pacmanx1

Is cause by or a result of: 100% chance of being granted. Is most likely cause by or result of: 75% chance of being granted. Is as least likely as not (50/50 probability) caused by or a result of: 50% chance of being granted. "should be all a veteran needs" Is less likely as not less than (50/50 probability) caused by or a result of: 25% chance of being granted. Is not cause by or a result of: 0% chance of being granted. I cannot resolve this issue without resort to mere speculation. This rationale will cause problems with getting an increase or service connection. It also depends on what is in the veterans file, a veteran can have a negative C & P exam but the evidence in his or her file could still warrant an increase or service connection. The veteran can have a positive C & P exam and a negative C & P exam and the veteran should win his or her claim.

When you file your claim for an increase for GERD and IBS, ask for the maximum rating allowed. You will need medical documentation that your condition has gotten worst. In your 2005 decision VA stated that you did not have credible symptoms. So that means, when you begin to have symptoms, you need to be treated so the symptoms can be documented. I would also suggest that you need to see an Internal Medicine doctor to evaluate your condition. If you have any hospitalizations or emergency room visits they would help document your condition also.

What are your service connected disabilities including their rating percentages?

Congrats.

Since I am on the Gulf War Registry, I get these in the mail maybe once a year. I am just glad to pass on the information and help in any way I can. GOD Bless and best wishes to all

I don't see how it could really hurt, I think it "should" add weight to your claim for P & T

