sixthscents

Murph, We understand.. we really do man. It has been 7 years since I was medicaled out, and I am still adjusting. I am 42 for crying out loud. I have worked all my life since I was 13 - I like to work - I MISS work, and the military. Yet, acceptance comes eventually... It is a bitter bitter pill though huh? All I can say is good luck, love your family, and let them be there for you. Don't shut yourself off, which I fell into. Find something which allows you to still connect - like this maybe. Thats how I got into advocacy and helping others with their claims. Don't say you dont know enough either, cause you found us and can learn... not that this is the only option. If you need any help or want to talk, IM me and I'll give ya my phone number and email. It can be tough buddy, I know, but we are all survivors here or would have never served. Bob Smith

OH also if they state you are entitled to: CHAMPVA Chapter 35 dependent ed benefits You are permanent and total - either TDIU or schedular doesn't matter. You CANNOT be eligable for Chapter 35, nor CHAMPVA if you are not. Smith

Yeah you can be T&P under TDIU... that's been around a while. I am curious why they are bothering with a C&P with the PTSD, since they granted TDIU T&P. There is no point really. Not that it shouldn't be treated, but it wont affect what you are paid unless it is deemed 100% in and of itself, then youd prolly qualify for housebound SMC. mmm... thats probably why they are doing it.

Oh, also unemployment laws vary, so I would look into the "inability to perform gainful work" issue before bringing it up. I know in Tennessee if you are truely unemployable, you don't qualify for unemployment (I know it doesn't make sense, but they figure if you are unemployable do to physical disablity you should file for social security) Also if you are unemployable - then you could qualify for social security disability. This is both a judgement call on your part and the medical side. If you truely feel that due to your physical condition you will not be able to perform gainful employment.. well thats what SSD is for. Just a thought. Bob Smith

Murph, I would also suggest that if you are concerned with what the HR department might say, then go to the source. Sometimes (not always I know) a person may have worked with other who are wlling to write a simple statement saying they were unable to perform their duties. I know a guy who retired, not because he wanted to, but because he had to due to his deteriorating physical condition. He made $30+ an hour in construction, but just couldn't do it. They tried to deny him because the HR department said he just retired... Yet a letter from his immediate supervisor along with letters from his spouse and other co-workers helped immensly. You may not be able to obtain a letter from someone at work, but how about people in your community. Persons of stature such as: Pastors, Councilors, Fellow Police/Security, Goverment officials - local mayor etc. The idea are letter in support from people who are not unreasonably biased - the VA assumes (rightly so really) that family members are biased toward your claim. They still have to give them weight, but they weigh other sources like those above more heavily. Further, you state your evaluations were good. Well I would get copies. If they were good up to the point you were let go, that could actually work against you unless you address the issue in your claim. The VA could say that since you had such great evals, you were clearly ABLE to perform the job. I would again, use unbiased submissions, and make your point immediatly in your claim that even though you had such great evals you were let go, thus defusing the argument before the VA can use it. I know the logic here is a bit convoluted but you have to think in legal terms... Honestly, I have had claims EXACTLY like this, and if you just tell your employer that you are filing a VA claim sometimes they will bend enough to provide a letter stating that you were released do to inability to perform essential tasks. They worry about unemployment claims, and comp claims. If you make it clear you are NOT filing these (which if you are unemployable you are NOT eligable to collect unemployment) sometimes they will be reasonable. Of course if you intend to file a comp claim, I wouldn't advise this... however that does not seem to be the case. You are filing a claim for worsening of conditions, as well as the other new. I would certainly file for an increase in compensation if in fact you are suffering from a worsening of these service connected issues. Anyway, best of luck. Bob Smith

Rob, Please make certain you have everything documented in your medical records. Now, while you are still active is the time to do this. I don't know how long you have until you get out, but it is essential that you get a diagnosis of everything you have incurred during your service, or has been worsened by service in there. You would be amazed at how many sailors/soldiers etc. who THINK they have a diagnosis and actually do not. The service often discourages this. Well they ALWAYS discourage this. It's an institutional issue that pervades all branches. Things that I encounter that many service members forget, or dismiss... shin splints... simple fractures eczema hearing loss - tinnitus ACQUIRED flat feet - fallen arches - aka ples planus knee injury low back injury (lots of airborn qualified guys hit all these yet only go to a TMC and dont get it documented in their medical records.) also there is STILL a stigma attached to PTSD... Now you may not suffer from these Rob, but others reading this post may. The SINGLE most important thing a service member can do prior to getting out is ensuring that any injuries get properly documented. The exam they do at ETS is less than one would wish, and many people assume the military will take care of them. The fact is once you are getting out, you cease being a soldier and are just another drain on their resources. I know thats NOT what one would hope, nor what our military deserves yet it is the truth. The is an issue with every branch, not just any single one, though some are worse than others. You or any other military member who is getting out is NOT going to get a fair deal without proper documentation. That is just a fact as many here will attest to. So the best way to prepare - is to prepare, and not leave it until the day AFTER you get out. That seems to be what you are doing so you are already ahead of the game. remember without a diagnosis you DONT have it... also good thinking on the secondary issues. These are often missed. Good luck and feel free to IM me. Bob Smith

