Jump to content
VA Disability Community via Hadit.com

Ask Your VA   Claims Questions | Read Current Posts 
Read Disability Claims Articles
 Search | View All Forums | Donate | Blogs | New Users | Rules 

chrome_305

Third Class Petty Officers
  • Posts

    40
  • Joined

  • Last visited

Posts posted by chrome_305

  1. Hi, All

    I just awarded 70% in MAY 13 that was backdated to July 1, 2011, but I was on Pension since Nov 2011. I called peggy today becuase i couldn't understand the amount deposited in my bank and they said that since I was on pension that the retro is being offset by my pension payments. Can this happen?

    eg: 70 % for single is 1336 and pension for single is 1038 the difference for it would be 298.

  2. I LOVE it !!!!!

    Re: this part:

    “Please prepare and award the proper rating and retro payment as an accrued benefit to me, under this clear and unmistakable error in the enclosed findings.”

    I would take out the “as an accrued benefit to me “ part as that only refers to survivors claims.

    This section of M21-1MR ,

    www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_16.DOC, states that

    “Reasonably raised claims for IU may arise in a Veteran’s original claim or in a claim for an increased rating. The Department of Veterans Affairs (VA) must consider a claim for IU if

    • the Veteran’s SC rating meets the minimum schedular criteria found in 38 CFR 4.16(a), and

    • there is evidence of current SC unemployability in the Veteran’s claims folder or under VA control.

    Reference: For more information on reasonably raised claims for IU, see

    Norris v. West, 12 Vet.App. 413 (1999).”

    ( This is under the link above for M21-1MRE,Part 4, Subpart ii,Chapter 2, Section f, under “h”.)

    The key word is “Must” if both above requirements have been met.

    'evidence of current SC unemployability' could be a SSDI award VA is aware ofm based solely on SC disabilities and/or a Voc Rehab statement that found the veteran's Scs precluded them from employment.

    In my opinion, it those 2 criteria are met, and VA does NOT consider a vet for TDIU, then that is a CUE on their part.

    However, I just noticed something else in what you stated:

    VA said

    "We determined that you are entitled entitlement to both VA pension and service connected disability. Overall rating or combined rating of 70%.” So I am assuming the pension would have been based solely on the SC conditions.

    NSC pension-

    Eligibility

    Generally, a Veteran must have at least 90 days of active duty service, with at least one day during a wartime period to qualify for a VA Pension. If you entered active duty after September 7, 1980, generally you must have served at least 24 months or the full period for which you were called or ordered to active duty (with some exceptions), with at least one day during a wartime period.

    In addition to meeting minimum service requirements, the Veteran must be:

    • Age 65 or older, OR

    • Totally and permanently disabled, OR

    • A patient in a nursing home receiving skilled nursing care, OR

    • Receiving Social Security Disability Insurance, OR

    • Receiving Supplemental Security Income

    from: http://benefits.va.gov/PENSIONANDFIDUCIARY/pension/vetpen.asp

    So, if you fall under the second category (deemed totally and permanently disabled) for the pension award, in my opinion this too should have triggered the VA to consider you for TDIU.

    Because I am assuming that the disabilities they used for both the Pension and the SC award are the exact same ones.

    I used this very point in my recent request for the VA. To CUE itself.

    When VA awarded a 100% retro for only 6 months, under 1151 in my award last year, for my husband's prior NSC, yet changed to Section 1151 Stroke, he fell into the second category above by all medical evidence of record for the first 6 months after the stroke and then started to receive SSDI for the stroke (which was changed to PTSD after we filed reconsideration).They still have refused to acklnowledge his TDIU form but 100%,when they fix this CUE, will due.

    I feel we both have very similar issues.

    Last week I thought maybe I was going nuts. (That happens to me when I review my claims and start to doubt my own thinking ability.....part of my VA induced PTSD)

    Much of my evidence for the similar CUE request I filed , was dated prior to my husband's initial SSA award.

    One piece of my evidence is a letter dated 1994 from the then UnderSecretary of Benefits RJ Vogel,VBA Washington DC, who stated that they were having problems getting my husband's SSA records and he was (at that time) 30% for PTSD and , as Vogel stated, had suffered a 'permanent and total” NSC stroke.

