Gastone

Yo Buck, if you're sitting on the "Totally Confused Bench" I'm right next to you on the"Ignorant and IDGAF" Bench, regarding the VA 20 Year Rule. I really haven't given it much thought until you brought it up.
I did see a VA Rating article yesterday that discussed the VA 10 Year Rule as far as SC Awards. As I recall, the File Date was the Clock Starter for the 10 Years, not the Award Date.
You know what they say about Opinions and AHs, so here's mine. Every SC a Vet has been Awarded, has it's own Effective Date for purposes of the 5 year Rule, 10 year Rule or 20 Year Rule.  Each SC's Aniversary Date is protected to whatever degree the applicable rule Covers.
Might be time to have your POA VSR check your C-File for any "Diary Dated Reviews."
 

Work, if enjoyable, is probably one of the best treatments for PTSD or any-other MH issue. If you can, do it.
If the time comes when you can no-longer hold an SGI (Substantial Gainful Employment) that provides in excess of $12,400 per year or your employer has to make special accommodations for you, it's time to file an IU FDC.
Prior to filing for IU, applying to the VA Vocational Rehab Program would be of great assistance. If in fact your SC PTSD has you so fracked up that you really can't work (earning above the SGI doing even Sedentary work) making the VRC not appropriate, A VRC Denial Letter could Seal the Deal on an IU Rating.

TINNITUS (claimed as 2nd to L knee osteoarthritis) (Secondary) That's a stretch.

No real tests for Tinnitus. Your self-described symptoms, MOS are basically what it comes down to. If your MSRs show combat exposure and your MOS backs up your exposure claim, shouldn't be hard to get SC.

To the best of my knowledge, all Military Branches incorporated hearing protection beginning around 1975 or so. In mid 60's no hearing protection was offered to Marines other than Air-wing. I think it was the same for Army. After 1975, Hearing protection was mandatory for all non combat firearms training. It will come down to how plausible your linkage to your Service Exposure is.

With that said, if you've had substantial Exposure to LOUD Noise since your service days, that could be a bit of a problem.

Semper Fi

Gastone

Check 2017 BVA Decisions for your Docket Number.
Make a copy and contact the Vet Legal Consortium (Pro Bono) CAVC Representation.

No, Berta. I got a letter Friday from them asking me just exactly what my disabilities consist of since I put down that I was 100% disabled and unemployed. I'm sure the OGC never bothered to look it up. They would immediately jump to the conclusion it was bent brain syndrome and use that to disqualify me. All Vietnam Vets have bent brains in their book.  The joke's on them. I've never filed for that one yet. Fortunately for me it was just a personality disorder which wasn't fatal nor compensable. Fortunately, I came to terms with it and I've learned to live with it. Apparently, it turned me into an argumentative a**h**e and little more.

So what's Chapter 17, 18 less than Chapter 35??
Bronc, you let me down, I was hoping for a Chapter 17 discussion. Now I have to look the "17" up.

It's permanent, as long as the PTSD doesn't get reduced.
The SMC S (1) "Statutory Housebound" is based strictly on a Vet having "1" SC Disability either rated itself as 100% or as in your case having an IU Award where the IU causative SC is now paid at the 100% Comp Level and you have additional SC's that excluding the IU SC, total a CSC of  a minimum 60%.
Vet's that are Scheduler CSC 100% but don't have a "Single" SC Rated individually as 100% can't get the SMC S (1) Award, they would actually have to be Housebound and have a Dr complete a supportive Housebound application.
Recently a Det Nam Vet 72+, IU T & P  No Future Exams (PTSD), filed a New FDC to get his adult Daughters Learning Disability Claimed as a possible Future AO Presumptive Award. His DAV VSO said it was a good idea, NOT!
Not only did he receive the Denial he and the DAV were expecting, he also received a notice of significant PTSD SC Reduction, that would eliminate his IU Rating and take away the SMC S (1). Of course he's Appealing the Reduction. He certainly is kicking himself in the A$$ for filing what I believe was an imprudent Claim.

