Quint7

I love the 'consideration of evidence' given by VA. On the 6th of this month, exactly 18 years and 11 months to the day after I got out of the Marines (and my claim was filed) I received my BVA decision denying a EED (raising my currently 20% SC right knee from 0% for 1994-2006). The 'judge' said that evidence was considered properly back then and that I had been rated based on my SMR's ('failure to show for exam' because of a post office issue with the notice back in 1994). He, like the rater in 1994, focused on one sentence from my discharge exam (done 3 months before my discharge) where the Corpsman wrote 'says knee isn't a problem right now' (which I did say as I ignorantly didn't want to take a chance on a medical hold), ignoring years worth of treatment. He did at least mention that I had treatment for the knee after the final physical, but totally dismissed it as a one time occurance. Chrondomalacia, patella femoral syndrome, probably 2-3 other diagnoses in my SMR and a statement from a doc in the middle of my 6 year enlistment saying right in my records that I had a problem for the 2 previous years but it 'wasn't severe enough to rate a medical board so unfortunately nothing can be done' (i.e. suck it up Marine, which I did, turns out I had torn cartilage since 1989 and have had 3 surgeries for it since 2006 when an MRI finally found it). I honestly think most VA employees think unless you have been shot or blown up you can't have an injury and they all have no real working knowledge of just how physically demanding being in one of the combat arms generally is (no offense to those other MOS's) nor the 'suck it up' mentality that permeates all ranks. Were I to have kids and they joined I would tell them again and again to keep as complete of a journal as possible of every single time they so much as pulled a muscle, treated by medical personnel or not, just to show that the average enlisted person has dozens of injuries over the course of even a regular 4 year enlistment and to submit it as evidence. Even if it is one sentence per incident with the date and injury (pulled left hamstring doing PT at Camp Pendleton, 6/14/13, etc.) having a real, handwritten personal record vs a SMR for a worst case situation like mine where SMR's are the only thing they use would be pretty hard for VA to ignore. Not that they wouldn't. The thing that really got me was the condescending wording of the entire opinion. Had I known back in 2006 what this site has taught me I would say I was a 3 to 1 lock for that EED, but bad advice from 'service reps' and I lose. I considered a CUE but was advised against it by my rep and a DRO (informal hearing so no record of it). C'est la vie I guess but thank you Berta and everyone here for always fighting the good fight. The VA will never see the Vet as deserving and work as advocates for our claims, they see us all as leaches, like we are taking money out of their own pockets instead of receiving the compensation we rate by law. Sorry if that is kinda off topic all.

WOW. I can tell you that for the 7 years I had my dog (a Chesapeake Bay Retriever, not an actual service dog) it made a huge difference in my life, just from a socialization point of view because I got out to parks and on walks that I just don't do anymore since he is gone. As soon as I get my knee and hip taken care of and can walk well again I'll be back to owning a dog (as a soon to be medically retired fireman my schedule while working just wasn't fair to the dog.... 16 hour night shifts with him at home as our city bans dogs from the firehouses). This is just another way VA gives us lip service. Someday they will give in like with AO and PTSD, but until then we suffer.

I agree 100%. Some administrator (not that all administrators are bad) decides that he/she is being the heroic public employee by saving the gov't money by denying a benefit, but by doing so they are violating not only the law, but the oath of office they took when they agreed to the job. I have been active in my union since my 1st day in the fire dept and it still amazes me that we the people have to constantly fight to protect the definition of the word 'shall'.

John thanks for the reply. Like I said, I also think I should apply now. I know it will take forever (a year? Who knows) for a TDIU claim to go through, I just don't know what the ramifications could be if I get approved and suddenly start getting a regular taxed paycheck for however long if they break my stones. I've been off duty for the most of the last 13 months, with only about 4 1/2 months total of work over that period of time (including light duty) and that was when I originally tried to return to work after the 1st surgery last October (about 4-5 weeks then light duty for December) and in the beginning of this year (mid-January til I went off for good at the end of March) when they hoped a cortisone shot would keep me from needing the 2nd operation I got in April.

