sixthscents

Yeah, I am often discouraged when I hear 20 years into this that Vets are still being told, be happy with what you got. My VSO rep actually sent a letter into the VA stating they felt that I wasn't due an increase and the VA had rated fairly. Yeah... that was when I immediately dropped my VSO rep. I don't know if it is actual collusion or incompetence but it seems to have been a staple story for 20 years now. Don't file for increase, you could get decreased. Well yes, and the sun could go nova tomorrow but I generally don't worry about it.
20 years doing this and I have yet to see a claim for increase lead to a decrease. So... at the end of the day it is your decision but I know what I did and I would have left over a million dollars on the table at this point (yes thats not hyperbole). So... it is your decision but I am incredibly glad I made mine the way I did.
The VA does change eligability to programs like the Caregiver act... and I could go on for days as to the lie they are selling there but... not to claims for compensation in my experience. 

Further, the rating for the genitourinary system - renal dysfunction in your case would seem to call for a 60% rating. When they decided to rate you 100% it didn't really matter but if they are going to drop the one rating to 40% then it does now. 38 CFR .115a. They would either have to combine the two or at the least rate the higher of the two. I would argue that since the renal dysfunction has NOT changed that the rater must either consider it to maintain the 100% or address it seperatly if they are droppng the 100%. I have little experience with the situation but that is something I would certainly note in any NOD. Just my thought here.

Yeah they typically do require it. On the plus side it will give you more information for your claim.
Sixthscenst

"1. Am I just out of luck because I didn't seek treatment during Active Duty?"
Not at all because they say:
"2. Under "favorable findings" it states that "a nexus, or link, has been established between your claimed issue and an in-service event". Isn't that the literal definition of a service connected disability?!"  Yes it is.
"3. What is the error?"
Maybe the rater could not read.
What have you all seen as timelines and outcomes for this? "
That often depends on your next step-
Something is wrong here- maybe,in an effort to correct a DTA error, they might have made a typo
under Favorable findings.....I am at a loss ... can you scan and attach the actual decision here to contain the Evidence List ?
What is the 50% for? Obviously VA had your SMRs when they awarded that claim.
Did you have private treatment records and/or VA medical records that the IME doctor based their opinion on?
Please cover your c file # , name, address prior to scanning it.
When you scan it you can save it into a word doc or pdf and then when you go to the "choose files "thing at bottom of the reply box ,it should pop up as an attachment.
When you described the inservice nexus were you able to detail it as to time and place?
I have seen VA say to vets that JSRRC could not verify their claimed incident.
I told a few vets to write to JSRRC themselves and give them details, and some got the evidence from JSRRC that they needed and succeeded in their claims..
 
 
 
 

As everyone has stated above, it doesn't look bad. It appears more an "administrative" error. At some point, the VA just failed to attempt to get a portion or your records, whether that is STR's, private docs or even LAY STATEMENTS.
Side note: even under other circumstances, lack of STR's for an issues is never a deal breaker. Could it be a little more challenging? Yes. However, it is not a deal breaker. My own experience, so far, can attest to that. My current claim appears to be stating that my issues will be presumptive and that is directly due to lay/buddy statements.
If you could find a way to upload a redacted copy of letter or just the evidence list as Berta mentioned, it may help in wrapping our heads around the Nexus/In-service event conundrum?

Sigh... ok... while I agree that something should have been done. You have essentially done it. You emailed him and he responded, so you have a copy of that should anything (which I really doubt) happen.
I have seen people ask this same question in many different ways over the years. To be concise... the VA has to jump through a bunch of hoops to downgrade a rating. If it is listed as static... just probably not going to happen over ONE doctors comment once. OK? So, you were worried and you addressed that worry exactly as you should have and had a right to. Now you might want to mention it again on your next appointment just to refresh his/her memory but I'd probably just let it lay at this point since you said they were decent otherwise.
Broncovet really broke down all this and you have received some really good advice form others like GBArmy (and taken appropriate action) but beyond that I just wouldn't worry. I wish you the best of luck with the continuing other claims and this one doctors one statement should not be a factor in that. Best of luck.
 
Sixth

OK gonna throw in my two... or Six cents in here. Prostrating is a medical term, and is also simply a word used to describe a person being so effected (affected?) by something that they cannot function. Such as "the widow was prostrate with grief over the death of her husband)... now as the VA and medicine normally uses it, it means a level of disability so severe that the veteran is unable to function.
Specifically in this instance (migrane headaches) it means that the veteran is in so much pain and sensory overload that they must lie down in a quiet place etc. Now the VA uses the number and severity of these prostrating attacks or episodes to judge the level of impairment. This again is all based on M21-1 and CFR 38. I can provide a recent BVA decison excerpt on this if you want it.
Now... it seems you both had some strong opinions here (and lord knows I am not one to judge here... I remeber a discussion I had with another fellow 12 or 13 years ago which was MUCH worse) but... perhaps voice those opions over direct message? Clearly I am butting in but... you both seem like great mods/answer guys on here.. (seriously you both ROCK!) but it's kinda a bad look maybe. In any case... good to see you both.
Sixth

JM... no you would not endanger his current rating. However any further claims need to be focused on an award of SMC if he has the qualifing need. (At least that is where I would focus my efforts at this point). While you can and some people do file continuing claims for illness after receiving a 100% P&T rating it is normally directed toward further award of some benefit.
 
