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SemperAye

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Everything posted by SemperAye

  1. My claim back in 2014 it was found that my tongue scar was 7822-7800 rated at 10% due to the Characteristic of Disfigurement width measurement. My 2015 reconsideration claim to add a separate code of 7804 for the account that it is also painful was successful, but, they removed the 7800 code for head, face, or neck. The changed it to 7822-7802 so it's still 10% lol....those bastards. So my question is, does it still count as head, face, or neck 7800? It's my understanding that every conflict should be resolved in favor of the higher rating. I mean...it would be a CUE to not see that my tongue is inside my head lol! Thank you!
  2. Often claims will go to prep for decision right before a c&P is requested, check ebenefis if there has been an exam request.
  3. I'm on my fourth c&p exam for the same condition. The first was done on my original claim a year ago, it was done great, but the doctor gave a different diagnosis because she didn't look at my records. I submitted for an increase a month or so later, and was given another C&P with VES...that visit went well. Two months later the VA requests yet another opinion, but this time with a dentist via QTC, this exam took 3 months for the VA to get the results back (the dentist just copied the notes from my previous exams and didn't even look into my mouth because he said he agreed with the evidence/diagnosis I provided lol). Just found out today from Peggy that the VA has requested a fourth C&P for the same condition...wth...it's like they are fishing for the results that they prefer! What makes this worse is that out of the two diagnosis's that the va is trying to decide which one to pick, they both have the exact same rating criteria, same etiology, etc as noted on my first exam. My first exam gave the VA all it needed to increase my rating, it should have been a CUE, but I filed a request for reconsideration instead. I have no idea what they are doing, but as I can tell I'm not the only one who is getting the same exams over and over again. Each time there is an exam it's 30 days until the appointment, and 1-4 months before the va receives them!
  4. Sound like it went back to gathering evidence because you have a c&p coming up, that would be the request from the VA medical hospital.
  5. I just had the QTC apt today. The Dentist didn't even open my mouth, he never left his chair! He said "I'm not sure why you are even here, there is already a diagnosis, already a service connection, and you already had a c&p last month for this....I'm just going to copy those results and forward it back to the VA." Who knows what the VA is doing lol.
  6. Hello! Just wanted to let you know that the same thing just happened to me today. My claim was in preparation for decision, and C&P's for all of my increases had been done by VES about two months ago, and they all went very well and the doctors left me feeling like I was getting my increases. Two days after being in preparation for decision, my claim moved back to gathering evidence and I received a call from who other then the VA's hired guns QTC! QTC said they received a request for a DBQ on one of my contentions that I just had a C&P for two months ago! After looking into who the QTC doctor was going to be I noticed that it was a Dentist this time, and not a doctor. My guess is one of two things: Either they are trying to deny me by fishing for the right C&P results, or asking a dentist about my oral condition because he is better qualified. In your case however, since the C&P's are with the same doctors, I feel like it's either a mistake, they are trying to deny you, or perhaps they didn't go the exam correctly and it's messed up so bad that a phone call can't fix it. Keep us updated!
  7. Update: After my claim went back to gathering evidence, I noticed C&P's where scheduled. Must have been the higher ups decided C&P's where needed AGAIN lol. We'll I ended up having my exams a month ago with VES, and Ebennies still says gathering evidence with the request for C&P's as past due (9-27-15). Just yesterday the dates changed again, to "At this time, your Regional Office is unable to provide an estimated completion date for this type of claim," oh great...going on 9 months now for a re-opened FDC claim turned into normal claim. This is out of Winston Salem RO in case anyone was wondering. I predict that the VA was planning on denying my claim without a C&P when the claim went to preparation for decision, but case review triggered the need for a C&P, and then I surprised them with positive C&P results for increase, then they said "oh sh*t, now we have to actually look into this claim...send it back to gathering evidence!" I would not be surprised to see another 6 months added on top of this claim while the VA does back work on it.
