Jay Johnson

Well, what they are hoping for is that the veteran will NOT appeal in the first place. Or that the veteran will not go above and beyond and get their own sources of medical evidence...this is where the IMEs help a bunch in my opinion. The VA is supposed to weigh evidence and rate based on a "preponderence" of the evidence (though RO's tend to go with the lower eval. regardless, the BVA and CoVA tend to follow the letter of the law). It's all a big circle in the hope that a veteran will either give up or die trying....I know it sounds horrible, but it is the truth. The VA puts up as many roadblocks as they legally can (or illegally...not like they have any oversight). P.S. - If you already haven't, be sure to copy everything you send and ALL of your medical evidence...the VAROs are known to "misplace" key evidence in your favor:-)

NPs and PA's have, basically, the same level of training. They cannot, officially, diagnose anyone with anything unless they get authorization from a surpervisor (MD). The reason the VA uses them is quite simple, they are cheap! Also, most self-respecting doctors will not work under the contraints of the VA....no MD is going to make medical decisions based on "saving the VA money", but NP's/PA's are more willing to sell their soles (so to speek). With that said, I hope you keep in mind that RO's are notorious for not following the regulations and you may be in for a long battle regardless of any favorable IMEs and/or outside help from senators, supervisors, etc.......It is still in your best interest to contact the people you have and prepare your case as best as you can, but be prepared for a war if/when the time comes. You are 100% correct in that it is up to the VETERAN to WIN a claim and the vet MUST stay on top of things or he/she can easily be low-balled/denied. You should treat your case like a lawyer would presenting evidence in court......gether ALL the evidence you can from as many experts as you can and use the regulations to your advantage (here is a link to a website with the full list of regulations - VA REGS ). Also, try to highlite everything in your claim that best supports your percentage....in other words, present the case like your trying to talk to a 3 yr old. Make it as easy as possible for them to get the best picture in support of your claim.

The best place to look would be in the world of sport's medicine. Concussions, and their effects, are a HUGE problem in professional football (not futbol). You may want to search the net for someone who specializes in that field and see if you can get a consult. Just because the VA may not recognize a disorder, doesn't mean you can't win your claim....it may take years, but you could set a precedent for vets in the future.

There were many who said we were needlessly worrying about the "72,000 PTSD reiviews", but, as another poster here just pointed out, how many vets died because of that review? The very nature of PTSD is to be paranoid and over-react...the VA knows this yet they push these vets time and time again KNOWING they could hurt themselves or others. Regardless of the VA's intentions or what you want to read into it, ANY review of PTSD cases is going to cause good veterans to die....what I really want to know, is how is this different then murder? If the VA KNOWS (from historical data) that veterans seem to take their lives when pressured by the VA (be it justified or not), then how is that not premeditated murder?

Flu shots aren't exactly an exact science. In many cases people have developed flu symptoms FROM the flu shots themselves. Plus, Flu shots are far from a guarantee that you will not get the flu.....basically, this years flu shot is for LAST years strain of flu. Flu strain mutate every year and we cannot predict exactly what the flu will mutate into, so we give shots that may or may not protect from the flu AND may cause flu like symptoms. As for what you experienced - You did not contract the flu in the traditiional sense from your flu shot. A flu vaccine is a dead flu virus that your body adapts to in order to better fight off a live virus. The down side is that your body can react to the dead virus as if it were real (not very likely though) and you can exhibit symptoms like a fever, chills, stuffy nose, coughing, etc even though you do not technically have the virus. IMO, the shots aren't worth it unlses you have a immune disease, lung disease, or are generally much weaker then the average eprson due to age or some other factor. But different people have different opinions on the subject.

Wow, well thank you so much for the information and please keep me informed. It would be great if I could take the kids for a small vacation without having to stay indoors with the wife the whole time. This isn't to say that I don't love my wife, but we all need a break every once in awhile:-)

Oh, I missed that it was an NP. There's NO WAY the RO should take a general NP diagnosis over your past doctor's opinion. In fact, the RO should know better then to send someone with specialized disorders to a general NP for an overall evaluation. As a nurse I can etll you that an NP is in now way traianed to deal with the issues you mentioned...they are, essentially, for medications and routine common problems like flu, colds and other common everyday disorders...in fact, an NP cannot even officially diagnose anything without the signature of a supervising MD.