Here is my situation: Currently rated 90%- 70% PTSD, 40% spinal fusion/DDD/IVDS, 20% right knee, 10% radiculopathy. I am 42, a firefighter and have had to have 2 meniscus repair knee surgeries on the SC knee in the past year after falling down the stairs at a fire. That is on top of having the same operation in 2006 after another work related injury. That earlier injury led to my knee being moved from a 0% rating to 20%. Things haven't gone well recovey-wise and the doctors have determined that i am not and will never be able to return to firefighting because of the knee, especially when combined with having a spinal fusion. They also diagnosed a cartilage tear in my hip this week that is most likely from the fall last summer. Today I met with my Union's lawyer to file for a performance of duty disability pension with the state. That process can take up to 18 months during which I will continue to be paid as I am now (tax free, directly from the fire dept. as we do not have workers comp for firefighters in NY) and when the pension is approved it will be the state paying me directly. My lawyer originally said that considering my age and the infamous MAY contained in the line "with treatment the patient MAY be able to sit at a desk and do some walking but cannot return to the rigorous duty of firefighting" that is in the letter from the knee specialist Social Security will give me a hard time even though law in NY will prevent me from collecting any form of pay once the pension is approved (it's in the NY constitution, a whole other cluster-f). The fire dept most likely won't contest the pension application and assuming it is approved I will be legally prevented from having any form of employment unless I forfeit the pension (again, a state constitution thing) so in my mind it is time to file for TDIU. My lawyer said that my VA rating might change the game as far as Social Security since a realistic expectation of retraining and reemployment would have to be weighed against my PTSD and spinal fusion. The fact that NY state law will prevent me from being employed doesn't matter to them he said (and yes, this is a good lawyer, best in our city). My question is when to file. I have the letter saying I am done firefighting, my pay is 100% tax free so therefore not 'income' according to the state and feds, but there will be a chance during the process that I can be forced into a light duty position (to break my stones...... it's a city budget/numbers for the mayor thing) where I would then go back on the books and be made to sit in what is basically a 'time out" room at the fire dept HQ until the pension is approved. That scenario is unlikely but is real enough to be a consideration to me. I currently have claims in for temp 100% after last year's knee surgery (July 2011) and another in for temp 100% for this years surgery (the one resulting in me being declared permanently unfit for duty). My C file is at the BVA and that is the excuse I've been given for the delay processing the original claim ('we need to get a temp C file from BVA'). I think I should immediately send a letter requesting that my last claim for temp 100% be amended to be a claim for TDIU from the date of the last surgery (April 2012) and list the doctor's statement along with my other ratings as the reason. But part of me says I should wait for everything else to shake out and then file for TDIU with a effective date of this year's surgery once the state approves me. I know VA is slower than the Mars rover and financially I am not in dire straights so there is no rush on that end, but after the fiasco VA has been with my other claims I have to think that sooner is better. I just don't know what the ramifications could be if the fire dept decided to mess with me and put me back to light duty after I apply for TDIU or worse, after I'm awarded 100% (they can lean on the docs to do what they want instead of what is best for the patient.... politics ya know). I don't know if that makes sense but I do know there is no better place to seek out the info I need than here. Thanks in advance for any replies.

