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Gastone
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Posts posted by Gastone
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You won't see the "Bi-Lateral" term on your E-Ben site. As to the 10% Bi-Lateral Factor, you're not quite accurate as to it's application. It's not an additional full 10% added to the SC. In your case, I see (2) Bilateral Conditions rated at 10% SC for both R & L feet and shins. The VA Bilateral Factor is the addition of 10% of the sum of the 2 SC's involved as Bi-Lateral. In your case, each foot is 10% = 20% (+1%) = 21% for your CSC Calculation.
Take a moment and run your SC numbers on the Hadit Calculator. 1@30 and 8@10 = 69.87 rounded up to 70%. Your erroneous understanding of the 10% Bilateral calculation would have you picking up an additional 20% for a CSC of 75.89, rounded to 80%. Run 1@ 30, 2@ 21, 4@ 10, you'll see that the CSC is 71.336, rounded down to 70%.
Was there anything mentioned in your Award Letter regarding "Bi-Lateral?"
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At some point early on in the Appeals Process, you made a Representation Decision to go it alone. From your above post, that decision has not been validated. At this point, you saved 20% of nothing by not obtaining VA Lawyer or Claims Agent Representation.
If there isn't enough Retro to interest a VA lawyer or Claims Agent, you might consider the Vet Consortium Pro Bono Service in DC. They'll take you all the way to the CAVC if necessary, for none of your Retro, just the Awarded Legal fees if a Win or Remand is Decided.
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Could you post a redacted copy of the complete Award Letter? What is "standard package home care"?
As to your legs, in the SMC Description for "Loss of Use" of different appendages, generally; a comparison to the appendage being Amputated is the Rating Standard. From your description, I'd say your legs are of no better use in mobility; then if they had been amputated.
AskNod is the SMC Encyclopedia, he's posted here on Hadit and on his AskNod.com site; a very thorough and understandable in-depth discussion of SMC Awards and their respective Rating Criteria.
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What makes you think that any condition that is actually "Bi-Lateral" has not already received the "Bi-lateral Factor" when computing your current CSC Rating? Have you filed a VA FOIA request to get a copy of your C-File? It would behoove you to do so at your earliest convenience.
You might want to read up on the VA's latest TBI Rating policies. Unless there is a Dent or substantial Scaring, the Residual Neurological Symptoms get the Disability Rating. If you believe any or all of your 09 SC's have worsened, definitely file the FDC Claim for Increase, let the VA C & P Drs and Raters figure it out. How about posting a redacted copy of your 2009 Award?
Do you use your VMC for all your Medical care? Have you been referred to the VA Occupational/Physical therapy Dept for your multiple joint problems? When you were initially referred by your VA PCP to the VA Neurology Dept, did you have an EMG performed?
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Which type of DRO Appeal Route did you specify when filing your NOD, a DRO Review (2+- yrs), DRO Hearing (3++ years); or you didn't specify and the NOD automatically became a DRO Review? When did you supply the VA mandated New & Material Evidence? If you don't have a POA-VSO, get one yesterday. Your POA-VSO Rep can access your RO Claims Status online as well as access your C-File, to see exactly what's going on.
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M, are you receiving any VMC treatment for your Gerd & BE?
Your above post indicates a Non-VA Dr has DX'd and is treating your referenced conditions. How long have you been a patient of this DR, is he/she a Board Certified Gastroenterologist? You don't need a formal IMO or DBQ completed by this Dr. Copies of his/her's "Treatment Notes" are completely adequate for ALL VA Claims and Appeals.
With that said, it's your responsibility to steer the Dr towards discussing any and all possible etiologies regarding your conditions. No Dr, Specialist or PCP, is going to offer an etiology claiming he is 100% Certain that it's the only possible cause. The list of possible causes of Gerd and "BE" is somewhat extensive, the best you could probably do is an Opinion that 1 or 2 are more likely than the rest.
What has your Private Dr had to say regarding both conditions in question?
