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brokensoldier244th
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Posts posted by brokensoldier244th
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Mine was applied as part of a 100% rating action in 2016- I didnt ask for it, and I was kinda surprised when I saw it on there because they did it all at one time. Id been static for a while on most things, and worse on a few others, and id been rated, starting with my low back and nerve issues since 2002. Other things crept up over the years.
- Riplip and ShrekTheTank
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Any disability can become 'static' after 5 yrs of no significant changes. This lessens the chance of mandatory re-examination regardless of age, or length of time you have been rated. After age 55, or 5,10,20 yrs of a condition not changing there are protections on the rating (you can google "protected ratings" and read about that)
P&T is only applied to 100% ratings or extraschedular/IU ratings, or convalescence ratings where you are 100% by regulation due to something like a knee replacement or heart surgery (Ive never seen one of these, thus far).
Ive seen people apply and ask for it, but its not really a 'rating', and by regulation its applied when all the criteria are met- usually during a ratings action of some kind. Basically someone has to look at your claim and see that you meet all the criteria, then apply it.
Start reading at
V.ii.3.D.4.a. Definition: Total Disability
- GBArmy and ShrekTheTank
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If you definitively know if its existence and its not been publicly published the best you could do, I think, is an FOIA but they have to be at least somewhat specific in what you are asking for., and FOIA's don't have to be fulfilled.
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BVA decisions are for the veteran, but CAVC decisions are for the veteran AND the VA as a while (pacmax's "precedent setting decisions" up above). BVA's are good seeing IF a set of criteria- contention, secondary connections, locations served, symptoms, etc are plausible. If that series of criteria apply to you then you at least have a good idea of if others have prevailed or if your theory of SC or causation is barking up the wrong tree, and you can get some ideas of how to approach your own claim by seeing what others have done.
It helps you to filter out what may not be as strong a claim because you can look for the results of similar claims. You also can get the names of other decisions used to help decide that claim- and THOSE are the ones that you can cite for yours as well, if a similar situation applies.
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Typ-o "Sexually assault-ED"
Instead of "in conclusion", use "at least as likely as not". That is the verbiage from the ratings criteria, so it makes more sense to use it and give them what they want. Sometimes I have to try to parse out what the doc is actually saying with "in conclusion, and heretofore and forthwith......" etc LOL. Gives that English degree a workout, you know?
Maybe list some of the ways you have tried to monitor and lose weight that didn't work. I did that, and managed to win that claim for OSA- it was a local appeal- but that was my fault because I jumped the gun and applied for it as soon as I got a Cpap rather than going through my notes and prior MyHealthVet and showing gradual weight gain, along with statements to my PCP periodically indicating that I was trying and failing. I had a chart generated from an app that showed calories and weight gain for like, a year, that was outside the normal parameters for someone that had similar calorie and activity intake. OSA is often caused by weight gain, so to combat the "lay off the doughnuts, fatty....." opinion, you can show that you tried to lose weight, or at least manage it, to no avail- even better, if you can show that you had the beginnings of sleeping issues at lower weights than what you were when you were prescribed, even better- it shows a progression.
I also had a letter from my spouse, and an audio recording of my snoring and cessation of breathing during sleep. The audio coudln't be submitted but she described the 4 or 5 different dates over a month period pre-cpap that she recorded and how often I stopped breathing. I don't know how much it helped, but it was in there when I appealed.
Otherwise, its solid. Maybe a few more sources, just so it doesn't look like they are cherry picked from the 'one' (I know there are more, but you know what I mean) that says what you need it to say. I can google a bit and find "one" also, but more than one, that means it was a repeatable result. In academic paper writing that lends more credence to a paper's results.
Did YOU find those articles, or did your doctor? If YOU did, check with the doc and make sure they say what you think they say. Im not questioning your intelligence, but I have a Master's degree, and almost another one, and I can't count off the top of my head how many papers I was ready to cite for something I was writing in a literature review that I 'thought' said something but then after digging into the technical terminology found that it was really a lukewarm or even opposite conclusion from the title. Measure twice, cut once.
