rigo

Dorothy, thanks for the info, like you said, I needed to read the info you provided to make the correct decision with my SMC claim. The VA should provide more info when they grant and SMC claim, specially what level of SMC the veteran qualify for. Take good care Rigo

Dorothy, Rich T, Sixthscents, Windy city, I really appreciated your help. First I thought I was under SMC L like Dorothy suggested but Sixthscents clarify what I was thinking, because my level of care I do qualify under R1 or R2. I`m under a physician that implements my care, he is in constant contact with my RN that comes to my house at least twice a month (Auxi Health Care), then I have a Home Health assistant that has to be trained to take care of me. She works seven days a week. My meds are luck-up and she has to give them to me. The problem with me is that I`m re-experiencing what happened to me in service and I become combative, suicidal and homicidal then I want to escape thru the window and I could kill myself doing this, but I dont remember doing all these, they have to re-inforce the window ans make safety changes to my room, sometime I have to be restrain to the bed. When the Home Health Care assistant go home is my family that have to deal with me, and I think is unfair to them because they have their own life. I have paid for my own A/A SINCE 2000 untill today. This is the monthly entitlement amount that the VA granted (and I dont think is correct) $2,533 Jul 1, 2000 Increase evaluation $2,621 Dec 1, 2000 Legislative increase $2,719 May 1, 2001 Legislative increase $2,791 Dec 1, 2001 Legislative increase $2,829 Dec 1, 2002 Legislative increase $2,888 Dec 1, 2003 Legislative increase $2,965 Dec 1, 2004 Legislative increse $3,086 Dec 1, 2005 Legislative increase $3,187 Dec 1, 2006 Legislative increse We are paying you as a veteran with one dependent. Your payment includes an additional amount for your mother. I have payed for my own A/A SINCE 2000 till today. Like I stated before, the VA should be paying SMC under R1 OR R2, maybe I`m wrong, but the evidence of record support a higher SMC level. What do you think????

Dear Berta and friends, in Jan30, 2007 had a C/P for my SMC at the Temple VA in Texas, to my surprice the staff was efficient and courteous. The doctor came into the waiting room call my name and we were off, in his desk were all my medical records, it look like a mountain of paper, he asked me why was the reason I was requesting SMC, I proceeded to tell him why, and at the same time I gave him a letter written by my mother in support of my SMC. He did examing me and after the examination he stated that I was in need of aid and attendance of another for my service connected PTSD. feb 24, 2007 received the white enveloped with the rating decision: We granted entitlement to special monthly compensation based on need for aid and attendance criteria being met effective June 21, 2000 This constitutes a total grant for special monthly compensation based on aid and attendance. Your overall or combined rating is 100%. We do not add the individual percentage of each condition to determine your combine rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions. REASONS FOR THE DECISION (This may help somebody) Entitlement to special monthly compensation is warranted in this case because the criteria regarding aid and attendance have been met. Letters from you received August 21, 2006, October 27, 2006, November 7, 2006, and January19, 2007, indicate you continue to disagree with VA decision regarding your claim. Information received from Texas Department of Aging and Disability Services dated March 28, 2006, to September 8, 2006, reveal that you have received services for the aid and attendance. Invoices and Time Sheets fro Auxi Helth Care from May 1, 2006 to September 30, 2006 indicate you receive service to help you with bathing, dressing, feeding, grooming, hair/skin care, transfer/ambulation; cleaning, laundry; meal preparation; shopping and assistance with self-administered medication. VA Examination, VA Medical Center, Temple, TX, dated January 30, 2007, show you require the regular assistance. You currently have posttraumatic stress disorder evaluated as 100 percent. Your posttraumatic stress disorder is severe disabling. You live with your mother who takes care of you with the help of other family members, outside help from nursing and home health providers. Your postraumatic stress disorder manifest with frequent episodes od rage, anxiety, panic, terror which includes aggressive, violent behavior and suicidal homicidal gestures. Your require medical surveillance/precautions. Medications are kept locked up due to prior suicidal overdosage attempts. You do not go out of the house socially only for medical appointments. You become essentially helpless for hours to days after episodes of violence, rage and terror/panic. The other condition which is not service connected is postphlebitic syndrome in both lower extremities which affects your independence to a much lesser degree. You do not go anywhere by yourself, do not drive and demonstrate anxiety and social ambivalence and avoidance. You are able to ambulate independently. You have psychological hindrances to coping with the stress and relationships of life. You are not physically hindered from the outside or from the environment but mentally and emotionally you are debilitated. You are capable of handling your VA benefits. The examiner diagnoses posttraumatic stress disorder severe and disabling. The examiners opines that this is the predominant condition causing you to need aid and attendance because you are emotionally unstable and unpredictable and sometimes become helpless in a histrionic fashion. The secondary diagnosis of postphlebitic and chronic pain syndrome of both lower extremities. Treatment Reports, Central Texas Health Care System (VAMC Waco, Temple and Austin Outpatient Clinic), dated September 16, 2006, show you reported for Kinesiotherapy. The findings indicate you are in need of aid and attendance due to your service-connected postraumatic stress disorder; therefore, entitlement is established from June 21, 2000, the date of claim. Even though my claim for SMC was granted, some important evidence is missing, some of the explanations given on my behalf makes no sence. I`m going to recuest the c/p. Sorry this was long but I think is important for veteran`s to learn about the VA and their rating decisions. What level of SMC do I qualify under, thanks Rigo