VA Made Secret Deal with Prudential; Families Lose Millions to Insurance Giant September 14, 2010 posted by Michael Leon · September 13, 2010 (Bloomberg Markets Magazine) – The U.S. Department of Veterans Affairs failed to inform 6 million soldiers and their families of an agreement enabling Prudential Financial Inc. to withhold lump-sum payments of life insurance benefits for survivors of fallen service members, according to records made public through a Freedom of Information request. The amendment to Prudential's contract is the first document to show how VA officials sanctioned a payment practice that has spurred investigations by lawmakers and regulators. Since 1999, Prudential has used so-called retained-asset accounts which allow the company to withhold lump sum payments due to survivors and earn investment income on the money for itself. The Sept. 1, 2009, amendment to Prudential's contact with the VA ratified another unpublicized deal that had been struck between the insurer and the government 10 years earlier — one that was never put into writing, Bloomberg Markets magazine reports in its November issue. This verbal agreement in 1999 provoked concern among top insurance officials of the agency, the documents released in the FOIA request show. For a decade, until the contract was formally changed, Prudential wasn't fulfilling its obligations to survivors of fallen service members, says Brendan Bridgeland, an insurance lawyer who runs the non-profit Center for Insurance Research in Cambridge, Massachusetts. 'Violated Terms' "It's very clear they violated the original terms of the contract," says Bridgeland, who is retained by the National Association of Insurance Commissioners to represent consumers. "Every veteran I've spoken with is appalled at the brazen war profiteering by Prudential," says Paul Sullivan, who served in the 1991 Gulf War as an Army cavalry scout and is now executive director of Veterans for Common Sense, a nonprofit advocacy group based in Washington. "Now vets are upset at the VA's inability to stop Prudential's bad behavior." That the VA allowed Prudential to issue retained-asset accounts for 10 years while the contract required lump-sum payouts is "more evidence that the VA was asleep at the wheel for a decade," says Sullivan, who was a project manager and analyst at the VA from 2000 to 2006. "When grieving families check the box that they want a lump sum, they should get it. We remain disappointed and irate at the VA's failure to provide advocacy for veterans," he says. State and U.S. Probes Since July 28, when Bloomberg Markets first reported that Prudential sent checkbooks instead of checks to survivors requesting lump-sum payments, state and federal officials have demanded the retained-asset system be investigated and reformed. The VA itself launched a probe of its life insurance program the day the first story was published. The next day, New York Attorney General Andrew Cuomo launched what he called a "major fraud investigation" of Prudential and other life insurers over their use of retained-asset accounts. Since then, Cuomo's office has issued subpoenas to Prudential and at least 12 more insurance companies. The insurance departments in Georgia and New York have also opened probes. The U.S. House Oversight and Reform Committee plans to hold hearings into Prudential's use of retained-asset accounts to pay money owed to fallen soldiers' survivors. 'News to Me' U.S. Secretary of Defense Robert Gates — whose department includes the VA and who was in office when the 2009 agreement was signed — said when the VA started its probe that he had been unaware that survivors were being sent retained-asset accounts. "Until today I actually believed that the families of our fallen heroes got a check for the full amount of their benefits," Gates said at the time. "This came as news to me." Under Prudential's original 1965 contract with the VA and a 2007 revised contract — both of which were released as part of the FOIA response — the insurer is required to send lump-sum payouts to survivors requesting them. The contract covers 6 million active service members, their families and veterans. The checkbooks Prudential sends to survivors are tied to what the insurer calls its Alliance Account. The checkbooks are made up of drafts, or IOUs, and aren't insured by the Federal Deposit Insurance Corp. Prudential invests the survivors' money in its general corporate account, where it can earn the insurer as much as eight times as much as it currently pays in interest to beneficiaries. Bond Income Prudential held $662 million of survivors' money in its corporate general account as of June 30, according to information provided by the VA. Prudential's general account earned 4.2 percent in 2009, mostly from bond investments, according to regulatory filings. The company has paid survivors holding Alliance Accounts 0.5 percent in 2010. Families that were supposed to receive lump-sum payments under the terms of the contract before it was amended in 2009 may be able to successfully sue Prudential for lost interest, insurance lawyer Bridgeland says. "Survivors would have a very strong claim for interest earned by Prudential on their money," he says. Prudential spokesman Bob DeFillippo says his company is following the terms of its agreement with the VA. "Prudential is in compliance with its contract with the Department of Veterans' Affairs," he says. DeFillippo declined to comment on whether Prudential was in compliance with its contract between 1999 and September 2009 or to answer any other questions. Prudential chairman and Chief Executive Officer John Strangfeld declined to comment for this story. Useful Service In July, DeFillippo said Prudential's retained-asset account was a useful service for bereaved relatives of soldiers. "For some families, the account is the difference between earning interest on a large amount of money and letting it sit idle," he said. Survivors can withdraw some or all of their money at any time, he said. Veterans Affairs Chief of Staff John Gingrich says the agency approved use of the Alliance Account because it wanted to help survivors. "We needed to give an option to individuals that allowed them more flexibility and time to react to the tragic family situation," Gingrich says. Verbal Agreement VA spokeswoman Katie Roberts declined to say when Veterans Affairs Secretary Eric Shinseki, who was appointed by President Barack Obama in January 2009, learned of the existence of the 1999 verbal agreement and the 2009 amendment. She also declined to make Shinseki available for comment. Roberts says that findings of the VA's investigation will be made public soon. The VA official who verbally agreed in 1999 to allow Prudential to change the terms of the 1965 contract and begin offering retained-asset accounts was Thomas Lastowka, the VA's director for insurance, according to Dennis Foley, a VA attorney. Prudential began sending Alliance Account kits to soldiers' beneficiaries in June 1999. Foley says the VA and Prudential would have been better off if they had put their 1999 agreement in writing. "Could that have been done better?" Foley asks. "Probably. Best practice would have been to legally memorialize it at the time." Foley says the 1999 changes to the 1965 contract were valid, even if they weren't in writing, because they were made by mutual agreement by people empowered to make such decisions. "It was changed by somebody who was authorized to change it," he says. Contract Terms The language of both the 1965 contract and the 2009 amendment make clear that Newark, New Jersey-based Prudential was required to adhere to the original terms until 2009, regardless of any handshake agreements in 1999, insurance lawyer Bridgeland says. The 1965 contract says any alterations must be made in writing. "No change in the Group Policy shall be valid unless evidenced by an amendment thereto," it says. "No Agent is authorized to alter or amend the Group Policy." The VA and Prudential signed a revised contract in 2007, saying it was "amended in its entirety." That contract, with the exact same words as the 1965 agreement, required that Prudential pay survivors with lump sums. The 2007 revision included the same procedures in the 1965 agreement requiring any changes be made in writing. It contained no mention of the retained-asset system, or of the verbal agreement struck in 1999. 2009 Amendment It wasn't until Sept. 24, 2009, that the changes agreed to by VA official Lastowka and Prudential in 1999 were put into writing. The 2009 amendment allowing Prudential to hold onto death benefit payouts was made retroactive to Sept. 1, 2009, not back to 1999. By putting in writing a change that was verbally adopted 10 years earlier, the VA is effectively trying to backdate the amendment, says Jeffrey Stempel, an insurance law professor at the William S. Boyd School of Law at the University of Nevada, Las Vegas, who wrote 'Stempel on Insurance Contracts' (Aspen Publishers, 2009). "They're trying to reinvent history," Stempel says. "You really can't do that. This is a blatant giveaway by the VA with nothing for the agency or the people in uniform." Nine of every 10 survivors ask Prudential for lump-sum payments, the VA says. Prudential sends those families "checkbooks" instead of checks. 'Disasters Do Happen' Documents released in the FOIA request show some signs of concern within the VA after Prudential proposed the retained-asset accounts in 1998. Lastowka, the official who allowed Prudential to introduce the Alliance Accounts, said that the insurer's "checkbook" system wasn't protected by the FDIC. "Disasters do happen," wrote Lastowka, in an e-mail dated June 9, 1999, to Stephen Wurtz, the agency's deputy assistant director for insurance. Lastowka said in his e-mail that the lack of FDIC coverage could backfire on survivors. "Who is responsible if Alliance goes belly up?" Lastowka asked. "I think we have to also be prepared to defend the use of the Alliance Account." Lastowka also asked whether Prudential had adequately disclosed to survivors that the Alliance Accounts weren't covered by FDIC insurance. "Did Pru alert us to the non- FDIC fact?" he wrote to Wurtz. "Or was it in small print as the notice to beneficiaries?" Documents turned over by the VA didn't include a response from Wurtz. 'Aware of Issues' Lastowka says his e-mail shows the decision to allow Alliance Accounts was carefully considered. "This e-mail demonstrates simply that the VA's Insurance program was aware of issues that might be raised as we implemented the payment method and that we should be prepared to respond to inquiries," Lastowka says. "We were confident that we were making a decision which would benefit survivors." The FOIA documents show that on June 10, 1998, Prudential gave a presentation to the VA. It included 10 pages of key points, saying the Alliance Accounts would benefit survivors because they would provide safety, flexibility in how and when to use their money, competitive interest rates and customer service. In fine print, at the bottom of one of the pages, was this caveat: "Funds in the Alliance Account are direct obligations of The Prudential Insurance Company of America and are not insured by the Federal Deposit Insurance Corporation." Sheila Bair Twelve years later, the issue of the lack of FDIC protection in retained-asset accounts flared anew. After the first Bloomberg Markets story was published, FDIC Chairman Sheila Bair said consumers could incorrectly conclude that retained-asset accounts were insured by the FDIC. "The insurance company must take care to avoid implying in any way that these accounts are in fact FDIC- insured," she wrote in an Aug. 5 letter to state insurance regulators. Some families of veterans have taken their complaints to court. Five survivors filed a federal fraud lawsuit in Boston on Aug. 30 against Prudential claiming the insurer has earned as much as $500 million in profits by improperly keeping beneficiaries' money instead of paying it out in a lump sum. The suit, Lucey vs. Prudential Insurance Co. of America, says the insurer fraudulently claims to beneficiaries that the Alliance Account is a lump sum. 'This Ruse' "Initiation of this ruse does not constitute payment of anything to anyone," the suit says. "The Alliance Account is merely a bookkeeping device used by Prudential to hold on to beneficiaries' money." Prudential hasn't yet filed a response in court. Spokesman DeFillippo says he can't comment on the case. "It is important to note that several federal judges have rejected claims against accounts like our Alliance Account, concluding that beneficiaries are in virtually the same position they would be in had the insurer sent them a check," DeFillippo says. He cited the dismissal of a case against MetLife Inc. on Sept. 10. Insurance contract professor Stempel says that regardless of the outcome of that lawsuit, it's clear that Prudential and the VA wrongly manipulated a federal contract at the expense of military members and their relatives. "At a minimum, survivors ought to be made whole with their missed interest," he says. "The VA really seems to have had the best interests of the insurance company at heart, instead of those of the soldiers and their families. David Evans is a senior writer for Bloomberg Markets in Los Angeles at davidevans@bloomberg.net This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Since you got out last year, tell them about some of your experience that you went through from being deployed. Tell them that you feel that you have some type of depression (maybe PTSD). Try to explain to them in a letter what was going on with you at the time when you got out of the military. You may also want to look into trying to up grade your discharge to honorable. I am not sure if that is possible but you should at least look into it and try it. Others may chime in.

