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mountain tyme
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Posts posted by mountain tyme
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Axis C or (Axis III) are general medical (physical) concerns that may have a bearing on understanding your mental disorder, or in the management of your mental disorder. Physical conditions can have a bearing on your Mental health. So physical conditions are taken into consideration when a determination and treatment is determined.
There are actually 5 Axis in all...
the 4th one Axis IV: Psychosocial and Environmental Problems and the last one is the Axis V: whic is the number from 1-100 that reflects the your doctors judgment of the overt level of functioning you have at the time of the exam. This number can change with each visit.
Hope this helps
MT
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The following information is from the hadit.com search engine...hope this helps
How to request Veteran Affairs (VA) Records C-File
We can not stress enough how important it is to
1.) View your claims folder at the regional office call 1-800-827-1000 and request an appointment to view your c-file (claims folder).
A.)Ensure that all the records in your C-File are yours.
Check that everything you have sent to the VA is included in your C-File.
B.)After viewing your claims folder (c-file) and correcting any mistakes you may find. Then request a hard copy of your claims folder.
To request your military records use this form Request for Military Records
NARA SF 180 (go to this link for the form http://www.archives.gov/st-louis/military-...d-form-180.html )
To request your C-File which is your claims folder at the regional veteran affairs office use VA Form 3288 (go to this link for this form http://www.forms.va.gov/va/Internet/VARF/g...=3288-form.xft) Technically any release or waiver from that is signed by the claimant and that properly compiles with and cites the Privacy Act and FOIA is sufficient. However VA personnel are familiar with the VA Form 3288 so it will cause the least confusion.
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Good Morning Ray....here is some information that Vike 17 wrote quite a while back...he is very knowledgeable regarding the VA system which he was still on this site...but I kept quite a bit of his advice...so hope this will help you as well.
There are three avenues of aproach you can take in regard to this; 1) file an appeal and request a DRO review. 2) file an appeal and skip the DRO review and go directly to the BVA, and 3) request a "reconsideration" of the prior decision.
Here is a detailed explanation of all three process. Pay particular attention to the request for "reconsideration";
In any type of appeal, the first step is submitting a Notice of Disagreement (NOD) with your regional office telling them what issue you disagree with and why you disagree with that decision made by them. There is no special form to fill out, just a simple letter to your Regional Office with "Notice of Disagreement" at the top with the rating decision date and issue(s) you disagree with is needed. You have one year from the date of the rating decision to submit your NOD. In the NOD you should also specify which way you wanted your appeal handled i.e. the traditional way (Board of Veterans Appeals, or “BVA�� ), or through a DRO review. If you don't tell the VA which one, they will send you a letter asking which route you want. You then have 60 days from the date of that letter to choose. If you don't answer the letter, the VA automatically processes the appeal through the traditional process. Also in the NOD you should state if you want a hearing or not.
A DRO review is where a Decision Review Officer, hence DRO, who is a senior rater with many years of experience that works in the appeals Team, will completely review your claims folder and NOD and decide whether or not he/she can grant the benefit the claimant is seeking. If the DRO grants the appeal in full, he/she will produce a rating decision telling the claimant of the percentages ect... just like the Rating activity would on a normal claim. If the DRO cannot grant the appeal in full, then he/she will issue a Statement of the Case (SOC) explaining the actual laws and rational which pertain to the denial. Even if the DRO is able to grant a partial appeal, they still must send out a SOC. For example, let's say you are appealing a PTSD rating of 50%. The DRO grants an increase to 70%, but since the DRO didn't/couldn't grant the highest possible award pertaining to the disability, they must still produce a SOC. In this scenario, the DRO would send out a rating decision with the grant in increase from 50% to 70%, and a SOC stating why he/she couldn't grant the full benefit allowable i.e. the 100% rate. Once a claimant receives a SOC, they have 60 days from the date of the SOC to either "perfect' their appeal by submitting VA Form 9, which will prompt the RO to send the appeal to the BVA, or submit 'New" evidence that were not before the decision maker when he/she made their prior determination. When the claimant submits "new" evidence, the VA will evaluate the new evidence and either grant the benefit sought on a appeal or issue a Supplemental Statement of the Case (SSOC) outlining why the new evidence was unable to be used to grant the appeal. A SSOC will only address the new evidence the claimant submitted. From the date of the SSOC the claimant again has 60 days to either "perfect" the appeal by submitting VA Form 9, or again submitting "new" evidence. If the claimant submits new evidence again, then the process of either a grant in benefits sought or a SSOC will repeat itself until the claimant "perfects" their appeal.
The traditional appeals process is where the claimant wants to skip the DRO review and appeal directly to the BVA. In this case, the claimant still must send a NOD to the VA. The VA, more specifically the rating activity that made the prior decision or a RVSR in the Appeals Team will send out a SOC. Once the claimant receives the SOC the process afterwards is the same as when the DRO issues a SOC. You either can submit "new" evidence and have the Rating activity reconsider their previous decision, which will either prompt them to grant the benefit sought on appeal or they will send you a SSOC, or you can "perfect" your appeal by sending in VA Form 9. Once the VA Form 9 is sent in, the regional office then prepares your claims folder for the BVA where it gets put on the docket. Remember you only have 60 days from the date of the SOC or SSOC to submit the VA Form 9!
