TiredCoastie

It depends on where you live and which RO is servicing your file in terms of how fast they get through claims, but it does sound like good news to have C&Ps this fast. Your contentions seem pretty cut-and-dry. In general, there is a rush to get through claims. At one point a few years ago, the President and VA Secretary announced a plan to have the so-called backlog (claims older than 125 days) eliminated by the end of this year. To do that, they have to make sure that few claims make it beyond 125 days old. Statistically, the VA isn't going to make that goal this year unless they really speed things up over the next 8 months, but the pressure still seems to be there. GP is right about how you'll likely be rated if they SC your hearing loss. The regs are not clear to me but one would think you'd be eligible for free hearing aids through the VAMC.

Hey, Brother, hang in there! It makes sense to rule in or out an underlying condition like Georgia Papa said.

No kidding! Sounds like that "BVA has decided your appeal..." statement is just nonsense, a catch all phrase that means something has happened with your appeal other than it was certified by the BVA, which could mean literally anything. Adding that one to the list of things to never believe from eBenefits...which is growing. It already contains the projected dates for a claim to pass through the current stage, what the RO has received for a claim, and the latest compensation payment before the 1st of the next month. Glad I found hadit, too! Asknod has been a huge help, as has Berta, Carlie, John, and a bunch of others. I wouldn't be where I am today with my combined rating if it weren't for them. Really hope your RO can get you a decision on your appeal soonest, or at least certify it and move it on, and I hope your decision is correct. I think you're right about the ROs being in a rush to move appeals and claims. Having thought through the DRO decision I received, it looks like he rushed to judgment. At least he decided a previously denied condition in my favor. But because he went with an analogous condition rather than the correct one from 38 CFR 4.124a, the RO did not include 6 months of 100%. So they got the rating right, but made an error (or maybe two) on the retro payment worth thousands of $$$. Seems like every time I get an answer, no matter what it is, there is always more work to be done. Bureaucracy at its finest!

Great job! Sometimes I wonder if they pull that when it looks like they're going to lose. I must have sent two or three copies to the RO before they put my NOD in the workpile. Definitely the card to play! But wait a minute...how can you get an eBenefits response that the BVA decided your claim when you didn't have a "valid" Form 9 in? There's a screw loose somewhere in the RO...

Sounds like an uphill battle, but 38 CFR 4.124a seems pretty clear in terms of the 3 major causes of stroke. If a veteran has one of those incidents as shown by competent medical evidence and is SC, no matter how severe or permanent, it appears that 100% for 6 months is warranted. My plan is to make them tell me "no" with some sort of explaination the RO and I can argue about further. Or they can agree, pay me, and I'll go away quietly and happy. I hope and pray you'll see some final resolution on your and your husband's situation soon. It's hard to imagine that this is still going on after all these years.

Thanks, Berta, for helping me think through this. I sent the RO a letter asking that they reopen my appeal, correct the analogous rating (38 CFR 4.20) to the right one listed in 38 CFR 4.124a and pay me 100% retro for 6 months from each TIA. Because the award letter said that I need to file a NOD (rather than a Form 9) and there are new rules about how to do that, it would not be surprising to get a response that I need to formally file a NOD via the form despite the decision being old enough to be grandfathered. I really hope that they rethink their decision without a lot more effort. In thinking through 38 CFR part 4, it would seem that the VA should pay 100% retro for SC disabilities for 4 or 6 months no matter when the condition was SC. However, the only way to find out is to formally ask and then wait for the response.

Thanks again, AskNod. Not sure how this will work, but just sent a letter to the RO asking that the SC for TIA be changed to the appropriate condition listed in 38 CFR 4.124a rather than an analogous rating (38 CFR 4.20) and that I was not retro'd 100% for 6 months. I wonder if the analogous rating was a way around paying me the 100%-for-6 months retro I should be owed. Mentioned in the letter that I asked that my appeal be reopened and that the letter should be considered a Form 9 if one is needed. If the RO pushs this into a NOD as the award letter said was the right document (not a Form 9 as if the package contained an SSOC), which just kicks the can down the road, there's the danger they'll reject it and demand I submit the proper form, although the decision is old enough to be grandfathered beyond the new rules. At least, per the award letter, I officially have a year from the date stamp to appeal. My letter is within 30 days. FLTMEDOPS, Paul - any news on your appeals?

Congratulations! It was a long month between your first posting and this last one...know the feeling.