[quote]Hi, My name is Kevin. I was in the Army active duty till last year when I got out on an OTH discharge which in some ways I deserved for my actions. But at the same time I feel that the things that happened could have been avoided if I had had proper help dealing with the things that were going on after being back from Iraq. I have injuries that I sustained while being in a infantry unit in Iraq along with several other problems. I went to Iraq fresh from AIT and as soon as we returned It seemed as though everyone I fought with went elsewhere. And none of the PA's seemed to help with me my injuries other than ibuprofen and "i am not sure shrugs." I got pretty depressed and made some very bad decisions with no one who cared enough around to guide me in the right direction. To be honest I was completely terrified of being in the field or returning to Iraq. Now I have several problems, the most of which my right hand is pretty messed up especially the pinky. And cant afford reconstructive surgery. I tried to file my compensation packet. and now they have sent me a letter saying that my service is not honorable for VA purposes, and that if I disagree with this I need to write them a "letter of Disagreement" That is where I am at a loss of what this letter needs to include and etc. Any help at all is more than I have now. Thank you so much for you time and answers. K. Caywood

Citation Nr: 0919318 Decision Date: 05/22/09 Archive Date: 05/26/09 DOCKET NO. 07-23 025 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Togus, Maine THE ISSUES Entitlement to an increased rating in excess of 30 percent for irritable bowel syndrome (IBS) and gastroesophageal reflux disorder (GERD). REPRESENTATION Appellant represented by: Texas Veterans Commission ATTORNEY FOR THE BOARD A.M. Ivory, Associate Counsel INTRODUCTION The Veteran had active military service from November 1979 to July 1986. This matter comes before the Board of Veterans' Appeals (Board) on appeal from January 2005 and January 2006 rating decisions by the Department of Veterans' Affairs (VA) Regional Office (RO) in Togus, Maine and the RO in Augusta, Maine. During the pendency of this appeal the RO issued the January 2009 Decision Review Officer (DRO) decision which granted the Veteran an increased rating of 50 percent for her service- connected migraine headaches, effective May 19, 2004, the date of the Veteran's claim for increase. The Board notes that the 50 percent disability rating is the maximum available rating under 38 C.F.R. § 4.124a, Diagnostic Code 8100. Therefore, since the Veteran was granted the full benefits sought on appeal, the issue of an increased rating for migraine headaches is no longer before the Board. The January 2005 and January 2006 RO rating decisions continued the Veteran's 10 percent disability rating for her service- connected IBS. The January 2006 RO rating decision granted the Veteran service connection and a noncompensable rating for peptic ulcer. In compliance with 38 C.F.R. § 4.114 a May 2007 DRO decision combined the Veteran's service-connected IBS and service-connected peptic ulcer, GERD, and granted her a combined rating of 30 percent, effective September 17, 2004. Inasmuch as a rating higher than 30 percent for the service- connected IBS and GERD is available, and inasmuch as a claimant is presumed to be seeking maximum available benefit for a given disability, the claim for higher ratings, as reflected on the title page, remains viable on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). The Board notes at the Veteran's February 2008 VA examination the examiner stated that her GERD and IBS interfered with her employment. Therefore, the Board refers the issue of total disability rating based on individual unemployability due to a service-connected disability (TDIU) to the RO for further development. FINDING OF FACT The Veteran's service-connected IBS and GERD are manifested by other symptom combinations productive of severe impairment of health. CONCLUSION OF LAW The criteria for the assignment of an increased rating of 60 percent for the service-connected IBS and GERD are met. 38 U.S.C.A. §§ 1155, 5103, 5103A, 5107 (West 2002 & Supp. 2008); 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.3, 4.10, 4.20, 4.114 including Diagnostic Codes 7319, 7346 (2008). REASONS AND BASES FOR FINDING AND CONCLUSION I. Duty to Notify and Assist Initially, the Board notes that, in November 2000, the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (2000), was signed into law. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, and 5107 (West 2002). To implement the provisions of the law, VA promulgated regulations at 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2008). VCAA and its implementing regulations include, upon the submission of a substantially complete application for benefits, an enhanced duty on the part of VA to notify a claimant of the information and evidence needed to substantiate a claim, as well as the duty to notify the claimant what evidence will be obtained by whom. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b). In addition, they define the obligation of VA with respect to its duty to assist a claimant in obtaining evidence. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159©. Considering the duties imposed by VCAA and its implementing regulations, and given that the action taken hereinbelow is fully favorable by granting the Veteran the maximum schedular rating available to her, the Board finds that all notification and development action needed to fairly adjudicate the claim on appeal has been accomplished. II. Analysis Disability evaluations are determined by the application of VA's Schedule for Rating Disabilities, which assigns ratings based on average impairment of earning capacity resulting from a service-connected disability. 38 U.S.C.A. § 1155; 38 C.F.R. Part 4. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the Veteran. See 38 C.F.R. §§ 3.102, 4.3 (2008). The Veteran's entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where entitlement to compensation already has been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Nevertheless, the Board acknowledges that a claimant may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505 (2007). The analysis in the following decision is therefore undertaken with consideration of the possibility that different ratings may be warranted for different time periods. The January 2005 and January 2006 RO rating decisions continued the Veteran's 10 percent disability rating for her service- connected IBS. The January 2006 RO rating decision granted the Veteran service connection and a noncompensable rating for peptic ulcer. In May 2007 a DRO decision combined the Veteran's service-connected IBS and service-connected peptic ulcer, GERD, and granted her a combined rating of 30 percent, effective September 17, 2004. The Veteran asserts that her service-connected GERD and IBS are worse then the increased 30 percent disability rating. The Board notes that the Veteran's IBS and GERD cannot be rated separately because 38 C.F.R. § 4.114 states that ratings under Diagnostic Codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348, inclusive, will not be combined with each other. A single rating will be assigned under the diagnostic code that reflects the predominant disability picture, with elevation to the next higher rating where the severity of the overall disability warrants such elevation. Therefore, in this situation the highest scheduler rating the Veteran can get is rated under the criteria for GERD and therefore, the Veteran will not be granted a separate rating. Additionally, the Board notes that to assign two separate ratings under 38 C.F.R. § 4.114 would constitute pyramiding and "the evaluation of the same manifestation under different diagnoses are to be avoided." 