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Richard1954
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Posts posted by Richard1954
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I know my response is late but here goes anyway. The VA rates of compensation have not increased at least since just after WWII. In reality the only raises we receive are COLA and we all know the COLA increased never actually increase our earnings. Recently, we were given one of if not the highest COLA increase in years, and at 5.9 it did nothing for any veteran because it is not actually based on the cost of living at the time the increase is given, and in addition in this day and age, everything has increased in cost, used auto's 34% as an example. Today the cost of gas is over $4.00 in Texas. I read somewhere that the next cost of living raise will be 8-12 percent because of what is going on. Frankly, those in power do not care about what is happening, if they did changes would be taking place. Writing a congress critter is about all we can really do, but does anyone remember writing their congerss critter and getting an answer to the issue other than the party line. Most of the time they ignore us unless in an election year. I am fortunate, I get two retireirement checks, SS and va compensation, but I am not rich, and my purchasing power has gone down by $5000 a year just for gas, according to the local news. Most veterans do not have my income. Honestly one reason I am always ready to file a new va claim is because I am looking for increased compensation. Most of my claims have not amounted to an increase in compensation, just a long list of disabilities. Congress should raise compensation rates, and I have written numerious letters concerning this any other issues, that only congress can change. but again, most will do nothing to help veterans just a lot of talk. In fact if anything VA is trying to limit compensation by changing the rating guidelines for many disabilitys, those that come to recent memory are ratings for respiratory conditions to inclued sleep apnea. but in the last five years alot of ratings have been changed making it harder for the veteran to get service connection at higher percentages. Another rating that changed was those for Bask injuries , Degernerative disc disease conditions,, specifically where they increased the requirements to get higher ratings. If I were rated for my back injury today I would not be rated 60% because the ratings require doctor bed rest, when we all know most doctors don't generally don't give bed rest for DDD. The same issues arise for my ratings for COPD and sleep apnea, almost no one will get 100% for COPD or 50% for sleep apnea under the new ratings. So we have to fight against both issues and I am not sure how to do it.
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Just a few comments
Retired military personnal are requied to accept or deny survivor benefits at the time of retirement, and the spouse must also sign the decision to insure they are not left out in the cold.
VA survivor benefits are different, anyone rated 100% or TDIU upon death are usually awareded surrvivior benefits after the survior request the benefit., Those who are rated less than 100% or have no TDIU, may still qualify as long as the death was caused wholly or in part from a service connected condition.
Also, if the veteran was collecting social security or not ifs possibe the survivors may receive benefits if there are minor children or other factors exist. They would have to check with the Social security personne.
Most survivors should know alredy if the veteran fits into either catagory, however if not the family of a retiree can go to the retirement benefits office on a base, or check with military organizations for assistance, such as DAV, VFW etc.
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Unfornatuly this happends to many veterans. First if this or any issue was in your active duty medical records, and you still have problems and are receiving treatment, it should be considered service connected. Sometimes the VA will make stupid statements and say you did not receive treatment for two or three years after discharge. The facts are that there are no requirements to seek medical care for medical issues, just as there are no requirements to take any medication that was prescribed for any condition. I have noticed within the last 3 years that the raters are really being creative when denying claim, and sometimes even when awarding a claim.
You should not need an Independant Medical Opinion (IMO), however it is becoming more and more necessary.
Recommendations:
Speak to your primary care doctor and ask his opinion about how your service connected issue has gotten worse, and what can he do to make it better, The Idea is to get something in the record that your doctors think the condition started in service. You can also ask him straight out to write a medical opinion in you medical records indicating how these conditions are secondary to an already service connected. If he is a VA primary care doctor, many do not want to write letters for fear of reprisal from VA bosses, but rest assure they can and most will write something for you if you ask. See attached VA guidance concerning writing IMO's for veterans.
Another recommendation is to go on line, and find all the articles you can concerning your medical issues, and how they can be secondary to your already service connected condition, don't provide the va with every article, but 3 or 4 per medical issue can help.
The bottom line the VA was never setup to be adversial but they are now and have been for a long time, and many claims that should be approved on the first claim are denied over and over again, before they finally get approved. I too have faced this issue many times, and all we can do is to continue fighting.
