Phury & Rhage

Good advise from Buck and Phury. Not knowing if you might also have other physical issues as well, it also would be a good idea to send off a request to obtain all of your military medical records (str's) as well. It can take months to get ,and there should be evidence in there to help you ,so do that in parallel with the other advise. If you didn't have an Honorable, there should be a note on your dd214 which might be of help as well. I too am sorry for what has happened. Be strong; there is a lot of support here on Hadit. Stay with us. Good luck.

Hi Penguin,
So I'm not an expert, but if it were me?  I would withdraw the legacy appeal and submit the Supplemental Claim as I explained in my earlier post.  I didn't make recommendations earlier, but you are specifically asking for one 🙂  Here's why I would do that:  I work RAMP (there are still some out there) and AMA claims primarily.  But I regularly come across legacy appeals.  The thing is, even if they are ready to rate and there is nothing left to do but assign it to a rater, I see them sitting there where the last suspense date is OLD and it hasn't been assigned to someone to complete it.  The system (NWQ) knows when the suspense dates are and assigns the workload accordingly.  The 1st thing I do when I open a claim is check the suspense date and what item is due - response to a letter, attempt to get STRs, etc.  I don't know this to be true, but I suspect these legacy appeals are sitting out there unassigned because there are too many appeals and not enough claim processors/raters (sounds obvious, right?).  I don't get the same sense with the new AMA appeals (we aren't supposed to call them that - they're "reviews", lol).  I'm not working claims where the suspense date has passed.
As for the bad exam, if you can swing it (make it happen!), you should get a private exam.  There are tons of posts in here devoted to just what you need to do regarding a private exam.  That's not my area of expertise, but I've done that with my personal claims.  Read up on it - just like you were taking a serious test on the subject.  If you think you messed up the 1st time, prepare well for the next one....
Good luck,
Phury

That's gotta be a typo.  They probably mean "leave" without pay - also called LWOP.  The Veteran takes time off due to migraines and has used all of her sick leave.  It appears she's had people donate some of their sick leave, plus she's having to take LWOP.  I don't know about anyone else, but it sounds to me as if she's describing federal government pay/leave.  I'm a federal employee and I've been in that exact position.  I took leave for my disabilities and, when I ran out of leave, I took LWOP.  I didn't ask for anyone to donate, but that was an option.
Phury

I'm not being snide or anything - I'm just pointing out.  "Exposure" isn't a valid claim.  Anyone making a claim to the VA needs to understand that they are making a claim for a disability.  No disability; no claim.  I have actually seen claims where the Veteran says he/she was exposed to "burn pits" or asbestos or Agent Orange, but they aren't claiming a disability.  It seems obvious to people who've had a bunch of experience with VA claims, but newbies need to know (if they don't already) that your VA disability compensation claim has to be a claim for a disability.
I left out the pertinent part:  if your experience/exposure has resulted in you suffering symptoms, that is what you claim to the VA.  If you suffer a mental health condition/symptoms as a result of either assault, you make the claim as described by @Buck52.
I'm sorry for your experience and good luck to you.
Phury

Statement in support of claim. Should I do the VA 21-4138 or just type the doc and sign it? ? I have a buddy statement from someone I served with and my mom, with her account of the bombing and calling the red cross and my first shirt asking on information on me because she knew I was stationed at Khobar. Should I ask them to redo them and put them on the 21-4138 as well? 
As far as the c-file goes, I will call and request a viewing today.
So now that it says no longer needed I assume that they already verified it?
 
Do your STRs show that concussion?
I might have mis-communicated this. I did not get a concussion, rather I meant that the concussion of the bomb, gave me tinnitus, and quite possibly the hearing loss. Should I request an MRI?
 
I am overweight and find it extremely hard to lose weight. For whatever reason, I can diet and work out like crazy but for whatever reason, I hold on to my weight. 
 
I do get headaches but I can't say that they are really frequent. The are different from a typical headache however in that they are stabbing pains in my scalp. I can feel them coming on and they just have to run their course. Nothing that I have ever taken has seemed to help them.
Vision problems. So 3 years ago, I had to go to an opthamologist because in my right eye, I had severe pain and redness, light sensitivity, extreme shooting headache etc. He diagnosed me with Rheumatoid Arthritis in my eye. However, he did no bloodwork or anything to confirm that. 
I just had this flare up again a month ago and he sounded less convinced that it is RA. 
I do not have trouble walking a straight line. I do have dizzineess but it is reallly really infrequent. 
 
