john999

Since you are already 50% for depression I would try and get that rating bumped up instead of reinventing the wheel. You probably have PTSD, but you have to open up an entire new kettle of fish for a PTSD claim and you will probably get the same rating if not less. Are you able to work? That is the big question for mental health disorders.

I was entitled to SMC "housebound" and I had to file a CUE to get it. I got it pretty fast since it was obvious, but if I had not claimed it officially I would never have gotten it. When you get the 100% rating but no written consideration of SMC and you call them on it they may say that they did consider it, but did not note it on your decision. This is BS. If they did not note it in your rating they did not consider it. Even if they note it and then deny it I would appeal. I filed a CUE claim because I was awarded total in 2001 and got an extra 60% in 2008. The VA did not grant "HB" even though Bradley v Peake said they had to, so I filed a claim asking for HB. The VA said it was a valid CUE and granted the HB back to 2008. I think I filed in 2010-11 because someone brought it up here. If you are TDIU and have an extra 60% unrelated to the TDIU claim then you are entitled to HB. This is old news to many, but probably not to all. John

I have written congressmen and senators, newpapers, IRIS etc. about problems with VA health care. I don't bother asking about claims. I know that is usually a black hole. Nobody calls me back except something unrelated to the issue I raise. I know how to get money out of them, but it always takes planning, evidence, understanding of the rules of the game, and time. I told them I wanted fee base for all my dental care after making me wait a year for a cleaning, and exam because I was sick the day of an appointment last year. They are punishing me for calling in, and trying to reschedule my appointment. In the meantime I have spent $7000 getting implant, and two new crowns. I want to get paid for that, and I know what I have to do. I have to go to fee base and put in claim for "unauthorized care/payment". I did it before but it may not work this time. The VA just refused to do a crown for me, or an implant after pulling one of my teeth. They did such a poor job on one tooth it cracked and had to be pulled since it was already a root canal and crown. I have to get a partial or implants. I do think they want us all just to get dentures so we never come back to have our teeth worked on again. I plan to take my natural teeth to the grave. John

I thought that when you file any sort of claim your effective date is the date you filed the claim presuming you won the claim? In other words if you file for an increase, and you are denied and your claim is on appeal for five years the effective date for the increase should go back to the date you filed. When I filed for TDIU that is how it was even though I was denied on that claim and appealed and won. My ED was the date I filed the official form. Eventually on appeal I was given an EED based on a hospital admission in which I was given a GAF of 40. That was about 6 months before I filed the TDIU form, so I am confused about effective dates. The VA has made my effective date the date of a C&P exam. I appealed and the new ED was the date I filed the claim.

You can appeal that denial of Chapter 35 benefits. By the time your claim is rated a year or two will have gone by and if no improvement then you are P&T. I did not wait five years for the VA to determine I was P&T after I got TDIU. You and spouse are missing big benefits in the meantime. Your P&T benefits are retro as well to appeal date. P&T means spousal benefits as well as benefits for children if they are starting college etc. and ChampVA.

The VA will create a temporary file for your new claim if your C-File is in D.C. awaiting BVA Review or Hearing. Many vets have claims at different stages of development. You could have a claim at Court of Vet Appeals and file a new claim at VARO. The VA does not wait until your Court case is finished to begin work on your local VARO claim. If they did nothing at VA would ever move. Now if you have multiple claims at the VARO they may wait and then rate them all together at one go. They have done this to me. John