Form for Doctors Statements.pdf VHA directive 2000-029 Medical Opinions by VA Doctors.pdf
- blahsaysme2u and Whodat
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I am happy for you. For some reason many veterans find they need a lawyer just to get what they deserve, when I first started my fight we coulld not hire lawyers. VSO in my humble opinion are now and were then ( 1986) useless. A lot of them will put their picture in the DAV magazine with a veteran they helped, boasting that they are good at what they do. At one time I was a chapter service officer, working 8 hours a day, 5 days a week. I enjoyed helping veterans and I took almost every case of every veteran who asked me for help. I ws usually sucessful helping the veteran, but the veterans actually did the bulk of the work, I just guided them along with advice and resources and recommedations about how to write a claim. Some of the claims that were approved even surprised me, especially the ones were older veterans who were already totally retired on SS who had heart conditions or other serious conditions that they claimed were a result of service in the military. Every one of them got TDIU, why because age is not a factor in VA claims, even though they had not been working for years in some cases. The rules say compensation is based on the average earning, that disability lessens the ability to make more money, but then the va goes and awards TDIU to veterans who had not worked for years. I never understood that since both rules conflicted. Anyway I degress. I never saw the need for a lawyer, although from time to time I will ask questions more to reenforce my opinions than anything else. I have been very fornatuate getting most of my claims approved without any real assistance. I always loved the feeling of winning an appeal, and sometimes I wish I could walk up to the VA rater who denied my claim, and get in his face telling him he needs to do his job better. anyway good for you and best of luck to getting to the end of thre road.
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Yes I also read these new rating requirements as someone with a 100% rating for COPD requiring home oxygen therapy, I don't agree with the change that removes this rating. They say they have made it eaiser to get a 100% rating for lung disease , but I don't beleive it. Most times changes are made the va claims it is because of new medical knowledge. I don't believe this either.
As to the decision to stop rating cpap user @50% , I agree this never made sense. The only reason I claimed my sleep apnea was because of the rating, I was already 100% so it did not net me more compensation but, it may help me later.
Ironically, and in fact even Texas had made a change to the parking laws for DV plates, requiring them to either get a platicard, or ISA on their plates. In Texas it only takes 50% to get a free DV plate, so there was a problem with disabled parking at VA medical centers and other locations. Now since Jan 2022, most DV license plates holders will not be able to park in handicap spaces.
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This is nothing new, in 2016 I had a claim for torn meniscus left knee, secondary to the service connected right knee. My C/P examiner was a female N/P. Her initial medical opinion was veteran hurt knee while walking on slope in his back yard. It is not likely the right knee buckling caused the injury, the slope was the cause of the injury. Then 21 days later she decides to change her opinion, she cited an opinion from an Insurance document writen in Canada, the document concerned gaits. She cited a sentance within this document, but only part of the sentance. Saying that one knee is never the cause of a disability of the other knee. However the discussion was talking about gaits, and said that a poor gait is not caused by another limb, ( or something like that) anyway I was denied the claim. I found the document she cited on line. I read every sentence and realized that she had only partly cited a sentence and that it had nothing to do with a knee injury. I appealed the claim stating the NP had purposely gone out of her way, and purposely misquoated the document. I claimed she was bias to this veteran, and had no business doing C/P exams. The result was to send me to a local NP who had his own business, His opinion was that it was at least as likey as not that I injured the knee the way I said I did, and frankly when I appealed the denial , I also stated, it was just my luck to get a dishonest examiner, any other examiner whould have stated it was at least as likey as not , because there is no way to prove or disprove my story and how the injury happened. I even went on line and wrote reviews about her concerning her games to screw veterans. In addition to the doctor saying it was as likely as not, also said the arthritis was caused before the knee injury, making it impossiible to get a rating at that time for the arthritis. My point is , most examiners are honest and when a dishonest examiner is caught that is good for the whole system. My examiner had been doing C/P exams for a long time, she no longer does them maybe because I complained. I was awarded service connect secondary to the right knee because when I injured it my right knee had buckled and caused me to twist my left knee as I fell to the ground. I recently applied for arthritis of the left knee, and it was awarded but in the straingest way adding the condition to the raing for the torn memiscus granted in 2016, with no increased rating for the arthritis or the knee. This is on appeal for a separate service connected award for arthritis and an actual rating. By the way, when it comes to knees two different ratings are possible one for the initial problem and one for arthritis when discovered on Xray.
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The va examiner doesn't always require recent xray or MRI studies to make a decision. I had knee xrays about 3 years prior to a claim for an increase on one knee and a new issue on the other, the xrays showed arthritis of the knee. one knee the va increased the rating for arthritis while the other knee the rater decided to grant service connection but added the arthritis to my knee condition that was rated in 2016, and did not grant me any additional compensation. It seems they are doing this alot lately ( that is adding new conditions with old ratings without rating increases)
There isn't anything anyone can predict concering ratings you may get.We would have to know the entire history of the issue.
As others have said you can submit a claim for depression ( or any other mental condition) or anxiety as a secondary condition. Claims can be awarded secondary for almost any secondary reason. Examples include: medication for a primary condition causing more problems , or Left knee issues secondary to right knee injuries etc. Of course the doctors will have to decide if the secondary condition was actually caused by a service connected condition.
I have been awarded service connection for a few secondary issue, the va will adjudicate them just like any other claim.
Best of luck to you.
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The VA is stating that you had two conditions prior to service, how do they know this?
