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Gastone
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Posts posted by Gastone
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There is always the possibility that your claimed Secondary Nexus is in error. What VA or Private Nephrologist Treatment Notes or IMO backs up your DM II Nexus?
As to the IU Claim, if he's over 60% SC or meets the requirements for an Extra-Scheduler Award, why on earth haven't you already filed for IU?
Do you have a POA-VSO handling your Claims and Appeals, big mistake if you're doing this as DIY project? Especially true, if IU has been a missed opportunity for an extended period.
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DRO (?) Review or Hearing?
Could you post a redacted copy of your Denial Decision? Have you supplied the VA mandatory, Post Decision New & Material Evidence, required for either the DRO Review or Hearing? Failure to do so will result in an Administrative continued Denial.
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How about this, File your NOD specifically requesting a DRO Hearing, 2.5 to 4-year wait for an RO Hearing Date. I know, you're saying to yourself "WTF is he nuts, I wanted the Award yesterday." You have to come to the realization that the chance of a Denied Decision Reversal pre-DRO Hearing are slim and none; unless your Denial is pulled for a "Quality Review" by a Sr RO Rater.
Immediately, as in same or next day after filing your NOD, file an Official request for an "Informal DRO Evidence Conference? Your POA-VSO can handle all the Filings, just be sure to get a copy of everything filed on your behalf. At your leisure, read up on the "DRO Informal Evidence Conference," in the M21 Manual. At the very least, the "Evidence conference would supply you with exactly what evidence you need to prevail and/or possibly a DRO Award at the time of the Conference. I used the "DRO Evidence Conference" back in 14, worked for me, all issues Awarded at time of Conference, which took place 6.5 months after Filing the "Conference" request.
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On 6/15/2018 at 6:19 PM, Ddsr said:
Notes:
- The fact that a Veteran is participating in a program of rehabilitation does not preclude a finding of IU.
- The fact that a Veteran has completed a program of rehabilitation does not mandate a termination of IU unless sustained employment is also demonstrated.
- When IU is claimed following a completed program of rehabilitation, pay special attention to evidence of program results that indicate the Veteran's ability and willingness to engage in a substantially gainful occupation.
IU claimed following successful completion of VR culminating in a College Degree will always receive Max Scrutiny as discussed above. Ability and willingness to do ANY Type of SGO that would produce in excess of the SGI $12,440 yrly (under65) $239 per week becomes the focal point of the Rater.
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What was the date of the DM II DX (Diagnosis)? Is your BMI 28%++, neck 17+, Stomach circumference in inches (??)? The overnight Sleep Study results, OSA, Central SA or Mixed SA? Are you on supplemental Oxygen, do you know what if your P02 pressure fell below 90% at any time?
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Old Dog basic Hearing & Tinnitus issues never improve. As a Nam Vet, your way past the Double Nickel (55) where you have to worry about Rating Dept ordering 3 to 5-year "Diary Dated" C-File Re-exams to determine SC improvement. If you file for an Increase or Secondary issue, that obviously opens your respective SC's for a Rating Dept ordered C & P exam and/or VMC Med Rec Review.
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The Heart only gets (1) Rating, unlike the Knee. Whichever Heart Condition get the Higher SC, that will be your Heart SC, the Heart is a "No Pyramiding" Zone.
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SD-22, check out MilitaryDisabilitymadeeasy.com. Just found one of their comprehensive discussions pertaining to Peripheral Nerves of the Low Back and Legs (2013).
An in-depth discussion of the VA Rating Principles involved, very informative.
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Will have to eyeball the decision. Keep in mind, you won't see the "Bi-Lateral" factor, it's used only for computing your CSC Rating. Take all the SC% listed and forget about the "B-Factor, just run from highest to lowest using the Hadit Comp Calculator. Then run the same as B-Factor SC's, what the CSC before Rounding up or down?
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Are you currently seeing a Private or VA Gastroenterologist, who DX'd the severity of the Hemmies? When did you separate from Active Duty, any mention of Butt problem on your Exit Medical Exam? Any chance you could redact and post SMR's related to treatment and any DX associated with your Rectal Issues?
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Is this a Direct or Secondary SC Claim Filing? Are you SC'd for any other conditions? Do you receive treatment from your VMC for your associated Rectal Issues? Have you been referred by a VA PCP to the Prosthetics Dept for undergarments/Pads associated with your condition?
How about posting an actual redacted copy of the Claim and the DBQ?
As to the "Pads" issue, you completed a 21-4138 discussing the need to change your underwear "30x times" per month, due to accidents or leakage, correct. No mention of Bed Pads, Female/Male protective clothing/Pads purchased at Costco/Sam's or Walmart?
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Did you do this Claim as a DIY on your E-Ben site, or did you use a POA-VSO?
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F, just curious, why did you not have your Private DX of Hypersomnia medical Record Noted and scanned into your VMC Medical Record and also attached to your Claim as a PDF? You didn't request your private Clinician to copy your Med Recs to the VMC?
You knew you were filing a Secondary Claim, who handled the organization of Evidence and Claim submission?
