sixthscents

Nerve blocks, and steroid shots only ever helped temporarily. Going to a chiropractor would have made it even worse. I took a ocnservative route, but after a year I couldn't handle it anymore and the surgeries started. Where they will end, well who knows? In the end your case is your case and dependent upon how you feel. Once I had injured my spinal chord there was no going back, and maybe if I had taken the surgery option to start the spinal chord injury wouldnt have been so bad... who knows. Talk to your spouse, your family and do what seems right for you. Its a terrible problem, that slowly takes away your life it seems. But look at it this way, the VA has really nice electric wheelchairs... and before ANYONE bashes me, I HAVE one. I am being sarcastic... but its a truely terrible situation. Good luck and God Bless, thats really the best I, or anyone can say.

Personally I can address this for myself. I was a very active advocate for about 4 years, and never really got "burned out". I got sick, or rather "sicker". For me it was a very very hard decision but I had to cut back my advocacy. I simply could not then, (or now) support the level of activity I was managing online, locally, and nation wide. For a while I cut out all of my work. I had to, and it killed me, but I had no choice. Now, after a bunch of surgeries, and new problems (I go in for a bone marrow test on Friday)I still find that I am only occasionally able to help. I go thru the posts and look at what is being said with each. If I feel the person is being helped adaquately, I dont post. Some people ask basic questions that are answered again and again, generally I look and see if they have been directed to a FAQ etc. What kinda has always grabbed my goat though are the ones not willing to help themselves. (This is not pointed at anyone in particular) The idea here is we are a community that learns and passes on that knowllege, so others can help even more - but sometimes, well really often, people only worry about their claim, and when it's done they go away. Or they constantly ask you to do the work for them. Depending upon the veteran, I am willing to do much, but some don't need me to do it all. The most important advice anyone here can give is read. Read CFR 38 read M21-1MR. How you base your claim will depend on how the law outlines evidence, service connection etc., and you can find all that in CFR 38 all on your own. Now dont get me wrong I like to help, but I also like to teach. CFR 38 and M21-1MR and available totally on the web, and there are links here to them. There are always exceptions, but the best advice I can offer is read. Take the time, and do it. Then ask questions based upon what you have read.

Oh, if you haven't filed for loss of use of the foot, the AFO (ankle foot orthotic) you wear is very GOOD evidence for the claim. Obviously you have foot-drop etc. So the claim should be relatively easy to file. (Mine was anyway with the same situation except for 2 AFO's) feel free to email me at sixthscents@hotmail.com and I will give you my phone number and help you with filing if you need it.

Larry the VA views Loss of use and Loss of as being the same. So, Loss of use of any appendage is the same as if it were amputated. CFR 38, 3.350 (2) Foot and hand. (i) Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis; for example: and you can read the rest... but if you have established "Loss of use" of a foot, you qualify for the adaptive grant. I would wait a bit though as there is a bill in Congress that will raise the grant from $11K to $38K... go to Thomas and look it up. It's going to pass.

It is VERY true that you may have been rated permanent and total and not know it. Further Purples point of asking a VA doc to state such is worth considering as well, before you go spending money on IMO's. I would file for chapter 35 benefits and see if they award them. If so, you are P&T. They may have stated on your award letter a "re-exam" date, and if so you are NOT P&T. So at this point I would find out for sure what they rated you and go from there.

OK so from what I read you were rated 60% and granted TDIU. If so what are you filing for? Im sorry but your explanation is a bit - confusing.

Many of you know me, and know that I have been in the VA system since 2002. Today I recieved, for the first time ever a call from my actual rater. They agreed with my latest claim, and increased my SMC to R1. I have been arguing this one for about 2 years, but it was for all the marbles really. The rater was really nice, and explained why they were rating me (of course, I knew why since I know CFR 38 and the results of all the C&P exams but I let him say why since he seemed to really want to explain). Anyway, the only higher benefit is R2 and I feel that I just dont qualify for it. Anyway, I wanted all of you to know... dont ever quit, don't ever give up. If you feel you deserve a particular benefit, and the medical and regulatory evidence support you - dont ever ever quit. Make sure you have all your ducks in a row, and you will win. Most importantly READ - read CFR 38, read M21-1MR, and read the postings here. Take notes, ask opinions, and file. Then just dont quit until you are satisfied that the result is fair. My claim for R1 took 2 years, and there's quite a bit in back pay coming. Yet this is money that I have already paid out myself for CNA's in home, etc. It's fair and it will probably be the last claim I file on my own behalf (since there's only R2, and I just dont feel right asking for that). From a rating of 40% to over 200% schedular, and SMC of R1 - seven years of my life. All I can say is never quit, never surrender, never give up.