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VA Dr's are required by VA Reg to complete an Issue Specific DBQ at or near the time of the Vet's Request. The only exception to this rule is for MH & PTSD DBQs. MH Psychiatrists/Psychologists are required to hand off the DBQ Request to a MH Clinician that is not involved with the respective Vet.
Realistically, not all VA Drs are going to comply initially with the Vet's request for the specific DBQ. That's when the Vet pulls out a copy of the VA DBQ Directive and if need be, request Mast with the Department Head. When any VMC Clinician Denies a Vet's legitimate request for any service, the Vet must push back by requesting politely, yet firmly, to see the Dept Head and/or requesting a copy of the VA Reg supporting the Clinician's Denial/Refusal of the Service requested.
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What's the File Date of your Comp Claim? Are you now working with the same or different POA-VSO? No Claims specifics, no redated C & P DBQs; make it very difficult to opine regarding your circumstances.
Do you currently have a POA-VSO Rep assisting you?
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File an FDC for an Increase of the SC 10% immediately if not Sooner. All your PH and Heart Valve Treatment records are with your VMC, correct? If that's the case, the recent Clinician treatment note addressing the severity of your Valve is already available for the Raters Review.
The SMC S Award will automatically be considered when you File The FDC Increase.
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When you say "SHE," you're referring to the C & P Dr, correct?
Use a 21-4138 today, to file for an "Official VA DRO Evidence Conference." If you live within driving distance (30 min) to your RO, hand deliver it.
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The Jan 2016 DBQ indicating "Less likely than not" is never good.
Did you do your NOD as a DIY or with VSO-Rep assistance? No POA-VSO, might be time to sign up with local VSO-Rep. They can pull up your VA C-File and check DRO Appeal Status.
You're somewhat late regarding specifying which type of DRO You want. Failure to specify the DRO Hearing Route automatically locked you into the DRO Review, not good. A DRO Decision may have already been completed, the problem being it can take up to 8+ months to get the actual Award/Denial Decision, longer if it's a Denial of any NOD issue requiring the completion and attachment of a SOC (Statement of Case).
Be sure your specified VA Comp Direct Deposit Bank/Credit Union account is set to Real-time Txt & Email you regarding all Transactions. Any Retro Award will hit the Bank well before the Award Letter.
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Post a redacted copy of your E-Ben SC disabilities page showing what each SC is and it's Rating Percentage. Is there (1) SC at 100% or Multiple SCs that have a Combined Service Connection "CSC," that get's to 95% rounded up to 100%?
Take a look at the VA non-Scheduler Housebound Medical questionnaire that is required to be completed by your treating Dr., when filing an HB claim other than Scheduler. How would your Dr answer the Housebound questions?
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Help me with my reverse mat, 01/18 NOD New C & P, "Year or so" NOD Pending = Mid to end of 15 NOD Filing; so Appealed Award Issues Decision Letter received Mid to end of 2014, am I close?
That would put the SC's associated with this Claim as being held less than 5 years, correct? If so, any SC Held for less than 5 years can (Unless it's a100% Rating) be reduced based on a current DBQ, no need for the Rater to Review your VA Med Record for continuity of Improvement.
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Are you Rated (1) condition at 100% SC, multiple conditions with a CSC 100%, or IU for (1) condition rated at less than 100% SC?
(1) Scheduler SC Rated at 100% or an IU Award for (1) Condition, would put you in position for an SMC S (Scheduler Housebound) Award requiring (1) SC 100% and 1 or more that = 60%. An additional $342.00 per month, so you call the ball.
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Associating, Safe Bet, I Assume, or any other such guesswork with VA Claims, DROs or BVA Appeals; is like using the Old Black 8-Ball to determine IF and When.
Did you request a DRO Review or DRO Hearing? What New & Material Evidence have you furnished with or since filing your NOD? Can you post a redacted copy of the Recent C & P DBQ?
Ask your POA-VSO to review your C-File for any Rater's updates? If a NOD Denial is continued, it could take 4 to 8 months for an actual Denial Letter with SOC included to arrive.
