doc25

You request it from the VA Claims Intake Center in Janesville,WI. My C-file took 5 months to receive. So, June sounds about right that you'll get it.

Wow, I'll have to keep this in mind. I tried to get c&p results back in 2017 from QTC after my c&p exam and I was told I had to request it from my RO that ordered the exam.

Do you believe you answered the examiners questions as honestly as possible during the exam? Yes or No? To alleviate some of your anxiety; here is how PTSD and other mental disorders are rated: Which criteria best fits your occupational and social impairment?

Yea looks good but include this research article with your evidence or have the Dr. provide it in his rationale. I concur. Tinnitus article1.pdf

How much evidence do you have for your neck problem? How long have you been treated for it? Do you have those treatment records? The more evidence you have in your claim you will be helping yourself. I usually suggest having a minimum of a year of treatment, it'll be difficult for a rater to provide a favorable decision if it's less than that.(But, that's just my opinion). I agree 100%. --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Here is an example of how to secondary connect your cervical spine condition to your lumbar spine condition. Read through it word for word to research how this veteran got this claim granted. https://www.va.gov/vetapp16/Files5/1635827.txt ORDER Service connection for a cervical spine disorder, diagnosed as degenerative disc disease, secondary to service-connected low back strain is granted.

I'll try to answer your questions as best I can. It appears you may have tested positive for COPD or some other pulmonary condition. Your pft results are closest to a 10% rating if you claim it and the condition is granted. I imagine they did an X-ray where mild degenerative changes were present with your spine. What I find interesting is your elevated Uric Acid (Normal Uric acid levels are 2.4-6.0 mg/dL (female) and 3.4-7.0 mg/dL (male) could be a sign of a kidney issue that should be followed up on. Do you have problems with Gout or kidney stones? Hope this helps you out. IF you are diagnosed with COPD or another pulmonary condition here is how it is rated: Obstructive Lung Diseases Obstructive lung diseases cause the airway to the lungs to become blocked. Often there is significant swelling of the tissues and the airways collapse easily. Most of these conditions are rated on the Respiratory Rating System, but some have some small differences. Code 6600: Chronic bronchitis is the swelling of the bronchi in the lungs. The swelling causes them to narrow and block the passage of air. Code 6603: Pulmonary emphysema is a disease that gets worse over time and is normally caused by smoking or being exposed to pollution for a long time. It causes the tissues that hold the shape of the lungs to die, thus causing the lungs to collapse and loose their shape. Code 6604: Chronic obstructive pulmonary disease (COPD) is simply the presence of chronic bronchitis and/or emphysema. It is rated exactly the same as both bronchitis and emphysema, and the code can be used interchangeably. If both are present, then only one rating can be given under this code. Code 6601: Bronchiectasis is a condition where part of the bronchial tree becomes enlarged and causes obstruction of the airflow. This is a permanent condition that cannot be reversed. It is either rated on the Respiratory Rating System or on incapacitating episodes below, whichever provides the highest rating. The definition of an “incapacitating episode” for rating this condition is a period where there is an active infection in the lungs, and it requires bed rest and treatment by a physician. If there are a total of at least 6 weeks of incapacitating episodes each year, it is rated 100%. If there are a total of 4 to 6 weeks of incapacitating episodes each year, or if there is constant coughing of mucous mixed with puss or blood that requires near-constant antibiotic treatment with anorexia and weight loss, it is rated 60%. If there are a total of 2 to 4 weeks of incapacitating episodes each year, or if there is daily coughing occasionally of muscous mixed with puss or blood that requires between 4 to 6 weeks of antibiotic treatment 3 or more times a year, it is rated 30%. If there is occasional coughing with infections requiring antibiotics 2 or more times a year, it is rated 10%. Code 6602: Asthma is a condition where the airways and bronchi swell, causing them to close up. This condition has