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Master Chief Petty Officer
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Everything posted by Vync

  1. Welcome to Hadit! That sounds like a plausible approach. You could also try going for secondary SC to your existing disabilities. For hip disabilities, it might be helpful to get familiar with the rating criteria and compare that to your medical records to see if you meet the criteria. https://ecfr.io/Title-38/pt38.1.4
  2. Are you gainfully employed? If yes, you cannot get 100% for a MH disability (by definition "total occupational impairment").
  3. Vync


    Congratulations on your wins! The asthma/SA were combined due to the pyramiding rule. You'll get a single rating from the higher of the two. Same deal for IBS/GERD. I'm glad you filed a NOD for the back, knee, and GERD. Did you file for radiculopathy? It is common when you have cervical or lumbar disabilities. It causes numbness, tingling, burning, or pain on affected extremities. You could file for it as secondary if reflected in your records.
  4. Welcome to Hadit! Normally, when you are granted TDIU or P&T status, that really does mean "no future examinations". However, the VA can bring veterans back in for reexamination. In brief, permanent does not always mean permanent. However, you could probably call 1-800-827-1000 and ask if you have any C&P examinations scheduled in the distant future. In my opinion, your VSO should have double-checked to make sure you really do have an exam scheduled. If it is listed, they should be able to submit a request to cancel it because of the "no future examinations" statement. Someone at the VA might have got their lines crossed and created the future exam on the schedule, but forgot to remove it when "no future examinations" was determined. The only way you will know for certain is to keep digging.
  5. Welcome to Hadit! Based on what I have read, initial applications with SSDI, tend to be denial. Most get approved on appeal or hearing. Good idea getting a lawyer. By the way, did you use the SSDI fast track program for 100% P&T veterans or just the regular application process?
  6. I completely understand. Community care is currently a joke because it takes forever due to the amount of red tape. I had to get my Congressman involved twice to get the treatment I needed. Like the Choice program, it seems that Congress authorized funds for use, but the VA has gone out of their way to make it extremely difficult and inconvenient to use the program within realistic timeframes.
  7. Completely agree. I am currently in PT, but my private health insurance covers it. My copay is $10 per visit and it costs me more than that to drive downtown and back. I just go to a facility close to my job and beats driving downtown an hour each way and having to deal with parking and the shuttle bus.
  8. This is very good advice. It makes getting prescription refills a lot easier because the VA will not refuse because you haven't visited them in a while.
  9. Below is a link to the VA's FDC program. It doesn't specify how long it can take. However, it does indicate (toward the bottom) that Decision Ready Claims can be processed in 30 days or less. https://www.va.gov/disability/how-to-file-claim/evidence-needed/fully-developed-claims
  10. After using VA medical care for 23 years, I can definitely throw my support behind partial VA privatization. Nothing changes your perspective like the VA scheduling you for surgery and it turns out to be unnecessary because they failed to read radiology reports or listen to the patient. This has happened to me more than once. If veterans like getting their care at the VA and don't mind the long waits, let them. I don't mind visiting the VA PCP a couple of times a year for routine care. However, veterans should have the ability to see a non-VA doctor of their choice, show their VA ID, and the VA cover costs of the treatment - all without excessive delays. I have found that the VA takes about three months to do what the private sector can in just a fraction of the time. My dependents can use CHAMPVA to see a doctor of their choice, when they want to, and get the treatment they need very quickly - all covered by the VA.
  11. That sounds promising. I hope the VA finds in your favor. If they happen to bounce the status back to something else, don't feel discouraged. Until the letter arrives in the mail, it can happen.
  12. This proves the VA is really good at making veterans wait and very bad at getting decisions right the first time
  13. I had this happen a couple of times. They wanted to verify a couple of things.
  14. Vync

    Fibromyalgia claims

    Welcome to Hadit! That site is a helpful resource for FM in general, but the VA would rely on a physician (preferably a neuro-sleep specialist) to perform an examination. To get an idea of what happens during the exam, please refer to the VA disability questionnaire (DBQ) list. You could expect the VA to use one of the DBQ's listed below, likely the second unless there are additional symptoms to be evaluated. https://www.benefits.va.gov/compensation/dbq_listbydbqformname.asp Neurological 21-0960C-5 Central Nervous System and Neuromuscular Diseases (except TBI, ALS, PD, MS, Headaches, TMJ, Epilepsy, Narcolepsy, Peripheral Nerves, Sleep Apnea, Cranial Nerves, Fibromyalgia, and CFS) 21-0960C-7 Fibromyalgia
  15. I knew about Gray v. Wilkie, but I'm glad this one was accepted by the Supremes.
  16. It would depend on the type of information you plan on providing to the VA. VA Form 21-4142 (non-medical info) Authorization to Disclose Information to the Department of Veterans Affairs(VA) (Fillable) VA Form 21-4142 (medical info) General Release for Medical Provider Information to the Department of Veterans Affairs (VA) (Fillable)
  17. Vync

    90%er's the exclusive club...

  18. This could be grounds for an new C&P exam given the examiner failed to thoroughly go through your claims file and find the markers.
  19. Welcome to Hadit! When getting your limited ROM checked, you can have your regular doc fill out the DBQ. You do not need to wait for a C&P exam to do this. Just be sure you tell them where pain begins (i.e. Delucca rule) and ask them to note that down. https://www.benefits.va.gov/COMPENSATION/dbq_ListByDBQFormName.asp 21-0960M-13 Neck (Cervical Spine) Conditions 21-0960M-14 Back (Thoracolumbar Spine) Conditions Additionally, if you have any limited ROM measurements in your records from the past 12 months, bounce the ROM degrees off the rating criteria and see if they warrant an increase. You can request an increase in the manner, often without the need for another examination (depending on disability).
  20. I found this link on the VA's MST page: https://www.benefits.va.gov/BENEFITS/factsheets/serviceconnected/MST.pdf It shows some examples of markers they use to help verify claims. My apologies about the text formatting below, but I tried to clean it up as best as possible. I hope this helps.
  21. Here are the current VA rules regarding bilateral actor to save anyone from having to look it up: https://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_26.doc However, M21-1 specifically addresses DC's with one rating for a bilateral condition with the "Note" paragraph: https://www.benefits.va.gov/warms/docs/admin21/m21_1/mr/part3/subptiv/ch06/m21-1mriii_iv_6_sece.doc One may speculate having a bilateral 5276 with no other leg/limb issues may be considered a single rating not subject to the bilateral factor. However, if an additional disability also affected one of the legs/limbs, then the bilateral factor may be applied. I'm not sure if my interpretation is correct, but that appears to be how I read the "Note" paragraph.

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