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Posts posted by Scotter04
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Thanks Hamslice
I'll be faxing my C-file request today.
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Hamslice,
Did you send your C-file request to your RO or to Janesville?
Scott
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UPDATE: Got my BBE yesterday and as expected DENIED. I understand why I was denied and can live with it for now. My first issue is how can a Psychologist opine, during my C&P, that my NSC Sleep apnea and the fact that my CPAP doesn't help that much is the cause for my Insomnia and anxiety. Would that type of Medical opinion have to come from a Sleep specialist?
My second issue is: I'm mainly trying to get my insomnia and anxiety secondary connected to my tinnitus and that is what my VA MH Dr. is treating me for. So, in the following paragraph wouldn't this constitute a nexus for secondary SC to Tinnitus?
The Veteran also reports having sleep disturbance which he feels is due to
"continuous" Tinnitus. Although his tinnitus likely plays a role in his
insomnia, he has a diagnosis of obstructive sleep apnea and does not find
his
C-PAP machine to be very helpful. He also has anxiety. It is my opinion that
his insomnia/sleep disturbance is primarily due to sleep apnea (which is a
medical condition) and is excerbated by tinnitus and his anxiety.One last thing I am in the process of sending of my FOIA for my C-File so do I send it to my RO (Seattle) or Janesville WIs?
Any and all responses will be greatly appreciated.
Scotter04
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Hamslice
I have tried it out and it does not affect your claim. In my opinion its not as useful or helpful as ebennies. So far all you really can do is submit a claim, check status of your disability, education and health claims. The only positive thing I noticed is that you don't need a ds login to use it.
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All, I was just scrolling thru the "M21-1 Changes By Date" on the KnowVA site and came across the below info for the new GW Presumptive date. I thought I would share.The presumptive period for manifestation of qualifying chronic disability under 38 CFR 3.317
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begins on the date following last performance of active military, naval, or air service in the Southwest Asia theater of operations during the GW, and
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extends through December 31, 2021.
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LATEST UPDATE:
Had my C & P Exam the other day for Adjustment Disorder Secondary to my S/C'd Tinnitus. The Examiner said it was more inline with Unspecified Anxiety Disorder and not the Adjustment Disorder my MH Doc said I had. The Examiner wrote the Adjustment disorder as "The condition claimed is less likely than not (less than 50%
probability) proximately due to or the result of the Veteran's service connected condition." So my question isSo my question is...Obviously I still need to wait for the BBE but if/when I'm denied would I appeal and change the contention to " Unspecified Anxiety Disorder " or would I file a new claim under " Unspecified Anxiety Disorder secondary to my S/c'd Tinnitus"?
I have scrubbed and included my C & P Exam notes below. Any feedback would be greatly appreciated.
Mental Disorders
(other than PTSD and Eating Disorders)
Disability Benefits Questionnaire
Is this DBQ being completed in conjunction with a VA 21-2507, C&P
Examination Request? [X] Yes [ ] No
1. Diagnosis
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a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)?
[X] Yes [ ] No
ICD code: F41.9
If the Veteran currently has one or more mental disorders that conform to
DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1: Unspecified Anxiety Disorder
ICD code: F41.9
Comments, if any:
transient, moderately severe symptoms of anxiety (irritability,
edginess, nervousness, panic symptoms with chest tightness, pressured
breathing, sweatiness, heart palpatations, etc. that occur when he is
around a lot of noise or when someone is hovering over him at his desk
at work which makes him feel closed in, insomnia due primarily to
tinnitus, muscle tension in back muscles, concentration/short-term
memory problems, fatigue) that had onset after the military (approx 10
years ago) and cause marked distress and mild impairment in
occupational
and social functioning (due primarily to irritability and impatience at
work and at home, fatigue, concentration/short-term memory issues)b. Medical diagnoses relevant to the understanding or management of the
Mental Health Disorder (to include TBI): Obstructive Sleep apnea with
C-PAP; Tinnitus
2. Differentiation of symptoms
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a. Does the Veteran have more than one mental disorder diagnosed?