The va said you have not been treated for these coditions since you were discharged, but while this may be true they cannot use this against you if you already have a diagnoses, just like they cannot deny service connection for an issue becaue you do not take the prescribed medications.
AS to ED secondary to PTSD, I don't know enough about this issue to really guide you except to say get on the internet and read and print every article ( well 3 or 4 articles) that indicate this is possible.
as for Gerd, many things cause gerd, secondary issues cans cause it as well as medications prescribed for service connected conditions and non service connected conditioins, do you research find some information that can confirm what you claim to be true, the VA is required to review that kind of evidence too.
I was just granted service connection for ED secondary to diabetes II, I did not even have a diagnosis, and had only after the claim asked for meds for ED that I have not used. I was actually surprised that it was awarded with no diagnosis. Apparently the VA did an ACE c/p ( a procedure that does not require anything other than a review of medical records, and maybe a phone call to the Veteran) I received a phone call was asked 3 or 4 questions and 2 weeks alter received the award. I was not informed that the caller was doing an ACE C/P exam. I detest these types of C/P exams. So while I don't know anything about ed secondary to PTSD I can't actually address that issue, but it was so easy for me to get service connection with no diagnosis, that I wonder why they denied your claim, expecially since there is no way they can prove if you have it or not.
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Unfortunately the denial is valid. I have seen this before. If there is evidence of any serious medical condition not rated by the VA they will deny the insurance every time. They do not even consider if you have a claim in the system for something that is not yet service connected. Now if you had a claim in the system and later the award is granted, they will issue the insurance based on the new date that you applied.
I was not aware they were doing away with S-DVi and creating a new insurance system,, I will look into this. Every time I get a new disability award, they include paperwork telling me I am eligable to apply for insurance, But when I have applied I am denied because they will not allow you to have more than $30k insurance policies, the Free $10K and then a separate $20K. I never understood why they only allow a total of $30K. I have purchased some private insurance that I can not be refused, but its expensive and I had a two year period that it would not have paid if I died. I purchased it to pay for my funeral, ( anything over the cost of a militay/VA funerial). I alo have Veterans mortage life insurance, that will pay off my house ( up to %200K) if I die before it is paid off. This insurance is only for veteans who have been awarded adaptive housing, and its only good up to $200K. anything over that they will not pay. I purchased this for peace of mind for my wife. Its cost are based on the veterans age and the unpaid balance of the mortage at the time you apply. After your reach 70 they will not sell you this insurance regardless that you have adaptive housing.
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I had an initial claim in 2016 for my left knee secondary to my right knee, I also had a claim for sleep apnea. I paid for the first time ever for an IMO to service connect both issues, when the denials for the knee was isued , the rater did not even addres the IMO as part of the evidence. I also had an N/P C/P examiner for the knee who when out of her way ( 21 days later) and found someting to discredit my claim which she cited to justify her opinion. This backfired on the examiner, because Not only did she missquote the referenced material, but it was ovivous that she was out to get me ( why would any examiner go out of their way 21 days after the exam to find a new reason to discredit the claim.) I was awarded Sleep apnea on the first claim, but had to appeal the denial on the knee, and finally won the claim. In fact, in both cases the IMO's were not needed and the va never acknowledge they even existed. Since then I vowed if I needed an IMO, I would get one from someone with out paying for it. So far I haven't needed one since then.
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It is very unfornatuate that the VA turned the system into an adversarial one. Many of my initial claims were denied for no good reason. I was medically retired due to Asthma. The va in 1986 denied service connection for Asthma on the initial claim. It took me two years and two appeals to show them they had CUE. My COPD was in my army medical records, in fact when I retired the Doctors stated I had COPD secondary to Asthma, and wrote this in the medical records. The VA had to have seen this diagnosas but it was never adjudicated in 1986. Instead because of my ignorance in 1986 thinking COPD and asthma were the same thing, so I did not claiim it either. By 2005, I claimed it and provided copies from my active duty medical records that it was secondary to Asthma, they approvd it and gave me a 30% award, by this time I was 60% for Asthma, which by the way are basically rated the same way based on Pulmonary fuction test. I appealed and the appeal was denied, and that was when they combined the asthma and copd into one rating. TBI was also in my active medical records, it was listed as concussion and indicated I was out for 3.5 days, in 1986 the term TBI did not exist, fast foward to 2016, I was awarded 40% for TBI, the rating was based on my reactions to the examiner doing the C/P exam. I requested an EED for both TBI and COPD claiming the VA should have seen these issues in 1986. Of course the appeal was denied, saying it was my responsibility to claim the issues. It was also denied at the BVA. I am now fighting a denial of arthritis of my left knee. The rules say arthritis found on xray warrant a 10% rating. The c/p examiner I had for the left knee and also was the c/p examiner fop the right knee, stated my left knee was worse than my right knee. I received an increase for my right knee arthritis, for the left knee the rater combined the arthritis with my rating for a torn meniscus of 10% rating , that was awarded years before, denying not only a separate rating, but any rating at all. This is CUE which is on appeal as we speak. My claim for sinusitis was denied for years no matter what I did, I finally took my active duty medical records to Army doctors inm 2004, requesting they review the records and write an