38 C.F.R. § 4.14. Also, Esteban v. Brown, citing Brady v. Brown: "38 U.S.C.A. sec. 1155 implicitly contains the concept that 'the rating schedule may not be employed as a vehicle for compensating a claimant twice or more for the same symptomology; such a result would overcompensate the claimant for the actual impairment of his earning capacity' and would constitute pyramiding." Esteban v. Brown, 6 Vet. App. 259, 261 (1994), citing Brady v. Brown, 4 Vet. App. 203 (1993). The Veteran is currently rated under 38 C.F.R. § 4.114, Schedule of Ratings for the Digestive System, Diagnostic Code 7436. A rating of 10 percent is awarded with two or more of the symptoms for the 30 percent evaluation of less severity. A rating of 30 percent may be assigned for persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. A rating of 60 percent may be awarded for symptoms of pain, vomiting, material weight loss or hematemesis or melena with moderate anemia, or other symptom combinations productive of severe impairment of health. The Board notes that also applicable under 38 C.F.R. § 4.114 is Diagnostic Code 7319, which provides ratings for irritable colon syndrome (spastic colitis, mucous colitis, etc.). A noncompensable rating is warranted when there is mild irritable colon syndrome, with disturbances of bowel function with occasional episodes of abdominal distress. A 10 percent disability rating is warranted when there is moderate irritable colon syndrome, with frequent episodes of bowel disturbance with abdominal distress. A 30 percent disability rating is severe irritable colon syndrome, with diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress. The Board notes that the terms "mild," "moderate," "severe," "considerable," and "of lesser severity" are not defined in the rating schedule; rather than applying a mechanical formula, VA must evaluate all the evidence to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6. At the Veteran's July 2005 VA examination it was noted that she had diarrhea for 3 days every 3 to 4 months and the last time there was blood in her stool. It was also noted that she lost work due to her IBS. In July 2007 the Veteran had a VA examination where she reported vomiting once every few weeks; however, she didn't have weight loss or hematesis. There were occasional episodes of abdominal distress. She had frequent episodes of bowel disturbance and alternating diarrhea and constipation. She had blood intermittent with her periods of diarrhea, a few times a month for a couple of days. She also had lower abdominal pain, reflux, and vomited once every 3 months. She had no dysphagia, pain, hematemesis, or anemia. At the Veteran's February 2008 VA examination it was noted that her GERD and IBS were progressively worse. It was noted that the Veteran did not have any vomiting, esophageal, hematemesis, melena, or anemia. However, she did have nausea several times a week after meals and frequent dysphagia; it was less then daily but occurred more than once weekly. She also had heartburn/pyrosis and regurgitation several times daily and esophageal dilation once in the past 12 months. She also had weekly constipation and persistent diarrhea that occurred 4 to 6 times daily. In addition, she had sharp intestinal pain in the epigastric area that occurred several times a day for 1 to 2 hours and was severe. The VA examiner noted that the Veteran lost 11 weeks of work in the past year due to her IBS and GERD. She also had significant loss of stamina, weakness, and fatigue. Her activities of daily living were affected mildly in the areas of bathing, dressing, toileting, and grooming; moderately in the areas of chores, shopping, and feeding; and severely in the areas of exercise, sports, recreation, and travel. After a careful review of the Veteran's VA treatment records, VA examinations, and private treatment reports the Board finds that the Veteran's service-connected IBS and GERD warrants an increased rating of 60 percent under 38 C.F.R. § 4.114, Diagnostic Code 7436. The February 2008 VA examiner specifically stated that she had significant loss of stamina, weakness, and fatigue due to her service-connected GERD and IBS. In addition she had daily diarrhea, heartburn, and regurgitation and weekly constipation. She also had severe intestinal pain that occurred several times a day. While she does not have material weight loss, hematemesis or melena with moderate anemia, the Board finds that she still meets the criteria for 60 percent because the medical evidence demonstrates that she has symptom combinations productive of severe impairment of health. For all the foregoing reasons, the Board finds the totality of the evidence warrants an increased rating of 60 percent for the service-connected IBS and GERD. Because the Veteran is currently in receipt of the maximum schedular rating for IBS and GERD, the Board has considered an extraschedular rating under the provisions of 38 C.F.R. § 3.321(b)(1) (2008). Under 38 C.F.R. § 3.321(b)(1), an extraschedular evaluation is warranted only if the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization as to render impractical the application of the regular schedular standards. The February 2008 VA examiner stated over the past year the Veteran lost 11 weeks from work due to her service-connected disability; however, the Board finds that this was taken into consideration was granting her the increased 60 percent disability rating and there is no evidence that shows marked interference with her employment beyond that contemplated under her assigned schedular rating. In addition, the Board notes that the record contains no indication that the Veteran has been frequently hospitalized for treatment of her service- connected IBS and GERD. In summary, although the record shows that the Veteran's IBS and GERD results in occasional interference with work her maximum disability rating of 60 percent is in recognition that her industrial capabilities are severely impaired. After reviewing the record, the Board is unable to identify an exceptional or unusual factor which would render impractical the application of the regular schedular standards. Thus, referral for consideration of extraschedular rating is not warranted. Given these facts, the Board finds that an increased rating of 60 percent, but not higher, for the service-connected IBS and GERD is warranted. ORDER An increased rating of 60 percent for the service-connected IBS and GERD, subject to the regulations controlling disbursement of VA monetary benefits, is granted. ____________________________________________ CHERYL L. MASON Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs

