jalexand

Thank you, this is what I was looking for. Jim

Well, I must say this SMC-s would be good news for me. This is the first I have been aware of this and I really appreciate the information. Personally, I have been unable to locate where to find this information on SMC-s (oither than the rate table which I was able to locate), can someone point me in the right direction as to where I can find this in the reg's? Thanks

Getting back to the original post on this thread, I am intrigued by this information, especially as it might or might not relate to my specific situation. I suppose that I am one of the individuals referred to when it comes to believing that 100% is the maximum compensation one can get. At least under certain circumstances. I am aware of SMC, but from what I have been able to determine by reading the reg's I have not found it to be applicable to my situation, which is as follows: I currently receive 90% Disability Compensation as a direct result of wounds received in Combat. Under the guidelines of the new IHD Presumptive, as I understand them, I will likely be rated 100% for AO IHD. This in effect would make me 190% disabled? But, going back to my original understanding of what is the "maximum", I will receive only the basic 100% Compensation. Is this not correct thinking? Jim

It indeed will be interesting to see what kind of SNAFU the DAV can come up with to delay claims payments? Still, to rate and award to Vet's who have completed the claims process should be a simple matter? Personally, as noted in a post I made to this forum several months ago regarding my "C" file, I just this week finally received the copy of my file. The good side of the delay in getting the copy of my file is that it now includes my IHD Claim and I received a copy of the C&P Exam that I underwent in July. The C&P report, which states that it is "Final" in it's conclusion finds that I am diagnosed with IHD and that my LV Dysfunction equates to an ejection fraction of less than 30%. I assume that based upon this report rating my claim under the current guidelines should be a no-brainer? How long could it possibly take to have the computer cut an award letter and begin payments? I guess we will see? Jim

I have searched the web for any article addressing this situation and found none. Perhaps because Congress is set to adjourn until November 15 without having taken any action to block the program this is all the DAV needs to start implementing the program? Of course that assumption requires that one apply logic and we all know how logical government agencies are?

So anyone with any inside information or is anyone willing to make an educated guess on what is happening at present on award ratings and claims while we await the CRA period? Do you think that the VA might be going ahead with rating claims and drawing award letters that will be issued immediately following the CRA delay period of 60 days (now 39 days remaining)? Jim

This system contract does not bode well for Vets to begin with. The State of Indiana got involved in a big contract with IBM where IBM was to take over tha run Indianas Welfare System. This contract ended up being a SNAFU that did not work from the beginning. Heck faulty programing was resulting in otherwise qualified individuals being thrown off the system by the computers and the system was in melt down when the state was forced to fire IBM costing the taxpayors millions. This simply does not bode well for vets expecting a system that will speed anything up. More likely it will cause delays beyond belief.

How would this work? I have always assumed that 100% compensation rated is as far as one can go, with the exception of special care requirements that you can receive SMC for. Doesn't seem quite fair, such as a case like mine where I will likely receive 100% IHD on top of my already existing 90% rating for wounds received in combat, but will still end up only getting the same as someone who receives a 100% rating for IHD alone. But, to my understanding that is the way it works? I too have suffered from IHD for over 25 years but never filed for compensation as I had been informed that no awards were given nor expected to be for IHD developed post service. Heck I wasn't even aware of Agent Orange exposure until this year and I found that out thru the VFW not from the VA. I suppose that I am to blaim for not keeping informed about the latest findings over the years, but as much as I hate to say it, I was always under the impression that as a retired Marine and Nam Vet drawing Disability Comp for combat wounds that the VA or Department of the Navy might keep me informed on changes that would or might effect me. Certainly wrong about that!

I am assuming that any Claim number is the same as your existing file number, at least that is the way it appears on the documantation I have received. I have an 8 digit file number that was extablished back in 1969 and it has never changed. The only thing different is that prior to the file number it says "In reply, refer to: 326/pre/ab" and then lists my 8 diget file number. Of course I have no idea what the 326/pre/ab stands for. I wonder now that they have published the rule if they will begin processing and rating the claims, or will they continue to sit on them pending the 60 day CRA? Jim

