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So, I was given 70% almost three years after I retired. I never appealed anything or fought with the VA. The 70% was a partial award because they split the case and went back to evaluate some issues after the award. I ended up getting 100% (380% on that wacky logic scale=100% PT) I got the 70% back pay, then when the 100% award letter came almost a year ago, they never adjusted the back pay and just started paying me at 100% rate. I called about it after 90ish days went by and they indicated that the back pay was evaluated by DFAS already and it was simply a backlog on the payment... that was almost a year ago and nothing. I wonder what the interest would be on about 60K? I was told to fill out a hardship letter to get the back pay faster, that pissed me off that somehow I am supposed to show need over my fellow Vets, so I didn't do it. How Frustrating!!

Waiting on a retro payment for almost a year now, has anyone else had this issue with Reno NV?

Folks, I just remembered another technique I used during the C&P exam... I have this rash condition that seems to be brought about during stress, but every time I go to the doctor, it clears up before I can get in to let them see it. So, I took pictures of it and put them on my iPhone. Keeping in step with the easy going vet who is just trying to get help... I showed it to the doc, said it clears up quite quick... blah blah blah and it makes for a much easier time for the doc to document it. I also had all my supporting documentation copied and ready for the doc to inspect whenever he got around to asking me about the various things I was claiming. Frank

Congrats MO3! What great news for you and those who depend on you. I'd like to echo what Testvet was saying about those whom you thought would have your back... My own mother called me three years ago after talking to one of her friends who was retired military... she wanted to make sure I didn't get my hopes up too much because "everything I may get should be considered a gift"... I almost lost it right then and there. I'm 100% and don't tell anyone, it's non of their business. There are a lot of folks who pass judgement on you for whatever reasons... I look and act very healthy. However I've torched almost all my close personal relationships and live in a world of pain that you just can't understand unless you are there. So, good luck and live the best life you can now that your fight is over

I was awarded 100% with over 13 claims and a period of 30 months. They came out with 70% first with a hand full of stuff that they said they wanted to take a look at later. I went back to cnp exams and shortly I was at 100%. I wasn't expecting it, didn't plan for it and frankly am embarrassed to go to the VA hospital and hold myself out as a "disabled vet". With that being said.... I know I'm broken and will not get better, so I am coming to grips with all my limitations. I think there are some small changes taking place at the VA and they are seriously trying to clear the back log of claims.... Small side note... I volunteered at the VA when I first retired. Well, it was through the VA for Catholic charities. I found it strange that when I went to a VA Dr, or something VA affiliated... they asked me if I was still "working" for the VA. I think I got coded as a VA person.... Maybe that has something to do with my good luck with the VA. If you don't have a job and can volunteer, try to get yourself inside the system and infiltrate that way... aint nothin easy... Frank

After 30 months my case has been closed out. 100% P&T. I was pretty surprised to say the least... I want to pass on some lessons learned. 1) claim everything no matter what. I used a VFW service officer to help me with my initial claim. He was very professional but I could tell he had his doubts about the severity of my claims. (maybe it's just me feeling guilty that I "don't look hurt") I ended up going back to him on a second appointment and asked that he add an incidental finding of a small "spot" on my brain which was picked up on a cat scan. Through that, he struck me as busy filling out "legitimate claims" and seemed put off that I wanted this incidental finding noted. That incidental finding was rated at 60% 2) Continue to get treatment... Even if you have "had it" and are completely sick of doctors and all the crap that goes with it. I was rated higher due to ongoing symptoms, which I sought out acupuncture and continuing care while my claim was being evaluated. They called me back in for a second look around the two year mark on some stuff and I was able to pull those records out and show the examining doctor. 3) Be proud of yourself and keep a positive attitude. The evaluating doctors have seen it all. Back in the day, I had a pinched nerve and my pain was so high that I honestly couldn't function. After discussing with my wife how I felt that the doctors weren't taking me seriously, she told me that my behavior may not be believable to some of these doctors and it may look like I'm faking, or making it up. I thought about this and it made sense. I regained my composure and started acting like the proud military member I wanted to be and I started getting much better results from my care takers. I also focused on how I was going to get myself to a better place and actually started asking these doctors how I was going to help myself. I got more help from those who saw me seriously trying to help myself than ever! 4) Read the regs. After I decided that I was the only one who was responsible for helping me, I read all the regs pertaining to my case and was able to articulate exactly what was wrong in terms that VA doctors understood. Things like "I have a loss of sensation below my right knee, It is called Radiculopathy, It feels like it is numb and tingly at the same time" This gives your doctor something that is "ratable" per the regulations and a description for the severity. I hope this helps folks. My case was strange in that I didn't have to appeal anything, I felt like the VA did me right by giving me honest evaluations and feed back on the percentages and why. In total I had 320% rated for the secret formula that they could call me 100% P&T. Now the important part is to make the most out of what I have left and I hope the same for anyone who reads this.

