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Everything posted by broncovet

  1. If you read this over, you can probably find your answer: http://www.danaise.com/understanding-rating-for-knee-injury/
  2. Of course, they dont care if we understand the logic or not. However, take the hint: If they are asking for clarification of the fibromyalgia, give that to them or expect to be denied.
  3. There may be "overlap" of symptoms between the arthritis and meniscal tear. Example: Pain in your knee. This could be caused by either, or both. Maybe for loss of ROM, also. Pyramiding prevents you from being paid for the same symptoms twice. In other words, if you are getting paid for "pain"in your knee from arthritis, you probably wont get paid again for pain in the knee from meniscal tear. You see this with mental health disorders a lot. You could have multiple diagnosis..PTSD, depresstion, bipolar, schizo, etc. HOwever you will only get compensated for "1" set of symptoms, even if they are caused both from depression and bipolar, for example. Go ahead and appeal, but I would not be suprised if pyramiding prevents you from getting paid for both.
  4. Business as usual for the VA. The VA gets caught lying by the VAOIG, and then they promise to stop lying any more. And they wonder why Veterans dont trust the VA??? This kind of thing is not new, and usually will happen again. Remember the similar scandal where VA lied about the wait times to get an appointment and Veterans died waiting? So, what did they do? They gave VA more money, of course. This is proof "more money" wont stop VA from lying to us.
  5. Congratulations! Dont forget about state benefits, too.
  6. You are just going to have to wait for the decision, ebenefits doesnt mean much.
  7. "Higher level Review" (HLR) should be used "only" when you are sure you have no new evidence. Otherwise, you want to use Supplemental Claim Lane (SCL). If you are not sure what evidence VA has in its possession, I recommend SCL. HLR is a one way street, where you can not submit new evidence. I dont recommend going down that road unless your claim has "enough gas" to get all the way back again. That means you have a full tank, full of Caluza elements, and symptoms. And you know its full because you just filled up. The gas gauge does not work well because we dont know how much, of our evidence VA actually has. "Regular people", that is, non VSO's, or non attorney's, dont have access to VBMS, which is where our cfile is stored online. If you hire Alex, he can see your VBMS file. VSO's can also, but they dont have a clue what to do with that info. This is my opinion. I say, use HLR only with extreme caution. If in doubt, use SCL.
  8. I would probably not advise it. You see, you need evidence that "YOUR" sleep apnea is related to "YOUR" Asthma, not people in the study group from NIH. This can only come from a doctor who would opine "your OSA is at least as likely as not related to your SC asthma". To win it, you need the Caluza elements, and most of the other stuff is just noise. (You might try giving the article to your doc, but he may or may not agree).
  9. Ok. Here is the deal. I dont usually recommend a reconsideration, but rather an appeal, that is, if your decision (VARO) was within the past 12 months. So, if your decision is still appealable (within a year of the decision date), then appeal it. If its over a year, then you probably should apply for an increase. Its not impossible to do BOTH: File for an increase AND file a NOD. My recommendation would turn on "when was your VARO decision", that is, if it was within a year. If its over a year, file for an increase. Under a year, file an appeal (NOD). I dont recommend filing a reconsideration UNLESS you are filing it with new and relevant evidence. Res judicata pretty much prevents you from getting a new decision, better than the old one, unless you have new evidence. Of course, however, if you get a "de novo" review, this means a second decision maker can take a look at it without regard to the past decision makers decision. In other words, VA frowns on you just appealing over and over, until you find a decision maker who is highly vet friendly and will award, when others would not, with the same evidence.
  10. A "medical consulting" company may be a good choice "If" you need an IMO/IME. To find out, I suggest you order a copy of your cfile and read to see if you had a diagnosis of PTSD earlier, by another doctor. A doctor could opine, for example, that he read your file, and his opinion is that you had symptoms of PTSD (earlier), even tho it was not officially diagnosed until (the effective date of your exam). Such an IMO, could be used to "reopen the claim" due to new and relevant evidence under 38 cfr 3.156 b, and could result in an earlier effective date. This evidence would need to be submitted BEFORE 1 year from the date of decision. 38 cfr 3.156 b applies to "pending claims", and a claim would still be pending within a year of a VARO decision because its still in the appeal period.
  11. We always suggest "not" posting personal information. Redact (mark out) your name, address or any identifying information. This way, it could be anyone's c and p exam.
