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andrewdc
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Posts posted by andrewdc
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I was denied for the caregiver program. I am rated r1. Should I appeal to the bva?
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4 hours ago, Mr cue said:
This was good info on how to fight for the two smc l a&a for two separate disability.
This give the veteran smc o.
Than smc r.
I received aid and attendance smc l for copd and then received another smc l for major neuro cognitive disorder. I was then advanced to 0 and then r1 on account of 2 smc l.
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I have 2 separate and distinct 100% ratings (copd/asthma) and major neuro cognitive disorder. I received smc l for each and now rated r1.
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I assume oct 1 is still the application (caregiver program) date for post Vietnam vets and before 9/11. Anyone heard anything to contrary?
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I met Alex a few years ago on this forum. At that time, I was SMC S but believed I should be rated SMC L. I tried for a couple of years to obtain SMC L, but the VA always found ways to deny my claim. After joining up with Alex, and after a few battles with VA, he was able to get the board of Veteran appeals to advance me to SMC L. As my conditions worsened, VA again denied my new claims for increased SMC. He filed appeals to the BVA and later was awarded SMC L1/2. Later, a new claim was filed for smc M which VA found new ways to deny. So Alex filed another appeal to BVA and successfully obtained SMC M. Alex still belied the VA was not providing me with the appropriate SMC level and Alex filed a new claim for R1. Again, and on multiple times, VA denied my claims for R1 and even closed a few without even a decision. Late last year, Alex filed another appeal on my behalf for an earlier effective date for SMC L, increase to SMC O and increase to SMC r1.
Before I divulge the results of the appeal, I have to commend Alex on his knowledge of SMC.
Very few in VA know how SMC works which was certainly apparent in their continued denials. If you have issues with your SMC claims, your first thought should be Alex. On to the appeal, the judge agreed with Alex, and I was awarded an earlier effective date along with SMC O and SMC r1. My back pay will be over 6 figures. Take it from me, the only reason I obtained R1, is because of Alex’s extensive knowledge of SMC and his ability to craft thoughtful appeal letters that cite the appropriate case law. Again, thank Alex for your support. -
I found Alex on this site almost 4 years ago. I had posted multiple questions as to why VA denied my aid and attendance claim SMC L. Alex contacted me and agreed to help. He filed a new claim for smc l and of course va denied it. He then filed appeal to bva which was subsequently granted and I was awarded smc L. However I have 2 separate and distinct 100% ratings so I should have been awarded smc M. So, Alex submitted appeal to bva which after a year they closed appeal because they thought we were appealing original bva decision. We were not appealing decision just the m versus l. So Alex filed a new claim for m and va denied. Alex filed supplemental claim and va closed the claim without even adjudicating. He filed Again and same result. He made another attempt and that was denied too. Finally Alex contacted the secretary bva, the regional office coaches and raters claiming they had no idea how to adjudicate smc claims. Obviously he ruffled a few feathers and the truth needed to be said. Finally after more than 36 months of fighting, the VA admitted making 2 mistakes. They admitted the effective date for my original l should have been 6 months earlier and they admitted m should have been awarded when aid and attendance was granted. Bottom line- Alex knows more than va when it comes to SMC. Alex is a kind person who always listed to our concerns and always keep us in the loop. If you need thoughtful assistance with your smc and or claims in general, no one knows better than our friend Alex.
Andrew & Linda
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Our appeal was filed 2/20 and it’s still pending judge review
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My name is Linda. Alex agreed to help us with my husband aid and attendance claim. After zero help from va and other veteran organizations, my husband found Alex on this forum. Although we have been difficult at times, Alex has been on our side and shows this wisdom in all communications. We trust him and know our appeal will be eventually grAnted. We also believe Alex will endure my husband receives every benefit he deserves. Happy new year to all and when you are at wits end with va, you have a sincere and strong advocate with Alex.
- GBArmy, vetquest, ShrekTheTank and 2 others
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2 hours ago, jfrei said:
So just to wrap my head around these FDC anyone with a similiar claim and their results. I have one thing I filed for SMC based on my doctors 21-2680 he filled out and I submitted in with the claim on 1/12/2018
filed 1/12/2018
intial review 1/14/2019
Prep for a decision 1/18/2018
and no no movement after 30 days the RO and the phone say it’s in the decision phase but we all know anyday that could change....
I have a similar situation. I am currently smc s K. I have 2 100% ratings...copd and Major nuerocodnitive disorder along with several other rated disabilities. The va declared me incompetent in Oct. I then filed for aid and attendance along with a few other claims. My claims have been in prep for decision now for 40 days. Today we have a field visit from va examiner to discuss my wife being appointed my fidcuiary. I have heard from others she will also provide info on my current claims and other have said they have no knowledge of my claims in process.. so will find out later today
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I am rated 100% for copd (2008) and 100% mental disorder 2018. My wife provides my daily care. How is it determined if I qualify for program?
