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pwrslm

Master Chief Petty Officer
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Everything posted by pwrslm

  1. Real estate is the only thing going up. My Mortgage company has contacted me multiple time in the last 60 days telling me about the 107k in accumulated equity on my primary residence. They want to refi and give me 67k cash. That defeats the idea of paying off the loan from the git go. They still keep calling though, like they anticipate that I will change my mind.
  2. If you have a decent PCP you should be able to document your condition before you ever put in a claim. Bring the condition to your PCP and ask for evaluation if you think your condition got worse. Usually, VA will be fine to do this every 12 months. By doing this you have documentation already in the VA medical records of anything that needs to be documented for an increase. I have done this over and over for my lumbar and cervical spine conditions, arthritis in my hips/knees, and 2 years of work with neurology diagnosing my neuro condition. It works because you have evidence from within the system. The only time I got a non-VA IMO/IME was for my 1st claim. If you ask your PCP about hypertension or diabetes or kidney/liver problems, get them to note their answers in your records. The PCP is out to insure that you stay healthy, and typically will refrain from anything to do with claims, so do not try to drag them into a claim statement unless they volunteer. All they need to do is enter the professional opinion of what caused the condition in the VA system, the rest is downhill from there.
  3. It would be interesting to review how the VA contracts with NGO's to provide the mail system used in the administration of claims. One would think that the administration of a private or publicly held corporation would be more efficient, even in todays market with COVID, because so many people can work from home. It would not be that complex to put printers and supplies at the home of a disabled Vet to process VBA outbound mail. Printing and stuffing envelopes is not so hard, and if the volume is high enough the machines used to stuff envelopes are affordable. A $10,000 machine can process up to 2500 pieces of mail per hour. A commercial printers range from several hundred to 3-4 thousand can produce 50+pages per minute. Sending completed claim decisions or any notifications VA needs to make to a processor over the internet could be done in seconds and the letters could be generated and mailed within 24 hours. If one processor became backlogged, another processor could be selected. Its not that complex. The VA can bring 20-30 of these type of work agreements online in a very short period of time. Its obvious that the current system has a severe bottle-neck. Something should be done.
  4. A lot of things the Government does is bassackwards. Been that way for over a century now. That is probably why folks with common sense stick in the civilian sector.
  5. Without an actual 100% rating, you can never get there. If you have 99.0, and you get a 90% rating on top of that you only have 99.9%. The system is set to give diminishing returns on disabilities. Without that 100%, the only way is rounding up.
  6. This document shows the disability from 93. Your SS work credits can be frozen from this date if it would have in fact qualified for SSDI at the time. A lot of the time when we are younger we do not think about things like SSDI. A 2 year tour of active duty usually will generate 6 or more work credits. You earn a maximum of 4 credits per year so all you had to accumulate before you became disabled would be 1.5 years of work.
  7. Have you spoken with a VSO yet? Not sure what you situation or conditions are, understand you have 10% for TBI, down from 40%, but am not sure how that occurred. Did you get notice of a reduction, and if so, what did you do?
  8. pwrslm

