TiredCoastie

Yeah, Chief, I did REFTRA (or was it TSTA by then?) in those days at Mayport on a WMEC. The Navy has always been a good friend to my old service, and I've got Navy friends as well. May God bless you, too!

Yours ought to be faster than mine, only because DFAS has a direct way to transmit what's called the "Audit Error Worksheet" to the VA. Retired Coasties like me get ours done by USCG PPC, and we don't have a direct link. I have a feeling that my AEW is lost again, and it's not the first time. Something happens in the receipt process. The file was sent back in December and no one seems to be able to find it. If you haven't seen anything and it's becoming a while, it doesn't hurt to check with your pay clerk at DFAS and see if and when they sent the file. PPC actually sends me a letter giving me hard copy proof. Armed with the knowledge that your AEW has been transmitted and given three weeks to see the file loaded and made active within your C-file, it's time to start getting after the RO and ask where, oh where, has my backpay gone? If they open a claim to process your backpay, at least you've made it that far. I have routinely found that the respectful but squeeky wheel gets the greese in due time and uncovers problems along the way. It's a long and painful process, and I am looking forward to not having to address claims and appeals.

Are you retired? If so, there is a process that for DoD services includes a retired pay audit by DFAS. For those of us serviced by the Coast Guard Pay & Personnel Center, PPC does ours. That's part of the potential delay as they work out CRDP or CRSC depending on your situation. In my case, it takes between six and nine months to get the retro payment, maybe longer. I'm still waiting for one on a decision from September 2014.

I think this is a very good question and I'm not sure the answer is all that certain. JMHO - there's a firm "maybe" in whether or not the appeal would follow you.

That's a good question. You have a couple of options in my book and others may have more advice. 1. File a NOD after you receive your decision if you are not rated for this condition. Your C&P exam results discussed your MRI findings. Therefore, the RO has evidence from its own investigation that you have the condition. If they don't rate you for this, which they found in trying to investigate your migraines, you could file a NOD and point out that they should have rated you for this. In fact, that's one of the things I've appealed for in relation to my TIAs. In the midst of the back and forth claims and N&ME, I submitted evidence showing that I have had cerebral thrombosis. 2. Submit another claim specifically for this condition. If you file a NOD after you get the decision, you will get another look by default anyway, especially if you point out that a disability was not considered or rated. But if you lose after filing a second claim, you'll have to file a NOD anyway which just repeats the process before generating a SOC and will cost you a year or more longer to getting in line for the BVA. BUT, you could do file another claim RIGHT NOW to ensure the RO considers this condition and evidence as well, but it would slow down your claim's process if you were hoping to do an FDC. If DAV is your VSO, I'd get with them ASAP and discuss options. They'll probably tell you to wait and see what happens, which is part of either an option. You'll want to insist that they do what you want them to do when you decide what path to take. Personally, I'd file that second claim right now. The biggest questions will be when and why did the bleeding occur? That's what you'll want to ensure is highlighted in whatever package you choose. Sounds like you got your brain box rattled back when you were in the Corps. This could be a TBI issue and you might want to read up on 38 CFR 4.124(a) in regards to that to determine exactly how you should approach this claim. Meanwhile, I tried to see your documents from eBenefits but the system doesn't allow us to see what you can see after you log in. It does sound like you got an interim decision. In eBenefits, if you look under your disabilities in your profile, you'll find if your migraines were increased from 30% to 50% as well as if anything else was decided. It should also show what conditions they're still working on if they haven't been rated previously. Hope this helps! God bless!

Yeah, I did a 2-week holter looking for dangerous arrythmias to ensure I wasn't throwing clots causing which were causing my TIAs. But that's a different problem from migraine. The problem is that migraine is pretty challenging to unravel, and while research has uncovered some, there seems to be a lot they don't know about it. Maybe someday they'll be able to hook us up to a box and figure out the whys and best approaches. We had a neurologist tell my wife and me once that there are three areas in which even leading experts know suprisingly little: deep space, the deep sea, and the human brain.

