WOLF14

Greetings:
I am grateful that one afternoon a few years ago, I Googled "I've had it with the VA". That simple "search" born out of utter frustration led me to "Hadit". And there it all started!
As of two weeks ago, I'm rated 100% (long overdue). And, I am still NOT done with the VA.
For those looking to do there own research I offer this process:
Obtain your Military Service and Medical Records by mailing (certified, return receipt requested) an SF-180, found here: http://www.archives.gov/veterans/military-service-records/standard-form-180.html Obtain your full VA treatment records from the "release of information" window at the center you receive treatment at. Review the CD-rom (PDF file) for all CHRONIC medical conditions, treatments, and diagnosis - chronocity is critical! Identify the incident, event, or situation in service that "caused" this condition. If it's in your active duty medical records that's extremely valuable. If it manifest after service you'll need to find a way to "connect" it to service - the "nexus". Next search USC 38 part 4 for your CHRONIC DIAGNOSIS, found here: http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#_top Match up the conditions and rating percetnage to the CHRONIC diagosis in your medical records. Review the DBQ the C&P examiner "must" use to rate your current condition, found here: http://www.benefits.va.gov/compensation/dbq_ListByDBQFormName.asp Search for VA court cases on your condition(s) to understand how the VA Regional Offices is likey to "rule and rate" on your claim. HINT, the cases tell you what evidence actually supports a claim. For example, here's a search for Sleep Apnea secondary to chronic Sinuitis: https://www.google.com/?gws_rd=ssl#q=sleep+apnea+secondary+to+chronic+sinusitis Look for evidence in these cases that would support your claim, and THEN match and find your evidence - NEVER, EVER lie! Gather all your evidence, write up a Statement in Support of Claim, found here: https://www.google.com/?gws_rd=ssl#newwindow=1&q=va+"Statement+in+Support+of+Claim" and mail it certified return receipt requested. NUMBER every single page, make copies, and wait. Make someone sign for your mailed packaged - VA has NEVER lost my packages! Before you go to a C&P review your evidence and especially the questions the Dr. is going to ask from the DBQ. I usually hand write a list of the 6-7 items that supports my claim. I make sure the examiner see this. I'm so done with the VA, I walked into to my last C&P with my 4" binder and the Dr. undersood I knew what is going on. A C&P exam is a LEGAL MEEETING, not medical treatment. I submitted my last three claims in July and they were fully decided correctly in six months. Help the VA help YOU!
And, most importantly, never, never, never, ever give up. Be relentless!
Most grateful,
PJ
I got a request to see how I wrote Claims, so here they are:
Hearing loss, Peripheral Vestibular Discorder, and Tinnunitis. Digestive disorder. Skin disorder. VA's 2015 Decision on these three Claims. 1 -STMT IN SUPPORT OF CLAIM - PERIPHERAL VEST DIS - PG-1- redacted.pdf
2 -STMT IN SUPPORT OF CLAIM - PERIPHERAL VEST DIS - PG-2 - redacted.pdf
3 - STMT IN SUPPORT OF CLAIM - PERIPHERAL VEST DIS FOLLOWED BY TINNITUS - PG-3 - redacted.pdf
4 - DBQ WITH TINNITUS - HEARING LOSS & PERIPHERAL VEST DIS - AMENDMENTS_Redacted.pdf
5 - C&P EXAMINER'S DBQ FOR EAR CONDITIONS.pdf
6 - STMT SUPPORT CLAIM - RHIODS 2014 - redacted.pdf
7 - DBQ FOR RHOIDS - FOR C&P.pdf
8 - STMT SUPP CLAIM - ECZEMA 60% - PG 1-2.pdf
9 -STMT SUPP CLAIM - ECZEMA 60% - PG 3.pdf
10 -STMT SUPP CLAIM - ECZEMA 60% - PG 4.pdf
2015 DX REDACTED FOR HADIT_Redacted.pdf

Im not 100% on this but im pretty sure that if you have a current pending claim regardless if its fdc, standard or "expedited" and you submit another claim what happens it that if the new claim gets rolled into it. So even if you are at preparation for decision on the first claim and you submit a new claim you wont get a decision on the new one until the second one reaches that point.

This is also why if you are in a hurry to get a claim decided and you submit a request for your c-file (which is handled as a claim) it can hold up the actual compensation claim as well.

In my opinion as long as you are getting treatment that is the most important part for the moment.

