john999

You can file an appeal for denial of Chapter 35. That is what I did when I just got TDIU. Why wait 5 years for P&T? If you have evidence that your claim is permanent you can present it as an appeal. You can get an IME for this. I did it within one year of my TDIU rating. It will take the VA a year or 18 months just to review your claim. I got an IME that said my condition was permanent which it was and is. If you have MDD it is not just going to vanish. It will always need treatment and observation to make sure you don't fall out of bed again. John

I really do agree with Buck52 that vets should make their claims within one year of discharge. If I had not done this there is no way I would have gotten SC at all. When you wait even two years to file a claim the VA will often come back with statements that the disability cannot be shown to have originated in the service because of intervening events since discharge. About the only disability that can wait 20 years to file is PTSD. For instance, a bad traffic wreck can cause PTSD. It does not have to be combat. I have chronic back pain and cervical pain. What I have been told is that no surgery can definitely fix or resolve pain. You can get back things like ROM, but pain may persist or get worse after surgery. I had surgery on my shoulder and it still hurts and is weak. I have full ROM but I have pain as well.

If you cannot work solely due to your PTSD you should try for TDIU. The doctor has to say you are unable to work due to your SC condition and not just rephrase what you are saying to him. Claims are based on evidence. You can produce your own evidence via an IME. If I had relied on the VA exams I would still be at 30%. John

You need to get an IME/IMO and file a NOD if you want a chance at getting a higher rating. The idea that a NPR can give you a decent C&P exam is laughable. Did the VA do a MRI on your back? What kinds of tests did they do to determine your level of disability? The exam doctor is saying your DDD is not related to your lumbar strain since 12 years have passed since your discharge. How the heck do they know this? You need your own medical opinion to fight this assumption. Lumbar strain could be anything from a slipped disc to a slight muscle pull. Did you get ongoing care for your back over the years since your discharge? John

Are you using opiates for pain or just to get high? There is use and abuse, but the VA does not make that distinction in their medical coding. I would never admit to abusing opiates, or any drug including alcohol. I just would not admit to that even if I were taking 20 oxycodones a day since that puts you in a bad light with the VA for the rest of your life. Also since that information is shared with your state drug abuse watch dog. My VAMC asks the State of Florida Drug Abuse department for any prescriptions I get outside the VA, and the state gives them the information. A drug abuse history can follow you via your insurance. The VA tried to bill my private insurance for treatment of opiate addiction. I raised hell with them about that and refused to authorize them to contact my private providers. I am being treated for chronic pain with opiates and not for drug abuse. Are you sure you are a drug abuser, and not a chronic pain drug user? This is all part of the WAR ON DRUGS that has been a failure for 40 years and turned Mexico into a drug store for America.

The heart catheter test has risk of its own since they can rupture your main heart arteries when they are pushing that wire into your heart. If they find a blockage 99% sure they will do balloon angioplasty with a stent. What are you going to say when the cardiology surgeon tells you that your arteries are blocked and you will die if they are not opened up and kept open with a stent. The heart cath. is for those with symptoms, but what if you don't have symptoms like my father who was symptom free. He woke up one morning with pain in his arm (1956) and a few hours later he was dead. That calcium screening test is scorned by heart surgeons because they get paid to put in stents and do by-pass surgery. The calcium screen tells you how much disease you have now and what you need to do to keep it from not getting worse. That documentary called "The Widowmaker" I saw on Netflix woke me up. I would never base any surgery on some result I got from the VA. There is the process of winning claims and then there is your actual life and health. John

When you filed your appeal with the BVA did the appeal include all your residual issues? It should have if they were in original appealed claim. Did your NOD include disagreement for denial of residuals of prostate cancer. If you don't appeal it then it may be lost. Look over your paperwork to make sure. I assume the cancer had not spread from the prostate before it was removed?

Get the VA to send you to all available heart testing. To establish a decent rating for heart disease you need evidence and opinion based on evidence. I went from 0% to 60% based on getting the VA to do testing they did not do before my first C&P exam. If you get 0% rating I would appeal and get more testing. I would discuss with my PCP your fears of heart disease and sudden death due to presumptives and to family history. I have presumptive and awful family history for heart disease and sudden death from IHD. I don't care what the VA says I am going to get all the testing I can if it is non-invasive. If I have any symptoms such as chest pain etc. I will be getting angiogram in a hurry.

