[How does the VA define "loss of use"?]

 

I have service connected disabilities involving my lower extremities which result in my being unable to perform normal weight bearing activities.

All weight bearing increases my pain level to the point I am forced to restrict myself to the point where I am confined to the house most of the time.

Sometimes when I have flare ups of pain, I CAN'T walk.

My quality of life has been severely impacted as a result.

[Appeal timeline]

The Board provided me with a virtual hearing in front of a VLJ in January 2021.

Still waiting on the VLJ to render a decision.

[New BVA Grants]

UPDATE :

The BVA awarded service connection @ 0% rating in October, 2020, and ordered the VARO to perform a new C&P exam to determine my current level of disability for my pes planus and related foot/ankle disorders.

I received the C&P exam in 2020 shortly after the BVA ordered one.

However no new rating for these disabilities has been forthcoming.

Now here it is May 23, 2021 and I still have the same 0% rating, with no new rating decision by the VARO.

The VA knows that an increased rating for my feet/ankles will allow an EED for my SMC-S.

But anyway..no movement still.

 

[Uploading evidence to bva]

Wish I knew.

Had a hearing with VLJ a month ago.

I just faxed six pages of new and relevant medical evidence to the Board pertaining to a service connected condition.

I received an inadequate C&P exam from a remand BEFORE I submitted this new evidence which will directly contradict the examiner's assessment of the level of severity of my disability.

I prefer to let the VA play their cards with poorly performed  C&P exams and then submit new medical evidence to rebut their exams.

I allow the VA plenty of opportunity to go on the record first and always rebut their bad exams with new medical evidence.

VA's Duty To Assist isn't exactly followed as Congress intended.

 

Will the Board allow my evidence any weight?

Who knows?

If they don't, I will have a good chance of winning at the CAVC.

 

I have some matters currently before the Board and some at the CAVC.

Seems to me the Board weighs the evidence more to disprove and undervalue disability ratings.

 

If they screw this one up, it too will go to the CAVC.

[Can I file a claim for my out of pocket expenses for medical care performed by outside medical providers for my service connected disabilities?]

 

I'm service connected, and rated for bilateral ankles and feet disabilities.

I use outside care for treating these disabilities.

I was prescribed Richie braces(custom orthotics).

My private insurance co-pay is about $250.00 for these orthotics.

I don't have a VA PCP.

Will the VA reimburse the cost of these prosthetics?

Sorry for all the confusion.

[Can I file a claim for my out of pocket expenses for medical care performed by outside medical providers for my service connected disabilities?]

 If yes, can someone provide a link, or information on how to proceed?

The deductibles I'm paying have placed a financial burden on my family.

Thanks for helping.

 

[Did you get a bogus C & P exam?]

Yes, my latest C&P exam is chock full of lies.

 

When they LIE, they'll DENY(or low ball).

 

I'm currently rated at 0% for bilateral pes planus and 0% for bilateral sinus tarsi disabilities.

 

These separate conditions were recently service connected by the BVA and remanded for a C&P exam.

 

I can barely walk due to all the pain and try to stay off my feet.

 

I can't wear any closed-in shoe(good thing that I live in a subtropical climate) because my feet and ankles both swell and are too tender for shoes.

 

So, I wear Spenco orthotic flip flops.

 

Claims file records show I've had extensive diagnostic imaging, to include MRI and X-Ray, feet and ankles.

 

Claims file record shows I have been followed by podiatry, orthopedist, and PCP for several years now for my feet and ankle disabilities. 

 

Claims file record shows I have been prescribed a cane and Sweedo ankle braces for instability.

 

Claims file record shows I have been prescribed oral steroids, corticosteroid injections, and arch supports.

 

Claims file records show that due to the severity of my condition, I have failed conservative podiatry care, and was referred for reconstructive surgery.

 

As long as I draw breath, I'll never quit fighting for the benefits I have earned, and entitled to receive.

 

 

[Unfavorable Decision]

 

Often the VA evaluates similar disabilities(symptomology) under a particular diagnostic code even if they change the ICD-10 diagnosis.

