Lemuel

There is a problem with pain level reporting. I first define my pain level. And how long I can go with it without committing suicide for relief. I have to explain that depression is used to suppress the pain level which means my face does not show it the way the addicts fake it to work them for meds. 5 continuous for weeks is enough to drive you over the edge from there it only shortens the time before you are looking for that finale exit. Fortunately for me, Keppra, my seizure medication enhances my pain medication as well as reducing pain. I have not had a level 5 since I began taking more than twice. The longest lasting once was when I fell and fractured my knee cap. It took a day before I started feeling the fracture pain and because it was a broken bone, I got more than I needed. I will have to throw the left over away in another year or so. As the suicide rate rises again, there will be a new look at whether it is better to occasionally give an addict his fix rather than miss someone who really need the pain med. Yes the problem with back pain is that the source is not always seen on radiographic reports. I have MRI reports two weeks apart on my neck. The one done by a resident in training and signed off by his supervisor showed a lot of stenosis as the source of my pain. The other, read by a VA contractor showed no stenosis on an MRI of the neck by a different VA only a week later because the neurosurgeon wanted his on MRI to look at and the earlier one was not in the record yet. The problem with the readings may only be how much the two different sources pay for their software. The better the software the more you can see. In Japan the software is Nationalized. The research is done at state Universities. And every level of physician has the best software. Not so here in the land of the big Px. Most clinics cannot afford the best and the only time you get the best reading is if you go to a VA that works in association with a land grant university medical school.

There is another reason to use VA Medical (VAHA) for your medical needs. It is "socialized medicine" that is not an HMO that makes money by limiting services. Problem with VAHA now is the delays and physicians quitting to into private practice because of the "political atmosphere" limiting there ability to help veterans. In fee based medicine, most private providers that are not HMOs like Kaiser, the incentive is counter to your medical needs. Doing too much as in overprescribing to keep you coming in for that next visit. Marketing mean making you worry about your health more than necessary to control you pocket for as much as they can get out of it often subconsciously without realizing they are responding to their financial need and not your health needs. Example: In 1965 I was working as an orderly part time in a hospital in Waukegan, IL. One night, during my break, I was in the "canteen" getting something to eat out of the machines when a couple of physicians came in wearing scrubs indicating they just came out of surgery which I quickly surmised from their conversation was a cesarean birth. One doctor was saying to the other that he had been to the marina and say a boat that he just had to have on a previous weekend but did not have enough for the down payment. He then said, would you believe it, on Monday three hysterectomies walked into my office. That raises the questions, were all of those hysterectomies necessary and were any of them necessary? I am sure the obstetric surgeon believed they were necessary, but was his judgement clouded by his subconscious financial desire? We would be much better off with "health contracts" granted in small areas so that we could choose our contractor. And the contractors were paid bonuses for health on the morbidity reports, especially those coming out of the corner's office and the death certificates. We had that at the VA before the 2012 Cheyenne and Phoenix VAs screwed it up by falsifying their "service to patient" records in order to benefit the move to "community service" insurance contractors that cost more and do nothing to enhance your health. Ross Perot was right. If we take the "fee based" financial processing out of health care, we can provide more and better health care to the Nation. We could get back up in the top 5 at least, maybe even number one again in the World Health Organization's rankings of nations on health care. Now we are 38th. That is 19 places below the 19 industrialized nations putting us well down into the "third world nations" in providing health care to our citizens. I blame CHAMPVA, the community service contractor for the VA that provides health insurance to spouses and families of veterans, for the death of my wife. After her fall when she fractured her skull and had bleeding on the brain for which she was started on a prophylaxis medication to prevent status epilepticus in protocol with such injuries, we could not get a neurologist to take her as a patient. I realize now it was because CHAMPVA like Kaiser, and now a very different Secure Horizons that used to advertise no premium, no copay, dental, and optometry for Medicare Advantage that is now just like Kaiser, in greed charging extra for all those previous no extra costs and denying specialty services when they can get away with it. Secure Horizons, the original was able to provide longer healthier lives by eliminating billing processing costs and using the extra money for preventative medicine extending their customer base by extending their client's lives and health. They made their money in the '80s by not having to provide the more expensive health care by keeping their clients healthy. The idea of using a professional organization as a means to do that is now common among insurers. But the insurers are greedy. They have no heart like all bankers that want to live off others productivity without really providing much service to the others.

