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Senior Chief Petty Officer
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USMC_VET last won the day on December 1 2015

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    E-7 Chief Petty Officer

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    FREE EBOOKS on VA CLAIMS. howtoapplyvabenefits.com

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  1. A guy i work with has been on appeal since 2012 regarding his clothing allowance. He was on a Telecon with the BVA in jan/Feb 2015 and then had to wait until basically December to hear the decision. it was granted. He was repped by the DAV, however the DAV never told him to reapply every year (big suprise right?). Now that he has won the VA is telling him he will only get the 2012 allowance and not 2012-2016. Can anyone point me to threads (i searched couldnt find anything specific), BVA, CAVC (searched the site there as well) that could help me help him with this and/or point to precedent for retro for clothing allowance even if not reapplied for? Thanks!
  2. UPDATE: I uploaded a letter to ebennies and also certified/return receipt to claims intake center stating I AM NOT SEEKING AN INCREASE FOR MY PTSD I AM SEEKING A SECONDARY CLAIM. Well they did it now. it no longer is listed as an increase.
  3. roger i am working on that. I was moving quickly because i had to wait for my actual DX to get a IME and i wanted to have the claim in before any changes in the ratings took place. I know years back they were looking to change the ratings regs so that a CPAP was not automatic 50% that was SUPPOSED to come into effect around jan 1 2016. I havent heard anything about it, but i just wanted to get the claim in so this one was rushed a bit and now im scrambling for a IME. the doctors i have contacted either wont do it for a VA claim or the one that will wants to also write up about a few other ratings and try and get me to 100% so that he can get a bigger payout for his services.
  4. Soryr i have been offline for a bit... i filed my OSA claim secondary to PTSD in November, which they interestingly tried to originally claim it as "Sleep Disturbance TO INCLUDE PTSD - Increase" which i had to write several letters over the last month to state "I AM NOT SEEKING AN INCREASE BUT A SECONDARY RATING". which they finally have changed (in ebennies) to "Sleep disturbance - Reopen, Sleep Apnea- NEW". So that was successful.... Anyways i had put in multiple sworn declarations from myslef and my wife along with a friend i was in with. I saw on ebennies that they requested the "address for an individual who was named in your claim as having knowledge of your condition". I am confused as he had already signed the sworn declaration as had my wife... I feel like they are trying to tell if i made someone up or if there was something unsavory about the statement.
  5. alreday been said... but 1) you have to be diagnosed by a VA doc first, without a VA DX you dont have PTSD (in the VA's eyes) 2) always pursue new claims. the VA can schedule you for an exam at any time and they probably will somewhere around the 9 year mark (before you family is eligible for DIC). People worry about being seen as "greedy" as though the VA is easy going until a certain point and then they try to screw you. They try and do that all the time..... there is no reason you can give them, they are the reason themselves and no amoutn of claims is going to set them off on you, they are set off on eveyrone. So basically dont worry about them coming after you, pursue what their regs allow you to do and do it honestly, the right is on your side. That being said.. I dont know wha tyou are 100% for, but any of use no matter what the rating should know that at some point the VA is going to reschedule us for an exam (common is right 2-4 years in right before 5 year protection kicks in or 9 years before DIC kicks in for 100% folks or prior to 20 when you are home free). Keep journal logs of ALL your ailments relating or even unrelated to your claims (who knows in the future what they say might be related to this or that disease). I keep a journal of all my problems, when i cant sleep well, when my back hurts, when my knees hurt, when i get headaches, when i can jog because of my feet, everything. I keep a journal of my MH as well. While this is not some silver bullet, that along with regular check ups and smart notifications of issues to my PCP (explain below) helps to keep a good clean record of what is oging on with me and doesnt give them a reason to deny me. I did not do that for awhile. I had a PTSD rating but whenever i went in for things like my headaches for years after they would do screenings, i had no idea about how the VA worked, i thought once i got it i had it. I would answer no on everything depression related, even though my issues were still there. I dont like talking about my issues with strangers and i wanted to be seen for my headaches not how i was feeling so i just said no to get it over with. I think this is part of why the tried to reduce me, i applied for an increase and i think they looked back and said "gotcha! we got sustained improvement!" that was a mistake. ok, so by SMART notificaitons to PCP i mean when you need to be seen for something or want to notify them of an issue (regardless if you need/want to be seen for it)....ALWAYS SEND IT VIA SECURE MESSAGING. SM is part of your permanent record, unlike a phone call or a conversation in the PCP office. This way the info i want about my condition at that moment is noted. I got tired of going in for a headache issue and then they would start to talk about my already SC'd back and that became the note in the exam notes. a scant mention of "veteran reports headaches during the month" when i talked about it for 30 minutes and all the smptoms, etc. So in SM i would note down everything, how often i had headaches, how often i had to lay down, how many advil i took, how it affected work, etc. Be your own advocate on your medical record. So basically 1) keep a log of everything 2) any private doctors you see, after every visit CONTACT THEIR RECORDS OFFICE AND REQUEST A COPY OF ALL EXAM NOTES, MEDICATIONS, CONSULTS etc, ANYTING FOR THAT VISIT and keep it in your record, even if its not SC at the moment it might be in the future. 