opinion. both opinion stated I had serious sinusitisin service. I was award 10%, but it was a real fight to get it. I claimed hearing loss and tinnitis in 1986 again denied and denied 3 more times until 2005 when the VA doctor who gave me my first hearing aids, said I should have been service connected 20 years ago based on the history of my hearing test. The va gave me a whopping 0% for hearing, and 10% for tinnitis. I never claimed knee scars, for what? a 0% rating. Didn't seem worth the time or paperwork. The VA knew I had a second surgery in 1995, at a va faculity, and when I requested an increase ( which was denied) they mentioned the scars, but gave me nothing, Ok so when I requested an increase again in 2018, the c/p examiner measured the scars and I was awared 0%. In 2021 again the scars were measured when I requested an award for my knee rating. Both 2016 and 2021 increases were denied, but they sure made sure I got that 0% rating. The knee claims were not worth the trouble to appeal based on the higherst rating available, it would require IMO's and a lot of hope.My claim for specially adapted housing in 2002 was initially denied, I appealed and told them to read the requirements for an award, I won on appeal. Some of my claims came years after military service, because I had learned a lot since then about claims. But the VA isn't teaching raters how to do the job correctly, and I still get denials or awards for that matter that make no sense or are only rated at 0% or combined with other issues that were approved years before but do not increase the ratings. For examples read what I said above about my left knee arthritis, and for ED, they combied the ED to my diabetes II rating from two years prior without a seperate rating of any percentage, and failed to award SMC K. That claim is now on appeal for CUE. I could go on and on, but most of you see what I am saying. Its too bad the VA does not spend time and money on training raters correctly it would save a lot of time and money if the VA would issue the correct rating the first time. It is because of the VA that many veterans feel the need for lawyers, and paying for independant medical opinions even when the disability is in active duty records the VA will deny the claim. In fact when I asked for service connection for Sleep apnea, I paid for an IMO, which was a waste of money becaue the C/P examiner said that it was widely known that anyone with COPD and or asthma have sleep apnea, I was awarded 50% the first try, as secondary to my Asthma/COPD.
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I presently have an active claim where I am argueing that I should be awarded a K award for loss of use of my left eye. I will try to explain the case, in as few words as possible.
In 2008, I had surgery for removal of a cataract in my left eye that was caused by use of steriods for my service connect lung condition. The surgery when bad, and the replacement lens (IOL) was placed too close to the iris. Because of the positioniong of the lens, it rubed upon the iris, causing intermittent periods of loss of sight due to spikes in the eye pressure. I was diagnosed with pigmentary dispersion syndrome and pigmentary gloucoma. The pressure spikes continued for years, I would lose my sight intermittently for days and weeks at a time. When I filled a claim for loss of sight, it would be denied because the va will not compensate for intermitten loss of sight. In 2019, I was fouond to have multiple blood clots in my lungs, I was put on blood thinners. From here on, the intermitten loss of sight worsened because now when the lens was rubbing the iris, it was causing bleeding in the eye. In Nov 2000, I had a serious problem where the bleeding was getting to the back of my eye. I had what was called emergeny surgery to remove the lens, because now it was causing more damage to the optic nerve. At the time it was recommended not to replace the lens, instead to allow the eye to heal for 6 months and then have a lens sewed in place to prevent the rubbing. I never wanted this surgery, I was content to have intermitten sight than no sight at all. By this time my 30% for cataracts was upgraded to 60% because of numerious trips to the eye doctor and placement on bed rest, which was a failly new rating at that time. So the plan was to tlry to fit me with a special type of contact lens, as I had decided against any more surgery due to having 5 eyes surgeries with no good results. Well, they tried to fit a contact into my right eye and immediatly I had an adverse reaction, ironically they did not order a contact lens for the left eye. By this time I was done with trying to see out of the eye. I had allready fought one claim for temporary 100% due to the 6 months healing time, When it was finally granted, I though I was entitled to a temporary bump up to SMC M. This was not the case because it was a temporary award, I was not entitled to the bump, and waisted a lot of time and effort on the case.. At the same time I had request loss of use K award. Which continues to be denied. For a K award for the eye , the rules clearly state loss of use or blindness entitles a veteran to a k award. However, the va continues to state that loss of use is blindness , and continue to argue that because I have light perception, and can see shapes I do not qualify for a K award because I am not blind. Never mind the fact that without a lens the eye is useless, ( actually it present other more serious problems which I will not go into here) When I cite the rule Loss of use or blindness , they continued to say loss of use is blindness. The va is factually ignoring the wording of the rules and denying me a K award. I vow to fight this all the way to the federal courts if I have to ,, because the plain reading of the rule indicates two reasons for a K award, loss of use Or blindness. Without a lens I have loss of use of the eye. The va is now not using the claim that loss of use is blindness., instead they cite other reasons for the denial, such has veteran has light perception. The ignore the fact that I cannot disgunish anything further than two feet from my eye, and that when evaluated I am considered to be legally bilnd in the eye. So the fight goes on, its been almost two years and numerious supplemental claims, if denied again it will got to the BVA. I even considered just bypassing the local decisions and going straight to the BVA, but I enjoy putting forth legal arguements and making the va follow the rules they created. I also enjoy the learning process that this provides to hone my legal arguements. I have no doubt the BVA will award the claim eventually. In the meantime its money in the bank.
