NavyWife

Please do not feel guilty!!

The disabilities listed in the VA rating schedules are all valid disabilities.

Your claim had the proper evidence and doctors statements needed to prove your disability.

If it makes you feel better, donate some retro to a good cause!

http://www.benefits.va.gov/PREDISCHARGE/DOCS/disexm58.pdf

12 page guideline the VA docs must use for a TBI assessment.

Review this along with the ratings guide for 8045 to be well prepared for the C & P exam.

http://www.benefits.va.gov/WARMS/docs/regs/38cfr/bookc/part4/s4_124a.doc

After the exam, go to the Release of Information office at the VAMC & request a copy of the exam be mailed to you. Or MyHealth E Vet website Blue Button feature will allow you to view it in 3 days. Check over the exam report to make sure doc wrote down correctly what you said. If not, you can fill out a form to request a correction of your medical records.

http://www.benefits.va.gov/PREDISCHARGE/DOCS/disexm58.pdf

12 page guideline the VA docs must use for a TBI assessment.

Review this along with the ratings guide for 8045 to be well prepared for the C & P exam.

http://www.benefits.va.gov/WARMS/docs/regs/38cfr/bookc/part4/s4_124a.doc

After the exam, go to the Release of Information office at the VAMC & request a copy of the exam be mailed to you. Or MyHealth E Vet website Blue Button feature will allow you to view it in 3 days. Check over the exam report to make sure doc wrote down correctly what you said. If not, you can fill out a form to request a correction of your medical records.

VA does not understand their own rules for processing SMC claims. SMC claims are always at the top of the list for frequency of errors in the OIG investigation reports of the regional offices.

Stressors are conceded due to combat.

PTSD diagnosis is given by VA.

Examiner marked Total Occupational and Social Impairment.

Looks like 100% to me!


Hopefully they will rate you at 100% based on this strong opinion given by the VA examiner. If for some reason the rater decides to give you 70% instead of 100% you will definitely want to appeal. Everything that is needed for them to rate you 100% is given in this exam report.

It's possible you might even end up with an SMC - S rating once all your other conditions are rated. That would add approximately $300 to your monthly compensation.

Any other claims for mental health such as depression or anxiety will be rolled in with this PTSD rating -and they will only give one percentage for any mental health ratings.


If any of your other issues get denied due to no Nexus-you will want to check and see if they are on the list of Gulf War presumptives.

TDIU--
A veteran is entitled to a 100% disability rating if he can establish that his service-connected disability[ies] preclude him from obtaining gainful employment. In VA law, such claims frequently go by the abbreviation “TDIU”, referring to a Total Disability rating based upon Individual Unemployability.

It is a common misunderstanding that a veteran can only qualify for a TDIU rating if he meets certain percentage disability requirements: namely, a single service-connected disability rating of 60%, or a combined service-connected disability rating of 70%. Unfortunately, through many of its notices to veterans, the VA is largely responsible for this misunderstanding. The truth is that a veteran can qualify for a TDIU rating any time one or more of his service-connected disability[ies] prevents him from obtaining employment, regardless of the percentage of the disability rating.

Like Notorious Kelly said, that is enough evidence. I would consider that exit exam stating "head injury with transient amnesia" to be MASSIVE evidence.

It sounds like you are concerned because it was non combat. That is not something you need to be concerned with. Like Rob M said There is NO requirement in the TBI rating that it be combat related. I think a lot of folks think PTSD has to be combat related, too & that is simply NOT TRUE.

Your goal is to give them enough evidence to schedule you for the TBI exam. In your statement that you send when you file, be sure to let them know that your exit exam stated, "head injury with amnesia". If you have a copy of that exit exam, send it in with your claim. If not, they should have it in your records.

It's good that you are "negative" or "skeptical". That is a healthy attitude to have with dealing with VA. It will save you a lot of getting your hopes up and then having them dashed by VA! But really you need to look at what evidence you have or could acquire and then file your claims based off your evidence. And in this particular case, you have MASSIVE EVIDENCE!

　
In order for a VA claim to be approved, it generally has to have three parts.

Part One --something happened in service. In your medical records you would have an event, symptoms, treatment or a diagnosis of an issue.

Part Two-- Something is bothering you right now. You are currently undergoing treatment for an issue or have a diagnosis of a current issue or are exhibiting symptoms.

Part Three--a Dr. can tie parts part 1 & part 2 together. This is called a Nexus statement. An example would look something like this, " The veterans deviated septum -incurred in service- more likely than not caused his obstructive sleep apnea."