[ ] Yes [X] No
c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
[ ] Yes [ ] No [X] Not shown in records reviewed
3. Occupational and social impairment
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a. Which of the following best summarizes the Veteran's level of
occupational
and social impairment with regards to all mental diagnoses? (Check only
one)
[X] Occupational and social impairment due to mild or transient symptoms
which decrease work efficiency and ability to perform occupational
tasks only during periods of significant stress, or; symptoms
controlled by medicationb. For the indicated level of occupational and social impairment, is it
possible to differentiate what portion of the occupational and social
impairment indicated above is caused by each mental disorder?
[ ] Yes [ ] No [X] No other mental disorder has been diagnosed
c. If a diagnosis of TBI exists, is it possible to differentiate what
portion
of the occupational and social impairment indicated above is caused by
the
TBI?
[ ] Yes [ ] No [X] No diagnosis of TBI
Clinical Findings:
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1. Evidence Review
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Evidence reviewed (check all that apply):
[X] VA e-folder (VBMS or Virtual VA)
2. History
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a. Relevant Social/Marital/Family history (pre-military, military, and
post-military):
States he was born and raised in Nebraska, raised by both parents, and
he has 2 younger brothers and one younger sister. States he had a good
childhood, denies any childhood abuse or neglect, and states he had
good
social skills, had a good number of friends as he was growing, played
basketball and football in high school.He entered the Air Force in August 1990, had no unusual trouble
adjusting to the military.States he has been married twice and divorced once, first marriage was
from about 1999 to about 2009, has 2 sons from the marriage (ages 12
and
10), shares custody of both, sees them every other weekend, facetimes
with them during the week. States he has been married to his current
wife for 7 years, and they have a 5 year old son together. States they
currently own their own in Brimerton Washington, wife and youngest son
lives in the home currently and he is in San Diego for work (has been
gone since March, was able to go back home for several weeks in
August/Sept, will be done with his job in San Diego around Christmas).
States his marriage is "good", has good relationships with his
children.
States he currently has a couple of friends he works with in San Diego,
sometimes hangs out with them after work, also has friends elsewhere he
stays in touch with via facebook. States he contacts his parents about
once a month to let them know how he's doing, only talks with his
siblings about every other year when he goes back to Nebraska to visit.
States he is active in his church, and he enjoys golfing, spending time
with his family, and doing outdoor activities (camping, hunting,
fishing, etc.).
b. Relevant Occupational and Educational history (pre-military, military,
and
post-military):
Premilitary Hx: States he had no major behavioral or disciplinary
problems, got pretty good grades in school, graduated from high school
on time. States he worked as a fertilizer salesman for his father and
for farmers in the area during high school.Military Hx: Entered the Air Force in August 1990, honorably discharged
in Oct 1999. MOS/Rate was Fuels Journeyman, highest rank/rank at
discharge was E4. States he was reduced in rank one time in 1995 due to
DUI but states he was able to recover rank over time after the DUI. He
denies any other formal disciplinary problems, was awarded an air force
commendation medal, 2 air force achievement medals, 2 air force
outstanding unit awards, 2 good conduct medals, national defense
service
medal, armed forces expeditionary medal, 3 southwest asia service
medals, overseas short tour ribbon, 2 air force longevity service award
ribbons, NCO professional military education graduate ribbon, and air
force training ribbon.Combat Exposure: in Saudi Arabia in 1992 and 1994, but no combat
exposurePostmilitary Hx: States that after the Air Force, he worked in a
warehouse for circuit city until 2001, then got a job as a material
handler for the Navy, is now a material handler project manager (for 4
1/2 years), states the job can be stressful, but he likes his job,
feels
he is good at his job, performs well. States his wife is currently a
medical assistant.