I managed to somehow remember who did my sleep study yesterday and they agreed to send me the results so I should have them in 3 weeks give or take. That was a home sleep study done in 2012. So far, the VA has not asked me for a C&P for SA. My PC said that I could start getting my SA equipment from the VA but did not tell me how to go about it. I assume they will not just give me CPAP stuff without seeing a prescription which I no longer have. Should I ask for a sleep study?
 
I have frequent and very fast urination. My buddy is always commenting on how quickly i pee. He always says i must have a bladder the size of a walnut. Until I got my sleep under control with my CPAP, I used to have accidents at night. 
 
I do not have ED per say but I will say that since I got on Escitalopram for anxiety, I have a hugely diminished sex drive. I can still do it, I just have lost a lot of my desire to. 
 
Holy cow, I had no idea any of this could be tied together if it indeed can be, or if any of it is related. I have a lot more homework to do for sure. 
GeekySquid thank you so much, and I mean that, for taking time out of your day to answer all of this. 

Hi Penguin,
So I'm not an expert, but if it were me?  I would withdraw the legacy appeal and submit the Supplemental Claim as I explained in my earlier post.  I didn't make recommendations earlier, but you are specifically asking for one 🙂  Here's why I would do that:  I work RAMP (there are still some out there) and AMA claims primarily.  But I regularly come across legacy appeals.  The thing is, even if they are ready to rate and there is nothing left to do but assign it to a rater, I see them sitting there where the last suspense date is OLD and it hasn't been assigned to someone to complete it.  The system (NWQ) knows when the suspense dates are and assigns the workload accordingly.  The 1st thing I do when I open a claim is check the suspense date and what item is due - response to a letter, attempt to get STRs, etc.  I don't know this to be true, but I suspect these legacy appeals are sitting out there unassigned because there are too many appeals and not enough claim processors/raters (sounds obvious, right?).  I don't get the same sense with the new AMA appeals (we aren't supposed to call them that - they're "reviews", lol).  I'm not working claims where the suspense date has passed.
As for the bad exam, if you can swing it (make it happen!), you should get a private exam.  There are tons of posts in here devoted to just what you need to do regarding a private exam.  That's not my area of expertise, but I've done that with my personal claims.  Read up on it - just like you were taking a serious test on the subject.  If you think you messed up the 1st time, prepare well for the next one....
Good luck,
Phury

