MartyL16

I apologize. When I entered this topic, and saw one reply to mine, I just updated my reply back to FAT and now see yours. Thanks for your questions. Original reason same as above, or no records found from 2004-2005, no help from anyone. Of course I am claiming PTSD to civilian counselors and they say DEPRESSION, ANXIETY, "loose marbles". I was on VERY HIGH DOSAGES of PREDNISONE since Sept. 1985 (active duty) for my SC SARCOIDOSIS. I retired in July 1987, still on prednisone but down to 10mg per day. Long term, high dosage prednisone makes you very DEPRESSED, mood swings, anxiety, and a really bad "speed dater". All of which was listed in my MILITARY Medical records plus the fact that they had to put me ANTI-DEPRESSANTS to counter the PRED. effects. All my civilian doctors records reflect continuous anti-depressants for depression, anxiety, "no sense of humor", etc. even thru TODAY. The VARO has stated in their "lists of evidence" in ratings back to 2009, they have all my civilian medical records but always ignore them. Attached to my 11/24/2014 NOD, I again tell them the PROOF of PTSD is, and has been in the VAMC Mental Health records since 2007-2008 plus the 14 page ADDENDUM detailing all 9 STRESSORS, plus other denials that I disagree with. I also include all those years of VA Mental Health records they say don't exist. More than 100+ pages and if you refer to my original post plus the other reply I just completed, I "cut and paste" the LAW changes these IDIOTS are ignoring regarding PTSD. In the SOC they admit they received these RECORDS from me but state that these records only "discuss my symptoms". How arrogant is that? I am sure you realize, I am not medically qualified to diagnose anything, neither is the RO. As courts have ruled now for many years. The claimant asks for what bothers him (or her) using terms that he knows. The VARO, according the VCAA laws, is required to provide medical examination to determine what that ailment, sickness might be and provide compensation for the SC "stuff". This RO where I live, never does follow thru on my "informal claim". Don't you wish you could take all their BONUS checks and put them into a "FUND" to pay for LEGAL assistance. I joined the USAF in '67, was almost "flu less" for 17 years (I did not say "CLUE LESS"). How come we have to FIGHT for that which we deserve and if it NON-adversarial, why do they need HUNDREDS of LAWYERS who are not our ADVOCATES. After 20, I couldn't run, breathe, think, usually enjoy life. I am in my late 60s and can't put on my socks without help, or go out without my oxygen bottle. Venting------YES. My years of claiming DEPRESSION, PTSD, periodic BRAIN DEATH should have been resolved less than 27 plus years it took to get me here. SInce 2009 when the VA "shrink" doubled my 'brain meds' and my civilian doctors can treat the other stuff, my years of research has gotten me here, along with you guys from HADIT. I can repeat a lot of this "stuff" but cannot understand why the VARO will not follow the laws. Tell me what you think? If I have quoted something wrong, or misunderstood what I have read, used the wrong terms, please CORRECT me, or explain that which would be correct. I never ramble.......right

Thanks for your reply. This RO has ignored so much stuff over the years it is painful. I believe RATERS are IGNORING the laws, as Courts have stated many times, so in my APPEAL I am "enabling" them to "become aware" of these laws, and to show the Judge how arrogant they are to veterans. The rules and the law regarding PTSD changed in 2010 Stressor Determinations for Posttraumatic Stress Disorder Federal Register /Vol. 75, No. 133 /Tuesday, July 13, 2010 /Rules and Regulations 39843 DEPARTMENT OF VETERANS AFFAIRS, FR Part 3 RIN 2900–AN32, AGENCY: Department of Veterans Affairs. …….‘‘fear of hostile military or terrorist activity’’ means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, Regarding EVENTS in STRESSOR DETERMINATION In addition, an event does not have to be lethal. As provided in the rule, the traumatic event can involve actual or threatened serious injury, as well as death, or a threat to the physical integrity of the veteran or others. Therefore, if a veteran experienced, witnessed, or was confronted with an event involving actual or threatened death, serious injury, or a threat to the physical integrity of civilians, the event would qualify as a stressor. From the: July 12, 2010 New Regulations on PTSD Claims A Veteran will be able to establish the occurrence of an in-service stressor through his or her own testimony, provided that: a. the Veteran is diagnosed with PTSD; b. a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted confirms that the claimed stressor is adequate to support a PTSD diagnosis; c. the Veteran's symptoms are related to the claimed stressor; and d. the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service and the record provides no clear and convincing evidence to the contrary.

