McRay

Sounds like you may need an independent medical opinion or exam. You would have to have a nexus to get a rating for PTSD (in service event, current diagnosis, opinion linking the two). Not much info to go on, but it might be helpful if you could get a VSO to start the ball rolling. I think filing claims can be confusing and complicated and the VA is getting more and more requirements. It helps to have a strategy. Might even call a couple of VA attorneys and see what they say. I was a lot more confident about my claim after hiring an attorney.

Various C&P exams I've had done by the VA were always negative for me. I had one C&P exam done by an outside company and that was favorable. VA care is somewhat touch and go also -- a lot seems dependent on where the facility is located. It helps if you have a Dr who will advocate for you and your treatment. I've had 3 in 30 years.

Thanks. That explains it. I was not aware of staged/Fenderson ratings

Thanks for the reply, but my question is would the EED be at my current rate or if I win the appeal and get a higher rating, would that be the percentage back to 1978? I'm aware that 50% in 1978 was substantially less than than 50% today.

I was granted SC from a claim I filed in 2015. I currently have an appeal at the BVA for an increased rating and an earlier effective date. My question is if I win my appeal and am granted an EED of 1978 and increased % that would give me either 100% schedular or 70% and TDIU how would that work? It seems that some SMR's were not considered in my original denial in 1978 and were instrumental in overturning the denial in 2016 . The appeal legal brief is requesting a total rating of 100% or 70% and TDIU as of September 2015 and EED of 1978. Would the 1978 EED be computed at my current rate or would it be the increased rate?

Congratulations! Always nice to see someone win. What percentage did they give you?

I sent a secure message to the patient advocate this morning. Here's the response: It appears the VA is cost cutting. Not one of 5 prosthodontists in the Tucson community is accepting Tri West. Seems odd.. Guess the next step is my congressman..

There are many docs who specialize in Independent Medical Opinions/Examinations. I don't know if I'm allowed to post any links but I'm sure there are listings somewhere here on Hadit. Probably can google VA IMO doctors too. I had one done, it was handled by my attorney and I haven't seen it yet, but I'm sure it is pretty comprehensive. If I have to get another one, I would expect to pay from $1500 - $2000 but that's just a guestimate. Your situation may be less complex since you are already service connected and therefore less expensive. I've gotten so many different MH diagnosis from the VA that I no longer have much faith in them. If you can afford it, get an IMO. As always, do your research and consult several different docs.

Thanks @broncovet good advice. I guess another part of my question centers around 'Choice Care'. I thought vets were allowed to go into the community for care if they were over a certain distance from the VA med facility or if there was a scheduling problem where the Vet would have to wait to long for the appointment. Maybe this doesn't apply to Dental patients? I would think my situation would certainly apply for community care -- I'm more than 50 miles away from the treatment facility and they don't have a prosthodontist on staff at the current time. I sent the information via Secure Message to the dental clinic this morning and by noon, the dentist had called me back to tell me how she had gone to her boss and he had informed her the VA had no 'contract' with any outside prothodontists. I asked her "so this is basically a money/fee problem" and she said yes. I'm considering contacting the patient advocate, but I've got a feeling this is one of those 'dead end' paths. The dental clinic has decided my only treatment option is a denture and they are going to do whatever necessary to prove themselves right. Why is it that VA Math always favors the VA?

On a side note, I dropped off the form for travel pay and the lady told me they had moved to a new system and were working on travel pay forms from the 1st of July. Wonder if this is indicative of cost cutting measures?

That's logical and would work. Not in keeping with the VA motto of 'delay delay delay' though.

I'm service connected for dental care. Recently I have a problem with a bridge loosening up and it's complicated by bone loss and a span of 7 teeth. I saw my VA dentist yesterday and the Tucson dental clinic doesn't have a prosthodontist currently. One guy retiring, another being hired and going through the process. There are 5 prosthodontists in the community, but it seems the dental clinic has changed their provider contract to Tri-West? and they won't pay the going rates the community docs are charging. Apparently the new community care guidelines don't apply to dentistry? Any of you guys had problems like this or any recommendations?

https://www.federaltimes.com/management/2021/07/13/pandemic-exposed-strain-from-va-benefit-appeals-caseloads/ The amount of problem attorneys at the BVA is shocking. They only have to do two appeals per week?

I got my latest c&p exam from my attorney. If I remember correctly, he had to file a FOIA in order to get it. Now when I check my claim status on va.gov it says to contact the RO if you want a copy of your c&p exam.

Broncovet: Thanks for the thoughtful response! Only thing I want to add is that I'm not at the CAVC -- just waiting for appeal to go before a BVA judge.

This one is applicable for me. I have other claims I would like to file (OSA, sinusitis, rhinitis, etc.) but my atty tells me to hold off until current appeal is decided. Current appeal is for higher MH rating and EED to '78. He was able to get SMR's that weren't considered in original denial. The EED is warranted under 38 CFR 3.156 (c) so I imagine VA will do anything to not have to pay retro. I searched the BVA website and found only 1 instance of a case with 38 CFR 3.156 (c) in the past 3 years. I've read that it doesn't make any difference filing under the new AMA system, that the different lanes don't overlap but I guess I'll just hold off on filing the other claims. Seems a shame to pay top dollar legal fees and then not take my atty's professional advice.

Wishing you the best Buck and hope your wife recovers soon

I can never figure out what BVA is doing.. Last time I called the rep said they were working on stuff from June of 2019 and my docket number was issued in September of 2019. At that time va.gov said they were working on appeals from November of 2017. A google search on va appeals timeline shows a 270 day average from docket to decision in 2019, but so far I'm at 22 months and counting. I have other claims I would like to file however atty counsels waiting until this appeal is decided. Reasoning behind waiting is VA will use any opportunity to avoid paying out for an EED. And I'm like @pacmanx1-- just want the decision and hopefully the validation of being 'right' after all these years.

@john999 is right. I spent about 10 years between Port Charlotte, Punta Gorda, and Fort Myers on the west coast. Prices were cheaper when I first got there, it was kind of a rural area once you got 20 miles inland. I've heard in the last 5 years since I've been gone, they really have sky-rocketed. There were a lot of veterans in the American Legions there. The one in Port Charlotte was big, around 1500 members, but of course, lots were snowbirds. Summer heat and humidity is almost unbearable, though.

My vote would go to Florida. The state has been trying to attract disabled vets for years and has lots of state perks/assistance for vets. It's big business (or used to be) for Florida. That disabled plate that signifies 100% disability is a real chick magnet too Unfortunately, I don't like Florida...

The suicidal ideation will probably bump you to 70. But you never know with these raters. What did she say about risk of harming yourself or others?

Doesn't 100% schedular also have some benefits like spaceA military flights and base MWB benefits?

The way I have it figured out, and correct me if I'm wrong, is the HLR is a DRO review similar to the SOC review and the board review is done by VBA law judges. I think you can't submit new evidence with the board review. That said, I think Shrek is right, just go for the board review because HLR will probably deny.

I talked with my claim mgr about the teleconference listing and she said it's happening a lot. Some sort of default setting for the software.

I tried it and it didn't seem to make any difference.