sixthscents

OK, I am getting sick of your prattle about this 3105a. 1st, Army and I were discussing the merits and differences in the VA's PTSD rating system. He has a valid point, and since I DONT suffer from PTSD I can and do see his point, and weigh it more than my own. For your information Army already HAS a stressor, or nexus. The guy has a purple heart.... while he and I disagree from time to time, he is a fine veteran, and FULLY capable of handling his claims just fine. He asks for help on certain issues, and offers advise on certain issues... but he doesnt need to prove a stressor, and I doubt his claim can go back 10 years based solely upon section 3105 (a) of CFR 38. So... hush! Unless you have something real to offer.

Army, The VA cannot rate each individual mood disorder. By CFR 38 it would be pyramiding, so they can rate you for PTSD, and take into consideration the other diagnosis while making the rating but thats it. PTSD is classed as an anxiety disorder - but I'm no shrink so who knows. The VA is SUPPOSED to consider the highest rated disorder, and thats what they actually compensate you for. Further - They have stereotyped and lumped combat mental problems into PTSD Well, it is Post Traumatic Stress Syndrome..... combat mental problems are obviously traumatic, and post apllies, so what would you have them do? Honestly, its a rational system if used correctly. I am not stating that it is or is not used correctly, but how it is laid out makes perfect sense. In fact, I can think of no other way to do it. I am not trying to score points here off of you but I dont understand what you would prefer happen. The pyramiding rule applies to all injuries, not just mental, s its not unfair in that aspect. So, help me out here I dont understand.

Most of the time when I go to see my psych, I expect him to break out some chicken bones and lamb entrails.... They practice voodoo, or hoodoo, or whatever, but it sure isnt a medical science (or so it seems to me). My psych push meds now, and most Sociologists push counciling .... and they all push you out the office as fast as they can.... My wife says I do better when I take the meds, so for her sake I do, but honestly I have never noticed any difference, but hey I'm the one thats sick right? Anyway... just my opinion...

Thanks Streach, I'm gonna listen.

A further example is when I was filing my own claim in 2002, I filed for IVDS. It was denied because I had not proven that I was incapacitated for enough time.... I realized that all my convalescent leave records were in my 201 file, and just barely mentioned in my medical record. I pulled and copied them, resubmitted as a NOD with new and material evidence and got the IVDS rating I was looking for. Further, performance evaluation, Article 15's, Captains Mast records can all be helpful in certain claims if you are trying to prove a PATTERN of miscondunduct associated with say PTSD, or some other mental disorder.... So, ALL military records are submittable as evidence. They can and do often make a great deal of difference....

I think that the VCAA is important because it tells the veteran EXACTLY what evidence they need to support their claim, and what the VA rater is looking for. While I agree that it does render the 60 day wait null, I still think it is very important just for the fact that the information requested will help the veteran develop or perfect thier claim prior to BVA, or CAVC.... Thats my opinion anyway, and after reviewing several claims, I found exactly ONE VCAA notice...

Allan, I think you posted something about this earlier, or maybe it was someone else, but......... it significant and SOMETHING needs to happen about it. There is also a VA "back-channel" message system that the veteran never sees, and to my kowlege cannot get a copy of. Its solely among the medical VAMC's though, not on the raters system.

Cherie, As everyone else has said, your rep is an idiot. File for TDIU. LarryJ, You a mason?

There's some interesting points brought out in this topic. Personally I have heard a great many GOOD things about Dr. Bash, and the very few negative things were rather suspect. Howeever, the VA can and does ignore IMO statements ALL the time. They consistently deny a diagnosis, unless the IMO states in no uncertain terms that someone has whatever illness. Currently I am working with someone whos IMO is outstanding except the doctors states that they "think", and that it is most "probable"..... the VA, as usual took the out and denied that there was even a diagnosis.... I have seen this again and again. Some rater decides that a board ecrtified specialist is not capable of rendering a diagnosis.... or that THEY can interpret their statements in a way TOTALLY inconsistent with the veteran's benefit of teh doubt in mind. I can yell all day about this.. and so much other VA crap, but... its simply not productive. There were SEVERAL very good points made in this post without that. I applaude Berta and her post with the VCAA... it points out the flaws of the VA system, while saying what the veteran can do to help work around those flaws. Personally I agree with her that there seems to be a "stick claim here for 2 plus years" stack... I dont know why, but some claims seem to get stuck in denial after denial in a capricious (sp?) manner... some with COMPLETE and obvious disreguard for the VA's very own rules. What makes these claims different than others? I dont know, because I have not seen a pattern. I have looked over many claims and have had a great deal of success with achieving the veterans correct compensation, but for some reason some claims simply get.. well stuck in denial after denial... I have obne where the VA ITSELF diagnosed the veteran with PTSD.... this was during a normal intake to mental heatlh... they DIAGNOSED it, but deny service connection... and into limbo it goes... 2+ years now fighting it.... What made this claim different? Evidenciary requirements were met fro the stressor, with the same amount or more than with others that had been approved..... I dont know, but... I do know that discussing it amongst ourselves we may see a pattern... with so many of us, and so many claims we will eventually HAVE to see a pattern. So, I suggest that we look for one... does that make sense? Let us try and see what evidenciary levels normally FAIL and what SUCCEEDS... and try to keep track, even if its some scribbled notes... we see enough here to get a view of the entire nation, so its just a matter of connecting the dots. Anyway, its MY take on this... again some very good information so far... I reread your post about 5 times Berta, just to make sure I understood what you were saying.

