[1151 Hbp Award Letter]

Berta,

Good job - you hit another target !

[Im Sc 100% & Smc/s Over 10 Yrs- Varo Just Requested A C&p]

I'm just in hopes everything goes as stated and I don't

wind up getting some crazy paperwork stating . . .

A C&P was scheduled, you did not attend, benefits are reduced.

I wish I could laugh at that - but I know better.

[Official Request For Reconsideration At Varo Level]

I believe new instruction has been written that supports and

provides for an Official Request for Reconsideration

at the VARO level.

I am having computer problems and can not copy and paste

right now, so perhaps someone can pull the info up and post it here.

It is

M21-1,PartIII,Subpartii,Chapter2,SectionG

1. Request for Reconsideration

Change date - March 24,2015.

Hope this helps a veteran / claimant.

[Ive Looked But Cannot Find It .]

I need to find the M-21 version that states , p&t should be awarded when a condition has been static/ chronic for 5 yrs or longer.

Putting in for p&t coming up on 6 yrs of no change . My psych DR wrote a letter stating I have been suffering from ptsd for the past 15 yrs .

diagnosed and connected almost 6 yrs ago . Recently won appeal back to 2009 for TDIU .

Her last paragraph reads : Opinion : It is my opinion that Mr Marine has been unemployable since atleast his hospitalization in 2009, if not before,

due to the severity of his psychiatric conditions. Letters I have written in his support since May 2011 have consistently documented my belief that his psychiatric conditions have resulted in total occupational and social impairment,and rendered him unemployable. Even with continued treatment , his conditions of PTSD and related disorders , OCD AND MAJOR DEPRESSIVE DISORDER ARE NOT LIKELY TO IMPROVE IN THE FORESEEABLE

FUTURE. Therefore , in my opinion , his disability continues to be TOTAL AND PERMANENT.

Signed Dr PHD

PTSD SPECIALIST / ADDICTION SPECIALIST

I do not remember reading the above in M21 but maybe this 38 CFR reg

will help.

http://www.ecfr.gov/cgi-bin/text-idx?SID=1b7d33b57d85b0e56b01cd129e1f4b15&node=se38.1.3_1340&rgn=div8

§3.340 Total and permanent total ratings and unemployability.

(a) Total disability ratings—

(1) General.

Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. Total disability may or may not be permanent. Total ratings will not be assigned, generally, for temporary exacerbations or acute infectious diseases except where specifically prescribed by the schedule.

(2) Schedule for rating disabilities.

Total ratings are authorized for any disability or combination of disabilities for which the Schedule for Rating Disabilities prescribes a 100 percent evaluation or, with less disability, where the requirements of paragraph 16, page 5 of the rating schedule are present or where, in pension cases, the requirements of paragraph 17, page 5 of the schedule are met.

(3) Ratings of total disability on history.

In the case of disabilities which have undergone some recent improvement, a rating of total disability may be made, provided:

(i) That the disability must in the past have been of sufficient severity to warrant a total disability rating;

(ii) That it must have required extended, continuous, or intermittent hospitalization, or have produced total industrial incapacity for at least 1 year, or be subject to recurring, severe, frequent, or prolonged exacerbations; and

(iii) That it must be the opinion of the rating agency that despite the recent improvement of the physical condition, the veteran will be unable to effect an adjustment into a substantially gainful occupation. Due consideration will be given to the frequency and duration of totally incapacitating exacerbations since incurrence of the original disease or injury, and to periods of hospitalization for treatment in determining whether the average person could have reestablished himself or herself in a substantially gainful occupation.

(b) Permanent total disability.

Permanence of total disability will be taken to exist when such impairment is reasonably certain to continue throughout the life of the disabled person.

The permanent loss or loss of use of both hands, or of both feet, or of one hand and one foot, or of the sight of both eyes, or becoming permanently helpless or bedridden constitutes permanent total disability. Diseases and injuries of long standing which are actually totally incapacitating will be regarded as permanently and totally disabling when the probability of permanent improvement under treatment is remote.

