mtmorical

Hi Everyone! First, thank you to everyone through March and April that helped me through the TKR and temp 100% process! At the advice of many here, my doctors, and my VSO I filed for 2 claims secondary to my right knee. I filed SC for my left knee because the doctors expressed concern over my left knee for a TKR before the right, at that time my right knee was the only condition that was SC'd so I did the right knee and currently I am on temp 100. At the end of April I filed for SC for my left knee and for my lower back, which are the conditions that have been noted by the VA doctor. I had my C&P at the end of May, my VSO says that the C&P notes are favorable to me (good news right)? Today I checked the claim to see where it was at and it says, Pending decision approval, and then in the information needed is says VA medical center by 8/29/16, I looked at upcoming appointments and it shows that there was one appointment requested today 7/30/16. There is no doubt that my left knee is connected to my right, I have compensated on my left for years due to the pain and awkward gait of my right to the point that I have a really bad gait on my left now, and very limited movement without alot of pain, which the examiner was very concerned about. My lower back, my back hurts in what I assume is due to walking so funny because of knees and limits my ability for bending and picking up items. I filed for my dependents to be added and that was completed in May, however at that time the didnt pay me for one month because my son (who's a college student) was on spring break, my VSO went back and forth and finally the rater agreed it should of been paid, so that does show as a pending disability. Could the pending decision approval be for that one month? Although when they were approved and added as a dependents they were not a claim for disability it was a dependent claim and didnt really show up underclaims, and there wasnt away to see the status of that the way there is to see the claim for disability. SO there was no pending decision approval or notification status for dependents at all??? How can I possibly be at pending decision approval with another request for what I am assuming is a C&P? Does this mean that they have decided on one of the conditions and wants more info for another? Is it possible that it will stay in pending decision approval until they receive the 2nd C&P results? Or is it probably in approval for the 1 month they didnt pay me on my dependent?

I spoke with the VA on Thursday night and they indicated that my retro pay Jan-March (cuz VA pays backwards so all month are payable at the end of the month) example; Jan 1 was my effective date and they pay me on the 1st of the next month) is that correct?, they said 1 Retro through March 8320 because I owed them 399.00, and the payment I would get April 29th would be my new 100% 2906.00 minus the 10% 133.17 because claim didnt get approved in time so they couldnt stop it in system that I would be getting my OLD rate of 10% and a 2nd retro payment minus the 10% to 100%. My retro Jan 1 through March 31 came in at 8320 which is is right 2906 x Feb 1, March 1, And April 1, my 10% OLD rating came in 133.17 , but not the payment through April 30th 2906 minus the 133 they could suspend in time. Has anyone had that happen? Is it possible that even though it was approved the same day that it will deposit a different day? Is that common?

I assumed it was because somebody saw something, but I also thought at this point they are not reviewing my claim they are reviewing the work of the rater. Has anyone been told from their VSO that there claim was approved only to have it go back to prep for decision and be denied? I'm wondering also if its the amount of retro that they owe me for that is causing additional signatures?

I'm sorry for all the posts and all the questions, i just dont know where else to turn :( My claim is for temp 100, it was mess and finally the got my cfile they needed, my claim went from GOE to PFD yesterday and the PDA today. I called my rep and he said that it was approved for the temp 100 and that they have my rating change to 30% starting 2-1-17 pending a doc requesting additional time. Then at 5pm tonight my claim went back to prep for decision? Why would it do that? Could it be because the retro is over 10K? Does this mean that my claim is not approved and the person that would approve the rater decision is indicating its an incorrect rating?

Hi everyone! Good news, we finally have our claim approved today! YAY! It was a mess, but we have a great VSO that works closely with the VA raters and was able to get our claim expedited, amidst all the mess, it still worked out! VSO has even filed a secondary claim for his left knee due to his right knee and hopefully he'll be able to get the TKR that is needed on his left knee as well. I have a couple questions: Will the VA process my backpay and my monthly benefit while they are reviewing the dependents we add? Will I at least get the Veteran pay without dependents? Should we wait for that pay prior to adding the dependents? Can I add my mother in-law? She lives with us and has terminal cancer and we provide all care for her in our home. We do have a financial hardship in place for the temp 100% and for the secondary claim as well, will this apply to adding dependents? I have a son that is almost 20 but is attending the same college as I am, is there anything I need to supply aside from his schedule for him to be approved? Rough idea of how long it takes to add dependents? I have my wife, 1 minor child we had together, 2 step children, and 1 child over 18 attending school. Thanks everyone for the help the last few weeks!

Your right, I just know there are other Vets in worse places..... Should I have a VSO do these additional claims?

Thank you for your response! I have looked at cases and seems as though most cases similar the Vet won, there is obvious change in the condition after service which warranted the SC to 10% I have now. That helps me alot to know that. I did also read where there have been cases that the surgery temp 100% was denied because it was caused by factors outside of the SC. If they are saying its because of the ACL surgery then they never should of allowed me to serve because that was in High School. Once my open claim for temp 100% is closed I will add my dependents and I will do a new claim for my increase on my right knee, having my lower back and left knee to be connect to my right knee right? (or do I want til after the covelance period) I dont neccessarily want to "milk" the VA for all the disabilities because they are not disabilities right now, I manage through the pain, and as soon as I can get my doctor to let me go back to work I will. I just want to make sure my basis are covered for future problems.

