TiredCoastie

Just wondering if anyone has a good list of what exactly is considered to be a Gulf War related neurological condition? I've seen ALS, Parkinson's, and a couple of others. Reason I'm asking is that I wonder if my TIAs and cerebral thromboses could relate back to my deployment to Operation DESERT STORM? I never considered myself someone who had or would have the Gulf War Syndrome that was all the talk some years ago. I was on a Navy warship in the Red Sea for a few months supporting DESERT STORM a while after the major active combat ceased. Now I have what have been diagnosed as TIAs, very difficult migraines, and pretty consistent tingling and numbness on various patches of my left side at any given time. As a Gulf War vet with a Southwest Asia Service Medal on my DD214, I'm very interested not only in trying to find answers to my condition but also to establish service connection for TIAs and the thrombosis issue. I'm in the process of compiling a NOD of a recent decision to not SC my TIAs, etc. However, if this could be covered as a presumptive condition, I feel like I need to make that connection on the appeal. My migraines were SC via the initial claim at discharge and just increased to 30%.

63Sierra is right. eBenefits is notorious for not tracking what's been submitted no matter whether you upload documents directly online yourself, mail them, drop them off yourself, or send them through a VSO. Someone mentioned that there is an online checklist within one of the RO's computer systems that no one uses. That's the system that feeds eBenefits. An IRIS response is a whole lot more reliable regarding what they hold and what they don't. In my three claims, only one eventually came to state that they received something from me they'd asked me to submit. The other two stated that they asked for documents I'd already submitted with the claim up front but showed them unreceived even after the claim was closed. Meanwhile, both response packages cleared showed they received the information needed. The exception was the request for my DD214 back when I first submitted my claim, seeing as I filed a couple of months before discharge, and that one did show up as received.

Thanks, John! I've learned a lot from you all and see how the game is played. The tragedy is that you have a loss, and it's dead flat wrong that you do. At least some of us can gain from that loss. Thanks for sharing! Sure, the VA can try to reduce me. Trouble for them is that all of my conditions are legitimate. Any kind of look at my conditions may well result in the opposite happening...they may be forced to increase at least one or two. My sense is that the VA is trying to keep from having a bunch more of us at 100%. Throwing me a bone of 60% was a start, but they lowballed some of my conditions. I waited a year or so, then reapplied for increases but this time with top outside medical professionals treating my conditions and willing to write about them. Now I'm at 80% and should have been at least at 90%.

Thanks John and Berta. I knew I could count on you for widsom on this! To answer your questions, Berta, that is a direct quotation, and no, there was no regulation cited. The lack of a regulation cite was one of the first clues that there could be a problem since the decision rationale is peppered with them. I posted my follow on kind of blindly after you both had responded, as I got distracted by my beautiful wife while typing and posting. Looking at my case, my file was very quickly transferred back and forth between ROs - probably electronically thanks to the new technologies in place - and the deciding RO didn't get a good look at the whole file before making a very quick decision, literally within 3 or 4 days of getting my file and claim. So because they didn't take the time to make it right, they must have litereally blown through the decision, slapping it together without noting that the migraine contention was a follow on from a previously denied claim. What was a benefit to me for my knee was not the right decision to my 'noggin. I think 3.156(b) is the right regulation to quote back to the RO in the NOD. One of the lessons learned for me in this instance is to put everything I expect in writing and make it as simple to understand as possible whenever submitting anything to the RO. I relied on the VSO to pave the way for the "reconsideration claim" that they insisted I should submit and that a better rater would make mostly right. In their defense, they did write a cover memo stating that I was asking for reconsideration of the denied contentions which should have "footstomped" the need for a deeper look into the claim history - something that should have happened anyway. In my defense, that was before I found hadit. I'll be much more explicit in how the regulations should be applied next time I submit a claim...just like any of us would with a NOD.

Dug around and found 38 CFR 3.156(b) regarding new and material evidence -- (b) Pending claim. New and material evidence received prior to the expiration of the appeal period, or prior to the appellate decision if a timely appeal has been filed (including evidence received prior to an appellate decision and referred to the agency of original jurisdiction by the Board of Veterans Appeals without consideration in that decision in accordance with the provisions of §20.1304(b)(1) of this chapter), will be considered as having been filed in connection with the claim which was pending at the beginning of the appeal period. I was easily within the 1 year deadline for the introduction of new and material evidence, which should then automatically connect back to the denied claim...especially since I was asking to have that claim reconsidered. My brain's somewhat hazy - do I have this right?