Permanent total disability ratings may not be granted as a result of any incapacity from acute infectious disease, accident, or injury, unless there is present one of the recognized combinations or permanent loss of use of extremities or sight, or the person is in the strict sense permanently helpless or bedridden, or when it is reasonably certain that a subsidence of the acute or temporary symptoms will be followed by irreducible totality of disability by way of residuals. The age of the disabled person may be considered in determining permanence.

© Insurance ratings. A rating of permanent and total disability for insurance purposes will have no effect on ratings for compensation or pension.

[26 FR 1585, Feb. 24, 1961, as amended at 46 FR 47541, Sept. 29, 1981]

[Im Sc 100% & Smc/s Over 10 Yrs- Varo Just Requested A C&p]

UPDATE,

I'm still in shock and can now personally verify that an email to

Allison Hickey helped me with a problem, in a timely and efficient manner.

I believe broncovet may have hit the nail on it's head in his post, because

the VARO staff that called me this morning stated that the C&P exams were

requested, due to a VAMC hospital admission I had in April 2014, to see if

any increase in my current evaluation, would be warranted.

Below is exactly what went down.

(BTW - the 1st of the two phone calls came in to me at 7:45 am.)

"Allison and XXXXXX,

Wow - I am stunned and impressed !

I was contacted by both the Bay Pines VAMC,C&P department and a staff member at

the St Petersburg VARO this morning.

I was told by the VARO staff member that the C&P request was due

to a Bay Pines VAMC hospitalization admittance I had, in April 2014.

I was told by both callers that two C&P's had already been scheduled

for April 9,2015 and they have now been cancelled by the VARO.

I was also told I would receive a letter in the mail stating these appointments

have been cancelled.

Yea !

Now another veteran can fill those two time slots for their C&P.

I am amazed and truly appreciate your help on this issue.

Thank you.

Sincerely,

astressedoutvet"

So, for the record I feel there is something in the VARO computer program

that triggers action when there has been an admission, to a VAMC hospital.

jmho

Again, thanks to all.

Hopefully down the road, other's might read this thread and maybe this can

help them too.

[Im Sc 100% & Smc/s Over 10 Yrs- Varo Just Requested A C&p]

Thanks again to all for the encouragement.

Berta - seems like it never ends.

Being that I have absolutely no claim issues in process or under appeal,

there would be NO justifiable reason for anyone at the VARO even taking a

look-see at any of my medical records.

I mean, I do think they are supposedly so busy handling the backlog and current

claims - to be just poking around reading random medical records without any reason

to trigger such an exam.

Even at that I'm pretty darned sure that all of my medical evidence of record

only continues to support the evaluations I have.

Heck the effective date of my SMC/S is back to 2004, that's a bit more than

10 years and I am over 55 years old.

Anyways, I've been just trying to make it thru today, waiting to hear more from either

of the two that emailed me or one of their staff members.

As of this moment I have heard nothing further.

Maybe tomorrow will be a better day and hold more information / answers for me.

Again, I will update as soon as I find something out.

Thanks again to all for your kindness, encouragement and support.

[Veteran Charged With $800,000 In Fraud Of Disability Benefits.]

I think we should give him a fair trial . . . and then hang him!!!!

pr

I'll be glad to donate the rope !

[Im Sc 100% & Smc/s Over 10 Yrs- Varo Just Requested A C&p]

Oh what a crummy night I had - up and down about every 45 minutes.

I hope this stress doesn't put me in the dang hospital.

[Brown Envelope]

So I received the infamous Brown Envelope today. I read many talk about future reevaluations in their paperwork, but I cant seem to find anything stating dates except for date disability went into effect. Am I overlooking something or is there more paperwork to come?

The decision letter will not state when you will be scheduled for re-examination, just that a future examination will

or will not be scheduled.

If one is to be scheduled it's usually 2-5 years out, but sooner if it was a temporary evaluation

such as after surgery.

jmho

[Veteran Charged With $800,000 In Fraud Of Disability Benefits.]