Attached is the letter my doctor wrote for my local appeal, and what I wrote as a cover letter to my submitted evidence, when I appealed my proposal for reduction (that I got 6 months after getting OSA service connected).
- Phury & Rhage and 63Charlie
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Are you looking for an exam report, or something else? A vso with VBMS access could get it for you if you know the approx date of the decision or exam.
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1 hour ago, Richard1954 said:
I've seen it too, in fact many of my secondary conditions were claimed based on my reading of medical articles and realizing hey , this is exactly the issue I have. So I submit the claim with no nexas , and sure enough the claim is granted with an opinion its as likely as not. The va really makes it easy to get some claims approved because of the likely or not opinion. But I still recommed the veteran having an understand of the cause of an issue, and if its not known ask a doctor.
Oh absolutely, if for no other reason than to understand what they have, and self care.
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8 minutes ago, Richard1954 said:
This is a diagnosis, it may not be what you thinkj it should be but nevertheless its a diagnosis. Now you have to determine what is the cause of it. Can it be related to a service connected condition, as secondary, or is it a condition caused directly from you service. And as you know it may have nothing to do with your service, and is just a new condition base on something more recently. If you place a claim you need to be able to tell the raters what you think is the cause. If you do not know the cause, the va will likely deny the claim. You should have asked your doctor what he/she may think it is cause from. Since it involves light sensitivity, I am guessing it had nothing to do with your military servide, but that is just a guess, and I am not a doctor. I am attaching the VA rules for VA doctors to write an opinion for a medical issue, most don't like to write them and will say they are not allow to write them, but any doctor that says that is lying, and just doesn't want to be bothered.VHA directive 2000-029 Medical Opinions by VA Doctors.pdf
You don't even have to be exact, just plausible. Lay statements, no matter how far fetched, are admissible. I had one this week where someone claimed erectile disfunction secondary to tinnitus. #$()$*#)(#$?? But, hey, whatever, man. Still, if you can draw a reasonable lay opinion of why you think your condition is service related, and 1 better, get your doctor to say, "Sure, maybe...." thats still evidence that is considered. I see decisions all the time where a lay statement was considered in the final decision granting of service connection.
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Why be so specific? You have headaches. Claim it that way. They all fall under the same diagnostic code. If you claim a specific condition and have no DX some examiners may say “ no diagnosis” , so don’t shoot yourself in the foot. I see it all the time with "Sleep Apnea". You have sleep disturbances (a presumptive of Gulf War and SE Asia, by the way, look up MUCMI) but you claim Sleep Apnea. Well, you don't have a SA diagnosis anywhere in your file, so.......
You have a diagnosis. That’s only part of it. How are they service connected? That’s the next question you have to at least sort of have an answer to. Are you claiming them directly, I.e. chemical exposure, burn pits, SE Asia? Are you claiming they secondary to something already rated- hypertension, tbi, ptsd)?
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Hypertension is AO. They added presumptions to both AO and burn pit.
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15 minutes ago, worriedshrimp said:
this thread, at least for me, presents another question in regards to the new veterans bill H.R.3967 - Honoring our PACT Act of 2022. specifically the ruling on hypertension purportedly to began in october of 2022. at what level will pre - medicated hypertension/high blood pressure be measured? maybe someone with more knowledge of how the system works can chime in on this specific. noteworthy also are the many new presumptive issue for gulf war veterans and the like.
thanks again for this informative group of folks.
The bill authorized it as a presumptive I haven't heard that there are changes with how its rated/calculated from how it is now. The PACT was only addressing presumptive service connection.
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SEC. 406. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN DISEASES ASSOCIATED WITH EXPOSURE TO BURN PITS AND OTHER TOXINS.
(a) Short Title.—This section may be cited as the “Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2022”.
(b) In General.—Subchapter II of chapter 11, as amended by section 302, is further amended by inserting after section 1119 the following new section:
Ҥ 1120. Presumption of service connection for certain diseases associated with exposure to burn pits and other toxins
“(a) Presumption Of Service Connection.—For the purposes of section 1110 of this title, and subject to section 1113 of this title, a disease specified in subsection (b) becoming manifest in a covered veteran shall be considered to have been incurred in or aggravated during active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during the period of such service.
