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Senior Chief Petty Officer
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pwrslm last won the day on October 17

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About pwrslm

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    E-8 Senior Chief Petty Officer

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  1. Ebenefits site section for letters will tell you for sure. Print them out to see what you current disability benefits are, and it tells you there. That letter is indisputable for benefits. Step 2: Select a letter from the following list. Benefit Summary - Veteran Benefits <--- (this one tells you if you are P&T or UI) Create a Benefit Summary Letter to show you are receiving certain benefits from VA. Benefit Verification Send this letter to confirm details about the VA benefit that you are currently receiving.
  2. Code 5055: If the entire knee joint has been replaced by a prosthesis, then the condition is rated 100% for the first year after the surgery. After the 1-year period, the condition is given a permanent rating. If there is weakness and severe pain with motion, then it is rated 60%. If the pain is not severe, but does limit the range of motion, then it is rated under code 5256 if it is frozen, or under codes 5261 or 5262, discussed below, if it is not frozen. The minimum rating for a total knee replacement, however, is 30% regardless of how much motion it has. Get the claim in within a week of your surgery. send all the documentation and diagnosis with the claim and your surgery schedule. Easy to upload it when you submit after you put in intent to file on the EBenefits web site. You wont get an actual rating until after the surgery, and the 1 year period following. The 100% will kick in the date of surgery, your payment starts the 1st of the following month for a year. The second surgery will be the same, except you should collect SMC for that one, probably S-1/2.or better.... No need to get another nexus because your knee's are already SC. This is a request for increase. Might have been done several years back as your knee's got worse, but thats water under the bridge.
  3. Mental Health diagnosis from NON VA providers are ok unless its PTSD. Do you see anyone outside of the VA for anxiety and depression? How exactly is the anxiety and depression linked to your active duty service. Can you document the reasons that you think caused this condition? Without a little help, even the MH experts can not do this. You have to have laid out a solid case that you believe in before the MH experts will even try to help. VA docs really hedge against making statements even though the VA policy tells us that they are responsible to do so. I think its an inside joke on veterans to be honest.
  4. pwrslm

    Rogue C&P Examiner?

    Thanks for that link Berta. It is another way to fight the bureaucracy. Ive been using the WH Hotline and been getting results. This is another tool in the toolbox we should all employ.
  5. pwrslm


    call 800 827 1000 for info ebenefits is not the best or timely
  6. dbq will be in your blue button report on healthevet if it was done by the va
  7. Not knowing what your condition is, I cannot advise. Until you are 55, its a sure thing that the VA will call on you from time to time about re-evaluations. I am past 55, got to 100% P&T by submitting everything related to my spine/leg. Not supposed to get any more re-evaluations, but thats not a guarantee. Just be straight with all of them and if someone tries to railroad your rating, be prepared to fight to protect it. That means have a reliable alt pcp or other provider on your side. Meanwhile check ch 31 VR&E out. Free to look. If you increase your education it increases your income and will hedge against losing VA disability.
  8. pwrslm

    PTSD and gambling?

    A little old lady told me that if the devil keeps ya busy, it keeps you away from Gods work. I didnt realize it years ago, but that enlistment contract gave me an insurance policy just in case I got hurt. I went for 35 years and never realized it existed. My spine was screwed up something terrible, and it kept me from doing what I really wanted. It kept me from working hard, and I did work like a dog when I was motivated. When everything was falling apart in the end, someone told me that the VA should deal with my back problem because it was from way back where it started in the Army. That began an incredible journey to where I am today. I really am disabled. It took a year or so to finally come to terms and understand what that meant, but its ok. I can still get around, do things I really want, but some things I will never do again, like run, or even walk fast. If you put it in your mind that you are 100% disabled, it can destroy you. I wont let it stop me, I go to a gym now and use an elliptical. I can go 4 thousand yards on a rowing machine pretty fast. I keep hope up, and if I have a bad day and life knocks me down, I get right back up ready for anything else life throws at me. If you quit, it will kill you. Fight the good fight gentlemen, stand up and be counted. Its our hearts that make us men, not our injured bodies!
  9. SSDI will let you do a trial thing for work and still keep benefits. Talk to an SSDI rep on this. Dont know what your disabilities are so I cant recommend much but VA disability does not restrict your ability to work unless they awarded you 100% IU (individual unemployability). If you have IU, when they find out that you are working (usually through SS and taxes) they will re-evaluate you, or you can notify them that you need a re-evaluation after you get a solid job. VA will also give you some room for a trial before they pull an IU award, but then your disability compensation will drop back to whatever it should be without IU. You should check into CH 31 VR&E also. It will get you a degree if you are over 30% disabled and cannot work. You could get a 4 yr BA and be much better off in the long run with a degree of your choice. I did this, 59 Y/O in school, graduate next May. They pay everything including books, computers, pens, the whole shot plus you get a living stipend of 750+/- every month on top of your disability pay. If you already have a degree, they can get you the PhD also. Explore your options.
  10. pwrslm

    PTSD and gambling?

    I read about one guy who got into thrill seeking and ended up DOA one day. PTSD is a complex issue, not just anxiety and stress but also addictions and emotions. Gambling is an addiction. PTSD may be the primer, but the relief from "winning" makes you feel important and successful. It allows you to put on a mask and for a little bit life is normal. Most gambling addictions can go on for years before causing major problems. Some can become acute and destroy someone's life in short order. This link goes to a journal to an article that talks about this and other problem behaviors associated with PTSD.
  11. "Stable 40% chronic anterior wedge deformity of the T7 vertebral body20% chronic anterior wedge deformity of the T8 vertebral body" Did the examiner give any opinions on the wedge deformity? These deformities can be caused by osteoporosis in older adults or they can be a birth defect. The vertebra is crushed when its from osteo which is considered a fracture.
  12. pwrslm

    Back C&P Question

    lumbar strain was a catch all i think they used before MRI's... Im 40% for lumbar strain, but also claimed as ddd, scoliosis, stenosis and a few other things, its rated based on how far you bend forward now they dont prescribe bed rest anymore I ended up w/4 level fusion s1 to l3, 4 months off,, but they give you temp 100% during that time you cannot work...3k per month downtime plus if you have kids make sure you get reevaluated at the end, you should get to higher % after surgery because you can not bend like you used to radiculopathy is from nerve damage to the legs from spine problems and is rated secondary, so in addition to the spine and you should be rated for each leg, both count I ended up w.60% left leg because I ended up with foot drop, a lot of nerve damage in other words, the right leg is mostly sensory deficite i fell and tore the labrum in my shoulder, left leg gave out on me and injury was from the fall, so its secondary in addition to spine also literally everything that is tied to the SC injury is secondary, including arthritis of the hips and knees and ankles if you are affected as bad as I am as soon as symptoms start to manifest, get to the VA and document them, then once you have it documented, start a new claim
  13. pwrslm

    This could happen to you

    shuffle the pea
  14. pwrslm


    you said your spouse was SC also, yes? 100% P&T? that would give you champva and you can see non va MD's w/25% copay for proper evaluations it helps a LOT to have an MD on your side that way
  15. pwrslm

    Non-VA care

    Go to release of information, ask them for copies of all of the consults in this chain for care. That should give you everything that they have on who and why the request was denied. It could be something simple as a blood test needs to be done or as bad as someone dropped the ball.

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