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On the subject of Eye Glasses and your VMC Eye Clinic. If you need Computer Glasses, Special Frames (Big Head) or Self-Darkening (Transition) Lenses, request an appointment with the VMC Low Vision Department. Back in 13, after VA Optometrist advised me she could no longer give me Progressive/Transition lenses, either reg or sunglasses only: I requested an appointment with the Low Vision Dept. It took an extra 2 months, but I got the Prog/Trans Lenses in designer type frames with Magnetic Day or Night Driving clip-0n Sunglasses. Also got a pair of Computer Glasses. The Low Vision Tech balked when I requested the Prog/Trans Lenses citing "New VA Reg," to which I replied "OK, I want a copy of the VA Directive," before I leave. She left the office to get a copy of the directive, returned in about 10 min and informed me that after discussion with her Dept Head regarding my vision requirements, the would supply all of the above. No more having to pay the VMC Contractor the $125.00 Frame upgrade for Big Head Frames.
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I can think of nothing your PCP could offer regarding a VRC Denial Letter completion. E-mail, no phone calls (Think Paper-Trail) your VRC and let her know your PCP out of the Country, then address your question as to what she was trying to verify or Confirm by contacting your VMC PCP.
A VMC PCP doesn't know anything more about any of your Specific SC Disabilities, than your treating VMC Specialist. As long as it's just your SC conditions that are currently precluding you from a successful completion of the VA VR Program, a New VRC should be able to review both your VR And VMC Clinician Notes and conclude the Denial Letter is appropriate.
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The Jury is still out on the RAMP Program. To date, I haven't seen any Hadit Success Postings from Vets that went RAMP, for either DRO or BVA Appeals. A BIG Concern is, other than FDC, when did a New VA Claims/Appeal Program operate as advertised?
Quite often, accuracy is sacrificed for speed, especially when VA Programs are New. What good is a Faster DRO or BVA continued Denial, a faster trip to the CAVC for Remands?
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S-22, when your VRC advised you as to the need to contact your PCP, did you question why?
Did you follow up the VRC discussion with a MHV Secure Message to your PCP regarding the VRC Contact?
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Boomer, is your's a DRO Review or Hearing?
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What did they Award, what was continued, don't tease us now?
How about posting a redacted copy of both the Award Letter and SOC?
You Lawyer'd Up late last year, what was the Retro Percentage Legal Fee Agreement?
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How about a Two Prong Attack, NOD immediately after notification of the upcoming Denial Decision which has probably already been made and File immediately, a New Claim on your own using your E-Ben site to address the MH Conditions that you believe are Secondary to the PAIN Symptoms associated with your SC Joint Issues.
You could address the supposedly erroneous VSO Direct SC Filing, by personally filing a VA Statement in Support of Claim, discussing how this error unbeknownst to you, occurred.
Did you mention, did your VSO file this Pain Claim as an FDC?
Have you asked, or has your VSO offered to review your C-File to determine the current status of the Claims progression?
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Bronc, any idea of how long the VA has been using the Z NexGen? The whole LowBid deal gives a #10 Pucker Factor.
A few yrs ago, I already had the VMC Heart Echo Evidence I needed for both the SA Secondary PH 0% SC and subsequent SA Increase to 100% Claim. However, my VMC Cardio Dr unaware of any Comp Associated Filings, suggested the Heart Cath which is not only invasive but is also considered to be the "Gold Standard" when it comes to Cardio Tests. A couple months later, I met with the VMC Staff Cath Drs, young knowledgeable and seemed very competent. After careful consideration, I postponed my NON-Emergency Right-heart Cath. Immediately contacted my Medicare United Health supplemental Carrier and Started the "Full Boat" $145.00 per mos plan.
Following week, contacted my non-VA Cardio Dr that was involved in my "06" bypass surgery, a few weeks later a Full Heart Cath was completed at a local Area Top State Hospital. He decided to do a Full Heart cath rather than just the Right Ventricle because it had been 10 yrs since the Surgery. I like the VMC and the Drs, however, for life or Death or even any invasive surgery of any kind; I'm going to stick with the "Pro's from Dover." I know this is an exaggeration, but I want the Cutter with 4000 successful procedures under his belt, instead of the young Knife with 800. No matter the Dr's age, they're all still "Practicing Medicine;" but I want the Doc with the most practice and best Batting Average.
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Bronc, do a search for Zimmer NexGen Knee Replacement. A legal Firm (Schmidt Law) posted regarding 1000+ Painful Knee Replacement procedures lawsuits as of mid 2015.
The 1st US Jury Trial 11/9/2015, held in Chicago, resulted in Zimmer's Lawyers successfully defending against the allegation of a NexGen Design Flaw (causing loosening/severe pain) by putting a preponderance of the blame on the Ortho/Surgeon's inappropriate installation and the Plaintiffs returning to full activity too soon, not a Design Flaw that caused the loosening of the Joints.
Did the VA Surgeon discuss any of the pre-2018 NexGen litigation issues?
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Bronc, you have the (1) SC rated by singularly as 100% or are you IU for a Single Condition? Due to my IU Claims Filing ignorance, when presented with the "Inferred IU" on a Rating Decision back in 2010, I immediately Filed the IU Claim Listing my PTSD, SA and CAD as the SC's causing my IU. My BAD, I wasn't aware of SMC S & IU relationship. Boned myself out of about 2 years of SMC S $$ How long has the Zimmer NexGen been in use by the VA? Sounds like you're very comfortable with you're VA Ortho Surgeon. Were any replacement options made available?
Remanded back to st. Pete
in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC
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Lookup VA Accredited Claims Agent #39029 POA Code EIP. Do a Consult and get this over with. It's time to get this handled by a Pro so you folks can get on with your lives.
This VA Claims Agent can get it done either at the BVA Level or CAVC if necessary.