Following my claim for compensation based upon IHD as a result of AO exposure which was filed in June of this year and having completed both the C & P exams and having provided the VA with extensive medical records substantiating the IHD I have now received official notification of my claim being placed on hold pending the out come of the legal requirements associated with placing the disease on the list of presumptives. Here is the content of a letter I received from the DVA today. Qoute: We are working on your claim for: . ischemic heart disease "We have received your compensation claim for ischemic heart disease based on herbicide exposure. However, this disease has not yet been added to the Department of Veternans Affairs regulatons governing diseases presumptively associated with herbicide exposure. In order to add this disease, we must follow a series of legal requirements, including publishing a notice in the Federal Register. We have begun this process, but are holding your claim until these legal requrements have been met. When the process is complete, we will make a determination on your claim and provide you with notice of our desicion." I would assume that everyone who has filed a claim thus far will receive a similar letter pending outcome of the proposed regulation. Jim

Yes, I filed my IHD claim as a result of exposure to AO on June 2, received my C & P exam on July 10 and received my VCAA letter which was dated July 15, 2010. I have complied with all requirements of the VCAA regarding documentation and my individual statement and returned this information to the RO via Certified Mail last week. Now I wait.

I get the point and I do apologize to anyone I might have offended by my rant in my post. This was not the proper forum for me to make those comments, again I apologize. Jim

I didn't mean to suggest that there are not legitimate PTSD veterans out there. What I meant to indicate is that there are many that are not and those are the ones that clog the system and make it more difficult for those with legitimate claims to receive just and fair compensation without a fight with the VA. If you don't believe that there are many "trumped up" claims, then you are not living in the real world. I have a lot of Vietnam Vet friends and we talk among ourselves a lot. We know who those of us are that experienced a lot of trauma in Nam and we know who the guys are that came home after the war and put the war behind them and moved on with their lives, who the ones are that have legitimate problems and who the few are that have the attitude that they are owed a living because they served one tour in Nam. PTSD is obvioulsy the most abused because while you can't fake a bullet or schrapnel wound, you can fake PTSD and there are some that try in hopes that they will receive a pension check from the VA. This is not pretty, but it is reality!

Berta, I am sorry to hear of your situation regarding your and your husbands experience with the VA over the years. I for one have avoided contact with the VA for over 40 years due to just the sort of thing you sescribe. I had always heard horror stories of mis-diagnosis and just plain poor treatment from the VA and because I have always had private medical insurance I steered completly away from the VA. This claim for IHD is really my only contact with the VA I have really ever had and I am finding it to be just the sort of "circus" that I had alwasy heard about. It is a sad commendary that the VA treats Vet's claims as an adversarial relationship rather than one of assistance? I can only assume that this adversarial attitude of the VA is a direct result of the thousands of illegitimate, trumped up claims that they receive all the time. Looks like the latest quick way to a free paycheck is via the PTSD route. I personally know of a Vet who continued to file under that one until he finally got something, even though I know that there is absolutely nothing wrong with him. Unfortunately the VA compensation program has been turned into one of the latest "entitlement" programs. I believe that most any Vet coming back from Afganistan or Iraq that applies will receive some form of PTSD comp. Many will proably deserve some compensation, most will not but will get it anyway. Meanwhile many RVN Vets, like myself who had real dibilitating disfiguring wounds that have caused us to loose the best periods of our lives and leave us deteriorating and suffering in pain as we age don't receive half what we deserve. In my day, sure most of us had PTSD, it wasn't called that in those days, but was the same thing. I can't tell you the number of nightmares I had for the first couple of years after I came home from that was, but I handled it in my own way as did most of us, we didn't go off running around crying about it ans looking for a free hand out from Uncle Sam. In this days it was also considered a bit of a stigma and I can guarantee you that I would NEVER have held the job I had were it known I even had any negative thoughts about the war, let alone admit to nightmares and night-sweats. Not today. Some of these later guys wear it like a badge of honor. I basically think we live in a "sissy" culture and as a result we lack the kind of American Fighting Men we had just a few short years ago. In my case, the fact that I suffer IHD, in the form of CAD is a given and the fact that I already receive compensation for Service Connected Combat wounds received in RVN in 1968 while situated at KHE SANH, where I endured the Siege of the Tet of '68 and that it is a documented fact that in addition to the "presumption" of exposure just by serving in RVN it is known that over 46,000 gal of AO were sprayed in the Khe Sanh area during that period leave no doubt of my exposure. Since the VA is not now and will never pay any back claims regarding this disease, I see no point in my even trying to locate and transmit 25 years of medical records to them to establish the onset of the disease in 1985. Therefore, I have decided to file my current documents in the form of stress tests, echo's and ekg's that are current and just let that evidence speak for itself. I see no point in adding the additional stress to my life that any further "fight" would either be justified or necessary in this case. The only question in my case will be as to what degree I will be awarded. I have tests that show EF of 28% with 2.00 MET's, but other tests have shown EF of 30-35%, depends upon when and where the tests were taken. What is really unfair about this situation is if I receive the 60% rating on award (if and when it comes) due to the combined rating table I will still be 90% disabled receiving not on CENT of increase in pension.

