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smilen66

First Class Petty Officer
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Posts posted by smilen66

  1. If I may , I'd like to piggyback on what everyone has said and add additional info from M21-1MR, Part III, Subpart i, Chapter 1.

    Post-Determination Team

    Introduction This topic contains general information about the Post-Determination Team, including

    • the function and responsibilities of the Post-Determination Team, and

    • the types of issues handled by the team.

    Change Date September 27, 2004

    a. Function and Responsibilities of the Post-Determination Team

    The Post-Determination Team

    • develops and processes non-rating end products (EPs)

    • promulgates ratings (which may include development for an inferred issue when evidence is not needed from a third party)

    • prepares notification letters, and

    • completes entitlement determinations for issues not requiring a rating.

    b. Types of Issues Handled by the Post-Determination Team Types of authorization issues handled by the Post-Determination Team include, but are not limited to

    • accrued benefits claims not requiring a rating

    • apportionment decisions

    • competency issues not requiring a rating

    • original pension claims not requiring a rating

    • dependency issues

    • burials

    • death pension, and

    • specially adapted housing and initial CHAMPVA eligibility determinations when a pertinent rating is already of record.

  2. I am getting close, this is what old EJ said today about my increase!

    This is in response to your follow-up inquiry dated July 23, 2009.

    A decision was made on your claim today. We still need to review the decision for accuracy. We will mail you a letter of notification in the near future with our decision.

    Thank you for your patience.

    Is has been a pleasure to serve you.

    Thank you for contacting us. If you have questions or need additional help with the information in our reply, please respond to this message or see our other contact information below.

    Sincerely yours,

    E. J. Kruse

    National IRIS Response Center Manager

    Hmmm, this is interesting... this is a letter I received today from IRIS regarding my claim status. By the way, I couldn't help but notice we have the same VARO.The only thing I can really say and hope and that is hopefully it really won't be that long!

    This is in response to your inquiry dated July 23, 2009, concerning the status of your claim.

    We are pleased to inform you that your claim decision is complete. It still needs to go through a review process to ensure accuracy.

    We can not forecast how long it will take to complete the review and to receive your letter of notification.

    We appreciate your patience during this process.

    It is a pleasure to serve you.

    Thank you for your service to our country.

    Sincerely yours,

    E. J. Kruse

    National IRIS Response Center Manager

  3. Saw this and wonder if you can contact the VARO to submit your banking information asap? Or if all else the VA 1-800 # or IRIS. Questions and responses are free all in all.

    Cg'up2009!

    Cowgirl,

    I like your suggestion and will do a inquiry through (IRIS) tomorrow! Thank you!

  4. 30% for Veterans Children and spouse.

    Sounds to me like you have a good sized award to require more than 1 signature.

    I have my fingers crossed for you victory,

    Pete53,

    I was pretty excited when she said a rating decision had been made. However, I'm now starting to question whether(?) I heard signature or signatures. At any rate, it will be wonderful feeling to have money in the saving account. Thanks for your well wishes.

  5. smilen,

    If you have already provided VA with your bank account and

    routing number - the $ may be deposited into your account before you

    get your official notification letter.

    This happens quite often.

    Have you filled out, signed and submitted VA Form 686c, if not

    I would do that the day I get my official notification.

    A copy of this form should be in there with your rating decision.

    carlie

    Hi Carlie,

    No, I haven't provided them with any bank account information. How long does it generally take before I receive an official notification? Thanks.

  6. I think it is 30 % or greater for dependents Lenora.

    Lets hope this is good news!

    And if the rating is too low you can always appeal it-

    I am cautiously optimistic for you!

    Berta, I would be most grateful for 30% but I'm hoping for at least 50%. I have a student loan to payoff and the V.A. hasn't charged me yet for any prescriptions (9 of them). Thanks.

  7. Smilen, Congrats, prayers answered and a note of care, I have personally found it stressful to watch the mailbox and bank accounts when a rating was awarded for me. All the best to ya and have a cup of calming tea from me!

    Yours,

    Cowgirl'up2009!

    Thank you, Cowgirl.I wish I knew for sure the tea would help. Unfortunately, I have anxiety and there is not too much I'm not anxious about. On a positive note prayers are answered!

  8. yep yep,\

    I don't see any reason she would have mentioned "helpless child" unless you had some good news coming to ya. Knowing me I would be camping out by the mailbox.

    Frank

    Luckily, I can see my mailbox from my house and I know the approx. time mailman delivers mail. For the next few days, I will stay close to home with phone nearby. That's one call, I don't want to miss!

  9. I spoke with a V.A. CSR today and was told my claim was rated last Friday! Of course she didn't have any details to share other than they have to get signatures and she also mentioned my son who is considered a "helpless child" (V.A. terminology) I'm trying not to be too excited because this could be a denial and it is unofficial. I rather stay on the optimistic side of things though. Also, I learned last week (hadit.com) you have to be at least 50% before dependents can be claimed...or something like that. I'll keep you posted.