    I checked the above NSC link from VA days ago to make sure that a P & T designation by VA, ,whether pension or SC, is the same thing.Apparently it is.

    My award from last year changed the stroke to 100% 1151 yet VA claimed only 6 months was P & T as well as 100%. They were completely wrong.

    So the pension award you have might also be beneficial to raise under your CUE request as well as the other stuff you mentioned,if it was based on the “Permanent and total criteria” of the pension regs.

    I will re read this topic later and add anything else I can think of......I think you prepared an excellent CUE request and keep in mind, a timely NOD might well still have to be prepared,unless they resolve this favorably first.

    One other thing....when I cite a regulation they broke or anything from M1-1MR that they did wrong, I refer to and enclose a printout of the exact reg and/or M21 statement.

    38 USC holds the laws that govern the VA, CFR is the way they are supposed to be applied,and M21-1MR is the VA's manual that takes them step by step as to how to do that. A violation of M21-1MR,in my opinion, and I have made that point to VA, in my last CUE claims, is a CUE.

    M21-1MR also contains the exact case law references so that too can help use M1-1MR to support this type of request.

    Thanks for great information Berta, I will definite be using it.

    As far as the NOD I think the time on it doesn' t start since I wasn't mailed a TDIU form. I believe I read it some where but can't find it again dry.png .

  3. I had a over all rating of 0%. When I was awared Pension in 2011. Just was successful an appeal to 70% PTSD dated May 2013 back pay to june 2011. My NOD is counting down and what i have below I want to submit as CUE but need help. Now, Should I not be considered P&T since I have both comp & pension plus I have updated PTSD DBQ and records all in VA hands.

    I dont plan to use all but need anyine everyone help. TIA

    ====================

    I respectfully request the VA to call a clear and unmistakable error "CUE" under evidentiary requirements of 38 CFR 4.6., 38 C.F.R. 3.160,38 USC § 5109A, 38 C.F.R. 3.155, 38 C.F.R. 3.156,38 C.F.R. § 4.16(a) , 38 CFR § 3.3(a) (2) (iv)) and to correct it.

    1. Lack of TDIU consideration occurred in decision rating dated May 24, 2013 VARO St. Petersburg Regional Office. Rating Decision dated May 24, 2013 "We determined that you are entitled entitlement to both VA pension and service connected disability. Overall rating or combined rating of 70%. We do not add the individual percentages of each condition to determine your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious condition" " We enclosed VA form 21-8764, " Disability Compensation Award Attachment-Important Information" which explain certain factors concerning your claim.,

    Decision letter fails to acknowledge, refer or address TDIU."

    Summary: Veteran is entitled to a 100% disability rating if he can established that his service-

    connected disability [ies] preclude him from obtaining gainful employment. “TDIU”, referring to a Total Disability rating based upon Individual Unemployability. See 38 CFR § 3.3(a) (2) (iv))

    2. Decision letter May 24, 2013, C&P exam dated March 28, 2013 (PTSD Initial DBQ), VA Pension award granted Nov 1, 2011, and VA Pension Eligibility Verification Report 2011-2013 contain sufficient and current detail to warrant an adjudication for which is "reasonably raised" by the records documents or medical records held by VAMCs to include VARO St. Petersburg Regional Office, while not explicitly in the C-file, were still in the VA’s “constructive possession”.

    Summary: An informal request for TDIU or IU should apply to rating decisions May 24, 2013 awarded July 1, 2011. Potential entitlement to TDIU is part of every claim for disability compensation. See Rice v. Shinseki, 22 Vet. App. 447, 454-55 (2009) 38 C.F.R. § 4.16(a)

    3. See 38 C.F.R. 4.16 (Ratings for compensation based on unemployability)

    “Total disability ratings for compensation may be assigned, where the scheduler rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities..."

    Summary: The current over-all rating for service connection compensation of the veteran is 70% dated May 24, 2013. Equally, when a claimant or the evidence of record reasonably raises an informal claim for TDIU, the Secretary must furnish the claimant the form (VAF 21-8940) as prescribed by the Secretary. See 38 C.F.R. 3.160

    4. See Rating decision dated May 24, 2013: Enclosures: Evidence and Evaluation Criteria page seven.

    Summary: Rating Decision dated May 24, 2013 granting 70% does not contain form VAF 21- 8940.