Hello everyone! I'm in the process of digesting my latest claim decision and am drafting a NOD to address a denial of cerebral thrombosis/TIAs and a lowball of the migraine increase (from SC & 0% to 30%). Can I appeal the effective date? There's a statement regarding the effective date on my migraine increase which says: The effective date of this grant is XXXXXX. Entitlement to an increased evaluation has been established from the date of the medical evidence showing an increase in disability (Headaches DBQ completed by Dr. XYZ). When private medical evidence showing an increase in disability is received within one year of the date of the evidence, the effective date of the increase is the date of the evidence. So, in other words, the date my neurologist signed the latest DBQ is the effective date of the grant of increase. The problem is that I had filed for an increase about a nine months before the effective date of the grant, but was denied. In response and at the recommendation of my VSO at the time, I submitted a "request for reconsideration" claim. The NSO felt that I'd gotten a bad rater when I first requested the increase and running it through the system again had some probablity of success quicker than filing an appeal. In fact, the rater somehow missed that I had an informal claim in the system a month previous to when he or she assigned the date of that claim. Meanwhile, the NSO sent me back out to my doctors to get fresh DBQs as "new and material evidence." The signature date on the new DBQ is the date of the grant. Looking at the situation with the arthritis in my knee, which was another contention of the latest claim along with the items I asked to have "reconsidered," I'm benefiting because the date that doctor signed the DBQ is a little earlier than the date of the latest claim. But I had made no previous request for an increase for this contention. The effective date for the grant of the increase uses the same wording and rationale as the migraine increase. Do I have an argument here for an earlier effective date on the migraines?

Thanks, Chris. I've been going after this exact problem since I was initially denied on my first claim. My MEPS exam did include a hearing test which showed mid-range hearing loss. I've contended that this initial exam was inaccurate. My hope was that my ENT would look at the results, see that my hearing improved after I entered the service, giving me the argument that the test was clearly faulty. My ENT with his audiologist walked me through the hearing test results. They showed me that, for whatever reason, by the time I had my next audiology exam after MEPS, my hearing pretty much matched my intake exam. This may seem strange to have this memory reaching back almost 30 years to that MEPS exam, but I remember being frustrated because the booth was noisy. This particular disability was a matter of making something right rather than a distinct "gotta have it" service connection decision. I still believe that my time in the service damaged my hearing. But, by God's grace, I'm receiving the care I need to be able to hear better without my hearing loss being service connected. And I've got bigger issues that I've got to fight, like my TIAs. In the end, hearing loss will be a nusiance for the remainder of my life. The underlying condition that's causing my TIAs, which is without a doubt service connected, may well end my life.

The VA is supposed to pull your VAMC records as part of its pull of medical records across the federal government. My assumption is that this process is one of the more reliable parts of the claims processing system. That said, and seeing as I receive almost all of my care outside of the VA system, I submit all my associated medical records with the claim. If there's something you'd like to highlight with the RO, can't hurt to submit a copy of your VAMC records when you file even though they're supposed to be obtained automatically. By getting a copy of your VAMC records, you'll also know if there any "unexploded ordinance" in there to which you may need to respond. And, as Berta wisely discussed already above, there is a C&P exam after-the-fact review you'll want to make. Besides the "blue button" records download through MyHeatheVet, you can obtain a copy of your records by stopping by the Release of Information Office next time you go in for an appointment. I read somewhere that VAMCs are transitioning from printing paper copies to putting your records on a password protected CD. Looking back at your old posts, seems like you already submitted a claim back in March, so adding records at this time has the potential to slow your claim down. That will definitely happen if you filed a Fully Developed Claim (FDC). I don't have a lot of experience with how well VAMC records make the journey from the VAMC to the RO, so it's hard for me to say if you should go through the effort to drop records on the RO now or if there's a point at which you should. I think that if something substantial changes, especially in your favor, after your claim goes from the evidence gathering phase into the rating phase that you should submit those records at that time. It's better to get the claim right the first time, even if that means slowing it down, rather than go through the appeals process later if you can positively influence the decision with something new and substantial. The difference at this point is between months to a year plus for the claim versus multiple years for the appeal. Can anyone else who gets more care than me through a VAMC help out this vet?