What were the VA diagnostic code(s) you were rated under from the original, and the later decision?

[VA Violated U.S.C. 7104(b) (Combining Disabilities Error)]

The "why" is obvious to me.

[VA Violated U.S.C. 7104(b) (Combining Disabilities Error)]

I recently got a remand from the Board for scars 0% rating.

 

The Board ordered a new C&P exam. 

 

The RO increased my rating from 0% to 30% for scars(or so I thought), and granted SMC-S as a result this increased rating.

 

The RO implemented an incorrect effective date for the SMC-S.

 

It was difficult for me to determine the RO's effective date methodology but I didn't think that the effective date awarded went back far enough.

 

Then I found that in their decision, the RO unlawfully combined two separately rated disabilities(scars 0%, acne 10%),into one(scars with acne 30% ).

 

A 30% rating increase should have been awarded for the scar disability as the scar exam indicated two elements of disfigurement.

 

My acne disability 10% rating has been in effect for five years or more, and it had never been appealed.

 

The RO Due Process of Law violation has resulted in a loss of 15 months of retroactive benefits and has resulted in yet another appeal being filed.

 

See Boggs v. Peake, Mar. 26, 2008 520 F. 3d, 1330 which in essence, prohibits the combining of two distinctly separate claims into one.

 

I filed a new appeal yesterday with the Board on their Direct Review docket.

 

Any guess as to how long it will take for the Board to render a decision?

[SMC-S1 AWARDED, 1/21/2021]

I learned that the effective date the VA granted on my SMC-S1 will short change me for around 15 months of my increase in benefits.

I refuse to donate almost $5000 dollars of my benefits to an organization that can't perform simple mathematics.

I will appeal directly to the BVA for an earlier effective date.

The VA awarded an effective date that begins 10/17 when it should be 7/16.

I already have everything ready to submit and am just waiting on the decision letter to arrive in my mailbox just in case I need to tweak my appeal a bit.

If the BVA does make a wrongful denial, I can appeal it to the CAVC in a shorter time frame and not have to pay attorneys fees(again).

The St. Petersburg Regional Office might even be just a little disappointed that I have decided to bypass their hamster wheel.

Probably not really true...who knows, but sometimes the dirty dealing by VBA employees that refuse to follow the CFRs makes denials feel like personal attacks.

[SMC-S1 AWARDED, 1/21/2021]

John999...I'm fighting at the CAVC for  a recent BVA denial for service connection of Meniere's Syndrome.

It is a high value claim with my symptoms equivalent to a 60% rating.

 

[SMC-S1 AWARDED, 1/21/2021]

No attorney representation entitles me to 100% of retro award.

Thanks for teaching me to fight and never quit.

Now I'm waiting on my direct deposit retro for almost four years with the increase to SMC-S1  from 100%.

I have a docket # for my appeal at the CAVC, but no more money for me is involved when my attorney wins that.

 

[VA SOCIAL WORKER WRITING MISLEADING INFORMATION IN MYVAHEALTH]

Avoid the VA medical system if you have disability claims.

Find a private MH provider that you can trust.

 

 

[Short note: It looks like I won, was told it is %100 P&T with special compensation added.]

 

So happy you beat the machine(VA).

[question about rating accuracy]

You need to slow down and do some serious thinking before making that decision.

Disability is a tricky matter especially when it comes to mental health, and physical health.

Health can be like one step forward, then suddenly it can go two steps back on some conditions that are unstable.

Flare ups are common, and many conditions are chronic, and some conditions progressively worsen with age.

I wish you the best on whatever decision you make.

[VAMC APPOINTMENTS BEING CANCELED?]

Yes.

I  recently had an appointment cancellation notice sent to me from a local VA clinic.

[Requested Increase, and they removed my Service Connection!]

Might as well throw my two cents in as this topic was too temping to resist.

 

I filed for an increase around four years ago on multiple service connected conditions.

The VARO had a necktie party awaiting me by sending me to a general C&P exam.

