cannoncocker

How did I know the word simple should never be put in the same sentence as VA. I went to the table at the link you provided, thank you, and I fouled out, so I went to the link on that page which opened a new page with a new calculator. Unfortunately I wasn't paying attention in Latin class. So I will continue to try to determine from the original calculator how 70 turned into 60 and if bilateral hearing loss 0% at left ear 0% plus right ear 0% equals 10%? just curious if that only works to the VA's benefit meaning does that have to be two different SC injuries (the 0% plus 0%=10% IAW DAV Rep idea)? I need simple because so far I am lost. I do appreciate the help and it is my own fault if I don't understand, not the person trying to lead the blind. That make sense? Even the simple can be grateful! 30% 30 10% 37 10% 43.3 10% 54.073 10% 54.073 0% 54.073 What?

As it has been explained to me by the DAV Rep 0% plus 0% =10% So if that is correct information would my bilateral hearing loss of 0% equal 10% since it is bilateral. Hope this is an easy one. Could anyone tell me which SC item was pyramided to reduce a 70% to 60%. Nothing on the decision paper stated what that was other than my rating was 60%. sinus tachycardia 30% bilateral tinnitus 10% Pes Planus and plantar fasiitis left foot, status post bunionectomy with scar 10% Pes Planus and plantar fasiitis right foot, status post bunionectomy with scar 10% Hypertension 10% bilateral hearing loss 0% Thanks for any input.

Thank you carlie. I feel that covers this issue and can close this out. I am briefed enough to move forward. Time to let someone else to get helped. I will let this sit for about a month and gather the MRI discs, again, get the IMO, and request again for the DRO personal conference. If they stone wall that request I will submit the Form 9 for a BVA with personal conference. Hopefully with the additional IMO, VA documentation, and a VARO DRO personal conference will do but am prepared to move on to the BVA. Thanks a million to all and I hope others got some useful information from this. In general what I take from this is that you need C-4 to prove an injury if they decide you are not going to get approved so you are wasting your time if you think logic and their docotrs alone will do it. I suspect I will never get approved by the W-S VARO and the BVA is my next viable chance. Military medical notes: irrelevant once the decision is made. When 100% disability comes into reach they will resist with all methods, legal or otherwise.

Exactly what I needed to know! Thank you so much. I will do exactly that. I was going to drive to the W-S VARO and request a hearing with the /a DRO but without a sledge hammer in my hand it would be pointless. Once I get this documentation/evidence how do I go about submitting it? on a 21-4138 requesting an appeal to the BVA referencing this new evidence? Also I have the following submitted in the IRIS system. Should I add a reply requesting they suspend any action on my claim until I have gathered more evidence and given it more time for thought and research? ******************************************************************** I submitted a request for reconsideration on June 30th, 2009 for the denied Lumbar Injury, and then selected the DRO process and consultation with the DRO Officer. I received a letter from the XXXXXXXXXX VARO on Friday 21 August 2009: XXXXXXXX Dated August 19, 2009 CSS XXXXXXXXXX XXXXXXXXXX. XXXXXXXXXXX The decision remained the same with disregard to additional information submitted, in particular: 1. Charles George VAMC 1/2/2009 Fee Basis Approval Epidural Steroid Injections (which I declined as I rule out invasive procedures only as a last resort). 2. Durham Medical Center Neurosurgery Consult from Dennis Tuner, MD and Kenneth Rathey, PA-C 919 -286-0411 7010 (which delineated my options in writing and identified the injury from a pinched S1 Nerve, Left, L5S1, herniated disc, numbness in thighs due to nerves in groin, options: a. Medication b. Physical Therapy c. Epidural injections (I submitted the fee basis document to corroborate the Document from the Durham Medical Center Neurosurgery Consult). d.Surgery (discretionary) I selected medication and Physical Therapy, that was an option, not a medical directive! The epidural fee basis approval demonstrates this. At any rate it is clear by the brief period it took to come to the conclusion I was to be denied again, the total disregard for the additional documentation since the denial totally disregarded for this new evidence, disregard for my request to confer with the DRO, as far as I know no DRO was even involved, although I was required to select the DRO or normal Appeal procedure, I can clearly see that a determination has been made and no amount of countering evidence will change the predetermined result. I received a VA Form 20-8992 today 24 August 2009 from the Winston-Salem VARO dated August 21, 2009 in reply refer to me K. Pfanzelter Veteran Service Manager. Briefly it stated the VARO has received my application for benefits. I have no idea what benefits this is referring to since I have been denied twice and the DRO requests have gone unanswered. I have no plans to request further reconsiderations from the same office. I am not a genius but I can see it is clearly there is only one response coming from that office. So my question is: 1. What is that letter referring to? (VA Form 20-8992 from the XXXXXXXXXX dated August 21, 2009) 2. Should I, in the one year response time period, decide to appeal, how do I appeal to a different adjudicatory power? Sincerely,

