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x020574
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I do have a Story and then a Question:
Story part:
I recently learned I have a illness with called Paroxysmal nocturnal hemoglobinuria (PNH)it is a rare disease in which red blood cells break down earlier than normal. I have read that benzene can cause these types of symptoms. I was a Jet Engine Mechanic from 1970-74 so I had 4 yrs of exposure to this stuff - but can it rear it's ugly head 40 years later? We use to use a cleaning solution (I don't recall the name but it was P-something). We used it in-shop to clean grease and carbon from internal engine parts. Being young and stupid, we used to joke about how it gave us a buzz.
Also a concern was my extensive exposure to jet engine JP4 fumes. When in -shop maintenance was performed (we actually took J75 Pratt-Whitney engines apart, inspected and rebuilt) There were days when one would get drench with JP4 when underneath and dropping a fuel pump. My fatigues and boots reeked of JP4 no matter how many times I washed them.
Question part:
I was 90% scheduler and recently got TDIU 100%. I would consider putting in a claim for this if I thought it would fly... what do you think my chances would be? It's not about the money, it's more I'm concerned about what I can provide for my wife if I were to pass on as a result of one of my illness. I used to think it will be the IHD that will take me someday and that I am SC for, but now PNH can get nasty fast and that I am not SC for.71M10 - thank you for the advice!
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Just wanted to let you know I was able to get this resolved, I got the BBE on Sat and I am now 100% TPIU. And they did accept my proof of my eBennies print screen of the logging of activities. They awarded me the effective date of Jul/2013(the day I uploaded my application). They even gave me a little extra by granting me SMC-S (housebound).
Between SSDI and VA 100% comp I can sleep a little better.
I do have a Story and then a Question:
Story part:
I recently learned I have a illness with called Paroxysmal nocturnal hemoglobinuria (PNH)it is a rare disease in which red blood cells break down earlier than normal. I have read that benzene can cause these types of symptoms. I was a Jet Engine Mechanic from 1970-74 so I had 4 yrs of exposure to this stuff - but can it rear it's ugly head 40 years later? We use to use a cleaning solution (I don't recall the name but it was P-something). We used it in-shop to clean grease and carbon from internal engine parts. Being young and stupid, we used to joke about how it gave us a buzz.
Also a concern was my extensive exposure to jet engine JP4 fumes. When in -shop maintenance was performed (we actually took J75 Pratt-Whitney engines apart, inspected and rebuilt) There were days when one would get drench with JP4 when underneath and dropping a fuel pump.
Question part:
I was 90% scheduler and recently got TDIU 100%. I would consider putting in a claim for this if I thought it would fly... what do you think my chances would be? It's not about the money, it's more I'm concerned about what I can provide for my wife if I were to pass on as a result of one of my illness. I used to think it will be the IHD that will take me someday and that I am SC for, but now PNH can get nasty fast and that I am not SC for.
Lastly, thank you all that respond to my CUE/NOD for IU.
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Thank you Berta -
This is a copy and paste form my eBenefits Account Activity history - 07/18/2013 8:40 AM, Updated: ClaimId: 28896344,
DocumentId: {A596A9A0-F7AC-40E9-9FC1-D23435C404F1}, THOMAS xxxx, Successful
I usally do send it to the VSO ,to submit unfortunetly for me I didn't do that this time...
I sent an IRIS email coorespondence and spoke to someone one the phone, all they could do was pass the information along... no big help there!
While my claim was open, I got a call from the RO asking me if I wanted to add TDIU to the claim and what disability was I claiming that prevented me from working. I told her Hearing difficulties and Depression. She sent me an application, I filled it out and uploaded about a week after I received it.
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Thanks to all that responded...
Carlie - I reponded to your request to post the RD, also:
1. TDIU application was not reviewed, nor was it on the list of evidence. According to them I did not respond... not true. Had they read the application I feel strongly that it would have been approved... but with the VA one never knows!
