sambo808

August 13, 2013

I talked to my representative (American Legion) two weeks ago today. She said she talked to the guy at my RO which is in Huntington WV. He said that he can see the VA made a mistake and everything would be reinstated and it should be any day now. My question is...What is their "any day now". My "any day now" was 6 months ago. I don't know how long I should wait to contact them again.

Any day now could mean another 6 months as I speak. VA is working on claims with date of claim 10/01/2012.

August 4, 2013

Dependency cant go through as it is not a claim. It is an ancillary benfit awarded when a veteran is 30 percent or more disabled.

Call the 800 number and ask whats up.

Basser

Dependency is not considered an ancillary benefit. Dependency can be raised by the Veteran or inferred by the evidence of record. Ancillary benefits are DEA/Chapter 35, statutory housebound, Vehicle allowance, SAH/SHA, etc., but not dependency.

August 4, 2013

Ok so on 1/24/2012 i filled a claim for compensation and then on 11/02/2012 i filled a claim for dependency well as of 07/31/2013 the dependency claim went throw but not my compensation and i was told that they would go throw at the same time by the va so i just dont know whats going on should i wait to call or should i call first thing in the morning im just worried i wont get the dependency claim because im on 10% so im worried they denied it because of that and didnt do it after my compensation claim went throw like i was told they would do

Compensation claim is more extensive and in most cases takes longer than dependency claim because VA needs to make sure that they have dotted their i's and crosses their T's before they make a decision on your comp claim. Dependency is pretty straight up, and unless there are inconsistencies in your file pertaining to your dependency this type of claim realistically can be done in a few days once your Regional Office receives the necessary form. But in your case, you are only currently at 10% evaluation. So, most likely you would be denied additional monetary benefits for your dependents. 30% and above is the prerequisite for additional benefits on dependency claims.

August 4, 2013

I am going to file a claim for IHD, presumptive to agent orange exposure.I am already rated for other A O diseases. Is there a fast track form i need to use? I will be sending in proof of IHD from va reports and tests results.I am already in the system for presumptive conditions. Thanks

There are no known fast track forms that you can submit to expedite your claim unless you are 70 or older, homeless, in dire financial needs, or dying. FDC does not expedite claims it just means less development on the VA. You can submit a claim using a napkin or FDC form, or whatever VA form but at the end of the day you are still at the mercy of Regional Offfice's workload.

August 4, 2013

I need some advice since I haven't been getting much help from Neuropain after telling them my Lower lumbar needs urgent attention and that they only want to work on one part of the spine at a time.

I am getting a lot of pain in the ridge of my lumbar, enough to put tears in my eyes. I now have more radiculopathy, more pain in my calves and front of the thighs.

I don't take any opiates because the VA will not give me any. I guess this is the new policy. I do take Tramadol 300mg per day and Gabapentin 3200mg per day.

Is there any thing that will help this pain. I have tried ice but it comes right back. I can't lay on my back because it gets worse. The only thing I can find that helps is to lay on my stomach.

Are there any other home treatments I can try? I know about heat which never has helped me, its always been ice that has helped but not this time.

Thanks

Rob

Clean diet, light exercise, and minimize stress in your life... that is better than any medications available on the market today... diet, exercise, minimizing stress have no known bad side effects to date...

July 23, 2013

I went to the va mental health a year ago. told them I was depressed because of my hearing loss.
Made me do all kinds of testing. my GAF score was an 55.
On axis 1 the doctor wrote depression secondary to medical condition plausable.
Do I have a shot at a depression claim?

Hearing loss and tinnitus can be a symptom associated with schizophrenia as these condition do occur in the head. It does take a medical opinion to determine the nexus. Any physical or emotional ailments can trigger or exacerbate or directly cause depression. And so the examiner in your case rendered a positive opinion by medically resorting to plausibility. So it looks like you will be granted depression on a secondary basis.

July 22, 2013

STRS are silent ...means... there is no mention of this condition in the STRs (in the evidence that the VA has, which has been reviewed there is no mention of the claimed condition)

Yes.... send them any Active Duty STRS that you have that show you have treatment for the claimed condition. (it's called evidence). If VA has no evidence of the condition in service you claim will be denied. So by all means if you have evidence, make copies, and sent them certified to the Regional Office.

The examiner says there is no evidence but, why would the VA send you to an exam without evidence in the first place? Were you discharged within a year of filing your claim for compensatioin? I am wondering if this is a gen med exam.