That would be a great program, but my wife doesn't trust the VA as far as she can throw them and there is no way I could get her into a VA program...does anyone know if they offer something similar for medicare/tricare or if the VA will pay for a civilian hospital stay? God knows I could use a week off:-)

I don't understand how a fast decision is in your best interest. Once they make a decision you are fighting an uphill battle with, what could be, a lower amount of compensation. It's a lot less stressful to get a good first evaluation then trying to fight to get your old level back. Either way, it is VERY difficult for them to reduce a TDIU P&T claim....if you can't work and there is no evidence to suggest that you can, then they cannot lower you. To be safe I would seek another civilian evaluation of all of your disabilities, even if it takes a few visits to different specialists. The VA MUST take the civilian evaluation over the C&P if the civilian doctors are better qualified to make the decisions (IE - a cardiolist can better diagnos you then a primary C&P doctor). So, get some more evidence on your side, just in case, and do so as quickly a possible.....even if it costs you 100's of dollars to get the evals, it will be worth it when you save $1200 a month in lost compensation.

Typical VARO smoke screens in order to get you in for a reduction. I would cancel the claim all together. If they are indeed looking into an increase for SMC you have a right to terminate your claim at any time. Now, since new evidence was presented, they CAN reopen the claim themselves, but at elast then you'll know what their original intentions were. They pulled the same thing with my wife...they try to trick you into C&P exam illegally, in order to get some evdience to open your P&T claim against your will (the only way to open a P&T claim is if NEW evidence is provided, hence them tricking you into a C&P). I would also file a CUE under - § 3.327 Reexaminations. (a) General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability. Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. Individuals for whom reexaminations have been authorized and scheduled are required to report for such reexaminations. Paragraphs (B) and © of this section provide general guidelines for requesting reexaminations, but shall not be construed as limiting VA's authority to request reexaminations, or periods of hospital observation, at any time in order to ensure that a disability is accurately rated. (Authority: 38 U.S.C. 501) ( Compensation cases—(1) Scheduling reexaminations. Assignment of a prestabilization rating requires reexamination within the second 6 months period following separation from service. Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board, unless another time period is elsewhere specified. (2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled: (i) When the disability is established as static; (ii) When the findings and symptoms are shown by examinations scheduled in paragraph ((2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more; (iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement; (iv) In cases of veterans over 55 years of age, except under unusual circumstances; (v) When the rating is a prescribed scheduled minimum rating; or (vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions. © Pension cases. In nonservice-connected cases in which the permanent total disability has been confirmed by reexamination or by the history of the case, or with obviously static disabilities, further reexaminations will not generally be requested. In other cases further examination will not be requested routinely and will be accomplished only if considered necessary based upon the particular facts of the individual case. In the cases of veterans over 55 years of age, reexamination will be requested only under unusual circumstances. And a CUE under this regulation if/when they try to reduce you - § 3.343 Continuance of total disability ratings. (a) General. Total disability ratings, when warranted by the severity of the condition and not granted purely because of hospital, surgical, or home treatment, or individual unemployability will not be reduced, in the absence of clear error, without examination showing material improvement in physical or mental condition. Examination reports showing material improvement must be evaluated in conjunction with all the facts of record, and consideration must be given particularly to whether the veteran attained improvement under the ordinary conditions of life, i.e., while working or actively seeking work or whether the symptoms have been brought under control by prolonged rest, or generally, by following a regimen which precludes work, and, if the latter, reduction from total disability ratings will not be considered pending reexamination after a period of employment (3 to 6 months). (:D Tuberculosis; compensation. In service-connected cases, evaluations for active or inactive tuberculosis will be governed by the Schedule for Rating Disabilities (part 4 of this chapter). Where in the opinion of the rating board the veteran at the expiration of the period during which a total rating is provided will not be able to maintain inactivity of the disease process under the ordinary conditions of life, the case will be submitted under §3.321. © Individual unemployability. (1) In reducing a rating of 100 percent service-connected disability based on individual unemployability, the provisions of §3.105(e) are for application but caution must be exercised in such a determination that actual employability is established by clear and convincing evidence. When in such a case the veteran is undergoing vocational rehabilitation, education or training, the rating will not be reduced by reason thereof unless there is received evidence of marked improvement or recovery in physical or mental conditions or of employment progress, income earned, and prospects of economic rehabilitation, which demonstrates affirmatively the veteran's capacity to pursue the vocation or occupation for which the training is intended to qualify him or her, or unless the physical or mental demands of the course are obviously incompatible with total disability. Neither participation in, nor the receipt of remuneration as a result of participation in, a therapeutic or rehabilitation activity under 38 U.S.C. 1718 shall be considered evidence of employability. You can also use the second regulation as a basis for CUE because they reopened your claim and scheduled a reexamination without any new material evidence to suggest an improvement. I would also use these regulations to get your SO motivated and for your local senator's office. Make sure you make it clear that all you wanted was a letter stating that you were P&T and that the RO told you that you weren't and said you MUST report to a C&P. I wouldn't worry too much as the requirements for lowering a P&T TDIU claim are quite difficult to prove. The doctor did say something to giev them a window though..essentially, he/she said that the prior decisions were false which can lead to a reduction based on the RO calling CUE on itself, but this will be quite difficult given the higher of two evaluations rule and the reasonable doubt rule (not to mention the preponderance of evidence rule). I would suggest that you use Bash's IME AND get a seperate civilian examination from a specialist (even if it's out of pocket costs..in fact out of pocket appointments are much quikcer then waiting on a insurance company and time is not your friend). Basically, throw the book at everyone you can..this includes writing the regional director's office (or calling), writing your senator, getting your SO more involved (sounds like a bad one to me, you may want to change), contact your local newspaper with clear facts of your case and how they are tricking you, and many vets, into lowering your compensation because of the cost of this war (politics are your friend) and contact the secratary of the VA and file a complaint (but be sure to keep it in the context of "you just wanted a letter and the RO forced you into a C&P via a lie.....the secretary will not get involved in adjudication issues). Hope some of this actually helps:-)

