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El Train
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Posts posted by El Train
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I'll be following since I'm going through the same thing. I do have a law firm representing me so if I get any info. from them, I will pass it on.
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I'm at the 30% fee for a retro claim going back almost 30 years (80% and they are trying to increase it). It is two law firms working together (CCK & Woods & Woods). Nobody else was interested, so I feel fortunate. You know the old saying, 70% of something is better than 100% of nothing.
Now this eaja thing is not something I've not heard of. I'm not sure it's something they would even entertain at this point. Entertain me if you think it is.
In fact, I just emailed them about this.
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I'm not a believer in HLR, but my attorney just filed one on my behalf. We also have an appeal for the same conditions and retro filed last July. I wonder if they are just seeing if they can get it resolved through HLR, and if not, then proceed with the appeal. It was quite a lengthy letter sent off for the HLR.
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Ahh yes. The first C&P with the VA was a real eye opener. I learned so much from it. I should write that Dr. a thank you letter. Maybe I will when I win my NOD against him. After that embarrassment, I had IME/DBQ for all other claims prior to submission. I utilized outside Dr's who know the in's and out's of VA lingo. Found them through various websites and facebook groups. What a difference. Luckily I had the means to pay for and travel to get them. Winning was my end goal. And I didn't want to play their games. I hammered them, they hammered back, and now I'm 100% P&T. I abide by their laws and regulations and used it to my advantage.
Winning wars is what we were taught. I approached this with the same mentality. After all this, my VSO was asking me for advice.
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I didn't have any luck with my HLR. Doesn't mean you won't. I too had overwhelming evidence and nexus from a forensic MD familiar with VA lingo. Still denied. I can easily win in an NOD. But why should I have to go this route? Because the rater wants me to go this route in hopes we give up. Some of them are also lazy and rubber stamp it. So be prepared for this.
I got approved the first time for PTSD because I had a VA Psyc diagnose me. Also had some VA mental treatment history. I had two stressors I told the VA C&P guy. None backed up with buddy statements. However I'm sure they were part of DOD records and corroborated with my service records.
I applied for an increase with outside Dr's IME/DBQ. The VA did not like this approach at all. But in the end, I won on all mental and tbi conditions. They don't make it easy. I get it however. There are a few bad apples out there trying to take advantage of benefits that ruin it for people that legitimately need it. Keep up the fight and maybe go to VA mental health if you haven't. They are pretty good actually.
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You can hire an attorney and pay them their fee. It sounds like any VA law firm would love your case. Or you can do the medical gathering yourself like I did and take it to the VA yourself. I got 70% tbi (initial claim) for an in service training accident that knocked me out for less than 10 minutes. After I submitted my outside medical evidence from Dr's. that are well versed in VA claims lingo, I had several C&P's. 3 TBI & 2 PTSD. The initial TBI C&P was from a Neuro Psyc. with QTC. 2.5 hours worth of testing. I got agitated with the first guy about the tests. He said if we aren't thorough this first time, the VA will try to screw you. That chilled me out and put my trust in him. He wasn't bullshitting. He did me right. The VA put me thru two more TBI C&P's. Why? Only thing I can think of is they were looking for a different opinion, or clarifying things. Maybe they were hoping they would find something to screw me, like the good Doc said.
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Yes. He did a great write up for me. DBQ and IME. He destroyed the VA's DBQ. Also, did a TBI IME based on another MD's TBI diagnosis.
In the end I got raised to 100% ptsd from 50%. 70% tbi initial claim. P&T.
It takes him awhile to get at it and doesn't have the best communication. This worried me for awhile.
Don't make the mistake I did and hand the VA C&P examiner his evaluation. This pisses them off. Just have your VSO file it with your NOD and keep it on the low down. The rater will have access to it. I had to file a formal complaint against a QTC Psyc, for biased C&P in which she tried to undo everything Dr. Valette had to say. It didn't work for her. But I did have to do extra C&P's after that. You will get VA C&P's once you file an NOD with this additional evidence.
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This just happened to me. 100% PTSD and 70% TBI. Rating 100% PTSD with TBI rating because PTSD was the higher of the two. Also P&T.
They did separate 10% migraines.