I have seen some really good people with the PVA. I am not going to comment on the rest except for AMVETS, BUT there are some good people in all of them except for AMVETS... (I am sure there are one or two I just have not met them, or heard of them, or seen anything but really totally terrible reps - sorry but if I had to pick AMVETS or none... well Id pick none). Also, I doubt a 21-22 amended that way would have any real beneficial effect. I gotta agree with LarryJ there. I think most VSO's (even the good ones) would look a bit oddly at it. Now that doesn't JBasser isn't right, I just don't know how many reps would even read the thing.

Look I run into this again and again and again.... I tell all the vets I counsel... send in at LEAST two copies, on TWO colors of paper. If you get one back with a letter saying they already have it... then your golden. Yep, to all you all who want to say this is why there is such a backlog... well yeah it is to some extent, but I'd rather have the backlog and vets getting claims thru, than no backlog and vets losing claims due to "lost" or mysteriously missing evidence. If the system wasn't broke we wouldn't have to go to these silly extremes to get stuff in our C-file. Further I also reccomend that a veteran GO to their VARO and add the records in person. Do this first if possible, but if you cannot, if the VARO is 500 miles away... well mail at least two copies, and make sure you keep copies. Wait 120 days and then send another... until you get a set back. With the different colored paper you can tell which set actually made it to them. I average the 2nd or 3rd attempt - but almost always the first attempt in person at the VARO - so thats definatly the way to go if you can. Bob Smith

same questions as LarryJ

I didn't know that John thank you. Bob

MMM... they raised the rates recently, as well as allowing for the grant to be broken up and used partially and the remaining amount to be used on a later home etc. It is hard to qualify for, and honestly the requirements the VA puts on the housing is large as well, but in most cases make perfect sense to someone in a wheelchair. Renovating an existing home to meet these qualifications can be extremely hard as well. Honestly new-build is best if you can afford it. And yes, I have "adapted" a home to VA standards. It was... a bit of a pain. I didn't use my grant though, I am saving it for a new-build. There is also the HISA grant.

shoot sorry I hijacked the thread Streach... thanks for the post. I always wanted to be a pilot, but never had the eyesight. Oh well, it didnt stop me from doing all the other fun stuff. Bob

Nope most of the services allow a GED, but only under certain circumstances. The Navy accepts a GED, like most other brancehs only during "open" periods. Since the Navy is downsizing, I would guess they have no openings. However, most branches accept 15 college credit hours in lieu of a high school diploma. The recuit gets to join as a "regular" high school diplomad graduate and gets access to all the bonuses, etc. that are sometimes denied GED holders. The reasoning for this is thus - a GED is a test.. an actual high school diploma shows the willingness, and ability to complete a course of training. Since all the branches are essentially retraining every recruit, they want to maximize success rates among the service training schools. Someone who took and completed 15 semester credit hours in college - well they also have proven they can complete a sustained course of training. A GED while accepted by most universities etc. does not prove that the holder can complete a sustained training program. Dont ya'll yell at me, this is just their policy... not mine. And to be bluntly honest, they kinda have the numbers to back it up. Soldiers or sailors who hold a GED have "supposedly" been proven to have a lower success rate than traditional diploma holders. Now I never saw these actual numbers, nor did I ever see any new sampling to see if the numbers were current. However all recruiting branches practice a similar system, so I am led to believe it probably is true. The Army accepts more people with a GED than any other branch. Since the Army is the largest service this would make statistical sense, as well as common sense. I was in both the Air Force and Army so lets not get into a debate as to th3e merits of each service. I am just stating that a person holding a GED credential is more likely to get into the Army... further they are more likely to get something like the carrer path they may desire. Home schooling is accepted as a traditional degree by the Army, I have no idea about the other branches, but they probably also accept it since there is a proveable commitment to a course of study involved. Seriously this is all about money, and training costs. As a taxpayer I am glad they are worried that their recruits can complete the course they are in for. Personally I have had many many GED soldiers - and I have never once seen one who underperformed my more traditionally diplomad soldiers. In fact, it was my experience they performed better., again my experience. I know a lot of talking on a simple point but one I felt competent to address. The current Army enlistment policies can be obtained thru the local recruiting station, or online at the goarmy website in their online chat.

