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ArmChairRanger
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Posts posted by ArmChairRanger
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On 7/28/2020 at 3:41 PM, Tbird said:
@Ztmiller8 Congratulations.
thank you
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My current VA rating for veteran w/spouse is being paid SMC L1 since 2018.
Last month I won my BVA appeal for CRPS both upper extremities but my rating did not change.
The board granted the appeal but sent it back to the Houston RO to rate.
Should I be rated "R" for having two separate L1 ratings or do you think I should be rated higher (at least O)?
Can you become an HadIt patron with a 1 time donation? Be happy too.
Current rated disabilities:
L1 - Loss of use both feet rated on 8/24/2020 effective date 1/26/2018 (7-foot surgeries resulting in permanent use of mobility devices)
L1 - (A&A) permanent need for Aid and Attendance rated on 8/24/2020 effective date 8/21/2019 (on account of being so helpless due to complex regional pain syndrome & lumbar degenerative arthritis with intervertebral disc syndrome)
100% - 8/24/2020 effective date 1/26/2018 loss of use of both feet
30% - 4/10/2014 lumbar degenerative arthritis with intervertebral disc syndrome
(CRPS in all four extremities)
20% - 06/05/2015 complex regional pain syndrome left upper extremity
30% - 02/05/2020 complex regional pain syndrome right upper extremity
20% - 04/10/2014 left lower extremity complex regional pain syndrome with tibial nerve impairment
20% - 04/10/2014 right lower extremity posterior complex regional pain syndrome with tibial nerve impairment
10% - 10/09/2014 tinnitus
00% - 10/09/2014 bilateral hearing loss
20% - 05/25/2016 left ankle tendonitis and chronic regional pain syndrome
20% - 05/25/2016 right ankle tendonitis
10% - 04/12/2012 scar, s/p right plantar fasciectomy, thigh graph, fibromatosis
20% - 04/12/2012 scars, s/p left plantar fasciectomy, thigh graph, fibromatosis
10% - 04/12/2012 s/p left plantar fasciectomy, thigh graph, fibromatosis (now rated as bilateral)
thank you,
Steve
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I called the VA 800 number yesterday and they said my higher level review was complete Friday April 18 and the VA mailed my decision Monday April 20. They would have to be working to make a decision:)
That said, VA.gov still shows the case open and ebenefits refers you to VA.gov. Not sure how often VA.gov gets updated. Perhaps brokensoldier244 may have insight to that process?
Many thanks to the raters and other team members that are working through COVID-19.
Be safe!
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Seems to be a lot of confusion about SMC awards. I have been rated SMC L for loss of use both feet for three years. I received a second SMC L for Aid & Attendance a couple of months ago.
My rating did not increase. When I called the 800 number the person who answered was real nice. He said the VA rater checked the box for SMC S (instead of L) housebound therefore my rating did not increase.
He preceded to tell me he would send an email to someone to correct my rating but I am still waiting. He said to the best of his knowledge I should be rated either "O" or "R1". Guessing the wheels move slower during the holidays.
Any advice or thoughts? Does this sound correct?
Thank you in advance.
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See attached questionnaire from my Independent Living assessment done at our home this year. Has good information for items and home improvements you can request.
He did ask us to go online and send him screen shots of any specific items we would like to have. This helped the VA to provide exactly what we needed by taking the guess work out. The VR&E provided us an adjustable split king size bed. Most other items are pretty much general but helpful: shoe horn, wash brush, ring doorbell, iRobot, etc.
Good luck and hope all goes well.
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I am currently rated SMC (L-1) Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (l) and 38 CFR 3.350(b) on account of loss of use of both feet from 01/2018.
I had submitted a claim for sleep apnea based on weigh gain and submitted an examination for permanent need for aid and attendance to show that I could not exercise properly. The sleep apnea claim was denied but the VA approved a second SMC (L-1) Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (l) and 38 CFR 3.350(b) on account of being so helpless as to be in need of regular aid and attendance from 08/2019.
Do you have to submit a claim for additional SMC based on the new rating or should that be automatic?
Found this information on asknod.org.
The easiest way to get to R1 is the most obvious- §3.350(e)(1)(ii). You start at SMC L. If you are entitled to Aid and attendance, you are awarded SMC L #1. If you also lose the use of both your upper or lower extremities, or an upper and a lower extremity, you get another SMC L- #2. Two SMC Ls or any combination of of two Ls, Ms, or Ns gives you a bump to SMC O. SMC N ½ with a K will too. But-here comes the legal pyramiding- if you have two of any of the rates between L and N, with no condition being counted twice, and one of the ratings is for Aid and Attendance, you advance to SMC R 1 automatically.