If I had to live on my VA compensation even though I get HB benefits and a benefit for being married I could not afford to buy the house I have been living in for 28 years. I was a federal employee, and when I had to retire I lost my ability to contribute to the Thrift Savings Program. This was the third leg of my pension plan with the federal government. I lost 15 years worth of future contributions. My federal pension was reduced by future contractual raises and SSA contributions as well. Becoming disabled is expensive especially when your own government is underpaying your compensation. If young soldiers really understood the risks they faced when they enlisted for a hitch they would never do it. It is one thing to get KIA but another to be disabled and live like a second class citizen for the rest of your life after being service connected. I do remember my father got a 10% rating after WWII. It was $12 a month when he died in 1956. When I got 10% in 1973 it was $28 a month. The CPI does not include food or energy prices. It does include things like the prices of microcircuits, TV's and computers. You can't live in those things or eat them. John

The VA Medical system is planned failure. When the VA starts to talk about changing benefits like this Veteran's Choice you better duck fast. There is a rational way to create a good veteran's health care system based on the Medicare model. That would mean about 900,000 VA employees would lose their jobs. All the welfare to hospitals, University medical programs, and political appointees would have to stop. Medicare has tiny administrative costs while I bet the VA spends billions just doing the paperwork. The VA spends mucho money to bill my insurance to capture a couple of dollars. The only time we get any increase in benefits is when there is a war going on somewhere. Let's hope Iran is busy making an Atom Bomb so we have a good excuse to send 500,000 troops back to the Middle East again. Now that Iraq and Afghanistan are off the front pages the population and congress has started to forget the vets already. Our benefits have only increased according to the CPI since WWII. That just means that your compensation has the same buying power it had in 1960. A 100% vet gets about $2900 a month. Multiply that by 12 and you are below the average median income by about $15,000. If you we were on welfare we could at least get food stamps and have a free pad in the projects.

The VAMC's are doing routine Aorta Ultra sound testing now for free. This is a test that would probably cost you a pretty penny if you had it on the outside. I went and got one a few days ago. Now I wonder if the VA is giving the Calcium Scoring heart test. This is a test to see how much your heart arteries are calcified. It beats a stent. The test costs about $300-400 bucks and a stent costs about $30,000. You get the same result in ten years. John

I had the same experience with fee base eye care. An exam but no glasses. What kind of deal is that? My VA eye clinic is a sorry joke. You get the choice of ten different styles of glasses. If they don't fit too bad. John

NVLSP refused to represent me in my case against the military for giving me a "personality disorder" discharge when I returned from Vietnam. The thing was that the VA rated me as having a bono fide medical mental health condition effective the day after discharge. I guess I must have gone nuts within the 24 hours after discharge. I think they just want slam/dunk sorts of recent claims and not crusty old claims from Vietnam vets. I know it has been more than fifteen years since my discharge, but I know they make exceptions in pursuit of justice. You know Plato wrote a book just on that subject of the nature of justice. The NVLSP should read it. There is no justice in this world for most of us vets. You may get a check every month but that sure ain't justice. John

What is the neurologist's notion of "costly"? It is much more costly to wait years and have a claim denied than to have a good IME/IMO and win first time at the VARO. If your dad has to appeal he may not be alive by the time he wins the claim. Claims going to the BVA take 2-3 years after they get to that point. You want to win this claim at the VARO level. John

Even when the VA sends your decision to the wrong address, does not evaluate all the evidence, and makes all sorts of errors if you do not file a timely appeal you have an uphill battle. I went all the way to federal court and the upshot of it all was that I should have appealed even though the VARO made egregious errors I lost. I don't even remember filing a claim and no VSO represented me I got a decision on my claim and got 10% when I know I should have gotten 100% back in 1973. With what I know now I could have won a TDIU or 100% claim, but they don't take that into account. Back in the day the VA did not even have to list all the evidence they used to rate your claim. How do you fight something like that? The VA could just exclude half of your evidence and if you did not appeal you are out of luck. John

Dr. Ellis is famous among those who have filed federal worker's compensation claims. There is such a thing as a "Schedule Award" which is a cash award for those who have suffered a work related injury to certain body systems. Dr. Ellis was known as the guy to see if you wanted the biggest award. I think if he is doing VA IME's then you are in good hands. I don't know what he charges but I bet it is worth it. I did not know he did VA claims IME's/IMO's. I know OWCP hated him with a passion because of his large awards to injured workers. I got five awards during my postal career for injuries I had due to work accidents and repetitive stress injuries.

I would be careful about dropping Medicare Part B. If your spouse has ChampVA then they must keep Part B after 65 to keep on getting ChampVA. Also Medicare Part A&B is really dirt cheap. I have Medicare A&B and Blue Cross. My wife has Blue Cross and ChampVA. Neither one of us has any copays or deductibles. When the wife hits 65 I think we will suspend the Blue Cross. She will have Medicare A&B as primary and ChampVA as secondary. If you are a disabled vet the best gift you can give your spouse is ChampVA. I think a vet's job is to get to 100% P&T because that is when all the benefits kick in for spouse and yourself. She/he will have better insurance than you do via the VA. Her ChampVA plan is a complete medical plan which is a stand alone plan. You can even get a ChampVA gap policy that pays what ChampVA does not pay for. For most insurance Medicare becomes primary when you retire, so if you have employer insurance you can keep as part of your retirement plan then it will become secondary payer. When my wife gets Medicare then it will become her primary whereas Blue Cross is her primary now and ChampVa is secondary. Also almost every doctor takes Medicare assignment. This is not true for many forms of insurance. The doctor may not take assignment which means you have to pay upfront and go hunt your money. John