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This case is very simulair to my claim for retro under Bradley v peak, where a veteran can be rated TDIU and still recieve Housebound. I argued that because the statue was misinterped ( by general counsel opinion) and because there were two general counsel opinions that disagreed with each other I should be awarded housebound retroactive back to the date I was awarded TDIU. Of course the reason for denial was that the Bradley v Peak was not to be applied retroactively. In this case study, it appears to me to be simular to my case requesting houebound. I did not appeal past the BVA, maybe that was a serious error on my part.Frankly, while I did win one case at the COVA in 2007, the case was granted rater than adjudicated, and therefor it could not be considered precident. I have always tried to stay away from the court. Presently I have a case for loss of use of ,my left eye. which I will talk about in my own thread rather than to fill this with my own issue. I hope this case is in favor of the veteran, it may change a lot of denials where the denial is based on the laws and rules that were applied at that time of the claim, so it cannto be CUE, even though wrong.
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Look at the claims I have listed below, I actually appealed some of my EED because most of my conditions such as TBI, Sleep Apnea, Sinistis and a few others were not filed until years later, In fact in my days they did not have a name for sleep apnea, and TBI were concussions. I was shot down at the BVA and decided I had a long haul to get my EED's and let the issue die. I did the same thing with the original Housebound award, tried to argue that bradley v peak should have been applied retro activity - loss that one too. Two claims should have been awarded in 1986 - TBI and COPD as these were in my active medical records, but what did I know back then.....
Hope this guy wins, and hope it is retoractive .
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Ok so I will add my two cents. Until recently, I had always though that it made sence to persue claims that you think are service related. But at some point the time it takes to work on a claim may not be worth the effort. I actually have a TDIU rating, ititially it was with an 80% combined rating, then a 90% combined rating, and finally I was awarded 100%. Prior to the 100% I was awarded a k award for loss of use of a foot. When I reached 100%, I requested A&A, initially I got housebound, fought and got A&A at the L 1/2 step due to a separate 50% or more rating. In the meantime I was pursuing a claim for adapted housing, initially it was denied, I appealed and it was granted. Since my 100% rating, I have been rated 40% for TBI, 50% for sleep apnea, 20% for diabetes II, increase in knee ratings, one from 10-20% for arthritis, 10% for secondary larngatis , 60% secondary for my eyes because of steriods, recently ED award secondary to Diabetes, which was also secondary to steriod use for my lungs. I could go on and on. But in the end, I have a TDIU rating, a single 100% rating for one issue, and another 100% rating for all the other combined issues. I mentioned adaptive housing, I also was awarded vehicle grant with adaptive equipment. I am working on 2 more k awards right now, one for loss of use of my left eye, and one for ED that should have been granted when SC was awarded. Most of my claims were won on appeal, my initial claim for asthma was denied, ironically, that was the reason I was medically retired from the Army. I had to appeal it twice, the second time I claimed CUE this was in 1988, I won that claim at 30% and today it is rated 100%. At some time I may quit chasing claims, but frankly I enjoy the challenge, and I love it when I win on appeal, it makes me want to start the next claim. Some of you could fingure out my compensation, some may not figuire it out, so I'll just say my compensation is well over the 100% rating, per month. It was those 10% and 20% claims that finally totaled a second 100% claim.