After looking up 38 CFR 4.87 schedule for 100% you may not be as severe as my wife was before her cure. Use this link to check for yourself: eCFR :: 38 CFR 4.87 -- Schedule of ratings—ear. All that is required is sufficient to make you unemployable.

Using Bronco's post, you have such loss of use of both legs as to prevent you from walking without human support. You would even have problems using a wheelchair though if someone pushes you around you might be able to sit in one but probably need to be moved on a stretcher most of the time. Only your experience tells you how much of the time that is and how immobile you are.

100% Mineers syndrome should get you to R2 I would think. That indicates as severe as you can get. Can you actually get out of bed without falling down? You either need to have someone with you all the time to help steady you or, if you do not have someone, then you have to be in full care nursing home. My wife had Mineers syndrome but was cured by a neurologist. She suffered with it for about 3 years before finding the neurologist through a Doctor friend who could cure it in Japan. That was over about 15 years before her death and she died with a drivers license. If she had not taken a fall and fractured her skull she would probably have lived sever more years. If you are more interested in a cure than the SMC, ask you physician to find out how they cure it in Japan. May not work for everyone, but might work for you.

All complicated cases are supposed to be referred to the Director, Compensation Services. The first step of that is to send it to a DRO in the Central Office. (Where my TDIU claim was sent). A DRO from the Central Office sent the review and recommendation to the Director who made the award. A claim for TDIU does not specifically have to be made. If you have stated that your multiple conditions that make you unable to find work, for example, TBI that makes mental work, as in desk jobs not possible, and injury residuals that make physical work not possible. While neither alone qualifies you for TDIU, in combination they do making the case complicated. My case when I was 40% combined. Awarded to the date of my last full time attempt at being employed on a desk job. I did eventually get the "presumptive ratings" after the TBI law took effect in 2009. But my award went back to 1985 when finished in 2020.

Pen Fed posts mine a couple of days ahead of time.

I have a 100% P & T TDIU rating (80% combined). I have re-opened claims that are confidently before the BVA expecting to retain everything I have and possibly get SMS-t or at least SMS something. Temporary ratings and occasionally a fraudulent rating (as in the veteran committed fraud to obtain the rating) are the only rating revisions I am aware of. You can be discharged with a 100% TDIU temporary rating, or another rating which is expected to get better, which will be reviewed as the VA seems fit. If it does not say "temporary rating" then it is nothing to worry about. The fear mongers have had those temporary ratings revised to less. Jealousy makes people do irrational things.

From a bill board in the east somewhere. Saw a picture of it online.

SMC is special monthly compensation. There are different levels for veterans that have amputations or loss of use of more than one limb or meet the criteria of not being able to fully take care of themselves. Need help with basic needs like bathing or getting dressed. Adding to what pacman said above, your spouse can also be eligible. And there is an SMC-t that is paid at R2 or a little over $10,000 a month total disability compensation. Chisholm, Chisholm, and Kirpatrick (referred to as CCK on Hadit) is taking clients while a case on SMC-t is in the works. The CAVC and CAFC have recently created "class actions" out of cases where the VA has gone astray with the law. Haskel v McDonough now Laska v McDonough is stayed on SMC-t, a CCK case. With the courts ordering the BVA to create classes on cases like the Program for Comprehensive Assistance for Family Caregivers, PCAFC on February 29, 5 days after my sister was denied as a family caregiver is an example. The PCAFC case set a precedence against the VA saying that medical reports were unreviewable. The denial of PCAFC was done by the VAHA not the VABA and because it was a "Health Administration" decision was considered unreviewable by the BVA even though the decision may have not been compliant with the regulations. Finally the Courts are holding the VA to account. This should break the backlog of veterans claims in the "Delay, Deny, Wait Until They Die" mode.