The examiner says there is no evidence but, why would the VA send you to an exam without evidence in the first place? because STRs is one element in service connection that does not always have to be medical evidence. A Veteran's lay statement can establish an event or incurrence in service. See 38 CFR 3.303(a). There are many factors that might have contributed to the examiner's negative opinion in this case. It was possible that the RO did not send the STRs for the examiner to review. It was possible that Veteran's lay statement was inconsistent against the evidence shown in his STRs. It was possible that the examiner mistakenly cut and paste from one report to the other...this is not unusual as they examine tons of Veterans for C&P purposes. It was also possible that the Veteran did not submit his complete STRs or the RO received only partial STRs from the Service Department when they requested for this Veteran's STRs. The point is there are tons of possibilities and it is hard to pinpoint exactly the reason for the negative opinion by the examining C&P doctor without actually looking at this claimant's file. We can only speculate at this point. What this Veteran's needs to do is to request for a copy of his examination report and/or call the RO and ask whether they have complete and full STRs covering all his entire service.

Davo68 - New Member With Questions · July 21, 2013

I'm new to this site, very helpful and informative reading. I filed a claim in early January 2013 and have been going through the process. My claim is for hearing loss and had an audioligy exam by the VA at their hospital in Bonham Texas and at one point my claim was at the Reviewing Evidence stage, it was then sent back to the Gathering Evidence phase and turned over to VES. I was contacted by VES and underwent another audioigy exam. A few questions:

1) Since I was sent for another hearing exam after the evidence was being reviewed stage can I assume that the SC aspect was not an issue?

2) My claim was for Hearing Loss, but the VES examiner also checked out my tinnitus and asked asked a lot of question with regard to the tinnitus. Do i need to file a seperate claim for the tinnitus?

3) If I file for tinnitus will it slow my current claim decision?

4) I am not using a VSO for this claim, should I get VSO support at this stage?

1) it is likely that the first exam was insufficient or they are seeking a medical opinion

2) When they examine a Veteran for hearing loss they also examine for tinnitus both conditions are on the same DBQ because they are interwined.

3) You do not need to file a claim for tinnitus as I said in number 2, they are intertwined if you have hearing loss audiologist is also required to determine whether your tinnitus is a symptom associated with hearing loss and/or whether your tinnitus has the same etiology as the hearing loss (i.e. due to military noise exposure or acoustic trauma)

4. Having a VSO is good to have because they have easier access to VA than you do. They can initiate the review of your decision and determine whether there is error in the decision before the decision gets to you. If you have VSO VA sends them a copy of the rating decision and reviews the decision. They have a couple of days to look through the decision and if they agree then VA goes ahead and sends you the decision. Another reason that it is good to have a VSO is that VSOs are trained with the same laws and regulations that VA adjudicators have been trained on so they know exactly what to look for in the decisions.

July 21, 2013

Your combined disability since 2002 is 80%. It seems that your IU is based on the combined effect of all your disabilities. But if you were granted IU based on a single disability (let say PTSD) then you would have been qualified for statutory housebound based on one single rated as if 100% (PTSD) plus 60% (combining all the rest of your disabilities). Although you have total disability based on individual unemployability your IU entitlment is never a permanent benefit because every year you have to keep re-certifying that you have not sustained or maintained gainful employment for consecutive 12 months.

Both statutory housebound and housebound in-fact are decided locally if the evidence warrants them. It is not true that the grant of housebound in fact will have to be sent to Washington DC to be granted. The only time that a claim for entitlement would have to go outside the RO is when they are considering for you extra-schedular, special opinion or review for some very unusual cases, or when you are appealing the decision of RO.

You can be granted radiculopathy of the upper or lower extremities separate from your cervical spine or lumbar spine condition. If you have nerve conditions showing in your medical evidence you do not need to claim it because VA will consider it as an inferred issue. Meaning, if your cervical disability is also causing you to have radiculopathy in one or both of the upper extremity VA will automatically grant you for those without you having to claim it because radiculopathy is a well know complications of cervical or lumbar spine condition. But that is not to say you can not raise the issue yourself. If you do claim radiculopathy VA would have to set you up for medical examination for your cervical spine or lumbar spine to determine if you do have in fact radiculopathy.