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9 hours ago, Dustoff 11 said:
At age 76 and fully P&T 100% for well over twenty years I just received email from LHI to make an appointment for exam for the DOD Reserve Health Readiness Program ( a new one on me). In 1982 I received a total and final Honorable Discharge from The Army Reserve and "all reserve forces of the USA" as a CW2 Warrant Officer Medevac Pilot. Before that I received 3 prior Honorable Discharges as enlisted and Warrant Officer from Active Army and Army National Guard. I also resigned my appointment as a Warrant Officer and I of course have several copies of all those orders and discharges.
My VA health issues for P&T are heart disease, GERD, Sleep Apnea, PTSD and Tinnitus all of long duration.
It will be a cold day in hell before I ever again risk my butt for good old USA after being treated like a baby killer, joke and loser on returning from Nam in 71 and later years. Sounds like another Dem attempt at a Vietnam Draft?? Maybe this is attempt payback for my twitter post against present??
Has anyone else received one of these nasty emails??? I am not going to even reply to this garbage and if necessary will contact national but not useless local news media. I am not worried about this chit one bit after what I have already been thru for good old USA and at age 76. To hell with babe ruth as the saying goes.
I will be posting this comment on other social media where I have 4500 friends on FB.
It might help if you briefly described what the email is. Its not a VA email so I can't shed any light on this, I have no idea what it is, either.
This is all I could find on it in a quick search- Its a program to provide health services, not a recruitment effort.
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47 minutes ago, Dustoff 11 said:
The U.S. CAVC veterans court made this favorable to vets decision in 2012.
"In Jones v. Shinseki, 26 Vet.App. 56, 63 (2012), the Court held that the veteran is entitled to a rating based upon his unmedicated condition – that is, the higher disability evaluation – if the effects of medication are not explicitly mentioned under the applicable diagnostic code of the rating schedule.
Compare See 38 C.F.R. § 4.71a, DC 5025 (2014) (providing, inter alia, a 10% evaluation for fibromyalgia that “requires continuous medication for control,” and a 40% evaluation for fibromyalgia that is “constant, or nearly so, and refractory to therapy”); 38 C.F.R. § 4.97, DC 6602 (2014) (providing varying evaluations for bronchial asthma based on the type and frequency of medication required).
The Jones decision has the potential to help a lot of veterans. Most diagnostic codes do not consider the ameliorative effects of medication. Let’s take the General Rating Formula for Diseases and Injuries of the Spine under 38 C.F.R. § 4.71a, DCs 5235-5243 — not a word is mentioned about medication.
Therefore, a veteran’s forward flexion of his service-connected spine must be measured according to his unmedicated condition. That is, his range-of-motion must consider the limitation caused by pain when not relieved by medication."My comment is not legal advice as I am not a lawyer, paralegal or VSO.
Yup, this is why when you are going to an exam, consider how you feel/operate/move on a 'bad' day. Don't exaggerate and show up with a cervical collar, a walker or whatever (unless you DO use one, then by all means, please do) but be honest in your self assessment and communicate that to the examiner. When they flex or extend you STOP when it would normally hurt. I take a LOT of pain killers- my threshold baseline for pain is a lot higher than an average person's for this reason, and I have to consider how I feel prior to an exam (sometimes I take notes) if I wasn't medicated. My daily pain ating of 4 or 5 is a lot higher than most peoples'. Some of my medications I can stop for a few days prior because they build up over time. I CHOOSE TO DO THIS- I'm not saying don't take your meds and for gods' sakes don't endanger yourself. But, consider that the examiner sees what they see- if you are having a great day and don't tell them that explicitly, or physically display a 'not good' day, well, this is sometimes how ratings get low-balled.
I hate acting broken, too, and I love my good days. But when it comes to trying to ascertain what your current condition is you arnen't doing yourselves any favors trying to suck it up and soldiering on for the examiner. In a lot of you guys' cases that's what got you low ratings in the first place- lack of documentation because you were a little busy shooting at the enemy to go to sick call, or the 'culture of bravado' within a military unit was a strong preventative to seeking medical care.