Yeah, they do have to make sure of the total and permanent if TDIU... as well as schedular, so ... it may take them a bit... I wouldnt worry yet, if its only been a month. Like I said, as best as I can remember it took them a month or so... but that was 6 years ago, so memory fades... Call them and just check to see if they need any other documentation etc... then slip in the where my stuff at question. Cant hurt, its what those people are on the phone for.. so.

HA - Berta we were both typing the answer to this at the same time...... and we pretty much agree.

Charleese, Yes, it is confusing... lets try and sort it out ok? 1 You file a claim 2 The VA renders a decsion 3 You accept decision or file a Notice of Disagreement or VA Form 9 4 IF NOD, then claim is re-rated by a different VA rating officer who issues a decision and a statement of case (SOC) 5. Again you can NOD, or submit to BVA using VA form 9 6 If NOD, rater looks at it again and issue a Supplemental Statement of Case... (NOW the SSOC can be for 1 item of several, it just depends upon what you submitted new evidence for, or gave reasonable ground for review etc.... basically its was up to you when you filed the 2nd appeal) Now... if you get "new and material evidence", you can kick it right back to the raters at the Regional Office or submit a VA form 9 for a formal appeal to BVA.... So......... confusing isnt it? And to be honest I left a WHOLE bunch of stuff out, and cut a few corners... but thats the bare bones of it... to be honest you can... if you do it right, keep a claims at a regional office, for them to rate again, and again, and again..... I've never once HAD to push a case up to BVA, though I have done it... You can AT ANY TIME elect to have you claim sent to BVA (Bureau of Veterans Affairs), and have it decided upon... its called a formal or traditional appeal, but normally (OPINION....... OPINION) I have found that things move quicker at the regioanal office, but some claims get stalled there, and the only option seems to be to kick it to BVA. The SSOC can and does "clarify" decsions rendered, and can actually make further decisions upon the issue for which it was initiated... without making a decison.... it just UPHELD the other earlier decison right? Though I have seen them make complete decisions in an SSOC and I know of no reason that they could not. It is just limited in scope is all... OK? Personally if you have an SSOC, then it is probably time to REALLY review your evidence etc., and if you believe that the evidence bears you out, and follows VA regulatory guidance, well then I'd probably send it on to BVA... and let them sort it out, BUT... beware, look very carefully at the REASON the SOC and SSOC gave for denial, and really consider wether it passes all the requirements under VA law... because the BVA will make the SAME conclusion if the raters were correct. SO, if possible you may want to try and gather further evidence, etc. You have only a short window to respond... but there are some TRICKS, to getting around that... but there are actually processes in pace to allow you extra time... you can submit the VA Form 9 and gather the evidence, and submit it to the BVA with it as an addendum... and I do that all the time..., you can ASK that a decision be held pending a tests outcome etc.... so I am not familiar with your husbands case, but this is an anonymous forum.. could you give us more details and perhaps the REASON they decided against?.....

I dont know about anyone else, but I gopt my wife and daughter's in a month or so... Call them and see what the deal is, if its been more than that... umm did you fill out the paperwork etc. to get enrolled.. I know stupid qestion but I gotta ask...

Josephine, I perhaps, overreacted.. well heck I did over react. I am sorry, but you hit my button... its a failing I know, but its also one of my streangths. I am bent and determied that veterans get sound advise... good advise, because I have had to try and fix the mistakes of other "veteran advocates", and it's a NIGHTMARE... honestly I would much much rather take a claims from the start thann try and "fix" a broken one... so my button is the advise thing... Now you know my secret... if you wanna yank my chain offer bad "advise"... I'll tweak every time. I agree we ALL have differing opinions, and I have read some very real, and very good ones you have posted... so I am not out to say you are bad people... HECK no.. I kinda "tweaked" on it is all... So, I over reacted and for that I apologize, but please, I know we all have bad days, and I know that we all say things that are mis-understood... but please be really careful with that word "advise".. please.... I'm asking as a favor to me. Again, you have something to contribute here... you have and are doing so, and I admire the heck outa that. I think you chose an unfortunate phrase and my lights and whistles went off... I'll try and be a little more... tactful from now on, and I hope you did not take personal offense because it was not meant as a personal comment at ALL.