2. They stated my disabilities claimed for TDIU were hearing and depression, which is correct. They did not speak of the MH in the dermination of TDIU, but they listed what was on my MH C&P exam and granted 70% on MH alone, which clearly indicates my inability to pursue gainful employment. The type of work they claim I can do is:
(typical requirements of DBA from Monster.com)
Description: Database Analyst
Database Analyst Job Purpose: Maintains data storage and access by designing physical databases.
Database Analyst Job Duties:- Confirms project requirements by studying user requirements; conferring with others on project team.
- Maintains data dictionary by revising and entering definitions.
- Maintains client confidence and protects operations by keeping information confidential.
- Maintains technical knowledge by attending educational workshops; reviewing publications; establishing personal networks; participating in technical societies.
- Ensures operation of equipment by completing preventive maintenance requirements; following manufacturer's instructions; troubleshooting malfunctions; calling for repairs; evaluating new equipment and techniques.
- Contributes to team effort by accomplishing related results as needed.
- Determines changes in physical database by studying project requirements; identifying database characteristics, such as location, amount of space, and access method.
- Changes database system by coding database descriptions.
- Protects database by developing access system; specifying user level of access.
- Maintains user reference by writing and rewriting database descriptions.
Skills/Qualifications: Database Performance Tuning, Database Management, Requirements Analysis, Software Development Fundamentals, Problem Solving, Documentation Skills, Verbal Communication, Data Maintenance, Database Security, Promoting Process Improvement, System Administration
I was recently notifed by SSA that my request for SSDI was granted, first payment due in Jan/2014. Should I submit this letter as additional evidence for TDIU? For SSDI I claimed IHD, depression, anxiety, hearing, which are all SC.
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You will get the letter very soon, try not to be discourage... I know it is hard. Most of us have been there ( I know saying that doesn't make you feel any better, but we feel your pain and fustration).
When you get your package, scan the portion of the Reason for Decision part, a text doc would be preferred so that you can cut and paste results to this forum. Exclude any personal information (names, SSN, etc). There are some very knowledgable members here that may see something you have not picked up on.
Sorry this is happenng to you, sounds like you certainly deserve more! Just keep fighting and don't give up, You have paid dearly to your country, and we thank you for service, you have earned every bit of the benefits you are entitled to.
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Please post exactly what and all that is stated in the decision, in regards to TDIU.
Also, check the evidence section of your RD to see if the IU form is listed
in there.
The TDIU Form 21-8940 is not listed on the list of Evidence, nor anything else regarding TDIU..
I also has be granted SSDI last month, I did not forward that letter to the RO yet.
6. Entitlement to individual unemployability.
Entitlement to individual unemployability is denied because the claimant has not been found
unable to secure or follow a substantially gainful occupation as a result of service connected
disabilities. The veteran is considered capable of gainful employment. {38 CFR 4.16}
We sent you a letter dated July 2,2013 requesting you to complete and return VA Form 21-8940,
Veteran's Application for Increased Compensation Based on Unemployability. To date we have
not received this form.
A review of VA Form 21-413 8, Statement in Support of Claim, dated September 9, 2012 shows
that you are currently employed part time «20 hrs week). You feel you are underemployed
but attribute this primarily due to the issues you have with his hearing loss and depression. The
only impact on employment shown on V A examination was that attributed to your now service
connected coronary artery disease. Restrictions on labor requiring long walking, standing,
climbing, and! or carrying weight of greater than 15 Ibs are not an impact on your current job as a
database program analyst.
Marginal employment shall not be considered substantially gainful employment. For purposes
of this section, marginal employment generally shall be deemed to exist when a veteran's earned
annual income does not exceed the amount established by the U.S. Department of Commerce,
Bureau of the Census, as the poverty threshold for one person. Marginal employment may also
be held to exist, on a facts found basis. Because we have not recieved VA Form 21-8940, we
cannot determine if your current employment is considered substantially gainful.