Nope A&A rates are not going to increase, however a "stiped" will be provided for the caregiver, as well as access to insurance. Now why is this important... well right now the VA will only provide for 5 hours of contractual in-home care, and another 2 hours of fee-basis care which can be provided by family etc. Now while A&A is called aid and attendance let us remeber that it is in fact to compense veterans for loss of "quality of life" due to paticular, or overwheling injuries. A&A is not to actually provide for aid and attendance - go figure. It is in the end special monthly compensation, not A&A... However I digress, the key here is that it will allow for the veterans fanilies to recieve a stipend, for the care they give. Now my wife gets paid for 2 hours of care per day (thats the max), and I get a home care aid for 3 hours, and a homemaker aid for 2 (they are actually the same person). That still leaves me short 17 hours. I personally pay for 4 more hours of care directly to the same aid working for the contractor. This leaves 13...assuming 5-8 hours of sleep (HA!) and I am short 5 hours. In fact I spend many hours alone, and if its not here in my room, I cant get to it. Now with this bill I can direct that my current caregiver (the same for the last 4 years) is to be my directed one. That person will get the stipend, and hopefully eliminate what I am now paying and provide for full-circle care. Basically the "stipend" amount is to equal that paid to local care providers. My wife, for her fee-basis hours gets $14.50 an hour. I would assume something close to that for rural care etc. The VA will be doing a lot of hashing out of paperwork etc., but I cannot help but see this being carried out thru fee-basis, pretty much like they handle the 2 allowable hours now. As importantly, this will open up the hours to home care to exceed the allowed 5 hours granted now. Contract care-givers can expect a healthy boost in hours from this, since it stipulates that they can be used as well. Personally I disagree with the after 9/11 clause even though I am entitled under it. They limited it to limit cost, but that don't make it fair. Honestly if the VA has a program, except ones only for the blind, I qualify. I have supported this bill from the start with letters to my congressman etc., since if I only qualify for this what does someone who is less hurt than I qualify for? I was told by a VA social worker (while she was doing her nails) that I was lucky to get what I was... many vets weren't getting that much. (I still want to slap the woman). So, don't expect a raise in you SMC. Howveer if you have a family member caring for you full or part time, they will now get paid for it... and some other benefits. They do have to meet all training requirements. Yet thats not new my wife had to attend a special class prior to being awarded the fee-basis for 2 hours. So, it is a program that can be of great help, to some veterans and their families. A spouse can, hopefully, be able to care for their tramatically injured vet without financial ruin.

Well as one of the severely disabled veterans who recieves care from family... yeah this is a big success. I have been watching this bill for quite a while and I am anticipating a complete overhaul of the limits the VA places on in home care. Personally I am very very happy. Bob Smith

Sec. 4.58 Arthritis due to strain. With service incurred lower extremity amputation or shortening, a disabling arthritis, developing in the same extremity, or in both lower extremities, with indications of earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however, that arthritis affecting joints not directly subject to strain as a result of the service incurred amputation will not be granted service connection. This will generally require separate evaluation of the arthritis in the joints directly subject to strain. Amputation, or injury to an upper extremity, is not considered as a causative factor with subsequently developing arthritis, except in joints subject to direct strain or actually injured Basically the VA states that they recognize that if a lower portion of the anatomy is injured this would cause levels above to be subject to strain and injury due to it. This line of reasoning stops with the lumbar spine, and goes down to foot. So an injury to an ankle can, at a later date cause an injury to a knee... But you will need to get an opinion from a doctor stating that this is probably why you have this. I have won claims just like this, but expect to be in for a long round of NODs etc. Further, have you filed for loss of use? Have you filed for any SMC? Bob

Larry they are a rated conditon.. 6510 Sinusitis, pansinusitis, chronic. 6511 Sinusitis, ethmoid, chronic. 6512 Sinusitis, frontal, chronic. 6513 Sinusitis, maxillary, chronic. 6514 Sinusitis, sphenoid, chronic. General Rating Formula for Sinusitis (DC's 6510 through 6514): Following radical surgery with chronic osteomyelitis, 50 or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries............................................. Three or more incapacitating episodes per year of 30 sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non- incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting................................. One or two incapacitating episodes per year of 10 sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non- incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting................................. Detected by X-ray only................................. 0 Note: An incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician I understand exactly what you are trying to do, and it is a justifiable claim. You are saying that the service connected injuries have caused symptoms similar in aspect to sinusitis, and Rhinitis. Now this is also important... The Respiratory System Sec. 4.96 Special provisions regarding evaluation of respiratory conditions. (a) Rating coexisting respiratory conditions. Ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other. Where there is lung or pleural involvement, ratings under diagnostic codes 6819 and 6820 will not be combined with each other or with diagnostic codes 6600 through 6817 or 6822 through 6847. A single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. However, in cases protected by the provisions of Pub. L. 90- 493, the graduated ratings of 50 and 30 percent for inactive tuberculosis will not be elevated. So I take this to mean that even if you get a rating for sinusitis or Rhinitis, you can only get ONE, and that one be elevated due to symptoms... So, I would file the claim for sinusitis, but insist that it be raised due to the rhinitis symptoms. I would state that the Sinusitis is due to the service connected injury, and like Wings said, get an IMO stating that the deviated septum is and has caused these symptoms... Thats the way I would go. Bob

