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yvonne116 Welcome to Hadit...you've come to the right place. I retired just over a year ago...so I've just been through what you are about to start. carlie's right--tinnitus is subjective, there is not test. the fact that it is in your husband's SMR is good, he'll just need to mention it again to the audiologist when he goes for the hearing test for the VA. Okay...there are 2 exams. First, there is a retirement physical or assessment. You didn't mention branch of service, but the AF no longer gives physicals for retirement, instead you get an appointment with a doctor to answer questions and make sure your potentially disabling (for compensation) conditions are annotated. I actually brought a itemized list of things to discuss--3 pages and I still forgot things. No set timetable...I got mine 3 months before starting terminal leave. I think maybe 6 months is the earliest, but it should be in the retirement outprocessing paperwork...but retiring the end of Dec, I'd make an appointment now since it will probably take a few weeks to get scheduled. Second, you'll have an exam (or several, depends on your claim) with the VA, probably a contractor--QTC vs actual VA doc. If you are at an installation that offers Benefits Delivery at Discharge--DO IT! 6 months prior to retirement you can file your VA Claim, while still on AD, the VA will schedule you exams. They will need a copy of your (I mean your husband, of course) SMR. During final outprocessing, DO NOT handover the AD SMR!!!!! All BDD bases have a form letter to sign that turns medical/dental records over to you to hand deliver to the VA. If you mail, use something with tracking and verified delivery (certified/return receipt, FedEx, UPS). I handcarried to the VA about a week after I started terminal leave. I retired the 31st of Jan, My first check came in April. Again, if you haven't started this already, start now! BDD allows you to file up to 6 months ahead of retirement/seperation. BUT, you have to file AT LEAST 60 days prior to retirement, otherwise you are in a different program with less priority. If you don't have BDD, there is a seperate window for filing, but even if you hand everything over to the VA before retirement, you won't get anything scheduled until after your last AD day. The base probably has Veteran Service Officer(s), usually collocated with personnnel. If not, there are county & state veteran service officers that will help you file the claim. If your base offers a VA Claims counselling session (the one here lasted an entire day--half for benefits overview, half for how to fill out the claim form), go! It's worth your time. Read hadit...read the how to assemble a va claim website (really good info). Pros and cons of using a VSO, but I would for the original claim. They will (should) go through your SMR in detail and find things that you have overlooked (flat feet, shin splints, tinnitus, etc.) http://www.warms.vba.va.gov/bookc.html Link is to 38CFR--the ratings schedules. It explains how multiple disabilities are computed (you don't get to add them up), "pyramiding" (2 or more ratings for the same body part). You can't get compensated for two different disabilities on the same body part--ankle for instance--rather the RO will (or should, anyway) rate the most disabling condition. Ankles are not feet, feet are not toes, and neither are hips or knees. As you look through the ratings schedule you will see how the body is subdivided if you will. the schedule also gives you insight as to what is required for each rating (10/20/100%/Whatever), including limits on range of motion (like for toes). Good Luck...

The AF went from the stationary bike fitness test to a "normal" test including a 1.5 mile timed run. And where did everyone end up running? On asphalt and concrete, including airfield ramps (thick concrete). Number of running profiles ballooned. Next thing was predictable--orders from hospital commanders everywhere to the doctors: stop issuing running/PT profiles! Joep: 1st, are you on a CPAP right now? Where you on it when you filed your claim. Unless you were diagnosed in service (I was) and on a CPAP (I was/am), your pretty much guaranteed of not getting SC for OSA. Can you get letters from spouse, roommates, etc. that can attest to your snoring, or better, stopping breathing then snorting/gasping for air before resuming snoring? Classic OSA. You AF doc probably thought he was doing you a favor by not putting the OSA diagnosis/observation in your SMR--it would have been a MEB/PEB condition. Can you go back to him/her and ask for a letter (IMO) explaining the circumstances? Lastly, as Berta suggested, an IMO from your current sleep doc stating that you OSA "at least as likely as not" occured during your military service. Any private doc must be able state that he/she reviewed your SMR. Oh...start getting treated at the VA in addition to any other treatment/doctors.

