broncovet

Great question!!!!! I was awarded 100 percent, but had previously sought tdiu. When they awarded 100 percent, they stated tdiu was "moot". I appealed, specifically stating that tdiu was "not moot" because an award of tdiu could/would result in additional benefits. (SMC S and an EED as well). The board agreed with me and made a "finding of fact" that "tdiu was not moot" in my case. You could file, and, if it were denied as moot, you could appeal that denial as I did, which I eventually won. Therefore, YES, you can get 100 percent AND TDIU, but, I agree that rarely happens. ONE reason it likely rarely happens is that Veterans, VSO's, and VA employees alike think tdiu and 100 percent schedular are mutually exclusive, but, in at least SOME circumstances (aka mine, perhaps others) you can get both. It was a long fight for me, but, it resulted in both an EED and SMC S, and was worth it. Part of it is that 38 CFR 3.103 requires VA to "give Veterans a written decision" on their claim. (Which they did not do until I pressed the issue). If you are up to a fight, go for it!

Bluntly: I PM'd Tbird about your post. While I donk know this lawyer, the fact he has been around since 2008, or earler, obviously means he has significant esperience. However, I did NOT see his name in the NOVA advocate directory. Im not sure why. You may ask him that. Generally I recommend NOVA attorneys. Im sure it costs money to be in NOVA, and maybe all of them dont want to pay it.

Your nexus letter should include all of the following: 1. The CV of the doctor/physican/medical professional. You need to demonstate this physician is a competetent witness, and has significant training and experience diagnosing and treating your type of disorders. If you want an opinion on your back injury, dont seek that from a Psychiatrist. The VA probably does not know your doctors level of expertise. 2. The doctor needs to state "he reviewed your medical history". You probably are not interested in my opinion of "Star Wars" movie, if I have never seen it. A medical exam without knowing the patient history is not that useful. 3. The nexus opinion needs to be specific, not vague or speculative. Avoid "Could be/may be/might be" caused by an injury in military service. Instead, use "In my professional opinion its at least as likely as not that the Veterans (diagnosis) was caused from his injury in military service". 4. Give a medical rationale as to why the doctor rendered such an opinion. As an example, "a 2019 study by Harvard University showed that 88 percent of patients with fractured knees eventually had arthritis of that knee within 10 years." I did not see all of these things in the samples. The doctor needs to sign it.

I have never received an email from the BVA. (And, I had appeals there at least 4 times that I recall, probably more). But, things do change. It would be a nice change. I have to admit "IM SHOCKED" to hear BVA would send an email notification of a decision for more than one reason: 1. Email is not secure, and is often hacked. This alone, often means companies wont communicate a lot of stuff by email. My doctor will only do it "via secure mail" where you must login to myhealthevet. 2. BVA "just doesnt" summarize the decision like that. At least not that IM aware of. They send you "the whole enchilada" decision or none. No summaries. But maybe they turned over a new leaf.

I dont see how its possible "to only be housebound" for one day. Specifically, housebound defination (per VA) is that you are "substantially confined to the premises". Further, VA has added that "substantially confined to the premises" means the Vetean cant leave the house except for doctors appointments. Using the definition of "housebound" VA uses, I dont see how one could only meet the criteria "for one day". What day WAS that anyway? Chrismas? Most of us stay at home for CHRISTMAS!

It would take a complete review of the file to know for sure, but this sounds like "just one more" bogus denial to me. VA often denies for bogus reasons. Please Allow an example: The US Supreme Court Justice, Roberts, was "suprised" to hear that the VA persues claims "against the Veteran" (from a legal perspective) that are "substantially unjustified" way more than half the time.. I will explain. At the CAVC (Court of Veterans Claims) level of appeal, Veterans are often represented by an attorney. And, if the Veteran wins, or even gets a remand, the EAJA pays the VEterans attorney fees "if the VA took a position against the Veteran that was substantially unjustified". This is most of the time! Frankly, a Veteran can send a law firm a BVA decision and, if the law firm discovers an error (often) they will take the case "with no out of pocket money from the Veteran ever" because they know the VA often takes a "substantially unjustifed" (aka bogus) position agains the Veteran. The reason the VA does this is "because they can" and because it often works. It works because many/most Vets dont appeal. And, even among those WHO DO APPEAL, the VA delays it so long the VEteran often dies, or gets so sick he can no longer continue, or just plain gets frustrated and gives up. Even when VA loses, They win. Why? because the VA has just gotten a 0 percent interest loan on the money. I wish I could borrow money at zero percent interest! My advice is you probably need to appeal. To appeal you begin by filing a Notice of disagreement. https://www.va.gov/find-forms/about-form-20-0998/

Congratulations! Where did you receive this notice "online"? Did your VSO/attorney send you an email? Did you find it on ebenefits/va.gov? The procedure is that the BVA grants the remand (Im assuming this was remanded to the BVA from the CAVC), and then the VARO "implements" the BVA remand with a disability percentage and effective date. This can take about 2 to 6 more months, but it can be quicker or slower than that. If you are not already set up for payments to be electronically deposited to your checking account, this would be a good time to arrange that. (One of my BVA grants was implemented in just 2 weeks.).

