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New law would pay off the residents school debt @ 200k over 5 years if they stick around. That is a big incentive.

"The president made the announcement during remarks at a summit on prison reform at the White House." Prison reform? Go figure....

Go to Google scholar and find some studies that relate migrainess to PTSD (stress and anxiety attacks etc). Here are 2 I found right off the bat. ptsd and migraine association2.pdf Published in Health Psychology in 2017, authored by 6 professors who are prominent in US Universities, copyright by the APA. ptsd and migraine relation.pdf Published in the Journal of Behavioral Medications in 2016. authored by another 6 specialists in behavioral medicine. This is how you discredit the examiner, because he cited medical literature but failed to identify any. You can, very easily, show that he has no clue.

The new system promises that if a VSO submits the claim, its 30 days to completion. Alternatively, the EB website is 125 +/-....(+++++). Bottom line is do ya trust your evidence and the VSO? EB you are in control, w/VSO they say they are but sometimes are under a huge workload and cannot give you the attention your cliam needs.

All the secondary conditions caused by Rhinityis and sinus problems are also ratable as SC conditions. Make a full list of symptoms and look to see if they are pyramiding or separate from the cause, IE...headache is not pyramiding if it is caused by the SC condition..if it causes pain and no other symptom, it is rated at the lowest level for headaches. If you have sinus headaches that are severe enough to be eligible for a rating, then they can be rated under the VASRD Code for migraine headaches, since that is the condition that is closest to your condition, and would be expected to cause a similar degree of disability.

H.R.5674 - VA MISSION Act of 2018 This is huge, read it when you have a lot of spare time!! I like it so far. Requires the VA to pay for walkin care for vets at non-VA providers.

"VA signs contract with Cerner for an electronic health record system " For 10 billion, the Govt could become their own Microsoft/Google/Facebook. They gotta be idiots to ignore that self determination.

Like everything else, you are your best advocate with VA Health care. I hate to say it, but I am having similar issues. PCP's are swamped, some have over 2k patients to deal with. I am stuck with a resident, the PCP seems to have forgot her job! I research everything I can, when I catch them making errors, I document my convo w/healthevet secure email (copy paste/download to a file on my computer). Just keep your eyes open. If they respond to your communications, you are ahead of the game.

I found that getting a nexus letter from a VA Doc is like yanking a leg off and donating to the red cross. Pointless and ineffective!! I do seem to have good results getting them to list the etiology of my condition, including the cause, in my medical file. Just get him to attribute the pain meds that you use for your SC condition to the GERD/BE and its just as good as a nexus. Your lay statements are sufficient to document that you take the OTC meds for your SC condition. Your Doc doesnt need to say that. You are competent to make that point.

Bertha is 100% correct on this. I was SC for Scoliosis only because my STR showed it after they said I had lumbar strain. Since scoliosis is a sub specialty in orthopedic I went to a scoliosis specialist for an IMO. Without that IMO I probably could not have gotten SC. Its going to be hard to prove that there was progression of your condition beyond what would naturally have occurred without a specialists IMO. The tech in 74/75 was primitive compared to today. No MRI avail until 93 in the majority of US Hospitals, so they only had x rays. Did you get xrays in service? They are kept separate from the STR's, and you have to ask specifically for the xrays from St Louis archives. Helps if you ID the hospital, and month and year they were taken. If they exist its 3-4 months before you see copies, so jump on that fast. Get on the phone and call every scoliosis center in your region, ask for IMO based on a review of records and an examination. Provide a concise analysis of the records, and bookmark everything so the specialist can go right to the info you give him in both STR and private treatment records. Make it easy for them and they may be kinder to you. The IMO needs to state that your work in active duty did aggravate and make worse the scoliosis, and if possible, to what degree beyond what would be considered natural progression based on known medical literature. Make sure you add your own statement about what you have experienced with the Scoliosis, as well as spouse and family that are familiar with your trek. Parents statements describing back problems and your history would also be strong. If its done right, the VBA will take one look at it and give you what you ask for. I know scoliosis usually does not progress much at all unless the curve is beyond a certain degree. If you entered with a slight 12 Degree curve, your spec should state that it would have been very unlikely to progress on its own, if at all. The amount of progression should be well documented for this claim because it was identified when you were given your entrance exams.

Your Parents could give lay statements. They could testify that when you left for Iraq, you had 2 legs, and both were missing when you came home!! This is something they can see. If your brother was the only one you told about being raped in the barracks during boot camp, his lay statement is viable because he can testify that you reported the incident to him. If that corroborates with medical records referring to treatment for STD's around the same time, it is probative and sufficient evidence. There are many ways to use lay statements from family, friends as well as statements from people who you served with on active duty to shore up a claim. The only wrong lay statements are the ones you failed to get because you didnt think it would count. Just stay honest.