Another route that may be of some interest is the "reconsideration" route. This is where a claimant has received a rating decision and may disagree with that decision, but has "new" evidence that the Rating activity was unaware of at the time of their decision, and may think that the "new" evidence might result in a more favorable decision than the prior one. In this case the claimant has the one year appeals period to send in the "new" evidence and request that the Rating Activity "Reconsider" their previous decision. The claims folder would then go back to the Rating activity to be reconsidered and the RVSR would send out a new rating decision where the "new" evidence is considered and an new decision rendered. One thing to keep in mind is one MUST submit "new" evidence in order for the VA to "reconsider" their previous decision. Another reason one might consider the "reconsideration" approach is simply because a request for reconsideration generally goes faster then an appeal because the claims folder goes back to the RVSR and is worked according to the date of the request for re-consideration. If the request for reconsideration warrants a favorable decision, the effective date may be the date of the original claim, depending what the evidence submitted dictates . A request for reconsideration is simply "re-opening" a claim within the one year appeals period [(see 38 CFR, §3.400(q) for effective dates concerning reconsiderations) also see "Re-opening claims" for an explanation].
Another topic concerning "reconsideration" is whether or not one should file a Notice of Disagreement (NOD) if the VA hasn't yet rendered a decision before the one year appeals period has expired. If one sends in "new" evidence within the one year appeals period and request a "reconsideration" of VA's prior decision, they better be 100% certain it will change VA's prior decision; If VA accepts it as a "Reconsideration" (which as stated before is a "Re-opened" claim), they must follow the rules and regulations for a reopened claim and render a formal decision unless one withdraw the claim prior to a decision being made. If they do render a formal decision they must notify you of this decision which means that they cannot then turn around and accept the request to reopen as a Notice of Disagreement because it is dated and received prior to the latest decision on this issue. The NOD must be received AFTER you have been notified of the latest decision on that claim. Reopened claims and NODs are not worked by the same people nor by the same administrative procedures. If one requests a "reconsideration" with the one year appeals period and then file a NOD before the one year elapses because VA hasn't made a decision on the "new" evidence, then one is asking that VA go through all the administrative procedures for a "reopened" claim up to and including a review by a Rating Specialist and then if the claim cannot be granted to just stop without a formal decision and send it back out to start reprocessing as an NOD. This would create an Administrative nightmare and simply cannot be done. If after requesting a "re-opening" of the claim you then file an NOD, the "re-opened" claim is no longer valid and whatever evidence you submitted with it will be considered as part of the NOD. As soon as the NOD is received on that particular issue, whatever it is, it MUST be worked under the appeal procedures. One cannot have both a reopened claim and an NOD on the same issue at the same time. In short, one must keep an eye on the expiration date for the appeal period so you could convert the "reopened" claim to a Notice of Disagreement (NOD) in the event a decision was not rendered before the appeal period expired. If you disagree with the decision and you aren't 100% certain that the new evidence will result in a grant, you cannot let that original appeal period run out. If the reopened claim is not granted and you don't submit an NOD within the appeal period for the first decision, you have lost the date of claim on that decision as a potential effective date. There are a limited number of situations where one should "re-open" the claim instead of filing an NOD, but these are few and far between and one must really, really know what they're doing when they make the decision to do this. The overwhelming majority of cases a Notice of Disagreement is the best path to take.
I hope this helped!
Vike 17
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william yes I believe you would have a strong case...you just need to have your doctor put the dots together...
you can file a claim with the VA...but I am one that believes before you file get your ducks in a row...get the medical documentation first...the VA has a harder time denying a claim that is backed up by a strong IMO...from a civilian doctor...and the only reason I say this is because a civilian doctor is looking out for your best interest and unfortunally the VA doctor is working in the best interest of there employer the VA...(which in reality the VA doctors should be looking out for the veterans best intest but we do not live in a perfect world)...so get your medical documentation together first...then file. You can bring the VA worksheet for your back to your doctor so they can write an opioion to the VA criteria.
MT
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williamn wrote: "My question is ..will the rater consider the NSC disabilties once i SC them or start anew. Ive read trhat the rater is not too look at the NSC claim at all while determinig SC for the same DX's..txs, William n"
It is true that the VA rater will not take into consideration a condition that non- s/c at the time he is rating a s/c claim.
so what we have here is that you were granted a nsc pension. since receiving your nsc pension you have been able to file a claim with the VA on a disablitiy that you can now show incurred during active duty service...ok...once the said disability is granted s/c the VA will then determine when the Effective date for that condition only...if you can not link the other conditions that you receive a pension for the VA will not take them into consideration for compensation nor will the VA take them into consideration if you are applying for UI...now lets say that you are granted s/c if that condition alone is rated at 60% or above you can then file for UI...in some cases where that single condition does not rate high enough (60%) if you can prove through medical documentation that due to that said s/c disability you can no longer work due to the impact of your condition then the VA can send it to be considered under a VA schedualer...to grant TDUI...
