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Without treatment records from the time you separated from service to the present, there is nothing to show "chronicity". Apparently, the Service Medical Record showed a one-time event and you recovered with no problems, particularly since X-rays at that time were negative.
It's like the troop who had a knee strain in service and applied for service connection over Ten Years After (great group BTW). While he claimed that the knee strain had devastated his life (really, he did!), there were absolutely no following treatment records for any knee condition, that is, until he had an work-related accident at his work place and heavy boxes fell on him - five years after separation.
I have poof of it happening while i was in the army. And we submitted a claim back in 2010 and they denied my claim. Here in the article. Then we appealed the claim as soon as they denied it.As of today i am about to go for pyshical therapy because its getting to bed where i can sleep at night and/or move around threw out the day.And im only 30. Thanks for your help.Service connection for lumbar degenerative disc disease claimed as lower back.
Your service treatment records noted an injury to your back in service. X-rays of the spine were taken on October 7, 2002 after you complained of tenderness over the T10 T12 after trauma. The x-ray was normal. Your separation examination noted a "normal" spine and there were not complaints voiced by you at the time concerning your back and/or spine.
At the recent VA examination conducted on February 1, 2011 you complained of pain stiffness, weakness, and fatigability. You stated that you had an injury to back in the service when he went to stand in a tank and the tray where ammunition is loaded hit you in your back. You stated that you had mild problems afterwards, but notice more problems when you worked for the prison system from March 2009 to August 2010. You noted that with prolonged standing for a few hours as well as with sitting while driving for a few hours, you would feel low back pain. Lying down will help this. You saw a private provider and was scheduled to get therapy before trying back injections. You have numbness in the right leg to the foot that would occur with the back pain flare ups but currently you denied any numbness. You also start limping during a flare-up. The pain is located across the lumbosacral area and does not radiate. You are able to walk normally without any assistive device. This condition has no effect on your usual occupation. You are able to perform all activities of daily living. Range of motion of the lumbar spine: forward flexion: 0 to 90 degrees without objective evidence of pain; extension: 0- 30 degrees without evidence of pain; right lateral flexion: 0-30 without objective evidence of pain; left lateral rotation: 0-30 degrees without objective evidence of pain. There was no additional limitation of motion following 3 repetitions. The examiner stated that on exam today, there was no objective evidence of painful motion, spasm, weakness, or tenderness. You denied any incapacitating episodes in the past 12 month period. Strength was 5/5 in all muscle groups of the upper and lower extremities. Straight leg raise negative bilaterally,. Sensation to light touch was intact in the upper and lower extremities. DTR's: 2+ bilaterally, babinski negative. MRI of the lumbar spine dated June 29, 2010 noted mild bulging of the annulus at L4/L5 may abut but does not displace the exiting right L4 nerve root. The diagnosis provided by the examiner is lumbar degenerative disc disease. The examiner opined that this condition is less likely as not caused by or related to veterans service. There was no evidence found of periodic treatment for low back condition continuing from service. No low back condition was noted on exit exam from the service.
A disability which began in service or was caused by some event in service must be considered "chronic" before service connection can be granted. Although there is a record of treatment in service for pes cavus claimed as right foot condition, no permanent residual or chronic disability subject to service connection is shown by the service medical records or demonstrated by evidence following service. Therefore, service connection for lumbar degenerative disc disease claimed as lower back is denied.
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See, this is why Rating Decisions can be such fun ... documentation coming in multiple times, out of order, and so forth.
My assessment is made without review of your Service Medical Records ...
I'd defer a rating for TBI (spinning) and PTSD to deconflict the symptoms. Note: the TBI diagnosos was made by an audiologist and I want a neurologist's evaluation here. My quick review of the various examinations showed overlap in symptoms of TBI and PTSD.
Solicit a claim for a few other conditions.
Based on what I believe you claimed, my evaluation (exclusive of TBI and PTSD and the solicited items if you choose to formally claim them) would be in the 60% range. Again, that's what I'd do without the benefit of review of your Service Medical Records.
Thank you all for all your help I hope this helps some.
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I'd like to address why you believe your rating will be reduced ...
Do you have reason to believe that the VA will propose to reduce one or more of evaluations sometime in the future? Do some of your issues on your Rating Decision have a statement similar to: ... as this condition may improve, a future examination has been ordered ?
Is there a statement somewhere on your Rating Decision or notification letter to the effect of his rating is permanent and total ? Note: despite this statement, permanence really doesn't exist until that magic 20 year point (other than amputations, LOU, etc). ref: 38 CFR 3.951(b) http://www.benefits....ART3/S3_950.DOC
FYI, the rule on reexaminations is 38 CFR 3.327 http://www.benefits....ART3/S3_327.DOC .
The rule on Revision of Decisions for compensation is at 38 CFR 3.105(e) http://www.benefits....ART3/S3_105.DOC .
The rule on Reductions and DIscontinuances (Veteran) is at 38 CFR 3.501(g)(2) http://www.benefits....ART3/S3_501.DOC
Note: I cannot provide a citation at the moment to support the following, but ... an evaluation based on a re-examination if the reexamination findings are the same as were used to assign the original rating. (yeah, I know, that was really badly written). What I'm trying to say, I guess, is that if a particular medical finding(s) was/were used to support a particular evaluation (even if over-generously), and that the same finding(s) existed on re-examination, I can't propose a reduction. (that wasn't much better, but I hope you get my drift).
I am awarded 100% Sc however if VA for some reason reduce my claim to say 70%, can I immediatly file for TDIU? if so how long and what are the critieriasto file?
vet2010
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I am not trying to tell you or convince you to do anything ... but I believe it will be difficult if not impossible to overcome dateof receipt of claim from 38 CFR 3.400 (a)(b)(2) http://www.benefits....ART3/S3_400.DOC .