Sure sounds to me like this guy was a fraud and tarnishes / stains

the truly disabled.

I personally am glad the truth has come to light and hope he receives

swift and just punishment.

When I go to my VAMC, I continue to work hard on trying to NOT

judge other's.

I am not a doctor and do not know the other persons conditions

and medical evidence of record.

It's the VBA's job to adjudicate disabilities, not mine, as I have not walked in the

other veteran's shoes.

Even tho we know for sure that there are fraudulent claims made, let's try to be kind

to all veteran's until we are shown that they are not deserving of our kindness and compassion.

jmho

[Im Sc 100% & Smc/s Over 10 Yrs- Varo Just Requested A C&p]

Thanks for the reply's.

There is NO reason nor regulatory justification for any additional C & P exam, for me.

There is nothing that would warrant an increase in compensation,

a higher level of SMC or any additional benefit.

All of my SC'd conditions are of record as being static in nature and I am

over 55 years old.

I'm thinking this is just a waste of resources that another veteran could benefit from.

I will update as I get information.

[Im Sc 100% & Smc/s Over 10 Yrs- Varo Just Requested A C&p]

Well - I think I might be going into SHOCK !

I have already received two emails in reply.

1) from Alison stating she is going to ask the St Pete VARO

director, why they are asking for another appointment

and

2) from the director of the St Pete VARO stating her name,

her position at the VARO and,

" will look into the issues you raise and have someone from my staff contact you to explain."

So . . . for now I will look forward to being contacted.

Hopefully, this exam for me is not really needed and another veteran will get the opportunity to

have their C&P exam scheduled, thus helping to reduce the backlog.

My anxiety is not gone at all but I feel a bit less apprehensive in just getting such a timely response.

I will update as I get more information / answers.

Maybe some things are really going to change, for all VBA claimants, I sure hope so.

Hang in there.

[Im Sc 100% & Smc/s Over 10 Yrs- Varo Just Requested A C&p]

Well, I just sent out this email and sure hope I get a helpful reply.

If I do not have a reply by Friday morning I am going to my VA Regional Office

in person and try to get to the bottom of this.

carlie

Under Secretary
Veterans Benefits Administration
U.S. Department of Veterans Affairs

March 31,2015

Your Honorable Allison A. Hickey,

My name is Carlie. I am an honorably discharged US Army veteran.

I am in receipt of service connected disability at the 100 percent rate along with SMC/S, adjudicated to be permanent and total by both the Social Security Administration and the VBA.

Service Connected conditions by the VBA are as follows:

Major Depressive Disorder 100%, effective date March 23, 2004

Seizure Disorder 40%, effective date 1978, day following separation

Impaired Hearing 0%, effective date over 10 years

Bronchitis,Chronic 60%, effective date over 5 years

Degenerative Arthritis of the Spine 30%, effective date over 5 years

Ear Disease 10%, effective date over five years

Superficial Scars 0%, effective date April,26 2005

Traumatic Brain Disease 10%,effective date over 5 years

Bursitis 0%, effective date over 5 years

Tinnitus 10%, effective date over 5 years

SMC/S, effective date March 23,2004

DEA & Chapter 35 benefits granted, effective date 2004

Full Commissary and Base Exchange privileges, etc.

ALL of the above conditions are of record with my VAMC and Vet Center,as being static in nature, with no improvement for over ten years.

Today I had an appointment at Bay Pines VAMC, with my psychiatrist.

While I was in this appointment I received a telephone message stating,

"Ms Carlie this is XXXXX calling from the Compensation and Pension Department here at the VA. We've received a request from the Regional Office to get you scheduled for an evaluation for your service connected disability. If you could please call me as soon as you receive my message, my number is XXX XXX XXXX, extension XXXXX. Thank you."

I listened to the message above as I was walking from my psychiatrist appointment, to the hospital next door for a thyroid ultrasound appointment.

I then came home and called my psychiatrist and am waiting for a return call.

I need your help as I feel this unneeded and unjustified C&P examination, is just plain emotional torture from the St.Petersburg, Fl. VA Regional Office.