If you have decent insurance, see if he'll do a referral to a sleep apnea specialist.....

Aint that the truth

Yeah, I'm hoping for a lot of vets that they dont go back on allowing laywers..... imagine being allowed the same rights as in a civil court... or, if we want to compare.... the criminal court and we'd be allowed the same rights that Ted Bundy had.... they allow a mass murderer legal representation but not a veteran.... something seems wrong there, but maybe its just my cynical nature... Well see... I am betting on another illegal stay of some kind, or a rewrite allowing a laywer to only represent one client at a time... etc. They'll try and hamstring it, I'll just bet. All the while the DAV is helping them.

I did tell the truth... Veterans MUST go to their C&P exams if they want their claims rated ... perhaps PROPERLY was a poor choice of words... but the VA will not even render a rating if they require a C&P... Certainly they can and DO misinterpret, and imprperly rate the C&P, but they will not rate the claim at all without the C&P if they decided they require one... So, while I wish MANY things.... like the VA would properly rate claims from the beginning perhaps.... I will not stand for anyone offering advise which could damage a claim... I already went round and round with this... If someone is offering an opinion fine, but if they use the word advise, then they better be correct, and that includes myself. I've done the 5:30am C&P exam, and I've done the C&P exam that they ignored and about every other combination... thats NOT what I am taking exception to... heck, I KNOW they mess them up... BUT... it doesnt matter Nobody should offer advise, that will damage a claim... period. We have a great many people who offer a great deal of advise based on knowlege of the system, and the regulations. We are blessed in that we have vetrans who are willing to do this... and I thank them all. Yet we MUST be careful of the advise we offer... I'm sorry but I have NO leeway on this... consider it my "thing", I suppose, but when I see advise which is offered that is patently wrong... I have to correct it. Perhaps sometimes it is meant as a joke... if so, I dont see the humor.

Tamara, The guide that the C&P examiner is supposed to follow can be found here: http://www.warms.vba.va.gov/Admin21/GUIDE/...iciansguide.doc Now, the C&P examiners are given specific instructions NOT to state an opinion as to unemployability in M21-1. However you can look at the guide and based upon your disabilities you can have an idea of what to expect...

Josephine, I am sorry but I must point out that Testvet is completely correct. YOU MUST APPEAR FOR A C&P. Otherwise the VA can and will dismiss your claim, or claims. I understand we all have differing opinions, but this isn't an opinion... it's fact. DO NOT ADVISE VETERANS NOT TO GO TO THEIR C&P EXAMS. The statement you make: I advise Never go for a C&P examination at any VAMC, even ordered by the VA by any Psychologist, as there word is not accepted by the VA. Can and will cause damage to a veterans claim if followed. That simply is wrong... the veteran is required to attend their scheduled C&P exams, for rating purposes... VETERANS MUST GO TO THEIR C&P EXAMS, IF THEY WANT THEIR CLAIMS PROPERLY RATED..........

John, In MOST cases a veteran does have to pay back the severance pay they received. The veteran does not get to choose severance or retirement, the MEB board rates the service member, and if they rate them 20% or less they are severanced. If they rate them 30% or more, they are retired... The thing is the branches can pick and choose WHICH disability they say a person is unfit for, and ONLY rate that ONE disability... Like I said, I was discharged on a severance due to a back strain... after 4 surgeries, fusion, proven nerve damage, and a spinal chord stimulator being installed. The Army decided I was unfit to serve because of my initial diagnosis from my PCP, before any specialist etc... he diagnosed LUMBAGO.. so they rated me 20%, and shoved me out the door. When the veteran files their claim with the VA, if the receive a rating the same as or greater than the rating given by the service, they can recoupe the taxes (28%) taken from the severance. Further, according to M21-1.... I'll get you a reference in a bit... the VA can only recoup the RATED amount that matches the reason given for discarge... So for example, soldier A was rated 20% for lumbago, discharged, and given severance. He files his claim with the VA and they rate him at 70% for a whole bunch of stuff, of which 20% is also lumbago... then the VA can only recoupe the 20% compensation rate out of the total.... $210 or so... the rest the service member is allowed to receive. So, at 70%... say $1400 (guessing you can check the tables) the VA pulls out $210 for repayment of the severance... and the service member receives $1200 or so of the amount. Now the Army has been getting slick here of late, and putting 2 seperate reasons for discharge on the DA-199 and rating each at 10%... but it doesnt matter.. they only get back what they rated, so if the VA rates both, and rates them at 50% each... the VA still is only supposed to recoupe the 10% compensation rate, for each. Its kinda confusing, but I have seen the VA making errors lately and trying to recoup way tto much.... again I'll look up the reference later, but its under M21-1... I just have to dig thru it and find it again. There are certain circumstances where recoupment HALTS... HA! For instance if a veteran is rated 100% for a disability OTHER than that for which they were discharged - recoupment stops... Trust me, I was happy to read that, and sure enough, when it happened, my recoupment stopped.. so I get my full pay without any deduction other than insurance.