Hi Penguin,
Thanks for updating 🙂 You have an option here and it is not a widely advertised one because AMA is so new.  Supplemental claims filed on 20-0995 can be filed on anything any time - pre and post 2/19/19 rating decisions.  However, if you have a legacy appeal, you will have to withdraw it in writing to submit the Supplemental claim.  Ideally, you would do that simultaneously.  Withdrawing an appeal can be done on any form or piece of paper.  It just has to be written - you can't do it by phone.  I'm going to talk about that for a minute, but that doesn't mean I'm recommending it.  I just want folks to have the necessary information to make a choice.
***In practice, if you submit multiple pages to the Evidence Intake center, those pages could get split up - I've seen it happen.  Make sure your file/SSN and name is on each page.  That way, if they get separated, it will still make it in your file.***
If you intend to withdraw a legacy appeal so that you can simultaneously submit a Supplemental claim, you can do it on the same form - the 20-0995.  You need to be super specific though.  Say something like, "I want to withdraw my legacy appeal (NOD dated 1/19/18), but I only want to withdraw the PTSD portion of it.  I am doing this so I can file a Supplemental claim simultaneously and submit new and relevant evidence for consideration.  Please continue processing the other issues in my legacy appeal."  Or, you could say, "I submitted an NOD on 1/19/18 for my right ankle.  I am withdrawing that appeal in favor of a Supplemental claim so that I can submit a nexus statement from my private doctor."  The thing is, if you write that withdrawal statement on the 20-0995, the VA processor has everything they need to withdraw your claim from the legacy appeals process and initiate a Supplemental claim.
Now, why would you want to do that?  I'm not making recommendations, but here are the issues I see.  1)  Yes, it looks like the AMA process (including Supplemental claims) is moving quite a bit faster than the legacy process.  There are other reasons you might consider it.  2)  If you have new evidence to present, you can only do that through a Supplemental claim.  That's because the Supplemental claim is an "open" record.  In fact, you have to have "new and relevant" evidence to get a new decision on the merits of your claim.  Any new evidence requires a new decision, but if the evidence turns out to be duplicative or irrelevant, that's what your new decision will say.  And here's one of my favorite reasons (still not making a recommendation):  3) the rules change all the time and almost always are more favorable to Veterans.  The newer the decision, the more likely it is that judgment calls will be in your favor.  Also, if you get a new decision now, it's eligible for Higher-Level Review (HLR) on the 20-0996.  I am TOTALLY sold on those.  I've talked about it in other posts, but those go to 2 DROC locations for processing with people who specialize in those claims.  They are getting really good at spotting the errors that are made in rating decisions.  That's particularly true with procedural/development errors.  Your last processor missed evidence in your STRs?  The last processor didn't send you for an exam or the exam was inadequate?  Nobody tracked down your Reserve/National Guard personnel/treatment records?  I'm getting those "Duty to Assist" errors back ALL.DAY.LONG......sorry, bunny trail, lol.
Every case is different, but there are very common threads that run through each.  If you've been denied, it's CRITICAL that you understand "why" they denied you.  Your new and relevant evidence NEEDS to be something that was missing the 1st time around.  Or, find out if they SAID something was missing, but it was actually in the file.  Either way, you have to know/understand why you were denied.
Remember, for every Veteran there are 3 things necessary for service-connection:  1) an event in service; 2) a current disability; and 3) a link between the first 2 (nexus).  Never, ever turn in a claim that doesn't address all 3.  Here is the most basic example:  I broke my _____ in the service. (event)  It's bothered me ever since then. (nexus)  I "hurt" "can't do _____" "get therapy" "take medication" "am getting worse" (current disability).
Holy smokes, I got off track.  I've been up since 5 working overtime, lol.  Ignore what you don't need 😄
Phury
 

you of course can have your view, but this conflates change with a wholesale reduction in benefits. What was applicable and affordable 20 or 30 years ago, is just not the same today.
Both my parents were Army in WWII. At the end of the war, service members fled the services to go back to civilian life. The benefits created then were not distributed equally along racial and gender lines. Much of that has changed over the years. That is an improvement.
But let's look at Tricare. It didn't exist back then. With advances in medicine and social behaviors the life spans of veterans increased making that existing system, and now TriCare as it was implemented, a financially unsupportable benefit as a "free" or low cost service. It has to change to survive.That is how insurance pools work.
Veterans are part of society and as a society we cannot bury our heads in the sand and demand that nothing change. If it doesn't everyone loses.
If you are honest with yourself, I would bet you found dissatisfaction with military life, veterans benefits, and other changes even back when you first became aware of/affected by those things. That is human, but being human is not justification for demanding that nothing change or spending our energy complaining about change. It is bad for an individuals mental and physical health to expend energy that way.
you admitted you stayed in for (to paraphrase your other post)  "security", that you enlisted because the service was the best opportunity available to you at that time. That is all good and is true of many older veterans. Hell at one time judges forced delinquents into the service. ( I am not saying that you were a delinquent 🙂 )
In making that choice you foreclosed other options you might have had. You also accepted that programs and policies would change and you would have little control over those changes. I know that was not an active thought train, but it was there and your agreement was tacit if not explicit.
Retirement options have change, mainly due to long term retention needs, political aims and opportunity for veterans.
Back in the day an E3 might bring how what 200 bucks a pay period, or farther back 50 bucks a month! today a single E3 living in the barracks is making 2k a month or there about. Times change, costs change, recruiting needs change.
I do get a little chapped when I hear younger service people complaining they could make more in the civilian world, simply because in most cases 19-20 years olds can't. Their view is scoped by their limited experience. As elder vets our scope should have grown as we aged, learned, and experienced more things, but that doesn't always happen.
When I get that chapped feeling I have to remind myself of all that and that Congress decides their pay. It isn't personal to me and in the most part as a vet it does not affect me or take anything from me. As a taxpayer I am happy to assist in paying them to do the tough jobs.
I don't believe in living in the past or begrudging the future veterans any benefit they earn and is allowed by Congress.