Unless there is some kind of record within your claims file noting your attempt from that date (38 CFR 3.400(a), I can't see where you have a claim for an earlier effective date. I have seen some Board of Veterans Appeals (BVA) Decisions which in many ways are similar to your situation and the BVA would not award an earlier effective date.
Unlike what most posters here fervently believe (or fervently need to believe), not everything the VA does is a Clear and Unmistakable Error (CUE). I'm not saying that whatever is done is always equitable or fair by your lights, but that it may be legal.
I don't see your local VA Regional Office (either the Rating Veterans Service Representative or Decision Review Officer) agreeing to the earlier effective date. While I personally don't believe that the BVA will support an earlier effective date, I have seen the BVA do some pretty screwy things, and based on some pretty tenuous evidence at that.
It is the veteran's right and choice whether to file any claim or disagree with any decision and you are entitled to request an earlier effective date. However, since there was no decision based on your interview in 2002, you can't have a CUE. Again however, for lack of a better term, I don't know what to call this so you might as well claim a CUE if you proceed.
(snip)
Interested, No I went to the va to file a claim when i first got out and the VA rep told me i didnt have a chance at winning, so i never persued it until july 1, 2010.And was granted SC asthma. Come to find out the guy that told me i didnt have a chance was about to retire and didnt really want to work(I have a family member that works in the office).
Thanks Mark
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Did you file a claim for service connection for asthma when you were boarded out of the military?
When did you file your first claim for asthma?
Back in 2002 i went to Walter Reed and was medical boarded out and was told "because i had asthma as a child, i was ineligible"....my question is... i recently in, 2010, got 30% awarded for SC asthma. and they only gave me backpay when i filed the claim, but should it go back when i went in front of the medical board in Walter Reed? thanks for all the info!
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Based on what you wrote in this and your earlier messages, and a little knowledge of the Rating Schedule, it's not likely that the bilateral factor has any bearing in this situation. Unless, of course, there's something else ....
My 40% in 2000 was for chronic low back syndrome. It was increased to 50% in 2003. Not sure how the bylateral factor work on this.
Thanks
Ray
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Each bit of information makes this clearer ... almost like having full access to your claims file and being able to read it. In any event, based on what you've written, I presume you are a boots-on-the-ground Vietnam vet; you have been diagnosed with CAD/IHD; and, you initially filed a claim for service connection for CAD/IHD in 2002 (or have an implied claim from that date); your claim was resurrected (or transferred for processing under Nehmer); and, you are potentially eligible for retroactive disability compensation under Nehmer from sometime in 2002 .... am I correct, more or less?
Anyway, it is still not clear to me whether you have received a Rating Decision based on the disputed examinations/information from 2008 and 2009. Have you already received that Rating Decision? If so, a NOD is the way to go. If not, you have nothing to disagree with - yet.
However, your situation would not be a Clear and Unmistakable Error (CUE) because a CUE is a mis-application of the laws. From what you wrote, it appears to me that the laws, based on the evidence at hand, were applied properly. So, the NOD is the better way to go.
FYI, a C&PE is in most cases but a snapshot of a veteran's condition at that moment. Again in most cases, unless a Rating Veterans Service Representative (RVSR) has something else that states that those examinations were invalid, the RVSR still has to go with the examinations; otherwise, the RVSR would be supplying his/her own medical diagnosis. So, unless that C&PE from 2011 mentioned that those examinations were invalid, I'm afraid that the examinations likely will stand. With those erratic exams, an RVSR likely would: (a) have to rate the claim with the evidence at hand; or, (b) delay the claim even longer by sending the claims file back to the last examiner to state whether the previous two exams were valid/invalid; or, © do some fancy footwork to state why the disputed exams were invalid; again, this verges on supplying a medical opinion.
FWIW, when a nurse practitioner (CNP) says something that is in the veteran's favor, that CNP is caring, compassionate, and really knowledgeable. If the CNP states something negative, or with which the veteran disagrees, the CNP is superficial and incompetent.
Than You for the responds.
The 2 C&P were by nnew Nurse and lasted about 20 minutes. That is why I disputed them and when they scheduled the new C&P in Janurary 2011 it shower the correct LVL and METS, which matched in 2000. As you can see in the decision the VA stated the LVL was 48% in 2000.
I will file a NOD. I will keep searching here on the site to see if I can find how they apply medical evidents on a claim that is 11 years old.
Thanks for your advise and any other input would be great.
Ray
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Gee, the silence is deafening ...
First, is this a recent Rating Decision? What was the date on the notification letter? If the Decision is dated within the last year, a Notice of Disagreement (NOD) would likely be better - and perhaps quicker - than filing a Clear and Unmistakable Error (CUE). Unless of course, ya just gots ta' have a CUE to fulfill some inner need.
If everything actually is as you wrote, and all the alleged medical evidence is of record in your claims file, this is how the evaluation for coronary artery disease (I presume) should run:
2002-2008 : 60% because of EF between 30 and 50%.
2008-2009: Reduced to 10% because of METS greater than 7 but not less than 10.
2009: Reduction to 0% because of METS greater than 10.
2010: Increase to 60% because of METS greater than 3 but less than or (or, EF between 30 and 50%)
While I admit your medical findings are all over the chart, you'd need some other evidence to countervail or overcome the C&P examinations from 2008 and 2009 that you dispute. You might need your own Independent Medical Opinion (IMO), based on a review of all your treatment records, that those C&Ps were invalid.