Thanks again in advance. I get a good rating in late 2013 (100 TDIU from SC), some RETRO pay. Sent a NOD in almost 1 year later and PTSD denial was #1 denial. Interesting because the VA Mental Health had me since 2007 as a diagnosed PTSD, GAF-40, with "loose marbles", anxiety and OTHER. The RO has been turning PTSD down since 2005, so along with the NOD, I attached all 8 years of more than 100 pages of "active" VA psychiatrist (MD) and psychologist (Phd) VAMC records, plus 14 pages of very detailed "in service" stressors and other stuff that contradicted their DENIALS for all those years. They send me a letter in January 2015 stating they cannot read/understand what I am asking for, with a "copy of that Rating" I am disagreeing with BUT with a NEW entry listed in the EVIDENCE. Now it shows records from these years of MH records. (as if they knew about them all along). Then I send them a "small words" version of the NOD and this past June 2015, I get a SOC that is an exact copy of their modified EVIDENCE version form January, and in the last few pages of the SOC they put: We received your medical evidence from the TIMBUKTU VA medical Center which discusses the symptoms of your medical condition. The available medical evidence is insufficient to confirm a link between current symptoms and an in-service stressor. Therefore, service connection for post traumatic stress disorder remains denied. Wow, now they can change a DIAGNOSIS to a DISCUSSION of SYMPTOMS. Such power, such finesse, such arrogance! I want to find a way to inform the judge during my BVA Video that this has been done. Can I???????? How???????? Lastly, My Form 9 lists all items I am appealing, but general explanations of my disagreements plus some M21, Title 38, and Court citations that are HELD. The local RO wants to see my Appeal first (don't like that idea), and when I finish my many pages of Appeal evidence, I want to send that directly to D.C. after the RO officially notifies me that they sent my C-FILE to the BVA. I welcome your opinions, advice, and suggestions. Anybody want to see the SOC? Marty

Yes, I also feel that pain. Mine went in Nov. 2013, had a suspense date of early 2014 and now back in the initial stage till 'hell freezes over" is my guess. Actually, if e-benefits had anything, rather than nothing, it might make thinks easier....maybe.

Berta, Somehow I forgot where I posted this. Thanks for your reply

Berta, I guess I am really confused. I get my retired military pension(RMP) since '87. My VA comp just hit 100% TDIU last week, My SC total is now 70% I am a VN vet w/ AO presumption for DM II I am 65 since last February. I receive Social Security since my 65th birthday. The AL tells me that my RMP will get my VA comp amount that has been pulled every month since 1987, thereby making it whole again. The new 100% comp will come entirely out of the VA's "pot of gold". The SS will do what????? The 100% TDIU payment will be more than 2X that of the SS. Any help figuring this out will be appreciated. Your advice, and others, is ALWAYS welcome. M.

Thanks for that advice. The AL is telling me to consider not entering new claims. I guess they are representing themselves, rather that me.

State benefits???? I guess I need to call the ADOT and see if they will give back the "big bucks" I gave them last month for my registration. As for anything else, I do not know where to look, or whom to ask. Ah, another mission for next week. Thanks for bringing that up. Marty

Got this from E-benefits as you all suggested: Also got the actual rating document with SOC. I WILL GET INTO THAT NEXT WEEK. The biggest problem is that the American Legion "dropped the ball" by not sending my requests for extension of time, well before the due dates because of a significant "flare-up" of my cervical stenosis. I am still typing with 1 finger left hand. Also, just found out 4 months later that the American Legion did not submit that "dependents" form. I would have been waiting forever. Anyway, this attached letter takes some load off. Now to submit to SS for dis E-Benefits Dec2013.pdf

WOW, thank you all for the replies. All very informative. When the letter arrives I will scan and paste most of it here and list any attachments. Yes this makes me very happy but also found out today that they denied all other items, gave me the 50% depression instead of the PTSD. This means they did not review the VA PSYCHIATRIST or PSYCHOLOGIST diagnosis of PTSD. Since the AL failed to request the extensions I needed, the VA denied those appeal items and didn't even review my legal statement given to the "call center". Beyond any hopes that I had previously about filing an appeal, or NOD, or even understanding any of the process, you guys gave "tons" of useful information and I really appreciate the help, information, and support. free_spirit_etc: I never thought you "dropped the ball". You and others gave me all the help I needed at the time I needed it. I couldn't ask for more. Marty

