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ArNG11

Master Chief Petty Officer
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Posts posted by ArNG11

  1. what I think is going on is the VA is so used to lowballing and denying people, without question, they dont know what to do lately when veteran , challenges thier lowball denial that has the merit needed to overturn, after they just got finished putting the finishing touches on thier claim of mass deception. SO now, they have to go to somebody and say,, oh well, we have to start over, and do some"fixing" , after all these signatures,,summaries, , reconciling and on and on, and since that seems to be happening quite often lately, since veterans are now living in the information age, and are quite inquisitive by nature they just arent sure what to do with the claims, So they say, well lets put them in Admin review status. When everyone used to put the claims in DRO review status before they caught on that it ismost t of the time just a stall tactic, and claims rarely get overturned there .

    Just 10 years ago, most vets who were denied just ate it, and drove on, not anymore. BEFORE the soldier even exits active duty, they are being educated on the system. The fact is, ALOT of vets are calling bullshit on the VA and they dont know how to deal with it, so they stall.

    When they recently sent me a request for either a DRO review or traditional appeal, I chose traditional appeal. Because that will eliminate them being able to sit on my nickel for at least a year. It will likely take them a year to just write up and send me the SOC {statement of the case.). And in all actuality they are supposed to give a second review of the claim at this point anyway, so if they are doing that, then the claim is getting a second look . My thinking is if they have 18 months to jack with a claim, and couldnt approve it, why let them deek with it anymore than you have to after that. Just get in line to see the wizard, and hope they fold before that happens, but if they dont, then you that much closer to getting a more reasonable adjudication from a judge.

    Sometimes I think they just pick claims to deny and it dont matter what evidence u present, they chose it and its got a mark on it.

    Just my opinion.

    Sierra, I am starting to have the same feeling on this. When the newbie or unexperience claims examiner makes a decision the decision is reviewed by a higher, senior rater to get the decision approved or denied, to me, and just my opinion, this senior or more experienced rater should catch all the mistakes or the "giving the veteran what is merited" that were made on the claim. I think it's a brake system for the newbies that are giving too high of an initial rating. Many years ago I worked in the insurance business and you would not believe the shannanagans that I witnessed. Same game different costs, the same bottom line, deny at all costs, if unable to do so pay out the claim for the least amount of money.

    Anyways I think I might seriously consider the tradditional appleal route on one of my claims. I will no more here soon.

  2. Wow that is a hard concept for me to accept. In my dealings my experiences with the VA healthcare system haven't been the best since I hit disabled veteran status. The care is nothing compared to the care I got from the VA when I was active duty and even when I was active guard. I guess there lies the difference. I think that is good advice above. I use them for my meds and keep them updated with my care from my private docs. But there is a definite difference in the quality of care and the efficiency of care. That's just my opinion though and it's based off my own experiences.

  3. I'm not telling you what to do but man Venlafaxine is an evil, evil drug. I had the wackiest dreams and nightmares. My sleep was all backwards on this and I actually almost died from it. I would talk with your psych doctor about this because you could be having a reaction to it like I had. Then on top of that do not stop taking Venlafaxine cold turkey because you will regret doing that. That drug is for those who are in nuts houses, not us on the streets. Picture a person who sits there with drool running down their bottom jaw, that was me on that crap. Now I made sure it was on the Do Not Take list the VA keeps tabs on us.

    The Gabapentin is a drug that helps the nerve pain. It was originally created for people with seizures but it was found to work with people with nerve damage. The high the dosage the better it helps. Some docs will say 3600mg is the max but its not. There are people who take 5000mgs a day of it. I take 3900mgs and it helps a lot.

    I was on venlafaxine for a time, in my case it actually helped my anxiety and depression while I was on it. Of course I will state that each person reacts differently to certain medications and the mixture of medications currently prescribed. I was on a med that was meant for depression and it caused suicidal thoughts. I think it was called Pristiq not sure on the generic name though. Again different people's internal chemistry along with other factors can cause adverse results, hence, the warnings on all scripts. Later I was put on venlafaxine and clonazapam by a military doc. That rx mixture, tapered me down. Not happy, not sad, just kind of blah and indifferent, however, it helped the extreme ups and downs which was its intended effect and no suicidal ideations from it.

    I think the best thing that helped was behavioral modification. And the sort of reprograming of your outlook and moods. Kinda of like the glass is not half empty but half full of sorts. That was just my experience though.

    I will love the day that a drug is manufactured that works the way it is designed with no side effects. :smile:

  4. I received the same letter by mail last week. I opted to take the offer and am currently using the credit protection service. I have a paid service through another company and it compares to what I pay for. I am not at all pleased with the fact that this happened, but this kind of thing has happened before. The last time it was stolen laptop. The time before that it was PII thrown in the trash. At least this time they offered a free credit monitoring service and they notified me that my data had been compromised. That is a good step in the right direction, however, I'd be more at ease if this crap didn't happen in the first place.

    I would suggest that people affected take the offer and monitor your credit. Better safe than sorry and it would give you some peace of mind.

  5. If the examination was done at a VAMC you can usually request a copy from them through the records office.depending on how long it takes them to file it. Results and findings wont be posted on ebennies or evet, other than just the appointments dates themselves and that you attended them.