Hi carlie, thanks for the past help. the claim is still open, just waiting on me to accept or appeal. I did in fact submit new evidence for the request for reconsideration. Is the VA obligated to allow me a personal hearing with a DRO? If not there would be zero point in me driving to the VARO. Failing a DRO personal hearing How do I request a BVA appeal with a personal hearing and would that get my claim out of the W-S VARO? I do have some minor additional evidence still but would an IME nexus letter be the way to go? Thank you

jbasser, thank you for your service to the country and in particular your service to this forum, the best resource I have found on the net or any place else for that matter. Have you had a C and P exam for the back and neurological issues? Kinda, the C&P exam did not really focus on my back, more my cardio vascular system. From the denial it stated some practioner stated I was SLR negative. That doesn't pass the laugh test, if you have access to he internet you know how to respond. I would let their VA Neurologist and MRI's counter that nonsense. This is beyond any doubt confusing but here is what I have and where I am in repsponse to your post. sinus tachycardia 30% bilateral tinnitus 10% Pes Planus and plantar fasiitis left foot, status post bunionectomy with scar 10% Pes Planus and plantar fasiitis right foot, status post bunionectomy with scar 10% Hypertension 10% bilateral hearing loss 0% equals 70% but however they calculate it ends up being 60%. So I am currently 60% SC. Lumbar Injury claim and request for reconsideration both denied. Requested DRO hearing: ignored or denied, whichever, they did not respond yea or nea, but did acnowledge my request for the DRO hearing on the IRIS system. The VA Neurology consult written notes is the new evidence I submtted as new evidence. You need to get a medical opinion using the evidence you have that states your sciatica is directly resulting from your S1 Disk I do have that evidence and written opinion on the new evidence I submitted from the VA Neurology consult which stated "Left leg pain Left S1 nerve pinched" On another part of the written note stated "left leg pain since 2005" which he misinterpreted from my statement that the pain increased in 2005, but the MRI should narrow that down with the dark and light fluid leakage indicating old and new injury, which the MRI shows both. It also states the sciatica originates from " L5-1S, herniated disc. What can I do from there? Send it in Urdu? Your back is maxed at 60: back (lumbar denied) The MRI's wil help, do you have the report?: Yes I have both MRI reports from 2006 and 2008 and can relatively easily get the disc images. MRI's shows many problems. OR report: I was given options written on the new evidence which was on his stationary. It stated "option" 1. Pain Medication 2. Physical Therapy 3. Epidural Injections ( I have the Aseheville VAMV fee basis approval letter) 4. Surgery (optional) I selected 1 and 2. the denial letter stated that 1 and 2 was a medical directive, which as a matter of written fact it was my choice, and I choose not to have them stick me in the back or open my backup. I will have to be bed ridden before I resort to that! You do not have to have new evidence to file a NOD. You do have to have new evidence to reopen a claim. I have submitted new evidence which as previously stated they cut and pasted their way to another denial. The claim is still open, but just in my court as to how to proceed. I also submitted the NIOSH lifting equation which my field artillery job far exceeded the allowable limits. From the input thus far it appears: 1. Drive to VARO and request a personal conference with the DRO and as I understand it the VA is obligated to provide a personal DRO conference since they have written acknowledgement of my request. 2. Initiate a BVA appeal with personal hearing. Would an IME be worth the money to write a nexus letter? I am not clear on how to initiate 2. a BVA appeal with personal hearing. A walk through on that would be helpful. I know we are talking years but it is a fools errand to expect any justice on this issue from the W-S VARO. They have denied othe items and I accept that. So I am not hard noseing this but they are vindictive on this issue and I am beginning to be more concerned on retaliation if it stays in their office. I would rather wait longer than allow them more time to retaliate against me via my claim. Thanks J