ALSO... They listed the following on decision letter for my MH staus, taken from physc C&P exam, but apparently it was not considered? Wouldn't this sound unemployable?
We have assigned a 70 percent evaluation for your major depressive disorder (claimed as
depression) based on:
- Difficulty in adapting to work
- Near-continuous panic affecting the ability to function independently, appropriately and
effectively
- Difficulty in adapting to stressful circumstances
- Near-continuous depression affecting the ability to function independently, appropriately and
effectively
- Difficulty in adapting to a worklike setting
- Disturbances of motivation and mood
- Flattened affect
- Difficulty in understanding complex commands
- Difficulty in establishing and maintaining effective work and social relationships
- Forgetting directions
- Forgetting recent events
- Forgetting names
- Depressed mood
- Mild memory loss
- Anxiety
- Occupational and social impairment with occasional decrease in work efficiency and
intermittent periods of inability to perform occupational tasks (although generally functioning
satisfactorily, with routine behavior, self-care, and conversation normal)
The examiner's assessment of your current mental functioning, which is partially reflected in
your Global Assessment of Function score found below.
Your Global Assessment of Function (GAF) score is 53. A range of 51-60 indicates moderate
symptoms; or any moderate difficulty in social, occupational, or school functioning.
The overall evidentiary record shows that the severity of your disability most closely
approximates the criteria for a 70 percent disability evaluation.
A higher evaluation of 100 percent is not warranted unless the evidence shows total occupational
and social impairment, due to such symptoms as:
- gross impairment in thought processes or communication
- persistent delusions or hallucinations
- grossly inappropriate behavior
- persistent danger of hurting self or others
- intermittent inability to perform activities of daily living (including maintenance of minimal
personal hygiene)
• disorientation to time or place
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I had a claim finalized in Oct/2013 was awarded 90% (was 10%). I had also file for TDIU and was denied stating they did not receive an application. This is not correct, I submitted an application online via the claims upload feature. I can show the dates of the upload, it was indicated to be succesfully upload.
I can verify this in eBennies by reviewing the "My Activity" option. They had it one file, elctronically but never reviewed it. I hope I don't have to wait another year or two to get this resolved. If they denied me because I was not eligable I could accept that but to deny me for not submitting an application is wrong!
Which would get a quicker response, a request to reopen or CUE? (if I even have a QUE)
I have called my VSO office, but never get a live person, messages go unanswered.
10% Tinnitus, 10% DM II, 60% IHD, 70% Mental Health - 90%
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It might matter a lot (direct SC Vs, Presumptive) if there had been a past denial ,for what is now a AO condition , under Nehmer, as to the proper EED.
Did you file and get denied for DMII and IHD in the past in an unappealed decision?
No - I had always been brainwashed that Thai vets don't stand a chance when it comes to filing for AO. I had a dx IHD w/CABG in June 2010 but was not made are of May 2010 VA Posting regarding CHECO report, unfortunately I did not file then either. I only became aware of that notice in Oct 2012 and filed at that time for IHD and awarded 60% EDD 10/23/2011 (rule 3.114???)
Make sure you read this Thailand AO bulletin:
You have a really good question and I think to really think about it.....
But if there had not been a prior denied claim for the DMII and the IHD then Nehmer EED would not kick in.
That DMII rating is quite low. When you get the award letter (or even now) you should see if it really reflects your DMII properly based on the VASRD.
Longtime Pre-Diabetic, had a couple of fasting readings > 126, dx DM II without complications (no meds, just diet)
Question...what was the “70% MDD “- secondary to?
IHD/DM II/ED
You did GOOD here.....if you are not working the VA should make a statement as to potential TDIU consideration in this award.
Disabled - recently filed for SSDI, waiting for decision. Did apply for TDIU, won't know why until I get BBE.
QUESTION: will 90% disability letter help SSDI, should I send a copy to SSA/SSDI?
And Chuck (superb on AO claims) also made a very good point......as to the co pay......hope others chime in here with thoughts on that too.