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4 hours ago, GBArmy said:
SPO I truly think it would be a waste of time, unfortunately. I think as several have advised, submit another to Janesville or to NPRC, whichever you didn't send it to originally.
El Train So where was that posted specifically?
Where I sign in to see my claims filed with ETA's. They're not always accurate. In fact most the time they are not.
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I requested mine early Oct. 2019. Vets.gov is stating completion date of April 22, 2020. We'll see.
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I read through this a lot before applying. Hopefully it helps, if you haven't already found this.
http://www.militarydisabilitymadeeasy.com/tbi.html
Also, my three C&P examinations for TBI seemed to cover this outline pretty closely.
https://benefits.va.gov/PREDISCHARGE/DOCS/disexm58.pdf
There are DBQ's for it. Sounds like you have one.
Here is one I had done from an outside MD. This is what got the ball rolling. See files.tbi redacted E0021.pdf
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Well this is not what I was expecting at all. My outside IME/Nexus/DBQ all stated I should be 70% ptsd and 40% TBI. VA rated me higher on both. After 2 ptsd (for an increase) and 3 TBI C&P's for initial claim, I am more than happy with their decision. I did get 10% for migraines also. Even though I fit the 30% criteria (have more than 2 per month). And I specifically told the C&P examiner this. He stated less than 2 episodes per month. Oh well.
Sorry about the 3 different files. My scanner app just does it this way. Unless I pay for the pro version. And I don't pay.
tbi_ptsd redacted0018.pdf tbi_ptsd redacted0019.pdf tbi_ptsd redacted0020.pdf
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On 2/22/2020 at 2:25 PM, gba said:
In 2017, the Veterans administration audited my benefits. It was determined that I received an overpayment of 39,000. Waivers were denied. In 2018 I filed an appeal. I presented evidence which my audit.
The evidence was available on the E-benefits page outlining payment history. I was granted my appeal after 2 years and 24,000 dollars reduction of benefits. The financial hardships are heavy. I am single.
Cant imagine the impact on a family. This is a success because I decided to follow my initial instinct. Not sure about the return of deductions. Haven't received paperwork. Good fortune to all especially to families.
GBA
They audited your benefits? They deemed your percentages to be wrong? Did they do a follow up C&P to determine this? This would be terrible.
I'm P&T at 100% but I still worry this could happen to me. The words 'you're being audited' brings anxiety to another level.
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Sleep apnea isn't a presumptive to the Gulf War. Get with a VSO prior to filing this or you're going to get denied.
Here is some good info. on Gulf War. http://www.ngwrc.org/
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No, they won't. They can only rate one mental disability.
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1 hour ago, JKWilliamsSr said:
Any doctor whether it is a VA doctor or an outside doctor can provide a recommendation for a rating. It is still up to the rating officer as to what percentage is granted if at all. The best thing the doctor can do is make sure that the documentation they are submitting has the necessary symptoms that are necessary for the rating they think you should have.
This is true. I had two outside doctor IME/Nexus with percentage recommendations. The VA gave me higher ratings on both contentions. Blew me away. Usually the Va is notorious lowballers.
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2 hours ago, paulstrgn said:
I was 100% P&T when I filed my HLR for the VA not rating my hand correctly. THe VA agreed with me and moved my 100% P&T date back a few months and I received a retro of over $3K. So even if you are 100% P&T you can still when and in my case receive some retro.
In my opinion you should never give up if you are correct. When you give up the VA wins and you lose,
JMO
I hear you. I'm pursuing back pay to 93 as it is. Even if my HLR was approved, it would've got back dated to when I received 100% P&T. I have back dated appeals on other issues that will get approved prior to that, that should get me back pay. I'm also smc-s without the HLR approval.
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3 hours ago, pete992 said:
As always it would be your call to pursue and take your claim to BVA even though you are rated 100% P & T. The meaningless victory is telling VA you do not need the extra $300.00 a month/pay check if you meet the SMC level.
I'm at smc-s now.
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My HLR got denied. Dude still went with the VA's NP opinion over my outside IMO from a forensic MD. I had all three collusa (sic). In service incident, treatment records, and MD opinion linking the service disability to the in service incident, and buddy letters. I would easily win in an appeal. Easily. But since I'm a 100% P&T, I'll let the VA have it's meaningless victory. Throw them a bone. Good job guys. You got me good. If I wasn't 100% P&T, I would be stuck in appeals for years only to win.