New guys- At Least Mention Stuff on Your Exit Physical!! I see so many exit physical exams, both old and recent, where all the boxes are checked 'nope, im great.....', and then a year or 5 later you file a claim for something with little documentation, an entry and exit physical that say "Im great!", and no post svc care or treatment. If a condition or contention of yours doesn't meet Caluza elements, this can be problematic.
Caluza, basically is 1. in svc event- you reported it, more than once (this helps because the examiner can't say it was acute i.e. "you sprained your ankle 1 time playing B-Ball by the pool").
2. You have a current diagnosis or continuing treatment, even if sporadic.
3. a plausible connection between the two (this is where your lay statements come in, yours, or buddy statements, spouse statements, whatever).
- Phury & Rhage, flow1972 and Wico1337
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5 hours ago, FloridaNative said:
In my instance I contacted the facility I was last in and was told my records had been transferred to the National Archives. As in my previous post I began a months long quest to obtain copies of my medical records which I finally did. The VSOs I worked with were nice but not much help. They did do me a great favor though and had me file a notice of intent. As previously mentioned a few years of my VA health records disappeared. The VA blamed the loss on a facility move. I am a registered nurse. No longer practice but I still know how to read medical records and do medical research. In the course of reviewing the voluminous records (old Sears catalog size) I discovered a significant diagnostic error. I have chronic kidney disease rated at 80% along with other conditions that resulted in a rating of 100%. It appears someone took the easy way out and decided my type 2 diabetes was the cause. I discovered upon looking at my eye exam I had "no diabetic retinopathy" but I did have hypertensive retinopathy. Hypertension was one of the conditions I was service connected for. I confirmed my findings with my endocrinologist. My A1C blood sugar readings were over 7 only twice in 20 years. Occasionally they were in normal range. Under 7 isn't high enough to do the kind of damage my kidneys have. A later visit with a VA nephrologist further confirmed my findings. He told me after reviewing my records I have a profile of a prediabetic. With 1 exception (I had a qualified practitioner do my records review for 1 condition) I did my own scholarly research (via Google Scholar) and created files for each of the secondary and tertiary conditions. When I went for my comp physicals the examiners agreed with the research documents. I ended up with a 100% service connected rating on my first attempt. VSOs know which forms to file but do not have a medical background. I was told by one I saw that he would file my claim when I had a physician statement supporting my conclusions. I actually filed the claims myself online after I had all my research info. As I said before the VSO kept me from losing a year of benefits by having me file the notice of claim. For that I am forever grateful.
VSOs also have VBMS access (many of them, anyway) and so can access documents directly in your file. The issue is time. There is 1 of them, and 200+ veterans or more at a given time that they keep track of. I filed 1 claim with a VSO in 2002. All of them after were filed by me. Over the next 13 yrs I got to 100% P&T, though, I wouldn't say I was a 'winner'. I still loop in my DAV VSO office in anything I do if for no other reason than I need access to something in VBMS, or some kind of confirmation of something being there. Sometimes they reply, sometimes they don't, so I follow up. I don't begrudge them much, though, if they don't always get back to me, and here is why.
I work for VA as a VSR, and I see the amount of stuff in VBMS files for veterans. The filing system is a mess- its by date order, so if you upload a chunk of 100 pages of something it shows up at the top as 1 link that opens with 100 pages attached. Even if that 100 somethings consists of documents from 20 yrs ago its a 'new' upload, so this is why you all have 20 duplicates of things strewn throughout your files. Your uploads are named under a heading with about a 100 character limit of "whatever you called them when you uploaded them...." or, if you mail them in unlabeled, whatever the Janestown intake calls them- usually "Correspondence"- they don't read your stuff, either- its outside their wheelhouse. This is the most generic, useless heading ever because it says NOTHING about whats in it, how many pages, whatever.