No doubt vietnam hurt a lot of veterans in the public persona, but that perception has all but dwindled. I believe americans don't show a lot of interest in vets bcause they are blinded to the facts. If the SO's and the media allowed the general public to see all of the problems that disabled vets are having there would be a public outcry to fix the situation. I have no tangible proof of this other then the fact that the VA and our government (plus the SO's) do everything in their power to keep veteran's issues OUT of the public eye....I believe they KNOW that it is a losing battle once the public is involved, so they do everything internally to keep it hush, hush. Honestly, if CNN ran a piece about the guy in new mexico (or arizona?) that killed himself with his "review" letter in hand, what do you think the public's reaction would be? Do you actually think ANY government official would stand against the dead veteran? Regardless of what these politicans may want, they will NOT go against any veteran in the public arena for fear of losing their job. I guess it's not so much about whether or not the public will support vets, it's more about backing the government, and the VA, into a political corner, effectively giving them the choice of supporting the vets or political suicide.

Welcome to the fight mike:-) One person CAN make a difference if you can get your point to the right people.

Americans care deeply about veterans and would jump at any legislation to improve healthcare/benefits for vets, but the media glorifies the VA as one of the best healthcare systems on the planet and they portray the VA leaders as gods, because they don't have the foritude to challenge the VA and they just don't have the information that we do about the VA. This is where the SO's fail miserably IMO....they do NOT utilize the media at all because they KNOW it would affect change in the system if they did; instead, they string vets along one by one, which works in the VA's favor. If the media would have gotten ahold of that bill in congress that wanted to cut COLA to veterans and military personel, every repressentative that voted for it would be losing their seat in the house. Also, if the public knew exactly how many vets have committed suicide due to the C&P process that PTSD vets must face time and time again, you would see a rubber stamp on every PTSD claim for years. Politicians are motivated by two things: money and public perception (which is just another form of money, as they need to stay in power to be corrupt)....the public will ALWAYS side with veterans if given a chance and the politicians/media will not take an anti-veteran stance EVER. It's a win/win situation if we can get vet issues into the media....if only vets had some sort of organization that represented them on a national level, Hmmmmmm......

They're not going to stop until the VSOs and/or our representatives take a moral stand on PTSD. I'm sure they can easily look up the statistics of, exactly, how many vets have died as a result of PTSD and their dealings with the VA and use it against them, but it will require some hard work and dedication and I just don't see that out of the VSOs or our elected officials at this time. It all comes down to american influence. They know that if this stuff get presented to the american public that they will ALL lose their jobs and the VA budget will double, because the american people will not stand for policies that hurt disabled veterans. This is why I am not a fan of VSOs...I believe they intentionally keep the battles out of the public eye in order to make it look like they're helping vets in the small circle of vet related issues, but they keep it in said small circle as to not rock the boat and effect major change. Honestly, I can't see how the american public wouldn't have heads rolling if they knew what goes on in the VA.

I believe the VA must inform you of what, exactly, they are giving you a C&P for. I would take a harder stance on the matter if I were you....allowing them to strong arm vets helps no one. You have a right to prepare for your C&P and gather any evidence to support your claim.

