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brokensoldier244th
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Posts posted by brokensoldier244th
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There may still be an exam to confirm severity. PACT doesn’t say no more exams, so we still have to request them. If you send DBQs we send to a rater to evaluate first before requesting exams.
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Check to see if you fall under PACT, it may be presumptive now
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They will still be decided, you aren’t 100%, you’re just getting paid that way.
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I would definitely get another POA. Did you prior give you any thing back case related?
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SMC's can be, yes, it depends on what SMC category you would fall into. There are some 'gimme's' like having ED or the loss of some other organ, though ED (at least in men). Thats like 115.00 under SMC K
SMC-s is 'housebound' meaning that due to various issues you are pretty much affected bad enough that you don't leave much except for doctors appts and what not. You'll see this a lot with veterans with MH issues of various types.
There are others that are more involved, like those for amputees, blindness, or if you need someone in the home to help you take care of basic daily needs and activities ('activities of daily living').
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Receive- Yes
Lump sum- some of it- from the effective date to the current date. The amount changed in December, reflected in January's payment 8.7 percent INCR) so going forward your figures are a little off but you get the idea. The pay tables are here: https://www.va.gov/disability/compensation-rates/veteran-rates/
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It also depends on how long you have had your other ratings- the bar is higher at 5, again at 10, and 20 years is "can't be reduced unless fraud was involved", unless VA determines a CUE on their part. We are required to correct a record/submit for review any claim we find if we find a major procedural error or misapplication of regulation that might result in a ratings error. I've found 3 in my last 3 yrs that looked to be ratings or major procedural errors when compared with the totality of the record. 2 went up, one went down.
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If you give an approx time when it started then usually about that far, otherwise , all of it to find when it started
Yes, same as for any claim, though you’re going to need a sleep study or a disgnosis to say that you have Sleep apnea vs any number of other sleep issues rooted in MH issues.
Yes, same as any- evidence is evidence but someone from the local Quick Treat at Walgreens isn’t going to carry as much weight as a doctor or specialist
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True, but then not all medical opinions have the same weight, either. I get a few every so often from Chiropractors writing off on systemic non-mechanical conditions, or Social workers diagnosing PTSD, or examiners that are 8 states away and don't have the records in front of them from the veteran or us, or don't cite anything at all except "in their opinion.....". *shrug*.
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If they are in equipose yes, but then im not a rater and I don't have it in front of me. There are claims where the opinions are are not in equipose depending on what each opinion has available to them as the body of evidence, or if an opinion is completely opposite of the evidence of record.
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Legally we are obligated to read through all of it, but ill be the first to say that I really appreciate it when someone sends in a claim with at least approximate dates, seasons, a name of a duty station, or highlights relevant pages of their STR or Capri notes if they have them. Sure we get that stuff, too, but if yours is marked and/or highlighted, so much the better. I still read stuff but that other info definitely gives me a place to frame it within the context of the original documents so I can mark it there, too.
- Vync and ShrekTheTank
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Ebenefits has been in the process of being retired for over a year and I would not rely on it at all unless you are one of the few veterans that have a legacy only appeal going on. Everything has pretty much been moved to VA.Gov.
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Likely because you have two different opinions, one favorable, one not, therefore that has to be resolved. A difference of opinion doesn't mean SC, as raters can't make medical based decisions they can only go off of what is in front of them. If there is a difference of opinion between two examiners it has to be resolved, meaning the rater ordered the exam asking the tiebreaker to answer a specific question that wasn't addressed, or that was root of the opposing opinions.
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What directive is that? I get Capri records on every veteran I build a claim for because it’s required under duty to assist. I have to show proof of all attempts, and negative responses if there aren’t any. It’s been that way for years.
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it can be granted at 0% you only get paid if it’s 10%. It’s under dx code 7319, usually
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You can have a 0% rating for a condition.
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1. Yes, likely, under PACT, if you fit the criteria, though depending on how long you have had the rating it would be really difficult to drop it or eliminate it.
2. Yes, PACT claims can come in as "New" (526) or Supplemental (0995/0996). Since you would be appealing a prior decision it would be a supplemental
3. Depends. Likely your neurologist DIDN"T just "lump it in there". There is overlap of IBS and FM in some 60+% of cases, and 70% that have FM have one or more symptoms of IBS but maybe not full on. You didn't have to "claim it that way"- the rater looked at whatever you had for medical and they would know about the overlap of FM and IBS, also.