c. Relevant Mental Health history, to include prescribed medications and
family mental health (pr
e-military, military, and post-military):
States he has no family hx of mental illness that he knows of, and he
denies that he had any mental health problems or psychiatric treatment
prior to the military.States he was sent to mental health after his DUI in 1995, had 2-3
appointments with mental health and then 2-3 alcohol abuse treatment
sessions, was diagnosed with alcohol abuse, had no other mental health
treatment during the military. States he and his ex-wife had couples'
counseling/therapy in about 2008 (a couple of sessions), also had
marital therapy with his current wife and individual therapy sessions
due to problems with his ex-wife interferring in their relationship.He had a mental health intake at the Puget Sound VA in Nov 2015, was
diagnosed with adjustment disorder and other sleep/wake disorder, and
had 5 individual therapy sessions through the Puget sound VA after the
intake. Intake note from the puget sound VA dated Nov 6, 2015 states
"Veteran presented to this initial PCMHI intake reporting that he
experiences initial insomnia as a result of tinnitus. He also endorsed
waking up 2-3x/night, but indicated that he is usually able to fall
asleep within 15 minutes. Altogether, he reported getting between 3-5
hours of sleep, and he endorsed feeling tired during the day. He also
complained of irritability, indicating that he feels easily annoyed and
snaps at people both at work and at home. This has led to marital
conflict. Veteran also endorsed difficulty concentrating, short-term
memory difficulties, and depressed mood. He stated that he is "getting
tired of the tinnitus, sleepiness, insomnia, and I'm frustrated that
it's interfering with me and my wife's relationship." Veteran also
endorsed anxiety, describing frequent panic attacks when in a crowded
room. These panic attacks involve tightness in his chest, an immediate
urge to escape, increase HR, sweating, hot flashes, feeling faint,
nausea, and his "mind racing about am I going crazy or is it going to
get worse." He reported that these attacks last from 5 min-1 hour, and
he copes with them by "trying to analyze and wait it out." He also
engages in deep breathing to slow his heart rate down. He is confused
by
the appearance of panic attacks, which began 6-7 years ago and have
increased in frequency." "Veteran endorsed struggling with insomnia for
approx. 15 years and indicated that the other MH symptoms he endorsed
have slowly developed over the course of the last 10 years or so. He
was
previously prescribed zolpidem, which was somewhat helpful. However, he
reported that it still took a while to take effect at night, so he
discontinued it."States he continues to have difficulty sleeping, which he feels is
primarily due to "continuous tinnitus" (although he has been diagnosed
with sleep apnea and is prescribed a C-PAP machine, states the machine
is not very helpful, admits that sleep apnea might play a part in his
sleep disturbance). States he has had transient, moderately severe
symptoms of anxiety (irritability, edginess, nervousness, panic
symptoms
with chest tightness, pressured breathing, sweatiness, heart
palpatations, etc. that occur when he is around a lot of noise or when
someone is hovering over him at his desk at work which makes him feel
closed in, insomnia due primarily to tinnitus, muscle tension in back
muscles, concentration/short-term memory problems, fatigue) that cause
marked distress and irritability at work (states work colleagues in
puget sound have heard about his verbal outbursts) and states it does
not take much for him to "snap" at his wife.
d. Relevant Legal and Behavioral history (pre-military, military, and
post-military):
States he got a DUI in 1995, was reduced in rank for the DUI, but he
denies any other arrests or major legal or behavioral problems before,
during, or since his service in the military.
e. Relevant Substance abuse history (pre-military, military, and
post-military):
States he started drinking in excess in about 1993 (no excessive
alcohol
use prior to the military), got a DUI in 1995, was reduced in rank for
the DUI and sent to alcohol abuse treatment (3-4 appointments), states
he continues to use alcohol, but he denies any excessive alcohol use
since his DUI, denies that he drinks and drives, denies any other
occupational or legal problems due to alcohol use, and he denies any
other substance use problems before, during, or since his service in
the military.
f. Other, if any:
No response provided.
3. Symptoms
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For VA rating purposes, check all symptoms that actively apply to the
Veteran's diagnoses:
[X] Anxiety
[X] Panic attacks that occur weekly or less often
[X] Chronic sleep impairment
[X] Mild memory loss, such as forgetting names, directions or recent
events
[X] Disturbances of motivation and mood
[X] Difficulty in adapting to stressful circumstances, including work or
a
worklike setting4. Behavioral observations
--------------------------
The Veteran arrived at his exam appointment on time. He was dressed
casually,
appears to have good grooming and hygiene, demonstrated no evidence of
thought disorder or gross cognitive or memory deficits, made appropriate eye
contact, and was cooperative and alert and oriented during the exam. His
mood
and affect appeared euthymic and generally, and he denies any current
significant depression or any history of suicidal ideation, suicidal
gestures/attempts, or psychiatric admissions, also denies any history of
homicidal ideation or intent, manic/hypomanic symptoms, or psychotic
symptoms
(no auditory/visual hallucinations or delusions), and he demonstrated no
behaviors consistent with these symptoms during the exam.
