[Uncharacterized / Entry Level Separation (Els)]

I dont think she had enough time in, last I checked it required 180 days of Active service to qualify.

[Temporary 100% Increase]

Almost forgot, if your hubby was housebound or bed ridden make the doctor put that in the letter as well. If this is the case you will get SMC as well. This applies if he was unable to care from himself like going to the restroom or showering without assistance.

[Temporary 100% Increase]

You will need to get a letter from the Doctor, explaining the need to stay home for the last 7 weeks, and request an appeal to the VA. Take the letter you got from the VA Regional office with you to the VA, and have the doctor read it. You may have to get a little pushy with the doctor, and dont be afraid to ask for the Department Chief most likely the Chief of ORTHO in this case.

I have had some issues with the Docs here in Dallas, and I have found that the Hospital Administrator is a great tool to get them off their lazy rear end to write a letter. I had shoulder surgery, and had to stay home for over a month as well.

After you get the letter from the Doctor, you need to go to the VBA office in the hospital, and file the the appeal, and demand it be placed as a finiancal hardship. If you are out of money dont be afraid to prove it with a past due bill for the lights or water, or even have the landlord write a letter stating you are about to be evicted if the rent is not paid, and make sure there is a date.

Good luck

Hello everyone. Thanks in advance for whatever advice and words of wisdom you can offer. I don't know most of the acronyms or lingo, so forgive me if I get something wrong. I did search before posting, but didn't see our exact situation anywhere. Forgive me for the lengthy post, but I'm trying to include as much relevant info as I can.

My husband was in the Army from 1995-1997, when he was medically discharged. He was in an accident and suffered a severe compound fracture, and spent several months in the hospital going through several surgeries to repair his leg. He wound up with an intramedulliary rod with internal fixtures in his right tibia (a rod with screws, in case I didn't get the medical jargon right, lol). He was medically discharged and initially rated at 10% service connected disability. It was increased to 30% around 2002/3. Since then, he has had pain and swelling at the site of the break intermittently, but this past year, it increased to the point where the pain and swelling is almost constant and occurs every day. He was referred to the Orthopedic clinic at the Temple VA. The orthapedic surgeon there ordered x-rays, and when that didn't show anything, a bone scan was ordered at the end of April. The bone scan revealed new healing and growth at the site of the break from 1997. The surgeon didn't understand the reason for it, as there has been no recent trauma to the leg, and couldn't give a concrete reason for the continuous pain and swelling. So he decided that a rod (nail) and screw removal might relieve the pain and swelling. Surgery was scheduled for June 10, and the surgeon told him to expect to be home from work for most of the summer. Soon as we had all of the details, we started a claim for a temporary 100% increase evaluation on June 3rd. The surgery was a nightmare, btw (it looked like a butcher got a hold of his leg). Nonetheless, the surgery did take place. After four hours, the surgeon came to the waiting room and told me they were unable to remove the rod, and only took out one screw. As such, He released my husband to walk with full weight bearing on his leg the day of the surgery, but told him he could not return to work yet.

We returned to the Temple VA five days later for a post op follow up, and once again, the surgeon told him stay at home, no work, that they would follow up June 29. Went back June 29 for follow up and removal of surgical stitches. Dr told hubby they would discuss his being released to return to work in one month's time, pending pain levels, and to stay home and rest.

July 2nd, recieve response to VA claim, requesting evidence that he had had surgery and any other supporting evidence. We submitted the letter supporting claim, telling them everything I've just told you, as well as signing the release for his VA medical records. Mailed the same day. Then we waited. The wait was actually surprisingly short, even though it seemed to take forever. This past Thursday, we got the big envelope, with the letter dated July 16, informing us his claim was denied. The evidence they lised as using in their decision were his medical records from the Temple VA hospital, their letter requesting evidence, and my husbands initial claim form 21-0820, dated June 3, no mention of anything we sent in.

