jamescripps2

I don't mind telling you that my strategy and resultant award was in large part due to some excellent advice given to me by Alex Gram, aka Asknod. The whole thing played out and is documented over on the SMC "M" thread. There are not many people who understand the SMC regulations enough to carry on a decent conversation on the subject but Alex has a pretty good handle on it. Thanks a million Mr. Alex Gram, you make a difference! Without a call to the Veterans Whitehouse Hotline I would still be waiting for my appeal to be certified to the BVA. I owe Mr. Trump for that one!.

Yes I am there. My appeal only took eight months. In October , 2015, I was awarded loss of use of a hand and a foot and got the vehicle grant w/adaptive equipment and the SAH grant. I appealed that decision because upon any new 100% grant the VA is obligated by statute to consider A&A as an inferred issue and they failed to do that. In December 2015, I appealed the decision because A&A was not considered as an inferred issue. My contention was, I was awarded SMC "L" for loss of use of two extremities in the decision. Had the VA considered A&A as an inferred issue at the time of that decision as they should have, I would have qualified for regular A&A. An A&A award is also a SMC"L" award. According to 38 CFR 3.350 and USC 1114 if you are entitled to two separate ratings between L and N you qualify for the "O" award. In my case I have two awards at SMC L that qualify for SMC "O". The A&A automatically goes to the R-1 rating if you obtain the prerequisite "O". I got eight months retro but will appeal the decision for an earlier effective date of January 2011, the date that the loss of use claim was filed. More later.

Well, I said on this thread that I would reply back when I got the SMC "O" and "R1" award. I did succeed with my appeal and I now have the R-I. I will continue this thread over at the R-1 posting on this forum.

To get to R-2 you would need to show that you need care on a daily basis and that care would require and be preformed by a licensed health care professional.

Berta, I think that the VA has another word for what you are calling "proactive". I was always taught that hell was down but I have been so low that I had to look up to see hell! I know that you have seen hell from that perspective too. that seems to be the tie that bonds people like you and I. I am proud of what I have learned from the VA experience including what I have learned from you, Alex, and others. but ashamed that I don't know more, YET For the last twelve years I have kept a 38, CFR on the sink next to the commode. If I would have eaten more chili and Krystal hamburgers over the years, I would have gotten a lot smarter! Now, that is a bit of hind sight for you. One thing really bugs me, seems that I will be awarded the maximum award before I get a chance to appeal the denial on the claim for increase for diabetes, including a 'Colvin violation", due to my Endo doctor regulating and restricting my activities. And I haven't filed on the OSA yet either. I have beyond a doubt proven the service connection as due to heart disease, good nexus letters, IME and IMOs in order and ready to go. What a waste! I think I just might file and appeal anyway and blame it on my service connected severe anxiety and depression..

Yeah, asknod, they made me get doctors letters too. Did everything short of a biopsy of the brain, but evidently I got a green light. I am in no hurry, the OGC can drag me through the mud if that makes them happy.

In October of last year, (2015) I was awarded SMC "M"+1K, Vehicle grant W / adaptive equipment, a SAH grant and four years retro. I appealed the decision after I banked my retro and got my vehicle. The reason for the NOD was that they did not infer A&A upon the granting a new 100% grant for loss of use of two extremities. they pitched me a bone! Ok, good and bad news now, the bad first. The VARO, as a result of a DRO Denovo review, denied my claim for SMC "O" and R-1. According to the reasons and basis given in the decision it was denied because my 21-2680 Application for A&A was not filled out exclusively for heart disease. Take a look at that form, under the circumstances and the questions asked, my doctors filled out the form as best as they could. The questions on the 21-2680 do not pertain to heart disease. The form is all about extremities and ambulation, no place for heart failure related answers. Now the good news. In correspondence contained in the RO decision denying the claim, the RO goes on to say that if I submit new evidence showing the need for A&A based solely upon heart disease, they would grant the "O" rating, based upon two ratings under "L", one for A&A and one for LOUx2. pay rate will be at R-!. I will be expecting retro of sixty one months. I contacted the Appeals team at the RO and asked them, "if I can send you the requested evidence will you make me go through a four year ride to the BVA or will you take another look at the requested additional evidence before it is certified to the BVA". i was told that if I submitted the requested information, they would quickly review the decision and new evidence at the RO. I asked for a new 21-2680 to be completed at the Advanced Heart Failure Clinic, VAMC Nashville, based solely on the need of A&A as due to heart disease. I obtained the completed form. I could not have asked for a more perfectly filled out form along with a good letter and addendum explaining, block by block, my need for A&A as due to each existing heart failure issue that I have. Meal prep, keeping ordinarily presentable, showering, protecting against dangers of every day living, frequent adjustment of a leg brace due to daily progressive leg swelling as due to HF. My turn around time for the new evidence submitted to the RO was only three days. Indeed it covers it all. No doubt that my next post will be made, not on the SMC "M" thread, but on the" yet unused" SMC "O" thread. IMHO within 30 days or less . It is a done deal, not if, but when, just unsure of the time line, depending on how the holidays effect the RO decision timing. i am studying for my VA Independent Agent Exam as I have now been approved by the OGC. The OGC almost denied me as a candidate because of my extensive service connected medical problems. Nothing wrong with my noggin. I will update as I progress.

