SEJones

Berta I hope you are right about the TDIU form. It was attached to the SOC. I hand carried it on 11-4-05. So I hope that it just wasn't considered since I had not applied. But all of my docs thought I should have been a straight 100%. It seems that the VHA and VBA use different codes for illnesses. So they are still bickering about how to code the illness. The VHA wants my illness coded for billing and drug issues and easy of paperwork for the hospital. The VBA is rating out symptoms instead of the unerlying illness. I feel that some how I got short changed but if I get 100% I don't care. Some of the things they rated as symptoms are in my opinion secondary illnesses, like the thyroiditis, and diabetes. i just hope they will back date it to my original application date and make life easier on all of us. Do you think any of these ideas are worth appealing. I just think if I get to the BVA they still will not have a code. Thaks for your support. SE ;)

Did the check arrive? i got mail insurance letter on Monday and the DD on Thursday. The money should be arriving soon. ;)

Good News...it looks like they used the numbers from 2003. But it works out to 4.1 increase after last years COLA.

You were right. The money showed up today. I got the isnurance letter on Monday. Now I guess a break down of what it is for and an award letter will follow. Merry Christmas SE ;)

Thanks to Everyone Bert, Jim, Lady T for all the answers to all the questions. I got paid for someting because there was a VA deposit this morning and I got the insurance letter Monday. Now what percetage its for is a mystery. But for now I am happy that something has been back paid. Looks like it is about 80%. I guess the TDIU is still pending. Again thanks for all the answers to the dumb questions. Lady T thanks for all of your support. Your are phenomenal woman. Your donation is on its way. SE ;)

Jim At my VA there are docs that just do C&P exams. They are seperate from the docs and specialist at the hospital and clinics. I have many very specialized medical issues and have yet to go to a specialist for a C&P. The C&P doc just looks over the records in your c-file and fills out the forms. So if you have evidence form a private doctor include with your application. Good Luck SE

Carlie I have been wondering the same thing. On the bottom of the from 9 for an appeal it says. HEARINGS BEFORE VA REGIONAL OFFICE PERSONNEL: A hearing before VA regional office personnel, instead of before a member of the BVA, is not a BVA hearing. You can request a hearing before VA regional office personnel by writing directly to the regional office... I wrote to tem but I just got the DRO info in the mail. When I called asnd asked about the hearing they reffered me back to the form 9 for teh BVA. I think I am going to have camp out in the VARO to get things straighten out. SE

Thanks John Just confused the 800# said I would stay at 10% until the BVA heard my appeal if I decided to do so. Then I saw a reg that mentioned that during appeals the orignal rating rating will stay .Sec. 19.53 Restriction as to change in payments pending determination of administrative appeals. If an administrative appeal is taken from a review or determination by the agency of original jurisdiction pursuant to Secs. 19.50 and 19.51 of this part, that review or determination may not be used to effect any change in payments until after a decision is made by the Board of Veterans' Appeals. Does this apply if it was just a DRO decision. The first rating was very flawed it was like they typed my name on top of someone elses decsion so I asked for the DRO it went for 10 to 80 on same c-file. Now they say no more money if I appeal? SE

Does the fact that I requested a DRO last year and that is who sent the statement of case, mean that I will remain at 10% not the 80% the DRO decided if I question or appeal any of the issues in the SOC. After reading everytihng that was sent and the regs I found it looks like the only thing left is an appeal to the BVA. Is seems that that may be years and I would stay at 10% until then. If I don't appeal I loose my effective date. IS there another way? Can you NOD the DRO without filing the form 9 and a formal appeal? In other words I need the 80% now eventhough it should have been 100%. I guess I can always hope that they will decide the TDIU quickly. Any chance that will happen before my 60 day time limit. They told me that my 60 days was from 11-1-05. i am just puzzled by the 2 notes of the SOC in the decision section to bring in prove of a hospital vistit in 2003 and to complete the TDIU for for a higher rating. Need Advise. SE

