free_spirit_etc

This case is one where I questioned the medical opinion for accrued benefits http://www.va.gov/vetapp11/Files2/1119220.txt In this case, the veteran died in 2005 with an active claim for lung cancer. The widow was granted DIC based on the VHA expert's 2011 opinion. However, she was denied accrued benefits because the record as of the date of his death did not support the claim. They didn't consider the VHA expert's opinion to affect the accrued benefits claim. I guess because it was issued after his death. So I was still unclear whether medical opinions submitted after death would be considered evidence (i.e. if they are submitted after the death - they don't count for accrued benefits) or considered part of the duty to assist (i.e. the VA obtaining an opinion, if necessary, to help them decide the claim).

But if you get an increase on any of the conditions you are currently waiting on the decision for, you will be at 70%.

Yes. I know it can be a struggle raising a disabled child. My son is high-functioning autistic. Benefits for disabled children http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/156/~/benefits-for-disabled-children

Good point on the only one, or at least one, Sierra63. I also see this as a way to get out of a lot of the inferred claims, or the claims reasonably raised by the record. It seems like by requiring 21-8940 they are requiring everyone to file a formal claim. The inferred claim will still be there, if reasonably raised by the record. But if they don't have to adjudicate it, or pay benefits, unless the veteran returns the 21-8940, then they can reduce the amount of TDIU claims they process and pay.

Wow.. that was big........

That is odd. I am still able to find the thread with a google search, but it is coming up with an error. I found the contact information on a cached version - and sent you a private message with it. The thread was from 2008, so I am not sure if the contact information was still valid. I hope it helps. I also saw the book listed on Amazon, but they don't have any copies for sale at the moment.

Interesting point John. With SSA - the spouse can get 50%, but a widow gets 100% of what the worker got.

I am with you there Berta! I wish we could use ebenefits too! Sorry you still don't have them straightened out!

Here are some of the rating tables: http://www.benefits.va.gov/warms/bookc.asp 7907 Cushing’s syndrome As active, progressive disease including loss of muscle strength, areas of osteoporosis, hypertension, weakness, and enlargement of pituitary or adrenal gland ................................................................................. 100 Loss of muscle strength and enlargement of pituitary or adrenal gland .................. 60 With striae, obesity, moon face, glucose intolerance, and vascular fragility ................................................................................................ 30 Note: With recovery or control, evaluate as residuals of adrenal insufficiency or cardiovascular, psychiatric, skin, or skeletal complications under appropriate diagnostic code. 7913 Diabetes mellitus Requiring more than one daily injection of insulin, restricted diet, and regulation of activities (avoidance of strenuous occupational and recreational activities) with episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider, plus either progressive loss of weight and strength or complications that would be compensable if separately evaluated ................................................ 100 Requiring insulin, restricted diet, and regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated ....................................................................................... 60 Requiring insulin, restricted diet, and regulation of activities ................................. 40 Requiring insulin and restricted diet, or; oral hypoglycemic agent and restricted diet .............................................................................................. 20 Manageable by restricted diet only .......................................................................... 10 Note (1): Evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100 percent evaluation. Noncompensable complications are considered part of the diabetic process under diagnostic code 7913. 6846 Sarcoidosis: Cor pulmonale, or; cardiac involvement with congestive heart failure, or; progressive pulmonary disease with fever, night sweats, and weight loss despite treatment .......................................................................... 100 Pulmonary involvement requiring systemic high dose (therapeutic) corticosteroids for control................................................................................... 60 Pulmonary involvement with persistent symptoms requiring chronic low dose (maintenance) or intermittent corticosteroids ..................................... 30 Chronic hilar adenopathy or stable lung infiltrates without symptoms or physiologic impairment..................................................................................... 0 Or rate active disease or residuals as chronic bronchitis (DC 6600) and extra- pulmonary involvement under specific body system involved 7005 Arteriosclerotic heart disease (Coronary artery disease): With documented coronary artery disease resulting in: Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent.......................... 100 More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent............... 60 Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray................................................................................... 30 Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required............................................................................................ 10 Note: If nonservice-connected arteriosclerotic heart disease is superimposed on service-connected valvular or other non-arteriosclerotic heart disease, request a medical opinion as to which condition is causing the current signs and symptoms.

