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jamescripps2
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Posts posted by jamescripps2
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Good read Buck, WOW!
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Buck, can you define "expeditious" in VA language for us? Never mind it would be a long read!. It took them more than six months to pay me retro on a partial grant.
Berta, I wasn't aware of that fast letter, you are probably right because it seems like I did hear some second hand
rhetoric about that. Can we trust them?
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Permanent impairment of vision in both eyes to a certain degree. is one of the qualifications
First of all, your vision loss needs to be service connected. Apply and let the VA decide. It cost nothing to apply. If you are awarded you will not get the adaptive equipment grant on account of the blindness.
Nothing to be skeptical about it, either you qualify or not, there is no wiggle room. I got the vehicle grant and adaptive equipment this past year, because of loss of use of an extremity The best I remember, the new amount payable is $20,220.20.
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In my own mind there is no question as to what caused my OSA. I never had trouble sleeping until I had a heart attack and bypass surgery. From the night of the surgery until now, I never was able to sleep again without sleeping pills. I was told bu the doctor before I was released from the hospital after the bypass in 1997 that I needed a sleep study and a CPAP. I put it off all of these years because I just could not imagine myself sleeping with the mask and head gear.
Two years ago my Cardiologist told me that I should reconsider because my OSA was life threatening, I agreed to do the sleep study. It has taken me two years under the Veterans Choice Program to get the sleep study and the CPAP was issued to me last Thursday. Last night was the fourth night using the machine. Other than a dry mouth and some mask sealing problems it is working pretty good. It is just awesome as to how much better I sleep and feel when I wake up. I actually do feel rejuvenated. I think that the CPAP will be a keeper!
I intend to file the claim for OSA due to the Diabetes, heart disease and the medication side affects thereof. When my claim for increase for diabetes is granted because of restriction and regulation of activities, I will file the claim. According to ebenefits, the claim for increase for diabetes is at the, "awaiting approval of decision", phase at this time, so it should not be too much longer before i get the decision. There will be no increase in compensation if granted but it is a building block for possible future use.
My diabetes has caused all of my service connected conditions except Chloracne. The diabetes is uncontrolled and i was put on five shots per day of U-100 insulin. Lately the doctor changed my insulin to U-500. That is some dangerous stuff! on account of the extent of the internal organ damage and other problems connected to the diabetes I have asked for an extraschedular rating of 100%. We will see how that goes, but if the veteran ask for it then the VA has to refer the isssue to the director of compensation services for consideration.
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The Board’s mailing address:
Board of Veterans’ Appeals (01)
810 Vermont Avenue, NW
Washington, DC 20420Fax number: (202) 632-5842
Web address: http://www.bva.va.gov/
Status inquiries: bvaombudsman@va.gov; (800) 923-8387; (202) 632-4623 (M-F, 9 a.m. to 5 p.m. EST)
Check the status of your appeal online at: https://www.ebenefits.va.gov/
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Well Berta, I read some of that OGC link that you provided but that kind of stuff really is really hard for me to retain in my pea sized brain. If I am working on a claim and I need to understand something like that it takes multiple reads to digest and retain enough information to apply in building a case. It reminds me of my learning to play music, I learned to play but I seem to have needed to try harder than anyone else, but i don't quit.
You, on the other hand seem to have been at it for a long while and maybe have a knack for it. That and the fact that you have been forced to endure and live it. I can understand that because the more you read the more you comprehend. Whatever happened to the simple life that we enjoyed before all of this VA crap?
You made a statement up post saying that prosecution of a certain claim was actually fun. Well I haven't had any fun prosecuting a claim but I'll admit, it is fun to win. Every time I help a veteran win a claim, I win again, and I can't help gloating a little bit when I beat those people at their own game. I am certain that you and others here at hadit also know the feeling. Thanks for all that you contribute!
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Thanks for the clarification Berta. When I was trying to win the AO claim I kept 4138s everywhere, in the car, at home and in a satchel that I carried with me. You just never know where you will find the next piece of evidence.
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Berta, up post you posted,
I think I SCREWED UP!
I have an appeal in because I feel a General Counsel Pres Op (which VA refused to apply to my claim) and also refused to ask the OGC for an opinion,per my request ,involved the unusual issue I have.
I am not sure what you are talking about in the wording "Pres Op".Can you expand on that/?
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Thanks for the post Alex, your opinion carries a lot of weight. I really don't expect to end up at the court, but I intend to go as far as it takes to be granted the maximum benefit because I think that I qualify if the claim is properly adjudicated.
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ED is awarded at 0% but the SMC "K" from the ED generates $103.23 over and above your 100%+60 "S" compensation.
A grant for the OSA will get you zip in the way of compensation. File on it anyway, it could come in handy in the future as a building block for a higher award.
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Asking for another AO exam could end up opening more doors for you. Sounds like a plan to me, Good luck Buck!
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Buck, ED is awarded at 0% but the SMC "K" from the ED generates $103.23 over and above your 100%+60 "S" compensation.