As for Would a rating in 2000 that show 40% and a new award at 60% no bet = 78% , the actual number depends upon whether that 40% is a single 40%: several disabilities that combine to 40%; whether the bilateral factor comes into play, and so forth. However, almost any way you compute it, the number is 75% or greater, which rounds up to 80%.
If you have an enjection fraction of 48% in the year 2002. Would not your rating be 60%.
The VA rated me 10% retro for 2002 based on a C&P in 2008 that guest MET at 10,C&P in 2009 that quest MET at 11 and last C&P in 2010 that show MET at 5 and injection fraction at 50%
I would think it would be 60% based on the injection fraction in the year 2002, not some C&P in 2008-2009 that I disputed.
Would a rating in 2000 that show 40% and a new award at 60% no bet = 78%
Thanks
RDT
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Frankly, your situation does not occur that often ...
However, rather than guess or expostulate whether this gentleman qualifies as a veteran, how about looking at the book? The governing regulation appears to be 38 CFR 3.6 ( c) (4) http://www.benefits..../PART3/S3_6.DOC , based on Title 10 Chap 103 http://uscode.house..../pls/10C103.txt . That's where I'd start looking.
Recieved the following information from a "Vet"?? and I guess the question is, is this veteran entitled to a DD 214 for the military service he performed.
I was in an ROTC program voluntarily for 3 years and one quarter at Santa Clara University Sept 1975 - November 1979.
I attended the Officers Summer (boot) camp at Ft. Lewis Washington for 12 weeks (I think it may have been 15 or 16 weeks) during the summer of 1979. I had a traumatic injury to both of my ankles the first week at camp, but I toughed it out and completed summer officer's camp. The Madigan hospital radiologist did not understand why I didn't have any broken bones, but admitted they had a rotten Xray machine and that I probably had many hairline fractures through both of my ankles.
I was on a full ROTC scholarship for the last two years. My professor of military science offered me a deal. There was a change in years of service required that he felt was unfair to me, plus, if I did not hold the U.S. government responsible for my injury they would release me from my military obligation. I was not tendered a commission, but was given an honorable discharge per letter from my commander. Of course, I had to give up my ROTC scholarship (I had turned down a full California State scholoarship for the ROTC scholarship) so
I am stumped by this and do not know what to tell him. Any feedback?
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I agree ... the cutoff for this year has passed. FWIW, I believe that even getting your request in by the end of July is still cutting it pretty close, because the request has to be completed at the VAMC and then go over to your friendly neighborhood VA Regional Office for action.
Download VA Form 21-8678 http://www.vba.va.go...rms/21-8678.pdf , complete it, and either mail it or take it to your local VAMC Prosthetics Department. Myself, I'd take the form in if at all possible so I can talk to the person running that segment of the program. I'd ask them to make the allowance permanent, instead of having to apply every year.
I thought there was a cut-off (end of July??). Check with prosthetics, but if you file now, you may have to wait until next year to see the $.
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If you are thinking that 3 months is a long time, it t'ain't.
In the great scheme of things, an inter-agency records request can be relatively "fast", that is, along the lines of 1, perhaps 1 1/2, months, to receive the records after the request had been electronically sent by the VSR.
Upon arrival at the VARO, the SSA records are placed in the pile to be associated with your claims file. Depending on the size of the VARO and the amount of mail it receives, this may be as little as 1 week and mebbe 2+. Then, depending on whether any other requested information has been received, your claims file may immediately go into the Ready-To-Rate pile.
Right now, we may be at the 2 month mark.
However, if other information had been requested but not yet received, perhaps from previous employers or private physicians, the claim may wait until the "diary date" had expired and then forwarded as Ready-To-Rate; this may mean a couple more weeks or so.
Once your claims file is in the Ready-To-Rate pile, your claim is but one of many in line and has the normal Rating and post-Decision process.
So, three months isn't really "old. I don't want to speculate, put your claim may well be progressing at its normal course.
I was told the RO sent away for my SSDI medical records to make a decision on my TDIU, anyone have a clue how long SSDI takes to respond back to the VA, it has been 3 months already,
I have a feeling it's going to be a long wait. I'm in Florida if that helps. I sent the VA a copy of my SSDI award letter.
Thanks for the help you are all awesome!!!
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As far as the VA, do I need to be rated first or diagnosed by them before I can seek treatment there? You don't have to have a VA-rated disability to get treatment at a VAMC. However, if you want it free, that is, without cost or co-pay ....
Information about VA Medical Care eligibility can be found here: http://www.va.gov/he...eligibility.asp . At this moment, and without knowing anything more about your circumstances, I'd say your initial priority would be Group 8. However, this would change rapidly once you receive your Rating Decision.
However, you earlier wrote that you're retiring from Active Duty ... is that correct? If so, you understand you are automatically enrolled/eligible in TriCare Standard; "all" you have to do is find someone who accepts TriCare. You also are eligible for space-A treatment at a MTF, if close enough.
Thank you all for the info. I really appreciate it. I wasn't diagnosed for PTSD from the VA, because I never claimed it. I had no intention of claiming, until this civilian (prior military doc) said I had it. He said I shouldn't have been diagnosed as Chronic Adjustment Disorder (CAD), which the military diagnosed, along with depression. Now, with the VA diagnosing Major Depressive Disorder, military diagnosing CAD & civilian doc diagnosing PTSD, I'm all confused. I guess they don't see family murders often. I know I shouldn't worry about this stuff, but I don't want to drag this out. I want to get it over with IF something needs to be done. So, I guess I will wait until I get a rating. As far as the VA, do I need to be rated first or diagnosed by them before I can seek treatment there?
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if an active duty guy is in Afghanistan and finds out his wife has been murdered back home could this be used to claim depression or some other mental health disorder if the guy has a nervous breakdown. Yes. Basically, the precepts of 38 CFR 3.303(a) apply.
