jamescripps2

At this time I am rated at R-2. Can you even imagine how many times one has to file for an increase or just outright appeal a decision to finally reach the maximum rating? The fear of being reduced never hendered me or kept me from filing. I not only was working for my own benefits but for benefits for my family as well.

P&T is permanent and total. You can either file for the TDIU or you can file for an increase on the neuropathy, but without having the schedular 100% p&T or havinrrg TDIU P&T, unfortenatetly, the dependent insurance is just not going to happen.
If you refuse to file out of fear of a reduction you are just stuck at 90% and you can expect to never obtain a higher rating.
Example. I was granted 10% per limb for neuropathy, I filed for an increase and was awarded 30% per limb. I again filed for an increase and was granted 40% per limb. I appealed and was granted 100% for loss of use of lower limbs and another 100% forloss of use of upper limbs.
If your service officer would rather talk you out of filing for an increase than filing on the increase, replace that service officer, or file it yourself.

At this time I am rated at R-2. Can you even imagine how many times one has to file for an increase or just outright appeal a decision to finally reach the maximum rating? The fear of being reduced never hendered me or kept me from filing. I not only was working for my own benefits but for benefits for my family as well.

P&T is permanent and total. You can either file for the TDIU or you can file for an increase on the neuropathy, but without having the schedular 100% p&T or havinrrg TDIU P&T, unfortenatetly, the dependent insurance is just not going to happen.
If you refuse to file out of fear of a reduction you are just stuck at 90% and you can expect to never obtain a higher rating.
Example. I was granted 10% per limb for neuropathy, I filed for an increase and was awarded 30% per limb. I again filed for an increase and was granted 40% per limb. I appealed and was granted 100% for loss of use of lower limbs and another 100% forloss of use of upper limbs.
If your service officer would rather talk you out of filing for an increase than filing on the increase, replace that service officer, or file it yourself.

I would suggest that you appeal the PCAFC caregivers denial directly to the BVA. Ask that your case be advanced on the docket for the reason that you are a R-1 veteran.
 

38 CFR 3.352 contains all tou need to know about the qualifications for R-2, To fully understand, you will need to read it a few times.

Also, if you do indeed have service connected loss of use of both hands and both feet you might benefit by reading the entire threads posted here at hadit on SMC "M" and "R"1 and "R-2".
With your loss of use it sounds like you should be in the neighborhood of R-1 or R-2, instead of lingering around at TDIU.
I am rated loss of use of upper extremities at 100% P&T. A&A 1 was granted for LOU of upper extremities.
Also Loss of use of lower extremities. A&A 2 was granted for LOU of lower extremities.
The two A&A awards L-1 and L-2 warrant the SMC "O", 
Granting of he "O" award automatically advances the A&A to either R-1 or R-2, depending on your individual circumstances. You may have the makings of a CUE claim for an Earlier SMC effective date.

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.

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.

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.

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.
 

There is some validity in what Mr. Cue is trying to say.

At this time it seems that the attitude of the PCAFC caregiver program is to see what they can do to deny the veteran when the attitude should be to see what they can do to get the veteran enrolled into the program.
You never give up! If you appeal using the HLR or the supplemental claims, the very same people, the VHA, are going to deny you again. I suggest that you take your claim straight to the BVA. The BVA has nothing to do with the VHA but rather, they come under the VBA, and that is where you will find justice.
I don't know the particulars of your service but evidently you are not a legacy veteran in the program. If you are indeed not a legacy participant, you would file on a VA form 10182 Decision Revue Request.
True, the Board has a backlog, but if your medical records contain all that you claim, it will be the quickest path to a granted decision. The Board generally does not fool around and they do consider the evidence of record to make an equitable decision. You can look up my decision by going to the BVA decision search site https://search.usa.gov/search?affiliate=bvadecisions&_ga=2.77268117.1265507262.1648799257-1511624019.1640929699  Then enter the Citation Nr: A22011682.
Citation Nr: A22011682 Decision Date: 06/22/22 Archive Date: 06/22/22 DOCKET NO. 210903-192826 In the meantime you might consider filing on loss of use of a foot if you do have drop foot and you wear an afo brace. Also, you might consider filing for A&A  

Thanks Tbird, by the way, I like your new profile picture, gives you a really sophisticated look.

I buy antique cars, but I have trouble when it comes to selling them

 

This is the 55 Chevrolet with the Corvette engine as posted above. It is a sweetheart! Last but not least is my Agent Orange 1948 Ford F-100.

This is the 55 Chevrolet with the Corvette engine as posted above. It is a sweetheart! Last but not least is my Agent Orange 1948 Ford F-100.

Shure cure for anxiety and depression! Also a secure investment. These babys will put a smile on your face

I buy antique cars, but I have trouble when it comes to selling them

 

This is the 55 Chevrolet with the Corvette engine as posted above. It is a sweetheart! Last but not least is my Agent Orange 1948 Ford F-100.

Probably not the answer that you are looking for but, the easiest way to take care of that situation and get the base ID card is to obtain a marriage license, then visit the Justice of The Peace.

I buy antique cars, but I have trouble when it comes to selling them

 

This is my case wherein level 2 caregiver benefits were awarded to my caregiver. It is the first case before the BVA where level 2 benefits were granted.
 
Citation Nr: A22011682 Decision Date: 06/22/22 Archive Date: 06/22/22 DOCKET NO. 210903-192826 DATE: June 22, 2022

That is just it broncovet, they, the VHA, gave no excuses, they just state that you don't qualify and render an arbitrary decision. Unlike the VBA they are not required to give a reason or basis for a decision. I always knew that If I could manage to get my case before the Board that it would be granted hands down because the evidence was totally in my favor and always was. The VHA just ignores the evidence. 
We will hash it all out on the Exposed Vet Podcast next Thursday evening, the 14th with J Basser and Jerrell Cook.

That is just it broncovet, they, the VHA, gave no excuses, they just state that you don't qualify and render an arbitrary decision. Unlike the VBA they are not required to give a reason or basis for a decision. I always knew that If I could manage to get my case before the Board that it would be granted hands down because the evidence was totally in my favor and always was. The VHA just ignores the evidence. 
We will hash it all out on the Exposed Vet Podcast next Thursday evening, the 14th with J Basser and Jerrell Cook.