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Senior Chief Petty Officer
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Everything posted by pacmanx1

  1. The bottom line is no one can really say what the VA would and would not do, we or they are not the ones making the decision and we do not have your file to review. It is totally up to the VA to make that decision and we can only speculate (GUESS). By guessing it would not help you or any other veteran thinking of doing the same thing. We get this question all the time. What I would say based on my experience is that you should consider yourself medically retired. File for early SSA benefits, file a claim for SSDI that will begin your early retirement pay. You can always start a hobby, or volunteer, a lot of members stick around to help out other veterans. Be forewarned what you ask for, as stated no one knows what the VA would do. If you go back to work, the VA could re-evaluate your rating and remove your TDIU, or they could try to say that you committed fraud, or they could reduce your 100% scheduler. There are too many scenarios that could play out but then again nothing may happen at all but why risk it. A 100% P & T scheduler veteran is not supposed to be re-evaluated, but you never know what could happen.
  2. Well put nothing past the VA. I suggest waiting for your new award letter. Based on your post it is likely that the VA has sent you a separate award letter that should have the difference of your dependent pay on it. In your post, you stated that the VA awarded you an EED back to 1999 and that would have made your dependent eligible for dependent pay and the VA should have included that pay in your decision. It is possible that your new letter will show this difference and at the same time, it is possible that Ebenefits shows that you have no dependents because your dependent child is still beyond the age limit. Keep in mind that Ebenefits is supposed to show the current rating and your dependent child would not be on it because the child is well over the age limit. This would have nothing to do with an award letter for an EED for back/retro pay for your dependent. Back in 2014 the VA granted me a 2004 EED and I received my award letter and back pay. A few days later I received a second award letter for my dependent child that they left off. In 2019, the BVA granted me a 1998 EED that made my dependent child eligible for an EED and this time all my back/retro pay was included in my award letter, and I did not have to file a new claim. It is just a little too soon to know but your new letter may correct that they missed your dependent child off your award.
  3. This is just the new way that the VA is trying to paint a veteran’s narrative of his/her claim. As I always stated and IMHO (IN MY HUMBLE OPINION), a veteran should always have a diagnosis, treatment records and a nexus prior to filing a claim and definitely before going to a VA Contracted C & P exam or a VAMC C & P exam to prove that the veteran should be service connected for his/her claim. For whatever reasons claims are denied but if the veteran already has the Caluza Elements, it would be very hard for the VA to deny his/her claim. Instead of being hit with a denied claim, hit the VA with the Caluza Elements and make sure they get the effective date right the first time. Contracted C & P exams are considered VARO property and they will only release these documents when they choose, and the VA make sure that the Contractors do not give the veteran a copy of them because it is part of their contract. Veterans have to request a copy of the contracted C & P exam from the VARO, and they log it in as a claim making it take even longer to copy and send out. The only bright light that I see is that all of the Contracted C & P examiners opinions do not always match the VA’s narrative. Meaning, a veteran that is well educated in his/her claim and the evidence of records can prove not only to the examiner but to the VA that the veteran should be granted his/her claim. Doing your homework can really pay off.
  4. I just recently went through this, this past month. I requested a copy of my LHI C & P exam a week after my exam, but the VA refused to release a copy of the exam. The VA waited until they made their decision before sending me a copy of my exam and then they completely ignored their own examiner's opinion.
  5. If you are referring to a VAMC C & P exam, then it should be in your records at the VAMC, and you should be able to print them up in myhealthyvet.com under the blue button. If you are referring to a Contracted C & P exam, then those exams go back to the VARO, and they will not release the exams until after they make a decision. It normally takes about 8 weeks, but the VA log your request as a claim for FOIA and not just a request for your exams.
