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brokensoldier244th
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Posts posted by brokensoldier244th
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I have no problem with self representation/ I did it myself. In research, however, if you aren’t part of the study it’s not relevant to you. I know this because I’ve written some (not for medical things, but for other areas) while working in my masters area. If VA if different, that’s great. However, your cited text also says that the veteran is already diagnosed with the condition- an important part of Henlsey. Hensley doesn't establish that no plausible connection needs to exist other than the lay observation from the veteran and a pile of medical journal studies, and there are also CAVC limitations on the application of lay evidence towards establishing a nexus.
The United States Court of Appeals for Veterans Claims (the Court) has held that "[g]enerally, an attempt to establish a medical nexus to a disease or injury solely by generic information in a medical journal or treatise is too general and inconclusive." Mattern v. West, 12 Vet. App. 222, 228 (1999) (citing Sacks v. West, 11 Vet. App. 314, 317 (1998)). The Court has, however, also held that medical treatise evidence "standing alone, discusses generic relationships with a degree of certainty such that, under the facts of a specific case, there is at least plausible causality based upon objective facts rather than on an unsubstantiated lay medical opinion." Wallin v. West, 11 Vet. App. 509, 514 (1998) (citing Sacks, 11 Vet. App. at 317). The United States Court of Appeals for Federal Circuit (the Federal Circuit) held that "[a] veteran with a competent medical diagnosis of a current disorder may invoke an accepted medical treatise in order to establish the required nexus; in an appropriate case it should not be necessary to obtain the services of medical personnel to show how the treatise applies to his [or her] case." Hensley v. West, 212 F.3d 1255, 1265 (2000).
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The medical journals don't matter unless they apply to you, or to at least your condition or root cause i.e. tbi as an example. Medical studies are done with specific criteria in mind and if you don't meet the criteria for whatever he study participants were selected for then the studies findings don't directly apply to you- they are anecdotal, and not significant to you, unless your doctor says it is.
Insomnia isn't a separate condition under VA standards because it isn't a separate clinically diagnosable condition if its related to a mental health issue- insomnia presents under almost every mental health issue in the DSM V. If its organic then you can do OSA or respiratory (if in general related to breathing). Many vets go straight for OSA for sleep issues and get denied because they don't have OSA. OSA is not 'not sleeping', or "can't sleep because my COPD/Deviated septum, whatever is exacerbating sleep patterns", its a clinically significant diagnosable condition with very direct etiologies and a specific diagnosis.
You can file for it both ways if you want to, there is nothing stopping you. I see vet claims every day with a condition claimed 5 different ways for 5 different reasons, even if the reasons have nothing to do with what they are claiming. It all gets evaluated under the relevant DBQs for whatever they claimed, it just takes a lot longer.
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Are you evaluated for sleep apnea? Otherwise it would be mental issues if not organic, OSA if you are diagnosed, or it would be secondary to whatever organ system is causing the insomnia. Same with the CFR. OSA if dx, otherwise MH or whatever organic system is causing it.
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At the bottom left- arrow to the right to "Traditional Aggregate". That will tell you how many Legacy and RAMP appeals there are- for this week. This is a weekly report, that is available on the VA website: https://www.benefits.va.gov/REPORTS/detailed_claims_data.asp
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19 minutes ago, Mr cue said:
Stop it the VA still have there comp exam department. Still
It that the VA has contract out exams to these companies.
Matter fact a billion dollars contract.
Have you look at who own qtc.
I give you a min to Google it.
I have never- EVER said on here that VA does not have comp and pen departments, or that they are going away. That is a fantasy that you have created somewhere. I may say things you dont' like but at least be honest about what you don't like and don't invent things.
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If they don't follow the DBQ and answer all the questions we send it back to them to do it the correct way. They already know what questions to ask- they are on the DBQ. If you want something to refer to so you know what to expect make sure you download the correct version- many on the internet are old forms and dont have the same language or questions on them. Get them from the VA site.
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1 minute ago, Riplip said:
Would any of you recommend I bring a filled out DBQ with me?
Filled out with what? You aren't the examiner, and you can't sign it. Your private doctor might do that for (and shouldn't- OIG looks at these, too) you but an examiner won't.
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22 minutes ago, Mr cue said:
Good luck with the exam.
But I tell this really burn me up.
So now disabled veteran are to be able to travel an HR and half away.
And now veterans are acting like this is normal.
I understand ppl think there is nothing we can do but I feel s sign petition or something needs to be done about this.
This is new comp exam thing is going to create a big back log.
Can u picture who long it is going to take soon to get a copy of the exam.
There will be a back log on get them soon.
Why are veterans seeing work comp and SSI doctor for VA benefits.
An no one see the wrong in this.
Good luck again.
Good luck with the exam.
But I tell this really burn me up.
So now disabled veteran are to be able to travel an HR and half away.
And now veterans are acting like this is normal.
I understand ppl think there is nothing we can do but I feel s sign petition or something needs to be done about this.
This is new comp exam thing is going to create a big back log.
Can u picture who long it is going to take soon to get a copy of the exam.
