JKWilliamsSr

If your service medical records have conditions in them then service connection is pretty much a slam dunk. You do not need a nexus from any doctors because the VA should grant you direct service connection based on 38 CFR 3.304. What percentage (if any) is determined by your symptoms. The VA can give you service connection and only give you 0% This is where needing an outside nexus letter can come into play. If you get an unfavorable opinion from a va examiner you have to counter that evidence. It is most common to need additional evidence for secondary conditions. For example, you are service connected for your knees and after a while you start having back issues. This could be caused by a variety of reasons but it is commonly noted that foot, knee and ankle issues can cause back issues because of gait changes. However, the VA examiner gives an opinion that your back condition is not caused by your service connected disabilities. The VA uses that opinion to deny you. You can argue by submitting evidence that shows how a back condition can be caused by knee issues and it should have been submitted with your claim. There is plenty of evidence out there that shows that. BUT......the VA will still deny in a lot of cases. A big issue is overcoming a negative opinion from the VA examiner. A nexus letter from an outside source would help with that. Many civilian doctors will not write one for you. If you get your treatment from the VA they will tell you that they not allowed to even though the law says differently. So the only way is by a doctor that specializes in these letters. By law if you have evidence in favor and evidence against the benefit of doubt rule applies and service connection is granted. This rule is often ignored at the VARO level which is why so many people win at the BVA level. I will pretty much give this advice to anyone. File all claims before reaching out to an outside source. There is absolutely zero need to get a nexus letter until the claim is decided. See what the VA will do. If they deny you based on a negative opinion from their examiner then I would suggest getting an outside nexus letter. For me it was the difference maker. It took me 20 years to get to 100% and took an IMO I got in 2019 to do it.

This is a clear example on how the VA is very inconsistent in decisions. They just want to deny because for some reason the believed their pay will be docked to pay for your increase.....lol. When I filed my initial claim for sleep apnea I filed it using obesity as an intermediate step. I stated that my service connected disabilities prevented me from exercising and led to my gaining weight I had an IME that supported my statements. In the denial the VA examiner used their examiners opinion stating that my obesity was because of my personal choices such as eating habits. He went on the state that my service connected disabilities do not prevent me from "ALL" exercises and used in his rationale that paraplegics find alternate exercises and maintain a proper BMI......(I can't make this stuff up) I personally do not have PTSD but I have friends with it and a couple of them eat quite a bit when they are stressed. It is part of how they cope. The VA examiner IMO failed miserably at his job. A statement he made in his rationale shows how clueless the are. They stated that " You submitted many articles re: mental disorders and OSA but these studies show correlation and not causation." Here is the problem with that. A service connected disability does not have to "cause" a condition to be service connected as a secondary condition. Just aggravating the condition would be enough. I am service connected for Type II Diabetes because my sleep apnea aggravates it" and was granted by a BVA judge for that reason.

I actually commend you on being able to win this. I do think this situation is different than what most of the people here are going through. First your issue is not service connection. You are already service connected for your disabilities. On top of that it appears that you have a positive opinion from a VA examiner. That carries a lot of weight. I also understand that there was VA opinions against but the equipoise rule came into effect. You had VA opinion for and VA opinions agains. Please do not take this as a knock against your accomplishments. One thing I have read a lot over the years. TDIU is one of the hardest things to get. The horror stories I hear about the fight for it makes me cringe. To do this on your own is commendable but let's be fair. It is not easy either. In fact I hear it is extremely hard to just get TDIU and to get an earlier effective date on top of that. I can only say whew! that is a lot. Many may not be able to make the arguments you made. I am going to try to clarify my point. The biggest issue I had to overcome is the negative opinions I received from VA examiners and that is "S" for plural. More than one VA examiner gave negative nexus opinions for most of my disabilities. The direct service connection claims I did not have any issues. Any disabilities that were in my service medical records I was able to receive service connection. That was the easy part. However, when it came time to service connect secondary conditions the VA fought me every step of the way. I had everything necessary for service connection with one exception. I needed a nexus and the VA would not provide it. I needed an outside doctor to get one. Lay statements are not enough when you have a medical professional against you. These are not conditions that are in your service medical records.