Incoming VA forms are usually caught by the system if you upload them individually by the OCR (optical character recognition) and labeled correctly, but that partial STR from 1987 that you uploaded with no descriptive name? 1 link, in a page of links 50 deep, named "correspondence". A veteran VBMS file may have 20,30,50, whatever, PAGES of links like this. OCR also only reads typing about 75% of the time (anecdotal guess) and barely reads handwriting, so that medical scrawl from that corpsman 15 yrs ago still has to be deciphered by me. At least in the last 15 yrs or so most medical and personnel files are digital now, so when they are uploaded they are easier for Adobe to 'read', so long as the numbnuts at Soldier OneStop didn't upload the pages as images of PDFs instead of PDFs. In that case I have to break them all out and convert them back to straight PDFs, and that can take Adobe up to an hour or more depending on the size of the file. And that's if it doesn't choke on it along the way and time out.
I spend as much time in random veteran files that I am working on labeling stuff that isn't even relevant to the claim I'm working on at least with a descriptive heading or date range so the next person that looks in your file at least has some idea of what they might be opening. Multiply this by 900,000 or whatever the number of claims is lately, and you can hopefully empathize at least a little but with what we (VSR) and VSO's see when we look in your file. As much as I or they would like to read the novel of your military and post military life we have 10-15 other veterans a day on average to look through.
If you want to make your life easier:
1. label your uploads something meaningful and maybe with a date-range, also
2. Pre-prep your uploads a little bit- whip out that highlighter or pen and underline, highlight, write notes in the margins, whatever, the main highlights
3. Consider a coversheet or covernote- Name, SS#, brief description of what you are claiming/supporting with this upload, and a few sentences about what it is an how it relates to what you are claiming. It doesn't need to be Shakespeare, or medical-ese. Please don't- if you aren't a doctor, or quoting one, don't just start typing stuff from WebMd or whatever to try to self diagnose. If you aren't a doctor or medical person, its not a diagnosis, and therefore is just the equivalent of a lay-statement. Uploading medical studies? If you weren't in the study specifically, its not weighty as probative evidence. Sure, it may support your contention, and if it does GREAT! I love that, awesome, I get to feel like its a tiny win for you. But you still need someone medical to say that whatever that study concluded applies to you for it to have much weight.
4. Phone reps are NOT cleared the same as VSRs or Raters- thus they cannot see VBMS. They can see the notes that we leave on actions taken, usually, and they can maybe see a listing of what documents are in there, but see what I typed above about how they are named, and then remember that they aren't trained nearly as much on 'what' those documents are or 'what' they mean. They type up a report of contact (0820) and upload it with whatever your question/concern/rant was and I see it later. Sometimes I can answer whatever it was with a letter, or I can take the information as it was relayed and use it to find things in your file, clarify something, correct something like an address, name, gender, appt date or scheduling, etc. Sometimes I can't, because their description isn't always the greatest. Still- your calls ARE documented and those reports are uploaded into VBMS.
Sidenote-- KEEP YOUR ADDRESS and PHONE NUMBER UPDATED!! If something gets bounced back to us because of non-delivery we can't just go DeepSearch the postal service or whatever and find you. Thats how you sometimes end up with no notification of something, like "hey, we need *this form* or *you missed an exam, why, I can't reschedule it until I know why, and even then if its just a straight no-show with no reason, I usually can't because "no-show" with no good reason is considered waiving your rights to an exam, and it will go to rating with whatever is of record, and thats it.
I have some tricks and processes I can use to try to find you, like looking into your VHA file to see what address or phone you have on file there, but if its not correct either, well, there are things that can be held up on your claim because we can't contact you.
Thus endeth the lesson, time to get ready for work, y'all.
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You mean, like a prosthesis, but internal, and are you asking with regards to SMC, or a regular rating?
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18 minutes ago, Dustoff 11 said:
Then you admit you are a VSO or former VSO I take it. Transparency is good and great day in the morning.
Also I don't play by VSO rules thank the lord.
Wrong again, but thanks for playing. Its no secret what I do for a job, even in here.
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9 minutes ago, Dustoff 11 said:
Like I said Dude it worked well for me and fast but not for the faint of heart or followers. I had very poor representation from Korean War DAV in Waco in 1985 who was hostile to Vietnam vets and have successfully done everything on my own since then. There is a very good reason why many many vets do not use VSOs and rely on advice of experienced other vets so live with it.
Whatever works for you, bud.
You've got your opinion with what worked for you, Ive got mine, based on the thousands of claims that I have worked on.