JMHO, but there are parts of eBenefits that are more accurate than others and even that probably varies from RO to RO. I've usually had a good experience with the claims portion but had to know what to believe and what to ignore. The appeals part isn't anywhere near as good or accurate in my experience. What you've been paid seems right, and the diability verification letters have been an excellent indicator of what's coming in the mail - 100% accurate in my experience. Can't trust when they say a claim or a part of the claim's process will be complete. Can't trust what the system says it has and what you still owe them in terms of paperwork. Hard to trust the appeals part at all. The idea must have been that they could save telephone operators and computer answerers by making information available to the veteran community. But it sure doesn't seem like it helped a whole lot. Do they get more calls and emails now because of what eBenefits says? They've received a bunch from me!

Thanks, Berta. I appreciate your experience. It seems like I may have an argument for 100% for 6 months based on the 2011 TIA. JMHO in my case, but the RO should have found SC for cerebral thombosis which is a defined condition in 38 CFR 4.124a. Having looked at 4.124a quite a bit, there is no condition labeled as "stroke" and certainly not for "TIA." 4.124a lists two other major causes of stroke - cerebral hemmorage and cerebral anuerism - and handles them with thrombosis all the same way. You know this but others reading may not - a cerebral thombosis can cause either a temporary stroke (TIA) or a permanent one. If the clot clears quickly enough to not do any permanent or detectable damage, it's a TIA. If not and permanent damage is done, then it's a stroke. NO KIDDING that EVERYONE knows that TIAs are a major indication that a stroke is on the way! How any doctor could ignore that commonly known medical fact is beyond comprehension. SO...if you have one of those three major underlying conditions that cause stroke but there is no permanent damage or "residuals," the minimum rating is 10%. I have no permenant residual as far as the VA is concerned, so 10% is appropriate. In fact, I may have a small residual but not enough to be noticable. I'm happy with the 10% rating as it stands today. Again, the big question is what about the 100% for 6 months? I battled them over this underlying condition issue for several years, with your help as you'll recall. In the recent DRO's decision, the DRO did not acknowledge the DBQ from the hematologist who diagnosed me with cerebral thrombosis starting in 2008, two years before I discharged. If he had, then I would have a clear diagnosis from a 4.124a standpoint and it would be clearer that 100% for 6 months would be due having suffered a thrombosis in my brain. My timeline is this: I woke up one morning with half of my bottom lip numb in 2008. It felt like I slept on it wrong, if you know what I mean having ever woken up with your arm or hand numb from having slept on it. My wife insisted I visit the local ER. They said, "Mrs. X, your husband isn't having a stroke right now, but if he has [list of standard stroke warning signs], get him to the hospital immediately." Then we were back East visiting family a few weeks later when I had a severe confusion episode. In the end, I was back in a different ER and burned three days of leave in the hospital. They declared me to have suffered a migraine after extensive testing. I'd never had migraines before, and I think it was the result of whatever had happened less than a month before when I awoke with a numb lip. And...TIAs leave no tracks... I think they missed it. Shortly after discharge, I started getting tingling and numbness episodes in the lower left part of my face. Sometimes it would be my lip. Sometimes my cheek. We were moving to an area with top notch medical so I waited until we moved to begin to determine what was happening. Just before a year passed since discharge, in August 2011, I wound up in the ER when the tingling and numbness got worse one night and I got scared. I had a nuerologist appointment within a week, so the ER released me and insisted I follow up. Diagnosis - TIA. This was what the RO used to SC me. Then I had another bad episode a month or so later when the hemotologists took me off of my blood thinners, that I'd just started, to do a platelet aggregation test to try to find the underlying reason I have "sticky platelets." I almost had a stroke within 48 hours. The hematologists declared they had what they needed, put me back on blood thinners, and I haven't been off since. This one happened after my year was up. Meanwhile, my migraines were getting worse. Some of my symptoms could be explained by migraine, including the strange numbness in my face, but not all of the episodes and the symptoms all the time. I applied for disability related to this condition in June 2012. SC was just awarded back to 1 July 2012 through the DRO's decision. In July 2013, I had a severe dizziness episode and wound up hospitalized. By this point, my ill advised "reconsideration request" was in the system running like a snail in slow motion. The neurologist who saw me in the hospital was unclear if the episode was a TIA or a migraine. Follow up exams by a variety of doctors gave mixed results. This would be an uphill battle to prove either way but would be worth 100% for 6 months seeing as this episode occurred after the recent decision to SC back a year previous. To keep from slowing down the reconsideration request because I'd dumped a ton of N&ME on them and *thought* that I had an FDC and expected a decision any minute, per my VSO, I did not want to do anything to cause it to become a traditional claim. (As it turned out, a decision finally came 9 months later.) In an effort to prevent that from triggering, I got the hospital records to the VAMC where they were uploaded and available to the RO who was supposed to check what the VAMC thought as part of their decision. So...my request for a copy of my C-file has been on hold for over a year...and I need to get off my butt and get over to the RO and just look at it... The blood thinners do help my symptoms quite a bit, which is my own major argument for thrombosis/TIA beyond the specialists who have weighed in on my behalf. Do you think there is a difference between an 1151 claim based on malpractice and a regular SC disability claim in terms of how the 100% would work? I can see it being handled differently. Because the VA has never done anything medically for my neurological conditions...we have outside insurance and will use that instead to get the best care...I don't have an 1151 avenue (thank God) to pursue. My biggest reason to ensure this is right is to prevent a situation like yours from occurring to my wife. While we might get some retro in the shorter term, what I've really got is a life insurance policy that should guarentee DIC should the unthinkable happen. At least, it's a lot closer with a SC "condition" of sorts. Having run through this thought process a few times thanks to just having the conversation, I think I've got to go back to the RO and see if I can get this fixed. I don't know if I'll receive any retro or not for two events in 2011 or the one in 2013, but at least the condition needs to be right. And I was very plain, straight forward, and direct in my Form 9 that the RO had blown off the DBQ on cerebral thombosis and should have rated that underlying condition. But at least I got the VA to acknowledge that I've had at least one TIA, and that's a good starting spot to move forward to get it fixed.