JMO, but in your case, they should have also rated you with "8009 Brain, vessels, hemorrhage" with 100% for 6 months then a rating decision based on C&P results...beside the 50% for prostrating and economically impacting migraines. Check out 38 CFR 4.124(a).

In my case, my SMRs helped because I was hospitalized with a neuroligical event that was eventually determined to be a migraine back while I was on active duty. They progressed pretty rapidly after the stress of service came off after I discharged, and got very strange and very much worse as the months rolled on. Sounds like you had one of those prostrating migraines yourself as a kid. Glad you haven't suffered one since. Even when I'm not knocked flat, they keep me from thinking clearly. There are scans, apparently, that can be done that show some sort of migraine activity but having had MRIs, MRAs, and CT scans multiple times, there is no mention in the radiology report of any migraine detected. I also had an EEG once but it showed nothing. Like I keep telling people...I keep getting my head examined and all they ever find is nothing!

Your claim status can bounce back and forth before it finalizes, so there is certainly "going back" at this point. The rater may have decided that he/she has enough at this point to make a good decision and forwarded one up the chain. Maybe they are planning to grant you a decision on what they can decide now and get you a decision about your other contentions later? I've never seen any change in the benefits verification letter, etc, this early. Once the claim closes, then those update at least in my experience. However, like Gastone always says, put a watch on your bank account for a sudden deposit.

I keep a headache log like K9MAL and tally up the prostrating attacks monthly. My nuerologist also verified that they were prostrating based on what I reported to her. Man, I wish there was something like a holter monitor for neurologic events! I'd need one all the time!

It is hard to imagine that you, as a Desert Storm vet, did not have an MRI at some point. That's not your fault. You're not a doctor and can't prescribe one for yourself. JMHO, you haven't received the best care and now it's left you with a torn ligament. I am very, very sorry that this has happened to you. The question is how do you claim it successfully? Which is the question you're asking. Some doctor along the line is going to have to put in writing that he or she believes that your torn ACL is the result of the PKR which led to a TKR. This should not have happened, but again, JMHO. Hopefully someone with more experience with 1151 claims, like Berta, will chime in.

Looking at your C&P, you actually look like you have a good shot at success if the rater takes the time to read through the notes the C&P doc wrote and looks at the whole document. One section of your DBQ caught my eye: b. Does the Veteran have very prostrating and prolonged attacks of migraines/non-migraine pain productive of severe economic inadaptability? [X] Yes [ ] No That's the key question per 38 CFR 4.124(a) for the 50% rating and what I had to prove to meet the 50% level. You ought to win this one during the reveiw of your C-file and claims before generating a decision letter or SOC. Have you gotten an SOC or SSOC yet? If you are still denied, use the above statement as the major part of your Form 9 along with your more recent experience in school.

From what I've experienced with my knee, the ACL would have been found with an MRI which can see soft tissue like ligaments unlike x-rays. If no one has done an MRI and you had a PKR then a TKR, someone has really screwed up. That's like the second thing they do after x-rays and ROM tests. Is there some reason you can't have an MRI? Unless there's a very good reason, there is absolutely no excuse, IMHO, for you to have suffered exploratory surgery to find a torn ACL. We're getting outside the areas where I have experience, but this is beginning to sound like an 1151 claim to me. Either they screwed up royally in failing to propertly diagnose you using modern diagnostic techniques or the PKR caused damage to your ACL, which could well be from bad doctoring. Meanwhile, it sounds like you have one of those benefit of the doubt situations in which there is no proof either way that you had or didn't have a torn ACL at the time you left the service. What was the original condition that caused you to have a PKR?

And for you, too.