In the meantime, go to ebenefits, go into the compensation claim and "start a new claim" so that you can lock down your EED date for retro payments for the cardiology claim (claim). start to collect all the info now, sworn declarations (from yourself, friends, family, etc.).

once you get the meeting with the cardiologist and find out whats going on, if its not good ask the doc if it relates to any of your current conditions. If so ask him if he would mind writing up a ime report and fill out the dbq linking the issue to your current SC (also make sure he/she understands the importance of the words "more likely than not). Let he/she know that the VA is very stingy with these things and often the only way to get them to do the right hting is to hold their hand and the best way is through the words of board certified specialists like himself/herself, etc.

If you do all that then you already have the retro date locked down with a "intent to file" that is automatically created when you start a comp claim online. and once you have all the evidence you need submit it.

While it is most likely the most effective way to get an increase, there a cases where increases are still granted with little to no docter visits. Perhaps this varies upon types of disabilities in question. Some disabilities where test must be done after filing are dependent on results for a rating, whereas medical evidence or physician visits only carry so much weight, regardless of how much documentation. Of course the more the better the chance for an increase, yet say for something like Asthma, the PFT results will be the deciding factor. Not how much you have gone to the docter for it as test results normally wins out.

Congrats....The VA gave you your 100% in Aug, so they are saying that Sept 1, 2013 was the retro date start. From the way I read it , all the amount withheld from that date will be your retro x each month adding for the Colas of Dec 13/14/15. I can't tell you the exact amount and wont even try, but a good average would be around $1300 per month from Sept 1, 2013, based on the amount withheld.

Congratulations, nothing special for military ID cards just the renewals every 4 years for dependants. My wifes is coming up in December.

Yes and NO. A veteran can legally work and maintain a 100% SC P & T rating if he/she has a combined rating or a sole rating of 100%. Example a heart condition.

A veteran CAN NOT legally work with a sole rating 100% SC P & T for any MENTAL HEALTH CONDITION.
The 100% mental health rating criteria precludes a veteran from receiving the 100% rating and working at the same time.

Scheduler means you can still work. If you are 70% for whatever disability and 60% for another, 60% for another, your disabilities may not keep you from working, so you can continue to work full time, and get 100% VA disability.

IU means you are not employable. You can not work. If you are 70% for whatever, but cannot work they will pay you at the 100% rate. If you return to work they will lower you to the 70% rate.

P&T means permanently disabled. That means you will not be scheduled for a reevaluation, and they believe that your disability is permanent. If you apply for new disabilities, they may re-evaluate your condition. I think P&T gives you more benefits than Scheduler or UI. Dependent education, Insurance for family, and other benefits.

So you hit 100% schedular and were then determined to be P&T depending on your rating? You may have been granted TDIU, then P&T because of the nature of the TDIU condition driving the decision. I also think you should send the IRIS and ask for clarification if you need it, but if your eBenefits letter and decision say "no future exams" or "Chapter 35 benefits", you are P&T and it doesn't really matter how or why (JMHO). Just make sure you keep your appointments, etc. so IF you are ever re-evaluated or proposed for reduction, you have no issue beating the VA at this game.

I was awarded 100% schedular in April with the same issue (not P&T because I might improve) - it was no simple feat. I really don't see how the VA considers me as potentially improving, but there it is. So, I was advised to wait a year or so and have my doctor write up a statement that the likelihood of me improving was 'zip' and submit with a request for P&T. I'll let you know how it goes this coming spring. My wife and kids could really use the benefits if something happens to me. I'm still trying to figure out the Fee Basis Dental I received last week.

Good luck and keep posting questions.

One thing for sure with chapter 35 you are definitely P & T but now to get to the bottom line you need to find out if you are 100% scheduler or 100% TDIU and the only way you can do that is to request a complete copy of your rating decision including the legend sheet that shows all your disabilities. If you have this rating decision it should state if you are scheduler or TDIU.

With Chapter 35 if you get denied I would appeal that because it will take them a year at least to review your appeal. Then the VA has a year of records to look back on to see if there is improvement. This is what I did, and it took me about a year from the time I got TDIU to when I got P&T. I also threw in another IME to say again that I was permanently disabled. My doctors had already said it when I got TDIU. If you have SSD that is solid indication you are disabled for at least a year. Few who get SSDI ever go back to work and the VA knows this (but would they admit it?).

John

Congrats on the Good News Bud!!!

Wolf
Congratulations (again). After you get the envelope, you can calculate your retro, reminding you that you start getting paid the 1st of the month following your effective date, so lots of Vets get it a month off.
Then you can decide what to do, either accept the effective date, appeal it, or ask for an audit on the retro.