Just found out will be paid at 100% TDIU. Also told I got 50% for depression. Had neither one before last week but had submitted the form and evidence back in June 2013 for both. Actually, this decision came as a surprise. Letter not received but got about 1/2 total lump sum retro pay on Saturday. Brings my "scheduler" to 70%. If I am using the wrong terms it is because that is the exact explanation given to me. I was then told by 2 different VSOs that this 100% TDIU is not the same as 100% P & T, and the other said it is a 100% P&T even though the VA database says 100% TDIU. Can someone clear the fog for me. Also, I still have other items on the appeal that are awaiting C&P rescheduling. Two of these items will easily get 60% each, with one maybe to 100% by itself. Another thing "they" cautioned me about was filing any "NEW" CLAIMS as the VA then tries to lower existing ratings. Any truth to that? Thank you in advance.

Actually made some progress with tracking down the AL "chain of command". I actually spoke with Verna Jones in Washington DC and she passed me to a staff member who told me that in some states the American Legion VSOs are state employees and don't answer to Washington but to the Director in their state. That is the way it is here in AZ. So you need to find out first, who does your VSO answer to, then go from there. How did I get to Verna Jones? Hard to believe but I called the 800 Customer Service # in Washington DC and got her the 2nd day. She was nice to talk with but very quick to respond to me that she had no power to control the VSOs.

Thanks. Replied to this in a later post. Marty

I will make some calls this week to confirm but will post the name and adresses I am still unsure of how to get the DRO to indicate what records he actually has in his possession, as he has requested releases for the two groups of records the VA claimed it used for this rating, and the PTSD questionaire without regard for the 2010 change and the fact that I told him the same thing during the video conference. Here are those references: Mayhue v. Shinseki, 24 Vet.App. 273 (2011) Mayhue clarifies two important principles: 1) To verify alleged stressors in PTSD claims, the VA must undertake its duty to assist. For example, the VA frequently asks the veteran to provide details of the claimed in-service stressors within a three-month period; Mayhue requires the VA to look at the claims file to see if this information already exists in the veteran’s claims file rather than place the burden on the veteran to recall 40-year old events relating to the Vietnam Conflict, and 2) if a veteran requests a TDIU rating or submits evidence of unemployability, while the underlying claim is pending, the VA must consider all the evidence dating back to the filing of the underlying claim in assigning an effective date for a TDIU rating); see also Shipley v. Shinseki, 24 Vet.App. 458 (2011). And the particulars of the 2010 changes: …effective July 13, 2010, VA amended its adjudication regulations governing service connection for PTSD by liberalizing, in certain circumstances, the evidentiary standard for establishing the required in-service stressor. See 75 Fed. Reg. 39843 (July 13, 2010). PTSD Streamline Processing: A Veteran will be able to establish the occurrence of an in-service stressor through his or her own testimony, provided that: the Veteran is diagnosed with PTSD; a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted confirms that the claimed stressor is adequate to support a PTSD diagnosis; (Read above) the Veteran's symptoms are related to the claimed stressor; and (Read above) the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service and the record provides no clear and convincing evidence to the contrary. (Read above) This will eliminate the requirement for VA to search for records, to verify stressor accounts, which is often a very involved and protracted process. Marty

Thanks for the comments. Reply to Free Spirit and you. Will wait for the SOC until ......... I am trying to understand the importance of the SOC but I guess I can do the appeal without out it. As for the VSO, it is the Stupidvisor I am dealing with now and that person tells me a POA is neither a legal document nor binding. This person referenced the M-21 re: VSO General Duties and said they don't have any other requirements and a POA DOESN'T have any fiduciary resposibilities. I am submitting a "nice" letter to the National Director and the Commander of the AL. Fortunately, I have all the emails back and forth. I also believe that the AL VSOs and their boss are terrible representatives of this process. I don't know if you read my post on the E-Benefits screen on my account. I wonder how I can get it updated and since I am limited to one finger typing on my left hand and none on my right because of my cervical stenosis flareup if it would be a good idea to submit that problem and request for extension as I saw here on hadit. I have asked the VSO in writing since late Sept. to do this but they haven't. Comments welcome. Marty