Yes, combined total is better than TDIU. But no, why give up what you should have had. The extra-schedular claim to the Director of Compensation Services is reviewed at the Central Office. The AOJ did not forward my claim for review and I mistakenly thought their decision, which appeared blanket at the time, was all I could get. Nothing prevents you from increasing schedular after you have TDIU. And a higher schedular helps with SMC. Since they are two separate channels, one at the AOJ, and the other at the Central Office, and the AOJ was required to submit your case for TDIU to the Secretary even if you did not meet any of the presumptive qualifications. I suspect your TDIU will be much faster and now money is worth more than future money. It will buy more bread or gasoline.

I did not apply until 1987. I did apply for my head injury and hope to get my epilepsy EED to 1974 when I got out of the Navy. I was having partial and complex partial seizures that were seen as me being "drifty". I could talk myself into a job because of anosognosia, I was unaware of what was happening. The VA still will not diagnose anosognosia. I had a parttime employment from 1987 to 1990 when my state disability ran out thinking I could keep up a 20 hour per week job by putting in more hours. It did not work. The employer's statement is what was the convincing item in 2020. A 1990 BVA hearing ignored the 2nd page. It was a sheltered employment by someone who wanted to help a veteran. The point is, the date of my extra-schedular claim was ignored and the date of my last fulltime employment was used to determine the effective date. That is why I recommend anyone who is applying for TDIU that has not been employed for more that a year or has worked only parttime apply through the extra-schedular opportunity.

My "extra-schedular TDIU" claim was paid back to the "last day of your full time employment" as recommended to Beth Murphy, Director, Compensation Services. Redacted documents of the process are attached. No mention of anything other than employment. Note the dates of the decision and the EED. 20200406 - Admin Decision_Redacted.pdf 20200408 - TDIU Review - Admin Opinion_Redacted.pdf

I checked on Laska v McDonough, the SMC-t case today. It occurred to me that it might be under the stayed cases because of the decision delay. It is. Does not having an order for a stay on the docket have any special significance. For example, getting a stay from the CAFC prior to the decision from the CAVC by the VA GC because he did not like the way the hearing went at the CAVC. Maybe asking the CAFC to stay the case while the Secretary gets a clarity revision of the code from congress?

I am represented by Chisholm, Chisholm & Kirpatrick. But my case is in line with their Haskell and now Laska v McDonough case. They are also representing my wife's claim before her death. These are both TBI SMC-t paid as R2. And yes, The VA will take the case to the CAFC for Laska, insuring the Secretary's privilage of rewriting law through the writing of his regulations. And CCK is taking up other issues including remands not addressed by AOJ from my 2017 BVA Decision and the remand to the BVA to address my "Legacy Appeal" including evidence provided post slamming me into AMA without written consent. By creatively reading my suggestion we could do by email questions from the Judge if the hearing was going to be to complicated and long. According to the VAGC my wife will be denied even though her TBI caused her death eventually. I should be approved even though I am not falling as often as my wife was before her death. However she was admitted to the hospital and then a rehab center which is not the case for me. So now I finally have a good attorney in it for the long hall. And there was a recent CAFC decision I sent them that they say they are definitely going to use in my case re; EED. Attached. Possibly even for my epilepsy back to my first claim in 1974. And what will be the effective date for SMC? My wife was my caregiver from 1985, the effective date of my TDIU eventually needing a cell phone to keep track of me in Japan. I meet the standard set in the hearing by the VA GC for SecVA. But I am not nearly as bad off as Haskell was. If I get SMC-t, it will only demonstrate the VAGC cannot write the regulations any fairer than Congress did the Code. We are still waiting for the CAVA to render their decision. CCK had denied representing me earlier. I had a pro bono at the CAVC for the remand. A refusal of representation does not mean it is not a good case. Attorneys have only so much of a load they can handle before they would get in trouble for not adequately representing their clients. In my case they have already done a lot of the work and are waiting for a CAVC decision on the other case that is very similar. They have video of the VAGC saying what I have, a nurse controlling my medication, would qualify me for SMC-t and because Haskell did not have it, he was not qualified under the law. My nurse fills a dispenser and reorders the refills as necessary. I live at home with a family caregiver that is not yet approved. Another example of the VA not approving VA benefits just because they want to delay, deny and wait until we die to avoid the payment. 240324 CAFC 22-1504 Thomas v McDonough EED PTSD.pdf