The following is word for word the reason for denying the claim:

"Entitlement to a temporary total evaluation because of treatment for a service-connected condition requiring convalescence:A temporary 100 percent evaluation may be assigned when it is established that a disability, subject to VA compensation, required surgery necessitating at least one month of convalescence, surgery with severe postoperative residuals, or treatment with immobilization by cast of one major joint or more. Entitlement to this benefit is denied because treatment of the service-connected disability did not meet any of these requirements. VA Central Texas treatment records revealed you underwent hardware removal on your right knee on June 10, 2010. Two broken screws were removed, but the rod could not be removed. A treatment record also dated June 10, 2010 confirmed that Dr. xxxx cleared you to walk with full weight bearing on your right extremity on the same day as your surgery. The evidence of record does not show that you needed at least one month of convalescence, or had postoperative residuals, or treatment with immobilization by cast. Therefore, entitlement to a temporary evaluation based on surgery requiring convalescence is not established since the criteria were not met."

If he truly doesn't merit the temporary increase, that's fine, but I honestly don't understand this decision- he had the surgery, he's been home for going on 7 weeks now on Doctor's orders, he cannot return to work without his doctor's release, and the doctor won't sign a release. I would think that's the definition of convalescence. The decision letter went on to state that blah, blah, blah, you can submit additional evidence or appeal, or request a hearing if the evidence is something we haven't seen before and related to your claim.

Things are getting pretty desperate financially- we have 3 children (ages 12, 6, and 9 months), as of today, we're out of money, and will soon be out of food. Hubby returns to VA for another follow up on Thursday, and may or may not be released to go back to work- if he is, it will still be another 2 1/2 weeks before income starts coming back in. When we got the decision, we decided to try to apply for TANF, but did not qualify- for a family of 5, income has to be less than $268 per month, so we exceeded that with his current $497 monthly compensation. We tried food stamps, but don't qualify for expedited handling, because that same $497 exceeds our monthly utilities total by $3. They said they'd send us a letter, letting us know what they decide. I can't go looking for a job, yet, because if he's released to return to work Thursday, I'll have to quit after only a couple of days. We are in a lose-lose situation at the moment. (Sorry for the mini rant). I would have never waited it out if I thought the VA was going to out and out deny the claim- it never occurred to me that they would, because I thought the doctor ordering you to stay home for 6+ weeks qualified as convalescence.

Can anyone offer advice or an explanation? What would constitute new evidence? Is there anything we can do to reverse this decision?

[Important Topics - Please Review This Thread.]

It is funny I found this, My eye sight has gone from 20/15 to 20/40 in my right eye, and is 20/30 in left eye. I just turned 30, and my family eye doctor thought it was very strange that my eyesight changed that much in just 2 years.

I wonder if there is some truth to this article and something we used or was explosed to in Iraq has damaged our eyes.

I think I will call my eye doc back and talk with him about this.

Thanks

[Va Math - Determining Your Rating]

I was recently moved from 60% to 90% SC disabled. I asked the rater how they determine this when I have 7 disablities with the following ratings.

50%

30%

30%

20%

20%

10%

10%

looks like is should be 170% to me!

well he explained that the VA does not simply add them together and get a number. it is basically 50% of 100, and then 30% of whats left, and then 30% of whats left after that, and so on down the line.

They start with 100 points and subtract the 50% from that (50 points)... then they take the 50 points and subtract 30% (15 points), then they take the 35 and subtract the 30% (10.5 points)........

To make is easy I created a spreadsheet that calculates upto 30 disabilites for you.

The form is hosting on my company webserver, as I am not sure I can add the file here. Please feel free to download and use the file as needed.

Vet Assist - VA Math

[C & P For Several Sc Diabilities]

Well, that went better the I expected.... I got into see the Doctor in Clinic 14, as Dr. George was out on Mat. Leave.... He refered me to the Ortho clinic, Neuro Clinic, and the Pediatry Clinic.

The folks at TBI evaulated me and refered me to Neuro, Ortho, and Physical Therapy.

I am still waiting for Neuro to call me in for a follow-up, however my Family doc sent me to a Neurologist and he is trying some new meds, and is going to see me again in a month.

[C & P For Several Sc Diabilities]

"I am really tired of playing with these fouls up at the VA, and would like to go in fully armed....." Thanks in advance.

It is a War game on paper - but you have some good ammo here for TDIU- paid at the 100% rate-if you are not working.

You dont really need to put the rating codes in any claim for higher rating.

BUT understanding what code they used and why your evidence warrants higher rating under the rating schedule is an asset to anyone claiming higher rating.

You can access the code and rating schedule for any of these disabilities you have to see what evidence is needed for higher award.

In my opinion If you are unemployed I think the TDIU app will go faster in the long run for you-

Check Yes to # 18 and then apply for SSA.