How does this work? Do I have a leg to stand on should I continue to appeal a DRO decision on an appeal 38 CFR part 4 has several listings in which conditions are to be rated at 100% when they first occur, then evaluated for residuals after 6 months for a final rating. Some examples are the various causes of stroke under 38 CFR 4.124a. There are also a number of heart conditions with 3 or 6 months at 100% then rerated based on specific criteria in 38 CFR 4.104. So if a veterans has, say, a stroke, then applies for service connection and a disability rating AFTER the stroke has occurred, does the VA then pay the 100% for 6 months then whatever the residuals rating would be? Or, because the veteran applied for disability related to the new condition AFTER the stroke occurred, because the effective date of the disability is AFTER the stroke actually occurred (and likely more than 6 months afterward), does the VA only rate residuals and does not provide the 100% for six months? Here's why I'm asking. I had a TIA within a year of discharge in 2011, probably 1 or 2 on active duty before then, and probably 1 or 2 after being out a year. After battling the VA for several years, a DRO just granted me 10% and SC for "TIA" based on the one in 2011, which was the clearest case for SC. I cannot argue with the 10% residual rating which I believe is accurate. However, because I first applied for disability related to this condition in 2012, the effective date is beyond 6 months of the 2011 event. The DRO decision did not grant me 100% for 6 months. Rather than certify the appeal and send it onward, the DRO had pulled it back from going to the BVA and decided it "in my favor" instead. As an aside, I provided evidence of an underlying condition which causes cerebral thomboses with that condition starting a couple of years before I discharged which the DRO did not rate but stuck with a condition undefined by 38 CFR part 4 which he or she called "TIA." Meanwhile, while waiting for a "reconsideration claim" to process in 2013 (don't do one of these reconsideration claims, by the way) after I was initially denied SC for this condition, I was hospitalized for what could have been a TIA. With an effective date of 2012, this event could be rated at 100% without any controversy if I can prove it was a TIA. In fact, I attempted to have this medical evidence considered by passing it through the VAMC but it does not appear that it was considered based on the DRO's decision explanation. I'm trying to decide if I should submit another Form 9 of the DRO's decision arguing for a clearer SC'd condition based on the evidence I provided as well as 100% for six months based on the 2011 TIAs as well as decide how to handle the 2013 event and could really use some advice. If I've already lost because the 2011 event occcurred prior to the effective date, then maybe I shouldn't waste my time but figure out how to get the 2013 event rated? Would I continue the appeal or submit a new claim?

Thanks, AskNod! You're one of those who really helped me. How much time do you think I have to push the button on submitting something? I know you're big on just writting your claims and appeals in letter format, but is there a form I should lean toward? A Form 9, maybe? I'm not sure if I got what I should have in terms of the retro calculations. Since I had a TIA in August, 2011, which the DRO acknowledged as within a year of my discharge as the rationale for granting service connection, then 38 CFR 4 says that I should be rated 100% for six months afterward then have a mandated C&P to determine any residutals. I did not file for this condition until June, 2012, so it was beyond 6 months of the event. However, does the VA still owe me 6 months of 100% even if I file later for this particular event? That's the big question. I was also hospitalized for a neurological event in 2013, but that event was never fully explained, so I'm not sure if I want to open that can of worms or not. I suppose I could by pushing forward with the appeal as this evidence was perhaps not considered by the RO and should have potentially resulted in another 6 months of 100%. Otherwise, I don't have any other problems with the decisions. In terms of ratings and service connection, I got what I argued should have been granted in the first place and cannot complain with the 10% residuals for the TIAs. This will take some thought and research about if to proceed. With SC for TIAs, that does open up a vulnerability within the VA to push through the later hospitalization and additional retro of 6 or 12 months at 100%. That's a chunk of change and difficult to leave on the table... Either way, it will take until probably mid-summer for the retro from the initial win on the EEDs and the retro from this win will probably show around Christmas (hopefuly this year ). Coast Guard PPC is a good unit with good people, but they don't have the same technological advantages as DFAS.