In October of last year, (2015) I was awarded SMC "M"+1K, Vehicle grant W / adaptive equipment, a SAH grant and four years retro. I appealed the decision after I banked my retro and got my vehicle. The reason for the NOD was that they did not infer A&A upon the granting a new 100% grant for loss of use of two extremities. They pitched me a bone! Ok, good and bad news now, the bad first. The VARO, as a result of a DRO Denovo review, denied my claim for SMC "O" and R-1. According to the reasons and basis given in the decision it was denied because my 21-2680 Application for A&A was not filled out exclusively for heart disease. Take a look at that form, under the circumstances and the questions asked, my doctors filled out the form as best as they could. The questions on the 21-2680 do not pertain to heart disease. The form is all about extremities and ambulation, no place for heart failure related answers. Now the good news. In correspondence contained in the RO decision denying the claim, the RO goes on to say that if I submit new evidence showing the need for A&A based solely upon heart disease, they would grant the "O" rating, based upon two ratings under "L", one for A&A and one for LOUx2. Pay rate will be at R-!. I will be expecting retro of sixty one months. I contacted the Appeals team at the RO and asked them, "if I can send you the requested evidence will you make me go through a four year ride to the BVA or will you take another look at the requested additional evidence before it is certified to the BVA". i was told that if I submitted the requested information, they would quickly review the decision and new evidence at the RO. I asked for a new 21-2680 to be completed at the Advanced Heart Failure Clinic, VAMC Nashville, based solely on the need of A&A as due to heart disease. I obtained the completed form. I could not have asked for a more perfectly filled out form along with a good letter and addendum explaining, block by block, my need for A&A as due to each existing heart failure issue that I have. Meal prep, keeping ordinarily presentable, showering, protecting against dangers of every day living, frequent adjustment of a leg brace due to daily progressive leg swelling as due to HF. My turn around time for the new evidence submitted to the RO was only three days. Indeed it covers it all. No doubt that my next post will be made, not on the SMC "M" thread, but on the" yet unused" SMC "O" thread. IMHO within 30 days or less . It is a done deal, not if, but when, just unsure of the time line, depending on how the holidays effect the RO decision timing. i am studying for my VA Independent Agent Exam as I have now been approved by the OGC. The OGC almost denied me as a candidate because of my extensive service connected medical problems. Nothing wrong with my noggin. I will update as I progress.

If it is indeed a slam dunk, why did you even need an attorney? A legal team and an attorney cannot speed up your claim. Just because you have an attorney does not mean that you can buck the line.

If the VBA says that you were scheduled for an exam and it was mailed to your proper address, then the rule of regularity comes in to play. The rule of regularity says that the USPS is dependable and delivers the mail with regularity. if you contend that you did not get your mail, it is up to you, somehow, to prove it. ??????????? However, you can just state that you forgot, and beg for forgiveness, you don't have to prove that one..

DRO de novo revue comes first, then the statement of the case granting or denying, if denied, you only have 90 days from the date of the SOC to file a form 9 to perfect the claim for certification to the BVA. Lets just hope that it doesn't go that far. I have had two experiences with a DRO revue, first was denied and it was granted at the BVA. The second was granted at the DRO regional level. Good luck.