As for care. The VA can and does provide in home care as needed. They provide both homemaker services as well as aide services. Now the place to start working toward this is conatcting you local VA COBC (VA clinic). His assigned physician will be able to direct you to the local socail services person. These are normally (In my experience) the same people who handle the caregiver program. 
 
The people providing the care in the home are not nrses but a nurse does supervise the care. This is normally contracted out by the VA to a local home health organization. Again the level of service the CBOC provides varies (some are bigger and some smaller) but it is where I would begin. I would also print and prepare VA form 21-2680. Review the questions the physician will ask and see if oyu husband need assistance in those ADLs listed (activities of daily life). His assigned physician will have to fill out the form and can help guide you from there.
 
The VA can also offer adult daycare, temporary or even permanent nursing home care. While the latter probably would not be what you want right now it is available. However this all start with the CBOC or you regional clininc and physician and doesn't require a claim process. Now to increase you monthly payment rates you do have to go through the rater process and others have also mentioned that. Basically you are looking at extra money to help with the care. This is provided in addition to the actual physical care the VA can provide within the home. You husband can recieve the increase SMC (special monthly compensation) at the same time as having the home health aids within the home.
I hope this helps explain some of this and puts you on the right track.
 
Sixthscents

WOW... Hey guys good to see you all again. As to the post GBArmy, you need to order your C-File. It is easy just go to your local VAMC and locate the "Release of Information" office. They will print out the C-File and will also put it on a disk if you request it. I think there was a small charge for that... don't really remember. Also you can call and request it (though I have had precious little luck in getting any this way).
 
Bob Smith

Oh and as to CUE claims. Look a CUE claim is supposed to be a rare beast. To be clear it has to be such an error that any reasonable person looking in would say a mistake had been made. I have filed 2 CUE claims in ... I think 18 years now. I won them both but they were both very very obvious. I do not mean to discourage someone filing a CUE claim, but you have to be 100% certain an error has occured. (Unless something has changed).
 
Bob Smith

Paul,
I have been out of the VA claims scene for a hot minute but here's what I know from my own loss of use claim (bilateral) which I won. The actual functional loss is somewhat important. The ability to plater or dorsi flex, etc. What I reccomend, if you want to continue pursuing this claim (I would) is to ask your Primary care provider to refer you for an EMG of both your left and right feet. This will tell you what nerves are functioning and what level of injury might exist. If you have loss of sensation in both feet this would seem to me to be an injury to L5-S1 or around there. I have seldom seen sensory loss like yours without function loss as well. The thing which makes me say this is the bilateral factor. Since BOTH feet are numb, then you have an injury that is outside of just the one sciatic nerve for that leg. Hence L5-S1... the nerve conduction test will show the extent of the injury and what nerves are functioning and how well they are.
The EMG is important to proving this claim. You do not have to have a complete non-functional foot. I wear AFOs on both legs and feet for example and also like you have no feeling in my feet. 
Why is this claim important to you? Well there is a possibility for additional compensation but also you seem to be entitled to adaptive vehicle equipment and it could entitle you to an adaptive vehicle grant. There is also a possibility to an adaptive housing grant.
 
These are all kind of high-ticket items for the VA an getting entitlement to them is not easy. Yet it can be done if sufficient evidence exists to prove loss of use. SO... it boils down to the same question you had to answer when you received your first rating. Is this correct and do you believe you are or should be entitled to other or more benefits. Only you can answe that but, once you do you simply have to assemble the evidence and apply.
If you decide to pursue this hit me up and we can discuss it further.
Sixthscents - Bob

Bergie,
     Essentially what they said but also you can find the whole VA appeals process metric states, under m21-1, Part 1 Chapter 5:
1.5.A.2.a   The appellant may elect to have a formal hearing at any time during the appeals process.
Link: http://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ss/#!portal/554400000001018/article/554400000014081/M21-1-Part-I-Chapter-5-Section-A-General-Information-on-Appeals
Also under VA 21-0958 (which is what they require now I think) there still is a section for a DRO review or "traditional" process. I think the last update to this form was September of 2015, or that is the latest I can find anyhow.
Link:  https://www.vba.va.gov/pubs/forms/VBA-21-0958-ARE.pdf
Hope this is of some use.
Best of luck,
Six
   
 

http://www.bva.va.gov/docs/Pamphlets/010202A.pdf