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Throwing everything against a wall to see what sticks generally holds things up- just because it works for 1 doesn't mean it works for everyone. It takes extra time to sort through the duplicates of everything sent in, along with labeling and mrking WebMD and whatever other stuff, related or not, that the veteran sends in. Focusing your claim on relevancy and with medical evidence you can support, along with mrk the stuff that you send in in relevant places makes it easier to find what you are trying to claim.
Senatorial and Congressional requests? An aide sends a letter to VA. VA looks at our notes. VA responds to Congressional aide with a form letter, and our notes, along with whatever it is that we're waiting for, which, over 50% of the time, is something from the veteran, or an exam that needs to be scheduled on the examiner end. Thats it. I see them all the time. Receiving a Congressional inquiry is not as big of a deal as it gets made out to be on veteran side. Its just one more piece of paper, and your Congressperson has no authority to direct VA to do anything.
All it does is create a flurry of emails back and forth re-hashing what the notes on the claim already say, which takes time away from actually working on the merits of the claim. In many instances your claim is held up by things that the VA has no control over- examiners setting appts? Not VA most of the time. Need federal records/military medical records/military or civilian investigative or medical response? Not VA. Employer response to requests for records for IU? Not VA. SSA medical records for IU/Housebound? Not VA.
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6 minutes ago, Whodat said:
Will all of the stress that we are putting on the VA system, all employees at the VA will need a stress test, cycle break and a mental evaluation.
LOL. We already have internal programs for EAP/Therapy, Telework vs physical, etc. Those of us that specifically work PTSD/MST, Nehmer, and Legacy appeals claims also have access to services, also. I spend a lot of time playing VR Beatsaber on my breaks, or virtual boxing. *shrug* Ultimately, though, while its not 'physical' stress, it is mentally taxing, and we get reminded constantly to try to be aware of it and make sure we are not burning out.
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7 hours ago, David Brown Jr said:
I got my best result for answers for the status of my claim thru my congressman office they stayed with my claim from start to finish and kept me informed all the way thru the process
Just like exposure claims, or Camp Lejeune, there are a few RO's that are tasked specifically with legacy appeals or Nehmer or MST. Their VSRs are divided up into groups within each, so each smaller group is working specific claims. The bulk of ROs are still working general claims. The 'specialty' sites also work regular claims it's just a smaller group of the VSRs within that RO, the rest are dedicated specifically to whatever claim/claims special team they are on. For example, my RO works Nehmer claims that are part of being re-examined due to the the new presumptives for AO that were added last year, and MST (what I do). So, collectively, all MST and AO claims in the country are routed to those specific RO's. All ROs still have groups working regular claims, also. All claims are routed to whatever RO has the least workload that day, through the national work queue.
One thing that changed is that during the last two years with the NPRC basically being closed or on a skeleton crew, and examiner sites- both vendor and VAMC-also having their own staffing issues, the ROs never went to a reduced posture. We just took our computers home, set up a secure subnetwork, and continued working. The difference was that with those other sites on a reduced posture exams and records requests were backed up in the hundreds of thousands (NPRC), plus the number of claims filed went UP over what an average for the same timeframe would be. So, reduced workload on two prongs of the three that work with claims, an increase in the number of claims filed. We had the total number of legacy appeals almost completed a year or more ago but then the addition of the three presumptives meant going back through many of them again for the three new conditions. Plus, MST claims, both new, and re-examined claims (due to an OIG study a year and a half ago), have been going up instead of down no matter how many of them we work through and complete. That is due in part to an increased focus on awareness of those types of claims and an increase in the number of veterans feeling comfortable about filing them due to specific outreach to those populations. -
Thats kinda what I did in 2002. I got in good with a few of the medical people and during my out-processing time when I wasn't going all over post for whatever I was at the Internet cafe making copies of everything I had in my own possession, along with them getting me the rest. Then I got home and thumbdrived it. I got out before IDES so I didn't meet with anyone from VA until some months later after I got home and settled.
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Parkinson's Disease vs Parkinsonism
in VA Disability Claims Research
Posted
The two terms are synonymous.