KansasNavy

Good Morning, So now that I am P&T, I have a question about Health Insurance. I am a retiree so I already have Tricare. However, I have a daughter who is not qualified for Tricare any longer. She is 24. Can she get Champva? She is not on my VA award as a dependent. Thanks

brokensoldier. She is not on my award letter so that sounds like a good thing. I think I understand the rest of the process. Seems like it all starts with the school VA rep. Also I dont claim her on my taxes anymore either. Thanks

I was recently made 100% P&T. For the education benefits that go along with this the question is: I have a 24 year old daughter starting grad school soon. I believe she is still eligible to be my dependent until age 26. She is going full time. Am I correct in my thinking? Do I submit something to the VA intake center to get her back on as a dependent so that she can receive the education benefit at her school? I think its roughly $1000 a month. Thanks

Thank you. That makes sense. Very much appreciate of you walking me thru the steps you have to go thru.

Good Morning. VA site says evidence gathering, review and decision. Then it says we sent you a development letter. What is a development letter? is that the same as a denial letter? Don't think I ever received something saying we are developing your claim.

Anyone know if the intake center is still backlogged? I thought I read an article about it but cant find anything on it.

Anyone ever had this happen to them? So they closed my supplemental claim rather abruptly today. I just submitted it 7 days ago. No contact whatsoever with anyone from VA and I thought it would take months to see it thru to the end and then I received an email from DAV Pittsburgh telling me they are granting all the below claims. Problem is its someone elses information. I never had prostate cancer, no prostatectomy with scar, No erectile dysfunction since 1997 and I never applied for TDIU. I called DAV no answer. I sent them an email back telling them something wasn't right. Deleted the email because its not me. My big fear is my own claim might be messed up now and I wont know how to fix it. I wonder if they put my claim and medical evidence in someone elses claims folder. Curious if this has happened to anyone else?

All, so after talking with VSO in Pittsburgh and VSO here on island they recommended I do a supplemental instead of CUE since I had new additional evidence to submit. Doctor put me on more medicine. I submitted a supplemental just like I did last October with the new evidence. However, when I opened my VA.gov account today it had the attached update. It says they are doing an HLR by a Senior Rater. Is this verbiage what they would normally put in for a supplemental claim? I had new evidence and submitted on a 20-0995 form as per VSO. I have had bad luck when asking for an HLR, so this makes me nervous because they say don't submit additional evidence. New evidence is what I sent (medical records) in with the 0995. Is this normal or does this just sound like standard blurb? I wanted them to take the new evidence into consideration which is why I did the 20-0995 and submitted thru the VSO. Or did they do this because whoever looked at it found they make mistakes which is why I had originally thought it might be a CUE. Any advice is greatly appreciated. I know I will probably just have to wait for a denial letter in the mail. --------------------------------------------- A senior reviewer is taking a new look at your case By requesting a Higher-Level Review, you asked for a senior reviewer at the Veterans Benefits Administration to look at your case and determine whether they can change the decision based on a difference of opinion or because VA made an error. Note: Please don’t submit additional evidence. The reviewer will only consider evidence that VA already has. The senior reviewer will make a new decision The Veterans Benefits Administration will send you a new decision in the mail. Your review may take longer if VA needs to obtain records or schedule a new exam to correct an error.

Berta, also I have looked all thru the decision letter and cannot find anyone's initials on any page left hand or right hand sign. Do you think they forgot?

Flow1972, I agree with what you said about taking the higher rating of the two. It looks like in my decision letter they didnt do that. It was actually kind of a dis-jointed decision letter.

Berta, thank you for the quick response. I did not get retro. I think that may be correct because I don't know how I could prove that I was at least 10% disabled. I read in GWS IBS that they can only SC it if it is at least 10%. In my claim letter I didn't ask for an earlier effective date. I might fight that battle later on. More concerned with getting the right rating for now. I have a very good VA Rep here on island Okinawa (its our early morning here) and he agrees they made a mistake. He just wasn't sure what to do about it. He has a connection at the DAV Muskogee VA hospital that he was going to ask about this. I have never done a cue so am very appreciative for the help. I will prepare the CUE you sent me and await anything further you find in your research. Thank you