VA rating criteria for Limitation of motion is based ont he range of motion. it states wether or not pain radiates I'm sorry but no... as pointed out in the opening... pain is a factor considered in the rating of motion of joints. Neurologic components such as raciculopathy is ratred separate based on the effect of the nerve and the amount of paralysis Radiculapathy is pain... which radiates down or out a nerve. Nerve damage is rated, based upon the severity of injury, with pain again as a factor of consideration. Pain, in ANY situation, is not rateable solely by and of its own. There is no rating table for pain. IVDS, is another method of rating injury to the spine, which is based upon incapacitating episodes, and their frequency, again of which pain is a factor.... otherwise how could anyone be incapacitated?

but since I know they don't rate that way, but start doing SMC tables Well I know what you are saying but to be clear, no they do actually rate that way.... SMC as guided by CFR 38 S 3.350 only comes into play when there is loss of use, or the schedular criteria exceeds certain points, or there is a clear need for aid and attendance. You state you are rated 100% for PTSD, well if you get a further 100% rating that is covered under 3.350, as well as a 50% rating... and these schedular ratings can be single injuries, or combined... So when the schedular rating EXCEEDS 100%, they still use it, they just do not grant normal compensation for it... reserving special monthly compensation instead. Housebound SMC at 160% is paid at an o rate, loss of use k, for 1 limb, L for 2.. etc again as outlined in 3.350 but the schedular combination is still important, since it does effect SMC... and the VA Math rules still apply.... hence I am rated at 100% for general compensation, but actually have a scedular rating of 170% for special monthly compensation. If you are tired of fighting, I can understand that, but personally I wouldnt stop until I was satisfied that just compensation was being paid... and thats a personal choice...

I'm sorry, I realized I failed to actually ANSWER the question asked... If a veteran is awarded 100% permanent scedular disability, OR is awarded 100% TDIU (with the VA conceeding permanency) then a veterans spouse and children become eligable for ChampVa...(regurdless of the ACTUAL schedular rating of the veteran, if 100% TDIU is awarded) The VA MUST admit permanancy though, so if they say that there is no further exams scheduled, or simply state that the award is permanent and total... then all the benefits apply... these include: Chapter 35 ChampVa Free life insurance (20K I believe) and some other benefits... BUT AGAIN... it doesnt matter if someone is schedular or TDIU... permanency must be awarded or conceeded... you'll see this described as "Permanent and Total", or P&T... Hopefully that clarifys the point.

OK, I'm going to chime in here: Schedular refers to the VA schedule for rating disabilities, also known as the VASRD... if someone has a schedular rating, it siply means that they have a rating based upon the schedular requirements set out in Chapter 4 of CFR 38. So, if vet A is rated a 40% for loss of a limb, he has a schedular raing of 40%. Now schedular ratings may, OR MAY NOT be permanent. More and more frequently I am seeing th VA rate someone for PTSD, and saying that improvement is possible, so they set some distant re-evaluation date.... say 3 years, whatever... Sometimes the VA conceeds permanancy... that is, as in our example vet A had loss of a limb, well the VA will conceed permanancy, and they will have a 40% schedular permanent rating. OK, so hopefully we understand what the VA and we mean when we say "schedular" and "permanent".... Now... to get a SCHEDULAR rating of 100% is ... hard. I actually am rated above that, but I have 1 rating of 100%. Normally it is hard for a vteran to get 100%, because as they move up the rating table, their next rated injurycounts for less and less... to understand this, you have to understand VA Math, and I am going to do a post today JUST on VA math... but accept for now please that it is hard to get rated 100% schedular unless you have some BIG disabilties. Many vets do not reach 100% schedular... but they get paid 100% because of a part of CFR 38 called TDIU... or sometimes referred to simly as IU... - Total Disability Due to Individual Unmployability... TDIU... OK? With me so far? How that works is, say vet A's total combined scedular ratings are 80%... well can someone who is 80% disabled have "gainful" employment? Can they even get a job? The VA often conceeds that since a veteran is so disabled, they probably will not be able to have "gainful" emplyment in their current physical state. If so, they can and often do grant TDIU, which is that a veteran is paid at te 100% schedular rate, even though they are really schedular rated 80% or whatever. Again the VA can say that the TDIU is "permanent", or not... So, there you have it... a quiz will be given at the end of class.... HeHe.... this is a question that pops up again and again, so if I failed to make something clear, or confused anyone, please feel free to ask... and like I said, I am going to post a description and explanation of VA math tonight...