brokensoldier244th

Your two claims, if filed within a year before one of them is finalized, will be combined, so in some cases it can set you back because it’s ready to rate and then another contention comes in and it has to start over on the other claim. You CAN sometimes be partially rated in a pending claim, though, Covid loosened up the regs on that, I’ll have to check and see what the current status of that is.

Claims go back and forth through the cycle, sometimes daily, depending on what action is being taken on them at the RO where it is assigned.

One of the studies I've read on it concludes that there is, but whether or not it's due to the nature of the specific surgery, or just the fact that someone was opened up on the table (a risk for every surgery) is yet to be determined and more study is needed. That one was from 2018, though.

BVA cases only affect the case at hand, they do not set precedents. They are great reference for planning strategy, or for seeing 'what' types of things can be claimed and how it was claimed, what regs apply, etc. CAVC claims set precedent and can be cited, but unless your lawyer brings up a BVA case to cite I don't think it is useful as citable evidence.

Interesting question. I know that many doctors and health systems require mental counseling prior to approving any gastric weight procedure, in part because if you have an unhealthy emotional or physical relationship with food it doesn't matter WHAT they bypass where. I'm curious about skin, though. from 350 to 150. (I'm a little more than you were when you started, even with MOVE- a re-injured leg helped wipe out about 4 months of weight loss). You can PM me if you don't want to answer here, but I'm interested in loose skin and elasticity. You hear how some people have to get cosmetic surgery later, which most insurance and VA doesn't pay for unless there is a health/cleanliness issue associated with it. Others don't have to have any removed and they seem to bounce back just fine over several months. Which was it with you, and if it was the former, what strategies do you use to deal with the excess skin left over?

Ozempic is only done 1 time per week if someone is using it for MOVE, also. The liraglutide effect on an obese person is more pronounced than it is on a non-obese person. It affects the 'hunger' urge that is hormonally greater in obese people. The extra fat in many obese people becomes its own organ, and it constantly prompts the release of hormones to promote hunger for self-preservation. This is why most people that have surgical intervention are not lazy. At some point, they reach an equilibrium where their body is lying to them about hunger, and it also messes with their metabolism to fight to keep from being reduced. Even with willpower, they reach a point where their body may not release the fat stores no matter how much they work out and/or monitor their diet. Ozempic and similar tries to disrupt that cycle by counteracting the exaggerated hunger urge.

It is also used on 'conventional' medicine as a way to reach patients in inaccessible areas or those that are homebound, so its not just a veteran thing, most of the medical establishment is moving towards it.

You can also claim side effects from drugs that you take, if they are more than transitory, and are chronic and long-term. GERD is pretty well known as a side effect of NSAIDS (naproxen, ibuprofen, etc) and if you take 2400-3200 mg a day of Ibuprofen you are probably going to end up with GERD (acid reflux).

Wilky got it in 1. It started slowly with a few celebs here and there, but then TikTok/FB/Reddit got on board and the manufacturers were slammed. Because weight loss is an off-use of liraglutide drugs the tolerances and specifics for getting a prescription are looser. There were plastic surgeons and health and wellness coaches that were getting it, whether through writing scripts legally or finding 'compounding pharmacies' that will reproduce a drug for you, slightly modified. Saxenda was one manufacturer's answer to the issue. It's about 1/2 to 1/4 less effective, though- it mimics the same formula in a lot of ways except for the chemical makeup of some of the isomers. VA, while a govt contract and a guaranteed purchaser, does not have any real horsepower in being at the front of the line. Normally it works that way because they buy so much of everything from the manufacturers but in the face of such an explosion of demand being driven by the internet the VA was impacted by shortages. Getting Ozempic for diabetics was even a problem according to my MOVE coordinator, which is why I was given Saxenda. While it is not nearly as effective as 'melts it off' and it has to be microinjected every day, it doesn't have the same level of side effects as Ozempic. Sure there may be some slight nausea as you titrate the dose up from beginning to full (over about 6 weeks), but you have some of it in your system all the time. Ozempic has stronger side effects and acts as a 'negative reinforcement' to not eat shitty or too much at one time while taking it.

I'm getting Saxenda. They couldn't get Ozempic last year because of TikTok influencers promoting it so heavily, and anyone with letters after their names writing prescriptions for anyone that asked about it.

Heh, working right now, actually, until noon. "you haul 16 tons (claims) what do you get......"

DBQs are the reports filled out for any condition that it claimed, usually by VA providers or contract providers. Private providers do not get them unless you provide them, otherwise we look at whatever medical documentation you submit from your private provider, or authorize us to obtain via a 21-4142/4142a authorization to release records. We can still take your medical records and submit them internally for a records review by a VA clinician for an 'opinion only' or for a non-contact exam where they just review your records. Privately submitted DBQs, on their face, are deemed with the same evidentiary weight as one done by the VA, unless your doctor goes into the weeds and writes up something totally non-plausible. Also, if you have a private DBQ it is IMPERATIVE that your doctor write an 'opinion' also, i.e. a reasons and basis for WHY they filled out the DBQ that way AND how it connects to your military service (which, hopefully, you have provided at least some military STRs to them if you have them). They would then have to write an opinion of "at least as likely as not" (over 50% related to service) or "less likely than not" (less than 50% related to service. Preferably using that verbiage since it is what is in the regulation. It doesn't have to word for word but a DBQ with an opinion carries more weight than one without. Remember, VA Raters and VSRs are NOT medical people. We can't diagnose, treat, or interpret/infer things that aren't there. If your doctor doesn't write it down with an opinion it makes it a lot more difficult because the DBQs themselves don't have an opinion on them unless its written in, or supplied separately.

