Jump to content

pwrslm

Subscription Holder
  • Posts

    889
  • Joined

  • Last visited

  • Days Won

    18
  • Donations

    $65.00 

pwrslm last won the day on January 30 2019

pwrslm had the most liked content!

2 Followers

About pwrslm

Previous Fields

  • Branch of Service
    Army

Recent Profile Visitors

3,027 profile views

pwrslm's Achievements

Experienced

Experienced (11/14)

  • Conversation Starter
  • Week One Done
  • One Month Later
  • One Year In
  • First Post

Recent Badges

372

Reputation

  1. “Federal law, Title 21 U.S.C. § 360bbb-3(e)(1)(A)(ii)(I-III) of the Federal Food, Drug, and Cosmetic Act, states the following about products granted emergency authorization usage: Individuals to whom the product is administered are informed— (I) that the Secretary has authorized the emergency use of the product; (II) of the significant known and potential benefits and risks of such use, and of the extent to which such benefits and risks are unknown; and (III) of the option to accept or refuse administration of the product, of the consequences, if any, of refusing administration of the product, and of the alternatives to the product that are available and of their benefits and risks. Any entity or organization that requires EUA COVID-19 vaccinations, COVID-19 tests or masks are in violation of federal law, and will likely face lawsuits if they don’t allow exemptions or alternatives.” I am just waiting for the fall out. Class action suits over this will likely take years to evolve.
  2. I think communication with CC is about the biggest pain in my tush... You have to keep calling until you get through. They will give you the run about, but in the end, the squeaky wheel gets the grease.
  3. The VA C&P rep was a NP in my case, and knew less about ALS than I did IMO. He also omitted facts contained in the medical record, and made claims about what that did not exist in the medical record. The treatment I was given for ALS was overlooked, and he stated that I had never had a diagnosis for ALS. I tore his evaluation up and handed it to the VA which totally undermined the C&P. The medication I was given in 2019 was Radicava, and it may only be prescribed for probable or possible ALS, demonstrating my diagnosis in no uncertain terms because Radicava is not used for anything else. I was denied because the NP said I only had suspected ALS, when the term suspected never occurred in my medical record. The SC was denied because the basic criteria did not say "definite" ALS. See my post on that also posted today.
  4. The issue is the diagnosis for ALS is based on research criteria. Originally there was 4 base criteria similar to what they used for MS. These were suspected ALS, Possible ALS, Probable ALS, and Definite ALS. As more of the upper and lower motor neurons become affected, the higher up the diagnostic "ladder" you go. Newer criteria eliminated the suspected category, and replaced that with a clinical possible and clinical probable ALS, so that made it 5 levels of staging. And again, as the newest adjustment came out in the Awaji criteria, the suspected categories were eliminated and that left 3 diagnosis criteria. All of this happened from the early 90s through the around 2016. The PVA rep explained to me in no uncertain terms that the VA policy is that if you do not have Definite ALS, it will not grant SC for ALS. As the attachment I posted above explains (see "A proposal for a new diagnostic criteria, pg 2) it clearly states that "all three categories describe patients whose disease is in fact ALS, to a very high degree of diagnostic certainty. " When I found this, I sent it to the PVA guy, and he is lost to explain it. This triggered me (a brain thing I get)! This was why they denied my 1st application last year. How many more veterans are in that position, and are denied benefits for ALS because the VA is basing SC on information that is used to qualify for clinical trials, and not the diagnosis? The criteria of possible, probable, and definite, are not suspicions, but instead align more as a staging level. That opinion was written by 22 of the world most recognized ALS specialist, and the conclusions of that was adopted by the World Federation of Neurology. It is indisputable fact that cannot be overcome to the best of my knowledge. My goal now is to insure that other vets are accorded the rights to the benefits the VA originally denies, because almost all of the people who are diagnosed with possible and probable ALS will certainly die of ALS (the statistics show that 96% will do so). Many people w/ALS will die and never progress to having definite ALS. Good news is that my recent 12 July Visit to my Neurology Spec at VA got my claim Approved, and SMC's will be applied. Bad news was that they did so while totally ignoring that evidence I submitted, which was a side step to recognizing what I posted on here. What do I do to change the policy? Dozens, if not hundreds of veterans w/ALS are affected.
  5. I find it peculiar that they would do this. The COVID vaccines are classified as experimental. The nature of the beast says that nobody should be forced to chose between their job and any experimental vaccine. I find the moral stance offensive.
  6. Hello, I have been (finally) diagnosed with ALS by the VA. Started getting symptoms in 2015, by 2017 I figured out that the VAMC was not interested in diagnosing those symptoms that were progressing, so I had to go to a non-VA specialist. It took 2 years but in 2019 I was diagnosed w/ALS. VA dragged its feet, and finally in 2021 (after almost 6 years) verified the diagnosis. I have learned a lot about ALS in the meanwhile. The PVA rep told me that the VA has been refusing to allow SC for Vets if the diagnosis they presented was less than definite ALS. Seems odd because people with possible and probable ALS die and never progress to the definite diagnosis. Started researching this and learned that the possible/probable/definite diagnosis was for research and entry into clinical trials. Found a professional opinion from 22 top specialists in ALS that stated as a matter of fact, all three diagnosis were in fact ALS to a high degree of diagnostic certainty. I submitted that along with several other attachments in a supplementary claim after I was denied last Nov 2020. My concern is that there may be dozens of Vets with ALS that were denied service connection based on the erroneous criteria. Am attaching a few documents that may help others if they run into this situation. Hope it helps. 6 A proposal for new diagnostic criteria for ALS.pdf 7 World Federation of Neurology Vol 35 No 4 Oct Nov 2020.pdf 8-Neurology Live peer exchange APR 2021.pdf