I'm not jumping in to the fray, but I will say that I've had all of the experiences described:  I'm retired USAF; 100% SC; my husband (retired ANG) and I own our house right out the back of Davis Monthan AFB; we are living (different state - new job) 2 hours away from the Commissary/Exchange (it's only about 40 miles but we have some of the worst traffic in the nation); and we have lived in the middle of nowhere (North Dakota) where groceries were 50 miles one way and no Commissary in sight.  Davis Monthan has closed multiple buildings/services (Shoppette, etc.) in the last 5 years.  Smokey Point has closed it's Shoppette but left the gas pumps open.  NAS Everett turned its Shoppette into vending machines with gas pumps. 
My point is - they are closing them because they hemorrhage money.  In every part of government, there are initiatives/efforts to privatize.  In part, that's so that the activities are run leaner - like they would be in a free market.  But part of the problem is that they need a broader customer base to increase revenue and provide some financial stability and viability.  That's about the REALS; not the FEELS.  At the end of the day, everything costs and we/they have to decide how to pay.
By the way, here is an excerpt from the Davis Monthan housing website:
14.  Who is eligible to live in privatized housing?
 
 

None of this applies when you live in the sticks.  4 hour drive one way to pick up groceries.
Everything else I can get for the same price with my Prime account.
Just sayin,
Hamslice
Oh, and out in the sticks, a haircut costs $20....

Richard you are certainly entitled to your opinion and I respect that. On this one, I have to agree with Buck. I'm ok with it opening it up too. You see, if we start to put one veteran group against another veteran group, we weaken out strength and what we are able to get accomplished. And that's not o.k. And, when they open it up to more veterans, it makes the commissaries more financially sound. To me, that is important, because if it becomes more of a burden on the taxpayer, we may end up getting their services cut or even eliminated. And I am not o.k. with that. IMO.

As a veteran who had to fight for retirement for four years, original discharge was convenience of the government, I believe the commissary should be open to all that the DOD qualifies.  Any veteran who is injured in the service who must fight for his benefits should be allowed.  And believe me some veterans have fought hard for their benefits.  If you spent 20 that is great but what about career military that got sidetracked by injuries and was forced out?  Or just was happy to come home and wanted to be a normal civilian but couldn't?  If we start making this us against them there will be no hope for us the next time Congress decides to cut our benefits.  

Coming soon to a military base near you!  I'm attaching a document that was just released that describes new access granted to service-connected Veterans (not just IU/100%) to military bases and MWR activities including Commissary and Exchange activities.  There are a number of categories of Veterans and caregivers that this affects.  Spread the word!
Phury & Rhage
Expanded Patronage.v2.docx

Coming soon to a military base near you!  I'm attaching a document that was just released that describes new access granted to service-connected Veterans (not just IU/100%) to military bases and MWR activities including Commissary and Exchange activities.  There are a number of categories of Veterans and caregivers that this affects.  Spread the word!
Phury & Rhage
Expanded Patronage.v2.docx

Hi!
So, a couple of things.  You can qualify for SMC S, which is the Homebound rate, if you have a single disability rated at 100% and another disability or combination of disabilities that total at least 60%.  You don't need anything else and your employability is immaterial.  You can work full-time and still qualify for SMC S if you have 100% (single disability) and at least 60% (single or combined disabilities).
However, employability can be a factor in SMC S.  The only way it's a factor is if you are rated unemployable on a single disability.  That unemployability rating based on a single disability counts as your 100% single disability.  Then, you still have to have a total of 60% separately from that unemployability rating.  If you do that (I've done that) then you will lose the unemployability rating and the SMC S if you end up with gainful employment.
Another note:  VA will not process an unemployability claim from someone who is a natural 100%.  It's a waste of time and other resources.
Phury

Coming soon to a military base near you!  I'm attaching a document that was just released that describes new access granted to service-connected Veterans (not just IU/100%) to military bases and MWR activities including Commissary and Exchange activities.  There are a number of categories of Veterans and caregivers that this affects.  Spread the word!
Phury & Rhage
Expanded Patronage.v2.docx

Here is a document that describes new access coming for caregivers.  They (and service-connected Veterans plus others) will have access to military bases and MWR activities including BX/PX/NEX and Commissary.  Spread the word!!!
Phury & Rhage
Expanded Patronage.v2.docx

