jamescripps2

Don't over complicate matters. If your doctor did indeed diagnose you with DM II, and stated that diagnosis in your medical records, for service connection purposes, you are diabetic. Makes no difference how he/she came to that conclusion or what test was or was not preformed. As far as getting it service connected, that is a different matter and will involve more medical opinions in the form of multiple Nexus letters and an event in service that can be as likely as not identified as the cause of your diabetes.

After many years of working untold numbers veterans claims, After winning the first ever VA claim for AO inside CONUS FOR MYSELF. After producing the next three AO claims to win inside CONUS for other veterans. After winning a Korea AO claim for a veteran not serving in a unit on the DMZ. After winning a Thailand AO related sole surviving widow's claim for DIC along with accrued benefits for a non dog handler stationed at Utapao AFB. If I could sum it all up and explain in one sentence the most important fact of all, the most underutilized, hard to comprehend and misunderstood tool in veterans claims it would have to be, IF YOU CAN GET A DOCTOR TO SAY ITS SO, ITS SO. IF THAT DON'T WORK FOR YOU GET TWO DOCTORS TO SAY THAT ITS SO. IF THAT DON'T WORK, GET THREE! WHY TAKE A CHANCE, GET THREE TO BEGIN WITH AND NAIL IT THE FIRST TIME AROUND. HOW CAN A VETERAN AFFORD TO DO THAT ON A TIGHT BUDGET? I PLAN TO DISCUSS THIS EXACT IMPORTANT TOPIC ON THE PODCAST COMING UP ON THURSDAY EVENING OCTOBER 27TH. 6:00 CENTRAL TIME.

It is a fact that insulin injections cause weight gain problems. Another fact is that, yes, some VA doctors will be very adamant as to the cause of the OSA. If you expect a VA doctor to write you a letter then you need to know how to ask for it. Don't be meek, but rather confident and assertive. Ask for what you want.

If your C&P was actually preformed by the local VAMC you can get the result after three business days from ebenefits or from ROI at the VAMC. If your C&P was farmed out to be preformed by QTC your results will not be available to you until after the claim is decided.

The very first prerequisite for R-1 is to obtain a "O" rating. Read CFR 3.350 - 3.352 for eligibility rules. You don't mention anything about SMC "S" that you should qualify for, and you might qualify for regular A&A, depending upon your individual circumstances.

Marine,you need to be present at the C&P exam, not myself. The rater calls for the C&P exam. The request goes to the VA medical center. The medical center schedules the exam. The medical exam is preformed by the medical center or subcontracted out to QTC, just depends upon where your medical center is located. Any complaints by the veteran are to be addressed to the patient advocate of that medical center.

You are so right, that IMO is a book. I am very interested in your claim and as to why you was denied. Frankly, The IMO is too much for a rater to read, I found it boring and hard to comprehend myself. It was just easier for the rater to just pass the buck by denying the claim. An adequate IMO, IME is usually one page or less. It is to the point and does not go into detail. More is not better. You can win that claim if you are willing to go doctor shopping as I explained up post. Go after multiple letters to defeat that C&P examiner. Use the format from usva 101.org. I wrote that four years ago. notice the counter at the bottom of the page as to how many times it has been copied for use. Three properly written nexus letters in your favor is considered overwhelming evidence. Also, look up information on the C&P examiner, what are his qualifications. I would be adamant that the C&P exam was inadequate and would ask that the C&P be repeated with my being present. Complain about the quality of the exam in writing to the patient advocate at your medical center, not the RO. I did that myself in FEB 2016 and I was granted another exam was in March. Ask for a reconsideration at the regional level, you may need to do a NOD but you can just ask that they take another look, after you add more opinions and dispute the C&P. Do not get distracted and let the 1 year NOD deadline go by without filing a NOD to protect your EED. And yes, this may turn into a DRO de novo review. With three proper medical opinions you can win this at the regional level. Be tenacious and proactive in the claim if you really want to win it. Your first decision is SOP if you don't dot Is and cross Ts. Know that if you get a SOC as a result of filing a NOD, you only have 90 days from the date of the SOC to get the form 9 turned in.

Everything that you need to know about a nexus letter can be found at usva101.org. Click on NEXUS LETTER. Print yourself a copy and take it to your doctor, ask for a conforming letter. If you have medicare, medicade or any other outside insurance, use it for the exam and resultant letter. Ask your VA doctor for a letter, or, at least put the diagnosis and any helpful remarks in your record. You can retrieve the record and use it as evidence in your claim. You just be up front and out right tell the doctor that you need a letter and explain that the VA requires a nexus letter in order to win your claim for your veterans benefits. If you don't have outside insurance then call the doctor's office. Explain what it is that you need and ask for a price for the visit. Just go doctor shopping and expect to pay $85 to $100 for the visit and letter.

Buck, While I was in Germany I went to Schwetzingen every Friday to buy beer. Schwetzingold beer was my favorite beer while I was there, (snap daddies) We would usually buy all of the beer that we could haul back to Heidelberg in a Volkswagen to last for a entire week end poker game. Some weekends we would run short and have to substitute a local brand to finish out the weekend.

