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jamescripps2
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Posts posted by jamescripps2
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The VA makes the rules and calls the shots. In order to obtain our benefits we have to comply.
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Please note, the time line that I gave you begins with my filing at the CAVC, so your wait time might not be so bad as you have already gotten a decision from CAVC and are back at the BVA. If the BVA can make a decision, considering that anything that is remanded from the CAVC is advanced on the docket, I would say that you are about three to four momths out from a BVA decision.
However, if the BVA remands back to the AOJ, I would expect about a year. Whatever, never give up!
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My remand from the CAVC start to finish was two years. CAVC joint motion for remand (JMR) sent it back to BVA. BVA remanded back to AOJ. AOJ denied. So, filed a HLR. HLR found a failure in duty to assist. HLR closed and the claim was bumped up to a suplemental claim. At the suplemental level the EED was awarded and retro was paid.
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The initial Richard Leonard show about the shenanagains within the VA caregiver's program. Worth the listen. Does the VA record you at your VA appointments? I don't have the answer, but I now that I am aware that they have that capability, I will be very cautious.
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Seems like the VA is fumbling around in trying to salvage the program and naintain some kind of self dignity in the process.
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SMC R-2 and T are equal awards and pay the same. R-2 requires loss of use of two limbs. If you can't qualify for R-2 then with a TBI you might qualify for SMC T. I would venture to say that nobody has ever been awarded SMC T who can still work. When you get into SMC R-2 and T you are talking some really serious stuff, if not someone who is a vegetable.
I qualify for R-2 but I have loss of use of four limbs and I have four separate and distinct 100% P&T awards along with many lesser awards. Like John said, I doubt that you would qualify for housebound or A&A.
Go to the BVA search engine and type into the search box SMC T granted. There you can see what it takes to be considered for the T award. Then if you still think that you meet the qualifications, by all means, go for it!
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VA insurance benefits will change on January 1, 2023. Be aware of the changes and how it might apply to your present and future insurance needs and benefits.
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Having been a long time hadit member, I and many others who follow this forum have had the occasion to see differences of opinion develop and confrontations play out between moderators and members. I might take the opportunity to express my opinion in that the moderator always seems to win, but the moderator is not always right.
I suggest that in the recreated hadit that there be a committee to settle legitimate disagreements before hard feelings are allowed to be generated.
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The VA makes the rules and we are required to go by their rules.
It seems that you want to be allowed to circumvent VA's rules and make your own rules.
I guess that you can do that, but if you want the increase, then be willing to put in the time that it takes to comply with VA's rules or be prepared for a denial and a long drawn out appeal.
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It could be worse. It could have been that you didn't serve at all, and therefore have no hope of filing or winning a claim for whatever ails you. I fought them for seventeen years and it was worth it.
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30percent, good post, you are getting smarter already! The more you read, the smarter you will become. Use what you have learned to give some direction in filing your claim.
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First off, Being issued AFOs or wearing AFOs does not constitute loss of use. Loss of use of feet can only be determined by a VA rater. Refer to 38 CFR 3.350 to see what constitutes loss of use of feet. Most vets are awarded loss of use of feet as a result of a diagnosis of permanent loss of the common peroneal nerve.
Back pay will go back to the date that you can show that you actually do have loss of use compliant to the regulations at 38 CFR 3.350, or the date of the filing of the claim, whichever is later.If you plan to pursue the loss of use claim, I suggest that you file an intent to file ASAP. The date of the intent to file will preserve the effective date if you actually support and file your claim within a year.It would be a long shot, but If you actually do win the claim for loss of use of two feet. You can then file an appeal for an earlier effective date (EED) back to 2014. Most probably you would need a lawyer for the EED appeal.I suggest that you go to the hadit forums and read the Special Monthly Compensation threads starting with SMC "L" and continue through SMC "M", SMC "O" and then "R-1" "R-2" There is a lot of good information there that might help you.38 CFR 3.350 Special Monthly Compensation Ratings
(a) Extremely unfavorable complete ankylosis of the knee, or complete ankylosis of two major joints of an extremity, or shortening of the lower extremity of 3 1/2 inches or more, will constitute loss of use of the hand or foot involved.
(b) and Complete paralysis of the external popliteal nerve (common peroneal) consequent footdrop, accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of this nerve, will be taken as loss of use of the foot.
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I am a 100% P&T veteran. I had Medicare part A&B for many years. Upon the President signing of the Mission Act, I dropped part B Medicare. The Mission Act includes the Choice program whereby us veterans can go to outside medical providers and the VA pays the bill. True, it requires pre approval, but that has never been a problem for me. I have always gotten excellent medical care inside the VA. I have been through several life threatening situations that required emergency surgery. The VA doctors had the option of just making me comfortable and letting me pass on or to take a chance against the odds and operate. I don't think that an outside hospital would have elected to save me. I will choose VA every time.