Can "responding" be something other than a formal appeal? Can I add additional info that could/may clarify the concerns of the DRO that has my file. If I do does this cancel my DRO and start the BVA process that I am trying to avoid? Still a little confused SE

;) I received a SOC dated 11-1-05 from the DRO. It said Decision increased from 10% to 80%. As I said in the other post, there was much information attached about my rights to appeal to BVA and to file a form 9 within 60 days. There was also a TDIU form attached with a "note" stating that if I signed it would be considered "quickly." Yesterday I call the 800# and am told that I never accepted the SOC and that I needed to do something. What was not answered. Is this 800# BS or is there a step I MISSED? I went to the VARO the day after I received the letter and did file the tdiu form with supporting docs. I had the same job for 15 years and was terminated after exausting all sick leave and benefits after becoming too ill to work. The DRO had to know this since the court record was in my c-file about not being able to keep job longer to keep benefits and the 2001 SSDI award letter. (yes all about the same 1 s/c condition) Is there a step I missed? If I did how long to I have to correct it? My treating private docs and one VA doc are writing letters on my behalf to errors in the SOC. I thought I might need them just incase they decline my TDIU. You all said be ready for anything from the VA, including a deline on a perfect claim. So Berta I have my ammo but still don't know where the enemy is hiding. There are never any names on these letters. Will the DRO process the TDIU since he/she has my file "on their desk" or is it just like any new claim. Running out of time SE

Jim That would be it. It is considered and autoimmune disease that then cause other autoimmune disorders. The problem we have had is not getting it s/c but with getting a rating afterwards. As far as what the VA is suppose to do about undiagnosed illnesses didn't work form me. Most dismissed it as all in my head. Well now they know it is. In my head, lungs, thyroid and it keeps going. And just in case you googled the old artilce that says it doesn't cause many problems, that is in children. Most adults need chemo and then it still keeps coming back. Some of the vets were even diagnosed in service and then were never told. This time I don't think they were trying to hide anything but just blew it off because they didn't know what it was. So the lab finds out but the doc never tells the patient because it wasn't the answer they were looking for. SE

Thanks Everyone I have copied some of the notes and given them to my doctor. I have already fought this same issue in Federal court. What is all seems to come down to each time. They have never heard of SHML therefore it cannot cause this many problems. It is so rare that you don't find a doc that has seen more than one. But my doc as been dealing with me for 10 years. The Nexus letter for my initial claim was written by the doc that is credited with discovering the disease. So I plan to keep fighting until 100% P&T or dead! Gulf War vets with a diagnosis of chronic fatigue and swollen joints, and changes on MRI should get tested. We have a disporportionate number of vets in my shml support group. ALL had been mis diagnosed for years. Many were thought to have MS that didn't quite fit standard quidelines and a host of other problems. Does anyone know how to get a new disorder added to the REGs? We have been working on gettingit added to the blue book for SSDI. But I don't seem any process for the VA. Congress maybe? SE

Berta and John I met I went from 10% to 80% WITHOUT adding new evidence. My file is with the DRO This is why the SO thinks that I could get 100% back to 2003. Is this possible? Berta yes the SSDI is for the same (only one) condtion. The problem is the condtion is not in the regs. So I got caught up in them trying to rate its symptoms. My private doc is willing to wirte a letter to get some of the other symptoms s/c. I just need to know what format he should use. The VA has never treated or seen anyone with my condtion. The C&P examiner just googled my diagnosis during the meeting so ALOT was missed. SE

Is there a form or an outline of what my doctor must say in a letter to get secondary condtions s/c? He is willing to write it but only once. So I need to get everything in the first time. SE

John No there is no metion of a denial of tdiu. Just a note at the end of the SOC stating that I could apply and if I submit evidence of the last day I worked it would be processed more quickly. Oh and that I had a year from the date of the letter. The SO said they were holding my file waiting for the form. SE