Berta, this is great info. I have a question? My depression and anxiety claim was granted and made part of the PTSD claim. I raised a claim for panic disorder with agoraphobia that was denied. I was wondering if instead of anxiety they should off use panic disorder with agoraphobia as part of the PTSD. Panic dosorder with agoraphobia was part of at least 7 of my 8 C/P. I`m wondering if this is a correct assumption. I just notice that in my rating decision the VA worded depression and anxiety attacks as part of PTSD. Hope vets pay attention to the way raters write their evaluations, they could find lots of errors. Rigo

Fla Viking, I was wondering if they continue to denied your fee basis. Hope they are givin it to you. The VA has committed horrendous crimes against you, but, you have prevailed. The VA dont like people who rocks the boat. I have done my share of rocking the boat, but, gladly I have pay the price. keep up the great job you are doing for veterans and wishing you the best. Rigo

The only reason why the C/P doctor stated that your brother didn`t needed the hypertension medication was to denied this condition. I wonder if he wrote it in the evaluation. if your brother would of stop the medication and something had happened to him, he would of being liable. I just can believe he did that, what an ass... Rigo

Josephine, your reasons for discharge SPN 460 "Emotional Instability Reaction" could be interpreted as having severe anxiety, depression, anger, etc. (The Army use this stupid codes for prevention, if you wanted to re-enlist again). I was separated under SPN 264 "Unsuitability, character and behavioral disorder" I thought, for years, I was separated under medical conditions. The research the VA carried about personality disorder, showed that personality disorder sometimes was so intertwine with the other mental disorders that was almost imposible to separate. One of the reasosns I won my PTSD claim was because I requested a transfer to another unit (because of traumatic experince) You have good evidence of record to win your claim You have the evidence linking what happen to you to service You have the continuity of symptomatology You were discharge under "Emotional Instablity Reaction" You can win your claim with this discharge, it is providing the evidence and the link. Don`t give up, it took me 12 years to get SC for my PTSD, and my claim didn`t have the evidence or the linkage to service like your claim does. be your own advocate and continue learning the process. Rigo