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There is a chip in the CPAP machine. The chip transmits data to the VA. After using mine for more than five years I had to go in to raspatory for a face to face. They pulled up my machine on their computer and told me how often I had used it and how often I failed to use it. Next they asked me to make a return appointment and bring the machine in for a fine tuning because they noticed that I was having too many episodes. Before I left the appointment I was told that if I failed to use the machine I would no longer be able to order supplies and to be reinstated would require a new sleep study.
I have sleep apnea and the VA conducted the sleep study. I did fail to use the CPAP for a period of two months because I broke my nose and could not wear the mask. The broken nose was noted and treated at the VA and was verified by respiratory as being the reason for my not using the CPAP during the period in question. I have never filed on the sleep apnea and it is not service connected, nor do I intend to file on it because I am already at the max of SMC "O" to include R-1 and there would be no gain.
All of the CPAP readings are a matter of record in your VAMC medical records and the compensation & pension side of the DVA has access to those records. Looking back, I think that if I had been service connected for the sleep apnea, I would have stood a good chance of loosing my rating for failure to use the machine.
I also know that they still track my usage because they called me and told me that I was having fewer events since they fine tuned the machine, and that they had ordered a years worth of supplies for me, filters hoses, reservoirs etc.
I would suspect that if you did loose service connection for failure to use the CPAP, and was ever able to get re instated, it would be at a lesser rate because they are going to reduce the sleep apnea ratings across the board.
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There is some validity in what Mr. Cue is trying to say.
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Yes bronco, I agree. I just won an EED. The rater granted for something far different than I expected, but it ended up with the same EED that I had requested. We don't really care how they arrive at a decision, or what reasons and basis they apply, so long as it is granted to our satisfaction and the $ is correct.
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John, it could be that you are only a diagnosis away from having drop foot. As a general rule, podiatrist do not check for drop foot unless there is a complaint that happens to ring a bell. Make an appointment and then just ask your podiatrist out right. Explain your symptoms and ask, "do I have drop foot"? As you already have neuropathy at the amputation rate, chances are that you will probably get the diagnosis when the proper test are preformed.
That is exactly how I got my diagnosis. I too had foot pain and had to be extra careful that I did not fall. The prescribed braces really helped.
As far as a scooter. Ask your PCP for a scooter clinic consult. Explain to the scooter clinic about your foot pain and fear of falling. Expect to be denied, but be adamant about the need for the scooter and remind the person that you have a 40%rating for your lower extremities and the fact that 40% is in fact, the amputation rate.
In the end, it is like all things VA. If you are nice, but at the same time adamant and tenacious, you will prevail and be issued a scooter.
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Yes, there are other avenues to get to loss of use of a hand or a foot. I am pointing out the path of least resistance. Being permanently confined to a wheelchair might do it and so would having claw hand. In any case one would need to comply with the definition of loss of use of a hand or foot as set forth in 38 CFR 3.350 (2) as posted above.
The point that I am trying to get across is the fact that if you do have drop foot, then this is your ticket to have the VA concede loss of use, because drop foot is caused by paralysis of the peroneal nerve, and paralysis of the peroneal nerve causes drop foot.
complete paralysis of this nerve, will be taken as loss of use of the foot.
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This is an excerpt from 38 CFR 3.350
(2) Foot and hand.
(i) Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis; for example:
(a) Extremely unfavorable complete ankylosis of the knee, or complete ankylosis of two major joints of an extremity, or shortening of the lower extremity of 3 1/2 inches or more, will constitute loss of use of the hand or foot involved.
(b) Complete paralysis of the external popliteal nerve (common peroneal) and consequent foot drop, accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of this nerve, will be taken as loss of use of the foot.
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John999, to tell you more about foot drop, as you asked.
When you have foot drop, you can no longer lift the front of your foot. When you take a step on a tile, or any other solid surface, your foot strikes the floor, "toes first" instead of, "heel first". That situation trips you and you have to run to catch up in order keep yourself from falling. Someone can have drop foot involving only one lower extremity or it can involve both lower extremities.
If you have drop foot you can stand on your toes, but you can no longer stand on your heels, you can press down on the gas pedal and the brake pedal, but you can't let off of the gas or brake pedal unless you lift your entire leg from the hip.
In the case of foot drop, an Ankle Foot Orthotic brace (AFO) is prescribed. The AFO, with its spring action causes your foot to raise at the toe when lifted off of the floor. An amputation is never prescribed for foot drop. As far as driving, a person who has foot drop most probably has already adjusted and actually, without realizing it, raises the entire leg at the hip to decelerate or come off of the brake pedal.