  12. Read the critieria for your condition: https://www.law.cornell.edu/cfr/text/38/4.71a See how the symptoms listed in the critiera compare with what the doctor said about your's. If the doc did not document all your symptoms, then you may need an IMO/IME. Then you can decide if rated properly, or you are likely to win on appeal. That is my advice.
  13. You posted: When you appeal effective dates, understand the general rule is that your effective date is the later of the date of claim or "facts found". To appeal, you have to refute the statment I quoted. Here is why this statement is wrong. Refer again to the caluza elements. It says you have to have a "CURRENT" diagnosis. You did not have to have a PTSD diagnosis in service...and, if you read the effective date rules, they do not say, your effective date is the date of your first diagnosis. The VA pays you for SYMPTOMS, not a diagnosis only. If I were diagnosed with PTSD with no symptoms, then my rating would be zero percent if not denied. Sometimes docs change your diagnosis...medical science changes. As an example, Alex has pointed out there was no such thing as a hep c diagnosis in the 1970's..That does not mean you could not have been infected, and it does not mean you had not symptoms, either. YOU need a CURRENT diagnosis. Dont let VA pull that crapola. Appeal. You suffered with symptoms of PTSD, long before that doc diagnosed it. Equally important, read your file to see if a doc previously diagnosed your ptsd. Or, if he prescribed medications normally for PTSD. Your doctor CAN prescribe PTSD meds for something else...say a hangnail...but he should state that he is prescribing this drug "off label"..in other words he is prescribing this med when you dont have ptsd, but he is prescribing it off label. Off label means that its for a purpose other than what the drug company says its for. If you were prescribed a mental health drug..say prozac...and the doc did not say that was "off label" to treat your stomach issues, then its presumed you have a mental health disorder. "The date of diagnosis of PTSD" does not control here. The date of the onset of your symptoms is controlling. As I said, the Caluza element requires a "current" diagnosis. You could well have been receiving treatment for this malady PRIOR to this doc finally documenting you have PTSD. If you break your leg, you still have symptoms of a broken leg BEFORE . you go to the doc and he tells you its broken. (gives a diagnosis of a fractured leg).
  14. No one can help Vets like you do Berta. I do the best I can. I think I responded to Ann earlier, and I normally dont respond if I have nothing to add, or if I have no knowledge of the issue. And, you are right, sometimes I put in my 2 cents worth, when I should have shut up.. which is what I should be doing now.
  15. Im guilty, Berta. I limit the time reading, for good reasons. While Im glad you take the time to read every line....and you are right...the VA does that...(does not read our cfile and misses critical information). For me, I told the poster to read his own file and look. I feel if I help tell them to read it and what to look for, it helps more than if I just do it all for them. I feel its more important to TEACH them what to look for, than to do it all for them. In other words if they dont care about their own claims enough to read their file, then me doing it for them isnt always a help. Yes, I am pleased you go through all the DBQ's, exams, etc. that they post, Berta. You are an enormous help to Vets. Much more so than I am. Still, Im tapped out at about a half hour reading per day because of my cataracts. No, I didnt open their file, because I saw there were other Vets unanswered questions, so I moved on. We have a trade off...help more Vets, or dig in deep to help fewer ones. Im sorry you are angry at me for not reading their file completely. You and Alex are much better at reading through that stuff. I cant speak for Buck, but Im "tapped out"...giving as much time here as I can and going through their dbq's and c and p exams seemed to me like the poster could read on his own. The poster can do a better job finding the Caluza elements than I can..because they know about other exams they did not post here, and I dont have that access. Sometimes, we have people who post here who lack the skills to read a DBQ...I get that. Not every Vet has strong reading skills. For those, I try to help..but this poster appeared to have the skills to read same on their own.
  16. This answer (average time frame) is found in the BVA Chairmans report. YOu have to scroll down about half way through the report. https://www.bva.va.gov/Chairman_Annual_Rpts.asp I have read through these multiple times, but you will have to do so to get your answer. If you like, you can even compare 2018's statistics to 2017 or 2016. The average time frame does not mean yours will be completed in that time. If the average earnings in my state is 60,000 per year, this does not mean I earn 60,000 per year.