Getting a good IME is the best move a veteran can make. You just have to find a doctor who will do one according to the VA rules. I won my TDIU P&T based entirely on a IME done by a doctor who knew how to write, and the rules of the game. Social security lawyers often know doctors who can write an IME/IMO that will stand up. The doctor must at least say he has reviewed your C-File and your SMR's and current medical records. They must be available to him/her. None of the C&P doctors the VA uses actually read a vet's C-File (1000 pages plus). They just sometimes say they do. Often they don't even do that. They just scan your medical records. The VA uses those exams to deny or approve your claim every day. When you get to the BVA or COVA then the knives come out to cut the exam to ribbons. Your good IME doctor can cut it to ribbons if it is not good. That is what my IME doctor's did for me. I remember back in 70's, 80's and 90's the VA would use resident doctors from the medical school next door. All they would do is review the other doctors notes from last C&P and parrot it back. What lazy trash they were then and now sometimes. I met many C&P docs who believed every vet was scamming the system. One told me Vietnam vets get fat on purpose just to get more compensation for DMII. Hey, he gave me a decent exam for what it was worth. John

The way the VA actually calculates your rating % is to take 10% of 70% healthy bod/mind which equals 7%. When added to 30% and rounded up you get 40%. If you have chronic pain or depression due to your neck injury that could be another claim. Are you looking down the road at some operation to do a fusion or something for the neck? I have a similar problem.

If you sat foot in Vietnam your diabetes would be service connected by the way. If you went ashore in any port in Vietnam for even ten minutes, and can prove it, then you are "Boots on the Ground" Vietnam vet. This would be a very big deal for you. I think about half the Vietnam vets that post here have DMII. The secondary conditions are many and varied from DMII to heart attacks.

HM If you have a bone to pick with the military then you need to take it up with BCMR. Good luck on that one after 40 years. Forget about what the military did, or did not do in 1973. If you want to fight that case you will need to hire a lawyer, and pay about $10,000 just to get a decent hearing if they allow it. The BCMR does not even have to hear your complaint after 15 years unless you can show miscarriage of justice that is major. Concentrate on getting the VA to bump you up to at least 70% so you can file for TDIU and have a good chance of getting it. If you had filed for brain injury in 1973 maybe you would have gotten SC at some rate. I think there is no chance VA is going to go back, and reconsider your claim for retro back to date you were first DX'ed with some brain injury since you never filed a claim until recently. You are lucky to have gotten the 40%. Could you show continuity of symptoms or treatment over the last 40 years since discharge not that it would matter? I understand very well why you are pissed off since the VA and military knew you had a problem. Screwing you was just SOP in the 1970,s after Vietnam. After you get TDIU or 100% go back and fight this retro battle. That is what I am doing and I filed a claim in 1972. Not doing so well in that regard after 8 years in appeals with a lawyer. John John

The IMO should be part of the IME if you want the best chance. Your doctor does the exam and then writes an opinion for you with VA buzz words and format. I have seen some beautiful IME/IMO reports from the VA itself back a few years ago. I had one retired VA doctor do an IME/IMO for me. It was a thing of beauty and only cost $250. What a deal since I got p&t with that report. Good doctors are pure gold if they also understand how to write an IME/IMO. Many don't and many won't. John

You can dip even more if you have a private disability insurance policy. I paid $320 a year since 1984 for a disability policy. I started collecting on it in 2002 and have collected 103,000 bucks since them. As soon as you start to collect no more premiums. This is a well kept secret that disability insurance can be the deal of a lifetime if you get it before you are 100% disabled. I never thought I would need it but that is what insurance is for. My brother has a much better policy than I had and he will never use it since he is working and healthy as a horse so far. The thing is anything can happen on the way to work or sitting in your Lazyboy at night in front of the TV. Now I have VA, OPM and SSDI. It is OK except it does not provide well for surviving spouse. You can buy an annuity for that purpose. John