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21 hours ago, awgv001 said:
Yeah @El Train, and it makes no sense sometimes to me how I have been denied repeatedly, even though I have a majority of the "regular" symptoms, and in service event/trauma...(as well as all other caluza elements) they rubber stamped a denial saying "You did not have a conclusive diagnosis of TBI"...Bull hockey!!
Again, I'm just glad to be getting another referral to a new neuro---something so hopefully I have another shot at a better explanation and a more detailed exam ---
I'd be more than happy to attend a C&P exam if they would finally issue one for me...
Interestingly enough, the workups for TBI that I did sound nothing like what @Richard1954 has had, so now I'm really confused as to what they have had me doing this whole time.
I had CT/MRI - and a couple of questionnaires, and a test of touching fingertips to my nose, but no memory tests, or pictures or anything like that....wth????
When did I join the circus????
Good deal. If you need, I have a Psyc Dr. that will tear any of your past C&P's to shreds. He does C&P's for the VA and will work on behalf of vets too (for a cost of course, which is worth it). He will separate and diagnose as well as increases for TBI/PTSD. I will warn you however, the VA may not like this approach. But ultimately, they have to take this evidence into consideration.
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13 hours ago, FlyHigh1995 said:
I’m more confident now with an attorney and my evidence that I have a pretty good chance of rebutting the C&P examiners report. Not sure I want to spend more money on DBQs, IMOs, IMEs...if VA seems to ignore them. But I may give Dr. Anaise a try after consulting with him on getting an IMO for recent obstructive sleep apnea, chronic fatigue, peripheral neuropathy, diabetes Diagnosis secondary to Gerd. Been working overtime paying for medical expertise...just making my disabilities worse. But I will prevail in my quest for benefits.
I had a similar experience. VA gave more credibility to a VA NP vs. Dr. Ellis who is well versed in this stuff. I even had an HLR deny it too. I definatly would win in an appeal. But since I've gotten 100% P&T thanks to the wonderful Dr. Ellis on a host of other contentions, I'll let sleeping dog's lie. Throw the VA a bone, so to speak. Let them have there small victory.
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Before I applied for TBI claim, I had two nexus (MD & Psyc) letters and one dbq (psyc) turned in. Paid for out of pocket because I knew they would deny. Got called in for 3 VA C&P TBI's. First one took 2.5 hours with QTC. It was at least as likely as not. 2nd C&P took 1.5 hrs, same thing, with additional symptoms (she wasn't amused VA sent me in again and was very helpful). 3rd C&P, the Dr. says he's the tie breaker. Tie breaker for what Bro!. It's four positive opinions already (one MD, one Psyc & two Neuropsycs). Guess it went good. I just got my rating approved for TBI at 70%. They also increased my PTSD to 100%. The combined both under the PTSD. To many overlapping symptoms.
It's crazy what they put us through to get TBI approved.
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Similar situation as you. Except mine goes back to 1993. Got denied because no military medical records could be found. Found the military medical records and got approved at 80% in 2018 for the same claim in 93. Have a lawyer take my case for back pay to 93. I'll let you know how it goes.
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Good job Bronc. Used VA law and regulations to your benefit. I did the same. Only took me 3 years for 100% P&T. Another source for outside IMO's is great. There aren't a lot of them out there for vets. I had to travel to get mine. Lucky I have the resources to do that. Most vets don't. And it's unfortunate. These are key to fighting the VA hired guns. Fight fire with fire.
Next battle is getting back pay dating to 1993 for a BS denial back then. Got a high powered law firm that took the case.
Paid Fraudulent DBQ question
in VA Disability Claims Research
Posted
Get a copy of the VA DBQ. Then take it to your DR. and have them write up an IME. They can cover everything from there. That's what I did. Not like I've had a VA C&P examiner do a 20 minute exam, skip questions, fail to ask the question but put their opinion, state no in service incident when there is a whole page of the incident in my smr's, or opines the disability resolved itself while still getting treatment for it to this day, etc. An outside DR. can fill in the blanks or point out errors. It's just a second opinion, that's all. VA has a tuff job and are overloaded. They should appreciate the help. I stated this on the other forum; well they didn't see things my way. At all! That's too bad. For them.