    5. See: 38 C.F.R 3.155(a) See also: Enclosures: Evidence and Evaluation Criteria contained in rating decision dated May 24, 2013 page seven.

    Summary: “Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution."

    6. See: 38 C.F.R. 3.156

    Summary: The veteran is entitled to an effective date for the award of TDIU as of the date of his original claim, that being July 1, 20011. See also: Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009); see also Floyd v. Brown, 9 Vet. App. 88, 96 (1996) See: AB v. Brown, 6 Vet. App. 35, 38 (1983); see also Roberson v. Principi, 251 F.3d 1378, 1383 (Fed. Cir. 2001); Norris v. West, 12 Vet. App. 413, 421 (1999).

    Summary: A veteran is not required to file a TDIU application form before the VA is obligated to consider and adjudicate a TDIU claim. When a veteran files an original claim for evaluation of a disability or a claim for an increase in the evaluation of a disability that has already been rated by the VA, the claimant is generally presumed to be seeking the highest benefit allowable.

    Summary: If it is apparent that the service connected disabilities keep the veteran out of the work

    force, then VA must assign the rating of 100% disabled due to Individual Unemployability.

    I take exception to and preserve for appeal ALL errors the VARO may have made or the Board hereafter might could make in deciding this appeal. This includes all legal errors, all factual errors, failure to follow M21-1, all due process errors and any failures to discharge the duty to assist as violation of basic VA laws and regulations within 38 USCS and 38 CFR.

    Please prepare and award the proper rating and retro payment as an accrued benefit to me, under this clear and unmistakable error in the enclosed findings.

    =================

  4. hey guys here is a update I got the envelope in the mail.....

    Here is what the approval says it says ....."Your lay testimony was adequate to establish the occurance of the claimed stressor and the claimed stressor is consistant with the places, types, and circumstances of your service. the VA exaiminer also related your stressor to the fear of hostile military or terrorist activity, and the exaiminer linked your PTSD symptoms to the stressor.

    An examination will be scheduled at a future date to evaluate the severity of your service connected PTSD (posttraumatic stress disorder)."



    Then it goes on and denies some claims saying they dont have the c-file and their are some they denied saying this multiple times "The evidence does not show an event, disease or injury in service." When there is.

    It also says ...

    "we determined that you are entitled to both disibility pension and service connected compensation. Under Va law yo can't recieve both benifits at the same time. We have granted service connected compensation as the greater benefit. However, you may choose( or 'elect') to recieve either benifit program at anytime. Your overall or combined rating is 70%. We do not add the individual percentages of each condition to determine your combined rating. We use a combined rating table that considers the effects from the most serious to the least serious conditions. We enclosed Va form 21-8764, "Disibillity Compensation Award Attachment-Important Information" which explains certain factors concering your benifits."

    Here is the break down for giving me 70%

    We have assigned a 70 percent evaluation for your PTSD based on:

    • Occupational ans social impairment , with deficiencies in most areas, such as work,school, family relations, judment, thinking, or mood
    • difficulty in adapting to a worklike setting
    • Difficulty in adpating to stressful circumstances
    • Inability to establish and maintain effective relationship
    • obsessional rituals which interfer with routine activites
    • Speech intermittenly illogical
    • Suicidal ideation
    • The exaimer assessment of your current mental functioning, which is partially reflected in your Global Assessment of Function score found below
    • Difficulty in establishing and maintaining effective work and social relationships
    • Disturbance of motivation and mood
    • Flatted affect
    • Impaired judment
    • Panic attacks more than once a week
    • Anxiety
    • Chronic sleep impairment
    • Depressed mood
    • Suspiciousness

    It goes on to say why I fit in the 70% category and not 100% for PTSD.

  5. Sorry I thought you had already been to the BVA and the disabilities you have listed as reopened were reopened (remanded) by the BVA.. I must say it's difficult to follow your claim.

    Best Wishes

    C.B.