Hopefully, someone will finally get it right, and you won't have to wait so long. You seem to have a lot of fight in you -- which is a good thing when dealing with the VA. But if doing all the legwork gets to be a bit much, the VA does allow lawyers now. So that is also an option. They get a percentage of your retro, I think. Just make sure you take care of yourself because fighting the VA can be very draining (as I am sure you have already discovered). I still have trouble dealing with some of the disillusionment at some of the games they play. I am sorry you lost so much because of all of this. There is another useful site here: http://asknod.wordpress.com/ asknod is a member here at hadit. He also has a book http://www.amazon.com/s?ie=UTF8&field-author=Asknod&page=1&rh=n%3A283155%2Cp_27%3AAsknod. I got the kindle edition. I don't have a kindle -- but can read it on my computer. I think a lot of retirees didn't fight much before because it wasn't near as easy when all this info wasn't online -- and whatever you got in VA benefits reduced your retirement pay anyway. So it wasn't much of a gain when you had to fight and fight for 10%. If they sent you a letter for you to fill in doctors names, then they might be waiting for more medical records? I am assuming you made sure the DRO knew that you are on insulin and that you are on maintenance meds for the sarcoidosis.

I am so sorry to hear that. I look at all your medical conditions and then see your SC rating is 40%??? That is not right. Your ratings seem so low for the level of some of your conditions. Hopefully the DRO review will grant at least SOME of the correct ratings. The appeal with the BVA takes awhile.

63, That is sad. I am not sure how disabled he is - but you could see about filing for SSI for him. Depending on your income, he might be entitled to a check, medical care, etc. That would probably end once your income goes up. But it could help right now.

At some point, but not that we know of at the moment, you may have to get an IMO (Independent Medical Opinion) that connects some of the conditions. My husband's TriCare doctors did not want to get involved. In fact, they said they were not "allowed" to write opinions for VA claims -- that the VA doctors would decide. His on-base Pulmonologist (i.e. the doctor who first told him his cancer started in the service) said he would write an IMO (when we asked him in 2006) but then he called and said the base attorney told him they can't write opinions for VA claims. I ended up getting IMOs after my husband died (now that my claim is at the BVA)

63 - I know I asked on another thread -- but I don't know if you saw it - Have you applied for SSI for you child with autism?

I think they count on vets NOT having their medical records -- so then the vets just believe whatever the VA tells them the records said or didn't say.

Thank you. I went to that site again but cannot find ANY records except those that I created, name, address, favorite ice cream, etc. Could I be looking in the wrong place? For the record though: only have an eye exam doctor. hearing aid doctor, psychiatrist and psychologist at the VA hospital for years, although I haven't even found them listed. I was all TRICARE before and now MEDICARE. I was thinking of doing FOIA letters to all the VA facilities that could have or would have any records. Maybe even AF hospitals that I can think of. Favorite ice cream?? LOL I don't know much about the site. I don't think dependents can access records there. I think, technically, records about yourself should be requested under the Privacy Act. But most the agencies use the FOIA forms anyway. Whatever... I guess... it's the Government and all. You can request records from the National Record Center -- and see if they have any of your medical records (from service) They also have the military personnel records. But I don't think hospital records are included in SMRs (or I think they call them STRs now...). So those have to be requested separately. For Post-Service records, they can be requested from the providers, or from the base if you got treatment on base. But I think they only keep records for so long. I am not sure how long that is. As far as the base, though, they should have contacted you and let you know if they were about ready to destroy any records and give you a chance to get them. My husband got some lab stuff that way. I know for base records you should also request the doctors notes. My husband just requested his "medical records" and he just got computer print outs that were VERY brief. So he went back and asked -- and they told him he had only requested his "medical records"- he hadn't said he wanted the "doctor's notes" (which are apparently a different set of records.) Geez!!