I am pretty sure no one will ever dispute that you DO NOT need a medical nexus to get service connection. There is way too much case law on this one of the most well known is Jandreau v. Nicholson 1) A layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. I think those that keep pointing out that you do not need a medical nexus are completely missing the point by those of us that suggest you should get one. I will take this comment one step further. Can anyone identify a post and link where people have argued that an "MD doctor's formal nexus opinion is almost always needed for a vet to be granted disability benefit claims from the VARO and BVA" The following are things that happen on my own personal claims. 1. 18 years after my initial denial I was finally awarded service connection for flat feet. The rater and C&P examiner ignored my plantar fasciitis. These were all in my service records that the VA ignored and were in my C-File only when I submitted hard copies I got from the VA was the claim reopened. and I was lowballed with 10% total. I filed an HLR explaining the errors citing case law and regulations. The decision was upheld. I was fed up. I hired an attorney and we appealed with supplemental claim that included an IMO. I was awarded 50% for Pes Planus with plantar fasciitis. 2. I filed a 2018 claim for twenty one (21) conditions secondary to service connected disabilities. I had diagnosis and treatment records for each of the disabilities. I submitted statements in support of my claim for each diagnosis describing the effects and how I feel the are caused by my service connected disabilities. I submitted statements from my wife and ex-wife that showed continuity of symptoms and what they witnessed. The VA scheduled C&P exams each disability I claimed secondary and denied them all. These were part of the claim denials (with my foot claim) that led to my being fed up and hiring an attorney. We filed an appeal directly to the BVA with an IMO from an outside doctor. We opted to NOT have a hearing. I was award service connection on all of them at the BVA level. Four of them were remanded back after the grant for an exam to determine percentage. I was given 0% for 3 of them and 10% for one. Another lowball but I was at 100% before the remand exams so I am not going to make an issue of it. It took me 20 years to get to 100% P&T and it should not have taken long. I got to 50% (45% rounded up) on my on without any outside help but I was lowballed and denied on so many that should have been awarded. However I had to fight the VA and in order to do that I was forced to get outside medical opinions. I have said this before and I will say it again. Most people that come to these forums are more than likely at the appeal process. They had already been denied and need advice. My advice is going to be what I think they should do based on my experience. That advice will almost always include getting an outside medical opinion to counter the negative opinion from a VA examiner.

I am sorry dude but you are posting an opinion saying IMO's are not necessary and I think that is bad advice. An issue I have here is that someone disagreed with your opinion and your response to him is " are you getting a cut". It is clear you have a negative opinion of those that say get an IMO and your responses to them show it. I will say this from the personal experience of a 20 year battle with the VA. I will tell anyone that is going to the BVA with an appeal to get an IMO if they do not have a positive medical opinion in their file. It was the IMO that got me over the top. I failed at every turn without one.

I agree with you on this. The truth is there comes a time where the best advice you can receive is to get an IMO. The majority of people reaching out to forums such as Hadit have had to deal with multiple denials from the VA. They believe they have all the necessary information and yet keep failing. They are trying to figure out what the problem is. For the most part you only get one shot at an appeal and you want to make sure you have it right. Getting IMO's was the best decision I could have made. It took me 20 years to get to 100% P&T and the disabilities I am rated for now are all the same (except 1) when I first filed in 2002. The hurdle I kept having to jump was the VA examiners inept opinion stating my disabilities were not service connected. Once a VA examiner gives a negative opinion the best way to refute that is by getting a positive opinion from another medical professional. In my experience most VA examiners are Nurse Practitioners or Physician Assistants. I don't think they are qualified to give the opinions they are making. That is just one mans opinion. When people come here they are likely at the appeal level and this is where it can be daunting. When you take an appeal before the BVA you are dealing with attorneys. The VA is going to have an attorney argue against your claim. We will need evidence to the contrary. If you go before the BVA and they have a negative opinion you have to argue that opinion was wrong. There is plenty of case law on how claims are supposed to be adjudicated how many of us point out errors and get the VA to acknowledge and accept it. I know I can't because on 3 HLR's I cited regulations and case law and still had my claims denied. I will give an example on how that while we may have information our application could be incorrect. This is directly from my own argument that I made during and HLR and it led me to hiring an attorney and getting an IMO. For Diabetes I argued that because of my service connected disabilities I was unable to exercise. This led to weight gain which caused my Type II diabetes. The VA had 2 negative opinions. One from an MD who stated that paraplegics can exercise and maintain a proper BMI. Another from a NP that stated that she did not see where I was placed on waivers from exercising while on active duty and thus could not relate my weight gain to Diabetes. Both of those opinion are flat stupid but they worked against me. It was those opinions that led to my throwing my hands in the air and getting an attorney. Through my attorney I got an IMO and this was the difference maker. If I was to argue this on my own at the BVA I would have used the obesity as an intermediate step leading to Diabetes. Would that have worked on my own I don't know. However my IMO used that and other theories to service connect my diabetes. It was one of the other theories that the BVA judge granted my service connection on. In my BVA decision the judges stats and I quote: "In his august 2020 report, Dr R.L. opined that the veterns DM was aggravated by OSA. He reasoned that OSA can impair glucose control, citing a study showing a clear inverse relationship between OSA severity and glucose control in patients with DM. Dr. R.L also cited another physician who reported that OSA can also increase blood sugar levels because of the stress associated with Chronic Cleep deprivation and abrupt awakenings in the night." Although there is a negative nexus opinion of record, that the opinion address the relationship between the veterans orthopedic disabilities and his DM; The veterans OSA was not considered" Given Dr. R.L's positive opinion, the evidence is at least in equipoise that the veterans DMII was aggravated by his service connected OSA. Accordingly service connection is warranted" This is how an IMO can make a difference. Suggesting a veteran should get an IMO is reasonable.