  17. The VA is supposed to explain the decision and why they arrived at a certain percentage. Its remandable error when VA fails to give an "adequate reasons and bases for decision". They should show how your condition meets the rating critieria in the CFR's but no higher. If you feel they should have assigned the bilateral factor, you can likewise appeal it. Shinseki tried to get rid of the required "reasons and bases" for decision. Im glad he did not. If you feel their reasons were gone for bilateral factor, you can appeal it, arguing you are entitled to bilateral factor, citing the regulations. Bilateral factor means both joints are involved, such as the right knee and left knee. Often, if you injure one knee, the other will suffer similar symptoms. You body "limps" for the injured knee and inflicts damage to the better knee. If you have symptoms documetented in your file showing both joints are affected, then I suggest you appeal for the bilateral factor. Its one thing to be blind in one eye, quite another to be blind in both eyes. If they failed to explain the bilateral factor, then your remedy is appeal. The reasons and bases for decision is where they explain it. There are attorneys who literally make a living appealing on an inadequate reasons and bases for decision. The CAVC will remand it every time..if the reasons and bases are inadequate. Further, the VA has to rationalize their decision based on the criteria. They can not rate on "non criteria", which is everything else but the criteria found in the cfr's. You can appeal if they denied for "non criteria" reasons. For example, I was denied hearing loss because "it was too long since military service". I looked in the criteria. "Length of time since military service" was not there. I had an in service event (excessive airplane noise), a diagnosis of hearing loss, and my audioligist had also provided a nexus linking my hearing loss to exposure to loud jet engine noise because my barracks was at the end of San Diego airport runway...I showed them on a map!! When they denied based on "length of time since service" it was a "bluff". Its non criteria. But, if I bought it and did not appeal, it would become final in a year. This is a tactic VA often employes. They make stuff up, and if you dont appeal, it becomes final in a year.
  18. Go back to the basics. You need DOCUMENTATION of the Caluza elements for SC. 1. Current diagnosis. Check 2 In service event or aggravation. No check. 3. Nexus, or link between one and 2. You did not mention an "in service event". What event(s) are you alleging caused your Mood disorder? You can expect continued denials UNTIL you provide docutmentation of an in service event or aggravation, Caluza element 2. Your buddies, in service, may provide evidence of an in service event. For example, if they saw something happen that "may" have caused your mood disorder.
  19. Not exactly. You can look up the criteria for your condition's in the 38 CFR's. Then, you can compare your rating with the rating calculator on hadit to see if you "combine" them like VA math does. These people would flunk math the way they do it. If you dispute the decision, file a NOD..within a year. AFTER you get to the BVA, you can get a copy of the RBA. Then you can see the rating sheet. Talk about "due process" that's it.
  20. Yea..get a copy of the exam. It may be at your VAMC release of information office, but dont count on it. Sometimes, you cant get a copy of the exam until AFTER a BVA denial. Welcome to VA benefits where there motto is serving Veterans...they "serve" us with delays, denials, lowballs, and hornswaggled effective dates.
  21. Try using this disability pay calculator, we dont know your number of dependents: https://www.hillandponton.com/va-retro-disability-calculator/
  22. You posted: Like we have any choice on this matter??? This is pretty much standard: First deny, then lowball, then hornswaggle the effective date. The VA posits, "Why make the VEteran go through ONE appeal, when we can make him go through 4?" Instead of it taking 5 to 7 years, mine has taken 17 years (since I applied in 2002), and only "may" be resolved this year.
  23. Good question. I think I will take a guess. Its about the word "aggravation". If I get this correctly, here is the way it works. Lets say you have "condition A" before entering service. When you exit service, lets say condition A got worse (was aggravated by service) by a factor of 2. In other words, your conditions got TWICE as bad after service as they were prior to service. The VA then evaluates your condition at 60%. Only half of that 60 percent is attributed to service, you already had condition A prior to service, so the VA would accept responsibility for half of it. My advice is to file a NOD disputing this. First, check your entrance into service records. Did your entrance exam show you had sleep apnea (or PTSD)? If not then its not "aggravation", but FULLY related to service. Next, if you were diagnosed with PTSD or sleep apnea prior to service, then argue that it increased MORE due to service. VA is saying, "Yea we acknowledge its service connected, but all of your symptoms are from prior to service..and none of this was after service." You want to show how that is inaccurate, with medical evidence.
  24. The transition from legacy to RAMP is not a smooth one. Its kind of like moving from one state to another..stuff gets lost, and something goes wrong most of the time. You know..baggage gets lost, delays in getting into new home, weather delays, job issues, cars break down, utility transfers, and more. The date portion is probably "software generated". If you look at the weather report, you will see that it often changes. My advice: Dont worry about it. What ebenefits says about the date is insignificant, and it will be still less significant after you get your decision. When you drive somewhere, you often dont know if there will be traffic delays, weather delays, etc.
  25. DAV and a few other places frequently transport Vets. Contact them.
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