slightly different rating requirements than the Respiratory Rating System. These are outlined in the table below. It is important to note that it is difficult to get a proper test for asthma since the tests must be run while an attack is happening. An FEV-1 test done when there is not an attack will give normal results that will not properly define the condition. A methacoline challenge test is often done instead since the methacoline triggers an asthma attack. Once the methacoline is inhaled and an asthma attack begins, the spirometry tests are performed. After the tests are done, medications are given to treat the asthma attack. If spirometry is done with and without methacoline, the condition is rated on the methacoline results. If FEV-1 and FVC tests with methacoline are not performed, then asthma can be rated based on the kind of medication that is used to treat the condition or on the severity of the condition based on the number of ER visits. In these cases, however, the physician must clearly record a thorough history of asthma attacks. Test Result/Condition Rating FEV-1 Less than 40% 100% FEV-1 40-55% 60% FEV-1 56-70% 30% FEV-1 71-80% 10% FEV-1/FVC Less than 40% 100% FEV-1/FVC 40-55% 60% FEV-1/FVC 56-70% 30% FEV-1/FVC 71-80% 10% ER visits 2 or more attacks per week with respiratory failure that requires ER visits to save life 100% ER visits Requires monthly ER visits to save life 60% Medication Requires daily high doses of steroids or immunosuppressive medications taken by mouth or by injection* 100% Medication Requires the use of steroids or immunosuppressive medications taken by mouth or by injection 3 or more times a year* 60% Medication Requires occasional use of inhaled anti-inflammatory medication* 30% Medication Requires daily bronchodilator therapy taken by mouth or inhaled* 30% Medication Requires occasional bronchodilator therapy taken by mouth or inhaled* 10% *A definition of these medications is listed below. Swelling is the biggest problem with asthma, and so the majority of medications that treat asthma are for controlling swelling. Swelling is often a reaction of the immune system to things it doesn’t like. Immunosuppressive medications suppress this response, allowing the airways to remain open in an asthma attack. Similarly, steroids taken by mouth or injection are able to greatly reduce swelling. Both of these treatments are only used for the most severe cases of asthma and only when all the other medications listed below do not satisfactorily treat the condition. Some of the most common medications in these categories are Prednisone, Prednisolone, Decadron, Deltasone, Dexamethasone, Medrol, Orasone, Pediapred, and Prelone. Inhaled anti-inflammatory medications are steroids, but a smaller dose than oral or injected steroids. These reduce swelling and mucus production. They are used to prevent asthma attacks. Some of the most common medications in this category are Aerobid (Flunisolide), Flovent HFA (Flutocasone HFA), Azmacort (triamcinolone), Ipratropium Bromide (Atrovent), Asmanex, Pulmicort, and Qvar. The following are a combination of an anti-inflammatory medication and a bronchodilator (discussed next), but they are rated as anti-inflammatory medication: Advair (Fluticasone and Salmeterol), Duleva, and Symbicort. Bronchodilators are used by pretty much anyone with asthma. These keep the bronchi from swelling and blocking the airway. They are all inhaled, and there are short-acting and long-acting bronchodilators. Short-acting ones are the rescue inhalers that work very quickly and last between 1 hour and 4 hours. Common short-acting bronchodilators include Proventil, Albuterol, Ventolin, Salbutamol, AccuNeb, Levosalbutamol, Levalbuteral, Xopenex, Terbutaline, Bricanyl, Pirbuteral, Maxair, Procaterol, Metaproterenol, Alupent, Fenoterol, Bitolterol mesylate, and Ritodrine. Long-acting bronchodilators are used to control asthma and prevent attacks. Common long-acting bronchodilators include Sereveut, Salmeterol, Formoterol, Foradil, Symbicort, Bambuterol, Clenbuterol, and Indacaterol.

I second that. Click on this link to further educate yourself: http://www.diabetes.org/living-with-diabetes/complications/

IMO= Independent Medical Opinion IME= Independent Medical Opinion

My tinnitus sounds like a high frequency beep that lasts for about 5 minutes at a time throughout the day, but it comes and goes. I have to distract myself alot of the times. In recent months, I've had to ask people to speak up so I can hear them over the beep when it does occur.

