donews

TS, They gave no exact basis for opining that my Depression was due to my Heart Disease vs my DMII. Actually that is what has me confused. Originally my Heart Disease (CHF included) was not Service Connected, but after a Denovo Review, they gave me a full grant of Service Connection for my Heart Disease. One would think that they would go back and fix the denial of the Depression due to this, bu they have not. I am trying to figure out if I need to do a CUE or what to get them to go back and fix the denial, because now my Heart Disease is connected and was on appeal when the Depression denial was made. HPI = History of PResent Illness I think she forgot to write / delete the HPI on some of the headings in my report, as I don't and haven't had any substance abuse issues or suicidal thoughts. As for everything else, I am now taking Sertraline 200mg a day, Buproprion 200mg a day, and Trazadone 100mg a day. I am also now getting pain management throught the home health, they are giving me 15mg Morphine 2 times a day and Tramadol 4 times a day. I have not noticed a big change in my mood / mental state, but I for the first time in a long time have had a lot less pain.

Wow, I am glad this thread popped up, it is very useful information regarding NODs. And considering I will be doing many of these in the coming weeks, it is helpful. Thank you.

Ron, Yeah, these fat fingers tend to get carried away and hit all kinds of stuff before I am done. Same situation for sure. My adult son gave up his fulltime management job and his wife and kids totally changed their lifestyle, just to care for me. They even moved out of the master bedroom and set it up for me so I could get to the bathroom easier. They have been caring for me since 2003, and the most I can leave them so far is only what VA Disability Life Insurance I can get, that is if they approve it before I am gone. Its a shame.

I have to consider these things in my condition so I want to ask about this Accrued Benefits I keep hearing people discuss. If I have active claims when I leave this world, who is eligible to apply for those funds? Unfortunately my wife passed from cancer in 99, she was 48. All I have left is my two sons, one is 39 the other is 34, and there kids. Is it possible for them to collect any Accrued Benefits that are determined to be payable to me? I assume if I pass from a Service Connected condition, that since my wife has passed, no one can receive any kind of death type benefits besides any life insurance I might have.

Dizzy, IMO = Independant Medical Opinion. He is saying your doctor might be able to fill out a letter stating that you have the claimed conditions and what causes them ect..

Thank you. Yeah I am happy to have the file, just had to rant about the fee. Everything is expensive these days. I am going to go to the office store and make me copies tonight. Here is the breakdown of the fee they charged me and the reasons it listsed on the receipt: Section A: Hours Spent Searching for The Material: Employee's normal hourly rate - $20.17 Hours Searching x 1 hour Total $20.17 Multiply the Employee's normal hoursly rate by 2.1 (This is done to add the SSA's Overhead Rate of 110%) $42.35 Section A Total : $42.35 Section B: Fee for retrieving folder from storage facility: Retrieval Fee - $14.00 Section B Total : $14.00 Section C: Pages @ .10 per page : 290 pages - $29.00 Return postage to storage facility - $8.95 Section C Total : $37.95 Total $94.30 As you said, at least I now have a copy in my hands.

I requested my SSDI file so I could file a copy with my TDIU claim. They called yesterday and said it was ready, I could come pick it up anytime. Then they informed me the charge was $94.30 to be paid via check only. So today I am going to go pay a rediculous amount to get a file that I should have been able to get for free. All just so I can file for TDIU because the VA still hasn't fixed my rating and that appears the only way I have a chance at 100% for now. This whole SSDI file thing is a sham to me. I informed them when I first called them that I wished to obtain a copy of my file for VA purposes and they said since I wasn't going to use my file for an approved purpose there would be a small charge to obtain it. I asked them what the approved reason would be and they wouldn't tell me. So I said ok fine I still need a copy of my file and then they asked me why I didn't request it from a different office instead of theirs. I told them because they were 15 minutes from my house. He mumbled something and said he would order the file and call me with the charge. I called them after a few weeks and was told he was out with the flu but that he had the file so it would be soon, they also informed me this gem of a guy was the office manager for that location. Yes by now my confidence was building: NOT. So after he was out for over a week with the flu he called me yesterday to give me the news of the charge. I think some of the VA rejects are now working at the SS office is the problem here. Ok enough ranting for now. Just had to get it out.