MarineJay, welcome, looking at the criteria you do suffer from hypertension. Hypertension is present if the diastolic blood pressure is 90 mm Hg or more or the systolic pressure is 140 mm Hg or more, or if both are present. Most people with hypertension has no symptoms. However with long-standing or untrated hypertension there may be damage to certain target organs (eyes, kidneys, heart, or brain), resulting in symptoms such as headaches, blurred vision, fatigue, shortness of breath, chest pain, and many others. Secondary conditions affecting target organs require separate ratings. If hypertension continues for a long period of time an arteriosclerotic condition may occur. Therefore, if a veteran is service connected for hypertension, and receive a diagnosis of arteriosclerotic condition (ischemic heart disease or coronary heart disease), that condition should be service connected secondary to hypertension. Often the VA will fail to consider whether a veteran`s arteriosclerotic condition is secondary to hypertension. For example, a veteran who is service connected for hypertension and later develops an arterosclerotic condition may only be considered under DC 7101 (hypertension). The VA may fail to evaluate the veteran`s entitlement to a higher evaluation for his hypertension under DC 7005 (arteriosclerotic heart disease). The two most important explicit sources of information on how to evaluate hypertension and secondary conditions are contined in Manual M21-1MR, Part III, subpart IV, 4.E.20 and the VA Training letter 00-07 "Training Letter on Cardiovascular Disabilities." Both Manual M21-1MR provision and the training letter clearly direct VA rating entities to grant secondary service connection for arteriosclerotic or other conditions that develop in a veteran with service-connected hypertension. The arteriosclerotic manifestations specifically mentioned in Manual M21-1MR section include: cerebral arteriosclerosis, thrombosis with hemiplegia, nephrosclerosis, myocardial damage and coronary occlusion. Hoewever, any arteriosclerotic manifestation diagnosed in a veteran with service-connected hypertension would arguably be entitled to secondary service connection. The VA Training Letter 00-07, "Training Letter on Cardiovascular Disabilities" provides in relevant part: The criteria for 7101 are based only on blood pressure readings and whether continues medication is required in someone with a history of diastolic pressure predominantly 100 or more. Remember to separately rate secondary conditions affecting target organs. Both Manual M21-IMR and the training letter order VA rating entities to grant secondary service connection for arteriosclerotic conditions or other conditions that develop in a veteran with service-connected hypertension. Sorry, I just wen crazy with all this info, hope this helps Rigo

rickb54, you are right, you can acquire Housebound Benefits two ways: First: The veteran has to have a single service-connected disability rated as 100 percent and an additional service-connected disability (ies) (involving different system) that independently ratable at 60 percent. Second: The veteran has a single service-connected disability rated 100 percent disabling and the veteran is permanently housebound because of a service-connected disability or disabilities. The requirement of being permanently housebound is met (1) when the veteran is "substantially confined as a direct result of service-connected disabilities to his dwelling; (2) it is reasonably certain that the disability or disabilities will continue through a lifetime. Manual M21-1MR provides that whenever a single disability is assign a rating of a 100 percent, the VA should consider entitlement to housebound benefits and aid and attendance, as inferred issues.

1968 Army VV, here is the DRO desicion of December 27, 2002 We received your new claim for service connection of depression and anxiety attacks on December 13, 2002. We reviewed the evidence of record. DECISION Service connection for depression and anxiety is established and included in the evaluation of post-traumatic stress disorder which is currently evaluated as 100 percent disabling. REASONS FOR THE DECISION As you requested, we esteblished service connection for depression and anxiety attacks and included them in the evaluation for post-traumatic stress disorder currentlu evaluated as a 100 percent disabling. An evaluation of a 100 percent is assign whenever there is evidence of total occupational and social impairment, due to such symptoms as gross impairment in though process or communication, persistent dilusions or hallucinations, grossly inappropriately behavior, persisten danger of hurting self or others, intermittent inability to perform activities of daily living ( including maintenance of minimal personal hygiene ), disorientation to time or place, or memory loss for names of close reatives, own occupation, or ownh name. Although not all of the symptoms are present, no change is warranted in the 100 percent disability evaluation for post-traumatic stress disorder with depression and anxiety attacks based on the evidence reviewed. That was all the explanation I received (found the explanation a whole bunch of BS, related only to PTSD, the VA never stated how depression and anxiety attacks enhance the established PTSD. The VA has never give me the percentage of each disability, even though I have had ask for it. I now they have a percentage because they were service connected. The VA never mention any laws pertaining to this claim Hope this help, I do understand what you want to know and what you want to claim. If you believe you have a good claim for PTSD, DEPRESSION, ANXIETY OR WHATEVER JUST GO FOR IT. I also raise a claim for panic disorder with agoraphobia, but that is another story. Rigo