Lay evidence is generally afforded probative value if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. A medically-untrained individual is not usually competent to offer a medical opinion regarding the etiology of disorders and such an opinion is generally assigned little probative weight. (111.iv.5.A.6.b. When to use lay evidence)

Guidelines for evidence is located in M21-1, Part III Subpart iv, Ch 5, Section A "Principles for reviewing Evidence and Decision Making". You should start there for answers, just google the reference.

Nice. You got all you need. Go to the White House hotline. Demand to be told WHY the Executive Director of Benefits Assistance Service deleted your record of service from 1974. Then tell them that you are being investigated for Char. of Svc review. The WH Hotline should be able to get them to contact you to tell you why your record is being investigated after you already hold a 100% disability rating. Upload both of those to your Ebenefits claim you posted above. They have no excuse not knowing what they did at that point. Both are valid questions and you have a right to answers...you should white out your name in those 2 documents.

You should have a copy of your DD214, no? Show an Honorable DC? Upload it to the Ebenefits claim. They really dont need it, but its an obvious resolution. This might be under an arcane quality assurance thing in Atlanta. (VA Atlanta Regional Benefit Office)

An RFE is "request future examination in the M21-1. (M21-1, Part III, Subpart iv, Chapter 3, Section B - Scheduling Examinations, 2. Determining the Need for Review Examinations). Criteria: "b. Exercise prudent judgment and refer to 38 CFR 3.327(b) in determining the need for review examination. It is the policy of VBA to request future examinations only when absolutely necessary, and every effort should be made to limit cases where future examinations are requested. Consider whether the Veteran’s current condition is an acute exacerbation the Veteran is still recuperating following hospitalization, and/or improvement or recovery can be anticipated. Important: Medical evidence from any of the sources listed in 38 CFR 3.326(b) and (c) may satisfy the need for reexamination." So the VBA policy is to do RFE only when absolutely necessary. (First point) It also directs that medical records can be requested from the VHA to satisfy 38 CFR 326 as indicated here: "(b) Provided that it is otherwise adequate for rating purposes, any hospital report, or any examination report, from any government or private institution may be accepted for rating a claim without further examination. However, monetary benefits to a former prisoner of war will not be denied unless the claimant has been offered a complete physical examination conducted at a Department of Veterans Affairs hospital or outpatient clinic. (c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination." "Otherwise adequate for rating purposes" can be defined in "M21-1, Part Ill, Subpart iv, Chapter 5, Section A - Principles of Reviewing Evidence and Decision Making". (YES, your private, non-VA doctor medical records are sufficient to complete an RFE if they properly identify the problem and provide a current diagnosis.) Acceptible Clinical Evidence (ACE) process involves a request by the VBA to the VHA for an examination. The VHA examiner can review the records of the Veteran and if there is sufficient info in the VA Medical Record, or private records submitted by the Veteran, they dont need an appointment for an examination. M21-1, Part III. subpart iv. Chapter 3. Section A.4.a.Examinations Based on ACE In lieu of scheduling an in-person examination, VHA examiners generally (subject to some limitations) have the option to complete a DBQ based on review of existing paper and/or electronic medical evidence. They may also conduct a telephone interview with the claimant. Examinations based upon medical records and history without an in-person clinical examination or testing are known as ACE examinations or the ACE process. So they dont need to establish an appointment for anyone if they are in treatment at the VA or you submit your private treatment records. If the VA fails to review the records available to them from the VHA, they have not fulfilled this policy. This is grounds for complaint to the rating authority and if you are not confident that they will take action, a complaint to the WH hotline, Congresscritter, or the press (in that order) is the wake up call to the VBA telling them that they MUST follow their own rules and provide a competent service for Veterans in accordance with Laws (US CODE) and Regulations (CODE OF FEDERAL REGULATION-CFR) established by Congress. This is the purpose of the M21-1 manual, so they do follow the laws that are established.

Hi Kidhuff, I would start with the VR&E program. The worse thing that could happen is they send you to school for the next 4 years to get a new degree under Chapter 31, which allows 750/mo for housing and living expense. Not a ton of cash but its a future. If you have the CH 35 option, they will give you E-5 housing allowance, which is quite a bit more than the Ch 31 stipend. Need the 9-11 GI Bill to get it. If they reject you as unemployable, then you have very strong grounds to claim TDIU. They will do an assessment for employability and if they determine that your anxiety and depressive disorders prevent you from being gainfully employed they will not allow you into the rehab program.