Since you posted you are 100 percent plus SMC S and SMC K, the only way for an increase is an increase in SMC. The only reason I file for an increase is in the event it could result in additional compensation or additional compensation for my family. For me, I dont need to add a bunch more disabilities to a list which do not provide additional compensation for myself of my family. Its unclear to me how any of those disabilites you mentioned, except PN have any chance of additional ratings. PN "may" lead to a loss of use, tho I really could not give an example of that happening. And, SC for PN could result in needing A and A, if the other disabilities did not already do so. DAre you getting A and A, or do you feel the need for same? If so, you should have included that. As far as "not applying" for SMC K, you should not have to. SMC are generally inferred, and the VA is supposed to award them "when you meet the criteria". Its certainly ok, or even a good idea to apply, if you think you deserve higher levels of SMC which I guess I will assume you are going for. In the light of the above, my suggestion would have been to focus on applying for things which have a good chance of an increase including PN, loss of use, and/or A and A, as these may apply. Bloodwork, I may specualte, may be necessary for an increase of DM, if your A1C is significantly higher than when you were rated for it. Also, for other conditions as a doctor may diagnose. Its not unusual for doctors to order blood tests, even when we dont see a need for them. I guess you could try to go to medical school if you really want those answers, because conditions of the blood may well help diagnose other disorders, to include PN. However, IM not a doctor, so Im not qualified to answer that question, its mere speculation on my part. My advice would be to attend to the c and p exams, submit to the bloodwork, and probably add any of the issues I mentioned above to your claim. (Such as A and A, if you need it, loss of use, if you have it) As an example, if you cant use your feet because of the PN, you may add loss of use of your feet to the claim. Finally, even if its your spouse or other family member who provides A and A, I would advise applying for it. The regulation specifically provides that you can still get compensated for A and A, "even if" its provided by a family member. So, if your wife cooks for you, helps you put on your socks and shoes because of your PN, helps you get in and out of the shower, does all the shopping and housecleaning, including laundry, and takes care of home maintenance, and you can not dirve, for example, so your wife must run all errands such as take you to the doctor, then you may qualify for A and A. I could have provided links, such as the regulation which demonstrates that you can still get a and a even when providend by a relative, as well as application forms for A and A, but you seem to know your way around. Let us know if you have more questions or there are other things you need. I guess you know about Independent Living, right?

You do NOT have to have a diagnosis of sleep apnea in service to get service connection for sleep apnea from service. Instead, there are at least 2 ways to get service connected for sleep apnea. 1. (Secondary Service connection) Be service connected for "something else" (often a mental health disorder such as PTSD or MDD) HAVE A DIAGNOSIS OF OSA, and be using a cpap AND: Have a nexus letter from a doctor that states your current diagnosis of sleep apnea is at least as likely as not related to your PTSD (service connected). (And explain why the doc thinks so). OR 2. (Direct or primary service connection) Have the 3 Caluza elements of: A. CURRENT diagnosis (not necessarily an in service diagnosis) B. HAVE A DOCUMENTED "EVENT IN SERVICE" C. HAVE A DOCTORS NEXUS, WHERE HE SAYS YOUR CURRENT DIAGNOSIS IS AT LEAST AS LIKELY AS NOT RELATED TO YOUR "EVENT IN SERVICE". WITH SLEEP APNEA, IT COULD BE A FACE INJURY, SUCH AS BEING PUNCHED, OR DIVING INJURY, SUCH AS HITTING YOUR NOSE HARD DIVING INTO A POOL., OR OTHER injuries which may have fractured your nose/face. It could be related to a mental health disorder, or obesity, or, as a doctor so decides. None of the above requires an "iN service" diagnosis". Altho an in service diagnosis of OSA would be helpful, it is not necessarily required. Many people have OSA and dont know it. You could even have a clean exit physical and still have OSA because, they may not know it UNLESS they gave you a sleep study, and they rarely do that unless they have a reason to think you may have OSA.