Did you set foot on Vietnamese soil at any port in Vietnam even for an hour? TBI is different from depression, so I would pursue the depression as secondary to the TBi or any other emotional difficulties you have since your TBI. I would also get a private shrink to write a report saying that your TBI has caused secondary depression, anxiety, inability to work etc. If you can get 30% for one of those conditions you will have enough for TDIU. If you have to prove sleep apnea 40 years after discharge it is going to be harder. I got a 10% rating for a "nervous condition" in 1973. It took almost 30 years to get to 70%. Then it took only about 18 months to get TDIU P&T. You are really lucky you got 50% for the TBI 40 years later. That being said I think you have a great chance of depression, anxiety, mood swings etc. being SC as secondary if you just get some new evidence to make the nexus between them and the TBI. I also got college degrees and could not hold a job until 1985 fifteen years after I got out of the army. Then in 2001 after a long decline I got fired and got SSD and TDIU. If you can't work file for SSD. If you win that will help with a TDIU claim. Go after low hanging fruit. If I had not filed in 1972 within one year of discharge I would have gotten nothing. I know guys who were blown up and got nothing because they never filed for the headaches, ringing in the ears and inability to settle down and work steady. You are lucky something showed up on the brain scan. John

If I really want to win a claim I like to line up some IME/IMO doctors in advance. These are really doctors I know who will give me their opinions on my chances of being able to show a nexus between either my service or some SC condition to justify a secondary condition. For instance if you are SC for diabetes due to AO then what are the chances of making a nexus between DMII and some other condition I might have as a secondary. Otherwise, you may be trying to show that the numbness in your feet and hands is due secondary to DMII to an APRN C&P examiner who knows nothing about PN, and little about all the secondary conditions caused by DMII. I had two C&P exams for PN secondary to DMII. One was done by a VA internist and one done by a VA neurologist. Guess whose opinion the VA took? The internist said my numbness was as of unknown cause while the neurologist said "as likely as not due to DM11". They took the internist opinion and denied my claim. I appealed and got my neurologist to say it was "at least as likely as not" caused by diabetes. Now I won on appeal, but I had to get the IME and file the NOD and see the DRO. This took 18 months. This is the "time" game they play since they know many vets will not get new medical evidence and many won't even appeal. I think I would have won just on appeal since it was obvious who was the nerve specialist and who was a horse doctor. I know I have had C&P's done by residents and maybe even medical students. The VA really is a criminal organization that seeks to pervert its own rules and regulations to save money and get that bonus. Most worker's compensation doctors, SSD exam doctors and insurance claim examination doctors are also whores who just do it for the money. They must know what their paymasters want, and they give it to them. John

I had a senior VA psychiatrist who was treating me say I would never get more than 30% and I am TDIU P&T with Housebound SMC for the last 13 years. I did have a doctor who did my Agent Orange Exam tell me to file for the conditions he listed. I did file for those conditions and got them service connected eventually. The thing is that the VA ignored the AO exam and gave me a effective date of about five years later. Why bother to get the exam if you have to file for it using more medical evidence and go for a C&P exam? Back in 1997 I had a C&P doctor write that I was faking my symptoms because I had a college degree in psychology. John

Get an IME/IMO or you will be stuck with 10% just like the others say. At this point you probably will be rated 10%, but that opens the door. Now you must get more medical evidence to support a rating of 30%-50% if you are still able to work. The difference between 50% rating and 70%-100% is the ability to work full time at above poverty level wages. I started with a rating for a "nervous condition" rated 10% in 1971. It took many years and IME's to get to 70% TDIU. I was robbed for the first 15 years after ETS and only got 30% in 1996 and then 70% TDIU in August, 2001. I was actually on SSD and OPM disability retirement before I got even 70% for a emotional disorder. You probably have a long fight ahead of you, but you cracked the door, so congrats. I would appeal the low ball rating for sure, but get new medical evidence. John

If you really need help go hire a lawyer. So they get 20% of retro. If you are lost and/or over your head you get 100% of nothing. Before I started using Hadit and doing research via the internet I trusted VSO's to help me. They as often hurt me. VFW screwed me to the wall. DAV discouraged me from filing for TDIU, and for appealing a denial. If I had listen to them I would be starving now. I would not give any VSO the chance to make a deal with VA to squash my appeal in the future. This is what they are good at is telling vet to drop appeals for the sake of a current rating.