Unfortunately, there isn't much you can do to get rid of the appointment and, believe me, I know how you feel about future exams. Age can effect your rating and may help you get P&T on your next evaluation, but you will still need to attend the one scheduled for you '06. The only thing I can suggest is that you start seeing a civilian psychiatrist, even if it is out of pocket costs. You can submit your civilian doctor's evaluation in place of the C&P provided it is at least as complete as a C&P would be. Also, the VA looks favorably on treating doctor's opinions over one time C&Ps. The advantage of a civilian doctor is that you can shop around for one that you feel best represents your claim and you can work with the doctor in presenting a solid evaluation when the time comes (IE - read over the evaluation first and suggest corrections BEFORE you give it to the RO). As long as your civilian doctor says you have not improved and that you are still unemployable, there is almost nothing the RO can do to lower you. P.S. - It is still difficult for the RO to lower your rating even if you do not get a civilian doctor. In essence, if you do NOT work between now and your next C&P they cannot lower your rating unless you make it painfully clear that you are much better and capable of working. The regulations that govern TDIU specify that they must prove that you are able to work "under normal life conditions"...this means that you must prove you can work (IE - if you're not working how can they prove you can work?) WITHOUT the need of medications or therapy (IE - normal life conditions). I know it's hard to face and no one can gurantee your rating, but you are fairly safe with a TDIU for the reasons I mentioned above (it's actually better then a 100% scheduler rating in most cases). P.P.S. - It is also wise, in my opinion, to ask for an increase when you go for your next C&P. Present a solid case for an increase and the RO will be more willing to "settle" on the old rating. Essentially, you put them on the defensive when you ask for an increase and divert attention from your existing claim.

It appears he already got P&T as he said he had chapter 35 benefits. As far as the SMC is concerned - Why exactly are you seeking SMC? The criteria for SMC is quite strict and it doesn't sound, with the evidence you provided, that you qualify for SMC at this time. The severity of a single disorder has nothing to do with SMC...you are either housebound because of your disorder (which doesn't seem to be the case) or you are in need of regular aid and/or assistance as a result of your disability. Unless there's something you're not providing, I don't see SMC in your future:-( P.S. - I'm not 100% sure, but SMC for migranes sounds like a bit of a stretch...what exactly do you require aid and attendance for?

Well, with all those people in power it's really about getting the right person to be on your side at the right time. I know I was a little hard on the senator and I don't doubt she has good intentions, but the "this must mean your wife is better" reasoning from the RO really got to me and I truly expected the senator's office to be real upset about it...essentially, the RO was punishing my wife for trying to get help and murray's office should have jumped all over that.

How about a plan that actually guarantees affordable drugs and health care for our senior citizens and not another bureaucracy that just buries our elderly in paper work, quite literally, to death.

I got a study via regualr mail a few months ago about VA effectiveness and such.....as test said, as long as they're not asking for personal information I wouldn't be afriad to participate (though you may want to ask if you can do a paper study rather then a phone one if possible).

Little more on murray: As I said before, murray's office did little more then forward the information I gave them... they did NO investigation of their own and could care less about my wife. At one point, when the RO first tried to reduce my wife from 100% P&T with A&A to 70% TDIU, they used that fact that my wife "was able to communicate with senator murray's office, which shows improvement in her disability" as one of their major pieces of evidence....despite that being a highly illegal thing to use against my wife (we're talking letters here), murray's office did nothing more then forward my complaint and didn't even bother to call me. After 2 weeks I called them and they said, "There's nothing they can do...the VA says they are following the regulations and it is you (me) who does not understand them....the VA has broad discretion". Honestly, if I saw murray I would spit on her and tell her to rot in hell, but I'm sure others have had a better time with her people.

Though she may not directly participate in state legislation, her position in the US senate should be more then enough to improve washington's dismall VA benefits. Perhaps I caught them on a bad day, but I made several pleas to her office at the local level (vancouver), state level and national level (in washington).....I didn't even get a response from anyone but the local level and that person was nothing more then a patsy for the VA. My wife's case is very cut and dry....the VA is clearly breaking regulations in their decision (I mean no doubt about it). If murray's office can't help a vet on such a simple and direct case how is she going to help the majority of veterans who have complicated issues about interpretive medical problems? P.S. - VA financing is at record levels and it has little to do with murray or the VA commitee in the senate...I haven't seen any of the compassion and caring she claims to have because of her life experience <shrug>.

Murray's office was useless for me. I sent murray the problems the VA was having with my claim, they then forward it to the RO representative that deals with their claims and, of course, the VA person says they're doing nothing wrong, so I get a call back from murray's office saying "well, they say they're doing the right things...there's nothing we can do". Truely useless IMO and she won't be getting my vote next time around. I've got a complaint in to the local house person for the vancouver area at the moment...I don't have my hopes up though. P.S. - How good can murray be, given she sits on the vets board in the senate, yet washington is among the least vet friendly states in the country? I think she's a dismal failure.....I'll vote republican before I vote for her again.

Here's a link to a new drug I saw on the news last night Propranolol . It doesn't appear to be a drug that will help those with existing PTSD issues, but may help troops in the field who are having a hard time coping with an event or situation that could lead to PTSD in the future. It's far from a guarantee, but it does seem promising and may be perfect for military field studies to help those guys and gals before they get home and it's too late.

Wll, ya can't blame them really....admitting that you can't make a patient better is like admitting that you can't succeed at your job. Has a lot to do with pride IMO.