THOMAS89031

Sounds like you got bum information from the VARO who sent you the letter requiring a "medical opinion" for prostrate cancer. Also, the VA employee you talked to apparently does not know the rules and regulations relating to exposure to agent orange. Easy way to resolve this is to point out prostrate cancer is one of the presumptive diseases caused by agent orange. What VARO are you dealing with? You should not have to get an IMO for prostrate cancer.

Buck..For whats it worth, I have a friend who was a Hawk missle man in the Army and he started out with two or three circles on his arms about five years ago. He went to about 6 different doctors over the years and they just started getting worse and more blisters showed up all over his body. Well, about 2 years ago, he was finally diagnosed with Lupus. Two years ago, we filed a VA claim to get him service connected for Lupus caused by the "Air Shot Guns" they used to use. He had a statement from his DR. that it was "as least likely as not" the air shot guns caused his disease. VA in their wisdom denied his claim and we filed the VA Form 9 and are now awaiting a BVA Decision.

I would suggestyou have three options: 1. Ask the Location who did the C&P for a copy (Sometimes they will give it to you and sometimes they won't) 2. Go to the VA Regional Office in person and have your husband ask for it (No doubt he will have to complete VA Form 10-5345 below). 3. Complete the VA Form 10-5345 and either Fax it to Wisc or Hand carry to Regional VA office Good Luck! C&P REQUEST FORvha-10-5345-fill.pdf NEW_FAX COVER SHEET_Claims+Intake+Fax+Coversheet-1.pdf

Larry: Common sense would dictate using your "surgeon's" mets and thus you would be rated at 100% based on mets. However; in an attempt to "low ball" you, the VA might use the C&P's nurse estimate. If the VA does not give you a 100% rating; NOD your rating and request a C&P exam.!!! I would also have your doctor make a statement to the effect "treadmill tests are off limits due to your condition". At the time of my C&P, I almost ended up in the hospital because they administered THREE different test to determine my mets.. (Dr had to stop Treadmill Test after about 20/30seconds due to chest pain) Had I not had my "go-juice" (nitroglycerin) I would have no doubt had a heart attack!! On a footnote, my C&P exam doctor listed my mets as 1 also. But...VA rater Missed his comment(s) about my mets level being 1. I did not discover this until I GOT MY c-FILE AND READ THE EXCHANGE OF E-MAILS BETWEEN THE RATER AND MY C&P DOCTOR!! Good Luck