When did you have your C & P exam and when did you get your last rating? Can you scan them and cover all personal information? This will greatly help the board help you. Just scan the reason and basis in your last rating decision and the diagnosis, medical opinion (if given) and the rationale in your C & P exam.

Veteran fights VA over exposure to burn pits BY PHILLIP O'CONNOR poconnor@post-dispatch.com 314-340-8321 | Posted: Sunday, September 12, 2010 12:30 am Iraq veteran Tim Wymore spends most of what he believes are his last days worried about what will become of his family. He has three lesions on his brain, another on his eye. He suffers from a blood disorder, a damaged esophagus and abdominal problems that led to the removal of most of his colon. He can barely stand, and then only with the aid of a cane. He is 44 years old. Wymore, of St. Charles, is one of several hundred veterans across the country who have filed lawsuits contending that dangerous toxins from open-air burn pits operated on U.S. military installations in Iraq and Afghanistan made them sick. Last week a federal judge ruled the case could proceed. The Department of Veterans Affairs acknowledges that Wymore's health problems are war-related. But the VA believes his condition may improve. Because of that, the VA has yet to declare Wymore permanently disabled. As a result, his family is not eligible for many benefits. Those include medical insurance for his wife and college costs for their three sons. Also, Wymore worries that should he die, the VA will not pay a survivor's benefit to his wife unless she can prove his death is directly related to his military service, a challenge he doesn't want to put her through. "I took the oath and did what was asked of me," he said. "Now, I feel it's time for the military to do their part. I'm tired of fighting them." Wymore's wife, Shanna, quit her job to care for him full time. For now, the couple survive on his Social Security and military disability payments and the charity of others. The lawsuit is no guarantee of a financial payoff. The VA has told the couple they will review Wymore's disability rating in 2012 to see whether his condition has improved. The couple fear that could be too late. "We've gone so far downhill so fast I don't want to see what another six months will look like," Shanna Wymore said. OFF TO IRAQ Tim Wymore grew up in Arnold, graduated from Fox High School, then served three years' active duty with the Air Force. He met Shanna while home on leave between basic training and his first duty station. They married two weeks later and have been together 25 years. After active duty, Wymore joined the Missouri Air National Guard. He served with the 131st Fighter Wing at Lambert-St. Louis International Airport driving trucks and forklifts, and offloading planes. In civilian life, Wymore made good pay as a tool and die maker. Shanna, 43, sold industrial tools and supplies, and worked part time at a convenience store and as a real estate agent. The couple worked hard and were on track to retire at age 50. Wymore was surprised he was sent to Iraq; only five members of his unit deployed. He was stationed at Balad, one of the largest American military bases. Each week, he made several trips to the base burn pit, often driving his truck to the edge to unload anything he'd been ordered to dispose of - from tents to trash to air conditioners. Five football fields long and 300 feet deep, the pit spewed thick black smoke continuously. "They didn't even give us paper masks," Wymore recalled. Fumes lingered over the sprawling base. Wymore said he inhaled them in his trailer at night. "You'd wake up to that taste in your mouth," he said. Even now, he sits in the shower in the morning with his mouth open to rid himself of the bitter, metallic taste. During his six-month tour, Wymore complained of headaches, stomachaches and trouble breathing. "Everybody got the same medicine," he said. "800 milligrams of ibuprofen." Wymore said he knew at the time he probably was sacrificing his health. When he left Iraq in 2005, he demanded that his burn pit exposure be included in his medical records. "I was worried," he said. "I knew down the road something was going to happen, but not this soon." Back home, his health declined. He required emergency surgery to remove an infection in his stomach, battled pneumonia and was in and out of the hospital. He began blacking out at work and eventually could no longer do the job. About a year and a half ago the couple turned to the VA for help. Doctors determined he suffered from post-traumatic stress, but had no answers about his physical problems. They ordered more tests. Still, no one could provide a definitive diagnosis. Unknown to the Wymores, other veterans across the country were coming forward to complain of similar health problems, including cancers, respiratory disease and skin disorders. Eventually, the Wymores joined veterans or their survivors in 42 states in filing lawsuits against Kellogg Brown & Root, the military contractor that operated many of the burn pits. On Thursday, a federal judge in Maryland, where the lawsuits have been consolidated, ruled the case could go forward despite KBR's contention it was following the military's orders and bore no legal burden. The lawsuit contends the pits contained a poisonous mixture of plastics, metals, paints, solvents, medical waste and other products that caused severe illness. Jon Gelman, a New Jersey attorney representing some of the soldiers, said he believed as many as 30,000 to 40,000 veterans might have been affected by the burn pits. "It is going to have a devastating impact on our medical system to treat these soldiers. They start out as mystery illnesses and then blossom into conditions, just like Agent Orange," Gelman said, referring to the herbicide that sickened many Vietnam veterans. "We have a real tragedy ongoing." As far back as 2006, an Air Force study warned that the size and proximity of Balad's burn pit to soldiers' quarters made it "an acute health hazard." Since then, the Department of Defense has ordered a review of the burn pits and Congress has passed legislation limiting their use. Many are being replaced with incinerators that are more expensive to operate. The Balad burn pit was extinguished late last year, more than four years after Tim Wymore first complained. Earlier this year, the VA notified its employees that burn pits should be considered as potential health risks in veterans' claims. The VA also is paying the National Academy of Science's Institute of Medicine to conduct a study on the long-term health effects from burn pit exposure. The study is to be completed in May. A HOSTILE SYSTEM The Wymores continue to fight the VA over benefits and Tim's medical care. In August, Rep. Todd Akin, R-Town and Country, wrote a complaint letter to VA Secretary Eric Shinseki. "For nearly a year, as her husband's health continued to deteriorate, (Shanna) has fought an indifferent and sometimes hostile veterans medical system that has made giving her the runaround an art form," Akin wrote. The VA said in a statement Friday that it was continuing to review the case. Tim Wymore used to love to ride his Harley Davidson motorcycle. Now he passes the time sleeping and watching television. Sports, mostly. He wishes the Cardinals were playing better. He's heavily medicated, and his eyes often remain closed during conversations. Occasionally, he coughs. "Some really gunky stuff," he said. On Thursday, workers installed a stairway lift in the couple's home, eliminating a daily struggle that left both Tim and Shanna breathless. The couple once looked forward to an active retirement, traveling and playing softball with their sons, Tim, 24, Ben, 21, and Cody, 18. Now they are almost broke. Shanna lost her insurance and now forgoes the monthly $500 prescription to treat her Lyme disease. Their house is about to be foreclosed on. "This is the life I live. I'm losing everything," Shanna said. But she isn't going down without a fight. In the dining room, her stacks of paper sit on the table and spread across the floor. Two open suitcases are jammed with more documents. She's determined to learn as much as she can about what is killing her husband. She would like to see experts brought together and a hospital established to treat burn pit victims. She wants to pass on everything she's discovered. "I'm not going to stop," she said, her eyes filling with tears. "I'm afraid if I stop, he'll give up. There's got to be an answer."

