free_spirit_etc

$5,000 can seem kind of expensive, but with a multiple issue claim (tying in several diagnosis) I would not think you would find many doctors who would write an opinion real cheap. Well... you might find one -- but you don't want a simple opinion that it easily defeated. You want a rather extensive opinion with solid rationale to back up the opinion. Searching BVA claims you will see lots of denied claims where someone's doctor wrote the condition was connected to the service, but they used very weak reasoning, or no reasoning at all, to back the opinion. This decision is on a completely different issue, but I ran across it last night when I was looking for information on radiation exposure. It is a BVA case where I would say Dr. Bash saved the claim. You might be interested in reading it to go a sense of how deeply his opinions can go, and the reasoning he used. http://www.va.gov/vetapp05/files5/0529676.txt

Sorry. I missed that part. I only saw that the doctor had diagnosed her with asthma, but not that he had provided a nexus. Pointing out anything the doctor stated in the NOD would help make the NOD stronger. This was part of my argument to the BVA on my claim: 1. Two independent medical opinions were submitted at the September 3, 2013 Board Hearing. Both opinions are well-articulated and based on pertinent evidence in the medical records. Both opinions were written by specialists who are Board Certified in their respective fields in oncology. Both specialists have the requisite knowledge and experience to opine on the medical issues involved in the claim. Additionally, one of the specialists, Dr. xxxx, reported his experience doing bench research analyzing cell survival curves / growth rates. 2. Both specialists clearly stated that it is more likely than not that my husband’s lung cancer had its onset while he was serving in the Air Force. Their conclusions were based, in part, on the size of my husband’s tumor when it was surgically removed in 2000, the standard established growth rate of my husband’s type of cancer, the actual reported growth rate of my husband’s tumor prior to the start of his chemotherapy, the amount of time it took for my husband’s cancer to once again become detectable by CT and PET scans after his September 2000 surgery, the relatively small size of my husband’s recurrent tumor three years post-surgery, and the fact that it took a significant amount of time for his cancer to become lethal.

Does her doctor say he thinks it is related to the service? If so, perhaps he will write an IMO. I think the claim will take something stronger than the veteran saying she thinks it was caused by the military. And for presumptive -- the vet would either need a cluster of signs and symptoms for which they can't find a medical cause (i.e. undiagnosed illness) or an illness that is specifically listed as one of the presumptive chronic illnesses. If the veteran's illness doesn't fall under one of the presumptions, then they would need to show medical evidence that the condition related to the service (such as a doctor's statement stating it is more likely than not related to the service, along with the rationale the doctor used to make that decision).

i just did some research on BVA decisions. It looks like connecting the larynx cancer (or any cancer that is not on the presumptive list) would require dose estimates. Even if an IMO stated it was more likely then not, if the IMO isn't based on the actual dosage the veteran was estimated to have been exposed to, the claims are most generally denied.

Hang in there atomic widow! I had many people tell me that I would not get service connection granted for my husband's death, as his lung cancer was not diagnosed until after service and he didn't have boots on the ground in Vietnam. Luckily his treating physician on base told him -- that based on the nature of his cancer -- it had started a long time before he retired. Unfortunately, the physician said the base attorney told him he couldn't write a medical opinion for a VA claim. Fortunately private doctors would write such an opinion and were in utter amazement that an opinion was even needed as "ANY doctor should know his cancer could not have grown that fast..." Research other claims at the BVA and see what reasoning was used for both the grants and denials. That will give you some ideas on how to craft your argument. Also... the word probable bothers me for some reason. I guess because they might try to "re-characterize" it to the word possible. In fact, it looks like they did that. The denial stated "The death certificate recorded the Veteran's cause of death as Larynx cancer with possible lung cancer." The word probable means most likely. They downgraded it to "possible" to make it a maybe. The thing I would still need to research is whether a probable diagnoses is sufficient for presumptive connection. Keep in mind that presumptive is only one way to win a claim. The VA also has a list of conditions that are possibly linked to lung cancer. http://www.publichealth.va.gov/exposures/radiation/diseases.asp A strong IMO linking either or both of the cancers to your husband's radiation exposure would be very helpful. I am so sorry for your loss. Keep up the good fight!

Good luck with your claim! It looks like most of the issues that the doctor checked impacted your ability to work, the doctor also stated that they were less likely than not related to your SC conditions. You might want to consider getting an Independent Medical Opinion on this and see if another doctor thinks they are related. Have you applied for SSDI?