You are all over the place on this. Let's get some stuff down: Why did your enlistment end? Early release? Med Board? I don't think they do 3 year enlistments anymore do they? When you got out did you immediately file ANY claims with VA? Or did you file after being refused re-entry upon being recalled? Did you ever see anyone in the medical field for any injuries period while on active duty and is it documented in your service records? Did you have any type of undocumented back (or other) injuries while on active duty that are not documented but could be by things like Buddy Statements from other troops who witnessed the injury and will attest to it in writing? Do you see a neurologist or orthopedic doctor? My 1st advice is to see a neurologist. As mine told me after I wasted months and months with a orthopedic doc "I'm a brain surgeon, he does old ladies hips and knees. I'm a BRAIN SURGEON". This is your central nervous system, don't settle for a bone doc, demand referral to a neurologist if you haven't been seeing one. Also, demand a MRI. The VA itself lists the MRI as "the gold standard" in the Fast Letter about DDD/IVDS. Next, get any and all evidence you can to support your claim as far as proof of injuries, statements from witnesses, and after reading the VA Fast Latter on DDD/IVDS (IVDS is another name for DDD) in the Spine Claim Repository you write your claim and specifically list all of the things you did as a grunt that are listed on the DDD Fast Letter as causes of DDD. You then demand that the VA follow their own statements and service connect you for it. I have DDD and by using this site and specifically the info in "Spinal Claim Repository" to prove to VA that my back injury happened in service. There is a lot of info a guy named Rentalguy on here used to prove his case and it is all good, but the VA's own Fast Letter explaining exactly what DDD is and how troops can end up with it (including that it can take years to manifest itself) is the strongest evidence you can use. It outlines everything for VA and you need to plug yourself and your service experiences in to it to explain to these raters that they do not have a choice, they are bound by law and their own regs to approve you at a compensable rate. As for your pain, etc. you again need to see a neurosurgeon or a different one if you do already. I'm a fireman, I couldn't walk before my spinal fusion after having problems since 1993 in the Marines. Just got worse and worse. The orthopedic doc wanted to open my gut and back, remove 2 discs and put screws and a cage in, thus ending my career. After almost a year with that doc I saw our area's top neurologist (took3+ months for an appointment) and in 5 minutes he explained why that other guy was a quack. I ended up with one disc removed, only 2 screws (fusing 2 vertebrae instead of 8 fusing 3 vertebrae like ortho doc wanted), no cage, no opening my gut, and I've only had problems twice in 3 years and that is because of knee problems (also service connected) that have led to muscle spasms (knocked down in 2 weeks on melxocam). I just had knee surgery #2 in 9 months yesterday and did a 2 week stint on melxocam before it. It is supposed to be a 2-3 week long series of meds only. I hope they don't have you on it non-stop. The rest of the meds are boilerplate back problem meds. Meds aren't going to fix you. Like I said, you need an MRI and a review of it with a well qualified neurologist. Don't let them talk you into implants or pt or anything that isn't going to remove the problem. I hope that helps. The info you need to win a claim are on here. The info you need to get better is up to you to fight for.,........ sadly.

I have a claim in for it and told VA "all of my records on this issue are located with the VA Clinic Rochester NY, you may access my medical records there. Once you have them you must approve me as SC for this matter as required by law due to it being a presumptive illness for Gulf War vets. Proof that I am a combat vet of the Gulf War, which you requested, is also located in my VA Cfile and military service records which VA has access too. I have no further information. I demand that the law be followed and I receive SC for this issue. I will await your decision. As I stated, I have no further evidence to submit.". My % can't go higher from this so I decided for once to make VA do all of the work. When they send me for a C&P I'll go and explain my issues (constipation for 2-4 days at a time followed by the runs for a day or 2 straight and on and on, etc) and wait for them to make up some lame excuse to deny or lowball me then I'll appeal. My regular file has been at BVA for over a year so nothing is going to make this claim go any quicker. Good info on this page though. I hate that you have to think of every single shitty (lol) way that this effects you or the C&P hack will lowball you. I've been scoped twice, had my esophagus stretched once, take pills to keep the acid reflux down, etc. It is in my VA records as "IBS, unable to diagnose cause". Sounds exactly like what presumptives were designed to cover.

I would assume (ah..... the old assume) that it means you filed and stated that you worked with or were in an operation with what is considered Special Operations units (SEALS, Force Recon, Special Forces, Rangers, AF Spec Ops, Delta, etc) and that VA is using people trained in claims for members of and troops who served with those high speed, low drag guys. I've read a few things online that VA didn't know how to handle claims for these guys as their missions might still be classified or 'never happened' so they need to look at them from a different point of view compared to a person who has his/her service well documented in their Service and Medical record books. Again, I assume that is what it means. I believe there is a Fast Letter or Training Letter on it somewhere.

That's a good point, since the Chapter 35 site specifically states that the rules have change to STOP payment during breaks. Of course it will take you 4 years and 7 appeals to get a final answer....... lol.

Which is why I'm surprised. I would assume that VA and the US Gov't in general would assume the opposite. I know when I got out I had my lousy $15000 from the previous year in the Marines held against me as a vet and therefore "emancipated" person. My GI Bill at the time didn't even cover my community college tuition here in NY and like I said, I made "too much" the previous year in the Marines to qualify for grants. Oh, and since I got out in July they held it against me for the entire 1 1/2 it took to get my degree as "previous 2 years income", even though I made under $5000 a year during that time. $8000 in student loans for a lousy 2 year degree....... THEN they approved the Persian Gulf tuition coverage for NY in 1996 or so, just in time for most of us to have finished school. Again, I say hit them up for it and let us know!