AUGUSTA VA IGNORED WARNINGS ABOUT CONTAMINATED EQUIPMENT VA was told: "Stop. Don't do it any more. You're not doing it right. You're not doing it correctly. People are going to get hurt." NOTE from Larry Scott, VA Watchdog dot Org ... For complete background refer to our VA'S CONTAMINATED EQUIPMENT page ... here ... http://www.vawatchdo...edequipment.htm ------------------------- Warning of VA patients' risk was discounted By Tom Corwin Staff Writer http://chronicle.augusta.com/news/metro/2010-09-12/warn ing-va-patients-risk-was-discounted?v=1284251345 Nearly seven months before a patient at Charlie Norwood VA Medical Center noticed a problem with sterilizing equipment, setting off a national investigation that found thousands of patients potentially exposed to infection, an employee pointed out problems with sterilization of that equipment. Augusta VA officials insist the employee was relying on misinformation that would not have caught or corrected the problem. After the patient's discovery in November 2008, the VA notified more than 10,000 veterans that they might have been exposed to improperly cleaned equipment, and it offered testing. More than 50 cases of infection, from hepatitis C to HIV, have since been found, though VA officials say it's unlikely they came from the equipment. Seven months before others noticed, in April 2008, an Augusta VA employee sent out an e-mail raising alarm about the sterilization of flexible endoscopes, according to information obtained by The Augusta Chronicle . Infection control practitioner David Marana had attended a conference for VA infection-control workers in April 2008. Shortly after returning, Marana sent out an e-mail saying the VA was not following standards he had learned about at the conference. "At this time, I recommend that services involving reusable flexible scopes be discontinued until we have met the standards," he wrote. Marana, who is no longer with the VA and was reluctant to talk to The Chronicle , did say he thought some of the problems discovered later could have been headed off "if people had listened to me and took the recommendations seriously." Catherine McAdams, a nurse in infection control, also attended the conference. "They were told, 'Stop. Don't do it any more,' " said McAdams, who also has left the VA. "You're not doing it right. You're not doing it correctly. People are going to get hurt.' " VA cites misinformation The minutes from the infection control meeting, called soon after Marana's e-mail, stated that endoscope cleaning in "several areas of the hospital ... are not in compliance with standards set forth" in VA Directive 7176. Ellen Harbeson, the Augusta VA's quality management coordinator, said the conference that Marana and McAdams attended provided misinformation about Directive 7176, particularly which VA department was supposed to oversee the department where the reprocessing is done. Though speakers at the conference asserted that infection control was supposed to oversee that department, "that is completely false," Harbeson said. Supervision was later changed after the problems in Augusta and elsewhere were discovered, but it was not put under Infection Control, she said. The e-mail itself was "somewhat alarming," she said, but when two senior clinical leaders checked into the allegations, they discovered "where he was talking about a deficiency was not a deficiency." Much of the early discussion focused on having an appropriate space with the right kinds of ventilation for decontamination and sterilization, which was not an immediate patient safety issue, hospital epidemiologist Stephanie Baer said. "Yeah, we had some quality improvement to do," Baer said. "I think we all would agree with that. But the level of alarm to stop all procedures, there was not an immediate danger to patients identified at that time to justify that degree of reaction. When we did identify a problem that was potentially a safety problem for patients, we immediately closed the clinic. And that was appropriate." The kind of sterilization being discussed in April was different from the kind used in the ear, nose and throat clinic, so the changes suggested wouldn't have caught the problem right away, she said. When Augusta VA Director Rebecca Wiley testified last year before the House Committee on Veterans Affairs, she referred to the April discussion and e-mails as "some questions or controversy over where the supervisory responsibility needed to be for (the reprocessing department) in the future." She has said that she stands by that characterization. New oversights in place The VA has changed to the more-centralized kind of processing of the flexible scopes "just to improve oversight, not because it was a mandate," Baer said. Things are working better, and a team meets monthly to ensure that all manufacturers' cleaning guidelines on all reusable equipment are being followed, Harbeson said. "I think it's important to recognize that we identified a problem here that was common to every health care facility, VA or non-VA," she said. "And thus you've seen a growth in the industry of companies that provide oversight and assistance in the sterilization of reusable medical equipment." The VA has learned from its mistakes, Baer said. "Of course we deeply regret that we had to place any patient in this situation," Harbeson said. "We do believe that we have handled this in the best way we could have." Marana left the VA before the problem was discovered in the ear, nose and throat clinic and said he hasn't really kept up with what has happened. "Whether it was corrected or not, I don't know," he said. "All I got was, things have changed or a lot has changed since I left. Whether those issues have been addressed, I have no idea."