The Veteran was given a brochure containing information about mental health
and medical treatment resources for Veterans (includes suicide/crisis
hotline
information) during the exam and was encouraged to seek mental health
treatment through the San Diego VA if he feels treatment is needed. He was
also strongly encouraged to go to the nearest emergency room and to call the
suicide hotline in the event that he begins to have suicidal ideation in the
future.
5. Other symptoms
-----------------
Does the Veteran have any other symptoms attributable to mental disorders
that are not listed above?
[ ] Yes [X] No
6. Competency
-------------
Is the Veteran capable of managing his or her financial affairs?
[X] Yes [ ] No
7. Remarks (including any testing results), if any:
---------------------------------------------------
ADLs: The Veteran reports that he is currently able to manage his own
finances and other important activities of daily living (denies any current
problems with personal hygiene/grooming, cleaning, shopping, cooking, etc.).
Per Veteran's 2507:
**CLAIM TYPE: ORIGINAL
**SPECIAL CONSIDERATIONS: NOT APPLICABLE
**INSUFFICIENT EXAM: NOELECTRONIC CLAIMS FOLDER AVAILABLE.
CLAIMS FILE BEING SENT FOR REVIEW BY THE EXAMINER.An in-person examination is required for the following exam(s). ACE process
must not be used to complete the DBQ.DBQ PSYCH Mental disorders
The following contentions need to be examined:
ADJUSTMENT DISORDERDBQ PSYCH Mental disorders:
Please review the Veteran's electronic folder in VBMS and state that it was
reviewed in your report.MEDICAL OPINION REQUEST
TYPE OF MEDICAL OPINION REQUESTED: Secondary Service connection.
OPINION REQUESTED: Secondary Service Connection.
Is the Veteran's ADJUSTMENT DISORDER at least as likely as not (50 percent
or greater probability) proximately due to or the result of tinnitus?Rationale must be provided in the appropriate section. Your review is not
limited to the evidence identified on this request form, or tabbed in the
claims folder. If an examination or additional testing is required, obtain
them prior to rendering your opinion.POTENTIALLY RELEVANT EVIDENCE:
NOTE: Your (examiner) review of the record is NOT restricted to the
evidence listed below. This list is provided in an effort to assist the
examiner in locating potentially relevant evidence.Tab A (Federal treatment record in VBMS): Bremerton CBOC (Ajustment Disorder
Diagnosis) dated 05/10/2016
Tab B (Federal treatment record in VBMS): CAPRI Records -- Seattle VAMC
dated 05/23/2016If more than one mental disorder is diagnosed please comment on their
relationship to one another and, if possible, please state which symptoms
are attributed to each disorder.Exam Findings:
The Veteran was verbally notified that this evaluation is for compensation
and pension purposes only and that he should see his treating clinician for
regular psychiatric care.The Veteran's symptoms are not consistent with an adjustment disorder
(symptoms not due to difficulty adjusting to a specific stressor). His
symptoms are most consistent with DSM-5 criteria for a diagnosis of
Unspecified Anxiety Disorder (transient, moderately severe symptoms of
anxiety that had onset after the military/approx 10 years ago). His anxiety
currently causes marked distress and mild impairment in occupational and
social functioning (due primarily to irritability and impatience at work and
at home, fatigue, concentration/short-term memory issues).The Veteran reports having sleep disturbance which he feels is due to his
Tinnitus. Although his tinnitus likely plays a role in his insomnia, he has
a
diagnosis of obstructive sleep apnea and does not find his C-PAP machine to
be very helpful. He also has anxiety. It is my opinion that his
insomnia/sleep disturbance is primarily due to sleep apnea (which is a
medical condition) and is excacerbated by tinnitus and his anxiety.