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appears I have been assigned to VA ficuairy hub and I assume someone will now come visit me and wife. I also have an A&A claim pending review. does the home visit have any bearing on a&a claim?
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15 hours ago, asknod said:
AndrewDC
The best thing to do is to have a VA doctor do an A&A exam on you. Download the VA Form 21-2680 and take him a copy to fill out. They generally can do it while you are there for a regular checkup. If you do not use VAMCs, have your local private care provider in the community fill out and sign the 2680. The answers to that form will determine whether you qualify for A&A (SMC at the L rate). Here's the link to it.
https://www.vba.va.gov/pubs/forms/VBA-21-2680-ARE.pdf
As a note of caution, be careful how you answer # 27. A "no" answer will result in VA appointing a fiduciary for the Veteran and controlling how his funds are spent. It also takes a while to establish a fiduciary and VA will hold up the payment award until the Fiduciary Field Examiner makes a home visit. It's a paperwork jungle to avoid if the Veteran is indeed competent. I do this for a living (SMC) and if you have any other questions, feel free to contact me.
The VA has already proposed incompetence. Our issue is how can they say I'm unable to handle my finances but well enough to not be a danger to myself on a daily basis. Seems illogical especially based on the psych report...however, I have meeting with my va neurologist today to see if he will complete form but I find asking va doctors to complete forms for monetary benefits is usually not helpful.
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25 minutes ago, Buck52 said:
To receive service-connected compensation, you typically must demonstrate the following:
- You must have separated from active military service with a discharge other than dishonorable;
- You must have medical evidence of a current diagnosed disability;
- Evidence of an in-service illness, injury, or event; and
- Medical evidence supporting a link between the in-service illness, injury, or event and your current diagnosis.
Many veterans run into issues when they do not provide enough supporting evidence of a link between their service in their current diagnosis. Another common issue veterans face is the assignment of an incorrect disability rating.
To avoid unnecessary delays or improper claim denials, make sure you submit all the necessary evidence when you initially file your claim.
Evidence Showing Separation from Service
The first requirement to receive disability compensation can be met by providing the VA with your DD Form 214, also known as your military separation papers. This requirement usually does not cause as many issues as the other requirements for disability compensation because a DD Form 214 is fairly easy to acquire and the Veteran’s discharge status is written directly on the form.
Evidence Showing Service-Connection
''To show direct service-connection, you need to provide the VA with evidence that your disability was incurred in or is due to a specific event or injury that occurred during your military service. Some examples of evidence that could support service-connection are:''
- ''service medical records
- Pictures of your wounds or injuries
- Buddy statements from fellow veterans who knew about your injury or illness
- Separation health assessments
- Statements from your spouse, family members, or friends stating how your injury has affected you
- A statement from your doctor giving the opinion that your current disability is related to an event that happened during your military service''
''Evidence Proving Your Current Disability''
''In order to be eligible for service-connected disability compensation from the VA, you must provide medical evidence of a diagnosed disability.''
''You will also want to document the full extent and frequency of all of your symptoms because in most cases your rating will be based on the severity of your symptoms.''
''Provide the VA with a doctor’s diagnosis of your current disability. Statements from friends and family members may also provide evidence of the severity of your disability and how it impacts your daily life.''
''For some conditions, the difference between mild symptoms and moderate symptoms can result in a higher rating. You may want to consult with a veterans attorney for assistance in thoroughly developing your claim.''
Source: ''CCK Attorney's LLP''
I guess I should have started with I am already SMC S +K (100 % major neurocognitive disorder, 100% copd, 30% allergic rhinitis, 30% sinusitis, 20% diabetes ll, and 4 separate 10% for sciatica. what I'm asking if someone with knowledge of aid and attendance smc l would review my submission and tell us if its enough to get approved. Thanks
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The va denied my claim for a&a smc l. They did not provide a specific reason other than they say I didn't meet criteria. We have filed a nod. Atatched is spouse statement and medical psych report for 9/6. IS this enough evidence to get an approval?
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Is your monthly VA disability payment counted as income for va pension benefits?
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19 hours ago, asknod said:
I just did an A&A claim for a Vietnam Vet following a loss of use of lower extremities award on 9/28. It was final yesterday. I filed the original claim 5/15. It went to the BVA on 9/18. Depending on if you are seriously disabled, they will do them in a hurry. I do a lot of guys who are terminal and generally get top drawer service for them. I pray your VSO is as equally aggressive. Ask him to have the RO "flash it" in VBMS under your profile folder. If you have major medical issues that require AA, you deserve to get advanced on the docket. Best of luck, sir.
moved to prep for notification today...again that seems way too fast!
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My vso submitted my a&a form on 10/18 along with letter from my wife detailing the daily assistance she provides me. Today my claim went from under review to decision review pending. That seems way to fast? good or bad?