A grant for the OSA will get you zip in the way of compensation. File on it anyway, it could come in handy in the future as a building block for a higher award.
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Go to a local vet center and ask for help. Ask them for help, that is what they are for. They are not the VA per se and the VA don't even have access to their records unless you permit it. They don't work for or with the VBA or the VAMC. They are psychologist and cannot diagnose the PTSD but their opinion will weigh in heavily with the VA psychiatrist in making a diagnosis. If it is mental help that you are seeking, they are the pros with vets and have the experience to understand your pain. They are free and they will even see/help your family. What you got to loose?
If you don't like it, don't ever go back, no one will ever know that you even went there.
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Never assume anything, My preference would dictate that you deliver the document directly to the RO and request a date stamped copy back. If that is not possible mail it Certified Mail Return Receipt Requested. Include a waiver of review by the office of original jurisdiction to keep the RO from bouncing your claim for another review and that waiver needs to be included no matter how you deliver the claim to the RO. IMHO the exam in itself will trigger a RO review and therefore a new decision.That might even produce a grant by the RO, thereby short stopping the long drawn out traditional appeal process without you doing anything.
If you get a letter from the BVA communicating that they received your claim in Washington at the BVA, send them a copy too, but make sure you send a waiver of review of the AOJ. Again send it CMRRR.
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Buck, An agent orange exam at the VA can produce some compelling evidence. The exam covers a lot of body systems and can uncover some diseases or conditions that you don't even know about yet. The AO exam always, by law, produces a letter telling you about any malades that you might have. You will get your letter within two weeks of the exam. The Environmental Clinician at the VAMC Nashville who preforms the AO exams is sympathetic to veterans and will write supporting letters above and beyond his scope of duties and helps vets in any way that he can. Your clinician may be different.
You can schedule an AO exam at your nearest VAMC. If you have had a previous exam, you can request a second. It is also a real good opportunity to talk one on one with a doctor about the etiology of your OSA and any other problem that you might have. Three days after the exam the record will be available on ebenefits or at ROI at the medical center. Enough said here because we are hijacking John 999's thread again. You might consider taking this conversation to a new thread for your own benefit.
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This comes from CLE class material and the seminar given by the State of Oregon legal bar association.
M21-1MR VA Claims Adjudication Manual Rewrite Usually just called M21. The “How-To” book for managing and evaluating claims. Its provisions are substantive and have the same authority as VA regulations.
If this is the gold standard it will help my contention, albeit the M-21 statute that I need and referred to in my NOD is contained in the USC and the CFR also, just not as clearly written as M 21. It requires the VBA to infer A&A upon all new awards of 100% P&T decisions. ie loss of use of a hand and a foot. That is the basis of my NOD.
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If you want or need something from the VA you have to be adamant and ask for it in no uncertain terms. Hinting to a VA doctor will not produce even a kleenex.
Doc, I am having trouble with post voiding dribbling, can you please refer me to a specialist right away, or do I need to make an appointment through the Veterans Choice Program to insure that I get an appointment within 30 days? In the meantime, can you please prescribe absorbent material for me so that I can carry out my every day work and social life without fear of an accident? If not, why not?
If you have not already filed a claim, file a VA form 21-0966, notice of intent to file a Fully Developed Claim before the end of this month to preserve your effective date of claim and backpay. Then get your evidence together and file a FDC, they will send you for the C&P exam. If you have access to an outside doctor get an outside diagnosis and opinion also. Read CFR 3.303 then when you file that claim, copy and cite CFR 303 (b) underline and highlight "however remote"
Good luck Chris!
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I also an optimist and a opportunist. There are about three angles at play in my claim for the maximum benefit at "O" and R-1. I will just have to wait and see which road the VA chooses to go down. I think the VA already realizes that I am not just another speed bump. Not that that matters at all. I am in no hurry. I don't want to appear as being smug but I am confident in my contention, my ability and the evidence in the claim, not to mention the encouragement and help from the folks at this hadit forum.
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I see that this is an older thread but depending upon if/ or not that leg is shorter due to service related causes, and depending upon how much shorter, it could get you a K award and a vehicle grant. Read CFR 3.350 and then measure yourself to see if you are in the ball park.
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Post 911 vets have more of a chance claiming OSA as due to already service connected PTSD
Vietnam vets, especially combat vets, also use service connected PTSD, contending that the OSA is secondary to the PTSD. To win that one usually requires buddy statements. If a Vietnam vet already has Diabetes II and /or ischemic heart disease, IMHO it may be a better contention to claim the Diabetes including the Diabetic meds (insulin) as the reason for the weight gain and over weight BMI. Requires medical nexus but not buddy statements. Cite CFR 3.303 (a)(b) highlight and underline the text "however remote".