Berta, I am sorry to hear of your situation regarding your and your husbands experience with the VA over the years. I for one have avoided contact with the VA for over 40 years due to just the sort of thing you sescribe. I had always heard horror stories of mis-diagnosis and just plain poor treatment from the VA and because I have always had private medical insurance I steered completly away from the VA. This claim for IHD is really my only contact with the VA I have really ever had and I am finding it to be just the sort of "circus" that I had alwasy heard about. It is a sad commendary that the VA treats Vet's claims as an adversarial relationship rather than one of assistance? I can only assume that this adversarial attitude of the VA is a direct result of the thousands of illegitimate, trumped up claims that they receive all the time. Looks like the latest quick way to a free paycheck is via the PTSD route. I personally know of a Vet who continued to file under that one until he finally got something, even though I know that there is absolutely nothing wrong with him. Unfortunately the VA compensation program has been turned into one of the latest "entitlement" programs. I believe that most any Vet coming back from Afganistan or Iraq that applies will receive some form of PTSD comp. Many will proably deserve some compensation, most will not but will get it anyway. Meanwhile many RVN Vets, like myself who had real dibilitating disfiguring wounds that have caused us to loose the best periods of our lives and leave us deteriorating and suffering in pain as we age don't receive half what we deserve. In my day, sure most of us had PTSD, it wasn't called that in those days, but was the same thing. I can't tell you the number of nightmares I had for the first couple of years after I came home from that was, but I handled it in my own way as did most of us, we didn't go off running around crying about it ans looking for a free hand out from Uncle Sam. In this days it was also considered a bit of a stigma and I can guarantee you that I would NEVER have held the job I had were it known I even had any negative thoughts about the war, let alone admit to nightmares and night-sweats. Not today. Some of these later guys wear it like a badge of honor. I basically think we live in a "sissy" culture and as a result we lack the kind of American Fighting Men we had just a few short years ago. In my case, the fact that I suffer IHD, in the form of CAD is a given and the fact that I already receive compensation for Service Connected Combat wounds received in RVN in 1968 while situated at KHE SANH, where I endured the Siege of the Tet of '68 and that it is a documented fact that in addition to the "presumption" of exposure just by serving in RVN it is known that over 46,000 gal of AO were sprayed in the Khe Sanh area during that period leave no doubt of my exposure. Since the VA is not now and will never pay any back claims regarding this disease, I see no point in my even trying to locate and transmit 25 years of medical records to them to establish the onset of the disease in 1985. Therefore, I have decided to file my current documents in the form of stress tests, echo's and ekg's that are current and just let that evidence speak for itself. I see no point in adding the additional stress to my life that any further "fight" would either be justified or necessary in this case. The only question in my case will be as to what degree I will be awarded. I have tests that show EF of 28% with 2.00 MET's, but other tests have shown EF of 30-35%, depends upon when and where the tests were taken. What is really unfair about this situation is if I receive the 60% rating on award (if and when it comes) due to the combined rating table I will still be 90% disabled receiving not on CENT of increase in pension.

Any update on what happened with regard to this?

Thanks, yes if I run my rating using the Bilateral I end up at 88% (=90%) and without it at 87%. (=90%) This will make a big difference if I get rated at 60% with my IHD AO Claim, as with a start of 88% I end up at 95% (=100%), but if I start with the 87 I will end up at 94% (=90%). This is why I am trying to find out if anyone actually has seen their actual rating on any VA Documents? Like I said in my original post all I got was a list of the various ratings and was told it equaled a 90% overall rating. I would like to know whether the VA is considering the Bilateral as a factor in my rating or not? And, of course if not then why not? Is there any way I can find out from the VA how my acutal rating is being figured? Jim

Well.......I am not sure it does, but something is not right about the way I was figuring based upon my interpretation of the Bilateral Rule because using the rule the way I thought it was figured I end up with your rating at only 83, but then again if I then add in your additional 20% DMII I come up with 86%, which of course would put you up to 90% also. I can't believe how confusing this is??????????????? Jim