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Hi ArmChairRanger,
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Thanks
Tbird/VA Disability Compensation Benefits Forums - HadIt.com Veterans
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Thanks for the reply Berta, appreciate all that you do!
When they awarded ths 100% did they-at that time- consider you for SMC S? No
What Diagnostic code did they give you for the bi lateral pes planus? Code 5276 - B/L Pronounced
Was that more recent surgery done prior to this C & P exam? Yes, One surgery on each foot mid 2017 to remove multiple large fibromas
CRPS - http://www.rsdhope.org/what-is-crps1.html is rated as left & right lower extremity complex regional pain syndrome B/L
Did you get a C & P exam for this- VA Form 21-0960F-1,( the scars)?Yes: Scars are rated as: scars, s/p left plantar fasciectomy, thigh graph, fibromatosis (right and left) From C&P form 21-0960: 3. Scars Functional impact
Does the Veteran's scar(s) (regardless of location) or disfigurement of the head, face, or neck impact his or her ability to work? Yes Impact of the Veteran's scar(s) (regardless of location) or disfigurement of the head, face, or neck, providing one or more examples: VERY LIMITED AMBULATION, CONNOT WORK
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Hello all, Great site and I have learned a lot for reading. Thank you all.
Any thoughts on deciphering my C&P exam? I am 100% P&T. I am already service connected 50% for b/l flat foot & 40% CRPS but had additional operations last year that further worsened my issues. To get around now I use a VA prescribed wheelchair and 3 wheeled electric scooter.
Is this DBQ being completed in conjunction with a VA 21-2507, C&P
Examination
Request?
[X] Yes [ ] No
ACE and Evidence Review
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Indicate method used to obtain medical information to complete this
document:
[X] In-person examination
Evidence Review
Evidence reviewed (check all that apply): [X] Not requested
1. Diagnosis
a. List the claimed condition(s) that pertain to this DBQ:
FEET
b. Select diagnoses associated with the claimed condition(s): [X] Flat foot (pes planus)
ICD code: 00000000000
Side affected: Both
Date of diagnosis: Right: HISTORICAL
Date of diagnosis: Left: HISTORICAL
[X] Plantar fasciitis
ICD Code: 00000000
Side affected: Both
Date of diagnosis: Right HISTORICAL
Date of diagnosis: Left HISTORICAL
[X] Arthritic conditions
[X] Arthritis, degenerative
ICD Code: 0000000000
Side affected: Both
Date of diagnosis: Right HISTORICAL
Date of diagnosis: Left HISTORICAL
c. Comments (if any):
No response provided
d. Was an opinion requested about this condition (internal VA only)? [ ] Yes [X] No [ ] N/A
2. Medical history
a. Describe the history (including onset and course) of the Veteran's
foot
condition (brief summary):
veteran was seen and treated for arch pain on multiple occasions in service with many different diagnoses. he received steroid injections into arches and several occasions. after service veteran continued with foot
pain and saw several doctors. This progressed to large painful nodules in his arches. the tumors were so large and invasive that he required excision of the overlying skin as well. skin grafts from anterior thighs to cover the defects. he uses custom shoes and inserts with minimal relief. Uses cane as well. walks on lateral side of his feet. can not place foot flat on floor without increased pain. First surgery and second on left foot was 2005. later 2005 on right foot. op reports and photos were reviewed by me. If veteran walks on sole of feet he gets a tearing type pain in his arches. no stairs or ladders. limited walking. has bench at work to elevate his feet. pain requires narcotic pain meds, muscle relaxers and gabapentin for nerve pain and burning in soles. pin and needle sensation both feet worse at night. painful to wear shoes even with insoles. minimal standing
or walking. feet wake him at night. veteran does have mild pes planus, Not associated with current condition. Since the surgeries he has had recurrence of the tumors in both feet. Lederhosen disease to the
bilateral feet, as well as complex regional pain syndrome, presents to clinic today for re-evaluation of
his foot fibromas. Has significant pain to his feet when walking. Noted to have had 3 debridements to the left foot and 1 to the right, as well as skin grafting bilaterally. Has had 4 previous orthotics, which do not provide relief. Has been to pain management and plastics clinic.