In another post I had tons of questions regarding my claim and the TKR! Thanks all those who helped! I hope I put this one in the right topic! I was told to go to my VA and get copies of my clinic visits and my surgical reports, which I did yesterday! I have a couple questions/concerns that I fear may make me ineligible. Clinic Notes: Several times it was mentioned that I wanted the TKR on my right knee (fact), I was concerned about this until you get to the clinic note where we met with the surgeon and he stated "Mr XX wants the surgery for fancy word for TKR, given the state of advanced end stage degenerative arthritis, and his young age I agree and that the TKR is the best chance of improvement, Mr XXX will also require TKR on his left knee in near future." Will the fact that I stated I want the TKR become an issue? Also, in the progress notes it states "residuals from previous ACL repair" are they saying that my knee needed a TKR because of the ACL repair? That happened prior to the military and I received a waiver with MRI that showed NO signs of degenerative arthritis or degenerative joint disease. Finally they also did MRI's on my back, and now they are saying I have DJD in that area as well. Can I get that connected to my right knee which is SC? Can I get my left knee SC do to favoring my right knee for so long it affected my walk? Below are some notes about my knee, please let me know any input you have or if you need additional information, I have it all in from of me. Progress Notes: Impression: Residuals from previous ACL repair. Significant increase of degenerative changes involving the right knee complex since 12/2003 (last review) Surgical Notes: Preoperative Diagnosis: 1) Right knee end-stage degerative joing disease. 2) Prior ACL reconstructions, right knee. Same notes for posoperative. Radiology Reports: Large suprapateller effusion progressed since prior MRI, soft tissue of ligamentous injury cannot be excluded.

A few backs it was recommended to get my surgical notes which I did, nothing out of line there, just no estimated date of when I can return to work. However I got the rest of my info, clinic visits and radiology..etc from April 2014 to current in regards to my knee care, pretty surprised when I came across the below on the radiology report: impression / residuals from previous ACL repair , significant increase of degenerative changes invoking the right knee complex since 2003. so are the saying it's due to residuals from an ACL repair?

My ITF is dated 12/21/15 so good there! He's wanting a prior rating decision on my knee from what the recording says. I also looked at the historical claims there are things there I didn't file them so I'm assuming that is when there were issues with VA rates being dropped to 0 and they had to go back and review many those claims. Also, there is a degenerative arthritis rating schedule on the below table. Now I'm concerned I got increased to 10 on error but if you look at the description back in 2002 I fit the 10 def but they dropped me 0 and they back paid it to 2002?

Not too concerned it was in error that they took me to 0, their paperwork stated as much.

I have another stupid question!! i originally did an intent to file, started a claim online, and then read that it's best to have a VSO do it, so that is the way we sent it in. will my date be my intent to file date, claim online date, or the date the VSO sent it in?

It's the info from the 0 to 10 they are waiting on. All I can do is hope. He is a rater trainer and said he had to ensure he trained the person correctly. It was rated when this was discovered. Ugh, hopefully it's faster than I'm fearing

Ok great! Sorry I guess I missed that! this is the first time I've ever had to depend on the VA system and it will be the last!

The only thing they are missing is when they did the increase in 2013 all on their own with no claim or request, and to that fact they back paid me until 2002 when the put me down to 0%

Of course, I understand that. i have no doubt of the evidence, I have degenerative arthritis of the knee that has been in my file prior to leaving service. im just wondering if the VA has access to requesting the hard copies faster than I do?

I know, but they said my paperwork wasn't in the electronic version and they had to request the original, he said he'd try to expedite that, just wondering if it takes them as long as it would if I requested them myself?

Doc indicated at least a year to full recovery. They would do CP prior to docs suggestion of a year? i was 30 when discharged then dropped to 0, then in 2012 the VA started reviewing my file and increased me to 10, no exam, no claim request by me, they just increased it from 0 to 10. i know after the one year mark I will be evaluated to determine rating at that time. i should of been higher than 10, but didn't need to bother with the VA until my knee completely went to shit, hence the TKR and request for temp 100. now he need Cfile for temp 100 request, just trying to figure out how long it will take the actually VA to get it.

Right now I am going on 5 months and seem to be having major ROM issues, the doc has me in a brace and potentially may need another surgery. Had my FDC in since Dec 26th, and I was at notification until today. i know it will take me about 3-4 months but I'm wondering if the VA has faster channels or am I looking at that taking 3-4 months too

I can see in historical claims where they made the increase so they must have that information as well? will the VA be able to obtain these records faster than I can? My understanding is if I request them that will delay my claim further? i know many vets have had longer standing claims, and I am not unsympathetic to that, just my claim affects my family.

My VSO contacted me today when claim for temp 100 on SC TKR went back to gathering of evidence (WTH) he said my claim was ready to approve but that my original determination for the 10% increase was not in Cfile electronically and that Isacc who is a rater trainer is trying to expedite the request for the Cfile. He also said once that is received it will be approved. i read online that can 6months? Will it really take that long for the VA to obtain that? i was original at 30% at discharge then downgraded to 0%, and like posted before the VA reviewed my records and determined me at 10% in 2014 without an exam or me requesting that at all!!! Will that be in my cfile? thanks in advance for help

Well I called today to see if the 1-800 (nothing) would have an info for me since my country service rep isnt even really VSO, they confused me even more, last Weds I went from Gathering of evidence to preparing for decision, then on Friday it went back to Review of evidence (first time at that phase). So I called there today and he said that I am in the decision phase. Even more confused, can someone explain what review of evidence means (i would think that would of been done before going for a decision) why would they tell me its in the decision phase if its in the review of evidence?

Thanks for the reply! my doctor even moved two patients to later dates for surgery because my knee was so bad, plus my wife told them I dropped our then 8month on son and broke his arm and if another damned thing happened because they failed to provide the medical NEEDED and required she would sue. my notes are actually really good, surgery doc stated how he was surprised I manage to function due to severity and also that my other knee is quickly deteriorating which in his opinion is due from over compensating for so many years, TKR needed on L knee within 6-12 months

Good to know, thanks!

Why would it go all the way back to review of evidence? Will they tell me if there's an issue?