  7. Medicare Part B (Medical Insurance) The eligibility rules for Part B depend on whether a person is eligible for premium-free Part A or whether the individual has to pay a premium for Part A coverage. Individuals who are eligible for premium-free Part A are also eligible for enroll in Part B once they are entitled to Part A. Enrollment in Part B can only happen at certain times. Individuals who must pay a premium for Part A must meet the following requirements to enroll in Part B: Be age 65 or older; Be a U.S. resident; AND Be either a U.S. citizen, OR Be an alien who has been lawfully admitted for permanent residence and has been residing in the United States for 5 continuous years prior to the month of filing an application for Medicare. NOTE: Part B is a voluntary program which requires the payment of a monthly premium for all months of coverage. Original Medicare (Part A and B) Eligibility and Enrollment | CMS I think the ?? comes down to the above, if you pay a premium for Part A, you may not be eligible for Part B if you are only 42 y/o.
  8. PTSD requires a stressor to get approved. Unless you submitted more info on a different stressor, then it had do have been approved based on your evidence of MST. MST is not a rating, it is a stressor, the event that caused the condition. Wait till you get your decision letter to unravel this. Lots of mistakes in communications can happen, so as soon as you got it in writing, you can validate what the VSO told you.
  9. My PCP sent me to physical therapy for a Functional Capacity Evaluation (FCE). They yanked and pulled and stretched me out in every conceivable way to figure out if I was capable of working. If you can get one of these that shows the effects of DMII on your upper/lower extremities, which restrict your ability to function, it may go a long way in persuading a Dr. to give you a positive report for the claim. If the rating official did not have an answer because the C&P examiner omitted that, the FCE would document the omission.
  10. So far, I have used this in all initial claims since my first one. I think it persuades the C&P examiner more than the RO.
  11. If you have a VSO on file, you can get them to give you the answer to this. I have Legion as representative (they never helped me file a claim). They are allowed to get into the system and find these details for you.
  12. Check Ebenefits. Disabilities will tell you what they approved. This sounds like back pay for a 100% 12-14 months give or take dependents etc. If you dont think its right, call peggy....800-827-1000
  13. When you get a C&P exam with a bad opinion you can challenge that with peer reviewed medical literature. Most of the time, these opinions fail to identify any source proving the basis for the opinion. This can be challenged with medical literature from valid sources. I can access college library with links to professional journals, as well as Google Scholar that also provides links to professional journal articles. These are peer reviewed, and considered equal in weight to any opinion that a medical professional can provide. Anyone can use web sites as well that help find articles from journals that are recognized and authored by medical professionals, such as https://medlineplus.gov/ , https://www.merckmanuals.com/professional , https://www.ncbi.nlm.nih.gov/pmc/ , and Va HealthEVet also has a library with links. Example: Opinion from C&P exam states that there is no way that your service connected left leg condition can cause your shoulder injury. Claim denied. Request for reconsideration with new evidence can be submitted without an expensive IMO from a medical professional. New evidence include studies reported in Medical Journals stating that radiculopathy with foot drop frequently cause falls, and more studies that shoulder injuries are commonly caused by falls. Reconsideration includes 3-6 opinions each on both falls and injuries, which disproves the claim that there is no connection between your left leg condition and your shoulder injury. Results: award of 20% for shoulder injury because you proved that the examiner was a clown.
  14. SOmething to pay attention to. When you get a C&P exam with a bad opinion you can challenge that with peer reviewed medical literature. Most of the time, these opinions fail to identify any source proving the basis for the opinion. This can be challenged with medical literature from valid sources. I can access college library with links to professional journals, as well as Google Scholar that also provides links to professional journal articles. These are peer reviewed, and considered equal in weight to any opinion that a medical professional can provide. Anyone can use web sites as well that help find articles from journals that are recognized and authored by medical professionals, such as https://medlineplus.gov/ , https://www.merckmanuals.com/professional , https://www.ncbi.nlm.nih.gov/pmc/ , and Va HealthEVet also has a library with links. Example: Opinion from C&P exam states that there is no way that your service connected left leg condition can cause your shoulder injury. Claim denied. Request for reconsideration with new evidence can be submitted without an expensive IMO from a medical professional. New evidence include studies reported in Medical Journals stating that radiculopathy with foot drop frequently cause falls, and more studies that shoulder injuries are commonly caused by falls. Reconsideration includes 3-6 opinions each on both falls and injuries, which disproves the claim that there is no connection between your left leg condition and your shoulder injury. Results: award of 20% for shoulder injury because you proved that the examiner was a clown.
  15. Many time, nerve issue cause additional disabilities and are able to be rated separately. The CFR notes that. Typically, nerve problems like this are rated on how they affect the ability of the limb to ambulate. If the nerve is totally severed, for example, the muscles downline are paralyzed, and that would be the highest rating. Explore this issue here
×
×
  • Create New...

Important Information

{terms] and Guidelines