingestion of contaminated water from base and private residential wells. Other domestic uses of water (e.g., cooking and bathing) resulted in residents inhaling TCE volatilized from the contaminated water and dermal absorption of TCE from the contaminated water. Limited air monitoring data indicate that on- and off-site military and civilian populations near OU B and OU D were also exposed to TCE by the inhalation route. TCE exposure also causes cancer, so please spread the word and check the EPA and ATSDR site for bases you may have been to.

Pete992, Yes staff do get paid an hourly wage for the hours worked it is their hourly wage plus about $6 to %8 additional, but in this case there are no bonuses for the general staff. Management may get bonuses but not staff. Last year when OT was forced, there were no bonuses given to staff or end of the year cash awards or extra money. Again as I stated before the staff that are working the cases are not doing work over again, hence they are not getting paid to do the same work twice. Management may be getting paid to correct their poor management as they are not held to production standards, but staff working the cases have no choice but to produce a certain amount od cases each day and if they have corrections to make, its on their time. Myround0, I agree no one should get paid for correcting the same mistakes over and over again and should defenitely do the job right the first itme. Its my understanding that staff that work cases are on production and held to standards or have to complete a certain amount of cases each day and if a case comes back with errors that they already worked or got credit for the staff cant take credit for that case again, hence they do not get paid per say to make for corrections. halos2, yes all VBA's RVR and VSR staff nationwide were forced to work OT last year from May to September to work Nehmer cases and yes they get overtime pay but its not standard overtime, its about $6 to $8 additional an hour, not time and a half as many believe. As far as the nepitisim, I totally agree it goes on and is going on as we text, but I must praise San Diego VBA which is pro-veteran and their staff is over 85% veterans.

Pete992, It is true and it may be good for some to earn over time pay and others it is not good because everyone doesnt want to be forced to work overtime. As far as the comment that they will get paid to do the same thing over again, that is not how it works. VSR and RVSR staff are held to production standards, and if they fail to meet the standards they get relieved of duty. Besides it makes no sense to do the same thing over again. Once a case or claim is worked, it is moved to the next phase which means another staff. Finally, the staff doesn't earn time and a half either. So the true beneficiaries are veterans waiting for there case to get decided on.

The secretary of VBA has instituted manadatory OT nationwide for the remained of the fiscal year to combat the 800,000+ claims that are waiting decisions. This is good news for veterans waiting for a decision on their calim. VBA is being proactive and truely intends on speeding up the processing of claims.

The VBA has rolled out the new SNL, simplified notification letter and it looks like raters will be able to almost double the amount of claims they complete each day. The decision is simple, clear cut, and minimzes confusing jargon and explainations.

I know Camp Legune and Atsugi Japan are now a base that the VA recognizes as environmental exposure, but their list seems to be missing a bunch of bases, based on the list below. Im interested in finding people that were stationed at any of the bases listed below especially Air Force bases that have since developed neurological symptoms or conditions like tremors or Parkinson's Disease. Also if you have filed claims due to exposures from these bases, what was the result? If you fit this criteria, please hit me up through the messages system above. Thanks

@armygirl123, the advice below is an option. If your condition really affects your mood and makes you anxious or depressed, get treatment and put in a claim for a secondary condition. You must get an Axis I diagnosis. IBS can be caused by stress, and IBS can cause stress, so if you are stressed you may also have a mental condition. As far as getting a higher rating for IBS, its possible, but not likely since 30% is where IBS maxes out. How about other conditions that can be related like acid reflux or hemorrhoids, if you have eitherof them put in a secondary claim. Hope this helps.

@jokerswild, as stated below, you are already service connected, so proving exposure is not needed or helpful It is beneficial for getting the original grant. As far as getting a higher rating, that is based on how your condition affects you know, as all other conditions are based on not how you got the condition. Asthma is based on your pulmonary function test results or the percentages your test results showed. If you are using a daily inhaler you qualify for 10%. If they didnt do a pulmonary function test, request one.

@papa, Arnet you 100% yet? I recall reading your posts months ago and thought you were on your way to 100%. Well, when they address your claims below, all your back conditions will be grouped together and rated as one (lumbar pain secondary to lower back injury (New), Arthritic pain of the lower back, mutltilevel spondylosis with 3cm disc bulge as L4-5, facet arthrosis at L5-S1 and mild stenosis secondary to lower back pain (New)).They will rate your lumbar spine based on your range of motion and pain or incapacitating episodes. As far as your lower extremity and radiculitis conditions they will need to determine whether they conditions are secondary to your back condition, diabetes or parkisnsons. Your heart conditions will also be grouped together (mitral sclerosis (Secondary), left atrium enlarged (Secondary), aortic root dilated (Secondary), multi risk factors for CAD (Secondary). Hyperlipidemia is a lab finding and not an actual disabilty. Hope this helps.

To retiredat44, I understand your frustration and you are not alone. Contrary to common beliefs, in general, the staff at VBA are hard workers and they are held to production standards and have to complete a certain amount of cases (issues) per day and they are required to work cases based on the date of the claim, so if your claim is date December 2010 and mine is November 2010, my case should be worked first (whether I have ringing in my ears and you have a life threatening illness). As far as your local VBA, San Diego, their appeals are obviously backed up and it is my understanding that they are working cases from January 2010 or 2 years back. I would suggest writing a letter to your congressman briefly informing him about the facts of your case (timeline), your conditions, quality of life..once VBA gets notification from your congressman, your case will become a priority. As far as your knee, even if you have tons of records showing you have an knee condition or any condition for that matter, VBA has to assess your current level fo functioning, thats why they ordered an exam for your knee. They want to see how your knee condition affects you now (range of motion, pain, scars...). Hope this helps. Keep your head up!

Deluca isnt a rating or a number, it just represents the last name of a veteran who won a case. Deluca, argued that pain with motion should be compensated even if there isnt decreased range of motion.

Just checking, was the C & P done by a GYN doc or a GEN doc? If it wasnt a GYN, VBA needs to order a GYN. A PAP culture should have been taken as well. As far as compensation for GYN issues, the rating schedule is not so generous. Good luck.

It looks like you have an appeal pending, based on the DRO comment. It is my understanding that appeals are backed up 2 to 5years.

I understand your frustration. Using the IRIS inquiry online and calling the 1 800 # are good suggestions. Many VBA offices are back logged due to the amount of claims and lack or staff to rate the claims. The staff rating the claims are held to a production standard, which requires the staff to process a set amount of issues per day. Cases can have 1 issue or 100+ issues, depending on how many conditions you claimed (right knee, right ankle and anxiety is 3 issues). Cases are supposed to be rated based on date of claim and then the date all the medical C & P exams are in. It ususally takes 6 months from the C & P exam to get your rating. The more issues or conditions you claim the longer it will take. Remember you will get BACK PAY!

I didnt read your entire post, but what I think the issue your are discussing is the change in diagnosis and rating. All mental health diagnosis are given one rating per VBA, so you could have PTSD, MDD and anxiety and get a 30% rating. You also could have been diagnosed with one condition in service the C & P examiner may have added or changed your diagnosis, so that will be the diagnosis the rating is based on. If anyone is given a 100% for mental VBA is required to purpose incompetency. You just need to respond to the letter and inform VBA that you are either competent or incompetent to handle your finances. Hope thishelps.