    SMC Questions

    Secondary conditions can kill you. IF they are not SC, your spouse gets no DIC if you die. Pursue the secondary conditions. I am not really great on A&A, but the limitations leading up to A&A all have to be SC. If your secondary conditions contribute to your housebound condition, you need to get them SC to get A&A I think. If not the VA can claim the A&A is caused by non-SC conditions and you will be denied. You already have 100%. TDIU is for those with less than 100% that brings them up to 100%. No need to worry about TDIU.
  9. Grey is not so grey. How many years did you work before 93? Active duty counts. Spouse spent 5 years Active duty. Left in 84, has not worked since. Found out what's up from a post about PTSD from MST here on Hadit in 2016 and filed a claim. 4 months later they approved her 100% P&T. I was surprised to say the least. At 24, she had enough credits to qualify for SSDI. I suspect you did at 23 also. Check the work credits at SSA.GOV. They break it down from the first job you had up until today. You only need 6 work credits, and I would bet you have that. If they grant you a freeze, they pay you from the time you were qualified at the rate your income adjusted would be today. My spouse would be over 1k/mo at this point adjusted for inflation.
  10. There is something called a SS Freeze that will set aside the years you did not work due to disability. Just applied for my spouse, will not know if the approve it for 2-3 more months. She went through a MST that resulted in PTSD, with a severe startle response, anxiety, etc...she has not worked since 84 when we both left the Army. The idea is that they should award you benefits based on the work record from when you became disabled, which was when you were 23, and based on the work credits you had then, you would qualify if they approved the freeze. you might look into this
  11. My last 3 exams I had my cell recording on. Went home and transcribed it so I could be sure to remember everything the examiner did and said. Surely, I cannot present that as evidence, but it makes my memory much more credible and accurate. If I need to appeal the C&P I have a much better shot then not with this. ROI is now prohibited by VA from releasing your C&P exams because of complaints that the examiners fear attacks from violent out of control Vets who are pissed off because they believe the examiner screwed up C&P's (non the vets fault). That's the reason behind it...if it is true or not I have no clue because they did not document this issue.
  12. VA is supposed to review claims that are not P&T every 3-5 years. If you put in a claim and other disabilities would be timely for review, they may check how the existing conditions are doing. This is required by Congress. Exceptions exist, for example, if you are over 55 they should not be reviewing you at all unless there is a specific reason written in the notes of your CFile. Most of the time, P&T awards are not reviewed unless you apply for increase. Another issue would be fraud, so if the RO suspects fraud he may muck things up a bit. In 2018, the VA got dinged for unnecessary C&Ps, noting that in the following 5 years, the IG identified that over 100 million tax dollars would be wasted on unnecessary exams. Just keep your eyes open and understand the system and usually your claim will go just fine.
  13. Being confined at home gives you a lot of time to get through this. I imagine you have done a lot of reading and studying on these cases which is a good thing. Just remember you have to live, to have things in your life that bring you joy and happiness and not the anxiety and frustration of teaching turkeys how to fly. I know the obsession we can get into doing this, so I understand some about what you are going through. I think a good lawyer would probably have resolved this long ago because they have access to the governments lawyers and judges unlike we do pro-se. On the other hand, the work is a job for you I think and you have done very well filtering through all of the mess the VA created and winning. Gratz~~!!
  14. It is a cover sheet that goes on top of your file that requires expedited treatment. When I put in for ALS, the first time they denied SC and it took less than 30 day. When I submitted the supplemental claim through the PVA with evidence, it took them 8 days to approve the claim. Note that the ALS claims are handled by a special group due to the nature of the condition. With the electronic system replacing the paper files, I would imagine that some kind of header would be involved to notice the rating officials that your claim is under hardship circumstances.
  15. You can view your payment history on Vets.gov . My last claim was approved and I found out the award before it posted to my bank. You can also check the status of your disabilities listed on the VBA system at Vets.gov to see what they approved or disapproved and the % awarded as soon as the claim closes. Go to the "My VA" on the top right of the page after you are signed in, then to "Your disability rating" below your name to see what your ratings are. Both systems are tied into one at Vets.gov so you can see what changes were made before they send out the decision via snail mail. As soon as the claim closes results are posted here and you can get letters documenting your disability and pay as well. Monitor these 2 sources if your claim is pending completion to find out quickly how they rated you.
  16. Most medical offices are affiliated with more than a single carrier network. Ask if they would sign up to the VA system for you. Many of these offices take Medicare so the payment system is the same and they will get the same payout either way. I had a spine surgeon sign up in Orlando and today his business is over 50% from the VA. He sent me a gift card as a thank you. Not to mention the fact that he was covered by VA when he did my 4 level lumbar fusion.
  17. At some point, action to correct VA abuses need to be taken. Organization of IG complaints would be a beginning step. If enough people presented valid complaints the IG would have little choice but to investigate. Organization of the complaints in a single point would benefit complainants becuase they could turn the entire project out to the press if there were no response.
  18. Did you get a call through the 800 line? If they say your file does not have a hardship cover, then report that to your lawyer. If he submitted it then he should get answers faster than any other way.
  19. Back to basics. Supplemental claims require new evidence. If you have new evidence showing you deserve an earlier effective date a supplemental claim takes 3-4 months. RO should be able to award benefits up to 12 months prior to the date you submitted an intent to file (or the date the claim was submitted). If the evidence was already in possession of the government, but they failed to ID it, a HLR "should" correct that. This is another 3-4 months. Follow the HLR w/Supl if it is denied, gathering more info and adding a lay statement pointing to the existing records that were "overlooked". 6-8 months have passed for the above. If you do have convincing info documented and still disagree with the VARO, then the next step is an appeal. If you take the evidence through appeals, it takes years.
  20. Lay statements carry significant weight in claims. You experience migraines, so you can testify to the severity and duration. You can also explain when they started, as your experience can identify if they began in service as mild and then got worse, or if they were mild before you joined active duty and that active duty service made them worse. The PTSD award provides you with evidence that can be used also, did you mention headaches in C&P exam when they awarded you PTSD? That should be used. I always prepare myself for secondary conditions by taking the issue to my VA PCP. Let them diagnose the issue, refer you to specialists, whatever it takes. You do not have to mention you are going to claim this, just bring them the issue to deal with and let them handle it. If you were exposed to TBI, get that documented as well. When all of the VA PCP eval is finished, then submit the claim.
  21. Log in to the EBenefits site and check to see what they list as your disabilities. As soon as they close the claim, the info is posted on the system and you can see exactly what they granted.
  22. VA must maximize you benefits. If there were anything missing for PTSD, but the specifications for Generalized Anxiety Disorder would be met, they are obligated to rate you for GAD. Your decision letter should explain why they awarded the GAD, if not, FOIA your C-File to see if the PTSD was even addressed. I would guess that the VA's psych eval resulted in this change.
  23. Remember the new laws also grant you free or low copay visits to emergency care and urgent care non-VA facilities if you normally use your local VAMC for care. If you have a serious issue that is non-emergency, you can go to an urgent care center for free or for a low copay. The VA is responsible to pay the balance. They bill you for copays if you owe them also so you walk out without paying anything. UC_Assistance_Cards.pdf
  24. They have been playing a game by twisting terminology. If the MD puts a date into the system, then they have 30 days from the date entered to get you into the appointment. I noticed months back that the dates are being put out in the future far enough to avoid CC referrals. Example is if the MD says they will refer you to urology. Well, urology waiting list means the next available appointment is 75-80 days away. The MD checks the wait time and sets a date medically determined for 75 days out. This means that to qualify for CC, you cannot get an appointment from the date of your current appointment 75 days plus 30 days from now. As long as the MD does not put the current date as the date requested for the appointment, you do not qualify for CC.
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