    I have been denied those things labeled"reopen" and had let time expire but everything got reopen in 2011. Everything reopened was rated non service connected except rash on chest which was 0%

  6. Congratulations, 'Crome_305'... and good luck on the remands. You mentioned, you recently checked e-benefits, and it came up with 70% P&T (Permanent and Total)

    Is there an unemployability issue the VA has considered? Do you have a service rep?

    Best wishes,

    C.B.

    What is remands?

    My latest DBQ for PTSD says issue with work and that I haven't had a gainful work since 2010. I have plenty of mental health records showing issue with work.

    I do have a Rep but not a good one.

  7. Just having a diagnosis - does not make a condition SC'd.

    What medical evidence is of record / or do you have

    that shows a connection of the two blood disorders above,

    to either active duty - or medically related (secondary to) to an already SC'd disability ?

    This is what I have. A C&P report which has neuropenia axis from May 2006. Report also has lab results in the C&P showing the blood levels and says the condition is due to military service. I was discharged Sept 2005. There is also VA lab reports (lots), metal health diagnosis reports, VA doc report that says "Neutropenia now with mild Thrombocytopenia" that I sent them during my appeal.

    ======================

    I understand what your saying Berta. I filled for the "new" disibilities and secondary all at one time. VA added those items to the recent appeal. Shouldn't the VA have added those this long ago for me even if it was non service connected.

  8. A diagnosis is only one step.

    Until a condition is rated as SC by the VA - it is not really SC'd.

    In 2006 the C&P examiner may have opined a diagnosis but were these

    two adjudicated as SC'd ?

    I forgot all about the C&P report from 2006 until recently. I ask for all my C&P exams from VA clinic (which i have done plenty of times blink.png ). I went to my Va rep filled a claim send VA proof of the C&P from 2006 and also follow up lab results which they can produce themselves since I have been a blood bank to the VA since 2006.

    Then Va added the condition to my appeal as "new". i just recently did this while the appeal was gathering evidence phase.

    I never heard anything from the VA about a rating for the now "new" conditions after the C&P exam from 2006.

    My secondary diagnosis of Thromboyctopia is connected to Neutropenia. The VA can even Google it if they want. Shouldn't that at least be rated 10% by VA law?

    ================

    Also the Va has the "new" condition on E-bennies misspelleddry.png

  9. Congratulations on you win! I am not sure with your question hopefully someone has an answer for you. I would say yes on the P&T at 100%

    ty

    Congratulations!

    After you get the award letter, send in your dependents forms, along with birth certificates, AGAIN. The VA loves to deny dependent claims because you did not send in the stuff TWICE...once when you applied, and again after your award.

    See the thing is I sent the info in 4 times already once by mail,fax ,phone, VA rep. They even closed my dependency claim because it went to wrong department. -_- and reopened it after I called and did a Inquiry.

    Can I get SSDI and should I file for TDUI if im not 100%. Im a little confused since I was getting VA pension. I guess happy and nervous :D

  10. I looked again on e-bennies and went the "file new claim route". I seen that the 70% is for PTSD but all the conditions that were labeled "new , reopen & 2ndary" are shown as not-service connected. I have proof that they are service connected since I have a C&P exam from 2006 that has a diagnosis of " neutropenia and pes plantus" which I also sent the VA. Funny thing is the VA didn't give me an exam for the new conditions.

  11. My Current SC%
    Last Rating Decision was in 2010
    Currently awarded Va Non-service pension since Nov 2011
    Rating(s)
    1. Dysthymic disorder ( Not Service-Connected)
    2. Chest wall syndrome, claimed as chest pain, tightness and difficulty breathing (0%)
    3. Hearing loss, left ear (Not Service-Connected)
    4. Tinnitus, claimed as ringing in the ears ( Not Service-Connected)
    5. Residuals of fracture of the left ring finger with pinning, to include post traumatic arthritis with ankylosis of the distal interphalangeal joint (dominant) (0%)
    6. rash on chest ( Not Service-Connected)
    7. sycosis barbae, claimed as razor bumps of the face (0%)
    8. PTSD (posttraumatic stress disorder) (Not Service-Connected)

    ======================================================================

    *My claims
    Date Opened: 6/24/11
    Type of claim: Appeal
    Est Completion Date:Done
    1. PTSD (Reopen)
    2. Tinnitus (Reopen)
    3. Rash on Chest (Reopen)
    4. Hearing Loss, Left Ear (Reopen)
    5. Hearing Loss, Right Ear (New)
    6. neutropenial leukopenia (New)
    7. bilateral pes planus (New)
    8. mitral valve (New)
    9. thrombocytopenia 2nd to leukippenia (Secondary)
    ==========================================================================
    That you everyone this site is awesome and very helpful. I check ebbenies today and my AB8 showed me rated at 70%, but it also show the pay rate as single. I also check the benefits explorer and it showed 70% on both and P&T. I currently still have a dependency claim thats open but pending decision approval.

