scottinmt

I have Aetna and they do not require a referral to see a specialist, they also don't need to pre-approve seeing a specialist. I found a podiatrist today that doesn't require a referral, I'm hoping they will give me a referral to the Dr who performs nerve conduction studies. I would rather go see a Dr for this analysis than a non-Dr at the VA

I have significant peripheral neuropathy in my feet and hands. I had an appointment to see a podiatrist and I kid you not the doctor was so busy working on his computer I sat there for 2 minutes waiting for him to acknowledge me. He then spent no more than 2 minutes with me and sent me on my way. He was inept, If I get even a scratch on my lower legs it takes months to heal and this clown wouldn't even listen to me. My neuropathy has worsened over the last 6 years. More pain, atrophy of both the muscle and the fat pads, and even less sensitivity. I am on a dose of gabapentin that exceeds the pharmaceutical recommendation. Before I submitted my claim for a secondary rating on my hands and feet I paid for a nerve conduction study and EMG. In Tucson I simply called the office and set it up. Here in NY the medical establishment is a club. Specialists won't even see you unless they receive a referral. Do you think that the VA is going to give the veteran a referral outside of their sub-par folks? So I thought I would call a podiatrist and set up an appointment for a foot check thinking that the podiatrist would give me a referral for the nerve conduction study... nope, same thing, they want a referral from the VA. The joke is I have secondary medical insurance but can't seem to hire my own doctors without the VA being involved. I know this is a rant, I was wondering if any of you have the same issue?

We moved here in Dec of last year. I go to the VA med center in Syracuse for care. I'm not impressed. If I submit a request for rating on my mental condition or SMC I'm guessing Buffalo will do it.

That is fantastic Berta, happy for the vet. In what State does Dr. Bash reside? BTW, I now live West of Syracuse. Thanks, Scott

perhaps a 30% rating for vertigo and a 10% rating for TBI? that would work out to retaining the 40% rating you were getting for TBI. It sounds like the VA thought the vertigo should be a separate rating as a secondary to the TBI

Berta, Yes I have seen the VA for depression since 2011, I had been on meds at that time, I'm not sure how long I was off of them. The doctor who performed the C&P exams in 2016 told me I needed to see someone for depression as it was obvious to her that I had that going on. It was actually the genesis for me to ask for a consult and to start seeing a psychiatrist. I am on SSD, have been since 2018. They never tell you why it was granted, but my claim explained my physical issues and the fact my brain just doesn't function well. This is due to depression and the meds I take for pain relief and depression. There is also a documented cognitive decline for those who suffer from long-term diabetes.

My experience with the VA is that everything moves at a snails pace. Obviously no comfort in this statement, just know you aren't alone on this journey.

Thank you Berta, I am in constant pain which has a lot to do with my mental condition and seeing my body fall apart (loss of strength and feeling in my hands and feet as well as the digestive issues) prevents me from doing the things I once enjoyed such as hiking, playing the guitar, pretty much anything that requires movement has lead to my depression. I am on doses that exceed the max recommended for gabapenton and fluexetine.

As noted, the regulations don't state that a vet over 55 can't be reexamined. The regulations state that that a reexamination is only supposed to happen in "unusual circumstances". Who the heck knows what the VA considers to be "unusual circumstances". The one consistent justification to the VA going around the 20 yr, 10 yr, 5yr (and other) protections is suspected fraud. I suppose a jerk doctor or nurse practitioner who disagrees with a rating could initiate a reevaluation. I have received medical care from the VA for almost 40 years and have only crossed paths with 3 VA medical people I would throw into this camp. As soon as I recognized that they were sketchy, I wrote an email to the patient advocate and asked to be seen by someone else, they immediately made a switch. I believe patient advocates report directly to the facility director.

I found the answer to my question and as it was an ignorant question I replaced the text with the following. SMC is in lieu of a 100% rating exception being SMC K awards. SMC-K ratings are added to any other SMC rating (with a limit of 3 "K" awards).