Have you filed for loss of use? Bob

This is a really really good point. Esentially they are saying TDIU is the same as 100% schedular for entitlement to an S rating, and this was upheld. Yeah this could have a very significant impact on many vets out there right now. Huh... didn't know it was even in the works, thanks Berta. Bob

If a veteran has one injury or illness rated at 100% then they do not have to have 60% to get SMC... For instance... Loss of use is considered a K so if a veteran has the loss, or loss of use of a limb then that veteran is awarded SMC at a K rate REGUARDLESS of any other rating... furthermore If a vet has a 100% rating, and has other illness or injuries that are not connected to the 100% condiotn then they only have to have 50% to go UP 1/2 of a letter on the SMC ladder. CFR 38 3.350 clearly outlines the requirements for SMC etc. and 3.352 outlines the requirements for R-1, and R-2 ratings (the highest the VA pays).. Housebound is covered in 3.350 and is an S rating but pays less than say a K1/2... (I get the feeling they stuck housebound on later and just added it to the alphabet since it is the only SMC rating that is not consistent with the whole). A lot of poeple say it is hard to get a 100% schedular rating, but to be honest if you actually have the documentation to support your claim you will. You will have to fight for it but you wil eventually win. It is not "impossible", just difficult. Bob

I dont bother with pain blocks now as they are ineffective, but I had them many times and I was never sedated. I have had well 6 or 7 myleograms and was never sedated. I gotta be honest, I don't know why they would offer sedation for this - yeah it's painful no lie there (wow it really stinks, the myleogram especially) but I dobnt know what the would give, maybe valium or something? And yes I have actually had 6 or 7 (cant remember which) myleograms. Honestly and for true. They are, IMHO (stolen from carlie AGAIN) much much better at locating spinal chord injuries than an MRI. They actually show how well the nerve is working compared to both sides etc. EMG's are also good to show exactlly which nerve has been injured etc. Bob

It is important to note that the VA can and will service connect a knee, hip or lumbar spine injury secondary to a foot injury that is service connected. For exaplpe let us use Pes Planus, flat feet... now with a vet who has service connected flat feet, then they can at a later date file for an increase in compensation (or they can file for this in their original claim if it exists at that time of course) for an injury to the knees that is secondary to the injury to the foot. In short the VA does recognize that an injury to the lower extremity, be it foot, knee etc can and does cause injuries at later dates due to instability and a "shift" in the bearing weight etc. The VA will NOT (in my experience) rate anything above the lumbar spine as secondary to a lower injury, so they are NOT going to bite on a claim that a cervical injury was the result of an earlier damage to the feet. They stop at Lumbar when going up. I have had a lot of success getting claims like this thru, but you have to churn away at them. They deny you NOD etc. Like I said I have had lots of success with them. A key item of evidence is the C&P exam itself. It helps if the doctors physical assesment dovtails with the injuries you claim and an IMO that states it could have been or was caused by the improper throw of the weight etc... well those certainly help. Bob

mmm. The Army reg that covers this used to be 40-501 Standars of Medical Fitness. I doubt it has changed but you never know. Bob

You make a point here worth emphasizing. If the rater made a decision based upon partial evidence, or the C-file was missing significant documentary evidence - and you can prove this (simply by requesting the C-file and showing the difference like Streach did) then you could shoot for a new date of claim going back to the original date of file. Now I am NOT saying that is the case here, just that if the records were missing a vet could do so. Again if a vet requests a copy of their C-file andd compares it to their records from St. Louis, and finds a discrepancy this could change the outcome of a claim or even the effective date of the claim. The important points here are: 1. The evidence must be such that the rating decision would have been different. 2. The C-File must contain no copy of it, or reference to it in the raters notes. 3. The vets request that the deciosn be reviewed based upon submission of the new evidence, and asks for an earlier effective date etc. 4. Hate to say this but really must - sometimes the evidence that is missing could be used against the veterans claim. It may show that a decision made by the BVA or rater based upon the weight of evidence bearing in the veterans favor - was erroneous. NOT saying that is the case here at all, but it is a factor that must be considered when taking this line of reasoning. anyway, good points. Bob

The reason the bill was rescheduled was because a Senator raised exactly this point. He didnt want to stall the bill, but wanted it to encompass all veterans. I don't think there is any way to kill this bill. There is simply too much support for it. However I do think they WILL amend it to consider any veteran. In any case it will be coming up soon, it is in position 190 on the calendar. Personally I agree with all of you. It should include all vets.