Reading the charts, I would agree with you that you, as the Vet, should still get money as listed. I'm sure that since my mom is DIC it is a no go because they immediately cut her amount by the $200 or so the month her kid turned 18. They are appealing because she is still in high school. The other issue was does the time (since her birthday in October) count against her Chapter 35 since she is 'in school". I say go for it as far as getting the over 18 money AND Chapter 35. (I wonder why the amount is higher for over 18....?)

My mom's daughter (with my step-dad who was 100% and died of SC issues) is graduating from high school in June. We have been going in circles trying to get info about various programs (money) she qualifies for. From what we have found out: She will get Chapter 35 which is a stipend only for months actually in school (not even during the break between fall/spring semester). She does not get any type of tuition coverage from VA. She does not get any type of benefit from Social Security according to them. Berta suggested asking for payment from a SS program (REPS) and nobody in the Bath NY SS office had ever even heard of it. My mom will have her DIC reduced by $200 I think as her daughter will no longer be living there. The FAFSA application requires listing the amount of VA payment received by the parent, but not SS payments (my mom is 64). Either way, the applications estimated parental contribution to tuition to be $0.00. As I said in a recent post about Chapter 35, there is SO much misinformation out there. I know there are state benefits to cover tuition in some states, but they have residency requirements usually. I'm unfamiliar with "college age" benefits and would appreciate an explanation of what it is you're referring to. Cheers, Quint7

I also was rated 0% at discharge for this in 1994. I was given 0% for "failure to appear" for a C&P exam due to VA clerical crap. I am currently rated 20% for the knee as I've had 2 surgeries for torn cartilage and after poor advice from Docs going back to when it first was noted in 1989 my kneecap rides 2 inches to the side. I have an appeal at BVA requesting just what Hoppy had done, a rating of at least 10% going back to my discharge as my service medical records alone should've been enough to rate that, if not the current 20% but VA took the cop out of 'failing to appear leaves us no choice but to assign 0%" which is completely wrong. My example the other day on here was "a guy loses a finger in service and fails to show for an exam, do you not give him the minimum rating a loss of a finger requires by law?" No, you give him at least that. Anyway, chrondomalacia is a condition of the cartilage from what I know and since cartilage has no bloodflow and can't regrow, etc. it is permanent. My condition was the result of a torn meniscus that was misdiagnosed for 5 of my 6 years in the Marines. They said it was everything in the world, but in the days before MRI's if it didn't show up on the X-ray it was considered inconsequential. My file even says "nothing we can do about it, doesn't rate med board" from an orthopedic specialist. Get it looked at with an MRI, you may have a tare in there and as my knee guy said, you might be able to live with it for years with just swelling and pain, but when that flap gets big enough to actually get in-between the bones you are falling down, I don't care if you're Schwarzenegger. I'm a fireman and was lucky enough to have it finally reach that point as we were picking up after a fire. I bent down to put something in a compartment on the truck and dropped right to the ground. I've needed a 2nd surgery since and will have problems forever thanks to lousy docs. As for your back, again, MRI. I have what VA calls Intervertibreal Disc Syndrome or Degenerative Disc Disease. (IVDS/DDD). There is a lot of info on here about it. I had back problems in service and was told "Xray is negative, suck it up". I now have 2 vertebrae fused and almost lost my job because the orthopedic surgeons said 3 needed fusing which is a disqualification for firefighting but I got a top in the US neurosurgeon to meet with me and he went with the "you need 2 fused, maybe 3, we can't say til we get in there" approach and I was lucky to end up the way I did. On both cases, the VA actually has language stating the MRI is considered "the gold standard" in diagnosis so insist on it. Also, avoid orthopedic docs for anything to do with the spine. As my neurosurgeon said "They do old ladies hips, I'm a BRAIN surgeon." Ted Turner flew here specifically to have this guy do his back, I'll go with his opinion on orthopedic surgeons any day of the week. Both conditions are absolutely going to effect you quality of life in the future, don't make the mistake I did and expect VA to do the right thing. File your claims in a well researched manner with overwhelming evidence in your favor. Good luck my friend!

Again, thank you to all! This site has been a tremendous help and I did forget to give props to Carlie, along with others like you Bronco and John999, etc. Heck I wouldn't have SC for my spinal fusion were it not for the pain, suffering and time that was endured by rentalguy and his willingness to talk about it on here. I tell young vets about this site anytime I talk to them and it truly is a place where WE come together to help each other!