Well, to close out this story - I did approach our ENT again several months ago after filing my NOD. He relooked at my numerous hearing test results and determined that, based on what he was seeing, I did not have a solid argument for hearing loss caused by the service after all. Then, he advised me to drop pursuit of SC for hearing loss as it might jeapordize the VA continuing to provide hearing aids to me. (Our ENT doesn't understand the VA medical thresholds and at what point medical care gets paid for - the VA didn't somehow think I needed hearing aids until I was rated at 60% and had an outside hearing test in hand.) But without the ENT's further backing, I'm going to back off pursuit of the hearing loss. Our ENT is one of the best and most respected in our region. Meanwhile, in the latest claim decision, I was denied SC for HL again. This time, they said that the ENT didn't mark that he reviewed my SMRs, which he did but did not check the box on the DBQ. Way I look at it is that God doesn't want me SC'd for HL. Besides, I've got the care I need for them, and HL isn't very likely life threatening. Stuff that other vets have like IHD, the TIAs I get - now those are life threatening and more than worth the battle to get them SC because of the DIC impacts later.

You both are quite wise. I wish I hadn't sent it that late - it was on the deadline. Between my SC conditions, Christmas, and an ongoing family crisis at the time, I simply ran out of time. I'd been trying to get to it for months. Also, however, I was hoping against the odds that the "reconsideration claim" I was talked into submitting would come through at the last minute. So I felt that I was trapped into having to submit the NOD in order to save the original claim date. In hindsight, I would have submitted a NOD rather than that other claim. But given the situation as it stood this past fall, I would have submitted it a couple of weeks before Christmas if I had to do over again. At least I listened to some of the great advice here. The package was sent certified mail, return receipt requested. So I do have ample evidence that the NOD was submitted on time. And I've submitted this proof twice now. The NOD was lost somewhere in the system and in mid-March, learned through IRIS that it was never received. So I sent the NOD again with the proof of postmark. Then, earlier this month, I got a letter responding to one of the submissions (original one or the one in March, don't know which one). The RO claimed I'd submitted a statement in support of a claim rather than a NOD and that it was late anyway as "officially" logged in as received about two weeks after the deadline. "No, no, no!" I responded immediately and in writing (also sent certified mail....yeah, it costs a few bucks but it's like insurance). I pointed out that I had filed a NOD and even used the new version of the NOD form, sending them yet another copy. And I gave them another copy of my hand postmarked certified receipt while quoting 38 CFR 20.302(a) and 38 CFR 20.305(a) about the use of the postmark as the date filed (thanks again to a number of hadit folks who helped me quickly put together a response).

I think you're right. The rating is a two edged sword and it's been a little bit of a wake up call to know that I'm at 80% now. We were designed to work. The problem comes when that ability has been taken away completely or in part. In our cases, our ability been impacted by hard use in the defense and security of a somewhat grateful nation. For some, there is a point at which we cannot do anything. For others, we cannot do some things. It's a hard choice, IMHO, to seek after TDIU because I think it's hard to know where that boundary is. And it's going to be different for each of us depending on who were are and what our disabilities are. May the Lord bless everyone trying to make these kinds of decisions!

In my case, the RO is trying to say that the date they stamped the green return receipt card was the date the NOD was filed, not the postmark date per the CFR. I'd be all done if I hadn't sent it certified mail from the mail counter with a hand stamped postmark on the certified mail receipt itself along with the cash register slip. We're in the midst of getting this straighted out now.

That's why you've got to be ready to get to the Ombudsman ASAP if things are moving fast enough. If that doesn't work, you may need to connect with VAMC leadership.

VAMCs have chiropractors? Who would have known? 63Sierra, maybe it's time for a new PCP. Seems like you're to the point you need someone new. There is a process to do that, some form they have to send you. Call the primary care team you're under and ask for a new PCP. They'll ask why. Tell them. They'll send you the official form. Be ready to engage the ombudsman at your VAMC if you don't get shifted quickly.

No kidding! I submitted a NOD, on the latest version of the NOD form, postmarked a day before the deadline back in December. Earlier this month, after sending it again because they couldn't find it, I got a letter stating I hadn't submitted a NOD and if I had, it would have been late anyway due to the date it was officially inprocessed at the mailroom. Earlier is clearly better.

Hey brother, I hear you. I wish there was a quick way to get the VA to do something. Just in my experience, the VA often sees that they got you something and they'll move on to get someone else something. The trouble often is that the "something" you got wasn't right. However, the VA won't move quickly to correct an error because at least they got you something. And because it will eventually work out right in the end with a chunk of retro, then there's no harm and no foul in their minds. I don't know very much about the CUE process, but it sounds like if they're admitting to an error, they could be treating this as some sort of CUE procedure, which can be pretty slow. Do you have a VSO? It's possible that a good service officer will work something out internal. The trouble is finding a good NSO as they're few and far between. Maybe your best bet is to engage one of your elected represenatives in DC, especially if any of them are on one of the VA oversight committees. If not, pick your senior senator to ask for help.