Question regarding Private OSA DX acceptance by VMC, problems using masks, Medicare equipment costs, where to begin?
Your VMC will definitely accept the results of a Non-VA Sleep Study and the OSA DX & Rx rendered by a Non-VA Board Certified Sleep Specialist. Your non-VA Sleep Dr provided you with an Rx for the necessary CPAP or BiPap and Supplemental 02 if required. Hand delivery of the most recent SA DX & Rx to your VMC PCP will get it in your VMC Records and get you a referral to the Sleep Dept for your CPAP Machine and supplies. Your over 40% SC, so no cost to you.
How many masks have you used? I've been 100% BiPAP Compliant since 2010 and have tried about 7 different Masks. I'm currently using what I consider as the easiest and most comfortable to wear Mask of all that I've tried, the Philips/Respironics DreamWear under the nose mask.
As to Medicare, if you don't have a Supplemental Plan like AARP's United Healthcare, you get hit with a 20% Co-pay. Full Boat, small deductible but no Co-pays cost me $145 per mos without Rx coverage. I use both VA and Medicare for followup care.
You indicate you're 100% SC, is that CSC 100% or IU paid at the the 100% Comp Level? Are you certain that your OSA DX cannot be Secondary connected to 1 of your SC Conditions?
Any chance you could post redacted copies of the 2014 VA Sleep Study Results/Clinician Treatment Notes and also the most recent non-VA Sleep Study Results?

Like Sienfeld's "Soup Nazi," VA has an "AO Presumptive Nazi," "No New AO Presumptive for You!" Please check back in the future, like a prison term, say 5 to 10 yrs and always remember "We Appreciate your Service."

Porg, about 5 or 6 yrs ago there was an IU Vet posting, I believe here on Hadit, regarding his Self-Employment Income problems that had arisen after recently filing for Divorce. You know what they say about the Wrath of an X, right.
Turns out his couple year IU Award was based on his reported Marginal Income of about $60K +/-, substantially reduced due to his SC's from his historical $150K++. His X described in the Divorce Papers how he was fudging the Income Numbers both to the IRS and the VA, in an attempt to support her Alimony and Child Support Demands. The Family Court Judge believed her evidence, Awarding her everything she had asked for.
Her efforts worked so well, somehow the Income Evidence was made available to the VA and the IRS. At some point after the Vet Appealed to the BVA regarding his IU Reduction, the X recanted her Testimony after realizing her loss of the Chapter 35 Benefits as well as the Kids CHAMPVA Medical and college benefits.  The BVA wasn't buying it. Too Little, Too Late, the Vet, the X and the kids all lost the IU Bennies. He never mentioned how bad the IRS spanked him.

CAD is on the "presumptive" list for VEterans of certain wars.  See the regulation here to see if it applies to you:
https://www.law.cornell.edu/cfr/text/38/3.309
"Presumptive" means that if you served at the proper time, in the applicable country(s), and if you have been diagnosed with the disease, you are "presumed" to have gotten it in service, that is, its service connected.  
If your disease in on the presumptive list, (and Shinseki added CAD to the presumptive list) then it makes it much easier for you to get service connection.  You may not even need the nexus because its presumed you got it from service.  
This said, its often that VA denies without a nexus, even tho its a presumptive.  The board should "fix" that, as long as you point it out in your appeal.  You may even get it with the DRO review, too.  
 

The criteria for TDIU is that you are "unable to maintain SGE due to SC conditions". And, this is likely to continue for the rest of your life.   So, if your doctor says these words, AND your voc rehab counseler suggests that, even tho you completed the program, your sc conditions rule out employment, you are good to go.  
More likely, however, is that "even if" your doc says you cant work due to sc conditions, if the voc rehab counseler contradicts that, you probably will have an issue.  That is, if the voc rehab counseler says, you are "healthy enough to go to work", then you may need a voc rehab IMO/IME to get tdiu.  
Most states unemployment benefits are in conflict with TDIU because, when you apply for unemployment you state that you are "ready and able to work".  However, TDIU says you are UNABLE to work, due to sc condiions.  You can not BOTH be ready and able and also unable at the same time.  State unemployment is generally not a disability benefit.  
I suggest you order your cfile, and read what your doctor and voc rehab counselor says.  If the doc and voc rehab counsler says you can work, then you will either have to go to work, or else get another docs opinion to refute the first doc, or else you wont get TDIU.  
So, if your doc releases you to work, then you should be eligible for state unemployment benefits, if you meet their other criteria.  
But if your doc says you cant work, then you can persue TDIU.  Its all about what your doc says, and that will be the evidence that makes the difference.  