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My claim filed on 2/2012 has finally closed today (yeah!!!) I think I'm 90% if my VA Math is right...
0% Bi-Lateral hearing loss (previous award)
10% DM II - Agent Orange - outside Vietnam or unknown ??????
10% Tinnitus (previous award)
60% IHD - Agent Orange - outside Vietnam or unknown ??????
70% MDD - secondary
SMC-K $100
My new award went from $129 (hearing & tinnitus) to $1,930. That would be consistent with vet/spouse at 90% + SMC-K.
I'm happy, going for 10% to 90% and I don't mean to sound like I'm complaining but I have a question...
I initially filed a direct connect claim for herbicide exposure while at Korat AFB, Thailand 73-74, I was a Jet Mechanic, provided my training/performance reviews, maps indicating areas near perimeter where I worked and bunked. Army documentation referring to procedure for spraying herbicides (500 meter drift area), CHECO report, etc.
Afterwards gathering documentation I came upon a travel voucher showing a plane stop at Ton Son nHut Air Base, RVN. I sent this in via my VSO and indicated I should be considered in country and not have to show direct cause. (he is out on vacation right now)
My questions are "does it matter if I am awarded a decision for IHD/DM II based on direct cause in Thailand or presumptive in RVN?"
Are there any known pro or cons of one over the other? Should I be concerned?
If I was to disagree would this be considered grounds for CUE or should I file an NOD w/DRO review?
I did file an application for IU, but I won't know the story behind that until I get the BBE.
Thank you HadIt for all the informative postings, advice and guidance you have offered, I always recommend to other veterans and surviving family members to sign up for HadIt, ask a lot of questions and read, read, read!
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Vet2010 - you should expect, at the very least, that they will replace the machine, provide a new hose and mask. You should be seen at least once a year to evaluate you AND the machine. My VAMC (Boston/Roxbury) doesn't have enough staff so they contract for me to have visits every six months from a private firm. I get a new hose, mask and filters with every visit and told if I need them sooner all I have to do is call them.
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I doubt you'll get TDIU but I would apply, as your employer "is very accommodating, which most employers would not be. I doubt it was a tactic. jmo
pr
pr - Thanks, that was my feeling also... but I think I'm better off just withdrawing the IU contention as it would only serve to delay the processing of my claim without any realistic "granted" outcome for IU. Altough I'll certainly consider IU in the future.
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I have some pending claims for hearing increase, IHD new, DM II new, ED and Depression secondary to SC disabilities.
They have been pending since 2/2012 and I recently received a phone call from a RO person asking me if I wanted to consider IU. Initially I said yes but after receiving the va form 21-8940 I doubt I'll get it because i owrk part-time and make about twice what the Federal Poverty Level is (approx 19K after business deductions). I am an at home computer programmer, I'm self employed and work part-time because of my disabilities. I could never work fulltime and do not expect I will ever return to fulltime work. I am only able to work 10-15 hours per week under the condition that I can pick my own days/hours to get work done. I have a very accomodating client/employer. I have no other clients because of my stipulations on when I can or can not work.
Given all this, should I bother filling out the form or just tell them I have no other evidence to submit so they can move my claim along?? I'd rather them not hold up my claim while verifying employment info, and unneccesarily clog up the system with claims that are going to go no where.
And by the way, since I said yes I see that they added IU as a contention and eBennies shows the claim going back to gathering evidence... plus they changed the date of completion by adding another year at minamum. Could this have been a tactic to put the claim back in a holding pattern for another year. It is already 17 months old - Boston RO?
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I always read about the advantages of filling a FDC... are their any disadvantages. Does it effect whether you could file a NOD or Appeal to BVA?
I understand that if one files additional contentions after submitting 256ez, the claim will be treated as a standard claim (slow lane).
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There are three requirements to establish Direct service-connection for residuals of injuries and diseases;
1) In-service documentation of an injury or disease.
2) A current condition with a medical diagnosis.