When I was in Nam a guy shot himself due to getting a Dear John. He survived, but would his wounds and disability be service connected? Perhaps. It would depend on all the facts and circumstances and what the Line of Duty Determination stated.
This case raises some questions in my mind. For instance, if an active duty guy is in Afghanistan and finds out his wife has been murdered back home could this be used to claim depression or some other mental health disorder if the guy has a nervous breakdown. When I was in Nam a guy shot himself due to getting a Dear John. He survived, but would his wounds and disability be service connected? If a guy is active duty and has a car wreck while off duty he still gets disability. Where does the VA draw the line?
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Am I wasting my time claiming this, since it wasn't military related (even though I am still active duty until tomorrow)? No, you are not wasting your time although I'm not sure whether S/C for PTSD will change much.
I have already gone through my C & P exams (VA diagnoses: Axis I: Major Depressive Disorder, recurrent, severe, without psychosis GAF of 50). Will they deny my claim, since I have been diagnosed by the VA with that diagnosis? No, "they" won't deny your claim on that basis. You understand though, that if PTSD is service connected, you will not get a separate psychiatric disability. That is, the current disability might change to: Major Depressive Disorder, recurrent, severe, without psychosis with PTSD, or PTSD with Major Depressive Disorder, recurrent, severe, without psychosis.
How do I add that to my claim if I should, since I did Benefits Delivery at Discharge (BDD) approx 3 months ago? At this point in time, I'd recommend you wait until you get the initial Rating Decision. Then, send in a VA Form 21-4138 with the claim, dates and location of treatment with a claim for increase.
For me, it's not all about the money, like some people I literally know. I really want to make sure I can get treated for this long-term. The symptoms of many psychiatric conditions overlap. If you are awarded service connected for Major Depressive Disorder, I believe you'd be covered.
(snip)
My questions are: Am I wasting my time claiming this, since it wasn't military related (even though I am still active duty until tomorrow)? I have already gone through my C & P exams (VA diagnoses: Axis I: Major Depressive Disorder, recurrent, severe, without psychosis GAF of 50). Will they deny my claim, since I have been diagnosed by the VA with that diagnosis? How do I add that to my claim if I should, since I did Benefits Delivery at Discharge (BDD) approx 3 months ago? For me, it's not all about the money, like some people I literally know. I really want to make sure I can get treated for this long-term. Any other advice is appreciated. By the way, I realize I am putting my name out there, but I need advice & can't really do it without the articles. I don't mind my about my privacy. THANKS SO MUCH
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Will i be able to get atemporary 100% for convalsent leave? Maybe.
Will my rating go down because the hernia was repaired. Maybe. It all depends on how successful the surgery was.
What type of paper work am I supposed to submitt, if i am able to get the temporary 100% and how long am i suppose to be off of work to qualify. After the surgery, send your VARO a VA Form 21-4138 with the information about the name of the procedure, date, and location. If the surgery was at a VAMC, the VARO can get the surgical record and treatment records. If the surgery was at a civilian hospital, you yourself can either get the surgical record and treatment notes and provide them to the VARO, or you can ask the VA to request them. Information on convalescence is at 38 CFR 4.30 http://www.benefits....PART4/S4_30.DOC . Generally, the surgeon must make the recommendation for how much convalescence, unless there is a specific convalescence listed in the Rating Schedule. FWIW, open fundoplications from way back when really qualified as major surgeries. Now, with endoscopic/laparoscopic fundoplications, the procedure is still 'major', but far less debilitating as before.
just want to know what my option are before the surgery? Would you change your mind for anything but a medical reason?
Hello All,
I have a quick question? . I am having surgery to repair a hiatal hernia, i am service connect and is rated at 30%. My question is this
Will i be able to get atemporary 100% for convalsent leave?
Will my rating go down because the hernia was repaired.
What type of paper work am I supposed to submitt, if i am able to get the temporary 100% and how long am i suppose to be off of work to qualify.
just want to know what my option are before the surgery?
Reddit
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I am stunned that they failed to consider you for TDIU- (snip) . You don't solicit a claim for Individual Unemployability unless the evidence indicates (or, sometimes merely suggests) that a veteran is unable to work because of a service-connected disability(s). Guessing whether a veteran can or cannot work, based solely on a mere disability percentage or perhaps a particular disability, is not the way to go.
John is right!
"In the meantime, the VA never informed me of TDIU, however my VSO sent all of the documentation and I applied for TDIU while my SSDI was still pending"
I am stunned that they failed to consider you for TDIU-but maybe they were going to when the opther claims were resolved- still you did the right thin! Make sure they know of the SSDI award.
You could use the 21-4138 form as a cover letter and tell them you have enclosed copy of the SSA award letter. (I assume this was solely for the TBI...?)
Send a copy of the 21-4138 to your vet rep too.
They should give you the date of TDIU forj for the retro EED unless the SSDI award predates the TDIU filing date and then they should use the SSDI date if it is the most favorable date for entitlement.
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1.) I have read here that the VA has to follow the thread of everything claimed to look for SC. Can I, or should I try to "simplify" or ammend my claim at this time to only the PTSD and IU? I wouldn't recommend it, because you may not be service-connected for PTSD. It's best to keep your options open.
2.) Does asking to expedite just put it in another pile and possibly even slow it down? No, but merely asking won't expedite it. To expedite your claim, you must have a proven terminal condition; or, be homeless; or, be a POW; or, be an OEF/OIF veteran; or ... several other situations that I can't recall at the moment.