Coming soon to a military base near you!  I'm attaching a document that was just released that describes new access granted to service-connected Veterans (not just IU/100%) to military bases and MWR activities including Commissary and Exchange activities.  There are a number of categories of Veterans and caregivers that this affects.  Spread the word!
Phury & Rhage
Expanded Patronage.v2.docx

Hi Penguin,
Thanks for updating 🙂 You have an option here and it is not a widely advertised one because AMA is so new.  Supplemental claims filed on 20-0995 can be filed on anything any time - pre and post 2/19/19 rating decisions.  However, if you have a legacy appeal, you will have to withdraw it in writing to submit the Supplemental claim.  Ideally, you would do that simultaneously.  Withdrawing an appeal can be done on any form or piece of paper.  It just has to be written - you can't do it by phone.  I'm going to talk about that for a minute, but that doesn't mean I'm recommending it.  I just want folks to have the necessary information to make a choice.
***In practice, if you submit multiple pages to the Evidence Intake center, those pages could get split up - I've seen it happen.  Make sure your file/SSN and name is on each page.  That way, if they get separated, it will still make it in your file.***
If you intend to withdraw a legacy appeal so that you can simultaneously submit a Supplemental claim, you can do it on the same form - the 20-0995.  You need to be super specific though.  Say something like, "I want to withdraw my legacy appeal (NOD dated 1/19/18), but I only want to withdraw the PTSD portion of it.  I am doing this so I can file a Supplemental claim simultaneously and submit new and relevant evidence for consideration.  Please continue processing the other issues in my legacy appeal."  Or, you could say, "I submitted an NOD on 1/19/18 for my right ankle.  I am withdrawing that appeal in favor of a Supplemental claim so that I can submit a nexus statement from my private doctor."  The thing is, if you write that withdrawal statement on the 20-0995, the VA processor has everything they need to withdraw your claim from the legacy appeals process and initiate a Supplemental claim.
Now, why would you want to do that?  I'm not making recommendations, but here are the issues I see.  1)  Yes, it looks like the AMA process (including Supplemental claims) is moving quite a bit faster than the legacy process.  There are other reasons you might consider it.  2)  If you have new evidence to present, you can only do that through a Supplemental claim.  That's because the Supplemental claim is an "open" record.  In fact, you have to have "new and relevant" evidence to get a new decision on the merits of your claim.  Any new evidence requires a new decision, but if the evidence turns out to be duplicative or irrelevant, that's what your new decision will say.  And here's one of my favorite reasons (still not making a recommendation):  3) the rules change all the time and almost always are more favorable to Veterans.  The newer the decision, the more likely it is that judgment calls will be in your favor.  Also, if you get a new decision now, it's eligible for Higher-Level Review (HLR) on the 20-0996.  I am TOTALLY sold on those.  I've talked about it in other posts, but those go to 2 DROC locations for processing with people who specialize in those claims.  They are getting really good at spotting the errors that are made in rating decisions.  That's particularly true with procedural/development errors.  Your last processor missed evidence in your STRs?  The last processor didn't send you for an exam or the exam was inadequate?  Nobody tracked down your Reserve/National Guard personnel/treatment records?  I'm getting those "Duty to Assist" errors back ALL.DAY.LONG......sorry, bunny trail, lol.
Every case is different, but there are very common threads that run through each.  If you've been denied, it's CRITICAL that you understand "why" they denied you.  Your new and relevant evidence NEEDS to be something that was missing the 1st time around.  Or, find out if they SAID something was missing, but it was actually in the file.  Either way, you have to know/understand why you were denied.
Remember, for every Veteran there are 3 things necessary for service-connection:  1) an event in service; 2) a current disability; and 3) a link between the first 2 (nexus).  Never, ever turn in a claim that doesn't address all 3.  Here is the most basic example:  I broke my _____ in the service. (event)  It's bothered me ever since then. (nexus)  I "hurt" "can't do _____" "get therapy" "take medication" "am getting worse" (current disability).
Holy smokes, I got off track.  I've been up since 5 working overtime, lol.  Ignore what you don't need 😄
Phury
 

Phury and Rhage  We get a lot of handles on this site, but I got to give it to you, yours is pretty catchy. 