There will be a back log on get them soon.
Why are veterans seeing work comp and SSI doctor for VA benefits.
An no one see the wrong in this.
Good luck again.
Id have to travel over an hour to go to a VAMC. There aren't enough VAMC personnel to do all the C&P exams- thats it. Bottom Line Up Front.
Short of a huge budget allotment from Congress AND a stream of medical people willing to work at GS rate (or whatever scale they are on, and it isn't great) how do you propose to fix this? At least with the contractors you get a pretty good chance of getting a doctor with more experience and motivation (because they have their own practices- a lot of them moonlight as examiners and aren't full time, and they aren't relying on VA only for income).
You can't make people work for the VA that don't want to work for the VA, medical or otherwise. It certainly doesn't help that we tend to be called lazy, incompetent, welfare sponges. Or, told to everyone that we have agendas, or quotas. I can't speak to agendas- personal bias is just that, personal. But we don't have quotas, and the money for grants doesn't come directly out of VA operations, so we have no incentive to grant or deny based on quota anyway. Whether you get a grant or a denial doesn't affect us, on an employee level, one bit. I go and check mine, though, and keep track of every claim I touch so I can look it up later.
My personal stats that are kept and reviewed twice yearly for reviews have no mention anywhere of grants or denials. They are based on accuracy, total output, whether or not I kept up with required self-directed trainings, and whether I respond to error claims within or before the prescribed time frame and resolve them.
This 'new comp thing' was reducing backlog up until 2020- thats when it derailed. Prior to that it was working just fine, and veterans were getting exams faster than if they had had to wait for a VAMC.
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The locations are not always specialist offices, the examiners sometimes 'borrow' space from an existing nearby location. Good luck.
- ShrekTheTank and Vync
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It has to do with total disability effects averaged out across a large number of people. A 50% disability on one part of you (or collectively of a bunch of small things) is not the same 'net' effect on productivity potential for every person, every industry, or even that much of an impediment for some people. The VA combined ratings tables are the same that insurance companies use for the same thing. You start at 100% 'whole'. You get rated 20%, now you are 80% whole. If you get rated another 20%, the impediment is 20% of the remaining 80%, or 5, basically, which would bump you up to 30% (since VA uses 10 pt rounding-anything .5 and over moves to the next level). And onward, etc.
As for how, who, came up with the amounts and tables? Thats an actuary/statistical thing that I don't remember much about - its been many years since I took stats in college, and I wouldn't have all of the data that they used, to make an informed guess. They were also developed a long time ago, as were the definitions of the Ratings schedule (see, for example, "total occupational and social impairment"). 50 yrs ago, in an agrarian/industrial/mixed society having a 100% MH rating would render most anyone pretty ineffective in an employment setting. Fast forward to now, though, and you have lot of modernization and accommodation options that can make it relatively easy for people even with high ratings to be employable.
I have a 100% combined rating and I work full time- but- I work from home. I'm in comfortable surroundings with my support system (family) around me, and I can take breaks as I need to, and work my full 8 any time within a 12 hour period on that day. Thus, I can space things out, go to doctor's appts, take naps, breaks, etc, if im having a bad pain or bad head day. I'm also 45 and computer literate (I used to IT for hospitals across the country) before I finally succumbed to taking FMLA and 5 yrs off from ANYTHING about 6 yrs ago. During that time I was increased to 100% p/t. I started working again PT in 10 hour a week or so increments over the next few years for a city library, in the stacks, away from people. I gradually built my tolerance and self-confidence/self-worth back up to a point where I could relatively reliably work longer. Eventually I got to where I could work 40 hours in SOME job industries, with accommodations. That's where I am right now.
Granted, that path, or those types of jobs are not always the best fit for everyone, or in industries where they have experience, so that can be a challenge. Still, there are more and more companies at a national level that are starting to shed their 'building/campus butts in seats' model for a more streamline part or full tele-remote work model, and not just the big ones like Google/Microsoft. I have a friend that worked for an insurance company from home for the last 2 yrs as a cust service rep, and it was a big one (All State) I think. Cellphone/data companies often do it, also.
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No, that as part of the change in the regulations because things were getting held up when the veteran had already provided credible proof of Service for service connection. This is for proof of service only- if they had to request medical or some obscure personnel thing that isn't already of record because of one your claimed contentions that is directly relatable, i.e. an LOD, some police report of that bar fight one night that shore patrol broke up but resulted in some perm injury, whatever, THAT still has to be obtained. The change in regs was for establishing proof of service.
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Per a change in regs late last year if a veteran can provide OMPF/Proof of Svc that is credible and looks unaltered then VA can accept it in lieu of official OMPF. We still have to request it but the lack of the offcial package shouldn't hold up exams/etc- at least on our end.
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Yeah, unless its on the 21-22 we aren't supposed to change it in VBMS under the POA settings.
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Did you file a 21-22 and actually revoke the other guy? Its also possible that you filed the new 21-22 and the other POA didn't get revoked/changed.
