JohnO

I am a Houston VA regular. I transferred my file from Columbia Regional back in '10 or '11. My last update to my file went thru this year. My file at the Houston RO was gathering dust until I switched to a PVA officer. He found my file in a stack against a wall somewhere, not being worked. He jarred it lose and got some results for me. He told me that at Houston service officers (I guess that is the correct term) are graded on how many claims they work. Thus, they tend to grab the thinner files from the queue. My file happened to be a big one, therefore was not getting worked. I don't know if this has changed, but my officer told me that thin, simple claim files tend to be worked quicker than complicated ones.

Yes. Lyrica works better for me. Been on gabapentin for years. 400mgx3x3 or 3600mg. Gabapentin seemed to help at first but diabetic neuropathy kicked in on top of other pain and just didn't work any more. Has anyone been prescribed a Provant machine? I've been using one for about two months for my feet. I feel silly using it. It is a yellow electrical box about six by ten by fourteen. Has a one inch thick pad about four by nine that I rest my foot on while the machine is running. It is supposed to send out some sort of pulse that surrounds my foot and ankle. I can feel it tingling but not much of a decrease in pain, iif any. I'm in the middle of changing meds for pain and diabetes while I"m trying out the machine. It was prescribed by my primary care doctor. Some doctor at the Houston VA is championing it. I think it is primarily used for wound recovery. I'm not real sure. It came to me with very little information on what it is for and how it is to be used.

I second this most excellent post. I'm 50% secondary for sleep apnea and have had three open heart surguries (one a quintuple by-pass) and a heart attack with stents. My cardiologist stressed that I use my CPAP. It is on me to use it or not. I can tell you that I've grown lax and it is under my bed right now. Doc904's post got to me. I'm digging it out and hooking it back up. BTW, VA Houston took my outside neurologist's sleep study and opinion when rating me.

My claims were going no where at Houston and I finally asked the right person the right question. I found that mine were stacked in a hallway or some such and were not being worked. I was told that I had a thick file with several complex issues. I was told the workers at Houston are graded on how many claims they work so it is easier for them to grab a thin file that maybe can be worked quickly vs a big thick one that will take longer. I don't know whether this is exactly true or not because I didn't actually see the process. A VSO told me about how files are processed. Part of my problem was that I changed regionals from Columbia, SC, to Houston. That caused some delay. I changed VSOs and fortunately he was able to flag my file and get it worked. Still, from the time my initial claim was filed until I received resolution on all claims was about twenty-three months.

I was initially awarded 30% for IHD based on my AO exam. I'd had a heart attack followed by stent emplacement. My cardio records showed a diagnosis of IHD. My records also showed that at the time of my heart attack I had hypertension, though I was not being treated for it. I'm told that you can be diagnosed with CAD and not have IHD. I'd filed for IHD and secondary hypertension. My hypertension determination was deferred pending further evidence. The VA asked me for evidence that hypertension existed from military service. The VA also stated that my military medical records did not indicate that I had hypertension in service. I had several disabilities including IHD and hypertension under review and did not attempt to specifically link my hypertension to my time in service. I was later allowed hypertension at 0% secondary to DMII. I'm not sure why it was switched from IHD to DMII. My final award was 100% so I didn't go back and question it. I hope this helps.

Thanks for the help. The reason I did it the way I did was the bilateral factor. That made me believe I should combine the arms plus 10% then the legs plus 10%.

I have a computation question concerning my recent award letter. Am I doing the calculation correctly? I already have a 20% rating for DMII. I was recently given a test concerning peripheral neuropathy/diabetic neuropathy in all four limbs. The award for my four limbs is as follows: 30% for upper right limb, 20% for upper left limb, 20% for lower right limb, 20% for lower left limb. From the regs: <a name="38:1.0.1.1.5.1.98.22">§ 4.26 Bilateral factor When a partial disability results from disease or injury of both arms, or of both legs, or of paired skeletal muscles, the ratings for the disabilities of the right and left sides will be combined as usual, and 10 percent of this value will be added ( i.e. , not combined) before proceeding with further combinations, or converting to degree of disability. The bilateral factor will be applied to such bilateral disabilities before other combinations are carried out and the rating for such disabilities including the bilateral factor in this section will be treated as 1 disability for the purpose of arranging in order of severity and for all further combinations. Using the above referenced reg., do I combine the upper limbs and add 10% then do the same for my lower limbs, or do I combine all four limbs and add 10%? Calculation, combining upper limbs then adding 10% and same with lower limbs: 30% upper right, 20% upper left, 20% lower right, 20% lower left, 20% DMII. From the combined rating table, Table I, 4.25.2: 1. 30 combined with 20 is 44%, add 10%, then 48% 2. 20 combined with 20 is 36%, add 10%, then I have 39.6% or 40% 3. 48% combined rating for upper limbs, 40% combined for lower, 20% for DMII 4. Then, 48 combined w/ 40 is 69; 69 combined with 20 is 75. 5. Combined rating is 75% rounded to 80%. More from the reg on applying the bilateral factor: (a) The use of the terms “arms” and “legs” is not intended to distinguish between the arm, forearm and hand, or the thigh, leg, and foot, but relates to the upper extremities and lower extremities as a whole. Thus with a compensable disability of the right thigh, for example, amputation, and one of the left foot, for example, pes planus, the bilateral factor applies, and similarly whenever there are compensable disabilities affecting use of paired extremities regardless of location or specified type of impairment. (b) The correct procedure when applying the bilateral factor to disabilities affecting both upper extremities and both lower extremities is to combine the ratings of the disabilities affecting the 4 extremities in the order of their individual severity and apply the bilateral factor by adding, not combining, 10 percent of the combined value thus attained. © The bilateral factor is not applicable unless there is partial disability of compensable degree in each of 2 paired extremities, or paired skeletal muscles.