I had no idea what a " general " C&P exam even meant ???

Come to find out the VARO ordered this examiner to re-evaluate ALL of my service connected conditions, NOT just the ones I was asking increases for.

Her re-evaluations recommended reductions and also severance of my service connected conditions across the board(excluding mental health).

 

One of the conditions I  filed an increase for was for facial scars, which was rated at 10%.

I said to her nonchalantly, "By the way, would you please take a look at this one little scar on my face.?"

I asked, " Do you see how it sinks in when it is pressed upon?"

She said yes.

Next I asked, "Would you please measure it ?"

She said my scar measured 1.5 CM.

I asked, " Will you note these two things on the DBQ that you are completing?"

She said yes.

 

Those two seemingly insignificant facial scar characteristics qualified for a jump to a 30% rating.

Nobody could ever convince me that had she known the 8 characteristics of scar ratings, she "more likely than not" would not have noted those and performed an inadequate C&P exam.

To make a long story short, the VARO was notified I met the criteria for the increase to 30% based upon the new C&P DBQ scar characteristics.

 

Here comes the twist.

The VARO ignored the above-styled new evidence and continued with the 10% rating with not offering so much as a mention of that C&P exam in their decision letter.

 

Back on the hamster wheel I'm thrown...so I wait in line a few more years till my appeal gets in front of the decision makers at the BVA.

Now you're thinking, he's got this one in the bag, right?

Well...anyway, common sense made me think I did.

 

Not so fast, Jack.

Hold.... your horses.

 

I didn't get an increase to 30%.

More fun is yet to be had.

This must be really complicated stuff, right?

 

The BVA kicked my appeal back to the VARO with a remand.

 

I don't have the new BVA decision letter as of now but I'm predicting it will contain some strange rationales that would "more likely than not" drive the logical Vulcan, Mr. Spock, insane, based upon the lack of logic thereof.

Don't give up the fight even when things make no sense.

Live long, and prosper, you guys!

[New BVA Grants]

The diagnostic codes on the three granted appeals are 5271, 5277, and 5284.

Also, the Board remanded an appeal for scars currently rated at 10%. 

The Board denied several more conditions.

I'm hoping that the VA will award me enough rating % so I will qualify for SMC-S.

I'll probably drop my other appeals if they do. 

I just want to live my life without anymore VA at this point.

 

[New BVA Grants]

The Board just granted left and right sinus tarsi syndrome, osteoarthritis of ankles, and bilateral pes planus.

What are the sinus tarsi syndrome rating percentages?

Waiting on the decision letter.

[Letter from Former Employer?]

I recommend that you obtain a vocational evaluation from a doctor qualified in legal medicine.

Watch Dr. John Ellis'(Ellis Clinic) presentation on Youtube.

After getting his IME, file for the increase.

Keep your award money in your own pocket.

If your claim for increase is denied, THEN hire an attorney.

 

[Another Grant. Again, use an IMO]

This site is AMAZING.

So much information shared by those who have gone before us.

Some members remain to voluntarily help other vets learn the complex VA disability process.

[Meniere's - A Better claim as primary or secondary?]

Marineleo, just file your MD claim and like Broncovet stated, let the VA sort it out.

I too filed a claim for tinnitus and hearing loss BEFORE knowing anything about Meniere's Disease.

Fortunately, another vet on here mentioned a MD appeal.

I went to a doc and was diagnosed with MD myself.

I filed a claim.

VA intertwined my MD claim with my tinnitus/hearing loss appeal.

Been almost five years and still haven't gotten a BVA decision.

[Special Monthly Compensation (SMC)- M Confusion]

I have a 100% rating for a single disability.

If I'm granted another 100% rating for a different, unrelated disability... I would have two 100% ratings.

Would these two 100% ratings qualify one for a SMC-M rating?

[VA Proposes Change ''Aggravation'' to ''Permanent Worsening'']

 

The VA recently removed the public-facing DBQs.

Now they've come up with this ambiguous problematic piece of garbage to be placed into the regulations so they can legally circumvent well-established case law.