Static ratings are not likely to be looked at again from a reexamination view point. All of my sc conditions are listed as static. Most have been static for more than ten years. I am 67 years old with minimal education. I have three 100% P&T schedular disabilities and numerous lesser % disabilities. Lately, I filed for an increase for diabetes due to restricted and regulation of my activities. When the C&P was scheduled it was for my static Diabetes and for my static kidney disease, and for PN to include loss of use of two limbs and for my static 0% Chloracne. So, never say never! Why does VA insist on wasting my time and their resources. At least I drew my travel pay and the wife and I ate out for a change. The rater that asked for those reexaminations needs to read the CFR as it pertains to reductions.

By the way Buck, I will be on the podcast Thursday evening, the 27th, 6:00 PM. central time. i don't know if it is recorded or in real time. You are welcome to call in.

Being delivered in that format does not lend itself for an easy read, not even for a doctor with a lot of patients. (no pun intended)

Buck, When you file for any kind of veterans benefits the RO request your records (SMRs) from NPRC, St. Louis in your case. NPRC sends the RO your original records, not a copy. The RO places those original SMRs, in your 201 file, along with anything else that they might have in your claims folder and it never ever leaves that folder again. Your C-file remains at the RO. At the point of two years of inactivity the folder is moved to an off site facility where it can be accessed at any later date. If you move to another region, notify the RO and they will relocate your C-file to your new local RO. With proper notice, you can make an appointment at the RO to view and go through your C- file. Someone at the RO will be assigned to sit with you and watch you to make sure that you do not add or remove anything from the file. If you call the NPRC requesting a copy of the SMRs they will need to contact your RO and have the RO send a copy to you. They seem reluctant to comply but if you request a copy through a congressman or senator's office you will get a nice complete copy of your C-file in a reasonable amount of time. Your congressman or senator has a standard release form that you will need to sign upon the request. I was in Heidelberg in 1969 & 1970. I was at Tompkins Barracks many times during my stay in Germany. I was in the 519th Trans Co. The 519th no longer exist either.

Go fot it! Sounds like a winner to me, especially if the hint of insidious inception of the disease is noted in your SMRs. A good nexus letter from your doctor would be a must. I helped a lady Navy veteran win her claim for menieres. Her disease was noted on her SMRs and is so bad that she can no longer drive.

Not knowing any more about this case than what Page indicated in the posting, my suspicion is that the decision probably was correct but the explanation by the VSO about the lack of medical and educational benefits for the son just do not make any sense at all.

Asknod, what is your take on this one? That is just my point Berta, You posted the chapter 35 regs. From what I understand, Page says that she was awarded DIC, CHAMPVA benefits which are awarded along with DIC would cover not only her but her dependent son also. The comment from her VSO as follows also troubles me. Also, I asked the VA if my son and I qualify for health benefits and educational benefits and was told no since my husband wasn't 100% before he passed but I could always try going to a VA Hospital to talk to them to them personally???? He said there's always ways around it. ???? What is wrong with this picture, it stinks to high heaven? If Page was awarded DIC in the end, Her husband must have ended up being awarded a SCed 100% P&T after his death. For benefit purposes it makes no difference whether the 100% was awarded before or after the death of her husband. The effective date of retro upon the favorable DIC grant would be dependent upon whether she applied for accrued benefits or actually signed on as a claimant substitute. I sure would like to see Alex weigh in on this one. Maybe he will come along. ·

A good night's sleep is more important than I ever realized. I put off the sleep study and CPAP since it was first recommended by my doctor in 1997 after the heart attack.

Not withstanding all that came before the decision in this claim, I am telling you that something really stinks with the award! Dic can only be awarded if it is determined that the 10 year rule has been met, obviously not the reason in this claim, or that the vet died as a result of a sc condition or a contributory factor thereof. If it is determined that the demise was indeed caused by sc condition, then DIC is in order and the award for sc cause of death should have been Necessitated at a100% P&T award, because the condition killed the guy! Chapter 35 benefits would be in order in that award. The entire chapter 35 package, to include CHAMPVA for the spouse and child along with education benefits for both. Berta, as Alex chimed in on this one or is he confined to the greenhouse courting the silver queen. I think that if Alex opened his window, he could smell the stench from this decision too..

I think I'll order a smaller mask and the liners. Mask sealing problems cost me two hours sleep last night but all in all I still feel better using the machine. The machine is ResMed and it shows that I used it 10 hours and 20 minutes last night, but like I said, I fought with the mask seal for the first two hours. I have read about the automatic on with the first breath but I need to study the manual to see how to turn the feature on. I did read that only the provider has access to some features. Does anyone not have mask sealing troubles at all?

