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brokensoldier244th

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Posts posted by brokensoldier244th

  1. 21-4142/4142a = release for private providers to release records to VA ( some providers still ignore them)

     

    10-5345 = release for VA to give records to 3rd party providers

     

    Either way works, though if you use a 4142/4142a we do the work of contacting the providers you list. It doesn't absolve you of trying also- Some providers ignore us, or charge money, or won't release without their own special form in addition to ours, which we dont find out about until later. If you want a third party IMO/dbq then a 10-5345 is more appropriate because your provider can say that yes, they did see your medical records, and you have the request form to show that you requested them.

  2. E- Benefits has been sunsetting for over the last year. About the only thing it still tracks is some legacy appeals. Most everything else is at VA.gov. 

     

    Benefits is going away. Don't use it unless something on VA.gov tells you to. 

  3. I have seen Pes service connected with nexus letters and a solid post svc treatment profile. Xrays and whatnot can sometimes show 'age' of an injury if the doctor or orthopedist is good. Your MOS and maybe a buddy letter or something that depicts a 'normal' day for you could help, too. We aren't all prior service and sometimes I think looking up an MOS while typing up my notes to the examiner doesn't occur to some of my peers.

    I empathize with you- I have flat feet, also, wear orthos, and I'm 46. It can really suck on a pain day. Plus, we rarely get to wear fun shoes that much because if Im wearing orthos not all shoes or boots can handle them. KeeN makes good shoes and boots, Red Wing, New Balance (some of them)etc, obviously, though you pay for not having to walk in pain.

  4. It's not a guarantee, as in "at 5 yr +1 veteran rating, if static, will be made permanent" but if it's been static for 5 yrs generally it won't be up for RFE anymore unless you claim something related to it. VHA will still stay on top of it, but VBA at 5 yrs of static is encouraged to not pursue RFE's on it. Making it 'static' is basically saying "it's not gonna change". The rating isn't protected until 20, just like any other rating, but the bar is higher for them if they wanted to try to reduce it for some reason. 

  5. 21 hours ago, flynsolo2 said:

    @brokensoldier244th Thanks! I am hoping only a few months. My VSO submitted it, so I am not sure if he checked the box or not, and he is now off for medical reasons, so I guess I will have to wait and see. But, he did file it secondary to PTSD, it is what I have been fighting them (and they keep denying). I think Dr. Anaise just put the GERD claim as well to help solidify it, in case my PTSD % ever gets lowered maybe? But, I get what you're saying. 

    I did not know that there is a backlog because of the PACT, so, I do hope it does not put my claim decision out too far. It is the only new evidence I submitted, and in the IMO letter, he included the most sleep study, so, hopefully they rate it sooner rather than later....I have a BVA appeal from April 2021 that I am STILL waiting on a date for, so, I know it can take a long time.....

    The PACT claims aren't taking priority over others or anything like that, we work whatever comes through. I just mentioned it because its an influx of claims that built up over 5 months before being released to be rated. We were working them during that time, we just couldn't do anything with them until January.

  6. I would have filed the OSA secondary to the PTSD only- GERD may cause sleep disturbance but it doesn't cause OSA, it's more a secondary symptom OF sleep apnea, so I don't know where he thought he was going with that. I see a lot of pro-veteran doctors write a lot of stuff every day, including Anaise, and quite frankly, many of them fill their rationale more with legalese than just getting to the point. It ends up being more spaghetti on a wall rather than 1 or 2 solid theories, and it takes a lot longer to read through, support with evidence from your file, and then rate later.

    Timeline, it just depends on what RO it goes to first, and how backed up they are. PACT claims were fileable from August of 2022 but not workable or rateable until Jan 2023 because Congress and VA did not have a funding mechanism for it, yet, so all the ROs are backlogged on those, along with regular claims. OSA secondary to PTSD is generally pretty straightforward, though, so I wouldn't think more than a few months, tops, and that's on the long end. If your other evidence is in a row, you can send a 5103 and check the box that says " I have submitted all remaining evidence...." yadda yadda. That will waive the mandatory 30-day waiting period that the claim is held in suspense to allow for other late-flowing evidence before going to rating.

  7. From what I remember they have 2, one for the eastern half of the US and one for the western half of the US. They don't make decisions like "prescribing" you different medications- that's your doctor. But, legally, a pharmacist can override a doctor and say "hey, this prescription is going to conflict with *whatever*" and then the doctor has to re-write for a different medicine in the same family, usually. Pharmacists are much more on top of drug interactions, they study it for 4 yrs straight. Doctors have a few classes here and there (my BIL is a pharmacist).

