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Tomahawk

First Class Petty Officer
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Tomahawk last won the day on August 17 2015

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About Tomahawk

  • Rank
    E-5 Petty Officer 2nd Class

Previous Fields

  • Service Connected Disability
    90
  • Branch of Service
    Marines

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  1. The way I read the statement is that someone has to form a medical opinion that your obesity was "caused" by the service connected disability. With that said, I had my SA claim denied based on obesity. Ill look for it when I get home. But it said something along the lines of "while medications taken for SC disability have contributed to weight gain, that alone is not the cause of the obesity as adjusting caloric intake would make up for the reduced activity levels" Basically the doctor stated that I had sleep apnea because I was overweight, and that I was overweight because I ate too much, not because of the 800 medications I have taken that weight gain is a side effect of.
  2. The major problem with your "little gem" is that you still have to have a doctor backing your statement. " 15. A determination of proximate cause is basically one of fact, for determination by adjudication personnel. VAOPGCPREC 6-2003 and 19-1997. With regard to the hypothetical presented in the previous paragraph, adjudicators would have to resolve the following issues: (1) whether the service-connected back disability caused the veteran to become obese; (2) if so, whether the obesity as a result of the serviceconnected disability was a substantial factor in causing hypertension; and (3) whether the hypertension would not have occurred but for obesity caused by the service- 10. Executive in Charge, Board of Veterans' Appeals (01) connected back disability. If these questions are answered in the affirmative, the hypertension may be service connected on a secondary basis." You will have to have a doctor state that your SC disability caused the obesity. Which will be much more difficult than you'd expect. Yes lack of exercise due to your SC disability may have been a contributing factor, however your eating habits are more than likely the primary cause in most doctors "professional opinions"
  3. Is it possible to appeal the diagnostic code used? In my case, I was granted 30% for CRPS secondary to a post operative foot injury. They rated me under 8599-8521 External popliteal nerve (common peroneal). 8521 Paralysis of: Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension (dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened; anesthesia covers entire dorsum of foot and toes............................................... 40 Incomplete: Severe 30 Moderate............................................................................................................. 20 Mild ................................................................................................................ 10 I believe this is the incorrect diagnostic code because it does not address the atrophy of the muscles below the knee which is what triggered them to reverse their denial before sending the appeal to the BVA. They stated the 1" of atrophy on the calf was enough to separate the CRPS from the SC post operative foot injury. I believe that they should have rated me under: Sciatic nerve. 8520 Paralysis of: Complete; the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost........................................................................................................... 80 Incomplete: Severe, with marked muscular atrophy.............................................................. 60 Moderately severe ............................................................................................. 40 Moderate............................................................................................................. 20 Mild ................................................................................................................ 10 Which would have granted me 60% and not the 30% due to the marked muscular atrophy of the muscles below the knee. Is this something I can appeal on? Or is it pretty much whatever they rated it under as it is analogous what I am stuck with? Secondary question to this. This was one of 5 items on appeal to the BVA. They awarded me this prior to certifying my file to the BVA. At my video hearing I stated I was withdrawing that portion of the appeal. When I called the 800 number prior to my 1 year mark to inquiry as to how I would go about appealing the diagnostic code used they stated I couldn't appeal it until the BVA has finished with the claim. If I am able to request it be reviewed under a different diagnostic code, is there some manner in which I can request a DRO review while my stuff is still with the veterans law judge?
  4. I have yet to received the letter. Though I am indeed employed.
  5. Almost there!

    So I have a pending appeal with the BVA still. However last year I got a phone call from a DRO who was reviewing my file before it was sent to the BVA. She said they were upping my rating based on the atrophy in my leg and wanted to know if I still wanted to include that part of my appeal. She also suggested that I file for "mood disorder" because the evidence is in my file for them to grant that. So in March I filed. I haven't gotten the letter yet but my rating jumped from 60-90% on ebenefits. So it looks like they granted me 70% for the new claim. Such a relief to have something in this process go so smoothly and it being something they told me about.
  6. So the likelihood is s certainty. They gave me 70%
  7. Need an IMO