I have no claims open for additional benefits or claims that are in process or under appeal. All of my prior claim issues are of record as being fully satisfied and closed.

I can not understand this additional C&P examination request made by the St.Petersburg VA Regional Office. I feel that this is doing nothing wasting resources another veteran could be utilizing and traumatizing me and probably many more veterans that are already sick, physically, mentally and of the VBA process as a whole.

I already have concerns and horrible anxiety in even attending yet another additional C&P examination.

All that needs to happen is that I get assigned a C&P examiner that's in a foul mood, got a ticket on their way into work, has their own stress such as a sick child or family member and BOOM !, I get a letter stating my benefits are revoked.

This really should not happen as I have received continuity of care from Bay Pines VAMC and St. Petersburg Vet Center, for decades.

As I stated, this should not happen, but knowing what I do know, I do know that it is a big possibility.

So here I sit with my anxiety at a very high level, getting ready to take some of my VAMC RX's anxiety medication's.

I ask this, at a time when there continues to be a huge back log, VBA and VHA are under the gun so to speak, with the media on a daily basis, when resources are limited . . .

WHY, is the St.Petersburg Regional Office, requesting this additional C&P exam.

Going by the regulation below, they should not be requesting this examination, so about all I can conclude is they want to torment veterans.

Is it possible for you to help me with this situation.

The last four of my social are XXXX.

My phone number is XXX XXX XXXX.

My address is:

Carlie

XXX - Helpavet Ave

Sinkingin, XX. XXXXX

This issue is time sensitive.

Thanks you for any help or direction you might be able to provide.

Carlie

38 CFR - Clearly states:

§3.327 Reexaminations.

(a) General. Reexaminations, including periods of hospital observation, will be requested whenever VA determines there is a need to verify either the continued existence or the current severity of a disability. Generally, reexaminations will be required if it is likely that a disability has improved, or if evidence indicates there has been a material change in a disability or that the current rating may be incorrect. Individuals for whom reexaminations have been authorized and scheduled are required to report for such reexaminations. Paragraphs (b) and © of this section provide general guidelines for requesting reexaminations, but shall not be construed as limiting VA's authority to request reexaminations, or periods of hospital observation, at any time in order to ensure that a disability is accurately rated.

(Authority: 38 U.S.C. 501)

(b) Compensation cases—(1) Scheduling reexaminations. Assignment of a prestabilization rating requires reexamination within the second 6 months period following separation from service. Following initial Department of Veterans Affairs examination, or any scheduled future or other examination, reexamination, if in order, will be scheduled within not less than 2 years nor more than 5 years within the judgment of the rating board, unless another time period is elsewhere specified.

(2) No periodic future examinations will be requested. In service-connected cases, no periodic reexamination will be scheduled: (i) When the disability is established as static;

(ii) When the findings and symptoms are shown by examinations scheduled in paragraph (b)(2)(i) of this section or other examinations and hospital reports to have persisted without material improvement for a period of 5 years or more;

(iii) Where the disability from disease is permanent in character and of such nature that there is no likelihood of improvement;

(iv) In cases of veterans over 55 years of age, except under unusual circumstances;

(v) When the rating is a prescribed scheduled minimum rating; or

(vi) Where a combined disability evaluation would not be affected if the future examination should result in reduced evaluation for one or more conditions.

© Pension cases. In nonservice-connected cases in which the permanent total disability has been confirmed by reexamination or by the history of the case, or with obviously static disabilities, further reexaminations will not generally be requested. In other cases further examination will not be requested routinely and will be accomplished only if considered necessary based upon the particular facts of the individual case. In the cases of veterans over 55 years of age, reexamination will be requested only under unusual circumstances.

Cross Reference: Failure to report for VA examination. See §3.655.

[26 FR 1585, Feb. 24, 1961, as amended at 30 FR 11855, Sept. 16, 1965; 36 FR 14467, Aug. 6, 1971; 55 FR 49521, Nov. 29, 1990; 60 FR 27409, May 24, 1995]

[Not Sure How I Feel About 50% Rating For Sa]

LOD = Line Of Duty.