Berta, as always, you are a saint. If this site ever was to have paid staff I would think that after TBird you would be employee #1! LOL As I said, looking back with a different view on what you posted in the topic I quoted it does make sense that you were getting the stipend, especially when I re-read the part where they gave your daughter the stipend and not the GI Bill amounts that she rated as being a vet herself. I am going to be doing some investigating on the other topic (REPS) that you were nice enough to rustle up. I don't know if she ever got that and I would tend to think not because there really was nobody to help her when he died other than me and I was thankful enough to have had HadIt as a resource. (we both know the pathetic state reps that she and my step-dad had been working with). Thanks again!!!!!! Also, Philip Rogers, I saw your reply to the topic in my email but don't see it here. I hope that you don't think it would offend me and took it down or that a moderator did the same. I agree that many, many people want something for nothing and I hope that I didn't cone off like that myself. As was said earlier, the 'barracks lawyers' got my family thinking so and so and as we all know, the truth can be not only a let down, but a huge reality check.

Yeah I know about that, but those benefits are for the veteran. I can get tuition paid for at a state school if I choose. This is a survivor (former dependent) of a deceased veteran who was service connected at 100% at time of death and who died of service connected health problems. Since she is going to school out of state the state tuition rate won't apply (at least for the first year) nor would I think Michigan will allow her to go to school for free as a New Yorker if they offer a program for survivors nor would NY pay for her to go to school in Michigan. I was under the impression that survivor children under 26 received tuition paid for as part of Chapter 35 along with the stipend to use for living expenses. I've found more than a few generic 'veteran help' type sites that list that as a benefit and I'm assuming they are wrong as I find no mention of tuition coverage anywhere on VA's site, just payment of a stipend if the survivor is participating in one of the approved types of higher education.

He was a Viet Nam combat vet with 100% due to PTSD and effects of Agent Orange (death ruled due to complications of Diabetes /Agent Orange but I've never heard that certain times of service meant certain levels of survivor benefits other than which GI Bill the actual veteran was eligible for and that effects only the vet). I must have misinterpreted Berta's meaning of reimbursing her to mean for the actual tuition she paid when what she meant was the amount of the then current rate of monthly 'stipend' available to all under Chapter 35 regardless of where you went to school.

As so many posts start off, Berta seems like the expert on this and I hope she has the time to answer. Step-dad was 100% P&T, died of service connected issue. His widow (my mom) and daughter get Survivors comp from VA. She is graduating from high school in June. She has been accepted at Michigan State University (she is a NY resident) as a pre-med student. My mom and I had been under the impression that Chapter 35 pays the entire tuition for widows/dependents of deceased 100% vets. What we are being told by VA's Education side is, no, you (she) get $957 a month while enrolled in approved schooling and that is all. I have read on here about people (Berta, you specifically I remember) getting tuition paid. This post contains posts showing that: Her (my) mom is 62, lives off survivors VA and Social Security payments and can't afford community college, let alone out-of-state tuition at a school like M.S.U. and she also gets $200 a month less after her daughter leaves fro school since she is no longer under 18 and in high school. Someone please tell me I'm getting bad info from VA and a million web sites. My poor step-dad had been convinced by his vet buddies that his entire VA comp transferred right over to my mom and when he died and her income was cut to below 1/3 of what he was getting she damn near had a breakdown. My niece got accepted as a pre-med student and it seems like nobody from VA or the school can give any answer other than "you get the $957 a month from VA period and tuition, books, fees, etc are all on you to pay with loans, etc if that amount doesn't cover your it ($40,000 freshman year, $20,000 the other 3 years). I'm hoping that she has just repeatedly spoken to misinformed or lazy people at VA. Thanks in advance.