    The thing I was wondering is what to do next? I have been getting the VA pension since 2011 which would mean I am P&T so shouldn't I be rated at 100% and P&T and not 70%?

    I don't have SSI or SSDI. It's been a long battle with the VA. I don't know what was rated what yet. I will keep you guys updated.

  12. I got an email from a very reliable source that informed me that his/her office has decided that they had screwed up my claim for my Back. I was finally awarded in Dec 2012, with retro back to 2011. But, I had injured my Back in 1969, and upon discharge, I had put in a claim, but would always get the same rely that I did not injure my Back in the service. There is nothing in my medical records. Even after sending them copies of the medical records, still denied. Gave up. Could not get any VSO to help. My source said that he/she does not believe it will go back to my first claim, but maybe to the claim that I put in prior to the 2011 claim. BTW, I did not ask for this, and it comes as a total surprise.

    Papa

    :O Same kind of story as me except VA hasn't ever called. lol.

    I put in a claim in 2006 that was denied service connection but awarded medication for Dysthymic Disorder. Sent them info that I have a Diagnosis from a VA doc which was within one year of service but still denied .Sent them proof that they even say I have a diagnosis within one year in their rating decision letter. Yet i'm still denied. Then I gave up. tried again in 2008 denied. Went to VSO with proof and told him my story only to see him do nothing really but make copies and get forms ready.

    Now, I just keep sending the C&P report from 2006 as new evidence in hopes it lands in the right person hands in the VA who can read.

  13. Many websites you "visit" can track you in computer land. Some can tag personal information from other sites you have volunteered personal information to. I understand the need for the DOB of children and marriage dates to make a completed calculation BUT I thought this was not considered as part of your original claim. Dependency claims are filed separately. Determining the retro pay for a compensation claim would NOT require these dates, IF that be the case. Determining the dependency retro once it is filed isn't difficult and would not require a computerized program, possibly a calculator to simply the calculation. BUT, this is a take on my understanding of how this whole mess works, I may be WAY out in left field???????? I do not know if Rodger Dodger's program is a "trap" and have no opinion on it. Just wondering why there was a survey in the first place.

    Because it a trap. he opened two post saying the same exact thing.