I am waiting at the BVA for SMS-t paid as R2 for TBI victims. Still waiting for the Haskell v McDonough, now Laska V McDonough decision with Margaret Laska having successfully substituted for Herbert Haskell. 8 Months since the hearing. I think a couple of CAFC remands favoring veterans and one that was a class action that I am submitting a 10182 on, the PCAFC decision that bodes well for challenging the VA's here to fore, unchallengeable medical reports, is slowing the CAVC and the BVA. For the SMC-t, I have the qualification that was argued to be additionally needed by the Appellee VA Counsel in the hearing at about 58 minutes. (see one of my posts for the link.) But if the argument had been for me, I am in much better shape than Haskell was. His only problem was he had a qualified nurse to dispense his medication to him, she just was not ordered to do it by the VA. Mine is ordered by the VA and paid for by the VA through community care. I do not have a live in caregiver since my wife passed. But my sister monitors me and the house with her cell phone from a block and a half away. I sit in front of the computer all day in a bathrobe monitoring HADIT and a date site to try to find a live in caregiver. I need help to get dressed because I cannot lift my elbows above my shoulders an need to be monitored for falls. But I am not bed ridden. Just need someone to find me if I wonder off in a drift off that happens very infrequently. But for many of us, our conditions needing care is defined by our worst day, not the day the social worker calls on us. And they cannot seem to grasp that. We could go out and cause an accident that would take someone else's life or burn our house down endangering firemen and neighbors. Possibly with us in it.

Wyoming does by combined rating for most things. There are some things that TDIU apply. Depends on what you are applying for. Auto license plates are free for 70%. Reduction of property tax the same. Hunting you have to be able to shoot the game yourself but you can do it from a vehicle. Kind of a reverse. Fishing free. Depended on the mood of the legislature.

I find an SOL on substitution of a year. This case the substitution has already been made. I do not find an SOL on a challenge to the substitution. Waiting until after the SOL date means you are "SOL" in another acronym.

Maybe you are right, the court may be waiting for the time to run out on substitution SOL. I had not thought of that. CCK is apparently still handling the case. The case is now in her name with no new attorney appearing before the court. The case was heard August 15, 2023. If the hearing had not already been finished then there would be a possible reason to change attorneys. The SOL on substitution would date from November 2023 when the substitution was finalized. 8 months seems like a long time for nothing else to have been entered to indicate why the decision was being held up. Seems to me the matter of who will receive has already been decided by the substitution which has not, as yet been challenged. I do see another case on the CAVC opinions link that is taking a long time, nearly 4 months to decision. I suspect the CAVC is dotting all their "i" and crossing all their "t" because which ever way it goes, it will probably go to the CAFC to see if the regulation is a valid interpretation of the 2015 CODE. But even that seems like a long time for the clerks to get their act together and write the decision for the court that appears to be on the side of the appellant watching the video of the hearing. The question then becomes, "how much authority does the Secretary have in rewriting law in producing the regulation effecting the law." Or is that coming from the Justice department overseeing the VA Attorney's office? This appears to be a broad revision of the Code in writing the Regulations.