4. It would be another secondary condition if it were claimed/awarded that way.
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29 minutes ago, Rattler767 said:
You file for what you can prove. I would file for the TBI. You stated, "I do have favorable findings such as vehicle rollover, explosion etc. while in service. I do have CT scans of the head shows what could cause my headaches." That would be form 21-526ez. Open it as a new claim if you haven't filed for it before. Make sure you submit the medical evidence with the claim. You know the VA will send you for a C & P so make copies of the records that shows you had the accident above and take them with you to the exam and give them to the doctor your self don't give them to anyone else.
You dont want to give them to the doctor, they can't do anything with them. If you know your STRs are in VBMS (the 'claim' file) then you give him a list of the approx dates, or even just years. They can ctrl-F search and do the rest. They aren't going to pour over paper records. They, for the most part, don't get paper records anymore, even from us. I send them a list of links or attachments directly attached to the exam request and it all comes out on their end as 1 thing. Contractors, especially. VHA can see the same things we can, with limits, even within our systems. Same with us and VHA- within some limits.
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If you are having difficulties in that area, then yes. MH drugs are notorious for this. Talk to your PCP about it to get it on record, and if you claim it you'll have a genitourinary exam (thats the DBQ name, you can go look it up on line and see what it covers), and a prostate exam goes with it (generally) because an enlarged prostate in men can also mimic/cause ED.
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Why not just request an increase to headaches, and file for tbi while you are at it? You have an in svc event…
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Headaches are all lumped under 1 category for exam purposes.
Are you claiming secondary to SC Migraines (specifically) or just headaches? Claim secondary to what you are already SC for and use the words that you are rated for. Don't play doctor, or pull up Web Med and try to self diagnose. It feels like you are strengthening your claim by trying to use the medical sounding words ( I know, ive done this back in the day, and I ended up having to appeal later) but really you aren't. Use your regular words for it, and only get technical if you know its written in your records that way.
VBMS takes your contention/claim, and barring some misspelling, etc, or combining of two conditions into "bilateral" to save space, that wording is what goes on the exam request, and that exam request is the question/s the examiner has to answer. If you claim something secondary to "X" specifically, but you don't have a DX for "X", well, the examiner answers the question with "No dx for "X" because that is what they are legally obligated to answer.
https://www.va.gov/vetapp21/files2/a21002562.txt -granted
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637068/ -Scroll most of the way to the bottom, or CTRL-F search for "Summary".
Granted, you weren't part of THIS study, so you can't cite it directly but you CAN point your doctor at it for saying "hey, this is plausible, right? I have tinnitus, and headaches, could they be connected?" If you phrase it something like that rather than marching in and saying " I want you to write an opinion about my headaches and tinnitus for a disability claim..." Your doctor may run screaming out the door. Lots of practice docs don't like to get involved in the disability process very much- they are afraid you'll sue, or something, and its their license on the line making the opinion. But, if you ask about it in the course of an exam and get them to DOCUMENT that it is a cause for concern, you talked about it, and whatnot, that kinda forces them to write something into their record about your complaint/why you were there, and a summary of what they think (usually).
Here is the current DBQ for migraines/headaches. (attached) so you know what the most recent one looks like. Your doctor can fill this out, too, its not a difficult form. Make sure they and you make note of how many time/s a month you are prostrating (have to lay down) and the duration, and if there is dizziness, or light sensitivity, smell, sound sensitivity etc. They also need to include something separate from this that says why they think your tinnitus and headaches are connected (study a, study b, neurology tests, whatever). The second part can be on letterhead from them. This is the 'rationale' portion you hear a lot about.
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Wow! Congratulations !
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Scottish- did you contact VA through an app or website at some point about an error you were experiencing, with VA.gov or Ebenefits? If so, that EVSS group would respond to you, in the context of whatever error you may have reported. Other than that, they don't just reach out to a veteran
Kicked out of the system
in VA Disability Claims Research
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What priority group are you in?
https://www.va.gov/health-care/eligibility/priority-groups/