Tinnitus can be severe or debilitating enough that it can cause secondary mental health disorders, particularly insomnia; anxiety; depression. Insomnia is considered a mental health condition. The VA will most likely combine all three to avoid pyramiding mental health conditions. Tinnitus article1.pdf Do you suffer from migraine headaches? Because if you are diagnosed with Migraine headaches that would be a seperate secondary condition that is rated seperately. Here is a BVA decision that would look similar to your claim. Read through it word for word to see how this veteran was able to get his claim granted. https://www.va.gov/vetapp15/Files3/1524859.txt

It's always a challenge get service-connected any condition, especially to link secondary conditions: 1. Most private Dr.'s don't know what a nexus of opinion is. 2.VA doctors will blatantly refuse to do them or are told not to do them by administration. 3.C&P examiners are usually not there to provide a favorable nexus of opinion.

If you are clearly diagnosed right now;with Anxiety/Depression then that is what you will be allowed to claim. If you are also diagnosed with insomnia, insomnia is considered a mental health issue. The provisional diagnosis is a temporary diagnosis. Your private psych doc administered a PTSD questionnaire, possibly to provided due diligence to you. Especially, if you mentioned a combat/non-combat trauma stressor that you don't recall mentioning. I would stick to your clear diagnosis to claim Anxiety/Depression. You'll be sent to a Mental Health C&P exam. FYI, all mental health disorders are rated the same. The majority of mental conditions are rated on the following schedule. Each rating has 5 main categories of symptoms/circumstances. Not every single symptom or circumstance has to be present in order to be assigned the rating, but the rating that most closely defines the condition should always be used. The Ability to Work: This individual cannot work at all. Social Relationships: This individual cannot participate in any relationships. In other words, they cannot interact or build a relationship with another person. Family members may care for them, but it is only a one-way relationship. They cannot seek, invite, or encourage any relationships. 70% rating: This rating will have the majority of the following circumstances and symptoms: The Ability to Care for Yourself: This individual cannot take care of himself most of the time. He is in the hospital or a care facility or is being taken care of by family members all of the time, and requires one-on-one supervision 50% of the time. This person cannot take care of his own personal hygiene. Medications: This individual requires psychiatric medication at all times. Symptoms: Some or all of the following symptoms will be present. – There is the regular possibility of hurting self or others (including suicidal tendencies) – This individual often cannot communicate logically – This individual is actively psychotic, but may have intermittent contact with reality – Obssessive-compulsive behavior that causes repetitive physical actions that interfere completely with daily necessary activities – Severe, constant anxiety – Mood often changes radically, without warning. – Almost constant severe depression or panic, with the inability to function at all in stressful situations – This individual cannot control impulsive actions like anger, violence, etc. – Often disoriented to time and place The Ability to Work: This individual may not be able to work at all or may be severely under-employed (such as a former intelligence analyst now working part time as a custodian). Social Relationships: This individual cannot participate in any relationships most of the time. In other words, they cannot interact or build a relationship with another person. Family members may care for them, but it is normally only a one-way relationship. They cannot seek, invite, or encourage any relationships the majority of the time. 50% rating: This rating will have the majority of the following circumstances and symptoms: The Ability to Care for Yourself: This individual is occasionally hospitalized, but can mostly take care of the basic personal needs like bathing or going to the bathroom, although their personal hygiene may not be kept up regularly. They may also be able to function in areas like shopping, driving, cleaning, etc. Medications: This individual requires psychiatric