"but this my 1st appeal, so I have a long way to go." Don't worry! If you deal with the VA you will get lots of experience appealing. ;) You will be an expert in no time. I wish Berta would have picked up on this thread - She is the one with lots of knowledge on Nehmer claims. I think she is back in school now - and her time is limited. (Speaking of school... I should be grading papers now... eek!) Anyway -- at some point -- you might want to change the title of your thread to include the term and Nehmer Claim. She will probably find it then. When you are on the forum and click View New Content - it shows all the new posts. But if you aren't here much, then there isn't time to view them all. I know Berta said she would look for your other posts. I think you can change the title if you click on edit on the first post and then click on full edit -- or something like that -- and then it opens the title up to be edited. But she knows a lot that could help you -- so I am hoping she will get back to this topic. But she is busy as heck!

I am not sure if this will help -- but it is a GOA document from 1972 talking about the drug exemption programs from all branches of the service. http://www.gao.gov/assets/210/200011.pdf

Though I am mindful that meg and some other VSOs do a good job for many vets, I understand the frustration of many veterans who have had bad experiences dealing with VSOs. My husband thought he had a good experience with his, but they really didn't do much for him. Sometimes the complaints are allowed to flourish. Other times the person complaining is admonished that there are good VSOs, and that can't all be lumped together, or even that the vets that complain are often the ones that cause the problem. But as meg pointed out - it is always about the veteran - not the VSO. So vets should feel okay complaining about the VSOs without having to put disclaimers on their posts - as we all know that they are not talking about EVERY VSO, just the bad ones, the ones who give bad advice, the ones who don't follow through, etc. etc. It is kind of a "given" in here, I think, that everyone knows there are some very good ones. But the really good VSOs are an exception to the rule. Just like when we complain about the raters, the DROs, etc. etc. we know that doesn't mean every single one -- but the general trend. When we remember to put disclaimers on the posts -- that can be nice. But if we don't put a disclaimer on, I think everyone understands that we are not talking about every single VSO - and that we do appreciate the good ones.

Here is another one. If you search Board Decisions http://www.index.va.gov/search/va/bva.html and enter some of the terms - it will pull up some decisions that are simliar to your case. I just typed in Mittleider and TDIU. http://www.va.gov/vetapp13/Files2/1314518.txt "Given the medical complexity of distinguishing the degree of disability attributable to the in-service injury as compared to the disability attributable to the injury the Veteran sustained after his separation from service, the AOJ, resolving all doubt in the Veteran's favor, has rated the Veteran's lumbosacral strain on the basis of all manifestations present (See January 2009 and August 2009 rating decisions). As the matter of distinguishing the disability attributable to the injury the Veteran sustained in service from the disability attributable to the injury sustained in February 1983 is not within the province of the Board, and the medical professionals qualified to opine on such matters on balance have determined that all present manifestations may be linked to the in-service injury, the Board also will evaluate all manifestations currently present as disability associated with the service-connected disability. See Colvin v. Derwinski, 1 Vet. App. 171, 174 (1991) (holding that the Board may consider only independent medical evidence to support its findings and cannot reach its own unsubstantiated medical conclusions); Mittleider v. West, 11 Vet. App. 181, 182 (1998) (holding that the Board is precluded from differentiating between symptomatology attributed to a service-connected disability and a nonservice-connected disability in the absence of medical evidence which does so)."