How long is the longest case you know of from a Hearing at the CAVC to a decision from the CAVC. This is the link to the hearing of Haskell v McDonough, 22-1018 on August 15,2023: haskell v mcdonough - Search Images (bing.com) The case, as suggested in the hearing, is now Laska v McDonough 22-1018 on the CAVC Docket search. There has been no actions since 11/23/2023 when Ms. Margaret Laska was substituted for Herbert N. Haskell in the original filing following Mr. Haskell passing on August 14, 2023. It is now almost 8 months without a decision being posted. My experience has been days not months. Is the CAVC backed up that much by recent CAFC remands in favor of veterans? Stating you case in terms of the Jurisdiction of the Court is everything. The BVA is the only decider of facts. Nearly impossible to challenge a fact at the Appeals Court. This case is challenging the VA's interpretation of Code in writing the Regulation governing SMC-t.

Well said.

I agree with Bronco. This is probably a good sign for you. There was a recent CAFC decision on EED that bodes well for your case as you have presented it to us. Thomas v McDonough, CAFC 22-1504 of 3/27/24. I am attaching a copy of the decision. This decision is only 5 days old. But may have spurred the Clerk to get this one out the door to help relieve the backload. I went through this from November 29, 2022 BVA Decision to a Remand from the CAVC on 10/26/2023. The BVA slammed me into AMA and ignored my brief and motions. The Clerk called me and seemed exasperated by my brief and motions. She sounded old. Was apparently working from home and insisted I change my browser to Google to get a hearing because she could not connect with me. I had no problem connecting with the test and verification I could work with the BVA video site. I think she wrote a decision for the Judge that the Judge regrets signing. Your situation is probably different. Your service Officer probably got the BVA clerk to agree to your appeal the way he saw it. It is unlikely that he thru you under the bus because of your right to appeal to the CAVC and get a remand based on not getting the Legacy Hearing as applied for on the 10182 the way I did. I had signed nothing to agree to a move to AMA and would not have agreed to AMA because it would have ignored my brief and motions as was done. That is the only way your representative would agreed to AMA without getting your hearing as I see it. Otherwise, he would have had to get your permission to drop the appeal because he had been convinced you did not have a case and were going to lose. New in the mix of things, is a CAVC rule for a "conference" between the appellant attorney and the VA attorney. It appears to me that may have filtered down to speeding things up by the BVA clerks being more receptive to your representative's position for a faster inevitable decision. I still do not have a BVA hearing date. But I now have Chisholm, Chisholm & Kilpatrick (CCK) representing me before the BVA. But another issue has come up. SMC-T. 240324 CAFC 22-1504 Thomas v McDonough EED PTSD.pdf

My VA check at Pentagon Federal Credit Union always comes at least a couple of days early. Tried to get my SS to come there but SS kept trying to send it to a wrong account number. Finally sent it back to Citi Bank and got the back payments. So yes, things can happen when you try to change direct deposit accounts. I like the way it is now because savings at Citi Bank are higher than at PenFed. But PenFed has lower interest rates on borrowing and higher interest rates on Certificates of Deposit.

Get a copy of your Social Security CAVES Report. Social Security does a much better evaluation and has no limitations in medical reporting with regard to etiology. The family statements are in there. Hopefully, when interviewed, they said, "since he came back from the service." They will have interviewed any employers, or friends you mentioned as witnesses of you disability. Rely heavily on the CAVES report in your brief and statements to the BVA stating as I have above. That the SS examiners have no pressure to avoid mentioning etiology (cause) from VA supervisory pressure including on the VA contractors to keep their contracts and SS physicians are not limited to following the examination wherever it goes. Their statements are unbiased against the veteran's service connection though it may not be stated in the VBA terms.

I have to write everything down because I do not remember yesterday.