3.) I have NOT been scheduled for any C&P exams. I did have on record at the time of the claim two recent assessments from VA psychiatrists for PTSD. Do they sometimes skip the C&Ps? Well, a C&PE is not absolutely necessary if "the evidence of record is adequate for a rating decision". However, generally a C&PE is required, if I intend to grant service connection. And, before I schedule a C&PE I have to have some good feeling that I could grant service connection, otherwise I'd be wasting an exam slot. Note: if you gave the VARO sufficient identifying information about the traumatic event, the VARO may be trying to get the deck logs from your ship to verify what happened. Or, maybe they're not.
4) I also read recently on this site from Pete53 "...You might ask for a pension to tide you over. It only takes about 3 months to get a pension, the only thing is you have to serve during a war period ...and have medical evidence that you are disabled." I will be 65 shortly, is there anything I can do about the pension part of this? Technically, a claim for compensation is also a inherent claim for pension, and a claim for pension also is an inherent claim for compensation. As an earlier poster stated, you are a wartime veteran so you meet the initial qualification. Additionally, if you are confined to a nursing home, or over age 65, you "automatically "qualify" for VA pension.
You understand that qualifying for VA pension and receiving any monies for VA pension can be different. The normal maximum VA pension payment for a single veteran is $11,830 a year or about $980 a month. This amount is offset by any other income (taxable or non-taxable) you or your spouse might have; additionally, your assets or estate are considered. However, there is an adjustment for medical expenses.
Hi Everyone. I did an "Introduce Yourself" today, but wanted to ask my questions here (and I appologize for the length of this but want to give full info.)
FROM INTRODUCTION:
"I am a veteran of four years service in the Navy during the Viet Nam War era as a 2nd Class Petty Officer. I was not in VN but served at an airfield and worked on the the flight deck of a carrier for a year. Because of events I survived, and the mess my personal and work life have been, I have recently been diagnosed with PTSD along with the depression/anxiety that I have been under treatment for (by the VA, over the last 8 years or so.) I filed a claim for disability & pension in Feburary 2011, so am almost 7 months into the wait. I turn 65 in a few weeks, and have not been able to work a steady job for my entire life, and recently went through bankruptcy and foreclosure."
CLAIM HISTORY:
When my claim was sent in, it probably was not done in the best way. It was done by the VSO at the state Comm. on Veterans affairs. (with too many things claimed, probably all as primary SC)
From the VA's response of March '11...quote: "We are working on your claim for: PTSD, Depression, Anxiety, Chronic back problems, Anger control issues, and non service connected pension." I responded to all of these with a lot of information, records of treatment by the VA, my accounts of service connection incidents, non-VA treatment records for my back issues, and reprints of VA psychiatrists assessments and comments. I also sent statements of support from two family members, and two "most likely" statements from non-Va doctors for my back.
In May, the VA sent me a letter saying that they had added to my claim: "Individual Unemployability" and "Sleep disorder" They asked for supporting evidence for these. I responded with copies of medical record statements from VA psychiatrists with highlighted passages referring to both my never having developed a career or maintained a steady job, and also that I suffered from sleep problems.
I have signed and sent in VCAA notices after both rounds of information.
My claim is, of course, still in the "development" phase. When I called the 800 # a couple of months ago I was told it "looked like they had everything they needed." When I mentioned my financial situation and that I felt helpless, the person I was talking to suggested that I send a letter asking the VA to "expedite due to financial hardship", so I did that and sent copies of court records of the bankruptcy and foreclosure.
I now know that it would have been best to only claim PTSD (due to a major event at a Naval Air Station, on record, for which there are my accounts, list of deaths, copy of newspaper article at the time. And the VA diagnosis, with my endless moving and relationship changes,etc.) And probably best not claiming others except as secondary, and maybe not claimed the back problems related to a flight deck accident (I sent detailed description of the dramatic event, but it was never reported so not on record.)
QUESTIONS:
1.) I have read here that the VA has to follow the thread of everything claimed to look for SC. Can I, or should I try to "simplify" or ammend my claim at this time to only the PTSD and IU?
2.) Does asking to expedite just put it in another pile and possibly even slow it down?
3.) I have NOT been scheduled for any C&P exams. I did have on record at the time of the claim two recent assessments from VA psychiatrists for PTSD. Do they sometimes skip the C&Ps?
4) I also read recently on this site from Pete53 "...You might ask for a pension to tide you over. It only takes about 3 months to get a pension, the only thing is you have to serve during a war period ...and have medical evidence that you are disabled." I will be 65 shortly, is there anything I can do about the pension part of this?
Any and all help will be appreciated.
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Sorry for the delayed response. I don't do much in life anymore but I manage to stay remarkably busy not doing much. I'll answer the questions I think you asked of me, and comment on the others.
My cfile, as it's called, should contain everything they have up to date, correct? Including all of my C&P exams? Yes, that's the drill. If you submitted it, or you told the VARO of the existence/whereabouts of sumpin, or it was generated by the VA, it should be in your claims file.
Can I just go get a copy of that, review it and then see what they are missing and then collect the additional information that I deem pertinent? Yes, you could do that. However, it isn't always as easy as you might think to just get a copy.
Also, to make a copy of the C-file - or for you to review it, the file will have to be taken out of one pile of records and placed into another pile. THIS MAY TAKE IT OUT OF THE RATING PILE AND THERE IS NO GUARANTEE THAT THE C-FILE WILL RETURN TO THE SAME POSITION IN THE PILE!
Sometimes, it doesn't help to be too proactive. At this stage in the game, it might be better (whatever that means for you) to wait for the initial decision and hope that all the information was considered.
Of course, it's your choice.