As explained above, if one or more VA employees/providers wrote down the incorrect pain level, then you could/should have it corrected. Its my opinion you are better off not to "attack" the individual involved, but instead simply explain that you did not make yourself clear; your pain level was a level xx not a level a, as indicated by the medical records. The pain level, is a level judged "by you", not by others.

Veterans have a right to amend their medical records if there are errors. You should exercise such a right, if applicable. The regulation follows: https://www.law.cornell.edu/cfr/text/38/1.579 In relevant part:

Are you using a cpap? I went to see my wife's (private) cpap doc. I asked him if depression/mental health disorders were related to OSA. He responded that sleep apnea and mental health disorders have many of the same symptoms. If you have insominia, consider getting a sleep study..you would need to ask your prime care doc. I use a cpap. It helps a bunch.

This is a familiar problem with both the VA and private doctors. In a nutshell, the government is "going after" doctors who prescribe too much pain medications (aka vicodin, oxy, etc, the real pain meds), and, in response the doc's pretty much quit writing pain med prescriptions except for 3 instances: 1. If you see a pain clinic, who monitors carefully your use with frequent blood checks to make sure you are not getting it also from other docs. 2. If you have had surgery, your surgeon will prescribe pain meds (opiates) on a limited basis for post surgical pain. 3. When you are in the hospital. Its a huge problem. A few years ago, VA handed out Vicodin as if it were candy. Problem was, people became addicted, and often turned to street drugs when docs cut them off. Some Veterans have turned to edible marijuana, such as gummies, as it tends to offer "some people" pain relief for some conditions, and, its legal in most states now. I checked and Florida is one where medical marijuana is legal. That, too, is problematic. Even tho marijuana is legal in "way over half" the states" it is still Federally illegal, so VA generally wont prescribe or dispense it. However, I did read about a pilot program where its being tested at the VA, but dont hold your breath. THE BIGGEST PROBLEM: Since doctors wont prescribe pain meds, it drives people to obtain street drugs and those are often dangerous and even deadly, since many are laced with fentanyl. For ME, what I do is use (legal) herbal supplements which are often superior to chemical pills. You would need to either see a herbal specialist, read a bunch online, and/or sometimes health food stores can be very helpful, at least some of them. Herbal supplements are not without risks, however, and you do not to be careful there too..there are scams. In my opinion there are scams with BOTH herb supplements AND pharmaceuticals. The Vicodin fiasco was a famous one, and, if "FDA approval" was so good, how come drugs get approved, then removed from the market sometimes just a few years later? Did they not do a good job with studying it the first time? Herbs mostly come "out of pocket". But they are generally far less expensive than many/most pharmaceuticals, and often safer. Its your life, and you make your own choices, but whenever I have a choice, I choose supplements first, and only then will I turn to pharmaceticals. And, I try more than one supplement, too. My health care is generally a "blend" of pharmaceuticals and herbs. Remember, tho: Doctors dont like Herbs, and Herbalists dont like pharmaceuticals. Medical schools are mostly funded by pharmaceutical companies. FDA generally does not approve herbs, in no small part, because herbs can not be patented. So, a company wont spend 100,000,000 dollars to reseach say, Pau D' Arco because anyone can sell it. Its sad that more research is not there for herbs, but the law does not allow a plant (herb) to be patented. Some pharmaceuticals extract the main ingredient of plants and research those, sometimes combined with other stuff. Its a big reason health care is a mess in America. Prescription drugs are the third leading killer of people in the USA, according to at least one site: Its not "just" pain meds, either. https://www.riscassi-davis.com/blog/2022/april/death-from-prescription-drugs/

You know your situation much, much better than I do as far as rating conditions, etc. So, using your knowledge you can apply your situation to the following to see what you come up with, as I just dont have any idea if your ratings involve seperate and distinct anatomical segments or not:

Another way is to apply for tdiu, that is, assuming you are not working. Or, if you are working, there may be other claims you overlooked.

Maybe. Review the criteria for IBS/Gerd. You need to look those up yourself. As an example, many Veterans have "dual" mental health disorders..PTSD and Bipolar, and or something else. For mental health disorders, once service connected, they are rated on SYMPTOMS. Generally, VA compensates you for your percentage of your loss of an ability to earn an income. IDK what your symptoms are for IBS/Gerd and I dont know which symptoms overlap. But I do know that you dont get paid for the same symptom twice. Let me cite a hypothetical example: Lets say you have bouts of painful diarrhea which last 2 or 3 days where you can not work with Gerd "and also" with IBS. You would get compensated for one, not the other. But the Gerd may have an additional symptom. With mental heatlh disorders you get paid for all they symptoms combined into one disorder. If that makes sense. Pyramiding prevents a Veteran from getting paid for the same symptom twice. But, if I was service connected for my Right knee issue and the main symptom was pain which hurt when I walked. However, lets assume I was also SC for my back "including" back pain. Well I could get paid for symptoms of my back pain and my knee pain especially if they dont occur at the same time and I could not work 2 days a month due to back pain, and 1 day a week due to knee pain.