    Lenora

  10. Thank you for your response...I had followed the recomendations the written way...met with a dro personal hearing...bogus...sent RO and heard zilch...I presented 2 IMO'S and now case is at BVA...the person at the VARO today was either a rater or higher position as she told me she worked on the 3rd floor...I was following the steps the CMO OF THE C & PVAMC told me to do...The way it should have gone through did not so I figured what do I have to lose. I know the call center have no idea what is going on the majority of the time...but the VARO rater/ said this form said to set up a new exam...I can't find the form, she said was VA 119- point of contact form. Sounds like it was too good to be true.

    V.A. Forms can be found at:

    VA Form Search List (http://www.va.gov/vaforms/)

    or via WARMS (http://www.warms.vba.va.gov/) click on “VA Forms” in the left-hand sidebar),

    which will greatly reduce the number of forms that must be kept in stock.

    You may have to copy address and paste in URL.

    VA 119- point of contact form attached:

    Point_of_Contact_Vaf_119_1_.rtf

  11. Purple,

    I just recently (last week) received a welcoming letter from Medicare The phone numbers are MyMedicare.gov 1-877-607-9663, Medicare General Questions 1-800-633-4227 and Coordination of Benefits 1-800-318-8782. My premium for Medicare part b is $96.40 (will be deducted from SS), according to handbook this is the standard premium, for incomes under $85,000.00.

    Lenora

  12. Rockhound, Broncovet & All:

    It does seem the V.A. initial intentions were pure. However, I don't understand why it seems there is no system for accountability in place. How can you get paid for 8 hrs of work when you have only worked 4 or 5? etc. Sounds like leadership problems to me. Maybe the claims processing model they are using needs to be reevaluated. This new and improved model is suppose to speed up the claims process. Some of what the two of you have shared about the team work ethics seems criminal.In any every organization employees should be held accountable for their work performance etc. Not sure if I would want some members of that team to handle my claim nor would I want my c-file transferred there. . Oops, I guess I wouldn't have that choice , besides... unfortunatedly I'm not old enough ...seems discrimnatory to me. Thanks for sharing guys!

    P.S. That was a great exercise (posting) for the brain!

  13. Ten months and counting. According to what I have been told by 1-800-827-1000 and IRIS. my claim for secondary issues has been sent someplace twice and returned to the rater and after having been told that a decision was scheduled for June, the claim was then taken over by the Tiger Team in Cleveland OH. It has been more than a month now since that time and about a month since the TT has a C&P exam done. My latest inquirey has nothing new to say other than that my claim has been in the process longer than it should have.

    There is just no excuse for such a claim to take this amount of time without a decision, good or bad. If it takes only nine months for the main claim the secondary issues are based on, then why should secondary issues take longer, it just doesn't make any since or follow any logic that I can make of it.

    Sorry guys for ragging on this, but I have to let of some steam somehow or I am liable to go down to my local VARO and rag on them and get myself into trouble and it wouldn't do any good because my claim is in OH with the TT. %$#*&@^ :)

    Rockhound Rider :) :angry: :D

    Please forgive my ignorance but who/what is the "Tiger Team". I've heard of the team through hadit.com, but never before.

    Thanks,

    Lenora

  14. If your going to a Psch. about your claim I'd recommend you go to the rateers manual and find the Section applying with your condition and see your report uses the terms and addresses the issues the RO uses to rate you. That is what I just did. VA DR. my Neuro wrote a letteer for me then I went back to him gave what I needed and he re-wrote letter.

    Claim was successful. Oh RO manual RO manual is schedule of ratings 4.124a was neurological

    Ausgmblr

    Thank you...I will check it out.

  15. I didn't know that states had disability insurance.

    I was a state employee. Here is the skinny..."The Disability Income Plan of North Carolina (DIP-NC) is a benefit provided at no cost to eligible employees who participate in the Teachers' and State Employees' Retirement System (TSERS) or the Optional Retirement Program (ORP). Benefits are available to eligible employees who become continuously unable to perform the duties of his/her usual occupation due to a mental or physical incapacity while actively employed. DIP-NC consists of short-term and long-term disability benefits."

  16. Well, Lenora, as I said, IF it were me, I'd file a claim for Major Depression (MDD) due to the pain suffered from my orthodpaedic disability.

    You certainly have such a diagnosis.

    Axis I: Mood d/o sec to GMC, Cognitive d/o NOS

    Axis II; def

    Axis III: s/p CVA wR sided weakness. chr pain (I understand this line)

    Axis IV: Mod-prim support, sig limitation in functioning

    AXIS V: 50%Actually 50% is not what was meant here, but, instead, a GAF (Global Assesment of Functioning or something like that) score of 50.

    A GAF of 50 along with your chronic pain and Mood Disorder (Major Depression, in your case), with significant limitation in functioning, would, in most cases, put you in place for a disability award of 50% (or, possibly, 70%, according to the mood of the VA rater).

    Most of the "work" has been done to facilitate your filing of this claim. This psych profile has all the indications to "back" such a filing.

    IF IT WAS ME! You do as you think best.

    Questions:

    Since, I've already filed claim and it is the raters office, should I wait to hear from VARO before submitting another claim?

    Do I need evidence of talking to a psych over the years for orthopedic problems, when I file the new claim?