3) KEEP UP ON MEDICATIONS. lets say you get prescribed ibprufen for headaches and you also had a bunch from an earlier treatment for back aches. like a normal person you dont reorder until you need it and are close to running out. uh oh in your med records with the VA you should have run out of you IB for headaches 2 months ago and you just refilled them now. The VA can use that as "you must be cured because you said you need these to cope and you didnt refill them for months, thus it must be ok now" Keep up. If you need to. and what i do. I look at the RX. its 1 pill a day. 60 pills. i set a alarm on my phone to refile X prescription 1 week before it should run out and have that recurring (until the dosage/# changes). 4) Save some money now, stick away 1500 in some bank account not linked to your current one with no checks for it and no debit cards. The only way to get access is to walk into that bank and ask for it. Someday when the VA is re evaluating you...IF they send you the Sad letter syaing they want to reduce you and you have 60 days to send in evidence to defend your rating you can contact some awesome doc for an IME and then walk into that bank and ask for a cashiers check for X dollars made out to that doc. No crunch on your account. its already there. yes some docs are more expensive, but 1500 will get you an excellent IME in most cases. even if it ends up being 5000 for a IME you need, you at least have a chunk already taken care of. most IME's are not that expensive though. 5) be aware of everything you say to a doctor at the VA. If you are say 100% for back issues and you go in to talk to a doc (as i mentioned above) regarding your PTSD and they ask "i see you are rated for your back how is the pain level on that" personally i will say how it feels when its at its worst, or i will just say that has no bearing on what i need help with right now. however you choose to answer be careful, dont say im fine just to move along. A better tact may be "right now its about a 5 because i just took my X prescription for that pain, however i dont want to talk about that right now". Check exam notes later make sure they dont write "Veteran reports moderately positive pain reduction in back" or something like that. if so ask for an amendment to records. +
  6. UPDATE: I see on ebenefits that it is being treated as an INCREASE claime to my existing PTSD. That is not what i want. I am just short of the 5 year rule, i dont want ot give them a chance to put me through that reduction fiasco again.
  7. Ive never ran into the "SC X + to include and not "secondary to" From what i see in BVA cases is that they deny these cases since you cant be rated for something seperately that is a part of an existing disability, under pyramiding rules. I guess i shall see, i was hoping someone had filed OSA under secondary and ran into this before or had been rated with this wording.
  8. I have no first hand experience with this however from what i have read, heard, etc its dependent on you and your history. If you are making a claim based on you forgetting stuff like paying bills, being to depressed to do it, then they just might saddle you with being "unfit to handle finances". However if you have a decent credit rating, dont have too many late payments, a few here and there you should be fine. Doesnt mean the VA couldnt try and do it, but you would have a good shot at overturning it if you can say "Hey i pay all my bills on time, i dont have a bunch of debt, no more than the average american, i have nothing in collections, etc" you should be fine.
  9. Post Traumatic Stress Disorder To Include Sleep Disturbance 12/03/2015 INC View Pending Claim So i just filed for Sleep Apnea but under the Sleep Disturbance secondary to PTSD route. This is what is showing. What is "INC" and i am claiming SECONDARY TO and not INLCUDING, i am guess the INC is "Including" however if they consider it INCLUDING they wont rate it seperately and just put the PTSD and OSA symptoms together for one rating. I think they are trying to avoid the 50% given for CPAP and just include it in PTSD but keep the rating level the same.
  10. Need to know a litle bit more information. Was the claim that was denied related to PTSD? If so and you get DX'd for it then yes that would be new evidence for your appeal and if it is compensable then the VA will backpay it. I imagine it is for PTSD because the VA doesnt schedule C&P exams for no reason without a claim being filed or a request for one via appeal.
  11. I agree with the above. QTC contractor exam notes DO NOT show up in you blue button. ever in my experience. none of mine have, however i have heard folks that did have it, so like everything with the VA its a "EEEHHHHH it depends", but generally speaking it does not. You can maybe go to your VSo to view results as they should have access to your claims file and it should be in there, since the rater will need it, etc. You can also try a form 5345a Release of Information request. This is basically requesting a copy of your medical records. thats how i got my original PTSD C&P exam results. I would just do a request for "Compensation and Pension Examination conducted on XX/XX/XXXX for PTSD conducted by outside contractor" They might have it they might not and you might not get it for awhile, sometimes can take a month to get the request filled. If you havent gotten your C file yet, you should request it after this last claim process is done.
  12. So i had filed in 2012 for sleep disturbances. I said i had trouble sleeping, that i moved around a lot, was tired everyday even after 9 hours in the bed. I was denied and told not SC. I was recently DX'd with OSA and now i am wondering if i can request a EED for that. From what i have researched to get an earlier EED you have to show that the VA had the information to SC at the time it was denied, etc. However since the symptoms i described in 2012 were symptomatic of Apnea, but no C&P was ordered or questions asked is that not a error on their part. Im not a doctor, i am asking for SC for an issue with X,Y, Z symptoms and they should sort it out? I feel this is not possible, however i felt i would ask.
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