The A & A shouldn't pose a problem, you definitely need daily assistance. The only problem, if you haven't already been notified of the VA's intent to appoint a Fiduciary, it's coming. The Dr indicated you're not capable of handling your own finances, see question (27). The Dr didn't supply the required basis for the "NO" but you can certainly expect a VA Fiduciary Social Worker interview in the near future. Be Prepared!
Is your VA Direct Deposit Account held Jointly with someone else? All funds could be in jeopardy of a Fiduciary Lock-down. Consider being proactive.

I am currently in the Voc rehab program and I just recently got approved for IU from the BVA which is still being developed at my RO but as to whether or not you should work while your seeking IU, I would be very careful about keeping any full-time employment during this period and Even part-time could work against you when it comes to their decision.  Being that you completed the Voc Rehab program and began to work right after would seem as though improvement had been made and in my opinion could ruin any chances for IU.  Please keep in mind that this is my personal opinion. 

"VA Revises Regulations on Reimbursement for Emergency Treatment of Veterans 
WASHINGTON — Today the U.S. Department of Veterans Affairs (VA) announced that it has, through a Federal Register notice, revised its regulations concerning payment or reimbursement for emergency treatment for non-service connected conditions at non-VA facilities. 
VA will begin processing claims for reimbursement of reasonable costs that were only partially paid by the Veteran’s other health insurance (OHI). Those costs may include hospital charges, professional fees and emergency transportation, such as ambulances. 
This change comes on the heels of an earlier announcement that VA was taking immediate action to address delayed payments to community providers, found here.
Effective Jan. 9, VA updated a portion of its regulations in response to an April 2016 U.S. Court of Appeals for Veterans Claims decision that stated VA could no longer deny reimbursement when OHI pays a portion of the treatment expenses. 
VA will apply the updated regulations to claims pending with VA on or after April 8, 2016, and to new claims. By law, VA still may not reimburse Veterans for the costs of copayments, cost shares and deductibles required by their OHI. 
VA will work directly with community providers to get additional information needed to review and process these claims. Previous claims do not have to be resubmitted unless requested by VA. 
More information on the amended regulation along with guidance may be found here. "
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https://www.va.gov/opa/pressrel/pressrelease.cfm?id=3996

I think the answer depends on a VMC C & P DBQ or an Outsourced C & P DBQ. It all comes down to how soon the Vet realizes there is a possible problem.
If the problem is realized immediately, filing a 21-4138 addressing the supporting Evidence of Record that was not considered by the DBQ Clinician and attaching Pdf's of the EOR or New & Material Evidence, should be adequate for the Raters Decision.
Sooner is much better than later. A Vet Dragging his feet will end-up locked in a NOD.

OK, you did say Ball Park,  how's anywhere from 2 to 41/2 yrs? What's the date of your NOD?
I know, that's not much help. Do you know how many DROs your RO Has? Any idea of how many DRO Hearing Requests are in front of you, it's 1st come, 1st served?
There are a couple things you can do in order to remove any self-caused waiting problems. Get the VA DRO Hearing mandated submission of New & Material Evidence submitted ASAP. Late Evidence Submission can add significant wait time, it all has to be reviewed. You could also file a Formal Request for an "Informal DRO Evidence Conference." Read about it in the M21 DRO Section.
A trip to your RO may be beneficial. Make an appointment with your VSO RO HQ for a sitdown with a Sr. Rep or the Director. They'll have more up to date DRO Hearing Timeline info. Keep in mind, any old or new DRO hearing Request that gets a Hardship Advancement will go before you.