Carlie I looked at both you suggestions...and no, not what I was thinking of. Now I'm wondering if it wasn't something I read in a BVA decision...the context of what I'm remembering (or dreaming up?) is where the RO sees, or should see, a condition that could be claimed, but wasn't listed in the paperwork, and where both SMR and C&P (or other evidence) clearly showed the condition existed in service, continues to exist post-service, and the RO then ignored the condition and didn't rate it and did not notify the vet that it was a claimable condition. The gist was the RO had an affirmative duty to consider everything in the SMR that COULD be claimed by the vet, NOT just the things he/she actually claimed. Or am I off in my own little world? Thanks Charles

I know I read this here...I just can't figure out what combination of keywords to find what I'm looking for. Isn't there something written (USC, CFR, VA Policy) that the RO must consider everything either brought up in the C&P or in the SMR (at least during the Original Claim adjudication)? My situation is that in my SMR there is evidence of periphrial neuropathy in my left are/hand. I'm pretty sure this was discussed in my original C&P (waiting for C-File, probably a year out--they are only up to Oct 2008 ROIs). It came up again a recent C&P for a different issue, and in the rating decision, the VARO asked me if I wanted to file a claim (well, duh?). Pretty obvious that the C&P establishes a informal claim date--but could this go back to the original claim since it was overlooked? Thanks for your help...

SS COLA formula is fixed by law and tied to the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). Yes Virginia, there is way more that on "price index". The CPI-W is measured from the 3rd quarter of one year to the 3rd quarter of the following year. Basically, the difference between the two is the COLA. The SS formula also determine military retired pay COLA, SSI COLA and--I believe--Federal employee annuity COLA as well. This year, Congress passed, and the President signed a bill tying annual VA compensation and pension rates to the SS COLA formula. If the difference between the 2 years is zero, there is NO COLA. If the difference is negative--which is what is this year--there is NO COLA, but there is no reduction in benefits either. Some bad news, but some good news there. Not only can we expect no COLA this year, odds are there will be no COLA next year either under the SS formula. The reason is we are roughly 2% in the hole--CPI-W would have to rise 2% just to get us back to zero. The problem with any fixed index is that is doesn't necessarily account for your life and situation. For the past few decades, wages have remained stagnant (in real, constant dollars), some prices have gone up...others down. As we age, healthcare consumes an ever larger portion of the average retiree income, partly due to increased need for healthcare and partly because healthcare inflation outpaces CPI-W by a hefty margin. As someone mentioned earlier, it would take--literally--an act of Congress to approve a "payraise" in lieu of the annual COLA.

True, but DoD has the online DEERS/RAPIDS Site Locator: http://www.dmdc.osd.mil/rsl/owa/home. Search by either City/State/Zip. Search will provide the nearest DoD facility with online access to DEERS and the ability to issue ID cards (dependant, retired, etc.). Your closest "installation" may be a reserve unit, or guard armory.

First question is: when were you denied SC for sleep apnea? If it is within the past year, you can ask for a reconsideration. BUT, if you don't have an answer on a reconsideration before the end of the year, then file a NOD to protect your appeal rights. If you are close to the year expiring, just file the NOD. You'll probably need statement from doctor(s)--your PCP and the sleep doctor would be good--stating that "it is at least as likely as not" that your sleep apnea is related to your military service (i.e., "occured in" or "caused by"). You'll also want to review you C File to see what the C&P examiner said. Did your buddies use the VA Form 21-4138-Statement in Support of Claim? If not, did each add the certification? (I certify that the statements on this form are true and correct to the best of my knowledge). If not, they RO may have discounted them. If that is the case, I'd ask for new letters, adding the certification. Lets see, you were diagnosed 4 months after discharge, and no less that 5 guys wrote letters describing a key indicator of sleep apnea--stopping breathing. Yeah, I'd appeal. Lots of things get SC'd without evidence in SMRs...