oh boy the formatting of that previous post was horrible... I think I have it down to two pages. Please bear with me when reading it. Thanks Frank

could someone look over part one of two for the NOD to split the two disabilities. I went back and simplified the argument, found supporting documentation (which I'll leave off for privacy). Hopefully someone will tell me I'm on the right track and I'll finish up the Vagal response argument in a few days. Should I send them in separate correspondence? Notice of disagreement with service connection for sensitive vagal parsympathetic nerve reflex and benign paroxysmal position vertigo. These two disabilities (claimed as presyncope syndrome and vertigo) are evaluated together because they share the same etiology and symptoms. They do not share the same etiology or symptoms. Appeal to separate the benign paroxysmal position vertigo from the Sensitive Vagal parasympathetic nerve reflex. A doctor who is feeling rushed during the appointment, or otherwise is at a lack of descriptive terms may describe the overall event as dizziness in order to simply the paperwork. I have documented instances of a vestibular disorder leading to vertigo (dizziness). Additionally, I have documented instances where there was a parasympathetic vagal nerve reflex, which was causing presyncopetic episodes and those were loosely classified as dizziness until a cardiologist made the final determination and classified those episodes as a vagal response. Appeal: My appeal is to separate the benign paroxysmal positional vertigo and the sensitive vagal parasympathetic nerve reflex into two separate claims. The first being rated as 6420 (peripheral vestibular disorders) and the second being rated as 8210 (Tenth (pneumogastric, vagus) cranial nerve) The following is my argument and supporting medical history for the Vestibular disorder: Attachment (1) 22 January 2010, I reported the similar vertigo sensations along with stumbling over my own feet. Attachment (2) On November 23rd, 2009 I experienced an incapacitating case of benign paroxysmal positional vertigo where I was unable to move between laying down and sitting up without incapacitating dizziness and nausea. I went to the flight surgeon that was very familiar with this condition and he treated me using a head movement method called “the Eply maneuver” where the head is moved along various rotational planes for approximately 30 seconds. The Eply maneuver is used to help usher out tiny crystals of calcium carbonate, which are a normal part of the inner ear’s anatomy, that have detached from the otolithic membrane and settled in one of the semi-circular canals. The procedure worked, I was able to function normally after the procedure. This fact lends itself to a certain diagnosis of BPPV. Attachment (3) Notes used for initial consult with Nevada Spine Clinic on November 20, 2009. I write out notes to avoid letting the consult degenerate into a complaining session and to pass useful information to the doctor.. Attachment (4) A mental health visit for which details feeling dizzy within the last month, this for was filled out June 13, 2007, prior to any surgery on my neck. I have experienced frequent feelings of ‘dizziness’ as it is related to vertigo in the past. It is important to note that I did not mention vertigo episodes each time they happened because of the impracticality of bringing up spurious subjects while at a doctor’s appointment for other reasons. I was aware of BPPV through my training as an aviator, we were made familiar with inner ear and vestibular problems. Through my treatment of BPPV and discussion with the flight surgeon, his estimation was that there are many different causes for BPPV and unless the symptoms persist and are incapacitating, there is no reason for a grounding status and there is no good explanation for why some people get it and some don’t. The flight surgeon explained that exposure to explosions or noises so loud that one can feel them in their chest or head, or flying a high vibration aircraft such as a helicopter. I have documented history of exposure to these activities, which can lead to these calcium carbonate crystals becoming weakened and dislodge over time. It is important to note that no two episodes of BPPV are expected to be the same. The size of the calcium crystal, the position of the crystal as gravity moves it within the semi circular canal and the magnitude of the nerve receptor response will all play a part in the intermittent pattern of symptoms. One common theme of BPPV is the symptoms present themselves in relation to movement against gravity. The rating for BPPV should come under 6204 Peripheral vestibular disorders: I believe I should be rated at 30% for this service connected dysfunction because of the occasional staggering, the need to reposition when standing still and needing to find something to hold on to when seated and having occasional dizziness. Peripheral vestibular disorders 6204 Dizziness and occasional staggering......................................................................... 30 Occasional dizziness................................................................................................. 10 Note: Objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned under this code. Hearing impairment or suppuration shall be separately rated and combined.