I can attest that a letter from your wife is all you need to show continuity of symptoms. My recent BVA appeal cited letters from my current wife and from my Ex-Wife granting some of my disabilities. Now I will say that I had an IMO as well. That may not be needed but the more evidence you have the better. My IMO was a positive opinion (obviously) and the VA examiner provided a negative opinion. The BVA judge cited the two letters and actually stated they were the reason for finding my IMO's more probative. It took me 20 years to get most of my disabilities service connected. Keep in mind you DO NOT need constant doctors notes from over the years to show continuity of symptoms. Now do they help? Yes they do...immensely. How could they not. Notes from a medical professional go a long way. But......VA disability is based off of symptoms. So what you need to show is that you have consistently had symptoms and a letter from your wife can show that. I will give you an example of my own. Some if it may be slightly different from your situation but the info may help. Upon separation from service I was given 0% for my knees. I got out in 1986. I 2009 I was awarded 10% for each knee. I did not submit any medical records. The only thing the VA had to go off of was my SMR's. I went in and described my symptoms. Told them they have been on going since I left service and I treated my symptoms with over the counter medication. Granted this was an increase because I was already service connected even if it was 0%. I just wanted to show that even after many years a percentage is available.

I believe so because there is a monthly premium for it.

Two things could possibly come into play here. There is the Survivor Benefit Plan for retirement and Dependency and Indemnity Compensation (DIC) for disability. Both have specific eligibility requirements that must be met. Here is a link that could provide some information. Survivor Benefit Plan (SBP): https://www.dfas.mil/retiredmilitary/survivors/Understanding-SBP-DIC-SSIA/ At the bottom of that page there is a link where you can initiate the process by clicking on the Reporting a death link. That will take to a page with step by step instructions. Indemnity Compensation (DIC): https://www.va.gov/disability/dependency-indemnity-compensation/#am-i-eligible-for-va-dic-as-a-

I think it depends on the situation on if someone should or should not pay for an outside IMO/IME. I think for the most part if you are appealing to the BVA it is not needed because they (unlike a lot of raters) know how to apply the law. That is why more than 75% are either remanded because of a VA error or outright overturned. If you are going to spend the money I suggest doing your homework. I don't think people should just get one because they saw an advertisement for a doctor that would do one. I do however, think an IMO/IME from outside doctors are a necessary evil. To counteract the clear bias VA examiners have against service connection. I have a lot of secondary conditions that are caused or aggravated by my service connected disabilities. For lack of a better way to explain it any idiot should be able to see the correlation but it seems VA raters (at least in my case) cannot. For example my sleep apnea. I was tying it to weight gain because of my inability to excercise. However through my attorney I had an IMO done and the doctor mentioned my weight gain but also mentioned how Asthma (I am service connected for that too) could cause or aggravate issues like sleep apnea. In the end the BVA judge granted my sleep apnea claim based on the IMO's asthma argument. There are pros and cons for either side. I will say this. For me the pros were for the IMO because the doctor that did mine was cited in just about every one of my BVA grants.

To be honest I could care less if anyone knew my real name or not. I have actually posted decision letters and did not omit my real name on this very forum. I only removed my ssn and address. There are others here as well that have had their real names posted. Otherwise what is the big deal? I am not a wanted fugitive. If I was I should stay off the web anyway.

My appeal to the BVA took a little over 2 years. My appeal was a direct review. I did not have a hearing.