Harry Your SMR--outpatient records only--went to the VA. You'll need to contact the NPRC in St Louis (http://www.archives.gov/st-louis/military-personnel/) and request Inpatient/Hospital treatment records and clinical notes. It would help if you provide the name of the hospital(s) and approximate dates. Good luck

cc: I acutally created an excel spreadsheet that does what the hadit calculator does--the advantage is I can save and update. The reason why ratings don't add up is "simple" and is why the spreadsheet is easy to build. You start off 100% ABLE and 0% DISabled So, add a 30% disability...you are now 30% DISabled, and 70% ABLE. Your next disability rated at 10% is now rated against your 70% ABLE rating: 10% of 70 is 7. 7+30=37 Another 10% disability is rated against your new ABLE rating of 63 giving you 6.3. Rounding gives 37+6=43 VA uses standard rounding convention: X.4 rounds down; X.5 rounds up. By the same token, 34% rounds down to 30%, while 95% rounds up to 100% (which is why the combined table stops at 95...95=100 due to rounding).

Actually, it's worse than you think. Prior to 1992, all records--personnel, health (SMR), and clinical records/notes--all went to the NPRS in St Louis. In 1992, the Army began sending personnel and health (SMR) directly to the VA, bypassing the NPRS, for safekeeping and storage. The other services followed suit, with the Coast Guard being the final service to begin sending records directly to the VA beginning in 1998. Clinical records--the inpatient hospital notes--are still submitted by the hospital to the NPRS. Since all new records go to the VA anyway, I doubt they send anything to the NPRS anymore--but that's just a guess. The upside is that the we don't have to wait for the VA to request and NPRS to locate and ship records when a claim as filed. Post shreddergate, maybe not a completely good idea. With service medical records available electronically, all services should be required to provide separating servicemembers with an electronic copy, along with a hard copy of any paper records.

Rhodesia File a request for SMC based on ED using form 21-4138. I would ask that the EED be set to when the VA began treating your ED. Also, any rateable complication of a SC disability can be SC'd as secondary to the SC condition and thus compensated. Like anything else, you have to connect the dots for the RO to folllow and show that the secondary condition was caused by the SC'd disability.

Matt 0% for hearing or 10% for anything will get you hearing aids from the VA...Like you, I have 0% for hearing and 10% for tinnitus. I have no idea what the VA issues for hearing aids. My son has one that we got privately. It's an over the ear model, but the newer ones are extremely small and light (hardly see it to be honest) with a virtually invisible, really tiny tube from the hearing aid to the little speaker (or whatever) that plugs into the ear. The crazy thing is the audiologist hooks the thing up to his computer (there is an incredibly small hole for the connecter) and reads usage data, and can reprogram the thing right there in his office. Oh, hearing is percentage rated, but its seems you have to be pretty deaf to get above zero--so I've heard, anyway.

Berta Amen and Amen...two problems with diabetes are denial and it's insidious nature--runaway high blood sugar is literally killing you, but with the execption of a few symptoms that can be passed off as the cost of aging, you feel fine. Until you don't, but by then a lot of damage has been done. Chuck

As long as our VA coverage is considered "creditable c As long as our VA coverage is considered "creditable coverage" at least as good as Medicare (not going there), then no, you would not be forced to enroll in part B. actually, you aren't forced to now, you just get penalized if you don't have creditable coverage when you finally do sign up. It keeps the freeloaders from saving their money, then signing up at the last minute when they finally need medical care and suddenly see the benefit of medicare coverage (thus saving the rest of medicare subscribers money). Everything I've read so far is that VA coverage will be a suitable substitute for medicare and any public option if there is one. Military Health Service has been able to bill private insurance for decades. It's a little known requirement that was ignored for years, but with health care costs spiraling out of control, hospital commanders have discovered a revenue stream to offset some of their cost. TRICARE aka CHAMPUS which was based on medicare will be creditable coverage should there be a public option. The government has longed billed other agencies for services. those of us around in the 70's and early 80's remember when there was no out of pocket cost while TDY for on-base billeting or "contract" hotels. Beginning in the 80's, that changed. No more contract hotels, and official travelers pay for billeting on base, then file for reimbursement. Believe it or not, airplanes away from home have to "pay" for fuel. It's a world gone mad. Anyway, billing medicare would (okay, should...this is the VA afterall) provide the hospital with additional revenue that they can use to improve (there I go again) service. I know, good luck. assuming it doesn't go to the hospital administrator's bonus, if the hospital gets $1M in its budget for patient services, and bills medicare for $300K, then the effect is a $1.3M budget. Better, it's a paper transfer within the government, so until they use it for something (a new doctor or nurse??), then it costs nothing. actually, I wouldn't mind the VA billing a private insurer as long as the policy had no lifetime limit--some do, some don't. medicare is run by contractors--as is TRICARE.