Obviously, you probably should seek treatment for PTSD.  To do this, simply make an appointment at your local VAMC with a mental health doc.  
Your doc will ask you questions, and then see if you meet a diagnosis of PTSD.  As always, for VA benefits you need these 3 things for service connection for PTSD:
1.  Current diagnosis of PTSD by a VA mental health doc.  (VA thinks outside docs can not diagnose PTSD..as far as the fairness of this..probably no)..but a PTSD diagnosis is required for SC for PTSD.  
2.  In service event or "stressor".  It sounds like you have this, but it needs to be documented.  I have no idea if this is documented in your records or not.  Sometimes, in wartime, for combat Vets, the threshold for documentation for "stressor" is lessened.  Its not like they have a photographer around to document every stress event in battle, for example.  
3.  Nexus, or doctors statement saying that your "Ptsd" (diagnosis) is at least as likely as not due to the trauma you received while in combat for the miltary service.  
     You can apply for PTSD VA benefits at any time, but you wont likely get a benefits award until you can document the above.  

OK, you did say Ball Park,  how's anywhere from 2 to 41/2 yrs? What's the date of your NOD?
I know, that's not much help. Do you know how many DROs your RO Has? Any idea of how many DRO Hearing Requests are in front of you, it's 1st come, 1st served?
There are a couple things you can do in order to remove any self-caused waiting problems. Get the VA DRO Hearing mandated submission of New & Material Evidence submitted ASAP. Late Evidence Submission can add significant wait time, it all has to be reviewed. You could also file a Formal Request for an "Informal DRO Evidence Conference." Read about it in the M21 DRO Section.
A trip to your RO may be beneficial. Make an appointment with your VSO RO HQ for a sitdown with a Sr. Rep or the Director. They'll have more up to date DRO Hearing Timeline info. Keep in mind, any old or new DRO hearing Request that gets a Hardship Advancement will go before you.

Strictly for SMC S (1) Statutory Housebound clarification, regardless of CSC 100% or IU Award you must have (1) SC which is independently rated as 100%, then (1) or more SC's that have a CSC of 60%.
Multiple SC's included in the determination of a Vet's IU Award would therefore not be eligible for computing the 60% CSC necessary for the SMC S (1) Statutory Award.

How about posting a redacted copy of the 21-2680 completed by your VA PCP?
Do you currently have any Disabilities SC'd, if so, what is your CSC Rating and when was it Awarded.
An A & A Award is generally associated with VA Pension Vets, whereas a Housebound Award, either SMC S or S (1) is generally associated with Vets receiving Service Connected Comp.
The SMC S (1) is a statutory Housebound Award not requiring the SC Vet to actually be Housebound. He must have (1) SC rated at 100% by itself and have 1 or more additional SC's that have a CSC of 60% when considered apart from the (1) issue rated at the 100%.

Good question but does it really matter at this point? You can't go any lower than the 10% Awarded for all (3) combined conditions, even if (1) all of a sudden became a (0%).
Is the "Low Dose Rx" in your VMC Medical Records? Print a copy of the VA Dr's "ClinicanTreatment Notes" concerning the SC'd condition and the requirement of the New Rx. Attach it as a Pdf to an official E-Ben FDC Claim for Increase of your existing 10% SC Respiratory Condition based on the attached VMC Treatment Note and Rx.
Let's now go hunting for BEAR, how is your Sleep Health since developing your SC Respiratory conditions? Any Snoring, choking or gaging? Daytime Somnolence (nodding off)?
Always a possibility that your relatively minor Respiratory conditions could either cause or exacerbate a Sleep Apnea DX, which then could be Nexus'd as a Secondary Condition. 

Are you Service Connected for any AO Presumptive Conditions?
Check in with Local DAV or VFW, DAV for sure has a shuttle service to your VMC.
You're 71 and on Medicare with both A & B coverage. Even if you're receiving VA Comp, probably should look into AARP's United Healthcare Medicare B supplemental plan. Cost's me about $145.00 per month for Full Boat, no Co-pay Coverage at ANY private Dr or Hospital that accepts Medicare. If you have Heart problems, you would be well advised to seek out non-VMC treatment. You want a Cardio PRO working on you, not someone just starting out or getting by.

Our wonderful member Carlie is deceased.
Perhaps the BVA ombudsman could give you some idea of what dockets they are working on now.
bvaOMbud.bvaOmbudsman@va.gov
The regulations are here under a search for Advancement on the Docket,if the criteria applies to you, that is something to consider and to apply for.
My BVA case took many years...years in which I continuously sought evidence and I sent my evidence directly to the BVA.