It was a long fight and something I wish we veterans did not have to go through. This took me 20 years. I filed my claim in 2002 and went through the normally BS we all have to go through. Gave up and started again in 2009 at the advice of a friend. Fought and fought and fought. Learned a lot from here and other places. Hired an attorney for the home stretch and it was worth is. Overall: 100% P&T Bilateral Pes Planus: 50 Sleep Apnea: 50 Diabetes: 20 L Upper Neuropathy: 20 L Knee Instability: 20 R Knee Instability: 20 L Ankle Arthritis: 10 R Ankle Arthritis: 10 L Hip Arthritis: 10 R Hip Arthritis: 10 L Lower Neuropathy: 10 (femoral) L Lower Neuropathy: 10 (Sciatic) R Upper Neuropathy: 10 R Lower Neuropathy: 10 (Femoral) R Lower Neuropathy: 10 (Sciatic) Low Back Disability: 10 L Knee DJD: 10 R Knee DJD: 10 Sinus Condition: 10 Bronchitis: 10

I understand and agree. I am normally fine once I understand the process of things even if it is not in my favor. I am ok with following rules and procedures and even waiting once it all plays out. If the VA was better at communication things would probably go smoother.

Thanks. It makes a lot of sense. I emailed my attorney a couple times but he has not responded. This is likely due to his being out of town or unavailable becuase he is always very quick to respond to an inquiry. If I was to make a guess i would say it keeps getting kicked back due to the specific remand instructions. From what I could gather when it is in "preparation for decision" the VSR has recommended a decision and is preparing the necessary documents for the decision to be made. The decision is then finalized by RVSR. My guess is the RVSR is kicking it back to make sure that each specific instruction for the remand is followed. (will attach) The annoying thing to me is that no matter what decision they make on the remand claims it will not make a difference in the overall rating. Right now I am only 10% for each knee. The remand is for an increase and also if a separate rating for instability is warranted. They could deny it all and I would still be 100% Remand.pdf

Give this backpay calculator a try. I have used it in the past and does seem to get pretty close. It is not 100% accurate but can get you in the right range. 1It is a wonder for people like me who are math challenged. https://www.hillandponton.com/va-retro-disability-calculator/

I am trying to figure out how the process works. VBMS shows me at 100% but for some reason there is no change in my rating. The BVA granted me service connection for Sleep Apnea, Lumbosacral Strain, Diabetes (type II). Bilateral ankle arthritis and Bilateral hip arthritis. However, the judge remanded a part of my appeal and I am wondering if that is what is holding things up. The remand was for an increase for DJD for each knee and for separate ratings for knee instability. On Ebenefits I can see what stage the remanded portion is in because they are being treated as a supplemental claim. Since last week the following changes took place on the supplemental claim : Tuesday 1/18 - Review of Evidence Wednesday 1/19 - Preparation for Decision Friday 1/21- Review of Evidence Tuesday 1/25- Preparation for Decision Wednesday 1/26 - Review of Evidence Here is the thing. Without the remand decisions I am still at 100% and while any increases from there will increase my total number in the end it still only keeps me at 100% So my question is this. Is the remand holding it all up? Before everything can be released does the remand portion of the appeal has to be completed as well?

Thanks for the response guys. They do help give me a better understanding of things. There was something that completely slipped my mind until I started clicking on other areas in Ebenefits. There was also a remand on my appeal that I had an exam on Jan 6th for and that remand is still ongoing. To recap: The BVA granted me service connection for Sleep Apnea, Lumbosacral Strain, Diabetes (type II). Bilateral ankle arthritis and Bilateral hip arthritis. The judge remanded my increase for knees and if a separate was warranted for knee instability (I will attach remand portion of decision). Before the BVA grant I was rated at 80%. When my attorney emailed me on Monday to let me know I was at 100% and to tell me about the VA fee issues ebenefits has not changed. I expected a few days would elapse before that happened. When he told I went from 50% to 80% it did take a couple ebenefits updated. That was on a supplemental claim (appeal of my most recent denial with new evidence) My remand based on what I can tell was still being worked. The VA I assume based on the remand instructions started supplemental claims for: Entitlement to a rating greater than 10 percent for left knee DJD is remanded. (Supplemental) Entitlement to a rating greater than 10 percent for right knee degenerative joint disease (DJD) is remanded. (Supplemental) Entitlement to a separate rating for right knee instability is remanded. (Supplemental) Entitlement to a separate rating for left knee instability is remanded. (Supplemental) I checked Wednesday evening after I got a couple responses to my post and it showed the status of those supplemental claims as "review of evidence" now keep in mind my attorney already showed me as 100% according to VBMS. When I checked on Thursday it changed from "review of evidence" to "preparation for decision" and I checked again on Friday and it changed again to "review of evidence" so to be honest I have no idea what is going on with the remand claims. I am guessing that until the remand portion is complete I will have to wait before the update all service connections. As of today there is no change. I know they have not released anything because all my granted claims from the BVA still say "not service connected" Remand.pdf