You could file for IU, if you have the medical/work documentation to support that your shoulder is the cause, though you would also likely want a doctor's opinion on the general state of your condition within the context of occupational fitness.

Sacro-Iliac is basically lower back. It's known and accepted that fusions eventually lead to more fusions, though, and place undue increased stress on the surrounding discs (as someone that can't get a fusion because mine is so low that its dangerous to pursue, I'm jealous of people with fusions, even if for a few years). If your fusion is causing you pain into other areas then file for it. Lots of things are connected to the back, or its movements.

Whether or not it can be adjusted is subject to the 20yr rule, that's it. You may 99% on paper which is rounded to 100, or the calculators math could be off due to bilat factor. I've never used the VA tool you are using, I used either Microhealth, or I break out the paper chart and do it manually.

You can always fire them as your POA, then they won't get anything. If they are just on retainer and not doing anything you may as well. If they have actually done work, though, I think you are stuck with them. However, you can add contentions to a running claim as long as it hasn't been adjudicated yet, or you can file a separate claim (supplementary, whatever) unless your current claim is the same type- then the issue would just get added to it. It happens all the time.

Who are you contracted with that isn't working on contingency? Thats how many of the VA adjacent law firms work. If you didn't win because of anything they did normally they don't get paid, its the risk of doing business. Are you using a non VA-accredited firm or advocate? If you still have a recently closed claim within the last year that pertains to the documentation you have you should be able to reconsider it/supplemental with the New/Relevant information.

Getting better on a sustained basis, finding an error if you were misdiagnosed the first time, filing an increase, filing for IU, and for some conditions just a set time after an initial rating because they aren't stable yet. After 5, then 10 yrs there are more layers of protection on your rating and it's harder to try to reduce. Look up "protected ratings" I work for the VA for the last 3.5 yrs. I started with regular claims but now I only work on specialized claims that involve just PTSD from sexual trauma. I am not a rater. I am the one that gets it before they do and tries to research it and your records to build it up as well as I can, or request more info from you.

https://www.va.gov/disability/va-claim-exam/#:~:text=You can't get the,VA Form 20-10206).&text=You can submit the form by mail or in person.

When we are waiting for exams from a provider we aren't calling them. They all have their own direct portals to upload those records. Until it goes over at least 30 days, usually more like 60, we don't contact the vendors to track them down. 30 days is the legal minimum that we have to wait, on average it is longer than that, especially if it is a vendor in a highly populated area with more veterans. QTC wouldn't be reviewing anything- they have no say in how your case is adjudicated. All they do is the examination report, and upload. That's it. If there is a 'review' of some kind going on it is happening on the VA side, either they are re-requesting the records from the provider, or they are ordering a new exam based on the information on record (so you don't have to go in again for the same thing). I haven't had a situation where the contract examiner no longer was around, the records they would have created would have remained the property of the contract vendor not the doctor, so even if the doctor disappeared under a bus tomorrow their workload would still remain with (in this case) QTC. Sometimes, though, yes, we suggest that you approach them to request the records- its often faster than if we do it, though that doesn't mean that they aren't still being requested from our end- it just means that you, as the veteran, sometimes carry more PR weight than WE do and if you call and complain you'll often get more action out of it than we would.

If nothing has changed, or if you have perhaps slightly gotten worse, or at least more sustained in some of your symptoms there isn't much to worry about. SSDI can't just access your record without a reason- there has to be a legitimate review reason to do so, they can't just monitor them, and every access to your VA records is audited and needs a reason attached- even when I do it within the context of a claim. I may log two or three instances for the same veteran over a 2 day period if I have to do something, wait for an update, then do something again the next day. Every access I do has my name attached and can be cross-referenced against my queue of cases for the day in question. If I don't have a claim in my queue I'm not supposed to be accessing it. It's no different with the SSDI people. So, in short, if SSDI is asking for information its probably in your best interest to provide it and not assume what they have and don't have access to. If they could just pull it whenever they wanted they wouldn't be asking.

It will be based on the symptoms as they were starting after the two years.

That depends- is your current degree and training no longer suitable for you in the context of your SC disabilities preventing you from doing it anymore? Voc won't pay for you to step up your current degree.

Your other claimed issue may not be finalized yet.

? You need to change your direct deposit information with the VA? That won't take effect instantly- whatever deposit you have coming on Thursday will still go to whatever information is there already. You can call 1-888-224-2950 to get information about changing your direct deposit. You can also upload form 1199A, or you can go to https://www.va.gov/change-direct-deposit/ and follow the instructions there.