Adjustment disorders are compensable under CFR 38, but.... as stated by Hoppy it has been MY experience that they do not award under it for some reason. Now this is just MY experience but I firmly believe that the service branch and the VA both use it as a tool to under-rate both medical discharges and VA ratings. Put simply I believe the VA AND the service branch uses the term "adjustment disorder" in place of more specific diagnosis like PTSD, or Mood disorder- depression, or panic disorder. I have seen again and again where they have service connected it at 0%, or simply denied service connection completely.

Halo2, I would do a specific addendum stating exactly ALL of this... a statement in support of claim, and send it foreward as well. Yes it could delay the decision even further, but I would make a certain that this error (or errors rather) was pointed out. Scan in the med records, and copy and paste the portions that apply to this into the document as well as attaching copies of all the medical reports that apply showing the previous date. Further, the 90 days is covered, actually up to 1 year from discharge is covered if you can prove a nexus - which you obviously can. So I would not let that worry you. But I would absolutely do a statement in support of claim and foreward it to the BVA. You can do this. You clearly know what you are doing, and are willing to work for it, so you can beat them on this, just dont give up! Good luck. Bob Smith

Woops sorry.. I thought from what you said that it was within a year of discharge. Obviously I didnt read it correctly. Your date of claim will be the original date of claim, May of 08, since you filed your appeal within one year of the rating decision. There's an issue with onset dates in this, but I doubt it applies to your case so, I think that May 08 is solid. Also, yes VSO's need to have all the information to do their job. A complete set of service medical records is very imprtant if you can find them. A question: had you ever filed a claim before, and were you severanced from the military? I am asking this for a particular reason.

Curt, In many civilian situations acceptance of partial payment can harm a legal claim. That is NOT how the VA works however, but I can understand why you ask. Yes you can accept the 30% without ANY repercussions to continuing your claim for a higher rating. As stated you will need to file a Notice of Disagreement with your local VA regiional Office and state clearly why you think the rating should be higher. The best way to do this is to read CFR 38, section four, and look for you particular injury, or injuries and see what each rating step (10%, 20% etc) requires in the way of evidence and making sure that you have it. If not, get it through either VA doctors, or outside independent medical opinions. You cannot just say I think I sould have been rated higher, you have to show WHY the VA should have rated you higher, and provide the evidence to support this claim. The evidence required is really outlined in CFR 38. So, pull all your medical records together, and go to CFR 38 for what the service connected and see what a higher rating requires. Good luck, and understand this is a slow process. Well, I think you already probably understand that... also broncovet is right, they generally lowball first claims, and then do a seemingly endless series of appeals, denials, or partial denials, reappeals, etc. Have patience and stick to it... or the VA wins.

Yeah as long as fee basis approves beforehand, they pay for everything. The issue with emergency room care is on cuurently being dealt with. And even in the new law, they are only going to pay until you were stabalized, and then yeah they will say that you should have been transferred. UNLESS they agree that you should stay, then they agree to pick up the rest of the tab. Sorry, but I ran into this myself, and had to pay the stupid medicare copay because the VA wouldn't pick up the tab. Under the new law they will though for most emergency room visits for veterans. Going through fee basis is the only way to handle this though. Thats a fact, and I would put heavy pressure on them - call you congressman or woman, and tell them the deal and have their reps call fee basis. You shouldn't have to pay this... and hopefully they will have some legislation passed very soon that will fix some of it. It has passed the senate already, I cant remember the bill number but can find it for you if you want. I would also tell fee basis you CANNOT pay this copay due to monetary reasons.. then see what they say.