Might think about finding a friendly provider to fill out another DBQ on your condition also, the old one showed a problem, if the new one shows a problem, the one in the middle is pretty much moot.

This is an easy (but a bit old) version of the M28 that is the guidebook for VR&E the VA administers. It references the CFR as well, so you can double check info and assess what they should do if you apply. [UPDATED 7/14/14: Get Updated 1,488 PDF M28R Here] I found info on Ch35 on page 1212 for elig. and entitlement/administration of the program. this is a huge PDF.

I think if I were to give suggestions, it would be to place a RO in the VHA Pact teams so the VET can sit down with the PCP and the RO and process the DBQ and the claim initiation right on the spot, face to face with the VET and the Doctor. If they need a specialist to opine about SC of specific nature, they could set an appt for that to happen as well. All of this could be documented and forwarded to the VBA with RO input. This way the RO would have first hand knowledge of the Vets condition, and it would eliminate a lot of the confusion when they assume things in error.

In the section where they show SC disabilities, they will also show pending disabilities below that. It should show NSC down there if they have not made a decision.

Ive had 2 RFE's on my LLE so far. I pulled the regs on them and, as usual, they dont follow the M21-1 on this stuff. These M21-1 rules are backed by the CFR and USC. M21-1, Part III, Subpart iv, Chapter 3, Section B - Scheduling Examinations (Table) If the case necessitates a(n) ... Then, at the time of the rating decision’s preparation, schedule the examination to be conducted ... routine future examination to monitor for anticipated improvement in an SC disability in three years. reexamination to monitor for evidence of sustained improvement in a stabilized SC disability that is shown to have improved in 18, 24, or 30 months, depending upon the facts and implications of the individual case. So now I see they should not be sending me to C&P exams every 12 or 14 months, but 18-36 instead. Then I go to the next section: III.iv.3.B.2.d. When Not to Schedule Review Examinations Do not establish a future examination control in cases when the disability is static, without material improvement over five years the disability is permanent in character and of such nature that there is no likelihood of improvement the Veteran is over 55 years of age (except under unusual circumstances or where required by regulation) the evaluation is the prescribed schedular minimum within its DC the evaluation is 10 percent or less, or the combined evaluation would not change even if the reexamination resulted in a reduced evaluation for one or more disabilities. Important: When deciding if a disability is static or not, only order a future examination if there is objective evidence stating clearly a disability is likely to improve. The principles expressed in this block apply equally to (1) initial routine future examinations and (2) reexaminations requested in the interest of substantiating sustained improvement. Therefore, where one or more of the above criteria are applicable, and the evidentiary record includes a single examination report (or alternative form of medical evidence) portraying improvement in a disability that has persisted at its assigned level of evaluation for five years or longer, do not proceed with scheduling an additional reexamination unless doing so is required by regulation, or warranted in light of unusual circumstances, such as in cases of Veterans over age 55. So, I turned 59 last week. Asked them why am I having to submit to these, the RO should be spending time on other vets. Besides, I gave them Non-VA med records from a specialist on my condition that prove my LLE is worse now than a year ago. So far they ignored me, so I also did a complaint on the WH Hotline. In light of all this, there is a THIRD section that covers over 55 exams: III.iv.3.B.2.e. Considering a Veteran’s Age in Connection With Review Examinations As is discussed in M21-1, Part III, Subpart iv, 3.B.2.d, and with only a few rare exceptions, Veterans over the age of 55 must not be routinely recalled for reexamination. (note: If, however, a future review examination is deemed warranted in light of unusual circumstances, the claims processor must identify and document the nature of the unusual facts found in the form of a remark in the SPECIAL NOTATION field on the PROFILE screen in the Veterans Benefits Management System (VBMS) – Rating, or permanent VBMS note, if no rating decision is being simultaneously prepared.) So I wait for an answer. They have no "special circumstances note in any of my CFile so I have a fairly solid ground to fight them about it. If your rating is 10% or less, they should not be doing this.

Hi Vet Dog & his wife. Is there anything in the CFile from the 80s that show what they did with your NOD and appeal? There should be a decision, otherwise that claim is still open.

I think that this is the exception rather than the rule. If it took 10 years for everyone to get a NOD replied to the stink would really make the VA pay attention. Press would be all over that!@! I'm not even sure I will get a SOC by then (if they dont grant my increase).

They made changes to RAMP over the last few months I think, mostly that they will start the 3rd lane appeals in Oct 2018 and that they will put RAMP participants in front of the line because they were getting such a low turnout (so they incentivised it).