Thank You Berta, so it sounds like I'm on the right track with an appeal? I will pair down the facts and site specific Dr. visits to support the claim in a chronological order. I don't know if the VA recognizes the Eply maneuver to 'cure' BPV, but it is a medically accepted practice to move the piece of carbon through the eustachian tubes. Should my appeal be worded to "split" those two items, or two appeals to recognize each item on its own merit, with accompanying documentation? VR Frank

Hope I am am posting to the right place. I received 0% on Sensitive vagal parasympathetic nerve reflex and benign paroxysmal position vertigo. These two disabilities (claimed as pre syncope syndrome and vertigo) are evaluated together because the share etiology and symptoms. I don't believe that these two disabilities should be lumped together. I don't believe that there should be 0% on either of these two disabilities. I started my appeal with a rough draft and wonder if anyone could take a look at what I'm saying and see if my research and reasoning are on the right track. The rough draft follows: Any feedback is appreciated. Appeal to separate the benign paroxysmal position vertigo from the Sensitive Vagal parasympathetic nerve reflex. Appeal: My appeal is to separate the benign paroxysmal positional vertigo and the sensitive vagal parasympathetic nerve reflex into two separate claims. The first being rated as 6420 at 30% and the second being rated as 8210 at 30%. The following is my argument and supporting medical history for the two ratings: I experience dizziness frequently in several different ways: The primary experience is the momentary feeling of falling or tumbling that lasts for several seconds. It causes me to stumble when walking, or seek firmer footing when standing and use my hands to stabilize when seated. The feeling comes when least expected and happens on a frequent weekly basis. I also experience is a sensation of having my environment continue to move when I stop or change directions. For example I can be standing still and turn myself to see or respond to someone calling out to me and the turning sensation will continue after my body stops. This also happens when I am walking in a straight line and turn a corner. I will feel as if my body is still moving in the direction that I was going before turning the corner. (I am in the process of going through my 900 pages of medical records to show where I have complained to doctor and neurologist about this) In _(Find date oftreatment)______ I experienced an incapacitating case of benign paroxysmal positional vertigo where I was unable to move between laying down and sitting up without incapacitating dizziness and nausea. I went to the flight surgeon that was very familiar with this condition and he treated me using a head movement method called “the Eply maneuver” where the head is moved along various rotational planes for approximately 30 seconds. The Eply maneuver is used to help usher out tiny crystals of calcium carbonate, which are a normal part of the inner ear’s anatomy, that have detached from the otolithic membrane and settled in one of the semi-circular canals. The procedure worked, I was able to function normally after the procedure. This fact lends itself to a certain diagnosis of BPPV. Through my treatment of BPPV and discussion with the flight surgeon, his estimation was that there are many different causes for BPPV and unless the symptoms persist and are incapacitating, there is no reason for a grounding status and there is no good explanation for why some people get it and some don’t. The most common cause of BPPV for persons under 50 is concussive force to the head. The flight surgeon explained that exposure to explosions or noises so loud that one can feel them in their chest or head can lead to these calcium carbonate crystals becoming weakened and dislodge over time. It is important to note that no two episodes of BPPV are expected to be the same. The size of the calcium crystal, the position of the crystal as gravity moves it within the semi circular canal and the magnitude of the nerve receptor response will all play a part in the intermittent pattern of symptoms. One common theme of BPPV is the symptoms present themselves in relation to movement against gravity. The rating for BPPV should come under 6204 Peripheral vestibular disorders: I believe I should be rated at 30% for this service connected dysfunction because of the occasional staggering, the need to reposition when standing still and needing to find something to hold on to when seated and having occasional dizziness. Peripheral vestibular disorders 6204 Dizziness and occasional staggering......................................................................... 