For most direct service connection claims you will need all three of these parts for an approval. If your claim is secondary or presumptive then the rules are a little bit different.


　
In the meantime, read up on TBI and how VA rates it. VA rates TBIs on how it is affecting your daily life right now, these things are called "residuals".

There's a lot in the TBI section of this forum. Here's a post that has the rating schedule.


Keep asking questions! There's lots of folks here willing to help!

Sounds like a classic TBI...

Yes you probably should file a claim for TBI & include those recent reports that you mentioned.

However the VA is going to want to see some evidence that this event occurred. Hopefully that evidence is already in your service medical records.

Was this accident documented in your service medical records at all?

Do you have a copy of the hospital report where they checked you out? Portsmouth?

Do you have a complete copy of your service medical records?

If you have some documentation either in your SMRs or from the hospital report definitely send that along with your claim for TBI. If not, then hopefully it is documented in your service medical records & the VA will look through them & find it.

The second thing you will want to send in with your claim for TBI is a short statement with your description of the accident as well as your current symptoms. Just copy and paste what you wrote in your first paragraph above -that is perfect. If you know the approximate date or month or year that it occurred include that as well. You will also want to say that these symptoms are affecting your daily life in a negative manner.

Additionally it sounds like you have some secondary issues caused by the TBI that you certainly could file for as well.
Just make sure you are clear to VA that you are filing "secondary to TBI". The secondary issues that you could file for that you mentioned above are:
depression secondary to TBI,
migraines secondary to TBI and
tinnitus secondary to TBI

I found that getting medical records is one of the most maddening parts of this process! So you are not alone in that!

Keep in mind, that LAST THING VA wants is for you to have your OWN medical records. That would allow you to prove your case and rebut any ridiculous denials they come up with. So they are going to make it very difficult.

Just a few notes based on my own observations:

Make multiple requests to NPRC. It even says on their website, that at your first request they will not send you everything.

Once a vet files a claim with VA, the regional office requests those records from NPRC. From that point on, those records are then stored at that regional office. If there is no activity for a long time, then the records are moved to VA Records Management Center. You should definitely send them a letter requesting your records. here's the link
http://www.va.gov/directory/guide/facility.asp?ID=5380

If your records are still at the regional office where you last had your claim processed, then the only way to get them is with a request for your C-file. VA will drag this out as long as possible. I've heard of many taking 1 or 2 years. If you live close to your regional office, then go in person and ask to "view your cfile". they might stall you by making you request an appointment for that.

Clearly you were dealing with an idiot employee at VA who couldn't explain to you that VBMS is the database that holds your cfile, among other things. Cfiles used to be all paper, but VA has decided they want everything electronic. So they are scanning all the paper cfiles into the electronic VBMS database.

All of your ships medical records go straight into your Service Medical Records aka Service Treatment Records.

Oakland Naval Hosp. (Oak Knoll) got demolished back in the 90s. Any other specific hospitals you went to, you can contact them and ask for a copy of any records they still have. I tried that and they said they were so old they had been sent to NPRC. They did turn up in the cfile.


Regarding the TBI, VA doesn't rate it based on how bad or severe your injury or accident was. They rate it based on the "residuals" or how it affects you now. Therefore, any old records will not help you get an increase in your TBI rating. All you can do to get that increased in file for an increase with a statement of your worsening residuals.

I think you are on the right track with Anaise. Save, borrow, whatever you gotta do...

You need a doctor that can include notations in his letter to the studies linking PTSD and sleep apnea. And then relate those studies to your case specifically. If he can do that then he is the one you need. If not, then you could look through imenet.com for other doctors. However they are not aware of VA protocol, so you would have to explain it all to them-and that might be difficult. Most IMOs are around $1500.


I'm assuming you already have a diagnosis of sleep apnea. You will need that current diagnosis.

Stressors are conceded due to combat.

PTSD diagnosis is given by VA.

Examiner marked Total Occupational and Social Impairment.

Looks like 100% to me!


Hopefully they will rate you at 100% based on this strong opinion given by the VA examiner. If for some reason the rater decides to give you 70% instead of 100% you will definitely want to appeal. Everything that is needed for them to rate you 100% is given in this exam report.

It's possible you might even end up with an SMC - S rating once all your other conditions are rated. That would add approximately $300 to your monthly compensation.