July 21, 2013

In 1998 I was awarded 100% IU P&T, my wife and five children received their chapter 35 and Champva paperwork. At that time I was rated,

30% depression

20% rt ankle

20% rt femur, hip, knee w/leg length discrepancy

20% DDD Lumbar

10% left knee

In the rating decision it stated that I was determined to be disabled not by my MH condition or physical conditions on their own, but when looked at together the record showed that I was disabled due to my service connected conditions, which were caused by a single event in service. (Parachute accident)

In 2002 the depression was raised to

50% for PTSD/depression

and also I received two different ratings for painful scars

10% Painful scar

10% painful scar

IU was continued.

Do the conditions that were initially used to grant IU count for 100% towards the 100% + 60%?

My question is how do the ratings in 2002 count for a SMC rate?

Is Radiculopathy a separate claim of DDD, can it be?

Can cervical spine bulging discs be secondary to DDD Lumbar. I don't think it should be a secondary, I actually injured my neck when I hit the ground wearing a Kevlar helmet, but at Womack Army Hospital the records only state that I complained of back pain.

I recently had a back surgery that did not go as planned and although its been 20 years since I've filed for anything to do with the back, I think I'm going to file for an increase.

I realize there are several questions here that don't really pertain to the thread, I hope it's OK.

Your combined disability since 2002 is 80%. It seems that your IU is based on the combined effect of all your disabilities. But if you were granted IU based on a single disability (let say PTSD) then you would have been qualified for statutory housebound based on one single rated as if 100% (PTSD) plus 60% (combining all the rest of your disabilities). Although you have total disability based on individual unemployability your IU entitlment is never a permanent benefit because every year you have to keep re-certifying that you have not sustained or maintained gainful employment for consecutive 12 months.

Both statutory housebound and housebound in-fact are decided locally if the evidence warrants them. It is not true that the grant of housebound in fact will have to be sent to Washington DC to be granted. The only time that a claim for entitlement would have to go outside the RO is when they are considering for you extra-schedular, special opinion or review for some very unusual cases, or when you are appealing the decision of RO.

July 17, 2013

Are you able to work? This is a big factor in rating PTSD. I cannot believe the VA will eliminate the GAF since it is a bedrock of their system of rating mental health.

John

GAF score was never a bedrock of VA's system of rating mental health. That is a myth. As a matter of fact VA often times put very little weight on person's GAF score because GAF score is a very unreliable indicator. One, GAF score is totally dependent on the person who is evaluating you, and so it is very subjective. Second, GAF score is very inconsistent, and can change from week to week. A person may have a GAF score of 30 this week given by one examiner and goes to seek treatment for mental health the following week and given a GAF score of 68 by another. VA focuses more on the impact of Veteran's mental health condition on their social and occupational functioning. Some examples of social functioning are: do they have friends or a loner, do attend social functions or avoid them, to they have hobbies, do they hangout with their friends and go hunting or tend to isolate themselves, do they have a good relationships with their siblings, spouse, children, relatives, do they get involved in legal issues, do they beat up their wives or children, do they have road rage, do they take illegal drugs, or engage in illegal activiites. And for occupational functioning some examples are: do they get along with their co-coworkers, do they get along with their supervisors, do they often receive disciplinary actions, have they been terminated due to bad behavior, do they have fight with their coworkers, do they yell or rude to customers or coworkers, are they often tardy or absent, can they finish the task on time or often behind schedule, do they move from jobs to jobs consistently. Again, these are just some of the examples and indicators that they look for in assigning the correct evaluation to any mental health disability.

July 17, 2013

Now that the new DSM-V is out, they eliminated the GAF when determining mental illnesses - will the VA be following the new DSM?

As it stands today and until September 30, 2013, VA will still be using DSM-IV when evaluating a mental health condition. The reason for this is that VA will have to change many of their regulations to reflect the new DSM-V, and that takes a lot of man hours to do.

July 17, 2013

They changed the DC from Cervical and Lumbar Sprain to Cervical and Lumbar DDD. I don't know the code for the DDD but I am thinking 5243. I was wondering about the 5003 Code since it deals with Osteoarthritis. I can't understand the meaning of that code, it's confusing.