  8. I dont think that will work with VES since it's a 3rd party you have to do a freedom of information request??
  9. Update. Had a MH C&P today by VES, I was so nervous I didn't remember to say everything I needed to say. The examiner said that the last doctor who gave me a C&P last year "did a good job in documenting." I said that they did do a good job at documenting etiology, however I didn't think that they did a good job at documenting the level of disability and that was why I was here at my 2nd C&P for this because I cant work. So the doctor replied that it would be hard to prove increased disability, and that they didn't know exactly what the rating criteria was for a rating in excess of 50%.......So I educated the doctor and showed them that the 50% criteria says panic attacks "3 times a week", when I really have them as the 70% criteria says "near constant," and showed my panic logs from therapy as proof. Then I showed that my agoraphobia and residual safety behaviors etc. are examples of the 70% criteria "obsessional rituals." The doctor said that the previous C&P 50% noted about my being fired from work at home job due to medical reasons, but I said that the 70% criteria advises of problems in "ALL areas," so I also explained social troubles, lake of friends, and problems with my wife. I told the doctor about dropping out of online school and they said "that will be hard to prove," I replied, "all the VA has to do is see the $ I had to pay back for my GI bill for dropping out." I felt like the doctor was not listening, but the doctor did say that they would indeed update my symptoms and "see if the VA will increase me." They never asked about suicidal thoughts, but I did advise of the attempt back in 2006... This was a weird C&P, the doctor wouldn't take any of my documents I brought along either.... This is the first C&P that I've had when the doctor doesn't ask any questions... Anyone else had something like this at VES?
  10. Thanx. I'll help him get his c-file and see what is says exactly then get him a VSO. I just wanted to be sure he could get post 911 GI Bill for now, to get out of this slump.
  11. I think its 20% VA. I think he said since he was still in MOS training, they played a dirty trick and tried to say he had pte-existing knee problems, told him to file with VA asap after getting home in order to rush process him out. I'll have to ask, thanx.
  12. Hello Hadit. A friend of mine from high school and fellow Marine, is going though some tough times, been drinking alot and throwing his life away. I am trying to get him back on track but his situation is very complicated and I cant seem to be able to get any straight answers, so I hope you vets can help! Here is the situation: He was discharged early do to an bad injury to his knees do to falling out of a helo training simulator, resulting in a Honorable Medial Discharge (20% VA rating). He told me he was only eligible for 16 months of MGIB, and has exhausted those funds over 5 years ago. I read somewhere that if you are medically discharged, and found service connected, then you are eligible for the entire post 911 GI Bill of 36 months. I know that the MGIB, regardless of service connection, goes by days in service (16 months in his case), but shouldn't he be able to get the remaining 16 months of the Post 911 GI Bill (16 MGIB+16 P911GIB = 32 months)? I asked around and some people said that if you use up your 36 months of MGIB, then you can get an additional 12 months Post 911 GIB, but what if you didn't qualify for 36 months of MGIB?!?!?! 1.) Would he get 16 months, or just 12 months? 2.) Also, couldn't he still use Voc Rehab until he gets to 48 months in total minus months used in the other two programs? Thank you!
  13. "No job I could ever find would work around that schedule." Look up West At Home LLC & Sykes. All flexible work-at-home job opportunities. These company's were given to me by a VA social worker last year. In my case, I was terminated from one of these work-at-home jobs after being disciplined by the company in which they wrote out that I "was not able to commit to the hours that I chose to pick up do to medical reasons." I had been working with them for a few years and kept on getting in trouble, but was not fired until things got so bad that I couldn't work at all. Thank God I was able to screen shot this and a few other things before I lost access to their system. Anyway, I've heard that many VA Disability Attorneys have access to doctors who they would recommend to fill out a DBQ about your unemployability if your getting nowhere with the VA doctors.
  14. I'm no expert but I have heard that it is harder for Educated professionals to get IU. Does he have proof that he can not work a sedentary job....was he fired from the school? How long has he been out of work? Any disciplinary action taken against him due to his service connected disabilities that you have on file? There is always work from home jobs to, it will be hard to prove he couldn't do such a job unless for instance he is having continuous panic attacks throughout the day, and/or is violent and rude to people, history of quitting jobs etc.
  15. Sooo...back in Febuary of 2015 I filed for IU along with an increase. At the time of filing I did not yet qualify for IU without extra scheduler consideration, however I had been fired from my job December of 2014 for schedual adherance issues related to heath issues (ie my panic disorder). I was working at home for an online company and I was not able to get them to fill out the 21-4192 because they outsourced the filling out of all documents for the company. Folowing advice on these forums, I filled out the form myself along with a printout of my paystubs, screen shot proof of disaplinary action against me for schedual aderance due to "health reasons," screen shot of terminated date, and emails from my employer, signed it "employer refused to sign." My question is would the VA pay me retro from the date of my proof of becoming unemployable (21-4192 and evidence), or will they use the date that I filed for IU even though I did not qualify for it because I was under 70% pending an increase, or will they use the date that I was approved for the increase to 70%, or will they use the date of my C&P where the doctor says I am unemployable? They have schedualed my C&P for this up-comming October 2015...8 months since I filed, and 10 months since I was last able to work. I do plan on bringing this evidence along with me to my C&P this time. Any tips would be appreciated. Thank you!