    Just to update. Ohio Specialty Network is a sham. All the guy did was write a report stating that I did indeed have the issues I was requesting him to examine me for and opine on. He would not write an opinion on cause nor correlation. Do not use them for an IMO
  8. Added the pertinent info to my original post. I understand based on the occupational report it could be 30%. However the fact that he indicated: "Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively" makes me think it may be higher. Just curious what the experts/former raters on here think. My question is based off of reading: VAZQUEZ-CLAUDIO V. SHINSEKI In Vazquez-Claudio v. Shinseki, the Federal Circuit ruled that the most important consideration when rating psychological disorders is the symptoms associated with each rating. For example, if a veteran is trying to get a 70% rating, it is less important that he prove that he have "[o]ccupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood," and more important that he prove that he have the symptoms associated with that rating, which include "suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships." So, in any case where you are trying to receive a higher rating for PTSD, remember that the most important thing you must prove is that you have the symptoms associated with each disability rating. As the symptom selected is associated with the 70% rating, I am curious what the likelihood is that they will grant the 70%
  9. So I just had my C&P exam for depression secondary to my CRPS. Based on the exam can anyone speculate on what rating I would get? SECTION I: ---------- 1. Diagnosis ------------ a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes [ ] No ICD code: F32.89 If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Other specified depressive disorder ICD code: F32.89 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): complex regional pain syndrome, OSA, herniated disks 2. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes [X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed 3. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [ ] No [X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI 3. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Chronic sleep impairment [X] Disturbances of motivation and mood -------------- TEST RESULTS: Mr. XXX completed the Beck Depression Inventory-II (BDI-II), a widely used self-report instrument concerning depressive symptoms experienced in the last two weeks. There are no norms. The instrument lacks a validity scale and is therefore susceptible to either under- or over-reporting of symptoms. Mr. XXX scored 30, which the test developer considers to represent "severe" depression. -------------------- OPINION: Mr. XXX's current symptoms meet diagnostic criteria for other specified depressive disorder, a diagnosis based on depressive symptoms that do not fully meet diagnostic criteria for a specific depressive disorder. The veteran's depressive disorder is as least as likely as not proximately due to or the result of complex regional pain syndrome, left lower extremity with atrophy; and to herniated disks.
  10. First of all. File the Form 9. You are on a deadline with that. You don't need an attorney, or an IMO to send in the Form 9 stating you disagree and want the BVA hearing. Hopefully you are close enough to your regional office that you can hand walk it in to get a time stamped copy for yourself. If not get it in the mail as soon as possible so you don't miss the deadline. After that you can get the attorney and/or the IMO. If you are going to go the attorney route they probably have a preferred company to use for IMOs. If you are going to just get the IMO yourself you need to make sure you print out the DBQs for the issues you are claiming. And make sure you have a full copy of your medical records and SMRs for the IMO doctor to you review. The IMO will need to state it is "at least as likely as not" service related/caused or aggravated by a current SC disability. And then it also has to provide reasoning for that statement. If your IMO does that it is highly likely you will win the appeal. As far as the VA Backlog goes, you may want to at least reach out to a VSO. There are ways to get it sped up and they can probably help you with that. However once you submit the Form 9 it doesn't just automatically get sent to the BVA. I filed my Form 9 in March of 2013. The DRO didn't review my file again until July of 2016 to then send my case to the BVA in August 2016. I had my video hearing November 3rd. And it is now my understanding that the average wait time after the hearing for the decision to be sent out is about 270 days. With that said, before they sent my file to the BVA the DRO did review my file and granted one of the conditions I was contesting. So if you do get the IMO and send it in they can indeed review it and possible grant your appeal prior to it getting sent to the BVA
  11. I would file the Form 9. If you submit additional evidence after that they will review it and may make a decision before it even goes to the BVA. I filed my Form 9 in 2013. They were finally submitting it to the BVA in July of this year when they reviewed the C-File and granted me 1 of the 5 items on appeal before sending it.
  12. I have been battling the VA for over 15 years. I have had numerous vet reps throughout that time and in the end I got rid of them all and took the time to do the research myself. Before finally sending my claim to the BVA, the DRO called me in mid July stating that they reviewed my claim and that 1 of the 5 issues I was contending was going to be granted for me. And they also told me that within that review they saw two other claims that I should have made. Which I found odd. She basically told me that I should look over my file. There are two conditions that are clearly related to my SC Disability and that were I to file for those they would be granted without any issue. However she wouldn't tell me what those two conditions would be. So I need to figure that out once I finish my appeal. With that said, after an almost 7 year wait I had my BVA hearing last week. I just started a job a month ago that is my first since service to offer medical insurance. So I answered all of her questions, and presented my case, then requested the judge to hold the record open for 60 days so that I can have time to get an IME on 2 of my 4 issues which she granted. After we finished the hearing and she stopped recording she stated that she was pleasantly surprised. Most veterans who represent themselves aren't prepared, it was clear that I had done my research, and that I did an exceptional job presenting my case. I'm hopeful that she wasn't just blowing smoke and that my case was strong in her eyes already. So now I have to get the IME's and hope the doctor agrees with the conclusions I have drawn. After that we will see how it goes. Keep fighting if you believe your cause is just.
  13. I was under the impression that if you requested a copy of your c-file that the VA was under time constraints on getting you a copy? I applied for a copy in August of 2015. I checked ebenefits today and its stating Estimated Completion: 10/10/2016 - 05/14/2017 Seriously? Up to 2 years wait for a copy of a file that is supposed to be electronic at this point?
  14. Need an IMO

    Well. I have my VA medical records which show I have CRPS. Which is already in my 30% service connection. However they rated me as 30% for "post-operative foot injury with complex regional pain syndrome". I just need the doctor to write something to get them to separate it.. The foot in and of itself is practically worthless due to the VA surgeon fusing all of my toes. I have zero movement on my own and they can only be moved by hand a few degrees. My ankle constantly rolls because of this which I thought would have been rated as well but apparently not. But for those 2 issues I shouldn't need anything in my SMR. The foot and the VA surgery that caused the CRPS are already service connected. As for the rest of my claims that were denied. There are entries in my SMR. But apparently not enough for the C+P doctors to opine in my favor. However everything I claimed is also exacerbated by my already SC condition. So they should be granted on that basis alone. I do have a copy of my C-File, or at least as complete of a copy as I can. As well as 1 copy left of my SMR. I do not have a VSO. I fired the one after this last claim because he put all sorts of shit in my claim that I wasn't claiming. He put a claim in for my opposite foot which there is nothing wrong with. He put a claim in for 100% IU. And he didn't include a 2 things I specifically mentioned. I learned the hard way that you shouldn't trust a VSO when they say "Sign this, Ill fill it out when I have time and submit it". been going it alone since. But I would most assuredly explain to the doctor that he needs to review the records and provide a complete rationale for his findings.
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