Under Remarks # 25, refer them to separate page with your C file number, name and address on it,and tell them of the problems you had on the job due to your SC, and add anything other info whatsoever that would help gain a TDIU award.

Tell them of all side affects of all meds such as the Motrin and tell them how the right hand problems interfere with employment.

Your private doctor might be willing to support a TDIU claim with an Independent medical opinion.

I cannot access the form, I keep getting an error, is there somewhere else I can retrive this form? Thanks for the advice....

[C & P For Several Sc Diabilities]

Reading Sgt(s) post and I'm simply amazed. My PCP is Dr. T Brown and has been for the past 4 years... and like Pete said, I believe she hung the moon as well! Gets me in to all the consults I need in a timely fashion - In fact, have a Pain Consult for the 24th of this Month - MRI this summer revealed neck/spinal damage I never knew I had from a IED blast 5 years ago, who knew! Dr. Robinson in Poly Trauma is truly awesome when it comes to treatment and care - My Headaches are rated at the max of 50% - Bit of Advice - keep that tracking log accurate and current - if a migraine occurs, immediately seek emergency treament (if possible and medicine fails); this shows the severity of the pain you are suffering. Here is what they use to determine SC for Migraine Headaches:

8100 Migraine:

With very frequent completely prostrating and prolonged attacks

productive of severe economic inadaptability 50

With characteristic prostrating attacks occurring on an average once

a month over last several months................................................ 30

With characteristic prostrating attacks averaging one in 2 months over

last several months 10

With less frequent attacks 0

As far as daily headaches, that may be due to TBI - or other injuries received in service - Hope this helps.

Thanks for the info.... I have an Appt with my PCP on the 24th as well at 9am... I also have TBI followup and re-eval on the 24h at 3 pm.... I am keeping the head ache log up to date the best I can, my wife helps with it some as well.... As for the ER, I cannot afford to do this... I usually take the meds the doc gave me or some advil Migraine, and go to bed. Thanks for the Advice as well, I just sent in my claim for the Migraines under 8100.... According to the rating scale I should be around 50%, as I have an average of 4 migraines a month, and a headache at least 11 days a month.

[C & P For Several Sc Diabilities]

I see Dr George at Hotel Clinic 11 in Dallas and I think that she hung the moon. She is on maternity leave and I would follow Larry's advise to the letter. As you deal with Dallas VA you will more or less learn that the PCP's Docs are so overloaded with patients that until they develop some sort of relationship with you they may seem aloof or uncaring.

If you continue with Dr George just talk to her about consults the only one that I have not been able to get so far is Cardiology and I think that she writes the consult but Cardiology does not do their part.

You might also try the Patient Advocate and see if one of them can help you.

Welcome to Hadit.

I have had Dr George for over 4 years and that is the longest time I have ever had a Doc at the VA. She has gone to bat for me many times over treatment issues and she takes the time to explain things that have helped me.

Thanks for the info, I have had her since 2006 and she has not assisted me like that, I hope she will, I have another appt with her on the 24th of this month... I have asked for a consult for my headaches at least 5 times and she dismisses the request.... I asked her to refer me to see if I had sleep apnea and she refused, I went to my family doc and talked to her, she refered me to sleep med, and they conducted a sleep study twice and found that I have sleep apnea.... If she refuses to send me for a consult on my headaches again, I will contact a Patient Advocate, and then my family doc for a referral.... I know theses headaches are not normal, and something is wrong... I am tired of taking a pill to mask a problem.... I want this fixed....

<_<

[C & P For Several Sc Diabilities]

I just read all your posts, Sgt Will..... I would advise you to keep the Nero specialist appointment, this time... Sounds like you are having way too many headaches. Have you ever been checked for TBI? Did you ever jar your jarhead, Marine?? You live 50 miles from the Dallas VAMC. Don't you qualify for fee basis? You can see a private Dr. in your town.???

Yes, I knocked the jar a little lose a few times, thanks for asking..... As for the fee base how do I find out about that, I would prefer to see my private Family doc anyway, see looks better then my VA doc...lol..... I was checked for TBI about 18 months ago, but they told me I didn't have it then, and they dismissed my headaches as not important.... I have since started keeping a log of my headaches, and they are getting worse..... I called the Nero / Poly Trauma Doc yesterday and I am waiting on a call back for an appt. I will call them back today if I dont hear from them by 10am local.... I live in north of McKinney, and from my front door to the VAMC Dallas, it is 49.7 miles.... Bonham is actually a little closer, and I am thinking about switching to it... it is 38.3 miles from my front door. I have been using VAMC Dallas, because when I moved to Texas in 2006, I lived in Irving, and it was only about 15 miles to Dallas VAMC.