    Thank you for your time!

    Lenora

  17. I'd also get online and file for Social Security Disability.

    If it was me.

    All this stuff can be filed for, online. The VA stuff and the Social Security stuff.

    I know what it is like to have to engage your mind and body to file for all this, but, it is much easier to do now than it was several years ago. And, if you are on the meds that I am on, then you certainly deserve considering the Social Security, also, because I know that I couldn't work taking the meds that have been prescribed for me (hell, I'd be a danger to myself and everyone around me, DRIVING to work, if I made it that far.

    Larry,

    I am currently receiving Social Security Disability as well as State Disability for the stroke. You're right driving while on lots of meds can be a chore. The state of N.C. won't allow me to drive on the interstate because of anxiety and I only drive during non-peak hours because of the meds.

  18. Okay from 2:50 until now or maybe a couple glasses wine later , I've been thinking of the submitted wonderful hypothetical yet true story.

    To say the least I enjoyed the hypothetical story, being in my formal life a "retired reading teacher". There was a perfect beginning, middle, and inferred ending. Missing in your hypothetical story were many details that could only come from me.

    True story in this is "Once upon a time, in a land not so far away, there was a US veteran.

    This veteran had suffered an injury, oh, say 40 years ago.

    He had documentation of this injury, both in his service medical records, and after discharge.

    He turned in a claim for this orthopaedic injury, and another claim for Major Depressive Disorder secondary to the pain that he had suffered for 30 years with the orthopaedic injury".

    Now for the details of the hypothethical yet true story:

    1. I can remember year to year (unable to connect the dots back to service), going to my private doctor for either the neck , shoulder, back and hips.

    2. The pain was sometimes intolerable especially with the shoulder and back. My neck discomfort I learned to live with.

    3. I continued to work as much as possible for 24 years after service as a classroom teacher (9 years), then reading teacher and assistant principal. It was youth, the birth of my own child (now 27) and other people's children that kept me going psychologically during that time frame.

    4. I can remember seeing a counselor or psychologist for general life and anxiety issues off and on.

    5. Then at the age of 50, I had a stroke primarily because I had high blood pressure and I spent the last 2 years of my career working under a great deal of stress.

    6. The only mention of pain to a psychiatrist was made after the stroke. The stroke affected my right side and my injury was on the right side. The stroke exacerbated the pain from the injury.

    7. Now, I spend a lot of time resting (on lots of meds), reading and very light house work. Infact, by the time I get up take meds, shower, do 1 or 2 things around the house, feed pet, maybe go to Dr. appt., and eat, it's almost time to retire.

    Not a pretty story and I know of worst stories from reading post on the site. I have only one question...where do I go from here?

    Thanks for a wonderful story and comments!

    Warmly,

    Lenora

  19. Larry and all:The claim filed was for my neck (bi), right shoulder, hip (bi) and upper and lower back (right side). My accident occurred more than thirty years ago...It is well documented in smr and private medical records. MY C-file is in the rater's division.

    The results from the 1st exam (according to xray report) are as follows:

    Shoulder: Degenerative changes noted of the acromion (with osteophytic spurring),coracoid,humeral head, glenohumeral joint inferiorly (?) and cystic changes at site of rotator cuff.

    Hips: Bursitis

    Neck (cervical Spine): Degenerative changes with bridging oteophytes of c4-c7. Chronic compression noted c5-c6 estimated 10% for each. Foramen narrowing on the of c5 and c6 right (claimed) and c3 through c5 left. Bilateral carotid calcifications. ( I had mri this week because of nerve pain)

    Back: Muscle spasms, dull ache.

    John and All: The medical condition is a stroke and not sc.

    Thanks to both of you!

  20. Good Morning All,

    My private Psych moved away a couple of months ago. He suggested I go to V.A., because visits were too costly ($40.00). Long story short, I had my 1st visit last week. I received a copy of mr(this week) and I do not understand the medical jargon, please help if you can.

    Axis I: Mood d/o sec to GMC, Cognitive d/o NOS

    Axis II; def

    Axis III: s/p CVA wR sided weakness. chr pain (I understand this line)

    Axis IV: Mod-prim support, sig limitation in functioning

    AXIS V: 50%

    By the way, I did not file a claim for this because I don't think it is sc.

    Thank you in advance for your input and have a great day!

    Lenora

  21. You all know that I won my TDIU P&T claim a few months back. I've been getting the correct amount with absolutely no troubles out of them. The wife and son are set up on ChampVA, which was too easy, and we are having no trouble on that end. We went to the reserve center and got our ID cards today, and had no trouble on that end. I applied for property tax relief with my county, and so far I have had no trouble on that end, except that they have yet to send me a refund of last year's property taxes. The only area I am having grief in is the DRO hearing that I filed for in August of last year. I am still on a waiting list to get a hearing date, but at this point all I am really looking at is a few months of back pay, so I can deal with it.

    See boys and girls, the VA can play nice sometimes. Now I need to decide if I want to file a claim for SMC K (foot drop) or wait until my appeal is finalized.

    It quite refreshing to hear positive news!

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