Vync

Master Chief Petty Officer
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Vync last won the day on May 19

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About Vync

  • Rank
    E-9 Master Chief Petty Officer
  • Birthday October 15

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Profile Information

  • Military Rank
    E-4
  • Location
    Ft.Living Room, AL
  • Interests
    Family, fishing, movies, video games, gardening, hot rods, computer programming, electronics, music

Previous Fields

  • Service Connected Disability
    100%
  • Branch of Service
    Army

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  1. For initial SC, you need the Caluza requirements: 1. Event/injury in service 2. Current diagnosis 3. Doc connecting 1 and 2 together By assigning the ICD code, it shows you met #2: current diagnosis.
  2. When you scan the documents to PDF, be sure to have them saved with full text indexing/searching. It makes it easier to find certain words. It's not perfect, but can help a lot.
  3. Welcome to Hadit! Even if you use an agency like the DAV, you are still responsible for providing any non-VA medical treatment records to the VA. They are supposed to act on your behalf, but are still prone to human error. Also, get a copy of any forms filled out by the DAV for you. Even if they say they submitted the request, go ahead and send an extra copy yourself via certified/registered/return receipt mail or electronically via ebenefits. Just make sure you have your own way to verify the VA got it because they have a habit of losing things or things might get lost enroute to them. The VA should be able to access your service treatment records (STR's) electronically, but they might not have been received yet. Back when I got out in the 90's, they gave me my medical records to hand carry. You did good by not submitting the originals to the VA. If you have and treatment records from civilian facilities which are not in your STRs, you'll need to fill out a separate Release of Medical Information Authorization form for each provider so the VA can request them (even if you send them your copies they need to verify). Additionally, I know this sounds like a lot of work, but It might be a good idea to go through your records, every page front and back, and only submit copies of pages related to your claim. It is what I call spoon-feeding the VA. Let's say only 100 pages pertain to your claim. If the VA has to go through all 1000 pages to find those 100, that takes time. Also, what if they are not accurate and only find 60 instead of 100 pages? It doesn't help. Give them exactly what they need, only pages beneficial to your claim, and never send originals. Keep your originals in a secure location like a fireproof safe, vault, or safe deposit box. I bought myself an HP scanner and spent many nights scanning pages into PDF files. Now I have a catalog of everything and a copy in my safe. It can also help make any future claims easier to research. Good luck!
  4. I'm not the heart expert around here, but others are. I'll try to hopefully provide good advice. If you were treated at the VAMC, then they already have your ER records. If you were treated elsewhere, you probably should request a copy of the records (plus billing statements like a UB04) and also fill out a VA Release of Medical Information form so the VA can request them for their verification. Never give the VA any original records. Only give them copies. Because you already have a claim in the system, I am not sure if the fast track claim would apply . I don't know much about the fast track system, but others here do. Also, I would notify the VA in writing about the treatment so it can be factored into your claim. Having one heart attack is one too many because it could be the last one. If I recall reading about the Nehmer ruling, AO claims were supposed to be a priority. It might be worth it requesting this to be treated as a medical hardship because of the risks to your health. Good luck! I hope they can take care of you.
  5. It is not uncommon for the BVA to issue a remand requesting C&P exams. I know because actually received my first ever C&P exam via BVA remand. Sometimes the BVA does this because an exam was not performed, you need an updated exam (BVA claims often take one or more years and the exams get out of date), need clarification, or perhaps even they felt a more specialized exam and/or testing was required. It sounds like they need clarification and/or a more specialized exam and/or testing. There is a chance that the C&P doc might be able to satisfy the BVA request without examining you at all. It might be a case of them more closely reviewing your records and/or the X-rays/MRI's and responding to the BVA. Whatever happens, I wish you the best of luck and hope the BVA finds in your favor.
  6. Like seminole said, it sounds like you won a pension first, but later won SC at 70% (at which I assume they canceled the pension). If your SC MH issue is the reason why you are unemployable, then, in my non-professional opinion, it might be worth just trying to file for IU first. By having a single MH rating of 70% and not working, you already met two obvious criteria for IU. If they deny, that would probably be a time to closely look at the reasons and bases section of the SSOC to find out why and then weigh the lawyer option. If you end up winning IU, you can try and request an earlier effective date back to 2010 or whenever they granted your initial SC.