I hope I answered your question...I sometimes have a hard time expressing what I am trying to say
MT
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You wrote in another thread the question "SC knees would correlate with low,thoracic, cervical back problems"....
yes, it is very possiable that if you have stresses that effected your right or left fibula at the knee joint, it would make sence that the stress would transfer..many chiropractors now think of the thoracic region as being reactive to the forces transferred from the extremities..I quess the best way I can explain this would be take for instance a base ball player...just swinging the bat could cause stress to there knees by the motion over time it would not be uncommon for the player to have to have knee surgery which overtime your body would have to compensate for the damage knees hence the transferance of stress to other muscleskelton areas which would be your thoracic cervical back problems....I don't know why you are s/c for your knees...but If I was you I would have my family doctor refer me to a specialist for joint problems...that could write you an IMO as to why your conditions are SECORDARY TO YOUR s/c knee injuries...I feel that you would have a strong case.
There is a member on this site his name is sixsence he know's alot about this area...more then I.
but prior to filing for the back condition you really should first get an IMO...as to how the knee's effected the overall deteriation of your back...it can be done you just need to have a doctor write that your back condition is secondary to your damaged knees.
hope this helps
and that others will chime in!!!
mt
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from the website.. http://www.co.bingham.id.us/Clerks/veterans.htm
"What do the terms "Service-Connected" and "Non-Service Connected" mean?
These terms define disability types in the VA system. Service connected means that the veteran is disabled due to injury or illness that was incurred in or aggravated by military service. Non-service connected means that the veteran is disabled due to injury or illness not related to military service.
What is the difference between "Compensation" and "Pension" in the VA system?
Compensation is paid to a veteran with service-connected disabilities. Pension is paid to a war-time veteran who is permanently and totally disabled from non-service connected disabilities and who has very low income.
How do I know if I am eligible for "Compensation"?
First, you need to establish with the VA that you are disabled because of your of active military service. Service connection for a disability may be established in the following ways:
DIRECT – Service medical records show that the disabling condition was diagnosed during military service and the condition has continued to affect the veteran.
AGGRAVATION – Evidence demonstrates that the disabling condition which existed prior to service was aggravated beyond normal progression during military service.
PRESUMPTIVE – Evidence demonstrates that the disability is one predetermined by the VA to be presumed for service connection by time, place and type of service.
SECONDARY – Evidence demonstrates that the disability developed as a result of, or residual of, another service connected disability.
INJURY AS A RESULT OF VA MEDICAL TREATMENT – This is a disability that the veteran incurred, had aggravated or died from because of medical treatment at a VA Facility.
How do I know if I am eligible for "Pension"?
The eligibility criteria for VA Pension are:
The veteran had at least 90 days of active service with at least one day during a recognized war-time period.
The veteran is shown by medical evidence to be permanently and totally disabled.
The veteran has very low annual income for his/her household.
Following found in the www.va.gov website
Department of Veterans Affairs
Pension
What Is VA Pension?
Pension is a benefit paid to wartime veterans with limited income, and who are permanently and totally disabled or age 65 or older.
Who Is Eligible?
You may be eligible if:
• you were discharged from service under other than dishonorable conditions, AND
• you served 90 days or more of active duty with at least 1 day during a period of war time*, AND
• your countable family income is below a yearly limit set by law, AND
• you are permanently and totally disabled, OR
• you are age 65 or older.
*Note: Anyone who enlists after September 7, 1980, generally must have served at least 24 months or the full period for which called or ordered to active duty. Service from August 2, 1990 to present is considered to be a period of war (Gulf War) in addition to other periods of war such as World War II, Korea, and Vietnam.
FAMILY INCOME LIMITS (EFFECTIVE DECEMBER 1, 2005)
If you are a... yearly income must be less then
Veteran with no dependents $10,579
Veteran with a spouse or a child $13,855
(Veterans with additional children: add $1,806 to the limit for EACH child)
Housebound veteran with no dependents $12,929
Housebound veteran with one dependent $16,205
Veteran who needs aid and attendance and has no dependents $17,651
Veteran who needs aid and attendance and has one dependent $20,924
Note: Some income is not counted toward the yearly limit (for example, welfare benefits, some wages earned by dependent children, and Supplemental Security Income.)
How Much Does VA Pay?
VA pays you the difference between your countable family income and the yearly income limit that describes your situation (see chart above). This difference is generally paid in 12 equal monthly payments rounded down to the nearest dollar. Call the toll-free number below for details.
How Can You Apply?
You can apply by filling out VA Form 21-526, Veteran's Application for Compensation and/or Pension. If available, attach copies of dependency records (marriage & children's birth certificates) and current medical evidence (doctor & hospital reports). You can also apply online through our web site at http://vabenefits.vba.va.gov/vonapp.