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This could be a good thing. Our VA in Lincoln did this. The CBOC was on a beautiful campus but most of the buildings were like 80+ yrs old. Gorgeous gothic stone architecture for some of the main buildings, but the insides had been reno-d over the decades. They built a new CBOC up the street that includes veteran transitional housing, and its been modernized (proper power, water, HVAC,etc). Its not a bad place now that its been updated and everyone has more space.
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24 minutes ago, vetquest said:
Yes and no @brokensoldier244th. I have run into problems in migraine rating and been told by the VA that they look at the effects it causes for work. Some migraine medications even make it harder to work. Depakote a medication that can control migraines can cause slow thinking and cognition, even so the VA never took this into consideration. Between migraines and medication I was no longer able to work and was rated at a max of 50%. I requested extraschedular rating and was denied. Never underestimate the VA's ability to make like hard on the veteran.
That may be the case for your situation but your denial of IU is not demonstrating the effects of medication being considered in a rating in the ratings schedule. You specifically asked for a rating outside the ratings schedule. You were rated the maximum for migraines. Your issue isn't migraines, your issue is how your doctor presented your request for an extra scheduler rating to get IU, and you were told correctly with respect to the IU rating application that the effects of medication on your migraine are considered in an IU rating. That being said, IU is not a claim based on the ratings schedule.
The effect of medication on a condition, except in limited instances where it is specifically considered (like Fibro), has nothing to do with the ratings schedule- this is established CAVC case law. IU is a completely different thing altogether, and by definition "extra scheduler". The migraine rating itself was applied properly. The determination was that the medication's mitigating effect on the migraine was enough that you were deemed to be employable.
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4 hours ago, vetquest said:
Unfortunately, the VA rates your disability on the effect it has on you seeking work or working. If your headaches are controlled by the Botox they will probably deny an increase. I also suffer migraines from service and they do not rate migraines very well in my opinion. Totally incapacitating migraines are only rated at 50%. If you are having migraines while being treated with Botox do request an increase.
Not so, the conditions are still existent and have the potential to render employment difficult or non-existent BUT for the mitigation provided by the medication or therapy. A person with a prosthesis is still disabled regardless of whether or not they can get around on it. Jones v. Shinseki covers this. Just because your condition is controlled by medication does not render it any less compensable based on the ratings schedule in 38 CFR Book C- unless the ratings schedule specifically notes controlled effects by medication such as Fibromyalgia. Raters have to consider the symptoms of the claimed disability based on what they are, not how well they are controlled.
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Not necessarily. It can be a contributing condition without actually being compensable. Ultimately it is a symptom of other things, which then leads to other things (in this case OSA) which becomes the secondary compensable condition.
Example- I have degenerative back and nerve issues and chronic pain into the sacral area- this inhibits my motion, and despite monitoring diet, still contributes to weight gain over the years. Also, there are many medications that can affect weight by way of suppressing the thyroid (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784889/). I take some of these, so in addition to pain my metabolism is negatively affected. The root cause of this is my back and nerve injury, but I don't have Central apnea, I have Obstructive. This is usually caused, as many of you know, by weight gain or existing weight. I was denied initially when I applied for OSA, too, but I could show that I did not have sleep issues prior to enlistment, and they developed during or after, but OSA didn't start presenting until after I got out. The weight gain is a side effect, but also contributes to the OSA. It, in and of itself, is not compensable but it is a 'secondary' factor in my OSA.
I think Hills and Ponton has an article on this, too.
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You need to make sure that your doctor documents the NUMBER of incidents per months that you have dizzy spells.
Vendors are vendors- they all have different contract doctors at each location and they are just as fickle as any VAMC exam or any other vendor. I see just as many LHI approved as I do vs not as with any of the other vendors- but I see more claims on a larger scale than you do.
OSA can be supported by buddy letters, incidents or counseling's for falling asleep, late to duty, etc, spouse/kids/sig other. My wife recorded me a couple of nights on her phone while I slept and wrote a note that I included discussing over the years that she had known me and then married to me how her sleep patterns had changed due to having to poke me in my sleep to move me so I would breath again.
OSA can also be supported via weight gain as a secondary to chronic pain, various medications, etc- IF you can show that you attempt to maintain your weight in other ways and are unsuccessful. Its a roundabout way to do it, and I had to appeal it once, but it can be done if you have a really well written IMO and documented challenges with weight loss due to secondary factors. My doc that wrote the IMO was our GP and had a background in sports medicine prior to a GP, and she had known me pre- and post army, so that helped, too. We had a LOOOOOONG history.
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Not really. Same criteria applies for initial vs review, except the hard part ( establishing sc) is already done
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There is no guaranteed re-Val at 5 years, that an estimate, and is often overridden if your treatment notes are up to date and regular enough
Loss of Use
in VA Disability Claims Research
Posted
If his doctors already established the causality (the PTSD) then you just have to file a claim for secondary connection to the PTSD. Loss of use is only a fixed payment of approximately 110.00 a month. You'd probably be better served by filing both for loss of use AND secondary service connection so that it is considered both on its own and under loss of use- the potential for a higher rating from that is considerably better since VA has to take the higher of the two.