Hi Penguin,
When you send in more than one application, on different days, each application (if it's valid) will result in its own claim.  So, your reconsideration/reopen claim in December is totally separate from the Supplemental Claim you submitted in April.  Even though both applications do very similar things, the rules say they can't be combined.  Also, different rules apply to the SAME type of application, depending on when you submit it. 
 
Your reconsideration is its own separate claim.  It appears that you haven't heard anything about the reconsideration, except what's in that 2nd paragraph in your decision. 
The 1st thing I would do is talk to your POA.  They should be able to look in VBMS and make sure there is an active claim pending for those reconsideration issues.  Mistakes happen - particularly in the transition from the legacy appeals process to the AMA.  Double-check that your reconsideration claim is still open.  If the claim is open, you....wait.  Or you can ding-dong VA in various ways.  Let us know what the answer is to that question and I'll follow up. Thanks,
Phury   

Hi Penguin,
When you send in more than one application, on different days, each application (if it's valid) will result in its own claim.  So, your reconsideration/reopen claim in December is totally separate from the Supplemental Claim you submitted in April.  Even though both applications do very similar things, the rules say they can't be combined.  Also, different rules apply to the SAME type of application, depending on when you submit it. 
 
Your reconsideration is its own separate claim.  It appears that you haven't heard anything about the reconsideration, except what's in that 2nd paragraph in your decision. 
The 1st thing I would do is talk to your POA.  They should be able to look in VBMS and make sure there is an active claim pending for those reconsideration issues.  Mistakes happen - particularly in the transition from the legacy appeals process to the AMA.  Double-check that your reconsideration claim is still open.  If the claim is open, you....wait.  Or you can ding-dong VA in various ways.  Let us know what the answer is to that question and I'll follow up. Thanks,
Phury   

Just an update.
 
Found out a few minutes ago via a call to the DAV that both items in my appeal were approved!  VA.gov still shows no info but eBenefits has them listed as increased!
 
Appeal was around 27 days.

I'm sorry your experiences have been so negative.  I've had my share of those as well.  In my case, I moved around a lot so I had an opportunity to see how different ROs handled my claims.  Hawaii and Nevada sucked, but Seattle and Fargo (of all places) really got the job done.  I'm sad that Seattle (hello, employee) can't work my stuff anymore, and worried about which RO will do that work (when I next file a claim).  It has been my experience (inside and outside of the organization) that the RO definitely matters.  My partner and I bought a house in Tucson 10 years ago and Phoenix is "no bueno".  Fortunately, I was able to continue using an address in Washington, so I was able to move my claims right back up there.
As for your RO, that stinks and it may not change anytime soon....
Phury

First and foremost, it would always behoove you to write out support of claim statements for each and every contention that you are filing a claim. Make sure to bring a copy of this with you to your exam. It would be highly intelligent to have any paperwork that would be critical for your examiner to have pertaining to your claim on hand with you when at your exam. Case in point, when I went for my sleep apnea exam, my examiner stated that they couldn't find the sleep study. I knew that it was in VBMS (the system that stores all documents and the system that VSRs and RVSRs aka raters use to process claims) as the VA not only sent me out for the sleep study to a third party, but I also submitted the results as part of my evidence that I was building and submitting for my sleep apnea claim. However, there was no issue because I simply handed her a copy of my sleep study because I had it on hand. I literally had a thumb drive with all x rays, MRI images, radiology reports, C File, buddy statements, support of claims etc, and paper copies of any relevant information that could potentially be asked for. 
 