Ok, RosyPalm You ask a LOT of very valid questions. I'm going to hit them in order if I can... 1.How long does the DRO appeal last? Well, it varies.. I have had a decision come back in 3 weeks, and others at 18 MONTHS.. so we can't really answer that. I can tell you things that seem to speed up the process from my experience. Submitting the appeal with all the evidence at one time helps - since the evidence does not have to catch up with the C-File. Further stating your appeal as clearly and simply as possible is also good. The actual physical location of your VARO is significant since some are much busier than others. Providing the VA with three things is important for any claim or appeal, and they are ... proof of nexus (this means time and place injury occured in service), actual diagnosis of illness or injury from a physician (you just cant say you have something), and evidence showing the severity of the illness. In your particular case you state... in service of a suicide report and call to the VA hospital six months after service for depression to when the suicide ideation and manifestations first happened Now theres something important here... any injury or illness which occurs within 1 year of discharge can be and normally is granted service connection. This is if you can prove even a tenuous nexus.. the attempted suicide during service is very strong evidence of in service depression etc., so I am almost (this is the VA after all) certain they will grant service connection for at least depression. 2. Is the initial claim then from the time the initial service connection for schizophrenia to include anxiety and depression was denied? OK, if I understand you right you want to know what they will determine as the claim date... and if you filed your appeal within 1 year of the initial decision, it will be the initial claim date - if they do in fact decide upon service connection for this. However since you filed within 1 year of discharge... it will be your discharge date and not the claim date as would be usual. This is a bit of a special case since you dont see a lot of veterans filing within one year however with the benefits at discharge program I do think that number will rise rather drastically. 3. Is this going to be retroactive? Yes, if the DRO decides that you do have a valid claim ( which from the information you give seems to be the case) then it will be retroactive to your date of discharge (since the claim was filed within 1 year from date of discharge). So, now you wait. And that stinks, but its the way it works. I would look at the appeal the VSO filed and see exactly what he filed for etc. VSO's are like anyone else, some are good, and some are... less that optimum. It seems like you have a decent one since they bothered to even do the appeal. Keep asking question and I can suggest that you research CFR 38, section 4 for your particular illness, and see what the VA requires in the way of evidence to prove an illness of that type etc. Of course if you feel it necessary get an IMO... they are generally VERY helpful with claims. The best advice I can give you though is to READ... CFR 38, section 4 schedule for rating disabilities and the other pertinent sections.

Many of the members on Hadit work "offline" as well doing VA advocacy locally or with veterans they met on Hadit. Many work on other boards as well. It can completely take over a persons life very quickly though, and it's easy to get burned out. Also most of us have our own medical issues that eat into our time and ability. Hadit is a very special site though. Many veterans online here have been doing claims for a very long time. I have been at this now for 8 years. Generally one of us knows the "answer" to whatever question is asked (the vast majority anyway). It may take a bit for that "one of us" to see the post but it will happen. If it doesnt repost and ask for a reply. I have learned a great deal from Hadit, and hopefully I have given as well. We are not physicians... that is completely correct. So we should NEVER render medical advice - but we can render adice on how to process claims. Many people fail to understand that the VA medical system and the VA rating system are two different entities. The only time they even connect is for C&p exams... that's it. The VA has created a system that is clearly "adversarial" towards veterans claims in my opinion. The least we can do is help level the playing field by pointing out where the veteran should look for answers. In the end we essentially use the VA's very own rules against them. The thing is to know what the rules are, and that can only be learned through experience and reading CFR 38, M21-1MR, the VACC cases, and the federal register. I have no problem with helping a veteran. And with an older vet, or certain vets I am usually willing to really just do the entire claim (if they are old, or just completely unfamiliar with computers etc). I used to do entire claims all the time, from start to finish - or at least as high a rating as I thought the vet could secure, etc. However, due to my own failing health and a very few veterans who abused my compassion - I just no longer can. I will answe a question happily and point out where in the regulation a veteran can find further help, but I just don't do entire claims anymore - except for exceptions (theres always those right?). Bob

Berta, I think he would qualify for SMC under CFR 38, 3.350. I quote: "(i) Total plus 60 percent, or housebound; 38 U.S.C. 1114(s). The special monthly compensation provided by 38 U.S.C. 1114(s) is payable where the veteran has a single service-connected disability rated as 100 percent and: (1) Has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or (2) Is permanently housebound by reason of service-connected disability or disabilities. This requirement is met when the veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime." Now would the other 100% rating apply. I dont think so, and thats because they evolved from the same etiology. That is the same thing caused all three, his exposure to AO. Further if it could apply, I dont know where they would bump the S SMC to. However, as long as this was the same (CFR 38 3.350 that is) then yes he was clearly entitled to at least an "S" SMC rate. I personally would file the CUE. You'll win, as long as the reg was the same then. It passes all the marks. You really don't need to reference anything else here except CFR 38, since it is clearly defined under the regulation right. Bob

also lets define some terms here ssa = social security administration ssd = social security disability ssi = social security (suplemental) income ss = social security (age based) sss = social security survivor so a person who draws ssd is disabled, depending upon how much income they have from other sources they may also qualify for ssi (ssi is a supplement) a person cannot recieve just ssi a person can recieve normal ss and also get ssi if need is proven. also surviving spouses and children may be entitled to some benefits. hope this clears up any confusion