1968 Army VV, in 2001 I was service connected for PTSD due to trauma, in 2002 raised a claim for depression and anxiety. In January 2003, the VA established as service-connected depression and anxiety and included them in the evaluation of PTSD. In my case, depression and anxiety were both diagnosed as part of the trauma. I know there is a persentage attached to each disability but the VA refuse to tell me (I`ve requested this info under FOIA). If someone has any sugestions how to get this info, please let me know. Like I said, in my case both disabilities were diagnosed together, if you have the evidence and can linked it to service file a claim. If something happened in service and you were diagnosed with depression and anxiety at the same time for the same problem you can file SC for both of them at the same time. If you file for depression and not for anxiety and both were part of the same problem in service, I will write an addendum and include anxiety as part of the claim. Hope this make sence to you Rigo

1968 Army VV, if you have the evidence to backup a depression claim file it. Have you ever thought to file depression as secondary to your PTSD. If you have the evidence file it, you have nothing to loose, that was what I did, it was a long shot and you see what happened they included them as part of my PTSD claim. Rigo

FLHRCI, this is my opinion, I will not be happy with a diagnosis of depression, if I could have a diagnosis of PTSD. When you are diagnosed with depression that is it, but when you are diagnosed with PTSD, you could also have: Anxiety disorder, Panic disoder, agoraphobia, depression etc.... if later in your life you required SMC, HB, or anything else, it will be easier to get with a diagnosis of PTSD. This doctor R/O PTSD, but other doctor my think that you have chronic PTSD, is such fine line between mental disorders. Rigo

1968 Army VV, the reason the VA included anxiety an depression as part of my PTSD, was because both of them were diagnosed as part of my PTSD and both were part of my C/P. I have requested the percentage of each added disability but the VA refuses to let me know, I even requested this info under FOIA. You have good chance that depression be included as part of your PTSD disability, because its being diagnosed and is part of a C/P exam. Rigo

Dear mountain tyme, keep us inform, specially when you receive the C/P report, and if you have any questios, just let us know. Good luck Rigo

For instance, in 2001 the VA grant my claim for PTSD related to trauma, in the same year I raised a claim for depression and anxiety disorder, this claims were granted and included as part of my PTSD. Probably, if I request SMC or HB, I will have a better chance to get it, because of the two other disabilities added to my PTSD. Anyway, the VA has to take into consideration all the evidence of record to grant or deny a claim. This is the way I see it, probably I`M WRONG. Rigo

Dear mountain tyme, like Berta, Carlie and Jangrin stated, you should request TDIU, and you should not wait to file this claim until the VA sends you the application form. Yoy can file an informal claim by simply sending the VA a letter stating that you wished to be considered for TDIU benefits and ask the VA to send all appropriate forms so that the claim could be perfected. If you are in need of counseling, go to the VA with the evidence and talk to a counselor and the VA will give you all the help that you need (stipulated by Congress) SSD evidence will enhance your claim for PTSD. Like you stated the VA is your worst enemy, and the best way to fight them is becoming your own advocate and learn as much as you can about their rules and regulations. In March 2002, the VA amended its PTSD regulation, 38 C.F.R. 3.304(f), to add a new section for PTSD claims based on in-service personal assault. The new regulation corporates earlier court decisions and existing Manual21-1 provision. Significantly, it states that the VA will not deny a claim for PTSD based on personal assault without first telling the veteran that evidence other than that found in service records can be submitted and allowing the veteran the opportunity to submit such evidence. It also describes some types of evidence that can be used to support a PTSD claim based on a personal assault. Mountain Tyme, if the VA didn`t inform you of the above law in your 2 previous denials, you probably can request a re-evaluation or include this information in your NOD. I understand that what you are doing is very hard to do, but, you need to be compensated for your suffering, be strong, and may god bless. Rigo