For hearing loss and tinnitus exams, know what can and won't give your statement more probative value. Yes, your MOS/Rate will be taken into account.  So will combat.  If you can prove via DD 214 i.e. Combat Action Bage, Combat Infantry Badge, Combat Medic Badge, Purple Heart..........you get the idea, they are awards that can concede combat exposure. This gives more probative value to any of your statements made concerning hearing loss. However, keep in mind, with regards to hearing loss, they primarily look at audiograms.............entrance and exit audiograms, and any audiograms that you provide up to 12 months after service..........much beyond that, one can't likely connect that to service. If one shoots guns recreationally, rides a motorcycle to work, uses power tools regularly etc, this also throws other factors into the equation that could affect hearing loss.
For tinnitus............if you are claiming tinnitus, I honestly don't know why one would show up to the exam and say that their ears aren't ringing, but it happens all of the time. Another common phenomenon is that people didn't complain about it in service or go to get treated for it (there is no treatment really for it other than trying lipoflavinoids or newer hearing aids that can block it out via white noise.)  However, there is one little-known thing about tinnitus......it is essentially the only illness that a Veteran can actually diagnose themselves.
Here is the most important manual reference for tinnitus claims.............it clearly says that you do not need a diagnosis of tinnitus in service so long as you provide a competent lay statement indicating that you had it while in service AND you get it diagnosed later on (hint hint........get an exam done privately.)       III.iv.4.D.3.b.  Requesting Medical Opinions for Tinnitus
  A medical opinion is not required to establish direct SC for claimed tinnitus if STRs document the original complaints and/or diagnosis of tinnitus there is current medical evidence of a diagnosis of tinnitus or the Veteran competently and credibly reports current tinnitus, and the Veteran claims continuity of tinnitus since service or there are records or other competent and credible evidence of continuity of tinnitus diagnosis or symptomatology. Exception:  An opinion may be necessary in the fact pattern above if evidence suggests a superseding post-service cause of current tinnitus.   A tinnitus examination may also be necessary if the STRs do not document tinnitus but    there is evidence establishing noise exposure or another in-service event, injury, or disease (for example ear infections, use of ototoxic medication, head injury, barotrauma, or other tympanic trauma) that is medically accepted as a potential cause of tinnitus, and there is a competent diagnosis or competent report of current tinnitus. Notes:  Under Jandreau v. Nicholson, 492 F.3d. 1372 (Fed. Cir. 2007), a layperson may provide a competent diagnosis of a condition when a layperson is competent to identify a medical condition.  Tinnitus is a medical condition that a layperson is competent to identify in himself/herself because the condition is defined by what the person experiences or perceives – namely subjective perception of sounds in his/her own ear(s) or head.  Therefore, a layperson may establish the diagnosis of tinnitus at any point in time from service to present.  However, consider credibility and weight of the evidence in deciding whether to accept lay testimony as proving tinnitus in service or presently.  The Hearing Loss and Tinnitus Disability Benefits Questionnaire tinnitus-only examination includes a number of options for examiner opinions on etiology.  The examination may be conducted by an audiologist or non-audiologist clinician. Only ask the audiologist to offer an opinion about the association to hearing loss if hearing loss is concurrently claimed or already SC.   Know the Disability Ratings before you go into the exam. You will want to check out this website: https://www.law.cornell.edu/cfr/text/38/part-4/subpart-B   38 CFR Subpart B   For instance, if you have any issues with bones/joints etc, you will want to check out this: https://www.law.cornell.edu/cfr/text/38/4.71 and https://www.law.cornell.edu/cfr/text/38/4.71a         Know the politics..................   There are some good posts on here about PTSD exams, and I agree with most of what has been said. I must add on to some of it, and some of it is very very crucial. We are Veterans.....that is why we are here. Generally speaking, most of us are going to be politically conservative. Guess what, most psychiatrists and psychologists do not tend to be.  Statistically speaking, of all of the MDs (yes, a psychiatrist is an MD), psychiatrists are the most politically liberal (left) of all MD fields whereas surgeons are the polar opposite. Guess what might not be a good idea to do in exams? You guessed it.........bring up politics. In fact, I would suggest that going in there acting like a hard ass would not bode well for you. If you walk in there wearing a MAGA hat, you might want to consider writing up your appeal later that evening. If it is a female examiner (and you're a male), I would suggest not grimacing at them during your mental health/PTSD exam.    I would suggest not trying to play the examiners; sure, you can roll the dice and try some of the advice about talking about wanting to kill people all of the time and acting super hypervigilant in the room and making sure to sit where you can clearly monitor all exits etc, but I suspect that most of these examiners see 5-8 people a day and have become very astute on picking up on the bull shit artists and won't think twice about drawing a line through your name rather than under it. I would suggest being truthful.......that doesn't mean that you can't elaborate on your worst experiences pertaining to the questions that are asked, but I wouldn't recommend lying or exaggerating. I certainly wouldn't recommend lying about anything pertaining to your military record either, as while the examiner might be none the wiser, the raters reviewing it are more likely than not Veterans are thoroughly adept at combing through military records i.e. don't tell the examiner that you were an Army Ranger when you were a chaplain assistant.