****************************************************************************
Medical Opinion
Disability Benefits Questionnaire
ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this
document:
[X] In-person examination
Evidence Review
---------------
Evidence reviewed (check all that apply):
[X] VA e-folder (VBMS or Virtual VA)
MEDICAL OPINION SUMMARY
-----------------------
RESTATEMENT OF REQUESTED OPINION:a. Opinion from general remarks: **CLAIM TYPE: ORIGINAL
**SPECIAL CONSIDERATIONS: NOT APPLICABLE
**INSUFFICIENT EXAM: NOELECTRONIC CLAIMS FOLDER AVAILABLE.
CLAIMS FILE BEING SENT FOR REVIEW BY THE EXAMINER.An in-person examination is required for the following exam(s). ACE process
must not be used to complete the DBQ.DBQ PSYCH Mental disorders
The following contentions need to be examined:
ADJUSTMENT DISORDERDBQ PSYCH Mental disorders:
Please review the Veteran's electronic folder in VBMS and state that it was
reviewed in your report.MEDICAL OPINION REQUEST
TYPE OF MEDICAL OPINION REQUESTED: Secondary Service connection.
OPINION REQUESTED: Secondary Service Connection.
Is the Veteran's ADJUSTMENT DISORDER at least as likely as not (50 percent
or greater probability) proximately due to or the result of tinnitus?Rationale must be provided in the appropriate section. Your review is not
limited to the evidence identified on this request form, or tabbed in the
claims folder. If an examination or additional testing is required, obtain
them prior to rendering your opinion.POTENTIALLY RELEVANT EVIDENCE:
NOTE: Your (examiner) review of the record is NOT restricted to the
evidence listed below. This list is provided in an effort to assist the
examiner in locating potentially relevant evidence.Tab A (Federal treatment record in VBMS): Bremerton CBOC (Ajustment Disorder
Diagnosis) dated 05/10/2016
Tab B (Federal treatment record in VBMS): CAPRI Records -- Seattle VAMC
dated 05/23/2016If more than one mental disorder is diagnosed please comment on their
relationship to one another and, if possible, please state which symptoms
are attributed to each disorder.b. Indicate type of exam for which opinion has been requested: Mental
DisordersTYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE
CONNECTION ]b. The condition claimed is less likely than not (less than 50%
probability) proximately due to or the result of the Veteran's service
connected condition.c. Rationale: The Veteran's symptoms are not consistent with an adjustment
disorder (symptoms not due to difficulty adjusting to a specific stressor).
His symptoms are most consistent with DSM-5 criteria for a diagnosis of
Unspecified Anxiety Disorder (transient, moderately severe symptoms of
anxiety that had onset after the military/approx 10 years ago, and treatment
records show he has had confusion about what the trigger for initial onset
of
his anxiety may have been).The Veteran also reports having sleep disturbance which he feels is due to
"continuous" Tinnitus. Although his tinnitus likely plays a role in his
insomnia, he has a diagnosis of obstructive sleep apnea and does not find
his
C-PAP machine to be very helpful. He also has anxiety. It is my opinion that
his insomnia/sleep disturbance is primarily due to sleep apnea (which is a
medical condition) and is excacerbated by tinnitus and his anxiety.
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR AGGRAVATION OF A
NONSERVICE CONNECTED CONDITION BY A SERVICE CONNECTED CONDITI0N ]a. Can you determine a baseline level of severity of (claimed
condition/diagnosis) based upon medical evidence available prior to
aggravation or the earliest medical evidence following aggravation by
(service connected condition)? Yesii. Provide the date and nature of the medical evidence used to provide the
baseline: It is my opinion that although tinnitus is not likely the cause
of his anxiety or his sleep disturbance, the tinnitus likely
exacerbates/aggravates his anxiety and insomnia beyond their natural
progression.*************************************************************************
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Hi All,
I've got a question about submitting a depression/adjustment disorder claim on ebenennies.
When I submitted the claim to include sleep disturbances and anxiety. Hit save and continue and the next page said I claimed Ptsd. It gave me the option of answering the questions or not.