Dear mountain tyme, you came to the right place for information, people in this board are very caring and they will help as much as they can. Welcome Sorry you had to endure what you went through. You have a very strong case, first, you have diagnosis of PTSD, second, you have a very low GAF score of 36, third, you have a link that service connect you to service, forth, you have enough evidence to back up your claim, fifth, you currently are on SSD that shows you are totally and permanently disable and unemployable. When you send evidence to the VA never send the originals, but copies and do it via certified mail, so you have the receip/prove of what ever you send. you said, that you were twice denied before, let us know the reasons for the denials, did you file anotice of disagreement (NOD) on both of the denials. ( My personal opinion, I dont know how the VA could denied your claim ). Did you requested a copy of your C/P, if you didn`t requested inmediatelly. If you are in need of counseling because of a personal assault you do not need to be service connected to receive it, if you have the evidence that this happened to you take it to the VA and talk to a counselor, and because you are so far away from the VA hospital request a doctor closer to your home. Hope this helps Rigo

John999, now, I understand about the differeces between SMC and HB, I thought the requirement were the same for both of them, but they differ, for SMC you need to be a 100 percent disable and for HB you need to be 100 percent disabled with other disability at 60 percent, or a 100 percent disabled and the veteran is permanently housebound because of a service connected disability. Thanks Patrick428, with your explanation of the "Layers of the cake" you answer the other part of my question, I didn`t know that PTSD had 44 disabilities linked to it. I have a diagnosis of PTSD then depression and anxiety were included on the diagnosis of PTSD, so this are the layers that will make the final product complete and how all of this disabilities affects my life. Thank you both for answering my questions Rigo

John999, if you had five (5) ratable mental disabilities and the VA only rated you for the disability with a higher compensation, ok, now you are claiming SMC, does the VA have to take into condireration all the mental disabilities or if it will be based only with the disability they apply the higher compensation????Sometimes, I think, hey I`m doing pretty good until you get to one of this questions stops me on my tracks. Thanks for the responce. Rigo 1968 Army VV Good point, that is what I want to know also, or is just wish thinking. One thing I know is that the VA need to look and evaluate all the evidence of record when they are making a decision. But will they give more importance to the service connected evaluation, to make the decision. I hope I`m making any sence. thanks for the response Rigo

Carlie, you are so right, you can only be compensated with one rating decision for a psychological/mental disability, the one with the highest compensation. I forget all about that regulation. Sometimes I have what is call "VA retardation". Carlie, thank you for the prompt response Rigo

Hi everyone In 2002 raised a claim for depression and anxiety, the VA in 2003 established service connection for both of them and included them as part of the PTSD. Depression and anxiety were diagnosed several times in service, also mention in the separation examination of 1966. The VA granted service connection for PTSD in 2001 Question Can the VA include depression and anxiety as part of the PTSD? even though depression and anxiety were directly related to the trauma the veteran suffered in service? My other question I`m wondering, if the depression and anxiety have a percentage assign to them (ex: 10 percent) even though they are part of another disability (PTSD), and if this percentage can be increase if the depression or anxiety gets worst. Thanks