Short answer: C and P exams are at VA's discrection and we dont know. However, its not that unusual the C and P exam is insufficient for rating. Many things can be omitted or inaccurate. Some examples: 1. "If" already service connected, then symptoms need to be documented. 2. A date needs to be given when symptoms began. The VARO often uses the date of the c and p exam, but that may not fly with the BVA or above. It does not take a rocket scientist to figure out if you have been treated for a disorder since 2002, and they gave you a c and p exam in April, 2024, your symptoms did not begin in April 2024. They began Much earlier. How much earlier? That needs to be documented by a doctor for a real accurate effective date. 3.. Etiology. "If" the examiner opined that your condition was at least as likely as not due to an event in service, they often want a medical rational as to why the examiner said same. 4. There can be other things, too, such as it would be impossible to tell from the exam, which if any of the applicable criteria were met. 5. Finally, the exam may be incomplete, may not be signed or dated. Or, the exam may be ambigious, or may be in conflict with other exams.

According to the VA website, you can get one or the other, but you can not switch: https://www.va.gov/education/survivor-dependent-benefits/#:~:text=If you're a dependent,%2C you can't switch. This said, you can not always trust what the VA employees, or even VA websites tell you. Yes, I know its disappointing. IRS is the same way. You could call the IRS hotline for tax advice, then take their advice. If the advice is wrong, you could still have to pay the applicable tax penalties or interest. Neither the VA, nor the IRS permits a GS5, or whover, works on updating the website, to make "official" statements binding on the agency. In law enforcement, its actually worse. More than once, a sheriff or detective lies to the accused, for example, they may tell them that. "your brother already ratted you out", when that is not true. Tricks (aka lies) often lead to arrests and or convictions. While Im no expert on law, Im pretty sure that, even if you are convicted based on a lie the sheriff told you, you are still convicted. The sheriff is not on trial..the accused is. I can see how, in some peoples mind, at least, its okay to fight fire with fire, as many/most criminals will lie to prevent conviction. Sadly, sometimes, it may even work, at least for a while.

Finally, still another example is your VSO or representative. Most Veterans sign "stacks of paperwork" and dont read every word, ever. I did. Maybe your VSO was sharp and saw a medical report and said, "gee, that Vet has a diagnosis of tinnitus", I will include that also. He may or may not have explained that to you, and you may or may not have remembered his explanation that happened months or years ago. The same thing often happens when you buy insurance or a car, or whatever. You may get tired of listening to his talking. Insurance agents often include something called "waiver of premiiums". Do they always tell you? No. You may not want to hear it all! You may get a headache when they start talking about double indeminty comprehnesive, other than collision, and a bunch of other stuff you dont know or care what it means. So, you dont ask. So, you bought waiver of premiums. 3 years later, you get in a car accident and are disabled. Your agent calls, noticing you stopped paying the premiums. You respond that you cant, you are disabled. The agent informs you that he included "waiver of premiums" which means your premiums are paid by the insurance company when you become disabled! You are happy! You get to keep your insurance without paying! And you did not know what waiver of premiums meant, but your agent did, and he included it.

Maybe. There is such a thing as an "inferred claim". While those are mostly not allowed CURRENLTY, in the past inferred claims were common. A great example is: You apply for PTSD. You speak with the doctor, AND you tell him you are unable to work because of your PTSD. Your doctor docutments this. This could be considered an INFORMAL or inferred claim for INCREASE for TDIU. Many Veterans, especially those with PTSD or other mental health disorders dont know the difference between TDIU and an IOU. The VA is supposed to have a Liberal interepretation of his claim for benefits, and its highly likely telling his doctor this, could be construed as a claim for tdiu. In many instances, the VA would be required to send the Veteran a TDIU claim form. But, what if they dont? Chances are pretty good, the Veteran "eventually" runs into a competent VSO or someone else who may explain to him that he/she should apply for tdiu. So, lets say he does. He could well get an effective date much earlier, since his statment to the doctor could have been construed as a claim for tdiu. There are other examples, too. Many of those involve Veterans "not understanding" a diagnosis. A DRO "could" view a diagnosis on a medial report "you did not apply for" because, for one thing, you may not have known you had the disorder" and applied for you. The vA has a duty to maximize benefits, and its presumed the Veteran, when applying for benefits is seeking the max.