Any other claims for mental health such as depression or anxiety will be rolled in with this PTSD rating -and they will only give one percentage for any mental health ratings.


If any of your other issues get denied due to no Nexus-you will want to check and see if they are on the list of Gulf War presumptives.

Well it's done!

Hubby is now 100%, plus P&T.

When I read the news, I dropped to my knees. Hubby started crying. I never hugged him so tight before!
1 year and 5 months ago, I logged on to Hadit and started ferociously reading the material. At first, it was every single day for most of the day.
Then Philip Rogers told me to buy the VBM. I did, but I was intimidated when that huge 2,000 page book arrived.
Next, I went after the C-file. VA sure didn't want to hand that over! In it, I saw all the injustices that had been done to him since he was medically discharged from the military. I saw that he had been wrongfully denied 4 TIMES. But this gave me an understanding of how the process works.



I can't thank enough each and every person on this website that takes from their own time, to help other veterans.
Tbird
Asknod
Berta
Philip Rogers- for telling me to buy VBM
John999 -without you pushing for IME, this never would have happened
Navy04- for lifting up my mood, when I got discouraged
Veldrina
JT
K9MAL
Georgiapapa
Notorious Kelly
Lotzapotz
Gastone
Broncovet
Jbasser
Mariorivera
Arng11
63SIERRA
Chuck75
Add55p
Pete53
Vync
aggie54
Stretch
And everyone else who is part of this community.

For those of you waiting, don't give up. But most importantly, get good medical evidence and good lay evidence to support your claims.

I wanted to add the link for the website that K9MAL found, which is a list of IME docs throughout the US.

http://www.imenet.com/

Amazing news!!!! It's been a long road for you to reach this point. You studied a lot, kept pressing forward and didn't give up!

diver,

First of all, congratulations on your win. Right now you are probably in a surreal state of mind because you still don't know whether to believe it or not. I think every veteran who finally receives the 100% P & T award experiences this same surreal state of mind. When you realize it's true, you feel a great sense of relief.

The AB8 letters are usually accurate but id_firefighter is right, you can't be 100% sure until you receive the official packet. I would also follow PR's advice and print out your AB8 letter and any other letters showing you are 100% P & T.

If you are 100% P & T, you will now have Champva health insurance and Chapter 35 DEA educational benefits available for your eligible family members. You would also be able to use the VA dental clinic. Depending on your state, state benefits could include significant property tax reduction, free disabled veteran vehicle tag, state income tax breaks, etc.

Good luck to you and take care of yourself.

GP

The actual decision will contain more as to how they determined the EED. ertc etc..This is GREAT News!

Try to relax and enjoy before you consider the next step......

You did a lot of research, as I recall, and that work ALWAYS pays off!!!!!

Slowlane--

Thank you for getting this going.

I started a thread before the VA Scandal hit the news, called "What Tricks has VA used to Deny You" and a lot of vets had the same stories over and over.



So clearly these issues are systemic and built into the way VA does business. I summarized from that post and this current post below:


If we had to pick just one issue for the claims side of VA, I think it has to be the "DENY, DENY TIL THE SOB DIES"!

And this could be alternately phrased as "Illegal Repeated VA Disability Claim Denials".



This would be the umbrella item over which all the other things happen. Things such as:

--illegally ignoring federal regulations which govern how claims are to be processed

--unfair, biased C&P exams with veterans statements altered or left out of report

--illegally ignoring claims evidence such as outside doctors reports

--illegally destroying evidence

--illegally weighing evidence and not giving the "Benefit of the Doubt" as mandated by law

--denying they received evidence which they did receive

--taking extreme amounts of time to process claims, typically 1 to 2 years

--taking extreme amounts of time to process appeals, typically 3 to 5 years

--hiding the true amount of appeals by not including them in the claim reports main total number which gets reported to the media (Monday Morning Workload Report). This makes it appear as if there are less claims and appeals than there actually are and it is accounting fraud. Major companies have gone out of business for this type of accounting fraud.



My hubby has personally experienced every item on the above list dating back to 1990 and I would be willing to bet most vets who have filed a VA claim have as well.

I hope someone; you, Berta, Commander Bob can send this to CNN and or FOX News or Huffington Post.

I certainly understand why you wouldn't want to deal with VA anymore.

But it might make sense to talk your case over with two or three veterans disability lawyers and see what they think about the past decisions and if maybe he should have been rated 100% previously and if there is a cue etc. etc.

VA continues to make mistakes and get away with it, because many people just don't want to deal with them anymore.