Got the Big White Envelope in the mail yesterday --- I won on both contentions! I haven't digested everything in there yet, but it seems like a DRO re-reviewed the appeal before it left the RO after receiving my Form 9. The DRO reversed both decisions in the SOC that I continued to appeal. I was granted SC for my TIAs, rated at 10%, and my migraines were increased to 50%. My biggest concern from what I've read and understood so far is that it does not appear that I was retro'd 100% for 6 months following the TIA that they acknowledged during the year after I separated, but that TIA happened before I filed the initial claim for TIAs so maybe it didn't count for retro? I had another one after I filed the initial claim, and that one probably should have generated 100% for 6 months. So I need to think this through for maybe another NOD. Because it was a DRO decision, the process to appeal starts with a NOD back to the 'RO. I can't thank the folks here on hadit enough for helping me through this appeal process and helping me with my Form 9 to make sure I got it right. It must have made an impact!

Hang in there!

With the VA, timelines are very hard to guess. Your NSO probably has better visibility on where the decision rests, but she can only really make an educated guess about when things move through your RO.

As long as your SMRs or other service records (Mishap Reports, etc) show your knee injuries, you should be OK from a nexus standpoint. Sounds like chrondromalacia may not have been the best diagnosis from what you described. Knees and other joint conditions boil down to range of motion without pain. Have you considered TDIU? JMHO, but I think you're on the right track try to round up to 100% schedular.

Try your senior senator. The governor can rant and rave but ultimately has little impact with federal agencies. Or, you can try taking your story to the local TV news.

Hey, Shipmate! Glad you got in with the audiologist. The hearing aids will only take a couple of weeks to arrive. If you can with your schedule, see if you can get a cancellation appointment about 3 weeks from now. It will take about an hour to set the aids up to match your hearing test results, personal comfort level, etc. I don't know how much they will help with the tinnitis. My tinnitis is not as bad as others are describing, so my aids help some. But just reading about everyone's difficulties...now my ears are screaming that high pitched bunch of supercrickets.

Just don't hold your breath waiting for your SOC. Hopefully there will some good news with that package as well. There was with mine - they CUE'd themselves and granted EEDs on two conditions.

Couple of thoughts, Diver. You've already got increases in for your knees. My right knee started off with chrondromalacia and progressed to out-and-out osteoarthritis after 22 years of active duty service beating it up. It's rated at 30%. I documented semi-annual lubricant injections, six months of PT, and imaging studies showing the arthritis and that it's never completely pain free. Your headaches sound like migraines. Migraines can gain you another 10-30% pretty easily. Getting to 50% requires that you show "severe economic impact." You ought to follow up with a neurologist. Your knees are SC already, so that's just the progression of the condition. Your headaches/migraines are going to require you to get a firm nexus statement from a specialist. There could be other things in your list, but these two I'm familiar with. Hope it helps.

Amen!

That's unsat! Hopefully you'll get some better definition soon on what's going on with your appeal. Sounds like some is here, some is there, and hopefully no parts hiding.

I ran your numbers through the Hadit calculator and got 75.7 as well. That should round up to 80%. As soon as your claim closes in eBenefits, you should be able to see your new combined rating under "documents" through the disability verification letter or old AB8. You may have gotten an off-the-cuff rough guestimate from your VSO. While it's too early to really know for sure, if 70% fits your PTSD, then you can probably declare victory. However, take a good look at 38 CFR part 4 and make sure that you were rated appropriately. If not, be prepared to drop another NOD. I still don't like what your VSO said to you about accepting what you were offered. Only if what you are offered is right!

Thanks, but have you heard anything yet??? There's still nothing in the mail here and all I've got to go on is the benefit verification letter/AB8. Praying you'll get some good news soon.

Thanks! I filed the NOD in late Dec 2013, but it wasn't accepted until June 2014. SOC was issued in Sep and I filed the Form 9 in mid-Nov. So this is somethink akin to light speed...if it's real.