Thanks for this idea. Yes, I believe I can submit enough for the diabetes to 100% and maybe TDIU also. Yes the extra money would really help. Actually found out that when my total % goes to 50% and above the VA comp goes back into my military pension and the VA comp comes as a separate payment from the VA 'pot of gold'. That would be very nice. So how do I get the DRO to forget about the new stuff until after this rating? And to reply to another post, if I can put the SOC off until later, I will. Marty

All I have is exactly what you have viewed. Thanks for clarifying that. It is entirely because of this lack of the regulations, laws, etc. that, as you said, should have been given when the NOD was accepted by the VA. Even though the rating states why in general terms, I don't believe it qualifies as a SOC and my understanding of the sequence is based on this: The appeals process begins with a claimant's filing of an NOD from an RO decision, which triggers VA's duty to issue an SOC. See 38 U.S.C. § 7105(a), (d)(1). Only after an SOC has been issued may a claimant file a Substantive Appeal to the Board. See 38 U.S.C. § 7105(d)(1). If the Secretary fails to act on a claim or if he fails to provide the veteran with information or material critical to the appeal, that claim remains pending. See Cook v. Principi, 318 F.3d 1340, 1334 (2002) (citing Hauck v. Brown, 6 Vet.App. 518 (1994)); Norris v. West, 12 Vet.App. 413, 422 (1999); see also 38 C.F.R. § 3.160© (2008) (defining a "pending claim" as "[a]n application, formal or informal, which has not been finally adjudicated"). I don't know if you also read about thge latest fiasco because of the American Legion VSO. Wonder if anyone knows how to get/demand/ask for my legally due SOC, and another question, how do I get the VA to "stop the clock" on me submitting anything, until they provide that SOC. i am writing a letter to the National Director/Commander of the American Legion Headquarters in regards to this AL fiasco. Thanks also for the info on attorneys. Yes it appears that most do 20% on your retro payments and some say they will always try to get it from the courts first and you 2nd, and nothing unless they win. Nice insurance huh? I want my life back. Marty

It appears I may have been abandoned. Also based on my E-Benefit page the AL failed to file paperwork on my documented PTSD from 2008 VAMC records and a 60 day extension request to the DRO and now it says its final. This should be interesting as the VA has had possession all this time but apparently because I didn't fill out their questionaire for PTSD and the above stated AL failure, I am not sure what to do. I requested this extension for returning anything to the DRO because of additional medical issues, and I was specific, as these are part of my appeal. I also made it clear in the DRO conference that the VAMC had all those medical records for PTSD. I just thought I would tell all of you that ALL of my posts have been with one finger on my left hand since the beginning of October. It takes me hours to type posts, reread, correct and repost. It is that turtle and rabbit thing. I think the warranty on my body and mind ran out years ago. If this doesn't improve, I am going to install DRAGON software and try to use it. Any ideas? Also I sure could use some ideas on lawyers that actually have success with the VA. Marty