30 Occasional dizziness................................................................................................. 10 Note: Objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned under this code. Hearing impairment or suppuration shall be separately rated and combined. The essential part of my argument to split the BPPV rating apart from the Sensitive Vagal Parasympathetic nerve reflex is that the BPPV was identified by an incapacitating episode of dizziness and treated successfully using the Eply maneuver. The second part of my argument is centered around a well-documented conclusion that the vagal Parasympathetic nerve reflex (VPNR) is caused by position of the neck specifically, it affects the 10th cranial nerve as it travels down the right side of my neck and specifically where the Vagal node is located where one would check for a pulse on the carotid artery. Background: Post surgical fusion of my neck and subsequent physical therapy dated and documented _date_ brought about a correlation between executing the stretching exercises assigned and a feeling of fainting, or the dizzying panic that comes with a rapidly lowering heart rate and blood pressure. I had been assigned a stretch to reach up with my left hand and pull my head directly to the side. This stretch caused the right side of my neck to stretch out and subsequently allowed me to draw an undeniable relationship between the position of my neck and the feeling of being ready to loose consciousness. Throughout the period from cervical surgery to present day I have suffered from episodes that felt as if I was going to faint. The symptoms could be grouped into simple dizziness, but they are very different. The more frequent these episodes became the more I was able to narrow down the position of my neck. The example I gave to the doctor, which allowed me to see a cardiologist is one where I was driving down the road and talking on my cell phone. I had the cruise control on and was lazily laying on my right side, right elbow on the center map case with my cell phone in my hand. This was causing my neck to be flexed in such a way that the vagas nerve was affected and it caused the vagal response. I felt dizzy, flushed; panicked and thought I may loose consciousness. I immediately hung the phone up, sat up straight and focused on driving. The symptoms left me as quick as they came and I felt normal. During the same drive I resumed my phone call. For the second phone call, I placed my left elbow on the driver’s side window to hold my phone in the left hand. I leaned my head to the left in such a way that it stretched the right side of my neck and I quickly had the same symptoms as before and I learned that this panicky dizziness with impending feelings of loosing consciousness were brought on by the position of my neck and held stationary in such a way that the vagas node on the right side of my neck was affected. The range of motion is quite small that brings about the vagas response. The physical therapy provided where I was actively pulling my head to the left and inducing the response and the more slight tilt of my head directly to the left allowed my cardiologist to draw the conclusion that the Sensitive Vagal parasympathetic nerve reflex was caused by some type of dysfunction on the right side of my neck where the Vagal node is located. The rating for sensitive vagal parasympathetic nerve reflex should come under 8210 Peripheral vestibular disorders: I believe I should be rated at 30% for this service connected dysfunction because of the extent of sensory and motor loss to my blood pressure, heart and respiratory system. There is frequent dysfunction, which can lend itself to distracting and dangerous situations. Tenth (pneumogastric, vagus) cranial nerve 8210 Paralysis of: Complete 50 Incomplete, severe..................................................................................................30 Incomplete, moderate..............................................................................................10 Note: Dependent upon extent of sensory and motor loss to organs of voice, respiration, pharynx, stomach and heart.