Bilateral feet
- Multiple fibromas to the feet bilaterally, with tender nodules
- Skin graft of the feet noted bilaterally
MRI DATED 4/28/17 INDICATED HE CURRENTLY HAS FIBROUS TUMORS BILATERALLY. HE HAS GROSELY ABNORMAL GAIT DUE TO PAIN.
b. Does the Veteran report pain of the foot being evaluated on this DBQ? [X] Yes [ ] No
If yes, document the Veteran's description of pain in his or her words:
SEE ABOVE
c. Does the Veteran report that flare-ups impact the function of the foot? [ ] Yes [X] No
d. Does the Veteran report having any functional loss or functional impairment of the foot being evaluated on this DBQ (regardless of repetitive use)?
[X] Yes [ ] No
If yes, document the Veteran's description of functional loss or functional impairment in his or her own words:
SEE HISTORY.
3. Flatfoot (pes planus)
------------------------
a. Does the Veteran have pain on use of the feet? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both
If yes, is the pain accentuated on use? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both
b. Does the Veteran have pain on manipulation of the feet? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both
If yes, is the pain accentuated on manipulation? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both c. Is there indication of swelling on use? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both
d. Does the Veteran have characteristic callouses? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both
e. Effects of use of arch supports, built-up shoes or orthotics:
Tried But Remains Symptomatic
Device Side Not Relieved:
[X] Orthotics [ ] Right [ ] Left [X] Both
f. Does the Veteran have extreme tenderness of plantar surfaces on one or both
feet? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both
Is the tenderness improved by orthopedic shoes or appliances? RIGHT - [ ] Yes [X] No [ ] N/A
LEFT - [ ] Yes [X] No [ ] N/A
g. Does the Veteran have decreased longitudinal arch height of one or both feet
on weight-bearing? [ ] Yes [X] No
h. Is there objective evidence of marked deformity of one or both feet
(pronation, abduction etc.)? [ ] Yes [X] No
i. Is there marked pronation of one or both feet? [ ] Yes [X] No
j. For one or both feet, does the weight-bearing line fall over or medial to the great toe? [ ] Yes [X] No
k. Is there a lower extremity deformity other than pes planus, causing alteration of the weight-bearing line? [ ] Yes [X] No
l. Does the Veteran have "inward" bowing of the Achilles tendon
(i.e., hindfoot
valgus, with lateral deviation of the heel) of one or both feet?
[ ] Yes [X] No
m. Does the Veteran have marked inward displacement and severe spasm of the
Achilles t
endon (rigid hindfoot) on manipulation of one or both feet?
[ ] Yes [X] No
n. Comments: No comments provided
11. Surgical procedures
a. Has the Veteran had foot surgery (arthroscopic or open)?
[X] Yes [ ] No
If yes, indicate side affected, type of procedure and date of surgery: [X] Right foot procedure: SEE HISTORY
Date of surgery:
[X] Left foot procedure: SEE HISTORY Date of surgery:
b. Does the Veteran have any residual signs or symptoms due to arthroscopic or other foot surgery?
[X] Yes [ ] No
If yes, describe residuals: SEE HISTORY
12. Pain
RIGHT FOOT:
Is there pain on physical exam? [X] Yes [ ] No
If yes, (there is pain on physical exam), does the pain contribute to functional loss?
[X] Yes [ ] No
(Further description of limitations requested in Section XIII below.)
LEFT FOOT:
Is there pain on physical exam? [X] Yes [ ] No
If yes, (there is pain on physical exam), does the pain contribute to functional loss?
[X] Yes [ ] No
(Further description of limitations requested in Section XIII below.)
13. Functional loss and limitation of motion
a. Contributing factors of disability (check all that apply and indicate side
affected):
[X] Weakened movement (due to muscle injury, disease or injury of peripheral
nerves, divided or lengthened tendons, etc.) Side affected: [ ] Right [ ] Left [X] Both
[X] Excess fatigability
Side affected: [ ] Right [ ] Left [X] Both
[X] Incoordination, impaired ability to execute skilled movements smoothly
Side affected: [ ] Right [ ] Left [X] Both
[X] Pain on movement
Side affected: [ ] Right [ ] Left [X] Both
[X] Pain on weight-bearing
Side affected: [ ] Right [ ] Left [X] Both
[X] Pain on non weight-bearing
Side affected: [ ] Right [ ] Left [X] Both
[X] Swelling
Side affected: [ ] Right [ ] Left [X] Both
[X] Instability of station
Side affected: [ ] Right [ ] Left [X] Both
[X] Disturbance of locomotion
Side affected: [ ] Right [ ] Left [X] Both
[X] Interference with standing
Side affected: [ ] Right [ ] Left [X] Both
[X] Lack of endurance
Side affected: [ ] Right [ ] Left [X] Both
Contributing factors of disability associated with limitation of motion:
b. Is there pain, weakness, fatigability, or incoordination that significantly limits functional ability during flare-ups or when the foot is used repeatedly over a period of time?