I have posted a question with regard to using the "Bilateral Factor" (par. 4.26 of Chapter A USC) when the VA figures disability ratings in another area of this web site, but have received no responses to it. Perhaps if someone that regularly reads this forum understands this situation they can look at it and comment? In addition to answering the question regarding how and when it is and should be used in computing awards I am a little fuzzy about the math they use to arrive at the Bilateral Figures Perhaps again, if someone understands the calculations better than I they can advise me of that my rating would be using the Bilateral Factor. I beieve that without the factor my rating would acutally be, using the combined ratings tables, 85% which of course is rounded up to a 90% rating. I think, if I understand the use of the Bilateral, if it were used my rating would be 87% at this point, again rounded to 90%. This is important because if I end up with only a 60% rating for IHD, even though it will raise my rating, if the bilateral is not used I would reach only a rating of 94%, which of course means I would not see any benefit from the additional rating. But, I believe if the Bilateral Factor were used I would reach a rating of 95%, which I think would be rounded up to 100%? Thanks for consideration of this dilemma. Jim

Yes, this all helps. Only one problem from my standpoint, my cardiologist is not enthusiastic about this issue. I think I mentioned in an earlier post that to begin with that when at my last visit I brought up the subject of Agent Orange and it's relationship to IHD my cardiologist said he had never heard about it. I asked him "if" he knew about "Agent Orange" and at least he said he was familiar with it. When I told him that the VA had associated it with the onset of IHD he seemed shocked and made some crazy statement about if the government does that then they are going to have to compensate all the Vietnamese people who were effected. My cardiologist happens to be of Mid-Eastern descent, I am not sure but I think he is originally from Iran or somewhere. One thing for sure, I don't think he will be inclined to offer me any help with my claim and I am actually considering changing doctors because of the attitude that he displayed during this encounter. He is a good cardiologist, but maybe not the guy I want on my team at this point? Jim

Thanks, good information! Do you think it necessary for me to actually get a letter from my cardiologist stating the CAD/IHD, or is it enough that I let the records speak for themselves? As I have suffered with CAD for over 25 years I actually have a file that is probably about 4 inches thick over at the medical facility where I have had almost all of my medical procedures done (St. Vincents Hospital, Indianapolis). In the last couple of years I was able to obtain the local services of a good cardiologist in my home town, so I stopped going to INDY for cardiology and I would think that just copies of my latest test reports would be enough to establish the claim and since they are not going to pay based upon when this disease began I would think it unnecessary to provide data that is up to 25 years old? But, if the consensus is to unload it all on them, I can and will. Jim

As I stated, I assumed thismight be a pretty standard response letter to my claim. What I am most upset about is there complete lack of acknowledgement of the documents that I presented them with at my C&P. I also figured that the reason for the request for the info back to my service period was because of the fact that the disease is not yet a presumptive condition. I guess I will just have to play the game? There should be absolutely no problem in establishing my IHD, that is a given, but of course I have no way to connect it to service as even I have only become aware of the nexus to AO in the last month or two. So, am I to assume that what will happen here is that they will acknowledge my IHD, but deny my claim at this point because I cannot prove nexus to AO exposure? Since I am a 90%, service connected (combat wounds received at KHE SANH in '68) I do not have to go to the trouble of proving my Military service or should I fill out the form and list all this in my own words, ie. provide them a history of my service? By the way I am not familiar with the term HTN? Jim