I just received a new award letter. This was in response to C&Ps triggered by my original claims dated May 28, 2010. The new letter is confusing. I hope someone can help me out. My last award was noted at the beginning of this thread. It totaled 70%, with TDIU 100% awarded. The 70% is broken down as follows: 30% ALS 30% Coronary Artery Disease (Agent Orange) 20% DMII (Agent Orange) 10% Tinnitus I'll share information on the ALS award in the ALS forum. My new C&Ps were for my original ALS claim, peripheral neuropathy of all four limbs related to either my motor neuron disease (ALS) or to DMII, and sleep apnea. The front page of my awards letter states the following: $2,919 start Jul 1, 2010, original award 3,239 start Apr 1, 2011 Special Monthly Compensation Adjustment 2,919 start Jul 1, 2011 Special Monthly Compensation Adjustment 3,023 start Dec 1, 2011 Cost of Living Adjustment 3,354 start Feb 1, 2012 Special Monthly Compensation Adjustment The $3,354 is from the 12/1/2011 Special Monthly Compensation Rate Table. "S" rate for veteran with spouse is $3,255. Another $99 is added from same table, "K" award. The explanation for the $99 addional award is that it is "usually added to another rate...when (the) percentage is zero." I do not know what this means. July 1, 2010 is the start date of my original award, claim filed May 28, 2010 April 1, 2011 is the date my CAD award went temporarily from 30% to 100%, I had quintuple bypass surgery. I was awarded 3 months at 100%. July 1, 2011 my CAD was lowered back from 100% to 30%. February 1, 2012, SMC adjustment, my CAD was increased from 30% to 100%. This is based on a January 19, 2012 filing on my behalf by the Paralyzed Veterans VSO at Houston Regional. I will give more detail on this below. I filed for an increase in my CAD award from 30% to 70% based on my stress test and other cardiac tests indicating that my ejection fraction was within the limit for the 70% award. I was denied this increase on July 1, 2011 because I filed insufficient evidence supporting my claim. My cardiologist simply wrote a letter to the VA stating that I was under his care and that my METs and ejection fraction warranted a 70% award. I had two C&P exams triggered by the Paralyzed Veterans letter dated January 19, 2012. Both were scheduled within 8 weeks. There were some claims on my original filing (May 28, 2010) that had not been C&P'd or that required addional information or followup. Included in my two C&P exams were the following: Neurological exam for possible ALS or other neuromuscular or motor neuron disease Exam for peripheral neuropathy, claims filed for all four extremities. Sleep apnea hypertension erectile dysfunction I was awarded the following adjustments to my original claim: 50% Sleep apnea associated with ALS 30% right arm peripheral neuropathy, also claimed as diabetic neuropathy associated w/ DMII 20% left arm peripheral neuopathy, also claimed as diabetic neuropathy, associated w/ DMII 20% left leg peripheral neuopathy, also claimed as diabetic neuropathy, associated w/ DMII 20% right leg peripheral neuopathy, also claimed as diabetic neuropathy, asso. w/ DMII 100% ALS, minimum award for this diagnosis Lumped in with the PN awards were erectile dysfunction and hypertension. No amounts were given for these two but the VA acknowledged the two diseases. --------------------- Based on what I've written above, any advise about how to proceed? I've got to say that from the start, my claims filings and my exams have gone smoothly. From start at 0% on May 28, 2010, to my award of 100%, letter dated July 30, 2012, I'm satisfied with the VA's efficiency and handling on my claims. I started with the Myrtle Beach clinic to file my initial claims, did my initial C&Ps at Charleston, had initial claims review by Columbia, had my files transfered to Houston Regional, and have used DeBakey VA Hospital in Houston as my primary hospital. I have no complaints.

Thanks, Teac It's much clearer to me now what is going on. I've reread my awards letter and it spells out why I'm having the two scheduled C&Ps. I have an anxiety attack every time I get something from the VA. My awards letter under "Decision" states: 2. Entitlement to individual unemployability is granted effective (deleted). 3 . Basic eligibility to Dependents' Educational Assistance is established from (deleted). Open claims listed as deferred in the awards letter stated that I would be scheduled for an exam. That is what is going on with me right now. Thanks for the help with understanding permanent and total.