Now, on to the comments, some were yours and some the other guy's
That's what I'm thinking. They told me it's like a jumpstart of sorts, since I filed before I got out. If you sent the VARO the operative report and/or the treatment records about the the additional disc herniations, your claim no longer qualified as a "QuickStart".
When the C&P examiners write "At least as likely as not" or "Likely" that the conditions manifested or worsened during service, those are key phrases that will more than likely cause the rater to grant service connection for. For your initial claim this soon after separation, unless you are claiming service connection by way of aggravation of a pre-existing condition, the terms ' ... at least as likely as not ... ' or ' ... more likely than not ... ' are not necessarily that helpful. The key is, no matter what anyone says here, can be found in 38 CFR 3.303(a) http://www.benefits....ART3/S3_303.DOC . However, if you are claiming - for the first time - a condition many years after your separation, those above terms are very important.
Looking over his records, it is listed in multiple annual physical exams "chronic low back pain" . Unfortunately, anecdotal evidence such as this really isn't too valuable without any other treatments or diagnostic tests. That is, a troop can say anything and the examiner simply will write it down ... but that does not necessarily make it true. Now, in the situation you described for yourself, your complaints resulted in an MRI and a diagnosis.
[quote nam
e='Colt' timestamp='1314289640' post='254707']
Interested, if you don't mind I'm going to use your way of responding. It makes it much easier to read and if I try to multiquote it denies me saying I've quoted too much.
So, while a claim for convalescence because of surgery in a VAMC MAY result in an automatic claim, I'd still recommend you notify the VARO and claim it. My cfile, as it's called, should contain everything they have up to date, correct? Including all of my C&P exams? Can I just go get a copy of that, review it and then see what they are missing and then collect the additional information that I deem pertinent?
Well, in the general course of affairs, the surgery is expected to improve the condition, so the pre-surgery VAE might be be unduly negative. And, normal post-operative items such as wound pain/discomfort during healing or "guarding" might mask the true result. I agree. However, all of my other issues still exist and wouldn't have been affected by surgery. I don't mind them lowering a percentage if it got fixed.
In your situation, if I had been made aware of the additional disc impingements, I might question how valid the findings from the earlier exam were and order a more recent exam; however, this will keep the issue open that much longer. Or, I might just rate it and let you appeal. I see your point. I'm trying to take this as relaxed as can be. I stress far too often about things and this would just be one more heaping pile of crap to add to the list. I've got the time; the frustrating thing is not understanding everything.
Thank you for the links you've provided. I'm going to go through some documents and see what I come up with in regards to my claim.
@ Timestamp
Quick start claim? I guess that's a new pilot program that ain't so quick? That's what I'm thinking. They told me it's like a jumpstart of sorts, since I filed before I got out.
When the C&P examiners write "At least as likely as not" or "Likely" that the conditions manifested or worsened during service, those are key phrases that will more than likely cause the rater to grant service connection for. Unfortunately, I didn't see any kind of phrases like that in my exam that I received. However, once again, there was a lot of stuff that wasn't mentioned in the C&P that I claimed and actually have issues with.
Buddy of mine recently got his C file, C&P examiner noted chronic low back pain worsening with movement and how it affected him physically, then on the last page stated there were no records of an in service injury. Looking over his records, it is listed in multiple annual physical exams "chronic low back pain". I don't have an in service injury though either. There was no specific event for me. It was multiple events that occurred along with the weakening of my discs that would set my back off that would send me to the doctors to get checked out (e.g., lifting a printer, tug of war on enlisted day, running). Eventually after the 4th year of going in for back issues they sent me to get an MRI and that's when they noted all my 'issues'.
My claim has A LOT of items listed. So much so that when I look at it I feel like at my age I should be broken (did I really go to the doctor's that much?). Granted one issue has secondary issues or other things that are associated with it… still, I feel like it is too much. When I went to the DAV they did add things when going through my file that they wanted to put on there to get SC since later on if it worsened it could be claimed. I didn't embellish at all when I went for my C&P although I was told to act like it was a bad day (even though for my back, it really was). I'm very much a liar when it comes to how I feel. If you ask me how I am, I'll tell you fine, even if I'm not. I tried to be as honest as I could that day, but I still get shy and tend to act better than I am. I can't help it, it's who I am. In this case, I very well could have done a disservice to myself. However, I can't undo it now.
In the end, I'd just be happy if my amount covers my bills. I have 5 specialists that I go to and at $30 a pop, it adds up quick as I'm sure most of you know. One of my meds just cost $205 (after insurance) for a 3 month supply. It's something simple… eye drops, but it's something I need.
I'm still young (I think
) and can work; so one day at a time is okay with me. I'm trying not to overwhelm myself. I'll see about getting the cfile and getting back with you guys. -
First, is this your: (a) initial claim for Adaptive Equipment; or, (b) has that benefit already been granted in an earlier Rating Decision and this is a request for payment of something?
There are a coupla reasons why a particular claim may have been sent to the Maine VA Regional Office (Togus?)
(a) As was mentioned earlier, your claim may have been "brokered out" for a specific decision to a VARO that currently has some excess capacity.
(b) Is it possible that your claims file is at Togus instead of Montgomery? What I'm trying to say is that if a veteran moves, and also does notify the new RO that he/she has moved, that does not necessarily mean that the claims file also transfers. The VA does not automatically transfer a claims file (and jurisdiction) unless there is some reason, such as a claim for increase or the veteran requests it. So, was your last Rating Decision made in an area that Togus may have been responsible for? If your claims file is at Togus, any request for payment for adaptive equipment or the automobile grant, that is, either a VA Form 10-1394 or VA Form 21-4502, would be forwarded to them for action.
© I recall a proposal several years back to consolidate some types of Rating Decisions at certain ROs. Although I won't say that an initial claim for Adaptive Equipment or the Automobile Grant is unduly complicated, perhaps this is one of those situations.