On number four the examiner marked the box that corresponds to a 70% rating. Now the rater must review all the other evidence in your file to determine what rating to assign. Here's a link to the rating schedule that explains a little bit more about how this is rated.

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5#sg38.1.4_1124a.sg13


If you aren't working because of your service-connected disabilities then you should file for TDIU. It's a special rating that pays you at the 100 percent rate, roughly $3,000 when your service connected disability's prevent you from working. The easiest way to be approved for TDIU is to have a letter from your doctor stating that you cannot work due to your service-connected disabilities. Another way is to get a letter from a vocational rehabilitation counselor stating that you "cannot work due to your service-connected disabilities".

Reading the narrative it sounds like the psychologist considered marking the 100% box but she did not because you still have a job currently. This is just her opinion and another psychologist may have a different opinion...

Please take the time to get professional counseling just for the sake of your family. When my husband was med boarded out of the Navy he really felt like his life was over. He had made plans that the military would be his career and now they were kicking him out. He felt angry and betrayed for a long time. It's hard to go through those feelings. But please know that those feelings are temporary. Eventually he got over it. Life is not always what we expect it will be. And that's okay. We just have to believe that we can adapt and change with the curveballs that life throws at us, simply because we BELIEVE we can.

Well it's done!

Hubby is now 100%, plus P&T.

When I read the news, I dropped to my knees. Hubby started crying. I never hugged him so tight before!
1 year and 5 months ago, I logged on to Hadit and started ferociously reading the material. At first, it was every single day for most of the day.
Then Philip Rogers told me to buy the VBM. I did, but I was intimidated when that huge 2,000 page book arrived.
Next, I went after the C-file. VA sure didn't want to hand that over! In it, I saw all the injustices that had been done to him since he was medically discharged from the military. I saw that he had been wrongfully denied 4 TIMES. But this gave me an understanding of how the process works.



I can't thank enough each and every person on this website that takes from their own time, to help other veterans.
Tbird
Asknod
Berta
Philip Rogers- for telling me to buy VBM
John999 -without you pushing for IME, this never would have happened
Navy04- for lifting up my mood, when I got discouraged
Veldrina
JT
K9MAL
Georgiapapa
Notorious Kelly
Lotzapotz
Gastone
Broncovet
Jbasser
Mariorivera
Arng11
63SIERRA
Chuck75
Add55p
Pete53
Vync
aggie54
Stretch
And everyone else who is part of this community.

For those of you waiting, don't give up. But most importantly, get good medical evidence and good lay evidence to support your claims.

I certainly understand why you wouldn't want to deal with VA anymore.

But it might make sense to talk your case over with two or three veterans disability lawyers and see what they think about the past decisions and if maybe he should have been rated 100% previously and if there is a cue etc. etc.

VA continues to make mistakes and get away with it, because many people just don't want to deal with them anymore.

I certainly understand why you wouldn't want to deal with VA anymore.

But it might make sense to talk your case over with two or three veterans disability lawyers and see what they think about the past decisions and if maybe he should have been rated 100% previously and if there is a cue etc. etc.

VA continues to make mistakes and get away with it, because many people just don't want to deal with them anymore.

great news... trying to reduce to scare a vet is one of VA s common tactics. the sad part is, your husband likely should have been recieving the 100 percent for a long time.

P and T benefits at 100%
1. CHAMPVA
2. Student Loan forgiveness
3. Base Privileges
4. Free Life Insurance
5. Free VA Dental
6. Free VA Optimetry
7. No Copays
8. Travel Pay
9. Priority 1 at VA
10.Free National Parks Pass
11.State Benefits
12.Private Company discounts

What did I miss?

Navy has a good point. If you feel like your Dad has strong evidence in his VA medical records supporting his claim, he should go ahead and submit his claim. However, he may have strong evidence of a diagnosis but his claim will not succeed unless he also has strong evidence showing a nexus or connection between his medical condition(s) and his military service.

Your Dad is 75 years old and has been out of the Navy for a long time. He will need his service medical records showing he had his current medical conditions while in service or some post discharge medical records showing a continuity of treatment for his current medical conditions from shortly after his discharge until the present. Absent either of those, he will need a strong IMO from a pulmonary doctor stating it is "as likely as not" his current medical condition was caused by his military service. The only exception would be if your Dad's medical condition has been identified by the VA as a "presumptive disease" and recognized as service connected due to exposure to certain substances and at certain locations during specified war eras. JMO