Related Benefits
Vocational Rehabilitation Program
Medical Care
hope it helps
MT
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ok...let me tackle the kidney stones issue first...you need to put in for a claim asap for this..first...are there any medical IN-SERVICE records that you have kidney stones? if not are you still within the one year rule (meaning you have medical records documenting that you have kidney stones within one year of military service. next how have you been treated...please see below...this is the rating schedual for kidney stones...you can go to this link
http://frwebgate.access.gpo.gov/cgi-bin/ge...3&TYPE=TEXT
Kidney Stones
(Nephrolithiasis)
7508 Nephrolithiasis:
Rate as hydronephrosis*, except for recurrent stone formation requiring one or more of the following: (30% rating)
1. diet therapy
2. drug therapy
3. invasive or non-invasive procedures more than two times/year
if the above schedual of rating fits your symtoms you can have your doctor confirm your diagnois of kidney stones and how often you are in pain. Make sure you have a medial diagnois and follow up on how many occurance you have. Also what kind of treatment your doctor prescribe. Then after you have your MEDICAL DOCUMENTATION IN HAND.
file a VA claim for compensation. by simply stating.
I am filing for VA compensation due to kidney stones that occured while in active duty give dates when you were in Iraq and then when you were first diagnoised with kidney stones.
I have recurrent stones which are treated with both diet and drug therapy. My Urologist confirmed these factors during my exam.
There is no reason a interim 30% rating could not be awarded on the spot. The
VA rater could later audit the rating for validation.
**REMEMBER YOU SHOULD ALWAYS REQUEST AT THE TIME OF FILING YOUR CLAIM WHAT PERCENTAGE YOU ARE SEEKING..IF YOU DON'T ASK DON'T BE SHOCKED BY WHAT YOU RECEIVE!**
High blood pressure...did you get diagnoised with HBP in-service? did they ever do a 3 day blood pressure reading on you? if so your luckey if not...have you been diagnoised with high blood pressure within one year of service? if so...get your claim in now. here is the rating of schedual for high blood pressure.
7101 Hypertensive vascular disease (hypertension and isolated
systolic hypertension):
Diastolic pressure predominantly 130 or more................ 60
Diastolic pressure predominantly 120 or more................ 40
Diastolic pressure predominantly 110 or more, or; systolic 20
pressure predominantly 200 or more.........................
Diastolic pressure predominantly 100 or more, or; systolic 10
pressure predominantly 160 or more, or; minimum evaluation
for an individual with a history of diastolic pressure
predominantly 100 or more who requires continuous
medication for control.....................................
Note (1): Hypertension or isolated systolic hypertension must be
confirmed by readings taken two or more times on at least three
different days. For purposes of this section, the term
hypertension means that the diastolic blood pressure is
predominantly 90mm. or greater, and isolated systolic
hypertension means that the systolic blood pressure is
predominantly 160mm. or greater with a diastolic blood pressure
of less than 90mm.
Note (2): Evaluate hypertension due to aortic insufficiency or
hyperthyroidism, which is usually the isolated systolic type,
as part of the condition causing it rather than by a separate
evaluation.
If you don't understand the numbers bring the above schedual of rating to your doctor and have him write up under what % you will fall into.
file a claim with the VA either though a Service officer or a State Veteran officer with your medical records in service of any blood pressure readings you have alot of time they will miss high blood pressure due to ignorance! but if you have reading that are consistantly high make COPIES OF YOUR INSERVICE MEDICAL RECORDS....*never and I mean never send in any originals always make copies!!!!...attach your doctors diagnoises for hbp and the percentage you are seeking.
I will need to do some checking on the neck but you will be able to receive compensation on that but I don't know much about bulging discs...there are some memebers in here that can help you better..on that.
MT
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Bill go to this site...
http://www.access.gpo.gov/nara/cfr/waisidx_03/38cfr4_03.html
this will have what you are looking for hopefully
MT
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Good Morning JTjones...
here is a web site that may help you determine what your condition would warrent...
http://www.access.gpo.gov/nara/cfr/waisidx_03/38cfr4_03.html
this web site list CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS
PART 4--SCHEDULE FOR RATING DISABILITIES
for most VA compensational s/c disabilities...
I am not sure if your injury would fall under the catagory of Sec. 4.73 Schedule of ratings--muscle injuries (rating below) or the catagory of 4.71a Schedule of ratings--musculoskeletal system. There are people here that would know better then I. But this is a good site to start with.
5322 Group XXII. Function: Rotary and forward movements of the
head; respiration; deglutition. Muscles of the front of the
neck: (Lateral, supra-, and infrahyoid group.) (1) Trapezius I
(clavicular insertion); (2) sternocleidomastoid; (3) the
``hyoid'' muscles; (4) sternothyroid; (5) digastric............
Severe...................................................... 30
Moderately Severe........................................... 20
Moderate.................................................... 10
Slight...................................................... 0
5323 Group XXIII. Function: Movements of the head; fixation of
shoulder movements. Muscles of the side and back of the neck:
Suboccipital; lateral vertebral and anterior vertebral muscles.