Good Morning, Attached is my Decision Letter. I think they may have made a mistake. Background: Retired 2014. Claimed IBS in 2015 but was denied due to no diagnosis. Didn’t fight it. Starting in 2017 to today started having more and more issues. Was diagnosed in 2017 with IBS by Doctors at Naval Hospital. Leads us to Decision letter Oct 29, 2020 – Requested IBS Service Connection via Gulf War Syndrome 38 C.F.R.3.17 1. Received Decision Letter today 13 Jan 2021. 2. A 10% evaluation is established for IBS and added to the previously established non-compensable evaluation for hiatal hernia/GERD (I did not ask for this or ask to be reevaluated for hiatal hernia. I realize they often combine the two. 3. Examiner provided opinion that current disability is at least as likely as not (50% or greater probability) incurred in or caused by the in-service Injury, event or illness. 4. Service Connection established. Huge Win However, I think they may have made a mistake. 1. On page 3 of decision letter: a. Paragraph 1 – Hiatal hernia warrants non-compensable evaluation b. Paragraph 2 – Irritable colon syndrome warrants 10% - Moderate symptoms c. Paragraph 3 – Additional symptoms – Alternating Diarrhea and Constipation d. Paragraph 4 – I don’t understand what this means e. Paragraph 5 – they agree and state that I do have alternating diarrhea and constipation in my records. I also have constant bloating and gas in my records as well. f. Paragraph 6 – Hiatal Hernia 0% I agree with, No argument. I wasn’t trying to get an increase. g. Paragraph 7 – A higher evaluation of 30 percent is not warranted for IBS unless there are severe symptoms demonstrated by diarrhea, OR alternating diarrhea AND constipation, with more or less constant abdominal distress. i. In Paragraph 5, they already agree and state that I do have alternating diarrhea and constipation. ii. Alternating diarrhea and constipation is the epitome definition of MORE OR LESS CONSTANT ABDOMINAL DISTRESS. h. Paragraph 8 – Deals solely with the Hiatal Hernia/GERD evaluation 2. I feel like when they combined the two 7319 & 7346 codes which they often do, I understand that however I clearly meet the Irritable Colon Syndrome of 30% evaluation in paragraph 7. See below as well. 3. But when they combined both codes they make it seem like I have to have the other Hiatal Hernia/GERD symptoms as well to qualify for the 30% 7319 IBS Rating. 4. Wanted to get some advice before I figure out how to proceed. 7319 Irritable colon syndrome (spastic colitis, mucous colitis, etc.): Severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress 30 Moderate; frequent episodes of bowel disturbance with abdominal distress 10 Mild; disturbances of bowel function with occasional episodes of abdominal distress 0 7346 Hernia hiatal: Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health 60 Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health 30 With two or more of the symptoms for the 30 percent evaluation of less severity 10 Redacted.pdf

I have had two back surgeries (both in service) on L4/L5/S1. Rated 40% Static. I also have PN in Left Leg at 40% static and Right leg 10% Static. I now have arthritis in Hip/Knee and Ankle of Left leg more so than the right. When I injured my back in service there was a lot of damage done on the left side. Was recently diagnosed with arthritis in Hip/Knee/Ankle 7 years after getting out of the service. Has anyone ever claimed SC and was successful getting arthritis in the Hip/Ankle/Knee secondary to Back surgery/DDD? Its really my left side that is really bad. Right leg is much better than left side. My back is still bad, just hasn't completely done me in yet. Thanks in advance

Thank you Thank you

Good Morning, Do Supplemental claims ever show up in E-Benefits? Using my DAV he submitted my supplemental claim thru the Muskogee OK VA. Had a C&P already and VES was the Dr. Will it eventually show up in E-benefits website? Thanks

All, Taking everyone's advice, I put together my letter that I plan to submit with my claim. I think it would be a supplemental claim since they denied me in 2015 due to no diagnosis. I typed out my history and included notes from my medical records. If someone has time, can you read thru it and give me an honest opinion? I used Blast Daddys advice for the presumptive piece. Anything you would add or change or that I am missing? We don't have VSOs out here in Okinawa so working on this by myself. I redacted names. I also have to submit the medical records from 2014 to Present but the files are huge. Can you upload then electronically or will I have to use snail mail? Thank you Claim for IBS Presumptive to GW Redacted.docx

Thanks for the help. Now I know what all those numbers mean. Had no idea. Appreciate the timely response.