Unfortunately, that's the way the system works. You are where you are in the stacks. It's possible that they will complete the claim in a shorter time than they advertise as the average in their response, and eBenefits' expected time frames are completely wrong all the time (if not, it's a fluke). According to what the VA just published this afternoon, the average time to completion for claims originating at LA is 314.6 days counting back to Oct 1st. With your claim still in the development phase, it's not actually pushed off to a rater yet. It could be a while or things could suddenly move very quickly. I've been told that the only way to re-order the stacks is to prove that you are in severe financial difficulty - filing for bankrupcy, house is under foreclosure, etc - or get your Congressman or Senator to change things around. The Congress-thing is pretty iffy and could cause more trouble than it solves. It's not right, but there is a concept that justice delayed is not justice denied seeing as you'll eventually be reimbursed with whatever retro you receive. Meanwhile, you've got bills to pay whether you're bad enough to be in bankrupcy or foreclosure or not. And the process is piling additional stress on you who is already carrying scars. Hang in there!

It's not like you don't have any recourse. If you have medical records that show otherwise, that's a substantial pile of proof. Be ready to stand on that. If you can, get outside medical opinions. However, you'll have to wait for your claim to close to see what was denied or lowballed before you really take that next step.

It's a wait-and-see, I'm afraid. One would think they'd take the opinion of the neurologist. But I wouldn't count on it. In order for migraines to be at the 50% level, they have to be "with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability." That's not well defined, but the 30% level is prostrating once a month. Be prepared to submit a NOD. But one never knows. I'm in the process of crafting a NOD to address my migraines being lowballed at the 30% level. God bless!

So...with all the emphasis on moving claims fast (subject of other posts here) and the number of decisions with obvious retro pay issues, I wonder how the VA's disability compensation budget is working out these days? It's not an unlimited pot of money but filled to a set level by Congress each year. They cannot pay out money they don't have.

You're welcome! Tech support ought to be there today...at least someone can get a trouble ticket written up and in the queue to be addressed on Tuesday or Wednesday when everyone gets back to work. Don't give up!

Approach your doc and ask if she would be willing to fill out the DBQs. You're going to need a written statement from her that indicates that, after reviewing your service medical records, it is as likely as not/more than likely that your conditions started while on active duty and that you were more than likely misdiagnosed with insomnia. Insomnia can be a symptom of OSA. Then I'd go with whatever she's willing to put in writing in terms of stand alone conditions versus one secondary to another. If you can't get any help from your doc, then you'll need either another doc or Berta's link to IMOs above. IMHO, I'd want to have them separate. Someone at the RO could decide that if you get your OSA under control, your BP will reduce under HTN limits, esp if you're early in the treatment. If you read through many of the OSA posts here, a common trend you'll see is that if you weren't diagnosed while on active duty, you will likely need some additional evidence such as a letter from your wife or from a shipmate who slept in your berthing area that it sounded as if you stopped breathing, heavy snoring, etc back during those active duty days. This is often refered to as a "buddy letter." This is particularly true if it's been more than a year since you discharged. When did you get out of the Navy? If you're within a year of discharge, then things are MUCH easier. Regarding your OSA, do your best with the CPAP. I don't like sleeping without mine, even if I take a nap. Keep working with whomever's issuing it out to you to get mask and settings you can sleep with. Don't give up. HTN is only one of the things that can come from it. Get a handle on it now. This is actually your biggest concern above what and how to claim the conditions...getting those conditions under control is primary.

Pete had a really good point above. Besides "Peggy," there is a tech support/IT desk for eBenefits at 1-800-983-0937. I'd try both numbers before giving up.

I think it will depend on what your doctor is willing to state on your behalf, including the testing/imaging results, diagnosis, and nexus to your SC condition. It could be a worstening of your SC condition. It could be a new condition secondary to your original condition. Your doctor will be the one to make that determination. I'd go as generic as possible, though, when you claim it to prevent getting boxed in later. Either way, this is why you went through the trouble to get SC in the first place. At some point, we all get worse.

In my experience, going through the VAMC is the better approach rather than trying the RO. I've never gotten any document requested of the RO. Around here, the RO "outsources" the C&P to the VAMC, including the QTC exams. So it all funnels back through the VAMC. However, I've never tried to get my C&P results before the claim closed. Each time I've received my records from a VAMC, I mailed this form, VA Form 10-5345a, to the "Release of Information Office:" http://www.va.gov/vaforms/medical/pdf/vha-10-5345a-fill.pdf In getting the form link, I read that the VAMC has started sending CD-ROMs with records now rather than printed paper versions.