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Let me add a side note to this. I was never diagnosed with ED. I had never been treated for ED. And Frankly it had been a long time since I enjoyed life in this area, mainly because I have COPD which makes it almost impossible to enjoy certain things in life. So recently when I discovered it would not work I suspected it might be due to the medications I am on for prostrate cancer. But I am also taking other medications that can cause this issue. And I have a couple of service connected issues that can also cause this. So I requested service connection for ED, and I threw everything against the wall, and whatever stuck, I used to support my claim. It wasn't until after I submitted my claim that I contaced my Primary care doctor and asked for some medication for this issue. He was more than happy to give me a perscription. Now less that a week after submitting the claim I received a call from a woman at the VA. I wasn't really paying attention to what she was saying because she had interrupted me while I was working on a pressing issue. She asked me was I ever diagnosed, I said no. She asked does it work at all , I said no nothing. She said how do you know its ED, I said I know my body. She asked me have I used any meds, and I told her I just go some by my primary doctor, she them said does the medication help, I said I don't know haven't tried yet. Then she said goodby. Now initially I though she was a pharmacist, or a nurse working for my doctor, but like I said I really wasn't tuned into why she was calling. Then withing 14 days I had a decision saying it was service connected, and they combined the award with my diabetes II award which is almost two years old. I also though it would be rated as a stand alone condition, and still think it should have been. I searched the letter for a K award and nothing. I now think the lady was doing a ACE c/p exam, ( you know they call you up fail to tell you what they are dong and you don't find out untill after the fact). To this date no doctor has said I have ED, I guess becaue I asked for medication a week after filing the claim, and it was given, they figured it was a diagnoses. Why did I tell you all this, because while I do not want anyone to lie, and claim something they don't have, at the same time veterans should know this is one area that they have to take your word for it. There is no way to prove you have it. If you have a condition that can lead to ED, or take meds that can cause ED and if you think you have ED, file the claim, you have nothing to lose, and a K award to gain. Now I would not have wasted my time filing if I could not have gotten a K award. I already have a 100% award for a single issue, and a second 100% for combined ratings, not counting the issue for the single award. I have collected so many 10% and 0% awards that it just isn't worth my time to file anything unless I can get an SMC. Ironically, under the new rating for lung disease they will not award 100% because of use of home oxygen anymore, and 50% for use of a cpap has been changed too and will not be awarded anymore under the new rules. If I were rated under the new rules I would not have the 100% for my lungs. I am always thinking ahead, and I could see this happining one day so I continued to file claims until I got a second 100%, in case they ever decided for any reason to take my 100% for my lung disease. I used to advociate filing for anything you think should be service connected, but there comes a time, when the time and effort spent on a claim becomes a wasted effort unless you are sure you can get additional compensation. At one point I even fought for a temporary 100% award due to a new surgery recovery preriod on my left eye, I finally got it, and I though I would get a temporary bump on my SMC L 1/2 to M. Turned out temportary 100% awards will not result in a temporary bump. What a waste of time on my part, I got the award but I did not get any more compensation. The rules for compensation are complex especially in the area of SMC's. Any way I have rambled longe enough , hope this info helps someone.
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1 hour ago, Dustoff 11 said:
You said they approved K with Diabetes then you say they did not award K. Which is it? Check your VA.GOV personal page on the VA.GOV website and then check your rated disabilities that will list all your current and in my case very recent ratings. ED should be listed as service connected with a 0% rating. Also the same VA.GOV website will give you a brief summary of your diabetes and K award.
Use the search box on VA.GOV for your disability ratings and it will then give you a link to click on.
The VARO often gives an award of 0% for SMC-K or ED and instead pays the vet a little over $100.00 per month in additional disability compensation for ED. Seems to be routine award for vets taking strong VA medications for PTSD and other mental issues that are service connected. Many different types of meds for different health issues can cause ED also. C&P exams are usually routine short questions and wolla there it is. Enjoy. If in fact they failed to award you K with added 100.00 then send them a statement in support of claim ASAP. Just saying and I am done here.
My comment is not legal advice as I am not an attorney, paralegal or VSO and you need to ask a VSO for assist.
No you missread what I stated.. so let me be clear.. I was awarded ED secondary to Diabetes II, the award was then combined with my diabetes rating ( something I have never seen) and they did not award SMC K for loss of use of a creative organ. It is my understanding that any award for SC of ED amounts to a 0% rating and a K award. In my case ED was not rated separately and it did not result in the K award... I am quite sure I understand the rules, just wanted to know if I am correct, or if someone is aware of any changes to the rules
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21 hours ago, Aquaria said:
I have spoken to the DAV and the FLDV VSOs and they state it is only awarded if paralyzed not loss of use like the grant states on the VAs website. This is why I am questioning what am I doing wrong.
Someone is giving you bad information, paralyzed will not get you the housing.... it must be loss or loss of use....
These are the requirements for adaptive housing:
Qualifying service-connected disabilities include:
- The loss or loss of use of more than one limb
- The loss or loss of use of a lower leg along with the residuals (lasting effects) of an organic (natural) disease or injury
- Blindness in both eyes (with 20/200 visual acuity or less)
- Certain severe burns
- The loss, or loss of use, of one lower extremity (foot or leg) after September 11, 2001, which makes it so you can’t balance or walk without the help of braces, crutches, canes, or a wheelchair
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Since you are not rated for loss of use of your arms or legs it is doubtful you would be granted the adaptive housing...
You can keep applying but the chances of winning a claim or slim.