Any medical conditions that arise during active duty or a result of

active duty, should be service connected and the veteran provided with

compensation and full medical care for those conditions.

That alone is the justification for it.

jmho

[Prepare For Bva Hearing]

Paul,

Your profile here shows currently service connected at 50%.

What condition/s are SC'd already ?

[Ptsd C&p Exam Results]

It would be best for you to repost this as a NEW POST please.

Thanks

[Everything Got Denied!]

So far - to me this just sounds like it will be a meeting with some

VBA staff members, not a DRO hearing or anything like that.

Perhaps you can get some things cleared up.

Good luck.

[Duplicate C&p Medical Appointments?]

Hi everyone. I've been a lurker here for a long time and I have learned a lot of information that has kept me sane (mostly!) during the claims process. I filed my claim in November 2013, a month after I separated. Before I separated, a medical board was done and I was rated at 80% by the VA for sleep apnea, depression, sciatica, tracheotomy scar and maybe something else that I am forgetting. I was also rated at 0% for a few things. Because my separation was a regular separation and not a medical separation, I had to start a whole new claim with the VA and start the process from scratch. This is the short version of a very long story.

In January of this year my claim moved from "Under Review" to "Preparation for Decision." After it was in the PFD phase, I received a letter from the VA listing 2 C&P appointments for March 31st, one for the physical conditions and one for the mental conditions. Today I received a call from "QTC" stating that they are a contractor for the VA and need to schedule me for a physical appointment and a psych appointment for my C&P claims. My immediate thought was "why would they schedule me twice for the same thing?" Or is the VA maybe looking at some conditions at one appointment and other conditions at another appoinment? Also, why would I have C&P appointments after my claim is in the PFD phase? The only contentions in my claim are the same ones that the VA rated in 2011.

Forgive me if this is too long. I thought I was nearing the end of this journey, but now I am thinking that I still have a while to go.

Thanks for your help.

Jeremy

Anytime a C&P is scheduled - show up for it, as missing a C&P exam is one of the

worst things one can do.

jmho

[Going To A C&p Exam, What Are The Does And Dont's]

Good Morning to Everyone,

I am due to go to my C&P this week and I am curious as what to expect when I go through this exam. Yes, this is my first time of a C&P. I also want to know what are the should do and should not do at this exam. I want to know what I am in for and what can I expect from the results. I must admit that I was surprise to get a C&P. I was denied my request for increased benefits a year ago, so I put an appeal in for my injuries. I guess this is in response to that appeal and I pray that they finally discover the issues I am having.

Thanks for your attention,

John

Here's a link for C&P exams, do's and Dont's:

http://www.hadit.com/things-to-do-at-your-va-compensation-and-pension-exam/

Here's some additional link's you might want to read:

http://www.hadit.com/a-veterans-benefits-raters-view/

http://www.hadit.com/veterans-affairs-claims-process/

And you might want to study at the following link posted in the first

post by broncovet, at this link:

[Nvlsp Common Va Errors For Increase]

On 12 February, 2015 I was sent back for neuropsychological testing which ranges from severely impaired, moderately to severely impaired, mild impairment, low average to borderline, low average, average to low average and average. If I'm jumping around I apologize.

Z,

Please pick a forum that your question fall under, probably the Claims Benefits Research forum,

start a new topic with a title and post your info and questions there.

Thanks

[Everything Got Denied!]

I missed the exam because 1) never got the letter 2) It would be VERY easy for me to forget. My memory problems are well documented.

1) "never got the letter" - let them know that. Also, you can call the 800 - don't know much number,

every week and check your scheduled appointments. I think I even remember calling my VAMC

and asking for the C&P department each week and checking with them.

2) "It would be VERY easy for me to forget. My memory problems are well documented."

That won't cut it. Plus, being that you are not SC'd for a TBI or MH issues, they won't look into

your records much for memory problems.

You have to keep up with everything to fight/argue your claim issues.