If you are awarded the automobile grant, because of the foot drop and resultant loss of use, you will also be awarded the adaptive equipment grant. A steering wheel knob with hand controls will solve the driving problem.
Drop foot in the veteran population seems to be heavily related to diabetes and neuropathy. The most common cause of foot drop is peroneal nerve injury. The peroneal nerve is a branch of the sciatic nerve. It supplies movement and sensation to the lower leg, foot, and toes. Conditions that affect the nerves and muscles in the body can lead to foot drop.
Once you know what foot drop is, you can sit on a bench or chair in the hallway at the VA and watch the guys feet as they walk. You can pick out the ones who have foot drop. Some drag their toes, some have developed a high stepping gait, some swing a foot out sideways to keep it from dragging, but you can hear the foot slap the floor as they walk. They are not even aware that they have foot drop.
All of those guys that you spot walking down the hall with foot drop would qualify for shoes and braces (AFOs). All would qualify for one or two $971.00 each yearly clothing allowances. Some would qualify for special monthly compensation "L" and some would qualify for SMC at the "O" rate, All would qualify for the approximately $22,000.00 automobile allowance w/ adaptive equipment and some would qualify for the special adaptive housing grant (SAH), of $108,000.0. IF THEY ONLY KNEW!
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I complained about an inadequate exam to the patient advocate. The only remedy that was offered was a reexamination by the same doctor, take it or leave it! The second exam was scheduled two weeks out and gave me what I needed to be granted loss of use of one hand and one foot.
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John, to tell you more about foot drop, as you asked. When you have foot drop, you can no longer lift the front of your foot. When you take a step on a tile, or other solid surface, your foot strikes the floor toes first instead of heel first. That situation trips you and you have to run to catch up in order keep yourself from falling.
You can stand on your toes but you can no longer stand on your heels.
You can press down on the gas pedal and the brake pedal, but you can't let off of the gas or brake pedal unless you lift your entire leg from the hip.
In the case of foot drop, an Ankle Foot Orthotic brace (AFO) is prescribed. The AFO, with its spring action causes your foot to raise at the toe when lifted off of the floor. An amputation is never prescribed for foot drop. As far as driving, a person who has foot drop most probably has already adjusted and actually, without realizing it, raises the entire leg at the hip to decelerate or come off of the brake pedal.
If you are awarded the automobile grant, because of the foot drop and resultant loss of use, you will also be awarded the adaptive equipment grant. A steering wheel knob with hand controls will solve the driving problem.
Once you know what foot drop is, you can sit on a bench or chair in the hallway at the VA and watch the guys feet as they walk. You can pick out the ones who have foot drop. Some drag their toes, some have developed a high stepping gait, some swing a foot out sideways to keep it from dragging, but you can hear the foot slap the floor as they walk. They are not even aware that they have foot drop.
All of those guys that you spot walking down the hall with foot drop would qualify for shoes and braces (AFOs). All would qualify for one or two $971.00 each yearly clothing allowances. Some would qualify for special monthly compensation "L" and some would qualify for SMC at the "O" rate, All would qualify for the approximately $22,000.00 automobile allowance w/ adaptive equipment and some would qualify for the special adaptive housing grant (SAH), of $108,000.0. IF THEY ONLY KNEW!
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By design, the "O" award is very elusive and hard to obtain.
A doctor can dx foot drop, but only the VSR or rater can make the determination that you have foot drop to the degree justifying loss of use of foot. Not being able to make a fist or reach above the head has nothing to do with anything except maybe range of motion.
Loss of use of a hand exist when you loose pinch grip and have other organic signs, Loss of use of a foot exist when you loose the ability to propel, along with other organic signs, muscle loss etc.
As you mentioned, loss of a hand or foot has to be to the degree that you would be equally well served with an amputation and a properly fitted prosthetic. Not that an amputation would be required.
If you read 38 CFR 3.350 you can see that loss of a foot will be held to exist and conceded if you have permanent loss of the perennial nerve, accompanied by other organic signs. (muscle loss etc.
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It could be that you inadvertently tried to diagnose your condition and even offer the etiology at the time that you filed your claim, but you are not expected to be the expert. If I was you I would consider that medical opinion as the doctor trying to help you make the connection in order service connect your knees. Although it may need some further development, it is favorable to you, and I would be happy with it.
I would also think that the doctors statement would be enough for a VSR or rater to initiate further development or at least invite you to file the claim based upon that statement by the doctor.
Optum Serve, has anyone used them?
in VA Disability Claims Research
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