Severe...................................................... 30
Moderately Severe........................................... 20
Moderate.................................................... 10
Slight.......................................................... 0
Hope this helps
MT
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here is the link to PTSD worksheet
http://www.vba.va.gov/bln/21/Benefits/exams/disexm37.htm
here is a link to "Index to Disability Examination Worksheets "
http://www.vba.va.gov/bln/21/Benefits/exams/index.htm#bm03
you wrote: "Does it have to be a state certified couselor and who pays for it?"
well I would think that any psycologist should be state certified...and you will need to pay for it unfortunally...most dr. will charge around $250.00 and up.
if the psycologist is doing the evaluation correctley he would need to have some type of personality test done.
hope this helps
MT
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I feel strongly based on personnal experiance that it is far wiser to go to a private counclor and if your therapist feels that you have PTSD to have them refer you to a State certified Pyscologist to be tested (which would include the Minnasota personality test amoung other's) to see whether or not you have PTSD. It is very important to bring a copy of the evaluation tool that the VA uses to determine if you have PTSD. Most State Certified Pyscologist will write you a IMO using the VA guildlines. If after the testing and it is confirmed that you do have PTSD due to an inservice stessor be it combat or MST, or other life threating situlations...the Pyscologist can determine in his/her opionion whether or not your PTSD occured due to the trauma in service (inservice is the key word here) at the same time s/he can preclude any MH issue was present prior to service.
After you have your medical documentation is when I would file a claim with the VA...it is harder for the VA to discard and IMO from a state cert. pyscologist esp. if the said pyscologist also makes determination's for Social sercurity.
this is just my opionion.
MT
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Morning Betty,
you wrote: "I received the Non- service connected Pension with unemployable back to 1983, now they wish to weasel out of it."
after reading the RO decision...I don't think that the VA is trying to weasel out of awarding you UI, even though the VA awarded you the VA pension back in 83' the pension was not based soley on your now s/c disablity...and the VA will not take condition's that are not s/c into consideration. As I wrote in another one of your threads...the paper work for UI that was submitted back in 83' is a moot point because even it you now s/c disablity was connected back then you would have had to have at least your s/c disability rated at 60% unless it went to the special schedualer...with that said...
I may be mistaken but I think I read that the VA sent you the form to fill out to apply for UI...so I would think once you fill out that form and send it in the VA will make your UI retro back to when they awarded you 70%...at this point you are going the right path...getting your ducks in a row...
you wrote: "I am going to get the letter from DR. Crowley and wait about three months and then sent in the TDIU Form and see where this takes me."
Yes..getting your dr. to write up a letter to how your s/c disablitly has limited your ability to work in all areas will seal the deal...but why would you wait 3 months? the sooner you send in the UI form the better...
but anyways...things will work out
MT
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here is the CFR Title 38 Veterans Affairs
§ 4.16 Total disability ratings for compensation based on unemployability of the individual.
a) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination.
(
It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation and Pension Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue. -
Hello Betty,,,
I found this information http://www.geocities.com/Pentagon/1151/text27.html
VA
INDIVIDUAL
UNEMPLOYABILITY
(IU) DETERMINATION
"There are two ways for a claimant to achieve a total disability rating. The first possibility is to qualify for a 100 percent rating under the rating schedule set forth in part 4 of 38 C.F.R. The second possibility is to meet the standards of the regulations governing "individual unemployability" (IU). IU exists as a concept to cover the situation in which a service-connected disability makes the veteran unemployable, even though an average person with a similar impairment could secure and retain substantial gainful employment. Since the rating schedule focuses on the average person, the concept of IU is necessary to take into acount circumstances such as education and past employment history that are peculiar to the claimant and to implement "the established policy of the Department of Veterans' Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled."
On occasion the VA has denied claims for IU because it believes that the combined effects of the veteran's service-connected and non-service-connected conditions have made the veteran unemployable. However, this is not the legal issue to be resolved when a claim for IU is filed; the sole issue is the effect of the veteran's service-connected conditions(s) on the veterans' employability. Therefore, in support of IU claims, Veterans' and Advocates should isolate the service-connected conditions and then argue that, at least hypothetically, these could make an individual with the veteran's background unemployable.
Most veterans struggle heroically to work for years before constant pain and stress forces them to stop working. If a veterans' service-connected conditions remained static (that is, if if there was no change in the severity of the disability), they could not claim entitlement to IU benefits. But if they had given in to their disabilities and had not worked, it is entirely possible that the VA would have granted them IU benefits. This rule seems to penalize those people people that endure great pain in order to function in society.
A veteran suffering from a service-connected condition who has struggled for years to work may develop secondary condition, a neurosis, because of the service-connected physical disability. The advocate should tactfully explore this possibility and if medical evidence reveals the existance of a secondary mental condition, the advocate should file a claim for a secondary mental disorder, the advocate will have a stronger argument for total disability benefits.
In order to apply for IU, a calimant must file a VA form 21-8940, Application for Increased Compensation Based on Unemployability. Veterans' and Advocates should not wait to file claims for IU until the VA sends them this form. Simply send the VA a letter stating that he or she wishes to be considered for IU benefits and to please send all the appropriate forms so that the claim may be perfected.