Missing a C&P is a big set back.

Try to make some calls and submit your paper work to get things rolling ASAP.

Hang in there.

jmho

[Everything Got Denied!]

I was wondering. Could i do a claim like gout second musculoskeletal system as per http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&sid=c130ec487ea61b8a40ad0836188b94bc&rgn=div5&view=text&node=38:1.0.1.1.5&idno=38#se38.1.4_171 Any thoughts?

(Yes, the VA says I have gout.)

Personally, with all the claims issues you currently have going on,

I would not file for any more conditions until I filed a NOD and requested

to have C&P exams re-scheduled.

[It's The Small Things, Nod Received]

I agree, anytime VBA even acknowledges receipt of something

we sent - that's a small success. These help us hang in there.

[New Va Form 21-0966]

I believe they will still want additional forms such as a 21-526, etc... as below.

"The update has three major components:

 It standardizes the traditional informal claims process by employing a new standard form,

VA Form 21-0966, Intent to File a Claim for Compensation and/or pension, survivors pension, or other benefits,

which an individual or his or her representative can submit in order to establish a potential effective date for benefits while they take up to a year to gather the evidence necessary to support the claim.

 The intent to file form may be submitted in one of three ways:

1) electronically via eBenefits or the Stakeholder Enterprise Portal,

2) on the paper form mailed to VA, or

3) over the phone with a VA call center or other public contact representative.

 The updated regulations allow VA to award increased benefits retroactive to the date of medical treatment

as long as the intent to file form is filed within 1 year of the treatment and the required claim form is filed

within the year after that.

It mandates use of specified forms designed to capture information necessary to identify and support compensation, pension, and other benefit claims. 

Compensation claims may be filed online through eBenefits, or submit VA Form 21- 526EZ, Application for Disability Compensation and Related Compensation Benefits, on paper.

 Pension claims must be filed on VA Form 21-527EZ, Application for Pension.

 Survivors claims for dependency and indemnity compensation (DIC), survivors pension, and accrued benefits must be filed on VA Form 21-534EZ, Application for DIC, Death Pension, and/or Accrued Benefits.

 It mandates use of a standardized notice of disagreement form in most cases when a claimant wishes to initiate an appeal of a VA decision.  Veterans initiate appeal of a decision with which they disagree by explaining their disagreement on VA Form 21-0958, Notice of Disagreement. Veterans, survivors, and their representatives currently use the form on an optional basis."

[Success]

THANK GOD !! The Bbe came in today ,thanks for each and everyone of the members of Hadit.com . I just didn't what to say but THANK YOU!! Here is the order in the decision.Scan0222.pdfScan0223.pdfScan0224.pdfScan0225.pdf

Great to read of positive adjudication and that BVA, SC'd your PTSD and headaches.

I noticed there are no evaluation levels shown and that most likely will need to be done

by your VARO with either (current to date) medical records or the need for an additional

C&P or two.

Depending on the effective date/s adjudicated this may also need to be done in

staged ratings for evaluation level.

This means the VARO would go thru your medical evidence of record to see adjudicate something like:

EXAMPLE ONLY:

PTSD - effective date of SC XX/XX/2009.

Evidence of record on XX/XX/2009, shows veterans symptoms of XYZ from PTSD warrant an

evaluation of 10 percent.

Evidence of record on XX/XX/2011, shows veterans increased symptoms of XYZ from PTSD

warrant an evaluation of 30 percent.

Evidence of record on XX/XX/2013, shows veterans increased symptoms of XYZ from PTSD

warrant an evaluation of 50 percent.

And then they may need some evidence up to current date.

The same goes with the headaches.

Be sure to check out the DC used for your headaches - I think it will be DC 8100

but check it against the schedule to be sure you have the correct evaluation to go

along with the medical evidence of record.

If you have direct deposit keep an eye on your bank account.

If you have a premium ebenefits account you might check it say

once a week or so for more info such as the letter generator, AB8, etc....

Congrats, just keep waiting a bit longer for more answers.

jmho