Actually Marine, you may have hit the nail on the head! I like to, and am used to, sleeping on my left side, and you are right, that does result in the mask being pushed off of my face. We, in the CPAP class had the option of selecting our mask from a selection of three different type mask. including the nose pillow. I am a mouth breather and the nose pillow requires the chin strap, that didn't sound good to me. We were measured and fitted for our particular chosen type mask. They selected the the large size for me. I will tighten the mask straps some more but they are fairly tight now. They say that about half of the time the problem is that the mask is too tight. I tried loosening the straps, "wrong". They also offer a gasket of some sort to get a better seal. Maybe I need the gasket. I have used the machine enough to know that if I can get a good seal at the mask I am going to be able to live a better life, not being so tired and sleepy all of the time. They also offer a special pillow for side sleepers. Too bad, but understandably you can't just call VA and order one of everything they have.

This may be posted in the wrong place, if so, I trust that it will be moved to the proper place. I have to admit that my newly issued VA CPAP is really helping me sleep better. I feel much more rested and rejuvenated when I awake in the mornings. I have the full face mask in the size, large. I get a good seal when I first turn on the machine but when it ramps up to full pressure it looses the seal and wakes me up. I can stop and restart the machine and get a good seal until it ramps up again and it wakes me up again. This is repeated multiple times in the night. So many Veterans on this site use VA issued machines that I might get an idea of how to correct my problem. I am thinking that the large size mask is too big. Anyone else having the same problem?

You said up thread, Also, I asked the VA if my son and I qualify for health benefits and educational benefits and was told no since my husband wasn't 100% before he passed but I could always try going to a VA Hospital to talk to them to them personally?? He said there's always ways around it. Question, did you sign on to the claim as a substitute claimant within the first year after his death as in 3.1010 Substitution under 38 U.S.C. 5121A following death of a claimant? Or did you just ask for accrued benefits? Form 21-534EZ- Application for DIC, Death Pension, and/or Accrued Benefits. I must not be understanding something here. It seems to me that if you were married to your husband for ten years following the effective date, then you would have won the DIC claim based upon the ten year rule. Otherwise, you must have won the DIC claim on the basis that the cause of death of the veteran was likely service connected. In the case of the latter, if the service connected disease or injury caused his demise, then it certainly should have/would have been rated as 100% P&T. If so, the award should have produced chapter 35 benefits for you and your young son. What am I overlooking or missing while reading this thread?

First of all, the negative attitude will not earn you one dime and it is hard on your social and family life. Now, file the other claims and forget going back to work. if you are successful with the other claims you just might achieve the "S" award 100% TDIU + 60%. That would help the piggy bank more than a 100% P&T scheduler rating. Unless you just like the sound, the ring and bragging rights of that type of award. Think about it. If you go back to work, you chance loosing the TDIU along with the chapter 35 benefits for the family. All that you are allowed to make and keep the TDIU is income that is not considered as gainful employment. Drawing compensation at the VA 100% rate is not peanuts and it is pretty good tax free income if you can manage to live within your means. Next, consider what insurance for those kids would cost you. If you go back to work, the cost of working in itself is not cheap, gas and automobile up keep in consideration of the increased mileage to work and back. Child care and education? Tip, You say about 4 years. If you can wait until the fifth year is up to rock the VA boat it really makes it hard for the VA to decrease your compensation if you have been at the same rate for a continuous five year period. The burden of proof of substantial and sustained improvement would fall on the VA after the five year period is up. Do you have any decisions that will become final where there is a substantial amount of back pay to be lost if you do wait until the five year period is up? That may enter into your decision and options. Good luck. Thanks for your service and welcome home brother!

By the way marine 1342, Thanks for your service and when you ask for that reconsideration give them an ultimatum, Tell them that you are asking for a 100% award based upon the new evidence submitted, to include a new C&P exam, or re adjudicate the claim and award TDIU. Sometimes it works just to instruct them as to what you want done in your claim. If they happen to award the TDIU, then bag it and press on with the other issues and go for the plus 60% ("S" award)

In your situation I would get one more medical opinion concurring with the one that you already have. You don't need to sell the farm to get another opinion either. Just make an appointment with an outside doctor. Be up front, tell the doctor that you are a disabled veteran and what the purpose for the visit is. Show the doctor the first opinion and ask if he/she concurs with that opinion and if so, ask if you can obtain a concurring properly written letter. Expect to pay in the neighborhood of $100.00 for the visit and opinion, or use outside insurance if you have it.. You can ask for the price of the visit before you make an appointment. Try the local Vet center. Ask those guys for an opinion and treatment. They understand your problems and will be sympathetic in your cause and your claim as they deal with the VA and claims all of the time. When you get that other opinion dispute your C&P exam as an inadequate exam and ask for new / proper exam and a reconsideration at the RO level. That will beat an appeal and waiting for years while trying to rebuild your claim. With new and material evidence a reconsideration is a viable request at the RO level if the one year time limit since the date of the decision has not been exceeded. Consider saying this on a 21-4138 and turn it in to the RO at the same time as the request for a reconsideration. "Actually, I did not have a adequate C&P exam because the only thing the examiner did was to restate and summarize my VA medical records which were already available to the rater. I was not afforded the opportunity to attend the C&P exam and therefore my claim was denied without me being afforded a proper C&P". For the proper format of a nexus letter( see USVA 101.org ) then click on nexus letter at the top right and copy it, take it to the doctor and ask for a conforming letter.