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Hello Ruby...I am sure that no one meant any offence...and behind there chuckles they too hope there is help out there for them as well...
so here is a web site that can help some of you help offset your utility bills in your state...yes, in many states if you are a disabled vet there is help for you to offset your utility bills do to cost of medical treatments..
please go to this web site:
http://www.govbenefits.gov/govbenefits_en....mp;category=ENA
another place to start to look is at your local amvets...they have information as well as to forms ect.
hope this helps
MT
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§17.275 Claim filing deadline.
(a) Unless an exception is granted under paragraph (
of this section, claims for medical services and supplies must be filed with the Center no later than:(1) One year after the date of service; or
(2) In the case of inpatient care, one year after the date of discharge; or
(3) In the case of retroactive approval for medical services/supplies, 180 days following beneficiary notification of authorization; or
(4) In the case of retroactive approval of CHAMPVA eligibility, 180 days following notification to the beneficiary of authorization for services occurring on or after the date of first eligibility.
(
Requests for an exception to the claim filing deadline must be submitted, in writing, to the Center and include a complete explanation of the circumstances resulting in late filing along with all available supporting documentation. Each request for an exception to the claim filing deadline will be reviewed individually and considered on its own merit. The Center Director may grant exceptions to the requirements in paragraph (a) if he or she determines that there was good cause for missing the filing deadline. For example, when dual coverage exists CHAMPVA payment, if any, cannot be determined until after the primary insurance carrier has adjudicated the claim. In such circumstances an exception may be granted provided that the delay on the part of the primary insurance carrier is not attributable to the beneficiary. Delays due to provider billing procedures do not constitute a valid basis for an exception.[63 FR 48102, Sept. 9, 1998]
Supplement Highlights reference: 31(1)
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Betty you wrote: "What should I do about the TDIU Form?"...you should fill it out and submit the form. Based on your case Betty you will be granted TDIU and most likley P/T...don't delay. The VA already knows your case and that you are not employed...and the only reason they are hell bent on you submitting the form instead of just granting it due to the fact of your case clearly points that you have been unemployed for quite some time is because the BVA over-ruled your RO denial...which caused the s**t to hit the fan...they are not going to make anything a walk in the park for you...
Betty you also wrote: "Do I go for the 100& or quit"...if it was me absolutly not...in order for the VA to grant you 100% based solely on aniexity would mean that you would be deamed incompentant at this late stage of the game...
Once you submit your TDIU form you will be receiving the rate of pay at 100% compensation.
For example I am rated 70% for a MH issue...yet the VA granted me 70% at 100%TDIU/Permant and total. So you do not have to be rated at 100% to receive full compensation....
Now if you have conditions that are secondary in nature to your s/c anixiey then you may want to file for those conditions and you may get granted s/c for them..but remember everytime you submit a new claim it does open a door that was better left shut...
I have alway's believed if you are already receiving compensation at the 100% rate why submit other conditions your rate of compensation will stay the same! and you are able to be treated for everything.
the one big differnts is P/T...esp. if you have children for chapter 35 benifits...and of course the life insurance ect..once you TDIU then P/T is the next step...sometimes the VA will grant you P/T at the same time as you are granted TDIU...which I hope will happen in your case...
I have you in my prayers Betty
MT
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Hello Berta...
ruffcreek posted this in a thread on hypertension a little bit ago...
he wrote:
"REPORT: VA NOW ACCEPTING CLAIMS FOR HYPERTENSION
LINKED TO AGENT ORANGE EXPOSURE -- Will determine
service-connected status at a later date, but
claims are expected to be approved.
VA begins taking claims related to Agent Orange exposure
By Chris Roberts
El Paso Times
Veterans Affairs has started taking claims for hypertension related to Agent Orange exposure, but it will determine at a later date whether the claims will be honored as being military "service-related," according to service organizations who received notices from VA.
A letter from the Texas Veterans Commission to its county service officers indicates that the claims are expected to be approved.
The claims won't be actively "worked" until the VA makes its decision.
Requests for comment made to local VA agencies were referred to Washington, D.C.
However, after two days, the public affairs office in Washington, D.C., still had no comment.
If the claims are approved, it could mean as much as $300 a month for Bob Snow, a retired soldier who worked as a forward observer directing artillery fire in the Vietnamese jungles.
Snow - who worked with special forces soldiers and Montagnards, a French name for the indigenous people of Vietnam's central highlands - operated in areas sprayed with Agent Orange, a defoliant that knocked down vegetation used as cover by the enemy.
Snow retired in 1982 and was diagnosed with hypertension by the VA in 1983.
However, the condition was not considered service related and therefore his disability compensation was limited.
If hypertension is connected to Agent Orange claims, it could mean as much as an extra $300 per month for Snow, which he said will relieve some of the pressure of the rising cost of living.
Jeri Elena Mark worked as a radar mechanic for Hawk missile systems at a base in Vietnam where she watched planes drop Agent Orange on vegetation surrounding the camp, which was being shelled.