(d) And, as far as DID THEY MAKE A MISTAKE , that is always possible.
But, all in all, it's likely item (a) above.
I RECENTLY SENT AN IRIS ON THE STATUS OF MY CLAIM AND GOT A RESPONSE BACK SAYING THAT "YOUR INQUIRY INTO THE STATUS OF YOUR CLAIM FOR ADAPTIVE EQUIPMENT HAS BEEN FORWARDED TO THE MAINE RO AND YOU SHOULD GET A RESPONSE WITHIN 5 FIVE DAYS" THE ONLY PROBLEM I HAVE IS THAT I SENT MY CLAIM TO THE MONTGOMERY ALABAMA RO WHERE I LIVE.
DID THEY MAKE A MISTAKE OR DO THEY SEND CLAIMS TO OTHER ROs TO WORK?
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I don't know if the 100% is something that is automatically done or if I have to apply for it. If the surgery was done in a civilian hospital, your friendly neighborhood VARO has no way of knowing about it ... you need to apply. For procedures done in a VA Medical Center (with a close-by VARO), I recall a daily report that listed hospital admissions for service connected conditions. "Someone" would usually review this list and determine whether any additional follow-up or action was needed. So, while a claim for convalescence because of surgery in a VAMC MAY result in an automatic claim, I'd still recommend you notify the VARO and claim it.
I have seen folks apply for convalescence based on surgery next month. However, you can't do a Rating Decision prospectively and you must wait until the surgery has been done.
On that note, it almost seems more like a hassle to me to go through all that. Although a rough time, I was pretty fortunate with everything. That's your call - there's no requirement to file.
Lastly, if you wouldn't mind, could you elaborate a little about not putting value on the C&P? Would the surgery kind of null and void everything? Well, in the general course of affairs, the surgery is expected to improve the condition, so the pre-surgery VAE might be be unduly negative. And, normal post-operative items such as wound pain/discomfort during healing or "guarding" might mask the true result.
In your situation, if I had been made aware of the additional disc impingements, I might question how valid the findings from the earlier exam were and order a more recent exam; however, this will keep the issue open that much longer. Or, I might just rate it and let you appeal.
FYI, intervertebral disc syndrome is evaluated under either of two sets of criteria: the General Rating Formula, or Incapacitating Episodes at 38 CFR 4.71a http://www.benefits....ART4/S4_71a.DOC The Diagnostic Codes (DC) for back problems are 5235 through 5243; Intervertebral Disc Syndrome is DC 5243.
I know, forgive me. I'm still trying to learn a lot about what I should do and how to go about it. I type things about assumptions and you would think after 8 years in the military I should know better about who knows what and what they should be doing. ;)
I could always find out if they put something in there about the time off. I know I wasn't allowed to work for 6 weeks per the doctor's orders. I don't know if the 100% is something that is automatically done or if I have to apply for it. On that note, it almost seems more like a hassle to me to go through all that. Although a rough time, I was pretty fortunate with everything.
Thank you though for your input, I appreciate it. For now I guess I'll just start collecting evidence (my records from appointments) until I get back my first results and then go from there. At least this way, I'll know what they need or are missing instead of trying to guess everything. Not to mention I could possibly come to you guys for help to understand everything. Reviewing my one C&P exam, I don't even know if it's in my favor. Would I specificially look under the diagnosis area? Not everything was referred to, which is why I was wondering if the rest would be a wash.
Lastly, if you wouldn't mind, could you elaborate a little about not putting value on the C&P? Would the surgery kind of null and void everything?
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No matter what you might think, I am not your enemy.
If you will note this was the FIRST RATING DECISION WITHIN 3 MONTHS OF GETTING OUT OF THE NAVY.C&P and RATING.
POINT OF FACT__S/C for both . And my response is ... yeah? So? What does this signify, that is, what specific point are you trying to make?
THE RATING FOR sinusitis and vasomotor rhinitis ARE SEPERATE ratings . No kidding ... really? So what? Actually, you are not service connected for a Diagnostic Code but for a condition and the resulting disability; the narrative or description of the condition is far more important. The DC, in some instances, can or must be chosen to evaluate the condition most accurately.
If vasomotor rhinitis were your only service connected nasal condition and the VAE showed no polyps or obstruction (even though you state there was a nasal septal ulcer), it would be appropriate to apply DC 6501 and assign a 0%.
However, you appear to have two service connected nasal/respiratory conditions which were service connected and combined into one narrative, for example, "Maxillary sinusitis with vasomotor rhinitis" because the sinusitis was ratable at 10% under DC 6513 and the rhinitis was a 0% under 6501. With the above narrative example, you ARE service connected for both sinusitis and vasomotor rhinitis, no matter what Diagnostic Code is used.
Then, if obstructive polyps develop at some later date, you could apply for increased compensation and the vasomotor rhinitis would then be broken out as a separate line item, and the 10% assigned if appropriate.
I have seen similar claims addressed in two ways, that is, sinusitis and rhinitis as one issue, or sinusitis and rhinitis as two issues. I suspect this might be for for widget counting purposes, for example, an RVSR would create a separate issue for rhinitis if separating the two results in 8 issues on the claim versus 7 issues. Eight rated issues results in one "point" toward production, whereas 7 issues rated results in only 1/2 point.
I'm basing this on what you've written and with only what information you've chosen to share. From what you've written, it does not appear to me that you have a basis for a CUE; there could be another issue but I am not sure whether it would result in any additional compensation. However, you are certainly entitled to file a CUE if you so desire; I shan't repeat my earlier comments because those seemed to get a whole lotta folks' panties all bunched up.