The VA can reduce your rating "regardless" (independent of) whether or not you apply for an increase. "If" the VA does not comply with the regulations, the Veteran can hold them to them by: A. Asking for a hearing in a proposed reduction. If there is no proposed reduction, then VA did not comply with their own regulations. B. Appealing a reduction "in the event" that you can not defeat it before it even happens with the proposed reduction. Source: I have had the VA do proposed reductions on me TWICE. NEITHER time had I applied for an increase. I easily beat the proposed reductions before they became final. The VA must give 60 days notice of proposed reduction, see below. I simply wrote a letter, with applicable evidence, explaining why a reduction was not warranted. The VA wrote back, and said that the proposed reduction would not take place, that my rating would remain unchanged times 2. Source: 38 CFR 3.105 e:

You should be getting paid at the 100 percent compensation rate, plus any dependents you have. I can check that for you if you let me know how many dependents. If you are married, with no children living with you at home, (who are not in college under age 26), then your compensation should be $3946 per month if married $3737 if you are single.

Let's assume they were not lying to you, and they grant the claim at the Board. If so, you could get a letter sometime in the next 2 to 5 months, perhaps earlier, if your attorney calls you as he may get some documents online earlier. Unfortunately, the procedure is that the award is sent to the VARO to "implement" the decision. The regiional office would then determine a disability percentage, if applicable, and an effective date. They would then send you and your attorney notice of this VARO implemntation of the board grant of benefits. This takes another 30 days to 6 months, sometimes more, sometimes less. In short my wild guess is that you have a 50 to 70 percent chance of seeing a deposit (money) to your account before Christmas in December. I would estimate that the chances of seeing money for this before July 4, are low, maybe 20 percent. And, the chances of you seeing money before memorial day (May 30) are about 5 percent. I would give an 80 percent chance you would have your money by VAlentines day, 2025. "ONE" of my Board decisions was implemented in less than 30 days. Most of the time they are in the 2 to 6 month range. You actually are waiting on 2 decisions, one from the board, another implementation decision from the regional office. On occassion, "the first notice" you get of a VARO implementation decision is a deposit of money, and the decision letter comes later. Its around 8 months or so to Christmas, so about 4 months for each would put it at christmast time. The board decision "could" move quickly now that you have had a hearing, but not always. They should have your complete package together. But, its often a different person who decides the claim than the judge who interviews you in person. It could be longer or shorter than 8 months. My guess is that its near equally likely for it to be longer or shorter than 8 months.

Dont be suprised. About 80% of VARO claimants are denied. Of those where the Veteran appeals, about 2/3 of those are eventually awarded. Of course, if you dont appeal, your decision will become final in one year. There are 2 types of SMC S. A. Statuatory SMC S. That requires a single 100 percent rating (tdiu counts) and additional combined ratings of 60%. B. Housebound in fact. This usually means your doctor makes a statment to the effect that you are "substantially confined to the premisis". In short, I suggest you appeal. fill out a NOD form and send it in. If you like a Veterans service officer may be able to help you. "IF" the VSO has VBMS access you could even view the file and see if there was evifence "already in your file" which supports an award of benefits. (I have no idea what is in the file, you probably dont know either, until you look at it and review it. Most people are suprised at stuff in their file). ASK the VSO if he/she has VBMS access. If he/she does not, I recommend finding one who has jumped through the hoops to obtain VBMS access. WITH VBMS acccess, and the decision in hand, you can craft an intelligent NOD, disputing their findings. Example: While the VARO decision dated April 2, 2024 stated there was no evidence that you were substantially confined to the premisis, Doc. Jones, in an exam dated 11-18-2011 apparently disputed that finding, when he noted that the Veteran has agarphobia and almost never leaves the home except for doctors appointments. The VARO decision did not explain why this doctors finding was not considered in the decision. Then, include a copy of the 11-18-2011 exam with your NOD. You can argue that 38 cfr 3.156 supports an effective date of 11-18-2011 or earlier, for smc s.

Veterans have asked about "buddy letters" sometimes to document an in service event which may have happened to them in miiltary service. This could be very useful to locate someone you served with, but are unable to locate. Your military friend could well have been a witness, for example to exposure to burn pitts, toxic substances, sexual assault, or many other things, that, if documented, could result in VA benefits. Your buddy COULD testify as an eye witness of an event (in sevice) he or she observed. (in a buddy letter). Remember the Caluza elements? Diagnosis, IN service event, and nexus. There cant be a nexus linking an in service event to your current diagnosis, WITHOUT an in service event. https://news.va.gov/130141/buddy-finder-find-former-service-friends/?utm_source=feature&utm_medium=email&utm_campaign=VetResources&utm_id=10APR2024