I had my son present during my Mental Health C&P Exam. When they called my name he began to wheel me back there and the C&P doc asked me if it was ok for my son to be present. I said yes and that was that. We had the C&P and all was fine. Its probably like all else with the VA - It depends on the day of the week, the temperature, and how you hold your tongue as to what type of problems you do or do not get during a VA appointment. Good Luck!

Thank you all for the replies. I found something on the internet called the "Veterans Specific Activity Questionnaire". It appears to give a good example of what activity levels equals what METs. If you believe what the VA says I currently can mow my lawn and rake the leaves. You betcha, sure I can. I also found several scientific cardiac studies that use the same VSAQ for a basis in several studies. It appears from everything I can find that this is a fairly accurate picture of METs. So I am going to take this information to my Non-VA Cardiologist (From the Hospital) and to my VA Cardiologist and plead with them to write up something saying what they would rate my METs at. I will take a preprinted form just to make it a little easier for them (I hear sometimes they are more wiling to sign a form if you have it ready to go). I am attaching a copy of the VASQ for you all to view and use if needed. Currently I should Service Connected fo Heart Conditions under the following codes: 7005 Arteriosclerotic heart disease (Coronary artery disease): 7006 Myocardial infarction: 7017 Coronary bypass surgery: 7020 Cardiomyopathy: 7011 Ventricular arrhythmias (sustained): Under each one of these I qualify for the 100% rating no matter how I look at it. Also under the 7011 I qualify because I have an AICD Implant and have had it since 2003, the VA replaced it this past summer due to the battery running dead. I have medical records that show an Ejection Fraction of 24% in 2004 and 22% in 2007 and 22% in 2008. I also have records showing CHRONIC CONGESTIVE HEART FAILURE going back to 2004. I see 3 big problems with this so far: #1 - I just decided to take another look at my latest coding sheet. They have all of the above conditions listed under ONE rating code 7005 and thats it. I have no clue how thats possible. Is this allowed? How can I fight them using one rating code for six conditions that all have separate ratings in the schedule? I know they are lumped together at some point due to them all being heart conditions, but they each have separate criteria ie 7011 and my AICD implant. If its rated under 7005 an AICD means nothing. #2 - They have these conditions as Aggrivated by not secondary to DMII. I guess my doctors opinoion wasn't worded strongly enough to get as Secondary to instead of Aggrivated by. CAn this be fixed with another IMO or more solid wording? #3 - Even at that I still qualify for the 100% rating. I have an IRIS inquiry in asking for a hearing/ meeting/ whatever with the DRO to point out the evidence that they clearly has made a mistake in the rating. YEs I know its asking from a pile of %$#$ to turn into gold, but I was hoping to avoid a long drawn out battle to fix this since it is an obvious boo boo. Yes I am allowed to dream now and then. I also noticed they claim I never sent in private medical records for them to review, but the VA Medical Records show my low EF and Chronic Congestive HEart Failure and they are the ones that replaced my AICD. I asked my VA Cardiologist and he double checked and verified that the VA Records show this already. Either way I sent them in and will resend them again (have signed receipt from first time) and take them to my hearing / meeting if I get one. I know this might be vering off my original title, but I get more questions each time I dig into my C-File, but it still has to do with my Heart so not too far off I don't think. Veterans_Specific_Activity_Questionnaire.pdf