I did a video hearing/conference for an earlier effective date with the BVA. They do not ask questions. YOU and YOUR REP are expected to lay out your case for why you should be approved. The guy in DC (I assume) basically sat there looking at us as my rep fumbled and mumbled along at first with his whole being 'gracious for this opportunity to speak' suckhole crap that he has done at DRO hearings and then trying to explain my case until I just cut him off and explained it myself. The judge sat there looking at us, not writing anything down and only asked me to clarify a couple of things. It was not a question and answer period type of thing. The same goes for the 1st in person DRO hearing I had in which the DRO was very defensive and confrontational (I won). The 2nd in person DRO hearing, which was about this same EED that is at BVA, was more of a discussion as the DRO had properly prepared for the hearing by reviewing my claim and discussed it with my rep beforehand. Even though he came across as 99% sure i would win, when I got the decision it was denied on what was a lame technicality in my eyes. The appeal to BVA was to make VA go back to the claim and review it from page one as it was filed immediately after discharge. All previous ratings and hearings skipped over the original reason for assigning the rating they did (0% for 'failure to appear') and went to why that was a proper rating, instead of looking at the medical evidence that was on hand upon my discharge and deciding if that evidence alone was sufficient to rate a minimum of 10%, if I showed up for the C&P or not as regulations say. They kept defaulting back to 'you don't show for a C&P, you MUST get 0% if it is found to be service connected because we couldn't examine you' which is not how it is supposed to go. The example I used was 'a guy loses an finger, he gets out on a regular discharge, files and misses the C&P due to a VA clerical error (as was my case for missing the C&P, I'm not missing a finger), does he get rated at 0%?' No. It is in his records that he lost a finger and there are minimum ratings that apply to that that MUST be granted as a starting point based solely off of his military medical files. That is exactly what VA is SUPPOSED to do. Instead, they save time and money by assigning a 0% and it is then on the vet to fight it. My claim has been at the BVA since April 2011. My 'status' since July 2011 is 'with VSO' which apparently means with my rep (local? state? national? I have no idea) who is supposedly preparing a brief for BVA. On a similar situation, I filed for 2 issues that are considered to be automatically service connected due to me being a Gulf Vet. I filed claims for them requesting the effective date to be the dates I first sought treatment from VA as I have read on here that getting treatment can be considered an informal claim and that since both are automatically going to be service connected as part of the list of presumptive illnesses for Gulf vets, the effective date is the date I asked VA for treatment. Those claims are at the VARO in Buffalo and are 'delayed due to us having to work off of a temporary file as your file is at the BVA'. That was the IRIS response as of last week. I filed those claims in Sept. I think and until I contacted IRIS 3 weeks ago I hadn't even received the usual 'we have received your claim and are working on it' letter which finally arrived last week. I don't know if that will help, but it's my experience with video and in person hearings.

Sadly my back surgery was 3 years ago today so getting the extra 3 months is out of the question. I didn't know I could've fought this back then thanks to lousy representation. I am waiting for the decision on my knee. I submitted the claim in Nov. and have yet to receive anything on it but it is listed on Ebenefits. I have a earlier effective date claim for it (going back to 1994 when my enlistment ended) 'at' the BVA. "At" as in it has been in the waiting for your representatives write up part since the beginning of April. VA...... the long and winding road. Glad my post helped!

Don't want to hijack (much) but they wanted nothing to do with any rating other than convalescence rating which they told me was only able to start on the 1st of the month after surgery even though mine was on Jan 3rd. Dr. said 6 months with no work. Like I said, they approved 2, I filed a NOD and got 3 which they said was the max. Took this from the Cornell Law website; A total disability rating (100 percent) will be assigned without regard to other provisions of the rating schedule when it is established by report at hospital discharge (regular discharge or release to non-bed care) or outpatient release that entitlement is warranted under paragraph (a) (1), (2) or (3) of this section effective the date of hospital admission or outpatient treatment and continuing for a period of 1, 2, or 3 months from the first day of the month following such hospital discharge or outpatient release. The termination of these total ratings will not be subject to § 3.105(e) of this chapter. Such total rating will be followed by appropriate schedular evaluations. When the evidence is inadequate to assign a schedular evaluation, a physical examination will be scheduled and considered prior to the termination of a total rating under this section. (a) Total ratings will be assigned under this section if treatment of a service-connected disability resulted in: (1) Surgery necessitating at least one month of convalescence (Effective as to outpatient surgery March 1, 1989.) (2) Surgery with severe postoperative residuals such as incompletely healed surgical wounds, stumps of recent amputations, therapeutic immobilization of one major joint or more, application of a body cast, or the necessity for house confinement, or the necessity for continued use of a wheelchair or crutches (regular weight-bearing prohibited). (Effective as to outpatient surgery March 1, 1989.) (3) Immobilization by cast, without surgery, of one major joint or more. (Effective as to outpatient treatment March 10, 1976.) A reduction in the total rating will not be subject to § 3.105(e) of this chapter. The total rating will be followed by an open rating reflecting the appropriate schedular evaluation; where the evidence is inadequate to assign the schedular evaluation, a physcial examination will be scheduled prior to the end of the total rating period. (b) A total rating under this section will require full justification on the rating sheet and may be extended as follows: (1) Extensions of 1, 2 or 3 months beyond the initial 3 months may be made under paragraph (a) (1), (2) or (3) of this section. (2) Extensions of 1 or more months up to 6 months beyond the initial 6 months period may be made under paragraph (a) (2) or (3) of this section upon approval of the Veterans Service Center Manager. [41 FR 34256, Aug. 13, 1976, as amended at 54 FR 4281, Jan. 30, 1989; 71 FR 28586, May 17, 2006] This was the logic explained to me that it is a max of 3 months if they approve it. They didn't. The knee thing I thought I had slightly wrong. Again, I'm no expert and was going off of a reply from one of the HadIt elders in a post I made about my temp 100%.