Can someone offer an opinion. Notes From my medical records The IBS is noted/listed in all my past medical history from 2015 on to present. I just didn't realize it. I just now got my hospital records from 2015 to present. I am SC for Hiatal Hernia/GERD and GERD is causing some issues again. I have had two stomach surgeries since 1996. ------------------------------------- 16 May 2015 - Discussed his multiple issues (pain, depression, IBS) and reassured him that he does have characteristics of Fibromyalgia and that we are treating each issue as they should be as he is already on Lyrica, antidepressants and meds and therapies for pain control, and that we will continue his current plan of care to address each issue. 29 March 2017 - "Likely with IBS-c. Discussed abdominal pain more bloating with pain which improves with bms and constipation only taking stool softener 16 June 2020 - "Dr noted Other Irritable Bowel Syndrome K58.8. Preciously dx'd w/IBS but was unaware, pa given IBS info packet, FODMAP diet etc... GI appts with Local Japanese referrals. ---------------------------------- The wording above, does this qualify as a diagnosis? Is this what the VA needs? Its worsened over the last five years and I have an appointment with Japanese Drs next week for GERD issues and the IBS issues. Naval Hospital cant see retirees right now. I plan to try SC GWS. I am putting together everything I can find to support my claim, and don't want to waste anyone's time. Thanks

I have an E-Benefits account but no idea what MyEhealth account is. I will look it up and try to get one.

Ddsr, I live in Okinawa so we have to be seen by the Naval Hospital. if they cant see us they push us out to Japanese Drs which makes things more complicated language wise. We don't have any VSOs out here so we are kind of on our own. There is a VES contracted Dr on island but cant see him till we get to the C&P stage. In my humble opinion the AD Navy Drs don't really understand the VA or DBQs. Generally we get the deer in the headlights look. I go to my PCM regularly, however as you know we change out PCMs every 3 years, generally less. In my 8 years out here, I have had 4 Doctors and getting ready to lose my current doc. Years ago there was an ex-rater that worked for the Retirement/Transition out of the military program, but she quit years ago and they cant seem to replace them. I wish they would put a VA Rep/VSO at the Naval Hospital, but I guess there aren't enough of us out here.

I found it. I found the NGWRC guide. it explained it nicely. Thanks again

brokensoldier, Thank you. What is 3.317-3/4? do I have to provide some sort of records showing I was in the Gulf? They already have my DD-214sf and everything else is current and up to date. I was there a few times while AD. Thanks

Shrekthetank, I did get a diagnosis back in 2016 by a real stomach Dr. My PCM told me that yesterday. I ordered my records from the Navy Hospital (Overseas Okinawa) to confirm all of the information so I would have documentation to submit. Thanks I will go the presumptive route. I have seen several topics on here where people have done the presumptive route. Thank you

I retired in 2014. I served during Gulf War so I qualify for presumptive list. My GERD was service connected at 0% back in 2014. It was service connected because I have had two stomach surgeries, one NISSAN surgery and then hiatal hernia surgery (Both while I was AD). I filed a claim for IBS back in 2015, but it was denied due to no diagnosis. I didn't fight it. Then in 2016 I was diagnosed with IBS by Navy Doctor but it wasn't bad enough to be compensable so I didn't file the claim because it was past the year requirement. I probably should have claimed it in 2015 but I didn't know what I was doing. Now its 2020 and IBS has gotten much worse so I would like to file a claim. My question is: Should I try to get it service connected IBS secondary to GERD? GERD has gotten worse as well. Or should I claim IBS as a presumptive? I believe and the Dr yesterday confirmed it has gotten worse. Trying new medicine to see what that does. Since I was denied back in 2015 due to no diagnosis, should I file a supplemental with the new evidence, open a new claim or reconsideration? Award Letter States: Service connection for irritable bowel syndrome is denied because the medical evidence of record fails to show a current disability. Thank you

I think I did it right. Portion of the award letter and the DBQ the VES Dr used. VA Award DBQ DDD and Radic.pdf