If you qualify, you may be granted A&A or housebound in fact, but not both at the same time. The determination would be up to the VA but they would be obliged tp pay the most beneficial benefit to the veteran. post 911 vets may qualify for caregiver compensation.

Just to clarify the above, I am not insinuating that an unscrupulous doctor might write you a letter in support of a claim. A dishonest doctor would do a veteran a disservice by doing so. When any doctor backs you up with a statement, he/she is placing their reputation on the line in support of a veteran and that professional should be commended for doing so.

I don't see a IME, an IMO or the required nexus letter, it will be required. A really good DBQ might suffice if the writer can make a connection to your already scd conditions but they will not just take it for granted. Go ahead and file the intent to file a FDC claim for the new conditions, that will mark your EED. Then get the IME/IMO, hopefully both together and then file the FDC.

That would be viewed by the VA as refusing medical treatment which could eventually be used against you. I agree with seminoles, you need to ask for a consult appointment with a Neurologist. if it can't be set up within thirty days, ask to use the Veterans Choice Program. Time is running out for the Choice Program and it will expire unless congress extends the life of the program. Ultimately, what you put into your body is up to you, just saying!

Good find syne 7 !

I like it all but I didn't pay attention in school, an incorporated spell checker would be a nice addition.

I am still learning Buck, next time I won't tell the nurse what I need, I'll just say it is personal. That ole gal acted like she had just caught me in the commission of a crime. She was so proud of herself that she noted my perceived transgression in my medical record.

I have written some of my own letters and asked a doctor to read and if they could concur, then sign on the bottom line. I looked up this example from my VAMC medical records to post here. The nurse asked me why I was there, I showed her the completed form and told her that I needed the doctor to read it and then sign it on the bottom line if it was in order. That nurse went bonkers on me. She yelled that the doctor would need to examine me before signing anything. She refused to let me see the doctor and proceeded to make a future appointment two weeks out. I kept that appointment and returned with the same form. I made the same request. The doctor read the completed form, concurred with it and signed it for me. All is well that ends well. LOCAL TITLE: PRIMARY CARE NURSING ASSESSMENT STANDARD TITLE: PRIMARY CARE NURSING NOTE DATE OF NOTE: JAN 04, 2016@10:09 ENTRY DATE: JAN 04, 2016@10:09:49 AUTHOR: EPPS,DENORIS J EXP COSIGNER: URGENCY: STATUS: COMPLETED Reason for Walk-In: PATIENT WALKED INTO THE CLINIC WITH A&A FORM FILLED OUT AND REQUEST PROVIDER TO SIGN AT THE BOTTOM LINE Signs/Symptoms:DENIES ANY PAIN

If that actually is just a draft, ask the doctor add to it in making the OSA connection on that same letter. He would be able to opine on the OSA,no matter what he treats you for. Focus on what you need done to make the connection and and just ask for it. Berta is right, you might consider writing your own letter. If you can get the doctor to concur and sign your letter then it is just as probative as if he/she had written it. Better yet, ask the doctor to transfer the letter to their letterhead.

Good letter indeed, but it fails to make a connection between OSA and asthama or sinus congestion.

John, the younger doctors don't even understand the true implications of AO exposure, much less the public. The younger generation connects the words agent orange with the pop music band.

I agree with Gastone but would rather see you go the TDIU route with an "S" award. Difficult to do if you are still working though. If you go the 100% scheduler route, you can still work. It does appear to me, that on the surface, the C&P examiner did you a good job. The exam should put you over the top. Generally, I would guess maybe a 30% award, but that comment the examiner made about how it affects your working ability adds considerably to the DBQ. It is not a wise move for anyone to try and guess what a rater might do, but you asked. I almost passed on my 2 cents but I could not resist. Nothing to loose considering that you are already at 93%. Who knows, with the bilateral factor added you just might reach 100 + 60 territory anyway. good luck and thanks for your service!

Berta, all I can say is "True Grit"! Been there and done that!

Berta got a bee in her bonnet, give em hell Berta.