Don't expect a lot though. VA will say 'yes, you had surgery on the 3rd for your service connected xyz, you were then unable to work that month, the next and until the 13th of the next month". On their minds that equals 1-2 months of temp 100% since they go by date, meaning you lose out on that 1st month by having the operation after the 1st. They also max it out at 3 months unless the regs specifically allow for more I believe. I was off for a spinal fusion, service connected, from Jan 3rd-June 15th. I got 2 months initially, appealed and got 3. They didn't care how long I was off, they said regs give you the month of surgery as 100% then the other 1 or 2 at the discretion of the rater, didn't matter that i couldn't work, temp 100% was for post op recovery per their regs. There are certain conditions where the amount is written into the regs. Knee replacement is a full year at 100% I think I was told on here. I blew apart my knee again in late June, was off from work from June 28th to Oct. 20th. Surgery was Aug. 3rd. I'm expecting them to say I get nothing for July (didnt have surgery yet), August (didn't get the surgery til the 3rd), get Sept at 100% and don't get Oct because I returned to work that month. I hope I'm not passing the wrong info along, but the system is brutal, set up to purposefully allow VA to not pay by institutionalized technicallity. Anyone else that knows better than what i posted please correct me. :)

An example from my mom's experience. Step-dad suffered from what VA could only call 'rheumatism, traveling, unexplained'. He also had Adult Onset Diabetes. The VA recognized the diabetes as service connected due to Agent Orange. he also was 70% for PTSD. He ended up TDIU 100% dues to the PTSD. He died when the mystery rheumatism got into his lungs and there was absolutely nothing docs could do. He died after a week or so. My mom had been told by him that his entire VA comp would just keep coming to her. He knew this because...... the guys at Group Therapy told him that. never checked it out, never asked how they knew. Wrong answer. She applied for DIC and was denied because he didn't die from PTSD or Diabetes. No service connection related death, not 100% for 10 years (think it was 6, 6 1/2), no DIC. My mom was crushed. I first joined HadIt to research her situation. What we found out was that if the Dr who signed the death certificate amended it to include that his diabetes made controlling the rheumatoid impossible because his diabetes was so severe (which it did, we just never thought about it that way until forced to) the VA should then consider his death as related to his service connected diabetes. Talked to his VA Dr who completely agreed to change the death certificate (not an uncommon thing I guess) to read "cause of death, rheumatoid fluid in lungs, un-treatable due to severe diabetes" and VA approved DIC back to date of death with no questions asked. Life insurance....... very good advice.

I am a Gulf Vet and currently have a claim in for IBS. It has been documented and diagnosed by VA doctors and no cause has been able to be determined after every type of test the University hospital (University of Rochester, which has a medical school, the local VA clinic contracts with them) was able to come up with. I filed the claim online recently stating that I am a Gulf Vet, I have been diagnosed by VA with this problem and according to the list of presumptive illnesses attributed to Gulf Service I should be service connected, rated and receive compensation from the date that I first sought treatment from the VA for IBS type issues.

Carlie, I have read on here multiple times that any diagnosis and treatment from a VA Dr for what is considered "Presumptive" issues is to be considered an inferred claim for such. GERD is considered presumptive for Gulf vets and my ED is documented as being related to my PTSD. Therefore I understand it to mean that the effective dates for service connection should be dated as when the treatment by the VA began. I haven't been on HadIt much the past couple of years so I can't give you a link sand hopefully someone will have one. Maybe I am wording it incorrectly, but in the end I am expecting the VA to give me effective dates back to when treatment was sought and given for these issues by VA personnel as opposed to the date I recently filed.