Sick Bay Commandos September 12, 2010 posted by Dale R. Suiter Soldiers and Marines that frequented sick call has historically been referred to as "Sick Bay Commandos". An old Jody Call goes: "Blind, Crippled and Crazy, we are all lazy" troops on sick call were made to sing marching to sick call. (years ago – I doubt many Troops or Marines have to march in formation to sick call in today's military.) Members of the military must now prove to the United States government, i.e. the military medical system and Veterans Administration that wounds received in action or line of duty injury or illness can be attributed to military service. This can be a complex issue for TBI victims and other wounded or ill members of the military that have not documented their medical issue. I urge family members to keep a separate medical file for their military loved ones. If they receive a yellow sticky note, make a copy of it. Keep it in chronological order too. Cases that go to medical boards and compensation and pension hearings (before the VA) must be documented. Any witness statements are very, very helpful too. There is no such thing as to much documentation. No injury or illness is to small. Case in point. Firefight, 42 years ago. Squad leader fires his M-16. The muzzle of the weapon is next to the right ear when he fires. The Marine says: "Damm Sarge" and moves to another position. Of course, now, 42 years later he has a bad ear. No proof exists. He did not leave his squad. There was no such thing as sick call for something considered so minor as a sore ear. Now, the guy with the "bad ear" can in no way prove the injury is related to combat service. There is no record of it. Finding the squad leader is not an option. Marines, Soldiers, Sailors, Airmen and Coast Guard Personnel – do yourself a huge favor – document any medical issue. There is no such thing as "too minor" today. This does not mean that you are "Sick Bay Commando". It merely means that you will be prepared if you need the nation to care for you later in life – when, if it is not in writing – you stand a reasonable chance of being denied benefits. Regards All Dale R. Suiter

VA is a national disgrace: "They are routinely denying our military veterans benefits that we have earned on the battlefield" September 11, 2010 posted by Michael Leon · Vietnam veteran James Davis, 59, of Willis has been trying since 2003 to get an increase in his VA disability benefits, but all he gets is a letter every six months saying he is being evaluated - Houston has highest appeals rate in the U.S. as benefits claims set records - Borrowing for war and not paying the service members who fight By Lindsey Wise at the Houston Chronicle Despite an influx of funds and staff at the Department of Veterans Affairs, the backlog of claims for benefits continues to grow at a record pace in Houston and nationwide. VA received 1 million claims in 2009 for the first time in the department's 80-year history. In Houston, the situation has worsened since the Houston Chronicle first reported on the local impact of the backlog more than a year ago. The number of veterans waiting for the Houston VA Regional Office to process their disability compensation claims jumped from about 19,000 this time last year to nearly 24,000, an increase of 25 percent. Almost half of those claims have been pending for more than four months, compared to 37 percent nationwide. "Clearly Houston is suffering under significant strain, and their office needs attention from Washington so our veterans can get accurate and fast claims decisions," said Paul Sullivan, executive director of the nonprofit Veterans for Common Sense. "So many veterans in Houston have been waiting too long," Sullivan said. He's particularly troubled that Houston has 12,060 claims in appeal, the highest number in the country for the second year in a row. "The high number of veterans' claims awaiting an appeal decision — which often takes four to five years – indicates the Houston office may still have serious and significant quality and accuracy problems," he said. The Houston Regional Office, which serves almost 760,000 veterans and their dependents in 90 Texas counties, is dedicated to the timely and accurate processing of disability claims, VA spokeswoman Jennifer Heim said in a written statement. "We are steadily reducing the inventory of pending claims, while continuing to address the appeals," Heim said. "We have seen a significant increase in productivity within the existing workforce." In August, for example, the office completed 3,898 disability compensation claims, up from 2,862 in the same month last year. Waiting since 2003 Heim attributed the significant increase in claims and appeals in Houston to outreach efforts to communicate VA's mission and the type of benefits available to veterans. She said the Houston VA Regional Office recently hired 50 veteran service representatives and promoted nearly 40 others to help reduce the backlog. The office also continues to outsource some of its claims processing to other regional offices, she said. Vietnam veteran James Davis, 59, of Willis has been waiting since 2003 for a final decision on his request for increased disability benefits. Davis, his wife, and his disabled mother barely scrape by on the $845 disability check he gets from the VA monthly for post-traumatic stress disorder and shattered knees. "All I get is a letter every six months explaining to me that they are still evaluating my status," Davis said. "I've been waiting for what, seven years now," he said. "Hell, I'm 59 years old. They'll wait till I'm dead till they finally make up a decision. And even then it probably won't be in my favor." Sullivan said the growing backlog is the cumulative effect of new VA rules about PTSD, Agent Orange and Gulf War-related illnesses, a tidal wave of new claims from half a million Iraq and Afghanistan veterans, and the nation's economic crisis, which left many veterans without private health insurance to treat their military-related medical problems. "That's five different things that all slammed VA at the same time," Sullivan said. "VA has some initiatives, to their credit, that they hope will mitigate the disaster." More workers hired VA Secretary Eric Shinseki recently touted the department's efforts to reduce the backlog at the annual American Legion National Convention in Milwaukee, according to American Forces Press Service. "We intend to break the back of the backlog this year," Shinseki said at the convention last week. VA hired more than 3,500 claims workers this year to deal with the backlog. The department also invested hundreds of millions in a computerized claims process and electronic records system. Shinseki said the goal is to reduce the time it takes the department to process a claim from the current average of 160 days to 125 days by the end of the year. Does anyone care? Vietnam veteran Bain Slack, 68, of Houston, isn't holding out too much hope that VA will become more efficient. He's been waiting more than two years for VA to decide on his appeal for increased disability benefits. Slack, who flew almost 800 combat missions as a Marine Corps helicopter pilot in Vietnam, became disabled in 2004 after suffering stroke and aneurism of the aorta. He's also been diagnosed with post-traumatic stress disorder, ringing in the ears and hearing loss. Slack said he's submitted extensive medical and military records that connect his health problems to his service, so he can't understand why his appeal is taking so long. Slack and his wife, a schoolteacher, recently had to put their house up for sale. He hasn't been able to work for six years because of his disability, and money is tight. Sometimes he doubts anyone at the VA cares. "The VA is a national disgrace," Slack said. "They are routinely denying our military veterans benefits that we have earned on the battlefield, and it's gotta stop."