  7. In rare cases, the VA may grant an extraschedular rating, but it might be an uphill battle and would require some compelling medical evidence. It is worth researching. I also recommend you research the regs on rating increases because you might have a better chance depending on your situation. Start by digging through your treatment records and tests over the past 12 months. If you find that you met criteria for a higher rating more often than not during that time, you might be able to win. There is even a chance that you might not need a C&P exam to win either. Let's hypothetically use the asthma rating criteria as an example because the criteria are ripe with options and there are a number of possible ways to qualify for each rating %: §4.97 Schedule of ratings—respiratory system. 6602 Asthma, bronchial: FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications 100 FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids 60 FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication 30 FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy 10 Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record. Let's assume you are currently at 30%. In order to reach 60%, you would have to meet a minimum of just one of the four criteria shown below because of how it is worded: ", or;". If this were for initial SC, the VA would likely base the rating result on your C&P exam : - FEV-1 of 40- to 55-percent predicted, or; - FEV-1/FVC of 40 to 55 percent, or; - at least monthly visits to a physician for required care of exacerbations, or; - intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids However, because this is an increase, if you look back at your treatment records from the last 12 months and found you met the criteria for 60% more often than not, this might be compelling enough to demonstrate that your asthma more closely met the requirements for a 60% rating over the past year. If you are denied, keep in mind that most correct claims are won on appeal. If you won, the VA would likely temporarily grant the increased rating because "your condition is expected to improve in the future" and then a year or so later they will bring you back for another C&P. As long as you continued to more often than not meet the criteria of 60%, then you may have enough justification to continue the rating. Keep in mind that this might not always happen, but there are possibilities which might work.
  8. Congratulations!!!
  9. Welcome to Hadit! I hope this information will help you better understand how the VA mental health (MH) ratings are determined. Further below is a link to the rating info which contains extra information and also I copied the rating table itself. According to the documentation you are not SC for PTSD, but you are SC for other mental health (MH) disorders. Whether you request SC for one disorder or 10 disorders the pyramiding rule limits the VA to grant a single rating based on how they negatively impact your social and occupational functioning. If you filed separately for PTSD due to MST, you will still need the VA C&P doc to sign off on it due to rule changes which went into effect a few years ago. Many veterans may instead opt to request an increased MH rating due to worsening symptoms, which would likely require a DBQ from a MH doc or another C&P exam. There is always a chance for anyone to be reviewed in the future, except in certain situations. Before you file for an increase in your MH rating, do your research and review the sections for 70% and 100%. If your MH rating gets increased to 70%, your combined rating would rise to 90%. If you are unable to work due to MH, consider researching and additionally filing for Individual Unemployability (IU) status. If you are still working, I do not recommend you quit your job just to file for IU because there is no guarantee the VA will grant any increase. It might be a better idea to compare your other SC conditions to see if they worsened and met the criteria for a higher rating. Obtaining 100% schedular is a steep climb with your ratings, but you would not need to file for IU or have a single 100% MH rating and it also means you could still work if you want/need to. §4.130 Schedule of ratings—Mental disorders. Rating Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100 Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70 Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 50 Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30 Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10 A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0