medication at all times. Symptoms: Some or all of the following symptoms will be present. – Trouble expressing or showing emotions (This doesn’t mean that they are just reserved. It basically means that they are completely blank the majority of the time), or shows the wrong or inappropriate emotion for the situation – Always shows significant signs of anxiety – Regularly gives unnecessary or unrelated details when communicating – Two or more panic attacks a week – Trouble understanding complex directions – Trouble remembering things (forgetting to complete tasks, etc.) – Trouble thinking logically and often has poor judgment – A serious lack of, or a seriously increased, mood or motivation – Occasional delusions or hallucinations – Regular to nightly trouble sleeping (nightmares, insomnia, anxiety, etc.) – Complaints of physical symptoms, like pain, that do not have a physical cause – Suicidal thoughts, but no definite plan to hurt himself The Ability to Work: This individual may try to work, but will not be able to hold a job for more than 3 or 4 months because of their inability to remember or follow all directions or other similar reasons based on the symptoms or circumstances described under this rating. (In other words, they wouldn’t lose their job simply because they have anger issues and would regularly get in fights. A person like that could also not hold a job more than 3 or 4 months, but they would still be considered able to work). This individual would only be hired for jobs like cleaning, picking up trash, or other simple-task jobs. Social Relationships: Like his ability to work, this individual may try to build and engage in relationships, but these relationships would not last long in most situations. Divorce or other breaks in relationships and friendships could occur due to his inability to properly participate in a relationship. 30% rating: This rating will have the majority of the following circumstances and symptoms: The Ability to Care for Yourself: This individual may have occasional, short hospitalizations, but can entirely take care of himself most of the time. Medications: This individual usually requires medication to function normally. Symptoms: Some or all of the following symptoms will be present. – Spikes or drops in mood, like depression – Often anxious or becomes easily stressed – Panic attacks occur, but no more than once a week – Difficulty sleeping (nightmares, insomnia, anxiety, etc.) – Mild memory loss could include regularly forgetting names or directions – Often suspicious of other people, particularly ones he does not know The Ability to Work: This individual will be able to work and will usually function normally. There may, however, be occasional times where he is unable to properly fulfill all job requirements. This could result in occasionally losing his job. Social Relationships: Like his ability to work, this individual will normally have fairly stable relationships. These relationships, however, will not be great and will often be strained by the symptoms of his condition. Divorce or breakups could occur, but not in every case. 10% rating: This rating will have the majority of the following circumstances and symptoms: The Ability to Care for Yourself: This individual will always be able to take care of himself and will very rarely, if ever, be hospitalized. Medications: This individual may or may not be taking medication. Meds may be taken all the time, or only during stressful times. They satisfactorily keep all symptoms under control. Symptoms: Some or all of the following symptoms will be present, but only during times of significant stress. The majority of the time there are no symptoms. – Mild depression or other mood changes – Mild to moderate anxiety – Mild panic attacks may occur, but very rarely – Occasional difficulty sleeping (nightmares, insomnia, anxiety, etc.) – A range of other, very mild symptoms, which could include suspiciousness of strangers and hyperarousal The Ability to Work: This individual will be fully employable and will very rarely have any problems at work that are caused by the mental condition. Social Relationships: This individual will have full, functional relationships with only occasional, mild stresses that are caused by the condition. 0% rating: If a mental condition has been diagnosed but there are no symptoms that impair social or occupational functioning or require medication, then it is rated 0%.