I really do not think that there is a difference. I have gotten both white and brown, increases and denials. Lately, I have been getting all white envelopes so don't worry about it.

UPDATE: PHONY GENERAL OUSTED AS VOLUNTEER AT VA HOSPITAL The decision to terminate his services was based on a concern that his continued presence could be upsetting to veterans. NOTE from Larry Scott, VA Watchdog dot Org ... Yesterday we brought you this story: VETS WANT PHONY GENERAL OUT AS VA HOSPITAL VOLUNTEER -- "Veterans, particularly combat veterans, have very strong feelings about how ribbons and rank are worn and consider his actions extremely disrespectful." http://www.vawatchdo.../nf091010-1.htm Now, the VA has taken action. ------------------------- VA drops phony Marine general as volunteer at La Jolla hospital by Tony Perry http://latimesblogs.latimes.com/lanow/2010/09/v a-drops-phony-marine-general-as-volunt eer-at-la-jolla-hospital.html In response to a protest from a veterans group, the Veterans Affairs hospital in La Jolla has terminated the volunteer services of a 69-year-old Ramona man who pleaded guilty to wearing military rank and ribbons that he had not earned. The Oceanside-based American Combat Veterans of War had sent a letter this week to the VA director of volunteers asserting that the presence of David Weber at the hospital was a sign of disrespect toward veterans. Weber in January pleaded guilty to a misdemeanor violation of the federal Stolen Valor Act. He had worn a dress uniform with the rank of a two-star general and several unearned ribbons to a military gathering in November. He had apparently begun telling tall tales about his military service over several years. Weber had served in the Marine Corps as a staff sergeant. He was working as a volunteer at the hospital as part of his court-ordered 240 hours of community service. He had worked about 100 hours at the hospital, doing errands for patients and staff. The decision to terminate his services was based on a concern that his continued presence could be upsetting to veterans, Lorelei Winn, director of volunteer services at the La Jolla Veterans Affairs Medical Center, said Friday. Winn said there was no indication that Weber had said anything untrue to patients or staff about his military service. Contacted by the North County Times, Weber refused comment.

The 810 Vermont Ave. NW Washington, D.C. 20420 should be the correct address. I always send my information express mail or return signature. It cost a little more for the express mail but I get a printed copy of who signed for it or I get the green card back in the mail. Hope the best

I totally agree, after having sleep apnea attacks who would not have some type of anxiety about going to sleep. A lot of medication can cause drowsiness and this could also increase a persons anxiety or fears of falling asleep.

Congrats

In order for your daughters to be eligible for CHAMPVA and CH 35, you have to be awarded P & T. I think you should talk to your doctor about it and if he writes a statement in your file then you should file for P & T. Let your doctor state in your treatment records that you are not employable and it is most likely not to change. You also get the military tan MWR ID card once you are awarded P & T. You will have to check your state for any benefits like property/auto tax exemption. You can also get a waiver for life insurance. Others may chime in. Hope this helps. CHAMPVA= Dependent Health Care CH35 Dependent Education Assistance (DEA)

Congrats

I think that most veterans are finding out that sleep apnea is a silent killer. A lot of veterans suffer from too many physical disabilities and they cannot exercise. I also think that a lot of veterans suffer from some type of depression/anxiety that can contribute to having sleep disorders.

Yes, you most certainly can

It is just my opinion but it seems that more of us are having two C & P exams for one issue claimed. I don't understand it; it is like VA is fishing for a negative C & P exam result. All I can say is make sure you go to both of them. Keep in mind if VA tries to deny your claim, depending on what both C & P exam states, plus what your evidence show, if it proves at least 50/50 for and against, VA must award your claim