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Upon receipt of the VA Intent to Reduce Letter, did you immediately File a NOD Requesting a Hearing, 2 Month Appeal Clock still Ticking? One would believe that any Vet with a Single SC Rating for PTSD @ 100% SC, would require constant VA MH Dept Treatment by a VA Psychiatrist. Do you believe this VA Letter of Intent to Reduce is based on you missing the Scheduled PTSD C & P or do your MH Treatment Records actually show significant sustained Improvement? Any VA PTSD C & P is Forensic in nature, Treating VA Psychiatrists or Psychologists are precluded from completing the PTSD DBQ of any Vet under their direct Care/Treatment. Who completed the Re-Exam DBQ? Can you post a Redacted copy of the DBQ from 17 & 18?
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If in fact the IU is Awarded due to your PTSD, a Total & Permanent should not be expected. Considering your Employment History and Educational Achievements, I could see a possible IU Denial Based on your probable ability to do "some sort of Sedentary work" that would provide you with Earned Income above the SGI/SGO figure of $12,440 for Vets under 65, $11,440 over 65.
What was the Effective Date for your original PTSD Award? Have you ever heard of the VA Vocational Rehabilitation Dept Counciler's "DENIAL LETTER?"
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Nam Vets are all Old Dogs now and who knows when OUR Expiration Date will hit. Time is not our FRIEND.
Once you have the Official PC DX, hit the Submit Button on E-Ben to file the AO Secondary Claim as an FDC Attaching the testing Results and the Private or VA Dr's DX and Treatment notes. The 100% PC SC would take effect almost immediately, with Retro back to File Date or 06/01/18 and continue as long as the PC hasn't been removed or successfully Radiated.
Scheduler SMC S (Housebound) should be Awarded simultaneously.
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I think you have more pressing concerns regarding which treatment for PC to use than worrying about future SC Reductions. A recent Major Medical Report indicates that a 10+- years PC Study results showed that there was no significant benefit to any of the current PC treatments over Watchful Waiting. Survival Stats were equal. Remember, Surgeons like to cut, Radiologists like to Radiate, both procedures have extreme side effects. Start the PC Claim on E-Ben to establish your File Date for Retro, just don't jump on the Submit Claim Button right away. A PC DX for a Nam Vet would possibly qualify you for a Statutory SMC S (Housebound) Award during the Watchful Waiting Period.
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M, you Filed a New IU Claim 03/2018, did you use the FDC? What makes you believe you're about to receive the Decision?
You haven't posted the redacted copies of the original 08 Denial so how about fast forwarding to now, could you post a redacted copy of your recent PTSD IU C & P?
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How about posting a redacted copy of your RO SOC?
Do you have N & M Evidence in your possession right now or are you "Hoping" to find something, somewhere? If that's the case, you may not want this BVA Appeal to go too fast. You're 80% SC, if the BVA went your way tomorrow, what would be the best you could expect?
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RDD, you need to start your own post regarding SA questions.
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W, post a redacted copy of your Denial. Give the last pages discussing what you can do if you don't agree. Do you see the reference to the "Official Request for an Evidence Conference?" Give it a couple Reads, then tell me your thoughts.
I can't say I've seen any other Vet on Hadit, other than myself, ever discuss using the "RO Evidence Conference." Besides being referenced on ALL Award/Denial Letters, you'll find it addressed in the VA M21 DRO Section.
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A Nam Vet Friend 50% SC for PTSD, got a Temp 100% for the period of time (3 or 4 months) that he was admitted to a VA Rehab Clinic for his PTSD associated Alcohol Abuse.
Question about compensation rate
in VA Disability Claims Research
Posted
How about posting a redacted copy of your Rating Decisions?
Is there anything mentioned in your MHV SA Treatment Notes regarding the possible etiology of your 2016 DX'd OSA? How do you comport with the OSA "Likely Suspects," Neck 17+, BMI 28%+, Large Tongue and sizable stomach?