If you will note this was the FIRST RATING DECISION WITHIN 3 MONTHS OF GETTING OUT OF THE NAVY.C&P and RATING.
POINT OF FACT__S/C for both .
( So, you are telling me that you have in point of fact been service connected for both sinusitis and vasomotor rhinitis since this Rating Decision in 1971... is that correct?)
THE RATING FOR sinusitis and vasomotor rhinitis ARE SEPERATE ratings .
And the ulcer is a leftover from continued polyp growth and ulceration starting in GUAM in 1967 & continuing there on.
And as expected the VA did not offer the complete SMRs from service .I think I got them all now last year from NARA .
6513 maxillary sinusitis
6501 vasomotor rhinitis
STEVE
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Once again, I think so. On my C&P exam it shows that he did an amendment to it showing that I had surgery. You need to learn that the VA is many things. There is the Veterans Health Administration (VHA, the VA Medical Centers, where the great majority of C&PEs are done) and there is the Veterans Benefit Administration (VBA, the VA Regional Office, where decisions on service connection and compensation are made). Unfortunately, they don't always speak well together. So, even though the VA examiner made a note, I recommend that you send in a copy of the operative report if it was done at a civilian facility, or if it was done by the VA, tell the VARO where and when.
If I had surgery post getting out, then I would get 100% for the time that I was required to bed rest and then reevaluated to drop down the percentage? Yeah, that's pretty much more or less the case, except it's not specifically bedrest but convalescence and inability to work. It also helps if somewhere in that pile of papers the surgeon made a specific recommendation to be off-work.
FWIW, I myself wouldn't place a great deal of value on a C&P for a lumbar back that was done either immediately before surgery or relatively shortly after surgery. And, in light of the continuing problems you report, it might be better to request a new C&P even though you have not yet been rated.
However, there is a risk to all of this in that it may - will - delay the claim even more, if possible. So, you can: (a) continue on as-is with the information available, and after you receive the Rating Decision, submit a claim for increase with the additional information., or, (b) submit the additional information and hope (note: it might, but I won't guarantee, shake the claim loose.
I can't advise you which way to go.
They should, they have sent me those automated letters, and I just haven't gotten one in over 6 months now. Not to mention I got the VCAA (I think that's what it's called, ebenies is down and I can't get into it) in Nov that I filled out and sent back. My claim was sent out from my local RO and over to somewhere in the Carolinas.
Once again, I think so. On my C&P exam it shows that he did an amendment to it showing that I had surgery. When I went back for my other appointments, I dropped off the MRI that he wanted and he talked to me for a few minutes. I never had a re-eval done though. I'm trying to grasp what the document you attached is saying. If I had surgery post getting out, then I would get 100% for the time that I was required to bed rest and then reevaluated to drop down the percentage? I'm pretty sure they have all the new info for the back considering it's updated in ebenefits showing (med evidence for back) on 12/20/2010. However, I reherniated it 4 days later. When they did another MRI they showed that one of the discs that got fixed reherniated and that I have scar tissue present from the surgery that can be causing pain from pressure. I have those records but haven't sent them in yet. I can make an appt to go to my VSO and give them to her.
I figured that most of them would be 'lumped' together. Not a big deal, I was more curious than anything. Thanks!
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I will say it again ... I don't believe you have a Clear and Unmistakable Error (CUE) because:
S/C for both . So, you are telling me that you have in point of fact been service connected for both sinusitis and vasomotor rhinitis since this Rating Decision in 1971... is that correct?
I asked you earlier what was the percentage of obstruction noted in the C&P of 1/5/71 but you did not provide it. So, what was the amount of nasal obstruction from polyps at that time? Likely, there were no polyps or obstruction noted ... is that correct?
So, both sinusitis and vasomotor rhinitis were service connected and incorporated into one issue because the rhinitis was not separately ratable. However, that does not mean that rhinitis wasn't service connected (which appears to be the case from your statements), and that it couldn't have been broken out into a separate issue if or when it became separately ratable.
Apparently, the nasal septal ulcer was addressed and denied. You had one year to appeal that decision ... did you?
And, when you did develop nasal polyps sufficient for the 10% you seek, did you file a claim for increase?
I came across this first rating decision of 2-2-71 that has this printed note on the top--
(for the veterans vasomotor rhinitis,because it cannot be distinguished from his sinusitis which was incurred in service.S/C for both ---then goes on to say service connection is denied for the ulcer of the nasal septum , because it was first noted after service.
10/1/ 70 I got out of service I believe the C/P was 1/5/71
I was only recieving 10% at that time so this could add another 10 % or more.
This wasnt even 4 months after discharge.Didnt go to 100% till 1994
A lot of this first rating was screwed up. THOUGHTS
thanks STEVE
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This is an opinion, correct?
http://answers.yahoo...13085329AATcows
Interested
I don't think your comments are helpful.
) and can work; so one day at a time is okay with me. I'm trying not to overwhelm myself. I'll see about getting the cfile and getting back with you guys.
Earlier Effective Date
in VA Disability Claims Research
Posted · Edited by Interested
I am a bit confused so please bear with me ...
I understand that you are being compensated at the SMC L 1/2 level, correct?
If so, why is Individual Unemployabilty an issue? If you are at 100% for another condition Meniere's Disease?), the issue of IU is moot (unless there is something of a historical nature that I'm unaware of).
On what basis are you applying for an additional 100%? You seem to have a good handle on SMC so you probably already know this: an additional, independent 100% grants a step increase in SMC, or perhaps in your case to SMC L 1/2 (if you aren't pursuing an increase for PTSD) from 38 CFR 3.350(f)(4) http://www.benefits....ART3/S3_350.DOC