Sounds like a nexus problem is at the root of your concern. The C&P is saying that your disability was caused by something other than military service. Who did the surgery, Mrueckert? Was it the VA or an outside doctor? If it was an outside doc, you might want to get with him ASAP and get him to put a nexus in writing - basically stating that the torn ACL either happened while you were on active duty or is the result of the partial knee replacement you had done in 2012. If the C&P doc is saying that it's due to something else, you'll need the orthopedic surgeon to say that it's service connected. Otherwise, if you have medical records which point to your ACL tear as being caused either a directly or secondarly to military service (like a result of your partial replacement), you'll want to ensure the RO has those ASAP if they don't have them already. What kind of doctor was the C&P examiner? If he was not an orthopedic doc, and you have one that says that your current status is service connected, you have enough already to successfully fight if it comes to an appeal. If the VA did the surgery, at some point you'll want to get a consult with an outside doctor to review your SMRs, your post-miliary records on your knee, and get you a written nexus letter. The question in this case is whether you wait until after you get the decision or not. If you have outside insurance, this is the time to use it. Then, as Saints13 aptly stated, it's all about ROM and stability. Take a look at 38 CFR part 4 to get an idea of what's what: http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#sg38.1.4.b.sg0

Congratulations! I was also recently increased to 50% for migraines, so let me echo that it is possible!

Glad you decided to go after the retro via Form 9, Jeff. Hope and pray this works out for you soon. In terms of timeframe, usually it's years to a decision. But you should get a notice in the mail that your appeal and C-file have been received by the BVA. That is, if the RO doesn't decide to re-review their decision against your Form 9 and grant something instead of certifying the appeal. That's what happened to me. However, the growing backlog of appeals at the BVA will hopefully start to gain attention soon. It may already be a concern at some level.

I think you're dead on with your concerns, Rootbeer. Personally, I think there is political pressure to approve more claims now than before. Otherwise, why would the RO pull my appeal back from the brink and grant me on both contentions? But that's just my gut and not based on anything solid. And you're looking for the right answer with your claim decisions, and I have seen that yet after five years. It didn't look like they would make the FY15 deadline of "elminating" the so-called backlog and, without more claims cleared faster, it still doesn't look to me like they'll make the September 30th deadline. But they turned up the tempo right after Christmas so it seems and started really driving things down. Quick check looks like there are between 32 and 38 weeks remaining depending on when you think they pushed the throttles forward, and there are 25 1/2 weeks until the end of the FY. VBA needs to reduce the overdue stacks by an average of about 7,393 per week to make it from last Monday's report. They've made the overall number of claims on hand and overdue about the same as they were when Nehmer hit, so the VA will have enough of an impact to declare victory and back off the overtime $$$ burn even if they don't make it to zero overdue claims. All I can tell you is that not one of my claim decisions that have been made, starting in 2011, have been 100% right. The only thing that was right was a CUE that the RO called on itself when presented with an effective date blunder. So if you do as well as me, your effort to get it right will continue for quite a while, no matter how fast or careful the RO is when your decision is made. They say all change in government is incremental. Guess you could also say that about getting our disabilties rated correctly...incremental improvements heading toward the right answer.

Thanks! I hope you get a quick response too. Of course, in my case, nothing is ever finished...

Great point, Rootbeer. I've been watching the same thing, particulary over the last six weeks. Two things seem to be happening. Claim numbers seem like they are dropping very fast. Looking at the published average number of days to process a claim by RO, seems like 250 days is one of the longer averages with many claiming much faster average times to a decision. Sure beats the year plus many of us have suffered through. But if you look at the published accuracy numbers in the MMWRs, they aren't that great. The MMWRs are only part of the story. Here's an example showing that you're right that accuracy is taking a hit as a result of moving too fast. I submitted a NOD then a Form-9 on a couple of decisions. Instead of moving the appeal off to the BVA, a DRO at the RO reversed decisions and granted me seemingly everything I asked for. However, he did it very quickly and used an analogous rating rather than picking the right diagnosis out of 38 CFR part 4 even though I highlighted exactly what my doctor's had said in the Form 9. Then the raters who processed the decision didn't pick up that they owed me 100% for 6 months, probably because of the analogous decision, although they got residuals rating right. My guess is that my contentions had sufficient merit so the fastest thing to do was get me off the books rather than have my easy win be one more claim clogging the appeals system. But because the DRO's decision didn't result in 100% for 6 months, then there's yet another decision that needs to be fixed. It sounds like other vets are having similar experiences. Like I wrote before - it's like a kid who cleans his room by stashing all his toys in his closet. Sure, it looks great at first glance, but mom better wear a hard hat to open the closet door! We like to complain that it takes too long to get a decision out of the VA. However, there is a cost to getting a decision too quickly. At some point, I'd like the "right" decision.