The radiculopathy is only from the Cervical and lumbar. Two EMGs on my arms proved this and I FINALLY get to have an EMG on my legs in late August. My sister in-law told me that she can't be the inhumane treatment I am receiving with the VA. She said if you tell a Doctor you are having pain in your lower extremities the EMG should have been done back then. I told her the whole story of how the VA has totally messed up my treatment up because its been 3 1/2 and I just now started to see Pain Management. She was upset about this and said that I probably now have permanent damage to my nerves. She is an RN so she knows her stuff. She can't believe the VA is treating veterans like this. She said "This is a vicious unfair cycle." She said that its going to get worse and with me being 44 she told me that if I can get in the Spine Program that Dr. Bash is going to refer me to then they might be able to help. She said once it starts it just progresses, mainly in the spine.

I am all good 71M10. I have taken much advice on here and have used all my energy to get ready for the Proposed Reduction of Ratings hearing. I have a majority of the evidence that actually shows how the C&P examiner basically used inaccurate data. I think what happened was the RO didn't get my treatment, MRIs and XRay records from the Tampa VA and those records are the most important ones. During the hearing I am going to ask the officer to see if those records are in the folder. If not then would that be a CUE?

But I am ready for the hearing and just waiting on Dr. Bash and his report and DBQs. Hopefully he will send them soon. He told me he would be a witness at the hearing but I don't have the funds for him to do this, I wish I did.

I appreciate all the help you guys and gals have provided for

VA will use either 5242 for your DDD. Diagnostic Code 5243 is for intervetebral disc syndrome rated based on incapacitating episodes.

July 17, 2013

Okay wow you answered the question sambo. I have a NOD they are currently working on for the upper radiculopathy and right leg radiculopathy (at the time my left leg didn't both me) and I just recently filed a NOD for the left leg radiculopathy, Bladder and Bowel Incontinence (last week a VA GI doctor diagnosed me with these even though the Dr. Bash had already done this last year but the RO still denied it because they said I didn't have a diagnosis). Yep crazy I know. Noway should a Veteran have to be diagnosed by a VA doctor. If I am not mistaken isn't rules on this that shows that ANY doctor can diagnosed and it's a legit diagnosis? Its all good trust me...

But on the ROM if the spine has reversed lordosis then the ROM is waived and the reversed lordosis has greater weight. I have an MRI report showing I have mild reversed lordosis of the cervical spine. I am trying to find one report that shows that my C5-6 is actually reverse.-VA

Yes, numerous precedents cases have repeatedly stated that a diagnosis is a diagnosis regardless whether by VA or a non-VA doctor based on the idea that doctors, whether it is VA or non-VA has presumption of competence. In fact the whole point of VA's Disability Benefit Questionnaire Program is to allow your private doctor to examine you and diagnose you so that you do not have to be examine and get diagnosed by VA Compensation and Pension examiner. Once complete, you should be able to take the completed DBQ and submit to VA and VA then must rate your claim based on that evidence. The caveat is that VA can still ask for medical opinion if VA is basically rebutting the findings by your private doctor or if they see some inconsistencies in the records and need clarification. But generally VA can decide on claims without VA examination, and based the evidence of record if the records are sufficient to decide on your claim.

When you filed your NOD you should have asked for DRO review of your case. Meaning, local review of your entire claim by a decision review officer. If you are not satisfied with the DRO review you can always take it up a notch and go all the way to the Board of Veterans Appeals. The reason I am recommending a DRO review is because it is much faster to go this route than the traditional appeal route. In many cases, appeals can be resolve by the DRO review.

As far as the lordosis in your spine. Limitation of motion of joints is never waived, at least that is not how VA views it. The most recent VA rating schedule for spine does contemplate lordosis of the spine but the most you are going to get for that is 20 percent. And you cannot get a separate evaluation for limited range of motion of the spine and lordosis of the spine. What VA does is they determine which route is going to get you the highest evaluation (whether it may be based on limited range of motion, or lordosis, or guarding of movement, or incapacitation). So the idea that ROM gets waived in the presence of lordosis is not entirely accurate, because every single one of them are considered at their own merit during the evaluation determination. VA will take the highest evaluation (limited ROM or lordosis, kyphosis, or guarding of movement...) and that is what they will assigned to you but not both.

Thanks for your service.. hope this information helps... take care bud

July 16, 2013

Any claim whether it is orginal or re-evaluation is at the mercy of current workload. Unless you are one of the priorities such seriously disabled Vet, homeless, 70 or older, or financial hardship a rater will get to your claim when they get to it just like everyoneelse.