I was looking at this a while ago and yes that is essentially correct if I am undestanding you. The point here is that what is mosy favorable (monetarily) is what should occur, if the situation is as described. The veteran dies, the survivor gets DIC, and they get still get their ssd (ssi is gone) unless ssd and ssi are more than ssd and DIC then the dont get DIC. Its whats most favorable to the survivor. As for an increase in the SURVIVORS ssd - if minor children are present they will keep that until 18, or the month they graduate high school, but their own personal ssd amounts wouldnt change (now - the ssa will calculate the payrate for the minors based upon the most favorable parents participation, but that should have already happened). However they may also qualify for survivor benefits under SSA in addition to their own ssd.. go to the SSA's website and click on survivors to learn how. Am I making any sense here?

They can put an "FLAG" on you file, but it takes a very clear process to do so. The problem is, while the may not be able to "flag" your file with an alert - they can add notes and often do. I had one left in all caps stating I was dangerous and the clinic was afraid to treat me because of my size and hostility. This all from one phone call asking for them to properly refill my meds (since they had screwed them up). The LPN who left that note quit 6 months later, but its still in my records - in all caps. However my file has not been flagged, I checked that personally during a visit. Oh and my hostility ... I told her to shut up and go ask the doctor about the dosages. This after 10 minutes of trying to tell her this certain med had been prescribed for over 2 years at the same dosage rate.... (sigh) And yet... more often than not - I am very satisified with the care I get. Yet I really think that just depends on where you live. Bob Smith

OK, seriously late in my response but Ive had major and minor surgery surgery... Carlie, I can agree that the St. Pete facility is one of the worst black holes I have ever seen for paperwork, claims and care... Its a shame too because it has the ability to be so much more... Im with you on most thiing and can certainly agree about that entire facility the VARO and medical center

I gotta say I have heard so much bad stuff about the staff and attitude of the St. Pete VARO. Once I could maybe understand, but this has been repeatedly over the whole time I have been doing claims. St. Pete loses records, treats vets like dirt etc. Again and again I have heard instances of this. To me, for a whole VARO to be like this indicates a set policy decided upon by upper management. Its a shame, and something should be done. I have never been able to get the first medical record for a vet from St. Pete. All I ever have gotten is a terse letter stating no evidence exists. Yet again, this is one VARO... that obviously stinks... I have had similar experiences with the Cleveland VARO, and Winston-Salem. I thnk management sets the tone, and hires people of like nature etc at these VARO's. In any case I would follow the advice to formally request a copy of the C-file. I would personally take the request to the VARO to get it date stamped as well if reasonably possible. I'd also file the complaint (while you were getting the stamp perhaps).

I know I have been away for a while, and I probably will be away again for a bit due to upcoming surgery etc. but I wanted to share with you all the most recent decision in a claim I filed. The rater states under DECISION.. "The previous rating decision was clearly and unmistakably erroneous in failing to grant service connection for ...." He He.. I won a CUE claim, and it backdates to the original claim date over 2 years ago. So, now the appeals (currently also at the rating board) will have to be decided. The claim that the CUE occurred on was the backbone of my claim for an increase in SMC though, so it was incredibly important that they see the mistake they made. I was so proud of winning my CUE I just had to share. As many may or may not know CUE claims are really difficult to prove, unless the rater really made a huge mistake. Mine did, and the system WORKED. Slowly to be sure, but it WORKED. So don't give up hope, but make very sure you understand what a CUE claim is, before filing one. Bob Smith

Thank you Carlie... I was wrong I see. So please tell me was is this a newish change - say last year or so, or is it something I have been wrong about for a while. Sorry all, I hate being wrong but thats why I asked someone to check me on this - I just couldn't quite remember and I thought but was not sure.... So... THANK YOU Carlie, thank you very very much. You kept me from putting out bad information and for that I owe you a bunch. I wonder why I thought they didn't allow adjustment disorders though? (sigh) anyway thanks girl I really do appreciate it, and to all I apologize - I made an error and will try not to do so again (please note the try). Most of you old timers know how crazy I am about putting out bad info - and this falls under that, so I am both ashamed and sorry. I should have looked it up myself before posting it. Carlie, thanks again (chagrin) Bob Smith