Ron, Thank you for the information. I appreciate the time you took to look it up. Their C&P person said 3-4 Mets. I absolutely think he is nuts. I am just looking for something to use as a comparison scale to give the cardiologist so they can feel confident giving me a METs rating or so I can show the VA that NYHA Class III should be 3 Mets or less. So far everything I have found should put me at a METs of 1-2. I can not even get dressed without stopping to rest due to shortness of breath. The one chart I just found so far shows a person with 4 METs should be able to mow a lawn and a person with 3 METs should be able to walk 1-2 blocks at a slow pace without having shortness of breath. I can not do any of that for sure. I did not have a treadmill test either. Their C&P doctor did an estimated METs, I have no clue what he based his estimate on. I just pray I can convince my VA Cardiologist or maybe the Cardiologist from my last stay in the Non-Va Hospital to write something saying I have METs of 1 or 2, which is what I really am at. I forgot to mention in my first post that I meet all the other criteria individually for the 100% rating, I have Chronic Congestive Heart Failure, an Ejection Fraction of 22%, and an AICD Implant Device from a Ventricular Arrytmia. In the Schedule of Ratings it says : Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent I am taking the OR in the above statement to mean I only need to meet one of the 3 criteria. Even if I take their C&P into account I meet 2 of the above criteria, I am just trying to get the METs rating on paper from other doctors so that I can prove I meet all 3 criteria just to leave them no wiggle room. I have learned if you leave the VA wiggle room, they will slip whatever they can by.

Does anyone know of a website or any other place I can go to determine what my METs would be? In the VA Rating Decision and the VA Rating Schedules they rely on a form of measurement of Heart Disease called METs (Metabolic Equivalents). The problem being that every private cardiologist I called (8 of them) do not use this method and none of them have actually any knowledge of its usefulness. They all use the New York Heart Association scale. Even my VA Cardiologist doesn't use METs to measure cardiac function nor does he know how it is measured or what use it has in evaluating heart function. I can find little so far through google to help me compare my current NYHA Class III rating to METs. The VA said I was rated at 4 mets and that is one of the reasons they said I am only 60% instead of 100% for my hearty diseases. I ran through my C-File real fast and found during one of my C&P exams the doctor said I was 3 to 4 mets at the most. Wouldn't you know the VA used the 4 instead of the 3 when rating me. Any help would be greatly appreciated.

I am sorry in advance for possibly duplicating this question. I know there have been some A&A questions recently but due to my mess of a brain I couldn't make much sense of the answers. I am 70% SC from DMII,Retinopathy,Neuropathy, Coronary Artery Disease, Heart Attack, Bypass Surgery, AICD Implant, Congestive Heart Failure, and some others. Should be 100% if they ever fix things (I have an IRIS in for the messed up rating). Basically, when I was released from the non-Va hospital a few weeks ago, the sent me Home Healthcare for follow up visits. Once the Home Health Nurse realized my EF was at 22% and that I had multiple complications she requested a Hospice consult for me. She and others felt I needed oxygen, but the VA said I didn't qualify. The hospice people came out and said I qualified and that Medicare would pay for everything. They faxed orders to my VA PCP and he signed off on Hospice Care, so now I am receiving Hospice Care, which is nice because they are providing me oxygen, hospital bed, and pain management (the VA knows nuthing about pain management). They send a nurse to my house 3 times a week, a health aide 3 times a week, and a case manager at least 1 time a week. Before Hospice, my son has cared form me since 2003 when I lost my job due to my disabilities. He quit work and they changed their lives to make sure I was being cared for. Ok so now you know some of the specifics, here goes my questions: Is A&A or Homebound something I should be eligible for? Which should I apply for? Which one gives more benefit? Is it just more assistance or is it an added amount to my compensation? Do I apply like regular claims or do I need to apply with a specific form or to a specific place? If the DAV ever decides to help me out I might get more done sooner, but for now I am on my own (well my son assists me) with the claims.

I have never heard of someone having their benefits reduced due to collecting VA Service Connected Compensation and SSDI. Every vet I know collects both with no reduction no matter which they filed first. The only time that would be the case would be if you were collecting a VA Non Service Connected Pension or SSI (Which is different than SSDI) Absolutely DO NOT wait to file for the Social Security Disability or the TDIU. JMO

Thank you all. That hit the spot. I will be busy reading for a while it looks like.

Well, I do not have any doctors besides the VA. After being disabled for 2 years the company I worked for finally dropped me from theirs. I was shocked that they let me keep it for so long after I became disabled. I was misinformed by the VA about Medicare part B when it was available to me, so if I apply for it now I have to pay a surcharge because I was eligible for it 3 years ago. I would have to pay like $130.00 a month for part B. When I leave the NoN-VA hospital after an emergency (happens about 8 times a year) the records are never ready. All the records I need now are from the past when I had insurance and a job. I guess I will just try to get a local doctor to see me on a cash basis and ask him to order them. That way I have access to my records cheaper than the $1800.00 and a local doctor if I need one. Seems so logical now that I type it. Sure wish my mind was as good as it used to be.