My first request for adaptive housing was denied, but I had loss of use of one foot, and residuals organic disease (60% back injury) I won my claim on appeal. This was many years ago.
You should work on getting a loss of use rating.
If your doctors do not specifically state you have loss of use, you will not get the grant.. and if he does state you have loss of use he must use sound medical reasoning
Best of luck
Below are the different ratings required to get the housing grant:
Qualifying service-connected disabilities include:
- The loss or loss of use of more than one limb
- The loss or loss of use of a lower leg along with the residuals (lasting effects) of an organic (natural) disease or injury
- Blindness in both eyes (with 20/200 visual acuity or less)
- Certain severe burns
- The loss, or loss of use, of one lower extremity (foot or leg) after September 11, 2001, which makes it so you can’t balance or walk without the help of braces, crutches, canes, or a wheelchair
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Its been a few years since I have posted anything, I am trying to stay busy and keep good thoughts.
On 16 May 2020, I had a face to face meeting with an ILP counselor. This was my first contact, when I arrived home, there was an email saying I was accepted to the program. I know by expierence this really means nothing. They have no choice but to take me into the program, since I have 2 100% ratings, and a TDIU. ( Yes I have been busy accumulating ratings)
In the past under this program I did not have much luck. In 1999, they gave me a cheap E-Machine computer, and printer with a few classes. In 2005 they kept stringing me along for two years,, and finally dropped my case. In 2007, I applied again and again nothing . This time I took a diffferent approach. First, the ILP program now has its own version of the adapted housing grant, and they do not require you to use any grants already awarded, this is good because you can get work done that you need to be more independant, and basically the law says there is no limit on the cost. So I asked for a new ramp, a new door iinstall, removing a window for the door, as an emergency exit from the bedroom, and a new Master bed room closet, since when I last used my housing grant, they used my closet to make a bathroom, and there were not enought funds to build a new closet. I am asking for a new lift chair, since my legs and back are too worn to get up by myself, I also asked for a good desk chair to help allivate back pain. Because I am on oxygen 24/7 due to COPD/Asthma and I use a Bipap , I need a house generator, since we lose power a lot here in Killeen Texas. so I asked for one, as well as a whole house filter, to fight my sevice connected allregies. My privacy fence is falling down, I have had it repaired over and over again, but its 20 years old, was here when we bough the house 9 years ago, so for security and safeity reasons asked for a new fence. The key to the remodeling and fence is that if it can be approved under the special adapted housing grant, it can be approved under the ILP program. Ever remodeling and the fence are all allowed under the adapted housing grant. I also asked them to replace my small power chair that I use in the home, my old chair is 20 years old, and my outdoor chair is too large to be used inside the home. I also asked for a good mattress to help with my back pain.
Most guys seem to ask for mowers, and other high dollar stuff but those kinds of things do not improve the quality of life, and now are not allowed under the program, the rules specifically say this.
I have no idea what I will get if anything, they may stretch this out for another 2 years, or I may actually get something that makes me more independant. I tried to be reasonable, and only ask for things that are out of my price range.With the cost of living continuing to get worse, there is no way I can afford most of the Items I asked for. Today, I watched from my wheelchair as my wife, paid $50 for 2/3 of a gas tank for my Chrysler wheelchair van. Its getting so that we have to really be frugal with our income.
If anyone can think of anything that might help me with my back injury, ,or breathing issues, let me know... as I ran out of ideas, but am open to anything that will help me allivate pain. I am on morphine now and even that does not mask all my pain, but that is Ok cause I know I am still alive. But I have to be really careful with the morphine because it can stop my breathing if I take too much.
Its nice the the board is still going strong. and it appears that most of the old timers are still around... Tbird did a great job back those many years ago....
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So within 2 weeks my claim was approved for service connectiion for ED. They combined it to my Diabetes II rating. The only reason I even applied was for the K award. But.... they did not award K award, and the rating letter says nothing about consideration of SMC. What is they deal? I was positive ED that is service connected automatically resulted in K award. Could I have been wrong? I have already appealed lack of K award as CUE claim... what do you think?
Thanks
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GB
Thanks for the reply... as to the temporary 100% , if I understand the rules they say as long as the doctors call for a least 1 month of convalescent after a service connected surgery it can be renewed incrementally for up to 12 months... certainly I would not get paid for two 100% awards.. but a temporary 100% rating should bump up my SMC L 1/2 to M for about $200 more a month.....