I am not seeing where these conditions would be presumptive. They wouldn't be undiagnosed illnesses, because they have been diagnosed. And they don't appear on the list of presumptive ilnesses. I think you would need something stronger than "I feel I should be granted for these two contentions because ____." If your IMO says the conditions are more likely than not service connected - point out what the doctor stated. A condition does not have to be diagnosed or treated in service if medical evidence shows the condition most likely began in the service or as the result of the service. I might be missing something, but I am not seeing the presumption.

snake doctor, I am trying to understand why you are posting all of these as separate threads. These aren't all separate claims, are they? Did you file one claim listing all of your disabilities? And this is your initial claim, right? Also -- You might want to look at the 38 CFR Book C, Schedule for Rating Disabilities http://www.benefits.va.gov/warms/bookc.asp#k That schedule has lots of information on the various ratings for various disabilities.

Never mind. I see you have claimed lots of conditions, and are only listing them in here separately. But since I already responded to this one, I would say I wouldn't see any specific percentage for constipation as a separate and distinct condition. I imagine it would be a symptom that is related to one of your other conditions (i.e. a medication side effect).

foreveryoung, if you think you might qualify, by all means apply. Everyone has the right to apply before someone determines whether they are eligible or not. I don't really know your circumstances that well. So any ideas I give may or may not apply. That would be great if the quarters you paid back entitled you to both. I think they make some other adjustments for military time too. Keep in mind that there is no partial disability on SSD. You are either disabled or not. They don't rate on percentages like the VA. I personally think it would be difficult to show you were unable to work for the last 30 years when you were working. You may very well qualify for retirement income from SSA. Even if you are close, you could even consider doing something very part time if you are able to, and pay in a few extra quarters over the next few years to make you qualify. But then again, you know much more about your own circumstances. In much of the time I fought my claim for accrued benefits and DIC, many people told me I would not win my claim --including VSOs, a couple of attorneys, and even some people on this forum, However, my research told me different, and I kept up the fight. So by all means, if you think you are entitled to benefits, keep up the fight - Don't let anyone talk you into not fighting for what you deserve.

I also targeted my claim to the BVA. After looking at my own notices, and all my husband's previous claims, I could see that I would get nowhere with the RO. They seemed intent to deny claims, even if it meant they had to "misinterpret" what their own doctors said when their doctors reports were favorable to claims. When I had to fight several rounds because the RO denied the burial claim because they couldn't see evidence my husband was buried -- and I had to point out that the cemetery plot I purchased, the grave I paid to open, etc. were evidence -- I knew my chances of getting anywhere on a claim that was more complicated than one page were slim. So I went into this not expecting to be awarded benefits until the BVA level -- and always geared my arguments toward setting up my claim for the BVA. I do think my RO actually reads the claims. They know exactly what to ignore and exactly what to point out (in their own twisted way). But I just let them play their cards first, and then build my hand for the BVA. A good rule of thumb is to look closely at the evidence the RO keeps ignoring. They ignore it for a reason - because it is favorable to your case, and they can't overcome it with one of their arguments, so they just keep leaving it out of the picture. So remember to keep building YOUR argument -- and keep targeting it toward winning the claim. If the RO can pull you into arguing about all those little side things that don't really matter -- you might win arguments that have absolutely nothing to do with winning the claim. Don't let the RO's silly logic distract you from building your case. Build your case, back it with evidence, and keep focused on your purpose. By all means, address what needs to be addressed in the SOCs, but keep your focus on building your case.

I think the worked 5 out of the last 10 years will work against you. That is that many quarters of insured work (as in insured with Social Security). My husband applied in Spring 2006. He ran out of "insured status" December 2005. He retired from the military in 1998, and then went to school. He did some teaching after that, but that paid into SURS (State University Retirement) instead of SSA. So at first they told him he wasn't eligible because he was no longer insured. We pointed out that he became disabled BEFORE December 2005 - and thus he was disabled while still under insured status. So, yes - you can qualify if you can show you were disabled while you were still insured under SSD. But that is not very hopeful if you have to go 30 years back. There might be other ways to qualify for benefits. If your spouse is retired, deceased, disabled - you could qualify for benefits on their record (i.e. on their insured status). But you would need to check on the Government Pension Offset -- http://retirement.federaltimes.com/2013/04/02/government-pension-offset-and-windfall-elimination-provision/ Even drawing your own benefits, you would want to check information on the Windfall Elimination provision. http://www.federalretirement.net/social_security.htm Basically, as a Federal Retiree, SSD benefits you would draw on your own record would be reduced under the Windfall Elimination Provision. Benefits you would draw on someone else's record would be reduced under the Government Pension Offset. The program for those who have not paid into the system, or who have not paid enough in to draw above poverty level SSDI is the SSI program. It is a needs based program that is pretty strict about the amount of money you can have coming in and the amount of assets you can have.

Social Security and Federal Retirement are two different systems. In this case, foreveryoung would have to show he was disabled while he still had insured status with Social Security (i.e. 30 years ago). It doesn't look promising.

I second that motion!

I am so sorry he is going through this. It is so uncalled for.

I think we covered the evidence, the examiner just seemed stuck on the idea that the kidney disease is responsible for an "adjustment disorder"instead of PTSD despite the timeline of when the kidney disease started and when the symptoms were claimed. I actually doubt he is stuck on this. It was just something he could use.