I believe I saw a training or operations manual for raters and such somewhere recently. Anyone have a clue as to what I am talking about or where to get it? It basically explained the rating and decision process from the raters point of view. I for some reason have lost my copy and was not finished reading it.

Ok heres the situation. I am trying to gather most of my non-VA medical records for an IMO and to have for when the VA looses them. Every doctor / Hospital I contacted except two want upto $0.75 per page for copies of these records. One hospital that I use a lot due to its proximity to my home wants $1800.00 for a full copy of my medical records. They will send them to another doctor free of charge. Three times they have send a CASE of records to the VA and the records room has lost them all three times. The only doctors I have are all VA doctors. Does anyone know if there is a service out there that will request all my records and then charge me a small fee and then ship them to me? Or does anyone have a suggestion as to how I might go about obtaining the records cheaper or free? I mean we have a right for a free copy of our credit report, but no right to free copies of our medical records, there is something just very wrong about that.

Atleast they have acknowledged thay have your information now and are working on adding them. Thats some progress. Fingers crossed it doesn't take so long to get done. You are right Pete53 - 50% or more will get you no co pays and don't forget 50% will get you travel pay if you were previously not eligible.

So this is what I am understanding so far: You were injured in service and received a va rating of 20% and have been collecting compensation. They rated you 20% for Arthritis of the Spine. You recently became unable to work. You recently had a C&P exam. Am I close so far? Now for the questions: Why did you get teh C&P Exam? - What exactly did you make a claim for to get it for example did you say my back is worse or did you say I cant work now due to my back or what? I am confused about the C&P Exam, you said you havent heard back from them about the C&P yet, but then you say the C&P doctor said it wasnt service connected. Have you requested a copy of the C&P records from the medical center? Your allowed to get a copy for free. Do you have all of your Service Medical Records or have you Requested them? What is the IT that the C&P doctor said was not connected? Sorry to ask more, just tryin to get a clear picture to offer some assitance. By the way do you have a Veterans Service Officer representing you at all?

Yes Berta I read it to mean the same.

As always Cowgirl, Thank You for your knowledge, help, and prayers.

I stand corrected. The VARO does not have access to the VAMC records without requesting them. Thank you for the clarification Rental and Ricky.

Welcome to Hadit! I am sorry you can't work. There are a lot of questions to ask to be able to assit you more. You might want to move this discussion to the VA Claims Research Section unless you are just looking for information on an attorney. When did you get the 20% rating? Do you have a Veterans Service Officer? HAve you asked the VA for an increase in your rating? What is keeping you from working? Have you tried to get SSDI?

Ok, here goes.... I got the records finally today. I am going to post a few sections of the records and hopefully someone can help me decifer it. Phychiatric Review of Additional Symptoms Somatic Sx: chronic pain, awakens him at night and during the day. Depression: hpi Panic: hpi Anxiety: hpi Eating Disorder ETOH/CAGE: denied Psychosis: hpi Other Substance Use/Abuse: hpi PTSD/Trauma: hpi Suicidal Gestures/Thoughts: hpi Violence: denied Parasuicidal Behaviors: denied Mania: denied Seizures: denied AXIS I: Major Depression, recurrent Possible complicated bereavement Possible PTSD by history Fairly revent delirium, March 2006 (Taken off Methadone) AXIS II: None AXIS III: CHF, CAD, Diabetes w/Complications, Hypertension, Elevated Lipids, Hip Fracture AXIS IV: Social Isolation, Complications of Chronic Medical Illness AXIS V: 35 So if anyone has a clue please help me understand what these two sections are saying.

No, I am not SC for any mental health issues - They denied service connection for my Depression as Secondary to DMII. They Claimed my Depression was soley due to my Heart Disease What is MH that you mention in your post? I am about to post an update as I finally got the records I requested from my Jan 08 mental health visit.