3) and a medical nexus connecting 1 and 2.
taken from a very good self help guide posted on HADIT, it sounds to me like you may not have had enough convincing evidence that you have a current illness AND it is not supported by a medical Nexus that links the in service condition to the current diagnosis.
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Impaired hearing will be considered to be a disability for VA purposes when the thresholds for any of the frequencies of 500, 1000, 2000, 3000, and 4000 Hertz are 40 decibels or more; the thresholds for at least three of these frequencies are 26 decibels; or speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385.
Tables are on the following link:
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IMHO... and probably the opinion of many others here... 90 days is an unreasonable expectation with the current backlogs. I am not saying that as an excuse... it'd just a fact. Whoever told you that a FDC it should be done in 90 days was smoking some pretty good shit.
Also, regarding DBQs, they are just a tool for the raters to use. They are 'intended' to circumvent the need for a C&P, but there are no garuntees... If they want a C&P exam that is their choice... and you need to go or reschedule or they will drop your claim like a hot potatoe.
If it is a FDC filed on a 21-256ez form, it is supposed to get into a 'fast lane' since it is supposed to not be as complicated as multiple contention claims. 'fast lane' is a relative term, greatly influenced by the workload at your VARO. If you add another contention to the claim, it will automatically be in the normal processing claim as if you filed a 21-256 form.
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I don't mean to sound crude, but we can believe it all we want. If you don't have it recorded in your SMR, you will need a very strong NEXUS showing how your SC disability has caused or aggravated your Sleep Apnea.
I'm assume you have had a sleep study done... was it done/dx before your dx of PTSD? Do you have a CPAP machine?
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There is Obstructive Sleep Apnea, Central Sleep Apnea and Mixed Sleep Apnea. IMHO, I don't think any doctor would prescribe a CPAP without knowing what they are dealing with first. And then they would have to test you to see what setting (PSI) would be benefical to your situation, too much air or too little air would be more harmful than no CPAP at all. More than likely, you will require a sleep study. They actually have, if you are a candidate for it, sleep studies that can be done at home.
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I am guessing here that the issue for the denial was that the claim for DM II was filed after 1 year of discharged. And there wasn't a specific diagnosis of DM II in his SMR (there was an inferred DX but it was never stated in the SMR as DM II).
That being said, you could resend your highlighted documentation with the NOD and ask that it be considered a infered claim, since your FPGs readings were already in your service medical records and the rater just did not pick up on it. And you think the fact that they didn't see it was unreasonable because there were many oppurtunities for them to do so. The raters are supposed to assist vets with their claims... which is one reason why some vets get awarded for things they didn't claim, but the rater found additional evidence in there c-file, SMR, etc..
Anybody have any thoughts on the infered claim idea???
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Ken - this is the rating scheduled for CAD (aka Ischemic Heart Disease)
§ 4.104 Schedule of ratings—cardiovascular system. - Diseases of the Heart, there are other conditions that you may or may not be able to claim. I would print off the whole section 4.104 and bring it to your cardiologist so that he could mention all applicable situations. I am not positive but yoou may also be eligible for 100% for recovery for several months. - you can review the complete scheduling for 4.104 at this link :
http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=036a0cf06d49a7c18f10ea8ce3e9c331&rgn=div8&view=text&node=38:1.0.1.1.5.2.103.49&idno=38
I read everthing I can on this subject since I have a pending claim for IHD. It is my understanding that if you have an EF > 50%, they do not consider the EF, they only consider METs. Read the criteria, you don't see any rating for an EF > 50%. Note the table does not have a rating for 30 or 40%. If you are unable to have a DREAD MILL TEST to measure METs or your doctor feels it is not advsiable, then have the doctor estimate it... the criteria for estimated METs in on the DBQ. Of course it is important for the doctor to note the 'results in dizzines, angina, etc. etc.' Good luck and keep us posted.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.
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My condolences to you and your family...
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Welcome... it would be helpful if we knew what the reasoning for the denial was.