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6 minutes ago, andrewdc said:
she also made comments such as : Severe memory and concentration impairments, difficulty understanding complex commands, anxiety, insominia
vets wife has to provide significant assistance at home due to vets memory problems. he is no longer able top prepare meals, manage his medications, and remember to engage in hygiene practices, manage finances, or manage his own medical care. His wife is now assisting with all of these activities of daily living to varying degrees. He has left the stove on multiple times while preparing food resulting in burnt pans and smoke damage.
This is from the va decision letter:
We have assigned a 100% eval based on:
Memory loss for own occupation
occupational and social impairment with deficiencies in most areas
intermittent inability to perform activities of daily living
depressed mood
spatial disorientation
impaired judgment
chronic sleep impairment\memory loss for own name
impaired abstract thinking
difficulty in adapting to stressful situations
neglect of personal; appearance and hyena
difficulty in adapting to work
impairment of short and long term memory
difficulty in adapting to work like setting
anxiety
memory loss for names of close relatives
The overall evidentiary records shows ther severity of your disability most closely approximates the criteria of 100%
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5 minutes ago, broncovet said:
I would like it better if it mentioned which ADL's she was referring to. I think this report is "marginal". You really need a doc who says you need help with things such as eating, bathing, toileting, getting dressed etc., just as it says in the critieria for SMC L (Aid and Attendance). Usually, VA wont "connect the dots" between your doctor saying you need assistance with ADL's, and those specifically in the criteria.
While this "might" do the trick, its been my experience if there is any doubt, the VA simply denies.
she also made comments such as : Severe memory and concentration impairments, difficulty understanding complex commands, anxiety, insominia
vets wife has to provide significant assistance at home due to vets memory problems. he is no longer able top prepare meals, manage his medications, and remember to engage in hygiene practices, manage finances, or manage his own medical care. His wife is now assisting with all of these activities of daily living to varying degrees. He has left the stove on multiple times while preparing food resulting in burnt pans and smoke damage.
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As I have posted before I am smc s + K. I recently received a 100% mental rating. In addition, the va has proposed incompetence. I really don't have much issue with that as my wife has to handle our finances anyway. Because of my mental health outcome, I now have applied for a&a. The Psychologist remarks said " The previously rated mild neurocognitive impairment has progressed ; symptoms now meet full criteria for a major neurocognitive disorder with multiple etiologies (copd, asthma, Severe obstructive sleep apnea) due to severity of memory and concentration impairment and the significant impact they have on the vets activities of daily living. An additional diagnosis with mixed anxiety and depressed mod is also provided and is considere4d a direct progression of the neurocognitive disorder as symptoms developed in response to difficulty adjusting to memory decline and associated functional impairments.
under competency she wrote " the current severity of memory impairment would prevent the vet from effectively managing his financial affairs. She also recommended that I not use potentially dangerous equipment at home. and acknowledged my wife helps with hygene issues and must administer all medications as he forgets to take them as required. The vet has gotten lost and disoriented credited while driving.
So, would her report be sufficient evidence for a7a
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My vso sent me a copy of my award letter. I was granted 100% for major neurocognitive impairment) I am currently smc s + k. If they deem me incompetent and my wife knows she would ne my fiduciary, would that then provide me a&a or smc L
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I'm currently smc s (COPD) + K along with other rated disabilities. I just received mental rating 100% but no mention of smc l. I received rating based on current mental impairment and unable to care for myself. I haven't received actual award letter yet but saw this in e benefits. Any idea why l wasn't awarded L?
major neurocognitive impairment (MCI) - (previously claimed as mild neurocognitive impairment , major depressive disorder, adjustment disorder with anxiety and unspecified neurocognitive disorder (also claimed as memory loss and sleep disturbance)
100% Service Connected 08/21/2018 -
17 hours ago, broncovet said:
I read the report. The issue of SMC L (Aid and attendance) wasnt really addressed fully. I think it would be difficult to suggest you need Aid and attendance while you are currently working. In other words, if you can not take care of your self, how is it you are able to take care of your jobs duties?
You can review the criteria for Aid and Attendance (SMC L) yourself, and see if you think you meet the criteria.
I dont think an increase to 100 percent for another disability would warrant SMC L. If I recall, Alex is SMC S and he has some 240 percent total ratings.
I really dont know any Vets who are working and still get A and A. They seem to be mutually exclusive of each other.
Yes, I understand you are not supposed to be driving, and not supposed to get lost, memory issues etc. The VA is more interested in actually what happens rather than completely rely upon the medical opinions.
what about the mental health rating? Should I assume 70% because that box was checked regardless of the totality of evidence?
Caregiver denial with r-1 rating
in VA Disability Claims Research
Posted
My application for the caregiver program was denied. I am appealing to the BVA on the basis that since I am rated r-1 (100% major neuro cognitive disorder) and require daily assistance for my mental disorders, that my appeal should be granted. Anyone in a similar circumstance that has appealed caregiver denial to BVA?