"question: do i [have] to have this doctor write something up about my condition and attach that to the 21-4138? or is the new MRI report, chiro visits, history, Rx's, good enough to put on the 21-4138 for an increase in SC for this particular condition?" Oops...sorry for missing this...since you have a VA doc, the VARO rater should have access. I would get a copy of the treatment record--especially for that day, did he downplay your condition in his notes, or just for you? If it is adequately explained in the treatment record, that should suffice, if not, see if the doc will either write a letter or make a stronger statement in the treatment record/notes. My wife has a slipped disc. Back in December, she aggravated it and the pain was so great she was bedridden, and ended up with 2 visits to ER/urgent care and round of painkillers. I finally got her to go see an orthopod--the best back guy in town. he took one look at her xray, told her she didn't need an MRI, she had a slipped disc and when it got so bad she litterally couldn't tolerate it anymore come in for surgery. Until then, try not to aggravate it. don't understand why he didn't fully explain what's going on, but if it's still at the "nothing we can do until it gets to the unbearable point where surgery is the only option" maybe he thought he was doing both of you a favor. I disagree, but hey, I don't have 4-years of medical school.

If you have a fasting glucose level from 100 to 125 mg/dL are considered to have impaired fasting glucose, which is an symptom of pre-diabetes. As John999 mentioned, FBG of 126 mg/dL or higher is considered Diabetes. Berta mentioned the HbA1c (or A1c) which measures the average of blood glucose over the previous 900 days or so. A1c is not used in diagnosis, but a reading over 6% is abnormal. 6.5% is the target goal for diabetic treatment. The all important question for you is, what is your fasting blood glucose? If you are pre-diabetec, you need to keep track. You won't know if you creep into the diabetic range. There are symptoms--read webmd or www.diabetes.org for more information on diabetes and pre-diabetes--but not everybody has all the symptoms and they can be subtle. Diabetes controlled by diet alone is worth 10%...add oral meds and you get 20%. Pre-D? bupkis Since you are, unfortunately, at greater risk for DMII, you need to keep checking.

Andrea...nothing is a lost cause First, your one year clock to file a NOD is about to expire! You have 1 year from the date the VA rating decision was mailed to you. Don't let that date go by! Second, http://www.warms.vba.va.gov/bookb.html will take you to 38 CFR on ajudication...scroll down to the "Ratings and evaluations; service connection" section and read 3.307 and 3.309. MS is presumptive SC for 7 years from date of seperation, so yes, you can get MS connected. You said your Fibromyalgia is secondary--secondary to what, Lupus? Pretty much any condition that is secondary to a SC condition can be SC'd. I wasn't sure if the Hyperparathyroidism, and Costochondritis were secondary to something as well. Either way, file a claim for the additional disabilities before your one year from seperation is up. You can send a letter, or (better) use VA Form 21-4138 (Statement in Support of Claim - downloadable from VA website) and attached post service treatment records. If you doctor will add a letter to help establish SC--even better. the trick is the wording: Is due to (100%) More likely than not... (>50%) At least as likely as not (50/50) -- and the min standard to meet the benefit of the doubt rule for secondary conditions, something that connects the secondary condition to the SC condition using one of the phrases above. for a non-secondary condition, same phrases, but stating it ...occured during (or as a result) of military service. http://www.warms.vba.va.gov/bookc.html will take you 38 CFR Book C -- Ratings Schedules. This, combined with your rating decision will tell you why you got the rating you have and what you need in order to meet the higher rating. Again, file this notice before your 1 year (from seperation) in order to be awarded back pay from the original date of claim. research...search hadit. take a look at the how to assemble a va claim site and the hadit site (not just the forums) for help in your claim. if you need help, find a good VSO that will work with you--pros and cons on having a VSO hotly debated, but having one may help you to begin with. Just remember, it's your claim and no one will work it as hard as you will. Get a copy of your C-File (your VA claim file containing everything--initial claim, exams, ratings, etc). Use form VA 3288 (Records Request). you may want to repost this question on the (VA Claims Research) Veterans Affairs Claims and Benefits Research forum...it gets the most traffic. Good Luck!