It looks like Gerd will be the first retro and it was the migraine claim that got you to 100%, so I would assume that will be your back pay date - the 90% you already had. Now what you need to do is jump on the state and Fed bennies that come with P&T.

1st, get your 19 y/o to the college VA person to get the Chapter 35 school benefits done, and refund of any monies due from the past months in school if your state offers tuition waivers, then get the retro from the VA for the same.
2nd, get your DOD cards for the family
3rd, get your family enrolled in Champ VA
4th, check for state bennies such as property exemption, car tags, ect... if there is such, apply for refund back to your 100% award
5th, make sure your award contains everything that you asked for, if you feel they were wrong, that will be a decision you need to make as you are now T&P, this is the golden ticket, and there is not much more to gain, unless you seek Voc Rehab, or the ILS program.
6th and most important.......enjoy yourself and your family, the retro may not be huge, but it can do some good for things you could not get or do before,

On the calculation, I really have no idea other than if it is based on the 11/12/13 date, just look at the schedule between 90-100 with the number of dependents you have x the amount of months between now and the retro date......it won't be exact,but it will be a good ballpark.

One other thing........Congrats to you and your family!

Congratulations! and a question - -
You stated that you were at 90% as of 2012, within one year after retirement.
Was the question of TDIU ever raised or considered by the VA. If not, why not?
That might allow the 100% (TDIU) to go back to the date you retired.
Some of the various court rulings seem to show that the VA has not done well
considering TDIU or SMC as they are required to do.

Congratulations! Your decision will state the effective date for 100%..it may be on the first page. You can only estimate the retro until you get the effective dates. You are correct that you will get the difference between what you got before, and what the new decision says, for x number of months (your effective date). In other words you get 100 percent back pay to your effective date, but you already got paid 90% so you don't get that again.

I did not calculate if this increase, indeed, is enough to get you to 100 percent. If you are at exactly 90 percent, it takes a full 50 percent increase to get you to 100 percent because of VA math. You can see this on the disability calculator, here, if you work out the numbers:

https://www.microhealthllc.com/veterans-disability-rating-compensation-calculator/

Perhaps starting a new thread would be less confusing, Wolf14. This thread is about Slick's 100% win. It began 13 June.

Started new thread. Thanks asknod

Just a word of suggestion.. Any time you file for an increase in rating

you make sure You are going to the doctor more than you was.

Simple answer but true. Don't ask if you go to a doctor once a year

you might get a proposal to reduce. After reading decision on reduction and how they

look at this. have your a** covered through VA or private doctors. I am beginning tothink

a private doctor may be the best. Some VA doctor will lie about things don't put things in your records

that mean a lot to you. Its a better way just be smart I don't like to c anyone reduce of anything.

I hope yall hear me on this its true its how it is. don't F your self that's all

Congrats !

Congrats,,,,,,,,,

Congrats on the great news bud

Slick, I didnt realize you were on Tricare---

have you looked into the CRDP/CRSC info here?

Youngsters are in their 30's and besides the VA I've got Medicare and Tricare for life.
waiting on the "envelope" to see why they disapproved some items.

While at 100% P&T what are the pro/cons to continue working those that were denied.
Unless there is an overriding benefit I'm kinda of the opinion to leave it as it is, humbly say thank you and not take up anymore of an RO's time that could be used for another vet.

Gee I always seem to think out of the box when I read these posts, and I just realized ...

I could easily claim my husband's 1151 stroke as directly service connected due to his AO DMII and AO IHD.

If they had to then make an award of 100% P & T on that claim, they would have to grant me a better Chapter 35 EED.

As you all know I am fighting aggressively the fact that they are saying the 1151 stroke was Total the entire 2 uears after my husband had it, a contributing factor to his death, and yet all of my medical evidence from the VA and elsewhere says it was Permanent,
but the VA says it wasn't, and refused to read my evidence that it was.
It should not even be an issue. But they used this to deny me addition 16 months of accrued benefits.

They did reverse their 1151 HBP denial very fast about 2 months ago....the HBP was malpracticed on, but still I know Dr. Bash could easily SC that to my husband's other SC disabiltiies..

Death makes 100% disabilities both P & T. This should not even be an issue....but this is a five figure award.....so no wonder they wont read my evidence....

I got Chap 35 and CHAMPVA because of a posthumous P & T 100% PTSC SC award.

Section 1151 100% awards are no different.But do not award Chap 35 and CHAMPVA

You might have some state bennies as well and even a property tax exemption with that award letter.