Buck, maybe this will help.... 23Share Receive Updates Review of VBA’s Special Monthly Compensation Housebound Benefits Veterans Affairs Office of Inspector General (OIG) sent this bulletin at 09/29/2016 03:20 PM EDT Having trouble viewing this email? View it as a Web page. You are subscribed to Oversight Reports for Veterans Affairs Office of Inspector General (OIG). This information has recently been updated, and is now available. Review of VBA’s Special Monthly Compensation Housebound Benefits 09/28/2016 08:00 PM EDT We conducted this review to determine whether the Veterans Benefits Administration (VBA) properly granted entitlement to all statutory housebound special monthly compensation (SMC) benefits for living veterans with a single disability rated as 100 percent and one or more disabilities independently rated at 60 percent. This review focused on whether VBA failed to pay or delayed paying any of these benefits. We also assessed the accuracy of SMC evaluations for veterans receiving compensation at the housebound rate, including statutory housebound, and housebound in fact, as well as SMC that had been incorrectly coded as housebound benefits. We conducted our review from March 2015 through February 2016. Our first review objective focused on a population of about 186,000 living veterans’ cases nationwide that at some point were entitled to statutory housebound SMC benefits based on a single disability rated as 100 percent and one or more disabilities independently rated at 60 percent as of March 10, 2015. To address our second objective, we reviewed a population of about 98,400 veterans’ cases nationwide receiving compensation at the housebound rate for any reason as of March 10, 2015. To accomplish our objectives, we reviewed applicable laws, regulations, policies, procedures, and guidelines. We also interviewed appropriate VBA management, employees, and other officials. We conducted onsite interviews with VBA management and staff at eight VA regional offices from September through November 2015. The VA regional offices in Atlanta, GA; Cleveland, OH; Lincoln, NE; Nashville, TN; Saint Petersburg, FL; Seattle, WA; Waco, TX; and Winston Salem, NC, were selected based on having the most cases in our samples. We reviewed a statistically selected random sample of 250 cases with eligibility to statutory housebound benefits, based on veterans having a single disability rated as 100 percent and one or more disabilities independently rated at 60 percent as of March 10, 2015. We also reviewed a stratified random sample of 247 cases of veterans receiving compensation at the housebound rate and grouped according to their combined evaluation. We reviewed the claims folders and electronic records for each of the cases and sought to determine whether they had been accurately worked. For more information on the scope and methodology of this review, go to Appendix B. We identified errors in 45 of 250 cases (18 percent) in which veterans were entitled to statutory housebound benefits based on having a single disability rated as 100 percent disabling and one or more disabilities independently rated at 60 percent or more. Errors included failure to grant housebound benefits, failure to pay housebound benefits that had been granted, and prematurely reducing housebound benefits. We also found errors in 127 of 247 cases (51 percent) in which veterans were being paid compensation at the housebound rate. In 10 additional cases, we could not determine whether housebound in-fact benefits were accurate because VBA’s eligibility criteria were unclear. We identified different error rates within each group of our stratified sample. As a result, we estimated an overall error rate of 10 percent for veterans being paid compensation at the housebound rate, and a 27 percent error rate for veterans with combined evaluations that were 90 percent or less. Generally, the inaccuracies we identified involved housebound benefits for unemployable veterans, entry of SMC codes into the electronic system, and housebound benefits on an in-fact basis. Generally, VBA staff failed to grant statutory housebound benefits because they overlooked the issue, and VBA’s electronic reminder was ineffective. Errors for veterans being paid compensation at the housebound rate were due to ineffective training and a multi-step process for entering temporary housebound codes in the electronic system. VBA staff were also confused as to the requirements for use of the SMC Calculator. Finally, VBA has not clarified the meaning of “substantially confined” for housebound in-fact determinations. Veterans entitled to statutory housebound benefits did not consistently receive correct benefits decisions. Based on sample projection results, we estimated errors in 33,400 of 186,000 cases. We estimated that these errors resulted in veterans being underpaid $110.1 million through February 2015, and receiving recurring underpayments of $1.8 million per month as of March 2015. In addition, we estimated that VBA staff delayed paying veterans $54.3 million. Errors for veterans receiving compensation at the housebound rate also resulted in incorrect benefits decisions. Based on sample projection results, we estimated errors in 2,600 of 9,800 cases for which veterans’ combined evaluations were 90 percent or less. We estimated that these errors resulted in veterans being overpaid $44.3 million through February 2015, with ongoing overpayments of $1.1 million per month as of March 2015. These overpayments included $21.4 million in benefits that were improper, which were ongoing at a rate of $678,000 per month. The remaining overpayments of $22.9 million were not supported by adequate documentation and were ongoing at a rate of $427,000 per month. Veterans’ monthly recurring overpayments generally continue for at least 5 months. We recommended the then Acting Under Secretary for Benefits establish plans to update the electronic system, conduct reviews of cases in which housebound benefits are being paid, provide updated training, remind staff to use the SMC Calculator in all SMC cases, and clarify the meaning of “substantially confined.” The Principal Deputy Under Secretary for Benefits concurred with our recommendations and stated that VBA will conduct an annual review of SMC housebound benefits with the initial review in October 2016, and then, each October thereafter. Compensation Service has provided business requirements for changes to the Veterans Benefits Management System Rating application to prevent staff from completing a decision without considering potential eligibility to statutory housebound benefits any time a veteran has a single 100 percent evaluation and to add a requirement to discontinue temporary housebound benefits when a veteran no longer meets the criteria. VBA has required decision-makers to use the SMC Calculator and to include the worksheet results in the claims folder. This requirement is included in updated mandatory training for all Rating Veterans Service Representatives and Decision Review Officers. Furthermore, VBA has initiated a working group to clarify the statutory term “substantially confined” to ensure consistent application of this benefit. VBA plans to complete these actions by December 2016. Finally, the Principal Deputy Under Secretary for Benefits stated that VBA has identified approximately 11,600 veterans being paid compensation at the housebound rate with a combined evaluation of 90 percent or less. VBA will review the cases and certification will be provided to the OIG. The target completion date for these actions is April 2017. The Principal Deputy Under Secretary for Benefits’ planned corrective actions are responsive to the recommendations, and we will follow up as required. To address Recommendation 1, VBA released VBMS 11.0 on June 17, 2016, which included new functionality that prevents staff from completing decisions without considering potential eligibility to statutory housebound benefits any time a veteran has a single 100 percent evaluation. Therefore, we consider Recommendation 1 closed and we will follow up as required. Update your subscriptions, modify your password or e-mail address, or stop subscriptions at any time on your Subscriber Preferences Page. You will need to use your e-mail address to log in. If you have questions or problems with the subscription service, please contact subscriberhelp.govdelivery.com. All other inquiries can be directed to vaoig.reportsstaff@va.gov. This service is provided to you at no charge by Veterans Affairs Office of Inspector General (OIG).