CONTINUATION Response of the VA to the charges of tampering/changing respons to a medical evaluation: HUGH COX ATTORNEY AT LAW 321 EVANS ST SUITE 102, POX 154 GREENVILLE NC 27835-0154 Dear Mr. Cox On October 10, 2003, we received your letter dated October 9, 2003, in which you requested a copy of a medical response submitted to the VA by QTC Medical Services. We have forwarded your request to our Release of Information section so that they may handle your request. In this letter, you also raised concerns regarding our handling of QTC medical reports. You enclosed a sanitized copy of a VA e-mail which you suggest shows proof that the VA personnel directed a QTC medical examination to alter a medical opinion in order to deny the veteran`s claim. We have reviewed the e-mail as well as your interpretation of the content of this e-mail which you have posted on your internert web page. We did this to attempt to understand how you believe this e-mail could be evidence of wrongdoing on part of the VA officials here at the Winston Salem Regional Office or of QTC medical oficials. In response to your letter, we will reiterate several facts from the e-mail itsel, provide a possible explanation for our actions and exlain the reasons for those actions. The e-mail from Dr Green to Mr. Blake contained several facts regarding the veteran`s claim: The case involved a veteran whose case was remanded to the regional office from the U.S. Court of Appeals for Veteran`s Claims for evaluation of his right knee. The regional office received a medical examination report that was prepared on or about December 27, 2001 by Dr. Stabler The report indicated that Dr. Stabler found pain, stiffness, awelling, flare-ups, use of a brace, limitation of flexion to 90 degrees, "fair" weight bearing with the us eof a cane, and x-ray evidence of traumatic arthritis called moderate by radiologist. Dr. Stabler concluded that "there was no disability of the right knee at the examination" Dr. Stabler also stated that a disability secondary to the knee condition was slight to none. From the e-mail, we noted that the issue of the remand was the evaluation of the right knee. Please note that because the identity of the veteran is not known, we do not know the level of disability assigned to the veteran`s disability at the time of the e-mail and therefore do not know how Dr. Stabler`s conclusion would have affected the veteran`s VA disability evaluation. The e-mail to Mr. Blake appears to identify a problem with the medical report that was submitted to the regional office by Dr. Stabler. In it, Dr. Green suggested to Mr. Blake that the medical findings listed on the report did not logically correspond with Dr. Stabler`s conclusion that, "there was no disability of the right knee at the examination". She requested that, "QTC fix this [discrepancy] and furnished a medical statement correlating the conclusions with the findings". When the VA identifies inconsistent examination reports, VA procedures state that we are not allowed to deny a veteran`s claim or reduce the veteran`s evaluation. We are required to return the inconsistentreport to the clinic or th the health care facility director with a statement setting forth the deficiencies to be remedied. At that time of the e-mail, local procedures dictated that Mr. Blake be made aware of problems regarding medical exam reports In turn, Mr. Blake was to forward the request for clarification of the medical examiner`s conclusions to the appropriate medical facility. Dr. Green evidently identified a discrepancy between the doctor`s findings and the conclusions. Procedures state that we are not allowed to deny a veteran`s claim when a discrepancy is identified. In the e-mail, Dr Green suggested that based on the findings, she could make a decision on the veteran`s claim without considering Dr. Stabler`s conclusions that the veteran had no right knee disability. Based on her comment, it is possible to assume, but not known for certain, that she planned to grant the veteran an increased evaluation for his knee based on the doctor`s findings alone, but knew that procedurally, this will not be correct. She