Wow..ok, Carlie.. all's good I respect your opinion. Please note I state "In my experience" and that's what it's been. You and many others have much different experiences, and I understand why you believe it will add to the time. I even agree that probably, based upon your logic it would. I am just stating what I have seen. In my experience it does not seem to add any significant time to the claim overall. And no, I think you are dead on in stating that a veteran should NOT walk out of any meeting with th expectation of a check in days/weeks. A veteran should walk IN prepared to clearly state and evidence their claims. I feel that if a veteran does this, they will get a fair and impartial hearing. (of course there are exceptions, but again I am speaking from MY experience). Veterans need the exact same things for the in person review that a good claim needs typically which are: A. clear diagnosis of illness or injury B. a clear nexus connecting this injury to the veterans service C. A reasonable description of the extent of injury or illness and projections for later improvement or decline. D. and of course, evidence that the veteran filed for compensation for this injury etc. exactly the same points that a good claim should meet. Plus the veteran should be somewhat versed in how the VA weighs evidence, and the requires thesholds for the injury or illness they are claiming. (otherwise how could they file a decent claim) what I see again and again is that veterans are ... reluctant to open up CFR 38 and start reading. New veterans asd well as old ones. Also, I commonly (as in a claim im overwatching right now)see veterans who believe that filing for an injury of illness sustained and evidenced is somehow immoral or cheating. In nay case Carlie, I think you have a great deal of experience, so perhaps you are correct - probably are in fact. Again I was speaking from my experience and my advocacy work solely.

Let me tell you, I saw case after case of medically unfit soldiers deploying on back to back tours. I have a friend who did 6 tours with less than 4 months between them normally. Now he was a commo guy for special ops - but still this seemed insane to me. The last 2 deployments there is no WAY he was fit, I have seen his medical records. Yet they needed his MOS desperatly so, they sent him. If the Army has to send a half blind soldier with massive PTSD issues to fill a slot and thats all they have for it - he or she is gonna go. It's as simple as that and i think we can probably say we have all seen instances of this. The mission before all, should be the Army's motto. It's just the way it has always been, this is nothing new. Soldiers are tolf to suck it up and drive on. Yet we wonder why our retention rates are so unstable that they have to do "magic math" to make them look good (I have seen this again and again, and helped do the magic math myself). We are destroying our Army. I was taught that if you fought a battle and won, but took 20% casualties you lost in reality - our Army is less than 80% combat effective right now simply due to rotation delays etc.... much less injuries or illnesses - schools, training etc. It is a "broken force", and desperatly needs a reduction in deployment numbers. Hopefully this is coming soon.

This is sad, but.... when I last went to my VARO to look at my file. I didn't make an appointment and waited about 15 minutes which seemed very reasonable to me. The person with the file was very gracious, and simply handed me the file and told me to look thru it at my leisure and left the cubical. She came back in about 1/2 hour and asked if I wanted any copies etc, and when I said no, she told me to take as much time as I needed to finish, and again left. (I'm not going to say which VARO because I doubt the young lady was supposed to let the c-file out of her sight) To be short, the service was simply excellent. I am sorry that your experience was so different but it is a case of different employees. The VA has many bad ones, but they also have good, and sometimes (for me anyway) it is so hard to remember that all it takes is one uncaring idiot to make the whole section look uncaring and belligerant. Don't get me wrong, I'm not cheering for the VA here, just stating that there are good people out there, so keep trying, you will find them.. I promise. I have a lady (Edna) in my Orthopedics department that I just call to say hello and ask how she is doing. I call her when I dont need anything, just to say hi. People like her make all the difference in the world. My social worked at the spinal chord injury clinic is simply phenomenal. I have never once called and left a message that he did not return that same day, and usually that same hour. So, it is simply a matter of finding the good people (and thanking them profusly - believe me I do because they do a heck of a job). Please don't let this one thing, or even many thing discourage you - you WILL find lots of good people in the system, you just have to keep looking and not lose your temper (Im the pot calling the kettle black here - sorry).