OIG Investigation at various RO's have found that if you are rated 100% PT; you are entitled to SMC "S" BUT the RO's are failing to award based on thinking you need an additional 60%. If you do not leave your house for "work", you should be awarded SMC "S".

One important thing to remember: If you are 100%, you don't need an extra rating of 60% or more to be entitled to SMC S. At 100%, you qualify on the grounds that "you don't leave the house for work" Yes, you can leave the house for any reason except work!! Asknod can chime in on this?

Mikey, I have a friend in the same boat. He filed a claim with the VA requesting a C&P. C&P was scheduled, Dr. completed the DBQ...VA granted his increase to 100%PT Thomas

Thanks for sharing the info and congrats!! Don't forget DMV DAV plates for your vehicle(s) and Champ VA for spouse/depn and county taxes...

Buck52... Have you looked at item 18 (f) of your DD 214 to see what it indicates for "Foreign and/or Sea Service? Is there anything in Section VII of your SR's indicating where you've been?? Do you have "DA Form 2-1" if so, check item 5? There should also be "Unit Diaries" or pay records you could obtain somewhere perhaps? Good luck!! Thomas89031

Buck, My prayers are sent your way and wish you the best!! Thomas

King156...My opinion is to submit your NOD after they send you the decision. Reason being, they will list reason(s) why /how they reached that decision. Then you can refute what is missing or incorrect. Also, you might want to do some research on the DR. who did the C&P to see if he is qualified to opine on your condition? (Kinda like to make sure he's not a dentist giving an opinion on a heart condition) Who knows, they might surprise you with a more favorable rating than what you were expecting... Thomas

Muffin; If you check the box that indicates you have submitted all your documents, I think they will process it quicker instead of VA waiting 60 days to see if you submit more documents. So actually, they should be able to process it quicker...jmho...tom

Saxman, please re-check the date you put on your "perfected" appeal.... Hope you did not put: __Nov 2016?

My understanding is they closed down the other one in GA.

This is the address and Fax Number pertaining to Bucks "opinion" Fax# 844 822 5246 Address: Dept of Veterans Affairs Evidence Intake Center PO Box 4444 Janesville WI 53547-4444

Trey, just from what you wrote, appears to me he will be rated 100% P & T .

According to VA Rating Manual,,, "0" METS Equal a 100% I think item 2.b the "Yes" Box should be checked; also YES for 2-d. and the DR. should have indicated Mets of"0" in item 14.F and 15 should be Yes?