She had experienced high blood pressure, a symptom of hypertension, during her Army career, usually associated with flashbacks from her Vietnam service.
She retired in 1985, but her exposure is not considered combat-related, so she would get no increase in disability payments.
However, her family would receive benefits after her death if the cause is related to hypertension
copied from www.vawatchdog org 5-9-2008"
ruffcreek
________________________________________________________________________________
_
also...Berta
I had heard that the VA requested a study back in 2006, One of the veterans I am helping is a Vietman Veteran and he filed for hypertension secondary to diabetes, He has a c/p for hypertension schedualed fingers crossed. I found this artical that I thought was interesting...
"In a report labeled “Veterans and Agent Orange” from the Institute of Medicine (IOM), mandated by the Department of Veterans Affairs, there is “limited or suggestive evidence of an association between exposure to Agent Orange and the subsequent development of hypertension.”
Because the findings are “limited” this does not mean claims will be validated.
The report states, “Should the Veterans Administration decide to establish a presumption” on the issue “it may still be another six-12 months after that date before VA can decide [a veteran’s] claim.”
If a Vietnam veteran is already service connected for diabetes and is newly diagnosed with hypertension, the claim should be filed secondary to diabetes."
Since the VA has re-opened the study regarding the link between AO and hypertenion I feel stronly it is only a matter of time that hypertenion will become a persumptive condition of AO "if" the veteran has diabetes. With the VA there is ALWAYS A "IF"...
MT
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Betty...
I would definantly nod the 10%...and request a rating of 50% starting back to 1992...it doesn't make sence that at all..unless there is something in writing as the VA states...as to why...think it over before you hire a lawyer...you may be able to do it yourself...have your doctor write you a letter stating that your condition prevented you from working and substaning employment and that your condition merited the 50% rating! As evidence I would kick in there nsc pension rating that the VA did back in 92 to indicte that the VA itself considered you at the 50% rating back then...you will prevail...I am shocked to say the least! Also submit your UI paperwork and have them back track it to when you submitted the new evidence you discovered in your miltary records...
but it is a start...at least now you know what to do and how to do it...
whew...
MT
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Good Morning Betty...I did a little time sheet to figure out what the VA "should do" ...your question "Now question please, with the Non service connected pension at 50% in 1983 can the VA come in with 10% beginning in 1992."
1.) based on the information you have posted...that back in 1992 VA granted you a nsc pension where 50% was based on anixity...I would think that the VA will now base your rate of your retro for anixity at 50% starting back to 1992...as it's base...then I would say that the VA will base increases based on the medical documentation that had been submitted from 1992-to present time.
2.) What the VA rater will need to determine is at what point from 1992 did your condition increase to the point to merit UI based on the aniexity alone...and only the VA can answer that based on the medical documentation you have submitted since 1992.
3.) I feel strongly that your retro will be based on 50% as it's starting point...from 1992-2003 (when va pension was granted) then from 2003- to present the VA will grant 70%.
4.) Now here is the zinger...what year will the VA determine that you are 70% UI/PT...even though you submitted UI paper work years back in 1992 (not sure if that is the right date) that was based on all your conditions that were considered nsc at the time...of those conditions your now s/c disability was rated for the purpose of the nsc pension at 50%...which that soley on it's own merit would not have given you UI at the time.
So now the VA will need to determine when your s/c disability increased enough to warrent a grant of UI...as I stated before I feel strongly that the VA will grant you 70% at the 100% rate for UI/TP once you submitt the UI form...and you are still thinking...I already submitted that back in 1992...Betty that is a Moot point because that UI form was submitted for your nsc pension...and your now s/c disability would not have merited UI back in 1992 and you would have been denied UI at that time.
This is just my guess but I think after reading everything the VA will most likely grant
1992-2003 50%
2003-2008 70%
and once you submitt the UI form they will most likely give you UI/PT from 2007 to present. that is just my thoughts...
BUT YOU WILL GET 50% from 1992...what the va will determine from there is only a guess...
Sometimes it is far better to Thank the Good Lord for what we have today...and let the rest just go...in order to find peace...in the end none of this will even matter what will matter is that you have your family and friends that have supported you all though this ordeal...that you have found vindication that the truth was told and accepted...what the percentage was or should be is only a number Betty...it will eat you up if you don't let it go...the stress alone will cause you more health problems then what? will all this stress cause you to have a heart attack? if so then the VA did win...so think about going forward you won the victory...and the greatest prize is that you are still young and healthy enough to enjoy the spoils...
May God keep you Betty and all those you love safe in his Loving Embrace...
MT
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Betty...had to re-read...your question was..
"If you were granted a Non Service Connected Pension with Chronic
Anxiety listed at 50 % with the other non service connected illness
and "unemployable".
Will the "unemployable" carry over to the Service Connection grant.
If the Non Service Pension effective 2003 declares you unemployable
since 1983
can the VA take this away from you."
1.) back when you received notice of nsc pension your aniexty was rated at 50% at that time for your nsc pension.