If the worker's compensation injury and the military injury are not the same injury they have no connection. The C&P doctor is just talking ignorance. You can, in fact, get full worker's compensation benefits and TDIU/100% from the VA if the injuries are not the same. It is only when you have the same injury that you may have an offset. For instance, you have a SC mental disability. It gets worse as a result of being aggravated by your job. You might claim worker's compensation and you might eventually claim TDIU. You would probably have to choose to take either TDIU or total compensation from WC. Now if you hade total compensation from WC injury and you also had TDIU from mental problem you could get both at the same time. If you have WC at the total level and you are getting SSDI then you usually have the SSDI offset. It is complicated but some C&P doctor you have knows nothing and it just a trouble maker. You sure should file a claim for her injuring you during the exam. You should have punched her in the face. "I couldn't help it. When she yanked on my arm then my fist jerked up into her face". When I worked for the post office I knew people who got into fights with the doctors doing exams of their injuries. The doctors would bend an injured limb or something and the worker would kick out or flay away and smack the doctor by accident, of course.

I have never heard of the VA taking away TDIU from a vet who is not able to work due solely to his SC disabilities. As Bronco says they must evaluate him under normal conditions of life which means when he is working. The regulation actually states that you are entitled to TDIU if you are unable to work due solely to your SC disabilities. The 70% rating requirement is an after thought. The intent of the regulation was to compensate vets who could not work due to SC disability. I would request a hearing right away if you have a letter stating they intend to reduce your TDIU. You might even consult with a lawyer who does VA work. They could pull a stunt on all of us if this reduction is legal. I have been TDIU for 15 years. I am 65 years old. Would they expect me to go out and get a job now? John

Are you working? If you are unable to work due solely to your SC disability then you are eligible to file for TDIU. Usually, if you are eligible for TDIU the VA will bump you up to at least to 70%. Just keep copies of all the claims you file. Filing for TDIU is a claim for an increase. If you are working 40 hours then getting TDIU is not really possible unless you earn less than poverty level. Just keep checking on your TDIU claim. If you get denied be sure to file a NOD within one year.

Yes, you can and should claim SSDI. I was a federal employee so I retired on disability under FERS. Often you may find that once you get SSDI they may have some sort of offset to your disability retirement. However, once you get SSDI you will get Medicare within two years. I think you can get all three without a problem. The problem begins if you are getting worker's compensation. WC usually has an offset to SSDI and possibly your TDIU and disability retirement. I had to deal with that but it is all doable. John

If you are talking about presumptive AO conditions all you need to show is that your father has them. If he has PD then he is presumptive for AO. If you can match your father's illness with AO presumptive disease that is what you need for a claim. If he has CAD or has had a heart attack that is probably enough for a rating as AO presumptive. Now the degree of the illness and rating are things a IME can sure help you with and also if their is doubt about conditions.

Buck That's right IMO. When you change RO's especially in the middle of a claim you are asking for trouble. Like you say they lose things. I have handed evidence right into the hands of my local VARO and they lost it. If you have a 100% scheduler rating and you move from one RO to another it is like putting raw meat in front of a wolf, except the vet is the meat. This is just my opinion and what I have heard over the years here at Hadit. The VA can't stop you from moving but they can examine your claim now that you are in their zone. I don't think they get points for having the most 100% vets in their RO. I would like to see statistics on this but I bet the VA does not keep those kind of stats. John

If you move out of your VARO you can probably expect a new C&P exam if you are 100%. A little silver bell rings at VA HQ if they can reduce a 100% vet.

Buck When I say a specific rating I mean any rating. If you have a 50% rating for sleep apnea for 20 years the VA cannot reduce it according to their own regulations. P&T does not mean P&T for any specific rating unless you have that rating continuously for 20 years. They can't sever SC after 10 years like PR says. Gastone I download the Employment Questionnaire every year and send it via Certified Mail/Return Receipt and I have had TDIU for 14 years P&T. I am not taking chances with those SOB's. When I look at my ratings it does say I must fill in the VA 21-4140-1 until my 70th birthday. I do go to the VA for treatment of my SC conditions even though they are not worth a damn. Even though I am 65 and definitely unemployable for a host of reasons now I still go to the VA. I can't quote all the regulations, but I have seen them so often on Hadit I know what they mean since we have discussed this stuff often and it is confusing. Why shouldn't P&T mean actual P&T? That is the tricky VA. If you are vulnerable to reduction I suggest you at least get treatment for your SC conditions at the VA. You don't have to let them do anything invasive no matter what they say. I would not let them do a colonoscopy on me or endoscopy on me. John