  6. OK be forewarned if you are trying to seek any type of EED (Earlier Effective Date). As Bronco suggested the first thing would be to get service connected first then seek a better effective date. The problem with seeking an EED is that the VA goes by symptoms not diagnosis. A change in diagnoses is not a basis for filing a CUE claim. If you can prove by medical evidence/records that you had symptoms at the time of your original claim, you can then ask the VA to consider that evidence. Keep in mind that to get a grant for SA (Sleep Apnea), you would need persistent daytime hypersomnolence for a 30% rating and you had to have a CPAP machine to get the 50% rating. Now CFS (CHRONIC FATIGUE SYNDROME) is a different animal altogether and to get a minimum rating of at least 10% you would need a licensed physician to prescribe bed rest and treatment. (Please review the Note below this rating). Unless you can prove that you should have been given a 100% rating that does not need a physician prescription. This is just the regulation now and it may be different at the time of your original claim, but it is best for you to review them and know what they were at that time. Also, you should request a copy of your C-File so you can know what was/is in your records. If I am off someone will chime in and correct me. 6354 Chronic Fatigue Syndrome (CFS): Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, or confusion), or a combination of other signs and symptoms: Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care ........................... 100 Which are nearly constant and restrict routine daily activities to less than 50 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least six weeks total duration per year .......................60 Which are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least four but less than six weeks total duration per year ........... 40 Which are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least two but less than four weeks total duration per year ............ 20 Which wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year, or; symptoms controlled by continuous medication ....... 10 Note: For the purpose of evaluating this disability, incapacitation exists only when a licensed physician prescribes bed rest and treatment. 6847 Sleep Apnea Syndromes (Obstructive, Central, Mixed): Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy...............100 Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine......... 50 Persistent day-time hypersomnolence .................. 30 Asymptomatic but with documented sleep disorder breathing........... 0
  7. OK, I just got this new email, and I am not really sure why the VA would be sending me emails. I am still going around in circles filling out form after form and once my forms are accepted then the VA send me more forms to fill out. Your opinion matters
  8. The best thing to do is to wait for your official letter or to review your official letter. It will show the breakdown of your award and how much the VA paid you and when the VA paid you including your dependents if you have any. Ebenefits and va.gov can be off and not correct at times. If I have not said it Congratulations!
  9. If the VA denies your claim after you have at least a positive and negative C & P exam, then you will have to file a new appeal and it should win at the BVA. If not, then file an appeal back to the CAVC.
  10. Prior to the BVA granting me a 1998 effective date, the BVA throw out five negative inadequate C & P exams to granting my service connection in 2019.
  11. Without even looking for a law, rule, or regulation, VA will most likely schedule a veteran for a C & P exam prior to making a decision, a grant or a denial to try to prove they made an effort and cover their backside in case the veteran files an appeal. Try this: M21-1, Part III, Subpart iv, Chapter 3, Section B - Scheduling Examinations | M21-1
  12. Once a claim is granted, it goes by the rating percentage and the combined rating chart. The VA must then go by the highest rating to the lowest rating, so it really does not matter, 50% + 30% = 65 + 10 % = 69 then rounded up to 70% which is your combined final rating.
  13. IMHO (IN MY HUMBLE OPINION). You have to learn how to fight the VA for yourself and anyone you want to help. Like many, I lost my family, home, job, cars and anything and everything you can think of, I was destitute. All while filing claims with the VA claiming financial hardships and them denying my claims for decades. I had a senior VSO (VETERAN SERVICE OFFICER) ask me why didn’t I medically retire. At that time, I knew absolutely nothing about VA or filing for disability. I then had a senior VA representative tell me I had no chance in getting VA disability. I decided to start reading the 38 CFR part 3 and part 4, along with any BVA and CAVC decisions that were similar to mine. I wanted to know what they were talking about, and I got tired of the VA denying my claims. I went from 30%-40% to 100% P & T within five years. I have been fighting the VA for well over two decades and I am finally getting some of my appeals completed and back/retro pay for all the years I could not work, and the VA denied my claims. You have to channel your energy in the right direction. There are sometimes you have to fight fire with fire, so I say learn how to fight VA with their own regulations and you wouldn’t believe that it is very possible to not only win your claims, but you can increase your disability ratings. Always remember that once a veteran gets service-connection, if that veteran develops any secondary conditions/disabilities, those secondary disabilities can be service connected also and you can be compensated for them.
  14. I agree with the above, not knowing what or if you have any other disabilities, it is hard to say. Keep in mind that any nexus statement must have a plausible medical rationale. In layman’s (plain language)words, your medical opinion must be believable in medical terms. SLEEP APNEA is not a known factor in knee injuries, but it could be connected to service connected: GERD, SINUS PROBLEMS, PTSD or something that has been well studied and or researched. I was awarded SLEEP APNEA secondary to my service-connected FIBROMYALGIA.