Sleep study or in the Dr.'s notes/nexus of opinion must also state "medically necessary/required CPAP". VA trickery. Here are two medical articles that links them. You can present them to your Dr. or submit them as additional medical evidence. Claim it "OSA, as secondary to Asthma/COPD." Best wishes. Asthma_and_obstructive_sleep_apnea_More_than_an_as.pdf sleep-problems-asthma-copd.pdf

Well, it wouldn't hurt to request your C-File. Copies of your service medical records might be in there. See forms attached. You will be making a FOIA/Privacy Act Request. If you don't know your C-File number it's C- [your SSN] You can mail it CERTIFIED MAIL. If you fax it, make sure to get a fax confirmation #. You'll get it within 5-6 months or more (unfortunately). Do not make multiple requests. You'll delay receiving your c-file. Best wishes. 2017-01-18+Claims+Intake+Fax+Coversheet-1.pdf va3288.pdf

Since you did enter service with pre-existing Pes Planus, you'll need to see if the examiner was able to state "at least as likely as not" (equal to or greater than 50% aggravation of pes planus was due to military service. That would provide you with a favorable nexus of opinion. What was your MOS?

#1. Were you diagnosed in-service for both, that you are aware of? #2. Hallux Valgus is rated 10% if you had surgery or if it's severe enough that it's would be as if the big toe was amputated. 0% if it's mild or moderate. Flat feet are tricky with the VA. If you were not diagnosed in-service for either, it will be very difficult to get a granted decision. Even if you were diagnosed in-service the VA LOVES to say that Pes Planus are pre-existing or congenital. Furthermore, even though your entrance exam would say "normal archs" they will still make the arguement that your flat feet are pre-existing and congenital. LOL. I know because I've been fighting that since 2007.

I thought claiming one disability at a time would save me time. I thought wrong. That's what I get for "thoughting and not thinking." Claim the disability/disabilities you believe have effected your daily life in a negative way or has limited your earning capacity(lost jobs, wages, promotion opportunities, etc.)

If you were clearly and unmistakably diagnosed with Migraine Headaches and not just "Headaches" in-service. You have a shot at seperating the Migraines from TBI. Be prepared for the VA to fight you on this tooth and nail. ED can be claimed for Special Monthly Compensation. It's rated 0%, but since it is considered loss of creative organ, it is still compensable. ED is an extra $100. OSA will be hard to direct-service connect if you were not diagnosed in-service. Secondary-service connection is the only way. Since you're service-connected for TBI....OSA is prevalent among TBI patients. Don't believe me? I'll just leave an article below. You could even secondary connect OSA to PTSD, if you're SC for PTSD. You can still re-open a claim under the new law, but you'll have to submit "new and relevant" evidence in the supplemental claim lane. OSA and TBI article.pdf

Read this: https://www.nap.edu/read/11443/chapter/6 You may be able to use the article as additional evidence below. Tinnitus article1.pdf

Yes for Sleep Apnea, as secondary to PTSD meds. Before RAMP was implemented. I had a VSO that tried to claim Sleep Apnea direct-service connection...got denied. I re-opened it, on a secondary basis to PTSD meds...denied again. I re-opened it again, but I had a DBQ filled out by my sleep dr that time. I was scheduled for a C&P exam and the examiner gave a favorable nexus of opinion. Tinnitus is capped at 10%, no matter how severe it is, but if it is aggravating or causing you anxiety. You can claim Anxiety, as secondary to Tinnitus. To secondary-service connect: 1. Must have a service-connected disability (your Tinnitus) 2. Must have a current diagnosis for Anxiety 3. Must have a nexus of opinion stating the minimum threshold of "at least as likely as not" (equal to or greater 50% probability) that #1 and #2 are linked. A rationale must be provided as well. I agree with Buck52.

Well I expected to get denied. It's a bummer, but at least, the claim was reopened and I can appeal. Should I go supplemental claim or higher review?? Possibly go to BVA? RO continues to overlook the daggum presumption of soundness. I went into service with normal arches and was diagnosed with flat feet in-service. Also, towards the end there's an error, I wasn't diagnosed OCT 9 2007 (I call BS). By then I was already out three months. I was diagnosed in-service Dec 6 2006...7 months before I was discharged JUL07. I noticed in my C-file, that they only sent me for a DBQ with LHI; even though I had already submitted a DBQ from a private Dr. Wasn't I supposed to be afforded a nexus of opinion with that C&P exam? Denial Letter 4-18-19.pdf Denial Letter 4-18-19p2.pdf

UPDATE: My re-open claim likely was denied. Ebenefits still shows Bilateral Flat Feet-not service connected. Hopefully, when I get my BBD they at least consider it re-opened and I can appeal. If not, I'll be 10 grand in the hole. Just my luck.

Yay! I'm another statistic. Lol. Well my reopen claim likely got denied. I'm not giving up on it though. I'll wait for the BBE to see what happened.

Check your disabilities list and see if your claimed condition was SERVICE-CONNECTED. If it says not service-connected and your disability rating did not increase then it's likely a denied claim. But, you'll have to wait to get the actual letter. Ebenefits isn't always reliable.

yea, I got a hold of skip back in october and I re-sent my records to his colorado residence. I kept copies of everything and overnighted those copies.