I agree, the prescription refill online is a great thing... I personnally would love to be able to access my records/labs/etc. via the web. For those of you concerned about having your records "online"--too late, they already are. The VA uses electronic records, which are kept in a database on servers which are available to any VHA computer, and to VBA computers as well. Myhealthevet (assuming it ever comes to pass) will just add you as an authorized user, allowing you to access your records--stored on computer servers--via a web interface. Any of you use online banking? Same thing. wheather you choose to signup for online banking or not, your bank account is on the bank's servers--your ability to access your accounts (or not) doesn't change that. someone's ability to "hack" your bank account, or VA medical records, is the pretty much the same regardless. Joe hacker isn't after your records, he's after the entire database.

blackbird Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months: 60% Tell the C&P examiner all about it in nauseating detail...but first, get a copy of your complete treatment record and hand-deliver or mail certified, return-receipt and keep a copy for yourself. If at all possible, get the treatment record to the VARO before the exam. for good measure, I'd take a highlighter and mark every entry where your doctor prescribed bed rest. If your doctor will write a letter, great. Give a copy to the C&P examiner and include with the treatment records provided to the VARO.

First, no it doesn't have to be secondary...you just have to follow the same rules as any other condition you are trying to get direct SC for--the biggest being the nexus which means evidence and medical opinion. I'm SC direct for OSA, but--fortunately for me--it was diagnosed while still in service and I began CPAP treatment over a year before retiring. You need statements--the more the merrier--that you snored. Better, if someone remembers you "snorting"--that is stopping snoring (and breathing) for several seconds then snorting (best description) when you finally started up again (essentially, you would be gasping for breath), that would help even more. While snoring is a symptom--the silence followed by gasping is pretty much a guarantee that you suffer from OSA, that and the daytime sleepiness. When you are younger, you can power through it; as you get older, it gets much harder. It would be a reach to get a doc to state even 50/50 that your OSA was caused by your service. However, he/she might be willing to state that the snoring--better, snorting and gasping for air--make it likely (50/50) that you suffered from undiagnosed OSA. Good luck

I suppose it depends on the RO, but I was SC'd 0% for hearing and 10% for tinnitus based on the same audiolgist C&P exam. If you had a job with hazardous noise exposure--in other words, exposed to acoustical trauma--the odds of developing tinnitus are much greater.