RE: what laws, rules, codes di the VA use for sarcoidosis in 1987 when I got my 1st rating After reviewing about 40 cases from 1971 thru 1993, it appears that the SAME codes used in the cases you showed, were used from at least 1980 thru 1993. which works for me. Also the laws appear to be the same thru 1993. What was also apparent is that even "back then" the VA was supposed to document "how this disability affected the person's ability to work". This from 1988: A 60 percent evaluation is warranted when the disease is chronic with frequent exacerbations and multiple joint pain and organ manifestations productive of moderately severe impairment of health. 38 C.F.R. Part 4, Code 6350. These codes are great for my 1st rating. And from the same case: Initially, the veteran's sarcoidosis was rated by analogy to systemic lupus erythematosus under Diagnostic Code 6350. Prior to the 1996 revisions to the rating schedule there were no published rating criteria for sarcoidosis. Thus, the condition had to be rated by analogy. See 38 C.F.R. § 4.20. Also: In the Board's judgment, the evidence of record is adequate to establish that the veteran's sarcoidosis was symptomatic during the period from January 1988 to July 1994 and as such would have warranted a 10 percent evaluation under the provisions of Diagnostic Code 6350 So I think that "nails" the code and laws for those years. Your research refs. put me on the "right path" Also found(different case),this but confuses me somewhat: Maybe the residuals caused the code change. The veteran's initial claim for compensation was received at the RO in February 1985. Service connection for pulmonary sarcoidosis with radiologic residuals of pneumonia was granted in a December 1985 rating decision, and a 10 percent rating under diagnostic code 6699-6600 was assigned, effective from February 1985. In a February 1987 rating action, the RO increased the evaluation to 30 percent for pulmonary sarcoidosis with a history of pneumonia, effective from July 1986. I. Sarcoidosis Pulmonary sarcoidosis with a history of pneumonia may be rated as unspecified pneumoconiosis, which, when definitely symptomatic with pulmonary fibrosis and moderate dyspnea on extended exertion, is evaluated at 10 percent. When symptoms are moderate, with considerable pulmonary fibrosis and moderate dyspnea on slight exertion, and confirmed by pulmonary function tests, a 30 percent evaluation is warranted. 38 C.F.R. §§ 4.20, 4.97, Diagnostic Code 6802. This ref is in exactly the same year and close to my July 1987 retirement date so this code is VALID for me: In July 1987, the RO granted service connection for sarcoidosis and assigned a 10 percent disability rating under Code 6699-6802, effective from March 1, 1987, the day after the veteran's separation from service. Then I saw this: In order for the veteran to receive a higher rating for sarcoidosis by analogy to pneumoconiosis, his symptomatology must meet the criteria set forth in Diagnostic Code 6802 for those ratings. To receive a 30 percent rating, there must be moderate disability as manifested by considerable pulmonary fibrosis and moderate dyspnea on slight exertion, confirmed by pulmonary function tests. For a 60 percent rating, there must be severe disability, as manifested by extensive fibrosis, and severe dyspnea on slight exertion with corresponding ventilatory deficit confirmed by pulmonary function tests, with marked impairment of health. 38 C.F.R. § 4.97, Code 6802. The keyword here is the PFTs that, in my case, were one of the many things that were not accomplished in my rating at the time, nor was the following: In reaching its decision, the Board has considered the complete history of the disability in question as well as the current clinical manifestations and the effect the disability may have on the earning capacity of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.16 (1994). The nature of the original disease has been reviewed and the functional impairment which can be attributed to pain or weakness has been taken into account. 38 C.F.R. § 4.40 (1994). Further, the Board has found that in this case the disability picture is not so exceptional or unusual as to warrant an evaluation on an extraschedular basis. Why is this important to me? Because when I go back even to the earlier denials to increase requests as early 2000, I now have additional refs. to use. Why? Because my sarcoidosis was very active AGAIN in '92-'95 as I have stated in other posts. Marty

From what I am reading in the "books", they still owe me a SOC. When I filed the NOD, the group that made the rating(San Diego under Nehmer) was responsible to send one to me. All I have is the rating, which all of you are privy to. I am not aware that can be a SOC according to what I have read. Tell me if I am wrong. Marty

Marty

Thank you Marty

Thanks for this reference. Actually, since this vertigo problem came up(internists says because of worse conditions from cervical nerve impingement (part of new claim), I can't go driving but I need to get to my pulmonologist sometime before this appeal ends. In my case(sarcoidosis) appears to have taken maybe more than 4.5 years to "get nasty". Just thought of this: Multiple PVCs in mid 1980, started having shortness of breath late 1983, all 3 pneumonias beginning late January 1985, confirmed diagnosis pulmonary sarcoidosis Sept. 1985 Marty

Thanks. I know you can only file a CUE once per item, or that rating. I might have nothing to lose for 1987, but would really like to say to them, on ther day I left Active Duty, I was Stage 1, on prednisone, had residuals, fibrosis etc, PFT exams about 2 weeks old now rate me fairly, and by the way, while you are at it, explain why all my requests for increases were never evaluated including my recurrence in '92-'95, at any rating subsequent to 1987, for changes, residuals, and yes, whatever was required to give me my ratings according to the current laws then and now. Somehow, I think that has to be valid and maybe a CUE but I haven't looked at an attorney because most probably I can't afford one. That is why I do all this work. Marty

I believe I may have explained this in a later post or reply. I am not sure where the confusion came from but the sarcoidosis and the PVC are only possibly related because of possible AO connection, as is the DM II is already confirmed. I haven't asked the cardiologist for his opinion lately. Marty