therefore appropriately followed procedural guidelines and submitted her request that the medical examiner provide a clarification of the examination report. Since we do not know the identity of the veteran, we are unable to conduct a review of the file to determine what the medical examiner stated in his clarification of the exam report. We have been unable to address your accusation of obstruction of justice, tempering of evidence and conspiray beause the identity of the veteran is unknown. However, we hope that you appreciate our explanation of the procedures that we believe our officials followed in this case. If you will like us to conduct a more detail review pf this case or refer this to the Office of the Inspector General to ensure that our actions were in acordance with the law, please provide us with the veteran`s name and the claim number. Pease send copy of this letter with your reply. L. W. Henderson Veteran`s Service Center Manager Interestingly, the RO officials did not voluntarily refer the matter to any investigative agency such as the VA Inspector General and took the position that the e-mail was evedently an effort ("possible to assume") by Dr. Green to "increase" the veteran`s rating ADVICE TO THE VETERANS: Veterans who are medically examined by QTC officials or physicians need to be alert to any "addendums" issued by the QTC officials after an initial examination. The veteran should seek all communication (written or otherwise) between the RO and the QTC examiners. A GUIDE FOR VETERANS FACING QTC EXAMS 1. Make certain that you write down the full name of the physician who examines you. If the examiner is not a physician, make certain you know the examiners credentials. 2. Try to obtain a business card from the examiner. 3. One valid way to accomplish obtaining the examiner`s business card and credentials is to suggest to the examiner that you trust the examiner, and that you would like to consult him about your own medical condition. Independent of the QTC exam. This tactic may cause the examiner not to be suspicious about your inquiry of his or her identity. 4. Try to find out if the examiner is Boar certified in any medical field or has any speciality for which he is recognized or licensed. 5. Write out the text of what you need to tell the physician about your disability and medical condition. It is very important that you get across all symptoms of your disability to the examiner. Even better, you should write out the symptoms you have and give a copy of those symptoms to the examiner at the QTC examination. 6. Fill out one of the medical care questinaire named "Medical Care Questionaire to be completed by client". Immediately after the exam. 7. Take notes during the exam as to what test are being performed . Physicians will usually tell you the name of the device or test used in the exam. 8. Be certain to note the time (and date) the exam actually began and the time that the exam ended. 9. Ask the examiner if the examiner has a copy of your claims folder (c-file) from the Department of Veterans` Affairs. The Department of Veterans` Affairs always gives preference to the VA physicians or QTC physicians because the VA will claim that the VA or QTC physicians actually read your claims folder before the examinaton. The physician will not let you examine or read the claims folder, but it is appropriate to ask the physician if he has a copy of the claims folder and if he will show you the folder itself so that you can be confident that your name is on the c-file. Please note how thick the file is. The purpose of this information is to gather evidence about whether the examining QTC physician actually read or examined your file before the examination. 10. Please give the physician a list of your medications, your job in the past fifteen years, and a pain questionare to place in your Veteran`s claim folder (c-file). Please use this documents as an opportunity rather than a burden so that you can enhance your chances of the QTC phyicians actually knowing your condition, your medications, your symptoms, whether you work or not, and any abnormal sensations such as pain. Rigo