  15. You can file an appeal/a disagreement. The VA is very famous for denying veterans claim and the BVA may grant your claim depending on the evidence in your records.
  16. The bad part of sleep apnea is waking up gasping and choking trying to get air. I hope I never wake up like that again, scared the hell out of me. After everything calmed down the only thing, I could think about was when we were in boot camp and had to go through that gas chamber. I had to realize; if I didn’t catch my breath I was going to die.
  17. The bottom line is you may have to appeal this decision. For whatever reason, the VA force some veterans to file an appeal for their benefits. I filed one claim in 1998 and it was denied by the local VARO, I filed an NOD, and it was lost. I reopened my claim around 2005 and it was denied. I filed a new NOD and the VARO processed it and it went to the BVA where they remanded it back to the local VARO. So, the local VARO continued to deny my claim and returned it to the BVA where they decided to deny my claim also. I fired my VSO and hired an attorney and filed a claim to the CAVC. The CAVC remanded my claim and sent it back to the BVA where this time they actually granted my claim. Long story made short, in this process the BVA found my original lost NOD and granted my effective date back to 1998.
  18. It's interesting how the different VA offices handles things. Years ago, I accidently destroyed my C PAP machine, and I contacted my sleep clinic and they scheduled me an appointment the very next day to come in and pick up my new machine.
  19. The simplest way to resolve your problem is to call the VAMC Sleep Clinic because they issued you your device. They have the authority to replace your defective C PAP Machine. Explain to them that it is broken, and you need a replacement. They (The VAMC Sleep Clinic) may call you in or set up an appointment for you to come in. You can try them in the morning, I would not wait.
  20. IMHO, more of a copout answer. Disability B can be secondary to service-connected disability A as long as you can get a medical opinion that disability B is as least likely as not caused by or is a result of service-connected disability A. Then give a good medical rationale. Post-Traumatic Stress Disorder (PTSD) & Migraine (americanheadachesociety.org) PTSD Linked to Chronic Headache • National Headache Foundation (headaches.org) The Link Between Migraine Headaches and PTSD | Keefe Disability Law (keefelaw.com)
  21. You can check with your state for state benefits but here is a form that should come in your packet. Also your packet will explain more. If you are just TDIU and not P & T then it is the 100% compensation pay. VBA-21-8760-ARE.pdf (va.gov)
  22. Not sure where you are with your SSDI claim but most claims are denied and most have to get a lawyer. It is a well-known fact that most people that win their SSDI win it by getting an attorney and having to go through a judge to make the final decision. The lawyers will contact your doctors including the VA.
  23. Typically, a veteran can file an appeal when the VA makes a wrong decision with their effective date and or their rating percentage. If you had increased symptoms when the VA originally granted your claim, then you can file and appeal to correct their mistakes. If you filed a claim in 2015 and the VA rated, you and sent you a decision and you didn’t file a new claim for increase until 2020-2021 and the VA increased your rating then what are you asking for? If your symptoms increased in 2019 and you didn’t file a claim, why would you think that the VA would give you an earlier effective date when you didn’t file a claim? Keep in mind that effective dates are always connected to both symptoms and when the veteran filed a claim. It is really hard to say, and I don’t want to discourage you. What do you want to appeal? What date are you trying to claim and think the VA made a mistake? Can you explain: “My effective date was the date of decision”? Did you file a claim, and the VA gave you an effective date of your rating decision and not the date you filed your claim? Did the VA give you an effective date of your C & P exam? Can you redact your rating decision and post it so we can better help you? Make a copy of your decision and redact/remove all personal information like: name, SSN, claim number if different, address or anything that would identify you and post it.
  24. I recently went through this within the last thirty (30) days. Contracted C & P exams are considered VARO records and veterans that have contracted exams must request their exams from the Regional Office and not the VAMC. I even filled out the form and mailed it to the VAMC and they called and informed me that I had to request my exams from the regional office. VAMC C & P exam records are simple, but those records can still be requested from the Release of Information Office in the hospital, but we are talking about records that the VARO controls and they will not release or make a copy for the veteran’s C & P exams until after they make their rating decision. My C & P exams were with the LHI Care, and they also refused to give me a copy and informed me to request a copy from the Regional Office.
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