Welcome to hadit! You said that since then you have had two surgeries. So I am assuming the decision was not recent. Can I ask how long ago the decision was made? Also, do you have a copy of the C&P report? If I am getting this correct, they granted both the right and left hip, (both with chronic ligamentous capsulitis bursitis) but with a degenerative cyst with the right hip and avascular necrosis of the left hip? Would the rating be much different?

Yes, it sounds very favorable that the vocational expert said that. As to the other question, I don't think they would go back 4 years, but 3 years would be feasible. If she applied two years ago, they should be able to go a back a year prior to when she filed. Keep in mind she will have the waiting period (which will already be "served"). The lawyer will probably try to show she was disabled longer than just when she applied. That will also help her be eligible for Medicare sooner. Here is a bit of information about the time frame: http://www.ssdrc.com/disabilityquestions2-84.html

I congratulate you on your success and wish you the best.

I think that is great advice asknod. And you can also point out how their doctor's opinion doesn't actually refute, or conflict with, your doctor's opinion. Since their doctor's sometimes write opinions that somewhat side-step the actual issue, it can be pretty easy to point out, "Yes. The VA doctor said this and that, but he did not actually refute X." Or the VA doctor's opinion does not actually conflict with what my recent IMO states.

You might be able to call and ask your case worker for a copy for your veteran claims, or just for a copy for your records. You have the right to see your file, and to make copies of anything you want to make copies of. But you most likely would need to make an appointment for that. I requested a copy of my son's file. I made a written request through their Privacy Act https://secure.ssa.gov/poms.nsf/lnx/0203311005 They were too busy to make a copy for quite some time. But I finally got it. I am sure many vets have had much better luck getting copies of their files fairly quickly for their VA claims.

Jerrod, Welcome to hadit! Do you have the paperwork from SSA that says your PTSD is severe? That should help. You will want to get any medical records that will support your claim for increase.

They would not go back to 2012, because as long as you are "earning" wages, you are considered having substantial gainful activity. But they should go back to the day you retired, especially if it was a medical retirement. Of course, you would have the waiting period that you would not get paid. But if you medically retired in June, the August date seems odd. But I think any decision done below the VLJ hearing is usually worded totally sloppy. My husband retired from the AF in 1998. He went to school and then taught part time at a college, which doesn't pay into SSA. So, when he applied for SSA in mid-2006, they told him he wasn't eligible because he didn't have enough paid quarters in the past 10 years. She was going by the day he was applying as the date he became disabled. That just does not make sense that people apply the day they become disabled. So I pointed out to her that he did not work since November of the previous year. If they took it back to December 2005, he still had insured status at that time. So she agreed. Then I pointed out that his income had actually dropped below substantial gainful in August 2005. So she agreed to take it back that far. So he was approved and his waiting period had already been "served" as they went back to August 2005. Since he had a terminal illness, it took less than three weeks from the day he applied until he had money in the bank. All I can say is it is a good thing I read the regulations the night before his appointment. Otherwise, he would not even applied, as she told him he wasn't eligible. You always have to watch out for yourself. ;)

Thanks PR and georgiapapa! Thanks Berta! Berta -- My claim was granted for direct service connection. The judge actually gave more weight to my IMOs than the VA opinions. My death claim was even granted as "likely." The accrued benefits claim was considered more in equipoise, with the benefit of the doubt given. Since my husband's death was in 2007, I was limited to proving that claim with the evidence that was in the file as of the date of death. We didn't have the two IMOs at that time. But they gave consideration to the doctor's statement that stated the standard doubling time of adenocarcinoma, and gave consideration to the articles from medical journals we submitted. They did not really consider anything except for the cancer. I had addressed other issues for increased ratings, etc. -- and asked that those be remanded to the RO, as they had not decided them in the first instance. The BVA handled that pretty much the same as the RO did -- by not mentioning it. But I got the main claim, which is the best part. I was not sure if I would get the accrued benefits, because of them having to go by the record on the date of death. But I think I built a strong case. And yes, I have had VSOs tell me the claim dies with the veteran. I also had them tell me that I was not eligible for benefits unless my husband's cancer was diagnosed in service. Plenty of people told me that. I should write the attorney who would not take my claim (and indeed told me I was not eligible) and thank him for saving me his share of the retro. Oh... and the AL rep that I fired right after the hearing -- the Legion's name isn't listed on my decision. To follow up on that -- Besides being totally rude to me and calling my IMOs theories written by people who had not met my husband then telling me that he had submitted everything on my case, but that he didn't have to send me a copy I sent a letter to the BVA asking for a copy of what he submitted. They sent me everything that had been added to my file since the hearing. He had not submitted anything. That is why he wouldn't send me a copy. He had not submitted anything. He just said that he did.