     

    There is a centralized VA formulary list that is all the drugs that VA can prescribe. I don't know who makes the decisions on that but it's similar to private insurance- there are some drugs that VA just doesn't carry due to cost or availability. I'm taking one now that I had to wait 6 months for because some TikTokker told the world that it helps you lose weight (it does) but it's also a major diabetes drug. SO, for several months VA couldn't get any of it anywhere because every naturopath, dermatologist, whatever that had letters after their name could order it from the company that makes it- and they were more than happy to sell it to anyone (ozempic). SO, VA had to schedule/prescribe me an alternative which is less effective but still works and isn't quite as in demand because its only about 1/2 as effective. Im not diabetic- I'm taking this in conjunction with VA MOVE for weight control, so I understood the hold-up and why, and I'm cool with it. Diabetics need it more than I do. 

     

    Here is a post from T-Bird that links to some info about it.

     

     

  8. 1 minute ago, allansc2005 said:

    pacmanx1, 

     

    I totally agree.

    In the early days when I was depending on the VA for everything, to do everything.., which I later learned was a big mistake.

     

    Over the years I have found that the LESS you depend on the VA for your claim needs, and the MORE you do to help your claim along, the better for you once all is said and done.

    Last month I came across a veteran who had been waiting 3 years for a simple tinnitus claim to come to an end, only to find out the veteran was throwing away C&P exam letters, changed his phone number without telling the VA..; what a mess!

    After giving him my version of an "ass chewing", he now understands the meaning of being "proactive", and is enjoying his 10% tinnitus  compensation.

    I try to stick to the motto: Keep the VA informed!

     

    Allan 2-2-0 HOOAH!

     

     

     

     

     

    Followed by the 2nd, slightly less known corollary "you are your own best advocate". 

     

    Okay, back to work for me, at least for a few hours. Enjoy your weekend, gents and ladies. 

  9. FYI- While information may still be missed in federal records like VAMC, STR,OMPF- you not submitting these records is not enough to remove your claim from FDC- Reason being because we are supposed to reach out to all federal entities already as part of or job to gather records. If we don't that would be a DTA.

     

    Now, is it possible that you have that piece of paper/pdf/thumb drive full of your STR, personnel jacket, whatever, that we don't? Yes. I find late following records sometimes years after your original personnel and STR transmission to us from the services (triggered by filling a claim for personnel records that are newer than early 2000s for personnel, and early mid 2000s for STR). If we gathered them at the time it's not a DTR. We are SUPPOSED to check every time a claim is filed, so eventually that stuff should end up in there but we all know how that goes.

    They are time stamped/date stamped when they come to us in the system and it...is...not...editable, short of a complete deletion, and there only people that have that level of access are IT. I've got 15 yrs of IT experience as a civilian and a masters degree in IT Admin/Sec, and I've tried, with dummy records, and only succeeded at getting in trouble for testing it. Later added stuff that is uploaded is time/date stamped, and flagged as a "new upload" to your file to call attention to itself. If you have an open claim submitted new documents from you, us, NPRC, whatever, triggers that claim to go back out to get looked at. 

  10. The cfr says

    The criteria for assigning an asthma VA rating is as follows:

    • 10% — For this rating, a veteran must show a predicted FEV-1 of 71-80%; an FEV-1/FVC ratio of 71-80%; or a need for intermittent inhalational or oral bronchodilator therapy
    • 30% — For this rating, a veteran must show a predicted FEV-1 of 56-70%; an FEV-1/FVC ratio of 56-70%; a need for daily inhalational or oral bronchodilator therapy; or a need for inhalational anti-inflammatory medication
    • 60% — For this rating, a veteran must show a predicted FEV-1 of 40-55%; an FEV-1/FVC ratio of 40-55%; physician visits at least once a month for required care of symptom exacerbations; or intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids
    • 100% — For this rating, a veteran must show a predicted FEV-1 of less than 40%; an FEV-1/FVC ratio less than 40%; more than one asthma attack per week with episodes of respiratory failure; or daily use of systemic (oral or parenteral) high dose corticosteroids or immunosuppressive medications
  11. 4 minutes ago, broncovet said:

    I agree with brokensoldier.  In addition to a possible SMC, DIC (for your dependents) is dependent on "the cause of death".  

    It needs to be service connected "cause of death" to get DIC for the first 10 years.  After 10 years, the dependents should get DIC regardless of the cause of death.  

    So, additional SC disabilites is a good thing for both SMC and DIC.  

    Drat, I knew I forgot something. My brain is fried today. 

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