RayBob "The BDD is great because I am "supposed" to have my rating right when I am retired net June 1. Then, that gives me "plenty" of time to file an appeal on those things that I feel may have been rated low = all while still within my frist year after retirement. I undertsand that that first year is critical because it is easier to link to SC. After 1 year, you have a harder time." Just so you know, you will not have a rating the day you retire--it will take a couple of months. Having gone through the process (in Virginia): You will need to check out your medical & dental records and copy the entire file. A VSO will want to see it, the VA will need the copy to begin the BDD paperwork. Under BDD, the AF will give you your medical records shortly before you retire/seperate/start terminal leave. Again, just check them out--making sure they are up to date and deliver/mail to the VA (or VSO if you are using one). At outprocessing, you'll need to had the clerk a signed form letter (they should have a blank) stating that you are filing for VA benefits and will hand-deliver your records to the VA. Getting your original records to the VA ASAP is critical--they will start the BDD process with copies, but require the original to complete the claim. One good thing, if you are missing something from the electronic medical records system, your primary clinic can print out--I had several records printed over a year after retirement. You can either fill in the 21-526 or you can use VONAPP. VONAPPs advantage is that you are not space limited--it will create as many blocks for disabilities as you need. I "think" you can now submit VONAPP electronically for BDD; if not, you can print, sign and date. The VA will accept the printed VONAPP as a substitue for the 21-526 (looks different, but works just as well). I found it much easier to work the claim on VONAPP. READ your SMR and READ the ratings tables--understand what disabilities you have, what the VA calls them and how they are rated. Read the clinician's guide so you understand how the C&P doc will conduct the exam. The exam is a snapshot, but give them a snapshot of your worst day--not your best day. This is not your annual physical where you are trying to pass...so stop putting the postitive spin on whatever ails you (which is what we were trained to do for 20+ years, right? Hard habit to break). Read the M-21. Search the forum. Be specific...I'm still battling the VA over "heart arrhthymia", which is generic description, but not specifically in the ratings table--they SC'd, but rated at 0%. I should have specified what is actually in my SMR (SVT and PVC). Live and learn. Carlie is right--twice: double check what is in your SMR--particularly the conditions listed and the medications prescribed. Also, you only get one original claim. VSOs are helpful, that said, I filed my orginal claim on my own and was awarded 90% right out of the gate. I'm using a VSO now (Virginia Dept of Vets Services), but I still do most of the work myself. I wish I'd found hadit and fantiscbooks' site before I filed my original claim. By the way, each county nationwide has a county service officer--plenty of claims help out there, so DAV dropping the ball isn't a showstopper. Good luck chuck

First thing is--what diagnotics codes are you rated under for back strain and arthritis? Degenerative arthritis is under DC 5003 and rates either 10 or 20% based on X-Ray findings, but can be rated on range of motion. Lumbar strain is DC 5237, and is rated under the General Rating Formula for Diseases and Injuries of the Spine. IDS is DC 5243 and rates under either the general formula or the IDS formula with incapcitating episodes. DC 5241 is spinal fusion. Second thing--ask the doctor who did the surgery. I think what you want to claim is 5241 spinal fusion and/or IDS 5243, either will be rated primarily on range of motion (general formula). Will the surgeon write a letter explaining what he did and why it was necessary? That, plus your treatment records and MRI results (both the pictures and the radiologist's report) should be added to your claim--this is where you can ask to change your lumbar (back) strain to spinal fusion and/or IDS based on your diagnosis from your surgeon. with your treatment records, MRI and (hopefully) IME from surgeon, you may not need a C&P--however, since you've had surgery I wouldn't let them rate you based on the pre-surgery C&P. I said MRI, assuming you have them pre-op, but if you have anything post-op (MRI, x-rays) I'd add them as well. Anyway, that's what I'd do.

Yelloow#5 "9/11/2008: Service connection for sleep apnea is denied. Your service treatment records show did not evidence of treatment for or a diagnosis of sleep apnea during your military service" I don't know, but since they referenced your SMR it sounds to me like they denied a direct service connection to SA. If the claim were secondary to a SC condition, then it wouldn't matter if you were treated in service or not. Is there any Since they denied, then it's denied. Hopefully, they will readdress and see that you were trying to show how your SC condiltion (GERD) had worsened, by relating it to your SA (for now, a non-SC condition).-the GERD prevented you from benefiting from CPAP treatment since you couldn't tolerate the mask/pressure. Otherwise, you need to file a NoD to keep the claim alive and present evidence to SC the SA--either as direct or secondary to something. If you don't NoD before Sept 10th, then you'll have to reopen the claim at a later date, providing new & material evidence. Which, when you think about it, is exactly what you'd be doing anyway, you just want the clock to stop. "Would anything matter that the RO opened a claim as secondary but when I claim it would be a standalone diagnosis?" My gut feeling is no...but perhaps someone with more experience could weigh in on this; but again, reading the post below, I really think the VA denied a direct SC. chuck

Put another way, if you don't file, the answer is no...they can't say yes unless you ask.