2.) so now the question is now that the BVA has granted you s/c for anixity the question that needs to be addressed is what is your s/c percentage for the condition now...
as I stated in my last post I would think based on the fact that the VA wants you to submitt a new form for UI that the s/c disability is rated high enough to warrent UI...
since the other condions that you were granted a nsc pension for are not s/c they will not have a effect on your s/c claim...the VA will not take in consideration of conditions that are not s/c for purposes of granting UI...the only conditions the VA will take in to consideration for grants of UI have to be s/c either by the condition alone or were s/c secondary to the s/c disability.
So even though back in 1983 the VA granted you a nsc pension based on your conditions at the time it will have no bearing on the VA percentage that you were given..if back in 1983 lets say that the aniexty condition was s/c would that rating alone be enough for the VA to grant you UI based soley on your s/c disabilty..I would say no...you would only receive the compensation at the 50% rate...then as time went by and your condition that was s/c increased...you would have put in for increases until you reached the point that the VA would then grant you UI...
in conclusion...at the present time 2008 the VA will now make the determination at what % are you disabled soley based on your MH issue's alone...and if the VA has requested that you submit a UI form it is because your condition merits UI consideration...
MT
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Betty...
1.) Congratulation!
2.) after reading the conditons you were granted NSC pension...it seems to me that the pension was granted for other conditions that were not s/c...and still are not s/c...so the question would be will your s/c anixiety % be enough to merit UI...on it's own...
3.) you stated that the VA sent you forms to fill out for UI..this tells me that the VA has rated you high enough to grant UI...now I may be reading your case wrong but yes you were granted a pension...but the pension was not soley based on the anixity disorder..and the VA will not take those conditions into considertion unless you can have them connected secondary to your MH disorder...I hope that makes sence...
that may be why the VA is not granting EED back to when you first were awarded your pension...
but anyways that is what I see
So once you submit the UI form based on the s/c anixiety is why the VA will then grant you at the 100% rate of pay.
jmo
MT
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I had heard that the VA requested a study back in 2006, One of the veterans I am helping is a Vietman Veteran and he filed for hypertension secondary to diabetes, He has a c/p for hypertension schedualed fingers crossed. I found this artical that I thought was interesting...
"In a report labeled “Veterans and Agent Orange” from the Institute of Medicine (IOM), mandated by the Department of Veterans Affairs, there is “limited or suggestive evidence of an association between exposure to Agent Orange and the subsequent development of hypertension.”
Because the findings are “limited” this does not mean claims will be validated.
The report states, “Should the Veterans Administration decide to establish a presumption” on the issue “it may still be another six-12 months after that date before VA can decide [a veteran’s] claim.”
If a Vietnam veteran is already service connected for diabetes and is newly diagnosed with hypertension, the claim should be filed secondary to diabetes."
Since the VA has re-opened the study regarding the link between AO and hypertenion I feel stronly it is only a matter of time that hypertenion will become a persumptive condition of AO "if" the veteran has diabetes. With the VA there is ALWAYS A "IF"...
MT
It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation and Pension Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue.
of this section, claims for medical services and supplies must be filed with the Center no later than:
Compensation Question
in VA Disability Claims Research
Posted
you may want to edit your topic to indicate you need help with your back ...this way members who are well versed in that area of disabilities will click on your thread and give there advice...
MT
here is a good site to read...http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=337.
also here is the schedual of rating for the back
(va website for schedual of ratings
http://www.warms.vba.va.gov/bookc.html#d
THE SPINE
Rating
General Rating Formula for Diseases and Injuries of the Spine
(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating
Intervertebral Disc Syndrome Based on Incapacitating Episodes):
With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease
Unfavorable ankylosis of the entire spine 100
Unfavorable ankylosis of the entire thoracolumbar spine 50
Unfavorable ankylosis of the entire cervical spine; or, forward flexion
of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of
the entire thoracolumbar spine 40
Forward flexion of the cervical spine 15 degrees or less; or, favorable
ankylosis of the entire cervical spine 30
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
Forward flexion of the thoracolumbar spine greater than 60 degrees but not
greater than 85 degrees; or, forward flexion of the cervical spine greater than
30 degrees but not greater than 40 degrees; or, combined range of motion of
the thoracolumbar spine greater than 120 degrees but not greater than 235
degrees; or, combined range of motion of the cervical spine greater than
170 degrees but not greater than 335 degrees; or, muscle spasm, guarding,
or localized tenderness not resulting in abnormal gait or abnormal spinal
contour; or, vertebral body fracture with loss of 50 percent or more of the
height 10
Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.
Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.
Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner’s assessment that the range of motion is normal for that individual will be accepted.
Note (4): Round each range of motion measurement to the nearest five degrees.
Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.
Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.
5235 Vertebral fracture or dislocation
5236 Sacroiliac injury and weakness
5237 Lumbosacral or cervical strain
5238 Spinal stenosis
5239 Spondylolisthesis or segmental instability
5240 Ankylosing spondylitis
5241 Spinal fusion
5242 Degenerative arthritis of the spine (see also diagnostic code 5003)
5243 Intervertebral disc syndrome
Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under §4.25.
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.