  14. My Current Claims
    *My claims are in the Prep for decision phase*
    -------------------------------------------------------------------------------------------------------------------
    1st Claim:
    Date Opened: 6/28/11
    Type of claim: Appeal
    Est Completion Date: New date: 8/13-1/14 | Old date: 6/12-8/13
    1. PTSD (Reopen)
    2. Tinnitus (Reopen)
    3. Rash on Chest (Reopen)
    4. Hearing Loss, Left Ear (Reopen)
    5. Hearing Loss, Right Ear (New)
    6. neutropenial leukopenia (New)
    7. bilateral pes planus (New)
    8. mitral valve (New)
    9. thrombocytopenia 2nd to leukippenia (Secondary)
    2nd Claim:
    Date Opened: 4/19/13
    Type of claim: Dependency Claim
    Est Completion Date: (New date: 8/13-2/14) (Old date: 10/12-4/13)
    ReOpened but shows as new claim
    Started receiving VA Pension in Nov 11
    First Opened claim Oct/12 to add dependents
    Claim sent to wrong department and closed 4/13
    Should be back pay since claim was within one year
    3rd Claim
    Date Opened: 4/10/13
    Type of claim: Freedom of information Act/ Privacy Act Request
    Est Completion Date: N/A
    Requested my C-file & Inquiry on Dependency claim
    -------------------------------------------------------------------------------------------------------------------
    My info : Entered service Sept 2001 / Honerable discharge Sept 2005
    Had a C&P for PTSD last month and got the Initial DBQ .The report seems to be in my favor for PTSD. It says the magic VA words, states the condition is related to service , that I have been getting treatment since discharge and that I been baker Acted four times.
    In the notes in the report it also says that I was diagnosed with Dsythmic dysorder at time of discharge. I tried to claim the Dysthemic disorder in 2006 but was turned down even on NOD.
    The C&P report from 2006 has a diagnosis of it and the rating decision has me awarded treatment for it since it was with-in a year of discharge. The thing is I tired to reopen it with the current appeal claims but they didnt add Dysthemic Dysorder to it.
    Can I reclaim/reopen claim for Dysthymic Dysorder even though it is closed but should have been added? or should I wait to find out SC% on the current appeals.
    There was no exams so far for the "new" condition I listed above. I called Peggy and they said if they needed more info they would let me know. They do have updated medical reports about the new claims like Neutopenia. My first C&P report has a diagnosis of the new conditions I'm claiming. I wish I knew before about the C&P for condition like neutropenia. I could have filed a claim in 2006 but found out about it last year. :(
    -------------------------------------------------------------------------------------------------------------------
    My Current SC%
    Last Rating Decision was in 2010
    Currently awarded Va Non-service pension since Nov 2011
    Rating(s)
    1. Dysthymic disorder ( Not Service-Connected)
    2. Chest wall syndrome, claimed as chest pain, tightness and difficulty breathing (0%)
    3. Hearing loss, left ear (Not Service-Connected)
    4. Tinnitus, claimed as ringing in the ears ( Not Service-Connected)
    5. Residuals of fracture of the left ring finger with pinning, to include post traumatic arthritis with ankylosis of the distal interphalangeal joint (dominant) (0%)
    6. rash on chest ( Not Service-Connected)
    7. sycosis barbae, claimed as razor bumps of the face (0%)
    8. PTSD (posttraumatic stress disorder) (Not Service-Connected)
    -------------------------------------------------------------------------------------------------------------------
    Can anyone give me a WAG on SC% for the appeals or what to do from here on out. Should I worry about not being service connected for Dysthymic dysorder when its in my 1st C&P and I am awarded meds for it.
  15. Sounds good.

    My dependency claim was opened Oct'12 via phone & fax & mail> Claim closed and disappeared from Ebennies on 4/3/13 because it never went to correct department > Got a letter on 4/5/13 saying I can not get dependent benifits unless im 30% or higher. > Shows as new claim for dependency 5/18/13 (today).

    I have been awarded VA pension since Nov 11 and been trying to add the dependents since Oct 12. I think the VA should have known. At least the retro should be nice I guess.

  16. Unfortunately, dependent comp of any typr is a lower priority issue with VBA at this time,

    so I think it will take a while to get solved.

    JMHO

    See the thing is the claim was already processed. Well kind of processed since it disappeared from Ebennies. There is not even a history of it showing that it was closed. Makes me wonder how they just looked at my SC issues and didn't think about me being awarded the pension.

  17. Definitely call and write in and ask about the status of your dependency claim if there isn't one then tell them that you wish to follow up that way it's done within a year

    Yea, everything was submitted with-in a year and the letter I received was for my dependency to be added to my pension so I thought.

    I will call them tomorrow and ask them why I got the letter which makes no sense, why I am being paid as singe instead of being awarded my dependents when they spend seven months processing the claim.

    The funny thing is that my claim was opened Oct 2012 it was suppose to be finished April 5 2013. Well around April 3 2013 the claim fell off Ebennies and I called the following day and no one had any answers. It was no where to be found on Ebennies. I think the VA got it all wrong since VA pension and dependents should be calculated per their Veterans Pension Rate Table.

  18. The letter had to have told you why (other than 30%) you are being paid as a single? Marital history discrepancies? Dob Ssn and place of birth missing for children? If adopted living under same household, or proof or relation to out the exact verbiage on the notification letter. Normally that is under the amount box....

    "We are paying you as..." Then it goes on to tell what is missing or why they can't add dependents

    wife. If it says 30% then I would be making a call. I really can't tell you with

×
×
  • Create New...

Important Information

Guidelines and Terms of Use