As I reported in another post a few days ago, I had my C&P exam on my AO IHD claim at the VARMC last week. At that time after answering the questions I was asked and providing the examiner with copies of my latest test reports from my private cardiologist which showed diagnosis, mets, ejection fraction, etc. etc, and being asked to have the results of additional stress testing that I am scheduled for next week be FAXED to the examining oficer I thought I had covered my bases. But..................apparently not! Today I received what might be a normal letter on a claim (but new to me) asking me to provide additional information. I am a little stunned, to say the least. First thing they are asking for is: "medical evidence that shows the diagnosis and earliest symtoms for each disabiity below that resulted from your exposure to herbicides (Agent Orange) Ischemic Heart Disease" "We need evidence showing that the following conditions(s) existed from militaty service to the present time: Ischemic Heart Disease" Well, to be truthful I have no evidence of the existence back to my military service because I did not have the onset of the disease until I was 37 and I retired at age 21. To make matters worse, all the records associated with the onset of my disease at age 37 have been destroyed as my doctors office indicated to me that they only keep records 7 years. (I may have some records that go back almost that far, but have not been able to locate them yet) And as to the first request, I have no evidence other than what will become effective down the road with the initiation of the Presumptions that are forthcoming regarding the IHD and AO. What really stuns me though is one of the things that comes next in this letter is: "What have we received?" Here they list the claim for benefits, VA FOrm 21-4142 (2), VA FOrm 21-256 (VONAPP). They make no mention of the medical evidence that I provided at my visit! They follow this with "what have we done?" Here they list: VA Exam Cardiovascular Heart and Hypertension (if the C&P I had is supposed to be that, I'll eat my hat) and they go on to say: "We have requested copies of treatment records or other evidence from: Dr. George B Bittar (my cardiologist) (again I state that I personally handed them these records, which now they don't even mention in this letter) They also state that while they have asked for these records, it is up to ME to make sure they get them. I don't know what would be more effective than my having personally carried them to them, which as I say again is not mentioned in this letter. Then they state that they have asked the VA Medical facility nearest me to schedule me for an examination with the claim. They will notify me of the place and time. What would this be all about? They have also included in this packet explanations on what I need to provide to prove the claim, etc., as well as a VCAA Notice Response that I am supposed to sign and return which gives me the option of including the info now and asking to have my case decided immediately or ask for a 30 day extention of the time to respond. So, I am totally confused about what is happening here. They give me a phone number to call if I want to contact them, should I try a phone call to see if I can get this cleared up? I hope I can get some good advice on this, cause I don't know what to do at this point, especially regarding the evidence they are requesting. Jim

After years of never having even looked at my original Medical ratings factors stemming from my service in the USMC during Vietnam, both my medical record from the Department of the Navy, which resulted in my permanent retirement and my original original VA award letter, which actually reduced my disability rating from 100% to 90%, I have become involved with the VA again in a claim under the proposed Agent Orange rule covering Ischemic Heart Disease. While it appears to me from reading thru many posts on this web site that some have been able to determine the exact way in which their ratings were determined, using the Combined Ratings Tables, I have no such information. When I was looking thru the USC Combined Rating Tables, I came across secton 4.26 which discusses the "Bilateral Factor" and frankly while it is a little confusing, I think I understand how to use it with regard to determining the use of it with the Combined Rating Tables. But in my case I am wondering if it applies? The jist of it is the Bilateral Factor was used by the Department of the Navy when they reached a determination of a 40% disability and here is how it appears: (1) Unfit to perform the duties of your rank because of physical disabiltiy 1. Mulitiple wounds, fragment, buttocks, arm, right leg, bilateral, abdomen, #9060, 2. Fracture, distal tibia, left healed, #8230, 3. Neuropath, traumatic, common peroneal and posterior tibial nerve, left, mixed, motor and sensory iincomplete mild, #9569, 4. Wound, perforating, colon and bladder, #8680; (2) That such disability was incurred while entitled to receive basic pay; (3) That such disability is not due to the intentional misconduct or willful neglect and was not incurred during a period of unauthorized absence; (4) That such disability is the proximate result of active duty; (5) That such disability is ratable as follows: VA Code 8522 10% VA Code 8521 20% VA Code 7805 0% right and left legs 28 Bilateral Factor 2.8 30.8 VA Code 7517-7512 10% 38 = 40% (6) That accepted medical principles indicate that such disability "is" permanent. The findings of the letter I received from the Veterans Administration (now the DVA) were as follows: Your disabiltities are evaluated as follows: 40%, For wounds, left buttock and thigh, Muscle Group XVII. 40%, For multiple wounds of the left leg and foot with neuropathy, common peroneal and posterior tibial. 40%, For wounds, right buttock, Muscle Group XVII. 30%, For wounds of the right arm and elbow fracture. 0%, For adhesions because of laceration of colon and residual of close colostomy. 0%, For laceration of bladder. 0%, For healed scars from your right thigh donor site. The combined rating is not arrived at by adding the percentages of your disabilitites, but is computed in accordance with a combined ratings table. So finally my question. Considering the 40% ratings for wounds to left and right buttock, Muscle Group XVII, would not my VA disability compensation calculation require the use of the "Bilateral Factor" as determined by section 4.26 of the code? Certainly the Bilateral Factor was used by the Department of the Navy when they made their calculations.

Berta, I am not sure what you are referring when you say I should ask for a copy of the "actual results" Are you talking about the results of the VAMC exam? If so, how do I go about requesting a copy of the exam results? By the way, I was going to ask this in a separate post, but I will address it here also. I had requested a copy of my "C" file about a month ago and while I received an acknowledgement of that request I have still not received anything else from the VA. How long should it take for me to receive this information from the VA? Jim