How about something like: Honorable ___, I would like to seek your assistance in handling a problem I am having with the Department of Veteran Affairs. The VA informed me my benefits were cut in error in March 2013. They stated it was an error in their system which wrongfully terminated my IU benefits in March, and promised to get the error fixed within 3 months. It has now been over 7 months and the error has not been fixed. Meanwhile, my family is in jeopardy, as we had to rely on my VA benefits because of my inability to work due to my disabilities incurred in the service. I received a letter January __ from the VA informing me if I did not complete Form ___ by February 1, that I would lose my IU benefits. These are benefits for being unable to work due to my service connected disabilities. I called the VA and was told they had sent me the form. However, I did not receive it. I called them several times after that and still never received the form. On January 22, 2013 I asked them to fax it to me. I received the form and faxed it back the same day. I then called the VA was confirmed they had received my fax. I was informed they had received the required form from me, and that it was showing up on the computer. Despite the fact the VA received the required form well before the February 1 deadline; my benefits were cut as of March 2013. When I followed up to find out why my benefits were cut, I was told that it was an error because the computer did not recognize the form for some reason. I was informed this error would be fixed, and it would take up to 3 months for the issue to be resolved. It is now October XX and to my knowledge error has still not been fixed. I have tried to be patient. However, as had to rely on my VA payments due to being unable to work due to disabilities I incurred in the military, the VA’s failure to fix this error in a timely manner is having a serious impact on my ability to care for my family and myself. It was an honor to serve my country. However, to have my benefits reduced by mistake, and wait over 7 months for the VA to fix the error which wrongfully terminated my IU benefits is not easy, especially as the VA admitted it was an error, and promised to get the error fixed within a few months. I hope you can assist me in obtaining a successful resolution to this matter.

Private Steve, I don't know much about FTCA and 1151 claims. But I am wishing you lots of luck!

Does your record reflect anywhere that you can't work? If so, you may have already have an inferred claim for TDIU - and you could go back for an earlier effective date after you get granted. Or you might even be able to appeal this decision -- in that they didn't consider TDIU. I am not sure which one is best to do - I am sure someone who has walked that path will know.

Okay.. sorry.. I didn't read -- (acting like the RO here) The examiner did say the panic disorder and depression were separate and didn't overlap. But he said the PTSD and depression couldn't be separated... That is kind of odd - but the main thing to keep in mind is that you ARE already 70% SC for mental -- no matter how they diagnosis it. Do you have copies of the C&P's to see what the examiner actually said??? Never trust the RO to report that correctly... I think if a SOC is especially confusing -- it can often be because the examiner didn't give them what they wanted... so they distort it a bit - which makes the decision sound puzzling. If they can report what the examiner said without distorting it -- it sometimes makes more sense. But no matter what they decided to call it - they did determine you are 70% and they determined that 70% is SC. Even if they attributed it to two or three diagnoses - it would still be 70%.

It still could be possible to get the PTSD service connected. But it looks like they aren't even considering a diagnosis of PTSD, but anxiety disorder (not SC) and depression (SC). It sounds like the examiner was saying that the reported stressors from the military don't rise to the level of PTSD, but do rise to the level of panic disorder. So it looks like he was putting aside the PTSD (from civilian employment) but still saying you had both panic disorder and depressive disorder from the military. The RO didn't accept that the panic disorder was related to the military -- because they said you weren't diagnosed with it and that your service medical records don't show any symptoms of it. Ironic, if a VA examiner says something is not related to the military they accept it at face value. Here, your examiner said it WAS related to the military - and they brushed that aside. If events in the military CAUSED your panic disorder, it shouldn't matter if it was treated in service... --- BUT the good news is they gave you 70% because they couldn't untangle the effect that each one has anyway. (I do find it odd that the examiner stated they were distinct conditions without overlapping symptoms - but then said they can't be separated. But since they have already granted you 70% SC for a mental condition -- they should be able to grant TDIU because the PTSD symptoms probably tangle in with everything else. I think it would be hard for them to say you could work if it wasn't for the PTSD -- when you are already at 70% on a mental disorder. I am not seeing a diagnosis for PTSD. Do you have a diagnosis from a private doctor? But when you give statements, etc. make sure to keep the focus on your SC condition - and how that affects your ability to work. Do NOT focus on any PTSD. I think the fact the examiner said the conditions confound each other is helpful. Disclaimer -- I am NOT an expert on TDIU claims or PTSD claims. I don't know a whole lot about either of them. There are lots of veterans in here who have SC for both. So I hope they can give you better guidance...