Thanks I did go and apply for the TDIU. My SO said it should go back to my application date and that it only takes a few weeks to process and collect the back pay. Is this true? It took 18 months to get my DRO which took me form 10% to 80% with adding any new evidence. Go figure. Should I get ready for a long wait? My SO did not even know that I had a decision and he is across the hall form the VARO. He said I got a SOC and not an award and that they were waiting for the TDIU form to complete the award and imput to the computer. Does that sound right? SE ;)

Well all I finally heard form the VA. The good news is they increased the rating the bad is I don't understand this 25 page letter. So I applied for ONE condition (SHML) and was awarded s/c. Then the problems started because there is no rating for the disorder. So a 2 year fight over what to call it that did have a rating. I thought since it is one disease that I would get the benefit of regular math not VA math. I was wrong. So here is how they broke it out to follow. They also denied several manisfistations of the disease. So should I appeal or just fill out the TDIU form. They did comment that they know that I have been on SSDI for same condtion since 2001. The SSDI award letter was part of my original claim in 2003. They said they could process the TDIU quickly. Should it go back to 2003 orignal claim date? Thyroid 30 diabetes Inspidus 20 pulmonary fibrosis 10 surgery scar 10 Total 60% for 2003 Migraines 50 as of 2005 Total 80% It seems that even if I win I will never get to 100% the way the math works eventhough they acknowledeged that this is one disease. All comments welcome and needed Thanks SE ;)

Jim I went through my SSDI review in May. They sent a form and asked some questions about hoplizations and if my condition had improved. I filled out the form and sent them a copy of the C&P report. I got a letter in about 6 weeks says they would contact me in 3 years. That makes 2 reviews for SSDI while that VA is still waitng to make up their mind if I. am disabled. Social Secuirty just needs something to put in their files sinc it is required by law that they check on you form time to time. B)

I heard on the news this moring. This is great and don't forget that it applies to SS and SSDI also. :( :( :( :( B)

The CPI is not due for a week yet. Social security and VA comp is usually based on the CPI. SE

The consult that was rejected is in my medical file so I got a copy of it. It says "Consult Veterans SC 50% or greater must be scheduled w/in 30 days. Patient is SC less than 50%" then is has a section about the code that was given but does not list the disease. Then "this consult will be cancelled" and it was. so my question is should I fight with the VA to give me codes for every single issue. I see the problem as besides that there is a long wait for care is that they are only setting appointments based on the codes and not the illness. After I saw the doctor at the other hospital he agreed that I should have been a priority because my illness does have a nuerolgoical component. But if they don't take the word of there own docs and don't read the file? What is left? I cannot seem to get around the schedulers who think they now more about diseases than the doctors. Thanks for all the input!! :( SE

Jim I had a complete neuro work up at a private hospital that the VA picked. I had an EEG..slowing left temp lobe. 2 tumors on the MRI and problems with the neuro-psyc testing all done by Neurologist and other MDs. Well then they sent me to the "C&P" general practice doc who said she didn't agree. She just looked at me from across the desk. In her report she said the doctor was not cabable of giving his opinion. This doc was the Chief of Neurology at one of the top 10 hospitals in the country. Needless to say I filed a NOD but it seems that they will do anything they want. And the condtion that caused these problems is already S/C. SE

My C&P for lung disease lasted abou 6 hours.. PFTs cardio-pulmonary testing, blood test, chest x-ray plus sent back for a PET scan to see if anyhing was active. It was a long day. So relax

I am s/c at 10% awaiting DRO decision for 100%. My question is how does the ratings affect medical care by specialist? I thought I was entitled to care at the VA for my s/c condition but when the Dr. I saw at the VA sent in the referral for Neurology it was sent back because they were busy and I was not a priority unless I was at least 50%. So I had to use my medicare to see the same doc at another hospital. My 10% condtions covers muitliple body parts/functions. Do I need to fight to have a code for each body part? There is no VA code for the condtion so my SO and VA doc requested that they use one for Lupus or Leukemia and rate is as 100%. It is currently at "the rating desk" where is has been for 1 year. I also contacted my Senator and Govenor all contacted the VARO. Thanks for any and all help. SE