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In 2008, the VA performed cataract surgery on my left eye, which were caused by use of steroids for my service connected lung condition. About one month after the surgery I started having complications which developed into pigmentary glaucoma. As time went on symptoms got worse causing loss of vision due to increased pressure in the eye. My vision would just go completely whiteout. This condition was caused by the lens being placed to close to my iris, and rubbing on the iris. When I ended up on blood thinners the condition got worse if my INR was to high, ( INR is the measurement of the therapeutic level of blood thinners) I would end up with internal bleeding in the eye. Recently ( three weeks ago) I woke up to find that I could not see again, having a total whiteout in the eye. Ironically, I was scheduled at the va on the same day to get an exam for new glasses. This time the bleeding was not caused by a higher INR. In fact, my INR was lower than usual but still within the required limits. I went to my appointment only to learn that my eye was bleeding due to a broken blood vessel again caused by the lens rubbing my iris, apparently moving slightly and caused the bleed. This time the blood was also behind the eye and not just between the lens and iris. I was scheduled to have surgery for tomorrow, which has been postponed until next week. Over the years there was talk of replacing the lens, but because the " strings", that hold the lens in place are broken, there was no way to secure the lens away from the iris unless it was sewed in. I always told the doctors no more surgery as I was afraid things would get worse.At least I had my sight 75% of the time. Now things are different, blood is getting behind the eye and eventually will damage the retina worse than it is already damaged and I will lose my sight. I was told it could take 6 months for the blood to clear itself, but in the meantime I could continue to have these bleeds.. so surgery has become necessary or I will lose all my vision. So, I have agreed to have the lens removed, but it will be at least 6 months before they can sew a new lens in, because they want to insure the eye has healed. I have already told them after this surgery I will not have another surgery( have had 3 minor surgeries on the eye already). So the only way I will be able to see is if they can fit a contact lens, or get coke bottle glasses for the left eye. After years of fighting with the va about the initial 30% rating, I finally received a 60% rating on the eye last year due to 7 or more visits to have medical care on my eye within a 12 month period.
So now comes the questions.... Will the va award me a K award for loss of use of the eye if left without a lens as I will only have light perception? Will the va rate me temporary 100% for the period I must wait ( at least 6 months) before the doctors will even consider sewing a lens in place. And if a contact lens will not work, and I am left with just my right eye, how does the va rate the loss of vision. I have tried to understand the rating schedule... but for Aphakia the rating says its only a 30% rating, if I am determined to only have light perception the va may rate based on loss of use, and best vision in my right eye without glasses.. did I get this right?
I don't want to waste time on a claim that will only net 30%... but if a claim results in a K award or temporary 100% rating.. it will be worth my time....
Any input would be nice....
Also... I know some of you may be wondering .. did I submit an 1151 claim ( malpractice) yes and it went no where.... I was also already service connected due to the use of steroids causing the cataracts.
I haven't been on the site in a long time, because I am already fighting stage 4 prostrate cancer, I am doing well, in that my medications seem to be working and delaying any progression of the disease...
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I know that Dr. Bash is well respected on this forum, so I sought out his service to write me an IMO for my prostrate cancer . He took a long time to get up with me , even failing to call me after a call was scheduled. I had to email him again, and request another call. He was never specific as to the cost of his services. I used Dr. Anise's services in the past and his fees for two IMO's were $1500, in fact that is what he charges everyone. Another doctor Dr. Seiter has his fees listed on his web site and his services for an IMO are $500. Dr. Bash's secretary called me a few minutes ago and quoted me $10,000 for an IMO. She wanted $3000 down, and to arrange a payment plan. I informed her the the fee was ridiculous, explaining what Dr. Anise charged me in the past and what Dr. Seiter charges. She asked me what did I think was a fair fee. I refused to answer her telling her that I though that Dr. Bass was trying to get rich on the back of veterans. Maybe my opinion of Dr. Bash is wrong, I sure hope so. If anyone wants to get an IMO check out the following link from Watchdog.org , it list many doctors willing to provide IMO's.
https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html
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Posted
You are correct, I am also appalied that the VA doesn't consider the overall impact of separate disabalites completing the picture for the acual total disability, its just a numbers game to the VA. Of course SMC should come into play here, but I cannot remember any award that the VA actually gave an SMC when it was due, and not when It was asked for.
Another problem I have is having 3 medical conditions ( COPD/Asthma?Copd) combined to one rating for compensation purposes. While I have 100% for all there, the other guy may hove one or two issues and he gets the same 100% that I get. I am not complaing that the other guy gets 100%, but I just find it unfair that I only get 100%. ( I know life is not fair) Recently some idiot rater awarded ED and combimed it to my 2 year old diabetes II award, without any increased rating. And forget or didn't care to give me the SMC K. The same thing happened when I was awarded arthritis for my left knee, instead of a separte rating, it was combine with the original issue of a torn meniscus, that was awarded in 2016 and did not raise the rate. Ironically, i have two separate awards for my right knee, one for the torn meniscus, and one for the arthritis . I don't think the raters are getting any training, Most of us on this board could do a better job.
But I degress. instead of the va making it harder to get an award, they shold be making is eaiser, even when they tell you it will be eaiser to get a 100% award ( new revised COPD rating) it just not so.