On the 21-4138 the DAV Rep. and I did for a fact request a "reconsideration". That is for sure. I plan on driving to the VARO and request a hearing with the DRO, if there was one at all. I have been told hear they are obligated to allow me a hearing with the DRO. So beyond that, since an actual appeal has not been filed, how do I go about filing an appeal? I am done with the DAV rep. so I should call the 800 number and request an appeal with a hearing? Or is there a form that I can complete myself bypassing the 800 number and DAV. I want the decision as far from the VARO as possible because they have demonstrated there is no justice happening at the W-S VARO for me. Time is not the major factor for me on this. Justice is. Thank you sharon

Now we get to action! Nothing with these guys is going to be bulletproof. Not possible! Of those three 1. DRO hearing about 1 year 2. BVA about 2 years (no hearing) 3. BVA about 2 years plus 1 year (with hearing) I am not that concerned with time, what would you think 1 or 3? Sounds like 1.

Hi Sharon, and to start, thank you for caring enough to put your experience and knowledge to work to help those of us not experienced and educated enough to contend with the curve balls the VA throws at us. I started, well actually, not even knowing the VA existed until I ETS'ed. until recently I honestly thought they were straight shooters and were really doing the best they could. I must have been completely out of my mind. They have misrepresented and plain lied to reach their quota or agenda. So much for the ranting. I believe the answer to your question is no. The following is what I have received in the way of Decision. I received an initial Decision on 23 June 2009 in 2 parts, part 1 starting with "Your Award Amount And Payment Start Date" then part 22 June 2009 VARO Introduction/Decision etc. Part 1 had 2 deferred items and 1 denied item. The rest increased or unchanged. The second Decision paper was titled "What We Decided" which addressed the 2 deferred items: 1. Unchanged 2. Denied (no problem/less documentation and would only serve to clutter the issue 3. 2nd denial of lumbar injury which was reworded from the Neurology Consult-cut and pasted to fit their needs-ignored/misrepresented new evidence which is easily rebutted by the VA's own Neurologist hand written document on his stationary and the VA evaluations of VA MRI's. So it changed nothing from the original Decision paper. I have never seen a SOC but this 2nd mailing is virtual the same as the first but it did mention my request for reconsideration. Nothing about DRO. It states my current complaints are not related to my service. how they can demonstrate that is beyond me as their own neurologist stated this was an old injury reproducable by the dark fluid leakge. They did not only review the old case but only addressed the defered items and re-denied the lumbar item but reworded the parts they wanted and deleted the parts they didn't and then they just plain lied. Only problem is their Doctor as he was explaining to me the situation, he was writing it all down. I also have another VA Doctor that drew diagrams of my major lumbar problems, which I have but have not submitted. They should really train their Doctors to not write if they plan on misrepresenting the truth, plus an mri is difficult to get around. So I would say that I have recieved 2 Decision papers. No SOC. Again, no reference to DRO or any conference. Do they have no responsbility to deny a DRO or conference or is it acceptable to let you just guess or they just ignore it? Then a day or so later I received a letter on VA form 20-8992 from my VARO stating they have received my application for benefits. What is that about? I have not requested any fuurther benefits since April 2008. Anyway, given that I have not received an SOC, what do you think I should do?