Guys it is really easy to get multiple properly written nexus letters from outside doctors, if you give a doctor something to go on. ie the example from usva101.org, click on nexus letter. In my claim for AO exposure inside CONUS, upon adjudication and granting of the claim I had already turned in thirteen nexus letters from outside doctors. If it would have taken longer for them to adjudicate the claim, I would have had even more nexus letters. When I got my big brown envelop containing the decision granting the claim, I still had more nexus letters that had not yet been turned in. If the vet has Medicare part B, all it takes is a $15 copay. Next, ask that doctor to refer you to a specialist that he/she uses, ie, heart doctor or a diabetic specialist or both, requires a $30.00 copay each, then, up front, show them your first letter and ask the/ those specialist for a nexus letter concurring with the first doctor's letter. If you want three nexus letters then show a third doctor the first two letters and ask if he/she can write a concurring letter. Three letters is considered to be overwhelming evidence.
The longer you are exposed to and work within the VA claims and benefits system, the more you realize that it is just a war of letters. Whoever ends up with the most and the best is going to win the war. We, as disabled veterans have one thing going for us, we have lots of time. Use that valuable time to your advantage, seek out those letters wherever you can find them. I am not trying to hi jack John 999's thread but I hope hope that reading this post causes John and other readers to get tenacious in their claims, get out of those pajamas and out of the house. Get yourself a little exercise and some determination, go after those letters and do it yesterday. Today is the first day of the rest of your life, make it count!
It has not been that long ago that I filed the claim for AO exposure at Fort Gordon GA. The DOD and the VA stood their ground making fun of me, refusing to budge an inch while saying, "Mr. Cripps, we have never, ever, used agent orange inside the Continental United States". "Why are you so adamant in wanting to waste our time and the taxpayer's money by filing this frivolous claim that you can never possibly win"? The RO refused, and never did send me for a C&P exam. I beat them at the BVA with time spent and letters, lots of them! I have said that I beat them and won the claim because they slept, I didn't.
As far as the C&P, I didn't need one because I furnished the BVA with adequate medical evidence in the form of medical nexus letters and statements.
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Alex, pertaining to the subject of the CAVC discussed above, Important: Concurrent entitlement to SMC under both 38 CFR 3.350(f)(3) and38 CFR 3.350(f)(4) is prohibited. Other than congress changing the law, I would think that the issue for the CAVC to decide is whether or not a latter rating decision actually supersedes a prior rating decision in its entirety.
There is no question in my mind that if a half step increase was awarded to a vet in a prior decision due to a 50% rating decision, using the provision at F(3), and then, in a latter decision the vet was granted a 100% disability for a new and unrelated condition, the new 100% award would have to be allowed to fulfill the statute pertaining to maximizing the veterans benefits. As I see it, according to the present policy at 38 CFR 3.350 the latter decision awarding the newer whole step increase using F(4) would replace the older half step increase.
We are talking about two separate decisions, the former and the latter. The question being, is there a statute that defines the policy as to what extent the latter decision replaces the former decision. No matter really as the prohibition, Concurrent entitlement to SMC under both 38 CFR 3.350(f)(3) and38 CFR 3.350(f)(4) is prohibited, would still need to be further defined by the CAVC or otherwise defeated.
Just rambling out loud here, but I would like to see the CAVC claim won by the vet, i just can't wrap my mind around what the argument to challenge would consist of.
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41. SMC for Additional 50- and 100-Percent Evaluations Under 38 CFR 3.350(f)(3) and 38 CFR 3.350(f)(4)
Introduction
This topic contains information on SMC for additional 50- and 100-percent evaluations under 38 CFR 3.350(f)(3) and 38 CFR 3.350(f)(4), including information on
· the proper application of 38 CFR 3.350(f)(3) and 38 CFR 3.350(f)(4)
· SMC under 38 CFR 3.350(f)(3)
· SMC under 38 CFR 3.350(f)(4), and
· examples of rating decisions addressing the issue of entitlement to SMC under 38 CFR 3.350(f)(3) and 38 CFR 3.350(f)(4).
3 hours ago, asknod said:There is also a case afoot at the CAVC of a claim I helped develop for a fellow Vet last year. His attorney maintains he can have several bumps up using the 38 CFR 3.350 (f)(3) and (4) bump method. For instance, If he has a separate and distinct 100% schedular for IHD and another for 50% on a completely unrelated disability, that he is entitled to both the half step and the whole step bump. He already has SMC L for A&A. I do not see any language forbidding the technique. It should be an interesting ruling. They're still haggling at the early stages and a judge(s) have not been assigned yet. VA OGC blew off the Rule 33 conference about five minutes before it was due to commence. Dumb.
If the policy set fourth and highlighted below could be defeated in that developing CAVC claim it would benefit many vets, including myself. Alex, thanks for what you do for so many.
Change Date
December 16, 2011
a. Proper Application of 38 CFR 3.350(f)(3) and 38 CFR 3.350(f)(4)
Apply the provisions of 38 CFR 3.350(f)(3) or 38 CFR 3.350(f)(4), whichever is appropriate, only once in a rating decision.
Important: Concurrent entitlement to SMC under both 38 CFR 3.350(f)(3) and 38 CFR 3.350(f)(4) is prohibited.
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Before I NOD, seeking input on SC sleep apnea
in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC
Posted
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.