  10. Hey Draggon, You might want to first check out the rating criteria for the knee. §4.71a Schedule of ratings—musculoskeletal system. which I posted below. If you meet the criteria, then it might be worth exploring. Just remember that you will need a current diagnosis and a doc connecting it to your back. Perhaps your doc can fill out a DBQ and write an appropriate medical opinion, otherwise you will likely have to go through a C&P exam. I hope this helps! Rating 5256 Knee, ankylosis of: Extremely unfavorable, in flexion at an angle of 45° or more 60 In flexion between 20° and 45° 50 In flexion between 10° and 20° 40 Favorable angle in full extension, or in slight flexion between 0° and 10° 30 5257 Knee, other impairment of: Recurrent subluxation or lateral instability: Severe 30 Moderate 20 Slight 10 5258 Cartilage, semilunar, dislocated, with frequent episodes of “locking,” pain, and effusion into the joint 20 5259 Cartilage, semilunar, removal of, symptomatic 10 5260 Leg, limitation of flexion of: Flexion limited to 15° 30 Flexion limited to 30° 20 Flexion limited to 45° 10 Flexion limited to 60° 0 5261 Leg, limitation of extension of: Extension limited to 45° 50 Extension limited to 30° 40 Extension limited to 20° 30 Extension limited to 15° 20 Extension limited to 10° 10 Extension limited to 5° 0 5262 Tibia and fibula, impairment of: Nonunion of, with loose motion, requiring brace 40 Malunion of: With marked knee or ankle disability 30 With moderate knee or ankle disability 20 With slight knee or ankle disability 10 5263 Genu recurvatum (acquired, traumatic, with weakness and insecurity in weight-bearing objectively demonstrated) 10
  11. Hi Porgee, The link you provided has a click though to the details of conditions which qualify under the post-service one year time frame. Do you have one of the conditions listed or did you have something else be diagnosed which is not on the list? Additionally, which branch and years did you serve? Were you deployed to the Middle-East? i asked the last two questions because it may matter.
  12. Hello Missy, As far as requesting increase for sinusitis and allergic rhinitis, are you 0% service connected (SC) or 0% non-service connected (NSC) for each condition? That makes a big difference. If you are 0% SC, feel free to file claims for increase or secondary conditions. If you are 0% NSC, then you would need to go back to the start and deal with the Caluza triangle: For obtaining initial SC: 1. Injury/event in service 2. Current diagnosis 3. Doc connecting the first two. For secondary SC, simply replace #1 (above) with an SC condition. For an increased rating, you just need medical documentation within the past 12 months which shows you qualify for a higher rating %. When the VA denied your asthma claim, they were supposed to have included reasons and bases for the denial. If you can post the denial text, minus any private info, we can try to help make sense of it and inform you what we would have done under the same circumstances. I assume you VA primary care doc refused the CAT scan. If you can get them to refer you to the ENT clinic, they might be able to order one. Otherwise, if you have not had one in ages, one might be requested from the C&P clinic, but you would need to file a claim for increase.
  13. Hey Oldtimer, Unfortunately, this is how the VA works. There is a VA policy called "pyramiding", which means multiple disabilities for the same body part or organ result in a single rating based on the higher of the two. Yes, you can be SC for both under a single rating, but they will try and determine which impacts you more and rate based on how much they impact your social and professional life. VA psych docs tend to start by diagnosing AD, GAD, or depression. Over time, other conditions like PTSD may be added. Whether or not if your VA psych doc diagnoses you with PTSD, the nexus required for SC of PTSD must be confirmed or diagnosed by the C&P psych doc. The rules for PTSD claims were relaxed a few years back, but they threw this monkey wrench in there. Until you receive the envelope in the mail, your claim status may juggle around in a seemingly random fashion. Yeah, it is better than not knowing anything, but it is still a veil. Again, it is unfortunate but normal for a C-file request to take what seems forever.
  14. As far as I know, the one year post-service info is found in this VA link (which porgee just shared): http://www.benefits.va.gov/COMPENSATION/claims-postservice-one_year.asp You have to click through to get to the list of diseases/conditions which qualify. Another approach might be to take the opposite limb secondary approach. I know it tends to work for legs, but am not certain about shoulders. For example, you are SC for one leg and the other leg goes downhill for taking up the extra workload. The Caluza triangle would still apply - You'll need to get a doc to tie it all together with a strong medical opinion. If you can get an ortho specialist, it should carry extra weight compared to other docs. If you don't have an opinion from a specialist, the VA would likely request a C&P exam for you to be evaluated from one of their "specialists" (never know what you will end up getting at the VA though).
  15. Welcome to Hadit! Check out this link and the quoted sections, below: §4.114 Schedule of ratings—digestive system I assume they rated your GERD under hiatal hernia: 7346 Hernia hiatal: Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health 60 Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health 30 With two or more of the symptoms for the 30 percent evaluation of less severity 10 You might get to 30% or 60% depending the symptoms and severity of your diagnosis. If you happen to be diagnosed with Barret's esophagus, there is a small chance that it could turn into an esophageal stricture, which is then the esophagus becomes narrower. There are separate ratings for that. Also, please be certain to read the text right after the heading for 1.114. There is a lot of overlap (pyramiding) between some of the rating codes, which means if you are diagnosed with more than one disability then they may simply take the higher rating of the two.