I think if the VA forces vets to use only their official forms it will disadvantage many older vets, housebound vets and poor vets. Anyone who has trouble getting these official forms or has trouble filing them out is at a disadvantage. IRS gives people more help than the VA. The vet community should not accept this because soon the informal claim will be gone if we let this stuff happen. The VA has taken over the DX of PTSD when this is an outrageous abuse of vets who have private doctors who have diagnosed them with PTSD. Yes, the VA is looking for ways to cut future compensation costs. They will use any backhanded way to do it they can get away with so they can slide under radar of congress. The VA cannot be trusted to do anything. They cheat, lie and misrepresent the facts to CYA and to get those bonuses. They need a watchdog outside of the VA food chain. The VSO's are supposed to be doing this, but they are house pets of the VA.

If you have other insurance don't depend on the VA for your care. It is suicide for many conditions. If that is all you have then you need to use the system to get the most out of it. Are you more than 40 miles from your nearest VA hospital? If I was I would get help via private sector doctors. This new law may give you a leg up if the VA takes too long for treatment. These guys could not even do a simple tooth filing for me. They made glasses for me when I had a cataract with 20/800 vision in my right eye. Medicare paid for cataract surgery when the VA refused to do it. They pulled a tooth and then refused to replace it with an implant telling me I did not need that tooth which was a bald faced lie. There are vets out there who have medicare and, yet, they use the VA to have brain surgery. Yes, they save money, but some medical student, or resident is operating on their brain. Somebody that takes that chance really needs brain surgery. For your claim you need an independent medical opinion from a specialist who is on your side. You have to pay for it, but it is worth it. Without IME's I would still be getting 30% instead of being P&T for the last 13 years. The VA has diagnosed me with things I don't have and missed DX'ing me with the things I do have. You just cannot trust them even if your PCP has the best of intentions since the VBA does not have good intentions. Their only intention is to save money at your expense. John

If they ask about childhood problems, unless they have proof to the otherwise, I would say my childhood was great. I only started to have symptoms during service and shorty after service that continue to this day. Work, relationships were great before military and bad afterwards.

They look at the way your dress and personal habits. Eye contact is something they always comment on and your orientation (time, place, date). If you start to cry during the exam all the better.

USdart How old are you if I may ask? If you are old enough to get SSA I would quit before someone at the VA wises up and brings you in for a C&P exam with aim to reduce your 100% for PTSD. Have you read the description of what 100% scheduler means for a emotionally disabled vet? If you are working full time you just can't meet that description. Guys with double amputations who are 100% can work no problem. Everyone admires them. Guys with 100% for PTSD can work and everyone at the VA thinks they are committing fraud. This is really the way it is.

Since someone at VA DX'ed you as being psychotic you should get 100% if you have an active, service connected psychosis. That means you are hearing voices and seeing things that are not there plus all the negative symptoms that go along with a psychotic type illness. Combat stress could cause a psychotic breakdown as could any type of the same type of stress that causes PTSD. If you can't work due to your emotional illness then you should be able to get TDIU or 100%. It is not the psychiatric DX that gets you a rating. It is the way the psychiatric illness affects your ability to work and function in society. I have no idea if they will do psychological testing on you, or the C&P doctor will just ask you a few questions. John

I would do just as Carlie suggests. You may want to file a claim again one day and you sure want the VA to know where you are. The VA does almost nothing automatically. They might send you an order to show up for a C&P exam in your old state not knowing you have moved. That will be trouble for you. When filing claims I usually tell people not to move once they have filed their claim because the VA can and often will send notifications to your old address. If your forwarding order has expired the letter from the VA will be returned addressee unknown.

Just go with it. If you are working and making good money I doubt you will get TDIU since your paycheck is proof you are not unemployable. I would write the VA IG and tell them you are being denied access to VA psychiatric care. What is the breakdown of your 80%. and what is basis of the VA's wanting to reduce you? You might want to wait for the C&P exam and then after you have read it go get an independent medical opinion to wipe it out if the C&P exam says you are getting better. You cannot depend on the VA for good evidence. You need to generate your own. John