Getting a VSO rep is good, but not all VSO reps are the same in terms of knowledge, motivation, etc - so the bottom line is that YOU are the owner and responsible for the outcome of your claim. VSO reps are there for guidance, some give good advice; unfortunately some not so good advice. If it were me, I would seek out a knowledgeable female rep (I'm sure I'll catch a lot of flak for that statement - but there is no denying the odds would better in your favor). In what area do you live, perhaps some have some knowledge of one in your area.?
The letter is good, every little bit helps. A 'Buddy Letter' (misnomer I know) would be better, it should state the facts, not necessarily in great detail, but enough to validate the incident/s occurred, the approx date and location too. The place/time should coincide with the two of you being there at that time, (Every 'Buddy Letter' should be signed and include the following statement: 'I CERTIFY THAT the statements on this form/letter are true and correct to the best of my knowledge and belief.'
A signed VA form 21-4138 (Statement in support of claim) would be best, but a letter on a plain piece of paper would suffice. This will be 'key' if the event is the basis for your PSTD 'stressor', nearly All, if not every, PSTD claim must have a verifiable service connected related stressor event.I would also recommend making an appointment to review your claim file (requesting a copy of it by mail would take a long, long time). While reviewing it, request a copy of anything that would be pertinent to your claim and ask to have each copy date/time stamped. More importantly, noted what is NOT in your claim file... is anything missing that is supposed to be in there? The rater/reviewer can only use what is in front of him/her at the time of reviewing the claim to recommend a decision.
I would also recommend getting familiar with cases that were approved via the Board of Veteran's Appeals. Do searches on things like:
'MST granted'
'Sexual granted'
'MST PSTD granted'
etc....
At the end of each listing is a 'viewing link', using it makes the it much easier to read the case. The BVA does not make law, so referrencing a similar case in your claim might be helpful, the VA is not oblibligated to take it in consideration. Thank goodness the BVA often gives the benefit of the doubt when the eveidence from both sides are equal and/or when obvious common sense prevails. Here is the link: http://www.index.va.gov/search/va/bva.html
You may find some helpful approaches that the VSO didn't think of, to be fare...frankly many of them are over-worked and don't have the time to dig for supporting documentation and would welcome any supporting evidence/articles you could contribute. Don't expect the VSO to spoon feed you and you will be better off for it.
I know MST can be very traumatic event for a very long time, but you can start the healing now if you haven't already done so. I truely hope you find the help that you need and wish you the very best.
And last but certainly not least... Thank you for your service to our country!!! -
SMC-K, about $125 a month. There is norating for ED.
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I'm not sure, but I don't think this is a VA RO office that is doing this outreach to find these Veterans. I think this San Bernardino County Department of Veterans Affairs is the CA State VA not the Federal Leval who approves or denies Veterans Benifits. I know in MO where I live, there are news releases from the MO VA for outreach for Veterans.
I am sure Veterans and family here and on other sites do as we do when we meet Veterans: that is to ask them if they ever talk with anyone about VA Benifits. And explain them different benifits if needed.
You are more than likely correct, but even if a widow reads this article it would prompt them to check with their own local VA or Veteran Service Organization to see if they might be entitled to benefits. Even if they call the number listed in the article, they (San Bernadino RO) sound pretty commited to try and reach this people. I wish we saw more RO's being proactive about this situation.
Need Advice - Jp4 And Benzene Exposure?
in VA Disability Claims Research
Posted
Thank you Berta,
You have certainly given me a lot of homework :)
My VA Hem/Onc doctor says nobody knows what causes PNH, but what we do know is that it is acquired and not inherited.
I believe you are correct, PD 680 sounds very familiar... I am 62yrs old and this was 40+ years ago.
I have met one vet that is SC, but he had anemia issues in service.
I will keep you posted, I also want to get a second opinion from a private Hem/Onc. Although the test making the dx is considered the Golden Standard, I believe it's call flow cytometry ???