jbasser The clock is ticking for you. I would request a complete copy fo the claims folder. I would also NOD the other denial. This will preserve your time. The C file may tell you what happened or that they are the unorganized mess that you are led to believe. If you have VSO, use them. They have inside folks. Reply: Actually after my DAV reps eyes stopped rolling in his head when I said I wanted a complete copy of my C-file, which he said he had never done before, we called the 800 number and requested the medical records for the lumbar time frame. I see a trip yo the VARO in my near future to physically request the entire file which i believe they said would be 10 bucks or something. I agree and will do that very soon. Another NOD. I do not currently ave any new documentation to open a new nod. They have: 1. Active duty ER notes 2. Unit Follow up notes which changed medication. 3. ETS 4. MRI 2006 which documents a plethora of protruded/extruded/degenerative/pinched S1 5. MRI 2008 same as above. 6. 2008 Neurology consult stating degenerative discs/pinchedS1/herniated discs Options: a. pain medication b. PT c. epidural injection L5-S1 d. Surgery (Discretionary) I selected meds and PT with use of TENS and Brace 7. Letter approving fee basis epidural injections from the Asheville VAMC. The VA Neurologist pointed out on the MRI the new fluid which indicates new injury and dark fluid which indicates old injury. both present. So maybe an IME? Thank you for your input! john999 You have to request a personal hearing with the DRO. The DRO Review often results in a rubber stamp denial Reply: that is rich, the rubber stamp part. I did indeed request a personal hearing with the DRO. The VARO acknowledged my reqest for the DRO then the next thing I received is a reworded denial as if they never received any new evidence or were cutting and pasting to fit their needs. Which was to refuse me a 100% disability. That is the issue. at 60% and the condition of my back, that has 100% written all over it. They evidently refuse to do that. Any Ideas on how to fight back? I do worry about retaliation if I push too hard. philip rogers If you're waiting for a DRO hearing, I believe they've been taking 18-24 months before you'll get one. This appears the average nationwide. Reply: I am not really concerned about the time so much as winning what I know to be right and fair. My brothers have my back like I had theirs when we were younger so not worried about that. I requested the hearing then they sent a denial so I can interpret that as a hearing is not part of their agenda. So the question becomes, what do I do now? hire a lawyer/IME/file another sort of appeal? I don't have any new evidence. I shouldn't need any new evidence. My ER notes from Ft.Polk has pt.states pain at waste level. Now who would walk into an ER and say their waste level hurts. doctor's have actually laughed at that. They just saw VA claim written all over me. That is funny because as dumb as it sounds, I had never even heard of the VA at that point. I didn't even ask for an ets physical since tey had told me at the er to leave the same way I got in whaen I told them I could barely move. My medical condition was clearly of no interest to them. But what now? C-file yes for sure. But what to keep the ball rolling without irritating them to the point they retaliate againsty me since I am satisfied with my claim minus the lumbar denial. I spent 6.5 years humping projos in excess of my own weight that far exceeds the NIOSH Standards. The VA Neurologist pointed out old and new injury on my MRI, which I had both, distinguished by light and dark fluid. They did zero diagnostic work at the Ft. Polk ER, just motrin for my pain at the waste level. Now what exactly could a buck Sarg do about that? Nothing. Later at the unit they changed it to pt complained of low back pain and tey changed meds, but still no diagnostic work. Does the military medical prof. have no conduct requirements?

Thank you for that definitive response. I think I can resolve some of my issues with this.

I wish someone would address this precisely. It would be helpful for many i am sure. I thought a NOD (Notice of Disagreement) was just a catch all name for Request for Reconsideration, which would lead the VA to inquire as to which process you chose: DRO-Decision Review Officer or "Normal Appeal Process" Whatever that is? That is what was presented to me and I was advised by the DAV rep to select the DRO I did that and of course they acknowledged my choice of DRO then totally ignored it thereafter. But in fact I do not know exactly what a NOD is either. In particular what form 21-4138?

All I can tell you is I have 0% high frequency hearing loss which obviously doesn't pay any thing but it is a SC disability and would allow for paid hearing assistance. But to the point, I was told by the Winston-Salem DAV Office Supervisor that to get above 0% the chart the VA uses you really have to be profoundly impaired. So you may want to consider that or dig up the chart and compare it to what your hearing exam revealed. That would tell you what you have earned or might expect for the forth coming battle with the VA. I was in Field Artillery for 6.5 years and I know the toll it takes but as I stated above, it is a particulary hard one to win. Why they won't allow 0 is beyond me other than all things VA are arbitrary.