I think my biggest mistake was telling the doc last time that I am learning to live with the headaches.... That was before they got this bad..... None of the meds they have given me help...

[C & P For Several Sc Diabilities]

Ask your Primary for a consult with the Copper Team (psych clinic,) Don Huff, PA.

Also ask your Primary for a scheduling with the pain clinic, Dr. Jamie Zavacavek (not the right spelling, everybody just calls her Dr. Jamie).

Are you seeing anyone in Ortho?

If your Primary Care is Clinic 14, then they'll at least try to work with you (Dr Harriharan Ramamurthy is my PCP. We have an understanding. He speaks Hindi, I speak Yiddish, he takes the notes that my wife gives me to give to him, BINGO! All is good.) :)

I had Dr. George as my Primary, and she doesn't seem to think I need any consults to the other Docs... I am thinking of changing to the Denton or Bonham clinic to make life easier for me.... Going to Dallas VAMC, was suppose to make it a one stop shot.... but no dice.... I am on the phone with the MC to try and schedule appt with doc.... Maybe the will give me a new Primary.

Also, does anyone have the dx code for Cronic Headaches, I cannot find it on the gpo site... I am trying to find the rating chart....

thanks

[C & P For Several Sc Diabilities]

I think you should go for treatment at the VA for all your problems. You should ask for a referral to both the pain clinic and psychiatry. You probably have chronic pain and that goes hand in hand with depression. Don't miss your appointments! You want to go to the VA and build a record of treatment. This will make it easier to get increases. You want to document continual treatment for all service connected injuries, or potential SC conditions. This is going to be a life long battle because many conditions get worse as you get older. When your PCP nurse asks you if you have pain don't down play the intensity of pain. What kind of pain meds are you getting now? If you have a condition the VA expects you to take medications or at least accept them.

The wonderful world of the VA seems to think all I need is Vitamin M "800 MG Mortin" I think this has destroyed my stomach.... I have been going to the VA clinic / MC since I got out of service.... I have asked for some pain meds, and they give me mortin. I have 30% PTSD as well, and they give me all the generic sleeping pills they can find, and it puts me to sleep so much I don't wake up for 10 hours and then I lose my job.... Had to learn to cope with only getting 4 to 5 hours of sleep a night..... I have to drive 50 miles one way to the VAMC in Dallas, and then it takes me 6 trips to get things done...

I have been logging all my headaches over the past year, and I hope this is enough to get them appoved with something other then 0%. My Family doc is considering sending me to e Nero specialist for an evaluation.... I just got off the phone with te TBI doc in Dallas, and they want me to come back in.....

[C & P For Several Sc Diabilities]

I have several SC Disabilities and I am filing VBA-21-4138 for an increase to my SCD.... I am looking for the actual codes I need to put in the 21-4138.

1. I have Migrane / Chronic Headaches that were rated as SC - 0%, since I got out they are occuring all most daily, and they are getting worse.

2. I have a shoulder injury on my left should that was rated at 10% when I got out but it was listed as temp.... It has gotten worse and I want the them to re-evaluate it.... I have limited ROM, and Painful movement. They have taken the 10% away 2 yrs ago.... This is my Dominate Arm.

3. I have a severe injury to my left ankle - Triple fracture and had 9 pins and a 4.5 inch plate.... I have had 3 surgeries on this ankle alone.... The VA gave me 10% when I got out in 2005, but the ankle is getting worse and more painful.

4. I have a right ankle injury that required 2 surgeries. The VA gave me 10% on it when I got out, but this ankle is getting worse as well. I have lost ROM and have painful movment in both ankles.

5. My Left wirst had a Cyst removed and I have pain that shots up my left arm all the time. This is my Dominate Hand

6. The TBI folks wanted me to come in for a followup a few months ago, but I never made it in, and I am thinking I should go back in for a the followup as my headaches are really getting bad, and are starting to affect my sight (Blurred vision in my right eye).

I am really tired of playing with these fouls up at the VA, and would like to go in fully armed..... Thanks in advance.