So, is this typical for depression/adjustment disorder? If so, do I answer the questions or if not, skip the questions? Any help would be appreciated.
Hope everyone is having a great weekend.
Scotter
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Try this link, I posted it a week or two ago on hadit.
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I was just on the VA website and saw this on the Compensation page. It looks like a one stop shop for Disability Comp. If you scroll over the topics on the left side there are drop down menu's. It looked to be the entire 38CFR, M21-1 and M21-4 as well. There's info for Ebennies and much more.
Online Resource for Veterans
KnowVA, the knowledge database that provides Veterans and the public access to the same information that VA uses to process and make decisions on benefits claims, is now available online.
Scotter04
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Congrats Navy!!
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Congrats on your win!!
and
GBR!!
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After a C&P or any VA appt. you feel like the Dr. or whoever it was threatening in any way or even rude, find the Patient Advocate's office. They are supposed to be there for us Vets when something like this happens. The incident will be documented in your own words. Sorry you had to go though that Tdubya82.
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Wingnut,
When I received the 5103 Notice I called the 1-800# and asked if they saw my evidence I submitted in my file. I was told that they were looking right at it. They explained to me that, in my case, the 5103 gave the VA 30 days to schedule my C&P's and submit their ruling. I still submitted my evidence again just incase. Suprisingly enough all my C&P's were done within the 30 days. I suggest calling the 1-800# and submitting your evidence again.
JMO
Scotter
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ArmyVet,
Look up FAST LETTER 10-35, it has all MOS/Career Fields that were/ may have been exposed to noise. there are three stages-severe, moderate and non existant (or something along those lines). If your MOS was in the severe to moderate range this letter will add weight to your claim but, depending on your examiner, is not a slam dunk win. Take a copy of the Fast Letter to your C&P exam and show the examiner your MOS in the table have them make copies and add it to your file and maybe even submit a copy yourself to ensure it gets into your C-file. As mentioned above tell the examiner how the tinnitus affects you daily whether its during the day or even at night.
Good Luck
Scotter
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rwoods,
That is the date your claim closed. I would check you VA Letters and see if your claim decision has been loaded to Ebenni's.
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Good Luck SeattleShay
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Markintexas,
I was able to get a Vic card just for being enrolled in the VA healthcare system, even before I was SC'd at 10%.
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Sparky,
It took about a year after I reopened a claim to get scheduled for a C&P exam. That only happened cuz the time was coming up for my claims so called completion date. Someone above my RO gave my RO a deadline to complete all C&P exams needed.
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Check your Myhealthevet blue button next week, it will tell you what the examiner wrote down for your exam. Good Luck Seattle
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Congratulations!!
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Buck,
I have SA and it sucks. always tired during the day, hard to concentrate, and I am very irritable all the time. Tell your PCP about your sleep issues and ask for a sleep study. I had a home sleep study done thru my Community Dr. but I don't know off hand if the VA does the home study yet. The replacement equipment (hose, mask and other stuff) wasn't covered under my private insurance after a year so it started to get pricey to replace. My VA Dr. made an appt. with the Respiratory Dept for me. I called about a week out from the appt. and let them now I already use a CPAP and the study was within 5yrs. They took a copy of the study and handed me a new machine. It takes awhile to get use to the mask and you may have to try a few different ones out before you find the best fit.
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Congrats Navy!
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Congrats on your win ArNG11!!
Preparation for decision
in VA Disability Claims Research
Posted
Buck,
This happened to me at the beginning of the year. I had four claims in since May 2016 and Ebennies kept bounces back and forth from gathering of evidence to prep for decision. Finally this past January it went to prep for decision and a date of mid Feb. It went to prep for notification mid January and the next day it went back to gathering of evidence with nothing else needed. Later that same day Ebennies showed that they decided 3 of the 4 claims and deferred one. I was told by Peggy that the gathering of evidence was just a place holder in Ebennies while they decided my 4th claim. It had a completion date of May 2016 to Oct 2016. Well, they closed my claims middle of last month. I was 2 for 4 on service connection and in the process of appealing the 2 denied claims.