I did not file any new claims. Some of my original claims have not been C&P'd. My original filing from May of 2010 included claims for a neurological condition and for sleep apnea. These two items are being C&P'd now, which is why I posted this topic. I did file for diabetic neuropathy, which shouldn't be considered as a new claim since I'm already getting 20% for DMII. I attempted to search this site for answers but searches only bring up titles and most titles of topics are not very descriptive. I am very curious about what P&T actually means. Obviously, it does not mean what I thought it did, giving me some sort of immunity from further examinations and possible reductions of benefits.

Thnx

Am I exempt from future C&P exams if I'm P&T? I am P&T, 80% SC, and TDIU. I just had one C&P yesterday and am scheduled for another in one month. I asked my VSO about the exam and he said the VA was just getting a benchmark on my health, tracking my disabilities for future reference. I received a letter today from DVA regional thanking me for my service. The letter noted my claim #, dates served and honorable discharge, and gave my VA information. Sevice-connected: Yes Combined service-connected evaluation is: 80% Effective date of last change: 1 Dec 2011 Current monthly award: $2,924.00 Am being paid 100% because I'm unemployable: Yes I am considered to be totally and permanently disabled due to service-connected disabilities: Yes I just had a C&P exam yesterday for sleep apnea possibly secondary to CAD. Also, the exam covered DMII. I had a C&P for DMII in 2010.

Answers to some questions posted below: "Did your award letter state P&T as well? " from Cooter No. From Carly: "2) Read your Rating Decision over real good. Chance are that they already increased one of your SC'd conditions high enough to fall into the criteria for 38 CFR 4.16 (a). 3) What issue/s do you feel remain to be "properly evaluated" for you to be "satisfied" " No to number 2, above. Only a new rating of 30% on one of my deferred claims. Reference Carly's 3, I've had heart surgery this year and medical evidence shows that I was underrated at 30%, should have been rated at 60%. I'm filing new medical evidence next week. Also, I've been seeing a VA psychiatrist and her evaluations and notes should give me an increased rating for PTSD from 30% to 50%. I have an open claim for PN for all four limbs. I have a NEXUS from my neurologist linking the neuropathy to my DMII, which was rated this past February at 20%. If I can get my CAD percentage up from 30% to 60%, and my PTSD up from 30% to 50%, and also link my neuropathy to my diabetes, then I'll feel much better about my claims and VA response to said claims. From Berta: "The 100% or TDIU is for increase in one of the 30% but you have a separate independent SC rated at 30 that should be 60% (by medical evidence)? Is that what you meant?" Yes, my highest individual award is 30%. The 30 to 60 you referred to is my CAD, and recent heart surgeries (three this year) support increasing my CAD to 60%.

I received a call from a rater earlier this week telling me that he was walking my claim through whatever approvals were needed granting me IU. My Social Security disability rating evidently weighed heavily in the decision. My highest individual rating is 30% so Berta, your advise some months ago to go ahead and file for IU was spot on. I received my award letter today. I get paid at the 100% rate from my initial filing date. I've been awarded 30%, 30%, 30%, 20% and 10%. I still have some claims that have not been rated. I also have medical evidence supporting the increase of one of the 30% awards to 60%. I'm still going to get everything filed and rated. I'm not going to relax or be satisfied until all of my claims are properly evaluated. I'm having a hard time getting excited about this. I'm grateful that vets have a safety net of sorts. Thanks to all that have posted and helped us. I ended up doing a lot of my own research and filing of claims based on answers from hadit members. Thanks to all of you that have contributed to this site. Perhaps some day I'll be able to help a vet the way many of you have helped me.

My claims file was transferred from Columbia, SC Regional to Houston Regional in February, 2011. I met with an American Legion service officer today to discuss some deferred claims. I also asked the AL service officer how to request increases in current awards based on new medical evidence. I want to share some information that might be beneficial to others about NODs, requests for increases, and the claims process in Houston. I have specific medical evidence that will increase my current benefits. I asked the American Legion service officer if I should file an NOD or if I should request my file be reviewed based on new evidence. He said the current wait time in Houston if an NOD is filed is about 4 years. He said that it is best to request a review based on new evidence. He also said the wait time for a C&P in Houston is about 8 months. This is not too bad but my wait time in the Columbia, SC region (Charleston VA hospital) from the time I initially filed claims to the time C&Ps were scheduled was six weeks. I asked about the current status of my C-file that is now in the hands of Houston Regional. He told me that my file had been transferred from Columbia to Houston mid-February of 2011 and it was in limbo, had not been assigned and therefore was not being worked. We're now working on getting my file assigned and worked. I know the question of whether to file an NOD or to file for a request for an increase has been asked. I hope that some of this is helpful.