RIGHT FOOT: [ ] Yes [X] No
LEFT FOOT: [ ] Yes [X] No
c. Is there any other functional loss during flare-ups or when the foot is used
repeatedly over a period of time?
RIGHT FOOT: [ ] Yes [X] No
LEFT FOOT: [ ] Yes [X] No
14. Other pertinent physical findings, complications, conditions, signs, symptoms and scars
a. Does the Veteran have any other pertinent physical findings, complications,
conditions, signs or symptoms related to any conditions listed in the
Diagnosis section above?
[X] Yes [ ] No
If yes, describe (brief summary): SEE HISTORY
b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis section above?
[X] Yes [ ] No
If yes, are any of these scars painful or unstable; have a total area
equal to or greater than 39 square cm (6 square inches); or are located
on the head, face or neck? (An "unstable scar" is one where,
for any
reason, there is frequent loss of covering of the skin over the scar.)
[X] Yes [ ] No
If yes, also complete VA Form 21-0960F-1, Scars/Disfigurement c. Comments: No comments provided
15. Assistive devices
a. Does the Veteran use any assistive devices as a normal mode of locomotion,
although occasional locomotion by other methods may be possible?
[X] Yes [ ] No
If yes, identify assistive devices used (check all that apply and indicate frequency):
Assistive Device: Frequency of use:
[X] Wheelchair [ ] Occasional [ ] Regular [X] Constant
[X] Walker [ ] Occasional [ ] Regular [X] Constant
[X] Other: SCOOTER [ ] Occasional [ ] Regular [X] Constant
b. If the Veteran uses any assistive devices, specify the condition and identify the assistive device used for each condition:
FEET
16. Remaining effective function of the extremities
Due to the Veteran's foot condition, is there functional impairment of an
extremity such that no effective function remains other than that which would
be equally well served by an amputation with prosthesis? (Functions of the
upper extremity include grasping, manipulation, etc., while functions for the
lower extremity include balance and propulsion, etc.)
[X] Yes, functioning is so diminished that amputation with prosthesis would equally serve the Veteran.
[ ] No
If yes, indicate extremities for which this applies: [X] Right lower
[X] Left lower
For each checked extremity, describe loss of effective function, identify the condition causing loss of function, and provide specific examples (brief summary):
SEE HISTORY
17. Diagnostic testing
a. Have imaging studies of the foot been performed and are the results
available?
[X] Yes [ ] No
If yes, is degenerative or traumatic arthritis documented? [X] Yes [ ] No
If yes, indicate foot: [ ] Right [ ] Left [X] Both
b. Are there any other significant diagnostic test findings or results? [ ] Yes [X] No
c. If any test results are other than normal, indicate relationship of abnormal
findings to diagnosed condition: No response provided
18. Functional impact
Regardless of the Veteran's current employment status, do the
condition(s)
listed in the Diagnosis section impact his or her ability to perform any type
of occupational task (such as standing, walking, lifting, sitting, etc.)?
[X] Yes [ ] No
If yes, describe the functional impact of each condition, providing one or more examples:
HE IS UNABLE TO WORK
thank you!
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Mine changed to this week, your Regional Office is unable to provide an estimated completion date for this type of claim. My est. completion time was 11/4/15 to 11/28/15. FDC too. Two contentions, hearing loss and tinnitus claim. The QTC C&P was on 9/8/2015 and the claim went to "Prep for Decision" a couple of days later. Ebenies showed new VBMS filed on 9/21/2015 which the VSO told me was the date the C&P was scanned into the system. He sent me a copy of the C&P stating the magic words "as least likely as not (50% or better) for both contentions. So guessing they have made a decision and my claim will finish processing soon. Best of luck and God bless.
am i eligible for SMC-L and how do I apply?
in SMC L and L 1/2
Posted
You need to have your doctor fill out VA form 21-2680 (EXAMINATION FOR HOUSEBOUND STATUS OR PERMANENT NEED FOR REGULAR AID AND ATTENDANCE) and file a claim. see link: VA Form 21-2680.
If approved you will receive SMC "S" or "L"
S is for housebound and L is for A&A
Best wishes