July 16, 2013

If you are rated under IVDS then its based on ROM but they are other things within that which can waive the ROM as I wrote:

Forward flexion of the thoracolumbar spine greater than 30 degrees but not

greater than 60 degrees; or, forward flexion of the cervical spine greater

than 15 degrees but not greater than 30 degrees; or, the combined range of

motion of the thoracolumbar spine not greater than 120 degrees; or, the

combined range of motion of the cervical spine not greater than 170 degrees;

or, muscle spasm or guarding severe enough to result in an abnormal gait

or abnormal spinal contour such as scoliosis, reversed lordosis, or

abnormal kyphosis.......................................................................................................................................... 20

Myself I WAS changed from Cervical and Lumbar Strains to DDD...Its all still rated under IVDS. You can't connect Radiculopathy to a strain but you can connect radiculopathy to DDD. See the difference and why they have change the DC? Its still under IVDS...

If person who has crepitus in the cervical spine, isn't that also the same as abnormal kyphosis? This is how I am reading it from the couple of medical books I have and what I found on the internet. I do know I have reversed lordosis. This was first known back on the MRI in 2007 and its getting worse....Heck the C6 Vertebra is actually tilted to the opposite side to where it should be...

IVDS is not only rated on limitation in range of motion you can also get evaluation based on incapacitating episodes under DC 5243:

Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months 60 With incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months 40 With incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months 20 With incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months 10 Note(1): For purposes of evaluations under diagnostic code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. Note(2): If intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment.

In addition, to above VA by law should also consider an extra-schedular criteria if your back condition is bad enough but do not fall within the VA diagnostic codes.

July 16, 2013

5003 is rated based on limitation of motion of a specific joint involves. VA should be checking the limitation of motion in your cervical spine separate from thoracolumbar spine. The middle and lower back (thoracolumbar spine) are rated together. Again, VA should be checking you for limitation of motion in this part of your spine. If the limitation of motion in your cervical spine is non-compensable and the limitation in your thoracolumbar spine is also non-compensation (meaning 0%) then VA would have to assign one evaluation for your cervical spine and thoracolumbar spine based on X-ray evidence of arthritis. The reason is that cervical spine, thoracic spine, and lumbar spine are considered a group of minor joints. If they resort to 5003 then it is either 10% for group of minor joints (cervical spine, thoracic spine, and lumbar spine) or 20% for group of minor joints with evidence of occassional exacerbations. If your medical evidence can show it you should be rated separately for if you have nerve dysfunction in each extremity (depending on the degree of severity of the affected nerves). If there is no identifiable affected nerves it is considered a wholly sensory dysfunction and moderate degree (usually 20%) is the most you will receive. And so you may be able to receive additional separate compensation for right upper extremity, left upper extremity, right lower extremity, and left lower extremity if it is warranted based on the evidence of record. In short, your spine is either rated based on limitation of motion or group of minor joints with X-ray evidence of arthritis. Pain is a cardinal symptom associated with arthritis and so you are not going to get a separate evaluation for pain alone. Hope this helps.

July 16, 2013

Okay I know most of you know my issues by now.

I filed for a claim for Hypertension last year because it seemed every time I went to see any Doctor my blood pressure was so high they always had to do an EKG or was about to send me to the ER, be it private or the VA.

I decided to talk with my PCP at the VA about this and he was able to get me a blood pressure monitor. I got this monitor last Thursday. Every reading I have taken my blood pressure has been okay with the DIA ranging from the high 80s to the low 90s.

Now, from all the readings on the net hypertension isn't considered until it reaches 100.

My pulse rate on the other hand has been in the 90s and even at 103 with no activity whatsoever before the check. This one here is what bothers me more than anything. My PR shouldn't be that high and I don't understand why its this high. This is the reason why I feel at times my blood pressure is up sky high.....

Could I be feeling like I do have hypertension when in fact its the Anxiety that I have from all the chronic pain? Is my pulse rate that high because of the Anxiety? I knew they underrated my Anxiety two years ago and they told me they underrated it but I didn't know I was that bad. I had a GAF score of 63 or something close to that during the C&P exam but they only gave me 50% on my Anxiety because they said it hasn't affected my work where now it has affected my work because it was Anxiety with all the pain that caused me to finally medically retire.

I am curious about one more thing. Will Anxiety stick with me for the rest of my life? Will it ever go away if the VA can find a way to stop the chronic pain?

Thanks for the comments...