Welcome aboard! It is too early to see a change in the benefits summary letter. Once the claim closes, that letter should update right away if your overall disability rating changed. There is also a new section in eBenefits on the "dashboard" (?) that shows what disabilities you have claimed and the rating for each. Just to let you know, the status can bounce around quite a bit still, so don't get your hopes too high that you'll finally get an answer.

Actually, the VA determined my increase from the date the DBQ was signed by my outside doctor. No complaints from me on that!

I'm rated at 50% for OSA with CPAP but was declined "reactive airway disease" or asthma in my initial claim. I'm thinking about submitting a claim for asthma now that I'm on ADVAIR daily. Does anyone have any experience in winning this? However, been reading on HadIt which highlighted 38 CFR 4.96(a) §4.96 Special provisions regarding evaluation of respiratory conditions. (a) Rating coexisting respiratory conditions. Ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other. Where there is lung or pleural involvement, ratings under diagnostic codes 6819 and 6820 will not be combined with each other or with diagnostic codes 6600 through 6817 or 6822 through 6847. A single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. However, in cases protected by the provisions of Pub. L. 90-493, the graduated ratings of 50 and 30 percent for inactive tuberculosis will not be elevated. One post from 2010 pointed to BVA citation number 0610557 which indicated one interpretation of the above regulation as being that not permitting DC 6600-6817 from being combined and 6822-6847 from being combined but that a disability from each group could be rated separately. But I just found BVA citation 1448605 in which a veteran used this exact argument to attempt to separate his OSA and asthma, and the BVA found the opposite - that 6600-6817 and 6822-6847 could not be combined. So they've ruled both ways. I'm not the best at looking at CAVC cases, but I didn't see anything that addressed the interpretation in their rulings, although I easily could have missed something. Asthma is 6602 and OSA is 6847. Based on the more recent BVA decision from last year, it seems like it's not worth it from a rating increase standpoint. If I'm successful, the RO will combine the ratings and keep me at 50% for both as a single rating. My OSA is more severe than my asthma. If my asthma was worse, maybe I could argue for a combined rating of 60%? Is my understanding on this right?

Here it is, the Monday Morning Workload Reports: http://benefits.va.gov/REPORTS/detailed_claims_data.asp Find the latest week, download and open up the excel spreadsheet, the look at the "Rating Bundle Measures - SOO" tab or Station of Origin data. You'll have to sort the ROs by region. It always seems to come up the Eastern region (there are instructions on the sheet). Click the box that says "Eastern Area" and it will give you a pull down tab to choose another region. You'll also see how your RO matches up against others in terms of measured accuracy. The data is what it is...self-reported information. It's supposed to be as of the opening of business Monday morning which is about the same as close of business on Friday afternoon and gets updated at some point on Mondays, usually, or Tuesday if Monday is a federal holiday. Some weeks, I've found the raw data to be notably off what it should be. It's a look, though, into what's happening at your RO. One of the more interesting things that I've seen is that some ROs are very, very quick in their turnaround times probably because they have a limited number of veterans in their geographic area. Other ROs are completely overwhelmed.

I agree. 125 days is a stake in the sand set by someone a long time ago for the purposes of gauging performance. It's a goal, but nothing more than that. If the department or agency fails to meet a goal, there's an argument for more $$$. Sure they're driving at trying to get rid of the so-called backlog which is defined as claims older than 125 days. Probably not going to happen most places and not nationally IMO. But they're setting themselves up to rush stuff through quicker which doesn't necessarily mean you'll get a better, more accurate decision. For Salt Lake City, the RO is reporting that the average claim worked since last October is taking 149.8 days to complete as of this past Monday. That's third fastest in the Western Region and whole lot faster than what my RO is claiming. There are ROs out there taking 9 months on average for each claim.