I have submitted a request for reconsideration to the VARO. They responded by requiring me to choose between the "normal appeal process" or the DRO Process. I selected the DRO process. They acknowledged this choice in writting. I then requested a personal conference with the DRO and submitted new evidence. I started the NOD request on 29 june 09. On 24 August I received a decision on 2 claim items that had been deferred and a rubber stamp denial of my lumbar injury denial. Completely in contradiction to submitted evidence, in writing from their Neurologist, on his stationary, and the approval of a fee basis epidural injection, which the VARO has denied ever happened. So, the question is, Does the VA have any obligation regarding the DRO process, since they asked me to chose. Their decision came in the same form as the rest of the claim did. They did not accept my request for the DRO conference nor did they deny it. They did nothing but deny the lumbar claim with the same form as the other deferred claims (1 they approved, the other denied) using erroneous information regarding the lumbar injury. I basically would like to know if they have any obligations regarding this or can they simply ignor it and in which case does anyone have a recommendation moving forward?

That is the definition of real property valuations from time to time they really spike. They know statistically x% will never even open the envelope. Another x% will say $#% and pay it. Then there are the x% that will say whoa mule then they will have an automatic reduction fallback position just because you got up and went to their office. I think the parallel is clear. They know a good percentage will just go away right from the start. Then there are people like me that went for years and actually never even heard of the VA.

My claim ended up being very messy but I got a decision/approval for several issues in 14 months in NC. 2 items were deferred for further examination. 1 denial. So really not so bad considering but the statement regarding where you are is probably very if not the most relevant factor IMHO. Of course complexity is right on up there too.

Hi Berta, it took me a few minutes to define SMR (Service Medical Record) That was in my active duty military records (progress notes) both visits but when they told me to basically hit the bricks and I was close to ETS I really just took my annual leave, which I had planned on cashing in, and my unit Cmdr. let me run the recreation activities at the Gym till I ETS'd really just as a favor to help me get through. Honest, at the time I had never even heard of the VA. I thought you got out and good luck. It was years later till some older guy, me now, got me up to speed. In smmation for the lumbar spine injury: Evidence shows the veteran suffered back pain while in service. However, other evidence received in connection with this claim shows that the veteran currently suffers from lumbar spine injury with radiating through the buttocks and down legs which is unrelated to the disability which occurred in service. Therefore, since there is no relationship between the disability which occurred in service and the current condition, service connection is denied. The rest relates to dates of contact and exam dates etc. It states where in 2006 I was sent to a neurology consult complaining of a 20 year old injury, which showed by MRI the injuries mentioned. In reality it just got worse in 2006 and is confirmed by 2 MRI's and I sent them the written Neurology notes their VA consult gave me indicating extruding discs, protruding discs, degeneration, new fluid leakage, old fluid leakage, and pinched S1 and options for surgery/epidural injections/PT/Hydrocodone. I have given them plenty of evidence and have now provided the hand written notes from their Neurologist for the DRO. Since no x-rays or other exams were done at the time of injury, what else can I do.

I would appreciate any suggestions on where on this forum and what subjects I should start reading to continue my claim. I am satisfied with the rest of the claim. I am interested in learning this myself. Thinking towards worse case scenario in the event they decide against me. I have a partially completed C&P claim with: Chronic Anxiety =Deferred QTC Exam Completed 4 August 09(current status) High Frequency Hearing Loss=Deferred QTC Exam (Additional consultation with original QTC Audiologist) (current status) Lumbar Spine Injury=Denied=Requested Reconsideration of Decision=DRO (current status) I was taken to the emergency room for this injury and on the progress notes they wrote patient complained of "pain at waist line". What does that even mean? Front, back, side? I told that to a VA doctor and he started laughing so that is proof it didn't even pass the laugh test. No x-rays. No other tests. Stated good range of motion, etc. Prescribed Motrin. I told them I could barely and they said I could leave the same way I got there. Why they would treat me like that is completely beyond me. Later at my unit they changed the "patient complained of" to low back pain and changed to different NSAID. Took annual leave then light duty till I ETS'd. Thank you