It seems you need more than just a blood pressure monitor you should try to get a full medical check-up either with your private provider or your assigned VA provider. You may very well have inter current medical conditions aggravating your anxiety and putting your blood pressure and pulse out of normal range. I agree with the rest of the folks in here it takes a medical doctors to really start ruling out what could be going on with you. It could be the medication you are taking that causing everything out of control, who knows only docs can answer that. As far as your curiosity whether anxiety will stick with you... you are service connected for anxiety forever as far as VA is concerned and according to you that your chronic pain and anxiety caused you to medical retire then you should consider applying for individual unemployability if you can in fact prove that your service connected condition caused you to prematurely retire or apply for increased evaluation for your anxiety, which avenue you choose to take you should take it as soon as you can.

July 15, 2013

Ok so the panic disorder with agoraphobia started because of my PTSD symptons . do the military doctors usually rate a gaf rating higher than the VA ? im rated at about a 64 and doctors says im getting worse at each appointment .

VA does not focus solely of GAF when they are rating or evaluating you for mental health disability because GAF is very subjective and it is dependent on person evaluating you. GAF also changes from week to week. You may have GAF score of 45 this week but 68 the following week. In fact, the use of GAF Scale has been abandoned in the 5th edition of the DSM of Mental Disorders because of, among other reasons, "its conceptual lack of clarity" and questionable psychometrics in routine practice. So I would not bank on the fact that you have low or high GAF score. VA focuses more on how your mental health condition impact both your social and occupational areas of functioning as opposed to GAF score.

July 15, 2013

That DX should make a person eligible for SMC "S".

A diagnosis of PTSD with agoraphobia at 100% fate entitles a Veteran to SMC S? under what provision of the law? SMC S1 is called statutory housebound and to get this additional entitlement Veteran must have 100% single disability with additional disability or disabilities of 60% or more. If you are thinking SMC S-2 Housebound in fact or SMC L1 aka Aid and Attendance that may be apply to PTSD with agoraphobia, but the requirements needed to get this additional entitlement is much higher that statutory housebound. But generally 100% PTSD does not translate to an automatic SMC grant, Veteran must demonstrate that he needs additional entitlement under SMC provisions.

July 15, 2013

Sambo,

Please read my statement again. If a treating VA doctor writes a statement that a veteran is unemployable due to his or her service connected disabilities and give a medical rationale, it would be very hard for the regional office to deny the claim for TDIU. A veteran can't be unemployable due to IU. He or she must be unemployable solely due to service connected disabilities. No VA or private doctor will write a statement if it is not true. Also I said a treating doctor, this is a doctor that has treated the veteran or a doctor that has reviewed the veterans medical history and then gives his or her medical opinion.

Pete, again doctor statement whether it came from a treating physician or counselor or during VA examination is a good evidence to include in the claim for IU, but as I stated ealier it is not the only determining factor. I guess, the cautionary statement that I want to emphasize is that we do not want to send the wrong message that - oh yeah just get a statement from your treating physician that you cannot work due to your service connected disabilities VA should grant you the individual unemployability. Entitlement to IU is never that simple I wish it is, but like I said earlier medical evidence is one thing but legal is another - and VA has a different and totally set of rules that must abide with when it comes to determining entitlement to individual unemployability.

July 14, 2013

Very few VA doctors will write a letter but I have found that they are more willing to write a statement in your progress reports about your condition. Basically you really don't need a letter all you need is a statement from your treating doctor that you are unemployable due to your service connected conditions. They should give some type of medical rationale of why your conditions makes you unemployable and then you can file a claim.

Doc medical statement and progress reports are helpful evidence in support for a claim for Individual Unemployability, but Individual unemployability is not a medical determination it is a legal determination. Veteran may have a medical statement that he or she is unemployable due to IU, but all other evidence in the file must also conform with that statement, and if not VA rating board are legally bound to deny individual unemployability. There is a lot more to individual unemployability claim than a simple medical statement or progress notes. Veteran must legally and medically demonstrated that it is impossible for him to sustain or maintain gainful employment solely due to his service connected disability(ies), if there are other intercurrent condition in play (i.e. drug use, alcohol abuse, got hurt on the job, legal trouble, collecting workers comp, etc.) it gets harder and harder to overcome the threshold for IU.

July 14, 2013

I have read here on hadit and other places that video and audio recorders are NOT allow during the C&P exams. I have also read the court ruling that states that its not a RIGHT for a veteran to be able to do this.