Dear Josephine and boar members, this is quite long so I`m going to doit in 2 parts This is a correspondence between a Winston Salem Regional Office Adjudication Officials of the Department of Veterans Affairs dated after December 27, 2001 appears to approve alteration of a disable veteran`s medical records so that the claim is denied. ( I call them the memos of death ). Green Nancy, VBAWSAL To: Blake, John, BVAWSAL Subject: QTC examination on COVA case The case of xxxxxxxxxxxxxxxxxx is on remand from COVA for evaluation of the right knee. He is represented by none less than Hugh Cox, attorney at law. Examination was done by Dr Stabler on 12-27-01. Dr Stabler foun pain, stiffness, occasional swelling, flareups, use of brace, limitation of flexion to 90 degrees, "fair" weightbearing with use of cane, and x-rays evidence of traumatic arthritis called "moderate" by the radiologist. Dr. Stabler concludes: "There was no disability of the right knee at this examination." "Disability secondary to the Knee condition is slight to none." As per our discussion, I can rate on the evidence and ignore the conclusion, as I would certainly do except for COVA and Hugh Cox. In this case, though, I think we cannot do that without triggering another remand. Can QTC fix this end furnish a medical statement correlating the conclusion with the findings? Thanks. N. Green M.D. This VA message raises disturbing questions about the integrity of medical compensation and pension examinations by QTC medical officials who examined veterans at the direction of the Winston Salem Regional Office of the U.S. Depatment of Veterans Affairs. Both Dr.Green and Mr. Blake were officials of the Adjudication Division of the Regional Office at the time of the incriminating e-mail. Because, the this message, the QTC physician named above (Dr Stabler) issue an Addendum" to his original report. The addendum-change was even less favorable to the veteran than the original QTC medical report. The claim was subsequently denied. There is an appearance that Dr. Green used Mr. Blake as a clandestine communication means to influence the QTC physician to tamper with the original evidence so that the veteran`s claim could be denied. Because Dr Green and Mr Blake worked at the Adjudication Office of the Winston Salem Regional Office, they were agents of the U.S. Government with a statutory obligation of duty to assist the veteran with his or her claim in accord with Manio v Derwinski, 1 Vet. App. 140, 144 (1991) ("Rather than defending against the claims of veterans, the Secretary has a statutory duty to assist claimants during the course of the ex parte and non-adversarial claims resolution process at the regional office and before the BVA.") Is Dr. Green`s communication so potentially biased as to obstruct justice for the veteran and his counsel, as to tamper with witnesses without knowledge of the veteran, or as to conspire with others to sabotage the veteran`s claim? Where the veteran`s civil rights violated under 42 United States Code 1983? Dr. Green was not just a physician, but she was a "judicial" and adjudication official working for the RegionalOffice and acting under "color of law for the purpose of assisting the veteran with non-adversarial evidence to insure fundamental fairness as follows,": "Information in VA records which are used by the Department in making any determination about any individual will be maintained with such accuracy, relevance, timeliness, and completeness as is reasonably necessary to assure fairness to the Individual in the determination." Cited from VA Adjudication Manual M-1 at section 9.15. In this case, the veteran was never informed of the Dr. Green communication with Mr. Blake and its detrimental effect on the veteran`s claim until someone within the RO revealed this "hidden" information in 2003 to the veteran. The courts have held that procedural fairness in an administrative proceeding generally requires an adequate opportunity to know the evidence to be relied upon and to rebut it. See Wirtz v. Baldor Elec. Co., 337 F 2d 518, 528 (D.C. Cir. 1963). "We caution, however, that the permanent removal of documents from a claims file without notice to the claimant may raise concerns regarding procedural fairness, particularly in view of the possibility that such documents, including BMAO`s, may be favorable to the claimant in some instances. Accordingly, if the Board considers it appropiate to permanently remove documents from claim files, we recommend that procedures be established to ensure that claimants are given adequate notice of such removal, and to ensure that documents which are favorable to the claimant or otherwise relevant to the Board`s decision are not removed from the claims file." VAOPGCPREC 14-98 Will cont. letter with reply from VA Rigo

Billyboy, no one on this board is a psychologist and no one on this board is walking in your shoes. The first thing you need is a medical opinion stating in detail the reasons why your disability significantly makes you unemployable, you can also use letters from family and friends corrobarating the symptoms of the disability (anger, dizzyness, shakiness, paleness, pain, inability to talk, medicaton side effects, etc) is what I call visual symptoms, and this is call Lay evidence. TDIU benefits will be granted "when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities." If a veteran has only one service-connected disability, this disability must be ratable at 60 percent or more. If the veteran has more than one service-connected disability, at least one disability must be ratable at 40 percent and the combined disability rating must be 70 percent or more. A veteran who does not meet the percentage requirement under the rating schedule described above but is unable to work due to service-connected disabilities may still be awarded a TDIU rating on an extreschedular basis. The TDIU regulation states that "it is the established policy" of the VA that all veterans who are unemployable because of service -connected disabilities "shall be rated totally disable". The governing norm for granting a TDIU rating on an extraschedular basis is: a finding that the case presents such exceptional or unusual disability picture with such related factors as marked interference with employment or frequent period of hospitalization as to render impractical the application of the regular schedular standards. Please, fight for what you think you are entitle to, no matter what other people says. Rigo