I have a rather interesting situation maybe someone can shed a little insight on. To be honest it seems baffling to me. Monday my attorney told me that according to VBMS I am at 100% with an effective date of 2019. I believe this happened sometime last week. What prompted the email is according to my attorney the VA sent him a letter because they have a problem with our contigency agreement. I went back and read the agreement. It is a pretty straight forward agreement. No tricky sentences getting me to agree to anything out of the ordinary. The agreement is for 20% of backpay received. I am very grateful for my attorney. He took me from 50% to 80% to 100% and has earned every cent. I have been fighting the uphill battle since 2009 and am not close to the finish line. I am probably making an assumption but my guess is the VA does not plan on paying my attorney from the backpay. I have no idea what the issue is with the agreement. My attorney did say I should be getting a letter in the mail from the VA about this and I should see a deposit from the VA any day now. He did say it would be easier to invoice me after my deposit for the 20% and I am perfectly fine with that. My entire expectation was 20% of all backpay and I knew this going in. What is confusing to me is why does the VA have an issue now? When I went from 50% to 80% the paid my attorney directly. Why not now? But I digress....here is my question. VBMS shows a rating with an effective date. What could be holding up the update on ebenefits? Would the fact that this was based off an appeal from the BVA? My guess is someone is looking at the issue of backpay because a decision was made on attorney fees. Yet as I type this there is no update on Ebenefits and my appeal is closed.

The fight is almost over. I got an email this morning from my attorney. VBMS shows me as 100% P&T with an effective date of 9/16/2019 so that is a huge win for me. The BVA granted most of my claims and remanded claims for my knees. I had the exam on Jan 6th. Ebenefits has not been updated so I probably will not see anything there for the next few days since today is a holiday so the increase probably happened at some point near the end of last week. The only thing left for me now is to appeal the EED.

You may both be lucky and screwed up but in all fairness I think we all are to some degree. I think needing an IME/IMO depends on who is doing your claim. My claims have been done out of Houston and I personally believe they have some of the worst/laziest VARO's in the nation. Now keep in mind this is from personal experience and there may be people that have had instant success. I have not. I have had both an IME (Dr. Ellis) and IMO (through attorney) and I personally believe they were worth every penny. A judge recently made a decision on my appeal and I was granted service connection on on 7 of 11 disabilities. The other 4 were remanded. I am waiting on the letter to see what the remand was for but I am sure it was because of inept VA practices. The IME/IMO I am sure played a part in those decisions because the VA has repeatedly denied for bullS*%& reasons. I probably could have succeeded without them but giving history I did not want to take any chances.

I would say no to this. The VA should only be addressing items that were based on the appeal itself. If they further adjudicate any disabilities not on appeal the BVA will more than likely reverse them if they are not in your favor. A key point and I will have to look up the case law on this but the law requires the VA to pursue all avenues to give the veteran the highest rating possible. Of course they always seem to do just the opposite. Once I find the case law I will post it.

What about those that are over 55? Unless I am mistaken an exam will not be scheduled for any disability if the veteran is over the age of 55. Found this from this website (https://www.woodslawyers.com/va-periodic-future-examination-affect-disability-rating/) after I googled it. "If you are 55 years old, then federal guidelines provide the 55-year-old rule that you should be exempt from reexamination, except in rare circumstances or by regulation. For example, a VA regulation requires that they schedule re-examination for veterans who have completed treatment for certain cancers six months after they complete treatment."

You can donate via credit card. I personally do not have a paypal account and will never get one again. I previously had one and they screwed me over....it was a small amount but I digress. Just select the option and when you get the payment screen you will have the option to select a credit card. I just did it.

I have to agree. This site is a God Send and it has helped me get from 30% to what is now about to be come 100% (Appeal complete...everything granted...will post in new thread). This site is by far the best site out there where veterans can get info to help with claims. Better than all of the facebook pages where some of the know it all mods who ban you or delete your posts when you prove them wrong. That never happens here. Everyone accepts if there are incorrect and I love the fact that the people here give it to you straight. I am not sure what the operating costs here but to it in perspective if 25 of us gave $25 that would total $625 and I am sure that will help. This is page is too important to not keep it up guys!