But, I have YET to find the actual policy on this. IMO there is NO policy and the the reason why the VA doesn't have a policy is because of the court ruling whenever they said its not a RIGHT. If there was a policy then the ruling wouldn't have been with if it was a RIGHT or not.

If there is a policy then please post the link here and that will let me know that I wrote the above in vain. If not then "I have a dream".....

I know I have talked about this before, with carlie, but I have yet to see a policy so I have searched and searched. BTW There is actually a FEDERAL LAW that is called the "One Person Consent Law" where it only takes one person's consent for the parties to be recorded. So if I am in a room with you I only have to give consent by ME to record our conversation. As long as one of the people recording is part of the conversation.

So, this is why the court also only said it wasn't a RIGHT. They didn't say you can't do it, they only said it wasn't a right....Big difference there....

Somebody please provide me a link to this policy/regulation. Thanks...

Veteran does not have legal right to record an examination or be accompanied by counsel during an examination... that is actually stated in VA's own policy in their Manual Regulation of M21-1MR.III.iv.3.a

July 14, 2013

It has been an interesting 3 year journey so far. I might see a light at the end of the tunnel or it could be a train. Been spending a lot of time fixing what the VA didn’t rate right. Below is my recent lumbar exam, the one that was never done in my initial claim, but somehow got a rating of 10 %. I am thinking it going to turn out to be 20% Lumbar and 20+10 bilateral rating for Radiculopathy. Anyone want to venture a guess how this will end. If I end up 40% lumbar and 20 + 10 for Radiculopathy I will be 100%
Forgot one thing, do they rate scaitc and femoral nerve separately or the worse of the two? Since the exam says they are both hosed up.
The lumbar exam.
4/10 lumbar back pain always
45 degree forward flexion of lumbar spine
Abnormal Gait.
Ankle Plantar Flex Right and Left 4/5
Great Toe extension Right and Left 4/5
1+ Deep tendon reflexes left knee and ankle
Decreased sensation to light touch L2,L3,L4,L5, S1 left and right
Positive straight leg test
Involvement of femoral and sciatic nerve left and right.
Level of Radiculopathy
Right: Mild
Left Moderate

Based on the evidence you provided. You are not going to get 40 percent for your back. 45 degrees forward flexion is only 20 percent. Femoral nerve and sciatic nerves are not separately rated they considered one disability in one extremity. You will get a separate evaluation for each extremity. Again, based on your exam results. Right lower extremity radiculopathy is 10 percent being it is mild and left lower extremity is 20 percent being that is it at moderate degree. Based on your data above your disabilities would be: 20% for the back, 10% for the right lower extremity, and 20% for the left lower extremity. Your combined disability then will be 40 percent and not 50% because VA do not add each disability (as regular math would) VA uses their own math based on diminishing effect.

July 14, 2013

In 2008 I was awarded my unemployability and have been receiving payvat 100% rate (with benefits) ever since. I was sent a questionare form in Sept 2012 (so they say) but never received it. In early Jan 2013 I got a letter in the mail saying I never returned the qyestionare form and my pay would go hack to 60%. I immediately called the 800 number and the form was faxed to me. I faxed it back the same day (which it shows in VA system) but was given a fax number to the PA office which I later found out was a huge problem. It was supposed to be faxed to my regional office in WV not to PA. I have filled out all the correct forms, even had to do a new C&P exam. My local state office says, they've never seen this happen before. When I log onto the ebenefits site it shows I have a new claim as of Jan 22. My pay is currently less than 1/3 of what I've been receiving and it's put a huge problem on me financially. The ebenefits site shows I'm at preparation for decision phase which ive been at for 2 months. If anyone has any advice to give, it would be grately appreciated.

It is by law that you return the VA Form 4140, serves a certification that you have not maintained or sustained gainful employment. If VA does not receive this form they are required by law to give you a due process and propose to take away your entitlement to individual unemployability, and if you do not respond in 60 days they will go ahead and revert you back to your original combined evaluation, in your case 60 percent. It is possible that they have sent you the due process letter and awaiting your response to it, and since they have not heard from you that is why your claim has been put in ready for decision status. The best thing for you to do is call the Regional Office directly and certify over the phone that you have not sustained or maintained gainful employment, and will go ahead send in the VA Form 4140 as soon as possible. Or you can call the same Regional Office over the phone and ask for a personal hearing for their decision on your IU. Once you initiate a request for a hearing VA cannot take away your IU until they give you the opportunity to be heard, hence provide you the personal hearing.

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