Additional protections include the "over age 55 rule" § 3.327 Reexaminations. (a) General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability. Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. Individuals for whom reexaminations have been authorized and scheduled are required to report for such reexaminations. Paragraphs (b) and (c) of this section provide general guidelines for requesting reexaminations, but shall not be construed as limiting VA's authority to request reexaminations, or periods of hospital observation, at any time in order to ensure that a disability is accurately rated. (2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled: (i) When the disability is established as static; (iv) In cases of veterans over 55 years of age, except under unusual circumstances; I however do not know what would constitute "unusual circumstances"

Broncovet, I believe the calculation for COLA is already decreased by 1% so the actual COLA should have been 6.9%. I haven't had cable for years, I pay Verizon Fios for an internet connection and stream Sling and Prime and Newsmax. All-in-all less than the cost of cable. Plus if you have Verizon you get a veterans discount for both your phone and Fios. These are crazy times

Broncovet - I contacted CCK Law. I spoke with a case evaluator on the phone who thought I was most likely eligible for A&A. As you stated however they wouldn't help until I applied and was turned down. Berta, I am sorry if I confused you. As I mentioned my brain doesn't process information well at this point and my ability to communicate thoughts is a bit...lacking. Rated Disabilities: 60% Diabetes I 40% Neuropathy Right Upper 30% Neuropathy Left Upper 30% Intestinal Neuropathy 30% Neuropathy Incontinence 20% Neuropathy Right Lower 20% Neuropathy Left Lower 10% Diabetic Retinopathy 240% total These per the rating table take me to 96% Rated to 100% Permanent and Total per award letter

Broncovet, I do not have a single 100% rating. My highest individual rating is 60%. Thank you for the feedback and guidance. Scott

Berta, I looked through my award letter and never does it state anything regarding SMC other than an SMC K award I received back dated to 2004. As for your question about mental health, no I never submitted a claim as I was already at 100% when I thought about it. I do have VA psych notes and care back to 2011 and they did diagnose me with a major depressive disorder several years ago due to the impact of watching my physical health deteriorate and no longer being able to do the things I enjoy. I have been on multiple anti-depressants for years. I just didn't know if I should submit a claim for service connection at this time in order to get it documented. I am also on social security disability and have been for a couple years now. Should I also ask the VA to note me as TDIU using the SSD as support? Lastly, my wife effectively provides aid and attendance for me, I don't know what I would do without her. I only leave the home for medical appointments and the occasional haircut. The reasons for both are due to limitations due to my service connected medical issues. Thanks so much for everyone's help. My brain doesn't function as it once did so please forgive me if I am unclear or seem thick.

Berta, I haven't been online for a few years but you and Asknod really helped me with pulling together my 100% rating documentation, I will always be appreciative of that. I will dig out the last rating and post to this string. Scott

This is what I am questioning: 38 U.S. Code § 1114 - Rates of wartime disability compensation (s) If the veteran has a service-connected disability rated as total, and (1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or, (2) by reason of such veteran’s service-connected disability or disabilities, is permanently housebound, then the monthly compensation shall be $2,993. For the purpose of this subsection, the requirement of “permanently housebound” will be considered to have been met when the veteran is substantially confined to such veteran’s house (ward or clinical areas, if institutionalized) or immediate premises due to a service-connected disability or disabilities which it is reasonably certain will remain throughout such veteran’s lifetime.

Hi Broncovet, LTNS. I thought the requirements for receiving SMC S were either: 1. 100% on one specific medical condition/issue and an additional or total of all other medical issues being 60% rated. or... 2. The actual merits of your condition that support you being "housebound" which can be physical or mental or both. ? As for my rating, I have stand alones that amount to 220% the rating criteria takes me just over 96% which gave me a 100% P&T rating. I have not asked to be TDIU but my conditions make it impossible for me to work. I am 60 yrs old on top of that and have a SMC K award. I am also on social security disability.

Buck52, so sorry to hear of the loss of your wife.

Hello All, It's been a few years since I last signed on and it seems most of my data has been purged from my profile. I received my 100% P&T rating in the spring of 2016 backdated to the summer of 2015. My conditions have seemed to worsen over time and I am now considering applying for SMC for being both housebound and relying on my wife to care for me due to mental and physical issues. I do not have a service connected mental health diagnosis but have seen VA Psychiatrists since 2011. It appears that being housebound is a SMC S rating but I am unsure of where what I'm calling "aid and attendance" falls. Any help would be appreciated. Thank you!

Thank you for your feedback, I had a follow-up appointment where they found 2 "bleeders" next to my optic nerve (one in each eye), I'm supposed to go back in for another appointment in a month. The Dr. told me I have "mild" retinopathy but I'm not really sure what this means, bleeders next to my optic nerves doesn't sound "mild" to me. I understand that it is service connected and eligible for a rating as a secondary condition but don't have any idea if it should receive a % rating. I would appreciate comments from anyone that has experience in dealing with this issue. Thank you! Scott

I have a service connected disability which includes Diabetes. I recently changed States and while getting set up for the new facility the Dr. stated that in an eye test over a year ago in another state they determined I have diabetic retinopathy. The prior VA facility did not tell me this, but the Dr. let me read it on the screen. My question is this, should I have this rated, does the diagnosis alone qualify me for a rating or does it require significant rather than minor damage? Thank you for your help!