  6. Well just as I was finishing my lunch the VA hospital called to confirm appointments. I am seeing a nurse practioner and and mental health professional related to my gulf war claim. A doc or a nurse practioner I understand but a mental health professional, I didn't claim any mental health issues. If I was a little more paranoid I'd think they would be trying do a psych profile on me and have some angle to use against me. A short time after my tour I did see a social worker and psychiatrist for bit, was on antidepressants but after some time I dealt with my issues and was taken off meds and was good to go after that. I am just gonna have to wait until the exams but I can't help to think what the raters are needing or looking for. Hmm this inquring mind wants to know.

  7. C&P GM and C&P NP. Does anyone know if this is General Medicine and maybe NP for??? The only thing I can think of is nurse practitioner or something. I know I will find out when I have them but I would like to know what to prepare for if there is such a thing.

    By the way this should be for my gulf war claim.

  8. jbasser don't forget the downplaying of conditions. Where medical records state moderate conditions and you get rated for mild. I imagine if they are asking for this you are going to need a independent medical opinion stating that with your conditions you are not able to secure or maintain gainful employment. However, per regulations:

    §4.18 Unemployability.

    A veteran may be considered as unemployable upon termination of employment which was provided on account of disability, or in which special consideration was given on account of the same, when it is satisfactorily shown that he or she is unable to secure further employment. With amputations, sequelae of fractures and other residuals of traumatism shown to be of static character, a showing of continuous unemployability from date of incurrence, or the date the condition reached the stabilized level, is a general requirement in order to establish the fact that present unemployability is the result of the disability. However, consideration is to be given to the circumstances of employment in individual claims, and, if the employment was only occasional, intermittent, tryout or unsuccessful, or eventually terminated on account of the disability, present unemployability may be attributed to the static disability. Where unemployability for pension previously has been established on the basis of combined service-connected and nonservice-connected disabilities and the service-connected disability or disabilities have increased in severity, §4.16 is for consideration

    Also:

    §4.16 Total disability ratings for compensation based on unemployability of the individual.

    (a) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination.

    Anyways you might have looked at this but I think it is a good reference point. They are supposed to look at every when considering unemployability. Service connected conditions and non-service connected conditions. Just my opinion but a functional capacity test might be beneficial .

    I find it convenient that in the DBQ it asks for this type of opinion and it was not thoroughly completed and answered not surprising though. thomasc, this is just my two cents, maybe this would be helpful.

  9. The VA examiner's examination and diagnosis carries a lot of weight. It does depend on the situation and the exact specifics of you claim. If you have in-service documentation and continuing treatment whether private or VA, that is supposed to factor in. The evidence is supposed to be thoroughly evaluated.

    §4.6 Evaluation of evidence.

    The element of the weight to be accorded the character of the veteran's service is but one factor entering into the considerations of the rating boards in arriving at determinations of the evaluation of disability. Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law.

    However, VA raters seem to forget this. My suggestion is to continue your care. Not only for health reasons, but as well as to show continuing treatment and continuity. It will make it harder for them to shoot down the claim. Also if the examiner understates your condition you will have evidence to refute his findings and evaluation. You always need ammunition to use for your NOD if it comes to that.

  10. Im actually wondering what the exam is going to consist of. I am getting two C& P exams for my Gulf War. claim I don't know for what exactly yet. I have submitted a lot of medical documentation on my thyroid,GERD, Sleep apnea, fatigue,digestive problems, chronic diarrhea, and so forth. So I am curious now as to what exams they are going to do. Ive done the registry exam (a big joke), Sent in about 20 pages or so of my well documented issues from my private providers (speacialist mostly)that date back to a few months after I got back from Iraq, where I wanted to do something about the symptoms. So it is making me go hmmm I wonder what they are up to other than trying to find evidence to use against me. Of course they could be just doing a thorough follow through for the adjudiation of the claim? Maybe, or more likely that not they are trying to sink the claim. Who knows? I can speculate and worry and be way off the mark. Until I see it on paper I will have no clue. The waiting game continues. :biggrin: ... Heh did you know it hit zero degrees out here in Oklahoma. Brrr,the wind, it burns.. It burns us.

  11. They have ample evidence that I provided, however, I'm positive, almost sure that the c&ps will be given more weight. But I'll just have submit more evidence and cite regulations. Although let me not get ahead of myself though. They may do what is right. : / besides on a positive note it's an update and it shows progress.

  12. 33%? The VA limits the attorney cut to 20% for veteran disability claims to the VA, not counting their fees that may be granted under the Equal Access to Justice Act (which the vet does not pay) if your claim is appealed to the Court of Appeals for Veterans Claims. I would be careful to choose someone certified to argue on your behalf before the Court of Appeals for Veterans Claims, because that is where your claim may eventually end up. I would not take veterans law issues to a local WC attorney. This is a very specialized area.

    Meant to write 30% but I had a type o. Good to know though, thanks for the info. I just get a little pre-emptive, and a little worrysome. I am not quite there yet though in the appeals process. I asked for an increase and I am still in the NOD period. I will seriously start looking for an attorney once a decision is made after the NOD. At that point if I'm not satified with the decision then I'll step it up. Again, I am pessimistic, but the VA hasn't been fair as of yet with me.

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