  16. Grats. Mine jumped from Prep for Decision back to Gathering Evidence this week. Then they changed the estimated completion date another 6 months out... One thing new I noticed was a request from others that was past due.
  17. I realize now that I should have just gone along with the housebound and iu the first time around, but if I did, I might have been living on the streets. I cant help but to think the fact that I turned down those two things at the raters suggestion, that it makes my case look bad, like it's not as bad as it actually is. Anyway, it's not a coincidence that there isn't a 60% rating for mental health. There is 50% and 70% and the fact of the matter is that some people who are rated 50% can not work, and yet do not qualify for IU. Especially in the case of agoraphobia...
  18. I think the first step is to obtain proof that your service connected disability(s) have caused you to be fired/loose your job. Did you get your former employer, and all other employers within the last 5 years to fill out the 21-4192? Even if they refuse to sign it, some people have had success filling them out themselves and certifying that they could not get the employers signature. If you fill it out yourself, I would make sure to attach any proof of disciplinary actions taken against you, printout of days you have called in late/sick-time etc. I think getting the IMO letter will help with an appeal, do not appeal without it. Looks like they already tried reducing you so that you do not qualify for IU without extra scheduler consideration. Appeal the migraines back to 30% so that they can not say that you do not qualify for IU, but 50% + 30% only = 60% by VA math I believe....is there something I'm missing?
  19. I bet this one hasn't been answered yet.... Lets say I want to have a DRO Hearing. I heard that these hearings can be done over computer web-chat. There are a few regional offices out of the USA, and I wonder if the VA will have your video hearing scheduled at one of those overseas offices. For example Manila Philippines. Anyone know? Would you have to somehow let the VA know you have moved so they can transfer your stuff?
  20. The VA did originally put in for housebound but when the rater called me back in December to expedite my claim, I decided not to claim housebound because I am able to go out in the yard, and down certain streets real close by so I thought that didn't' qualify me for it. For me the closer I get away from home the worse I get, especially if it's a new place, if it's new I do not even make an attempt at it...I just didn't feel comfortable applying for housebound since there are people much worse off then me that need it. I also decided to hold off on the IU claim because the rater told me that it would slow the rest of the claim down. Thanks for the reply. I'm not seeking 100% for panic/agora, just 70% and IU because right now there is no way that I can work, I need to stay in therapy and that is hard enough to deal with right now. Well.... I have an outstanding claim for request of reconsideration that is in prep for decision...but I have not had a new c&p, last one was 8 months ago or so...not sure if that is a bad sign or not. Thanx for the comments, it makes me feel better that I might win an appeal if it comes to that.
  21. Yup. I haven't worked for a year, I was fired due to attendance issues because of panic attacks, and breaking out with soars in my mouth due to the stress from my work at home call center job. I gave the va this evidence, but do not qualify for IU without a bump in my rating.
  22. Currently I am awarded 50% for Panic Disorder with Agoraphobia, and GAD. I have read the rating criteria for both the 50% rating, and the 70% rating, and I believe I have a mixture of both. What concerns me is that in the rating criteria's there is no mention of Agoraphobia, only housebound status that pays you more but doesn't increase your rating %. I really think the VA should add Agoraphobia to the 70% rating criteria, because not all Agoraphobics are 100% housebound. VA therapist will come to your house and help you with Agoraphobia, starting with stepping outside your door, then a few feet away, then do the yard, sidewalk etc, after this you are no longer "housebound." This has been the case with me as I am no longer bound to my house, but still meet criteria for Agoraphobia because I will only go so far from home and will not take public transit of any type. Does Agoraphobia help at all to bump up %'s? I think it should! I meet just about everything on the 70%, except current suicidal thoughts, but it is documented in my past that I did have those thoughts...so I'm not sure if that counts at all. How does the VA expect veterans with Agoraphobia to work a job until they are free from it!? The 70% criteria does have: "obsessional rituals which interfere with routine activities"That does sound alot like agoraphobic avoidance...my doctor did write down that this was "seriously affecting my ADL's (activities of daily living)." I would like to hear from anyone who was 50% and got 70%, or was awarded 70% for panic disorder with agoraphobia the first time, and are you working? How did you free yourself? Thanx! And thank you for serving!
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