brokensoldier244th

All it’s going to do is add time and another likely exam, whereas the chronic pain and ptsd can be looked at in one go if you do it now.

They rated it then and always have, its more that the way it is put together as a claim when we develop it is different and definitely more consistent.

It would be combined as it is classified as a MH condition. The existence of it could, perhaps, increase a rating, if it is not currently being considered.

There is some pretty compelling evidence out there that chronic pain can be exacerbated by other MH issues, and it can be a symptom of MH issues as well. Its a pretty common comorbidity. https://www.ptsd.va.gov/professional/treat/cooccurring/chronic_pain_guide.asp

Your company also gave you incorrect or incomplete information, FYI.

If you have a well-supported claim for PTSD/MST it's highly unlikely that it will be rated less than your chronic pain. Raters have to go with the higher rating, anyway, not the lower one. Your chronic pain will still be rated under mental, but collectively with the rest. Due to pyramiding restrictions, you can't have more than 1 MH rating.

You can file for multiple things under 1 'system' though it may get lumped in together on the same claim. It depends on where your current claim is in the process. If it's being rated but not finalized and you file something now then your current claim will have these new contentions added to it. Chronic pain is considered Mental, but it's obviously not PTSD or MST. Your current claimed contentions for MST/PTSD would likely have chronic pain subsumed within them, but you would also have to have a separate mental examination C&P because PTSD and MST have very specific things that are asked and looked at, and only specific people can do those types of exams and write the opinions required. I work remotely for the MST Operations Center in San Juan. 95% of what I've done in the last 2 yrs has been exclusively MST claims, and, as a side project, an OIG review of about 9000 prior denied MST claims that may have been wrongfully developed and/or denied, or may have the wrong effective date. So, if you want to PM me any questions I'm open to it. MST claims are only worked by certain VSR's that are trained for it, and it has been that way for a few years now. Incidentally, I'm representing our RO in June in DC at a national symposium about MST, treatment, claims development, and military strategies to prevent/mitigate/support veteran survivors of MST. I've read and seen pretty much anything you could imagine at this point but how specific you want to get if you PM me is totally up to you.

Also true. Nothing can be done about that, though.

That looks like a COLA adjustment. You would check your bank deposits first, then call or sent a VA message to the financial people (Fiduciary Hub) and ask them to audit your award. Do not EVER put your file number publicly in an internet forum like that. I deleted it- I managed to find your file in about 5 seconds. Granted, I work for the VA (not financial) , but I tested what you posted hoping that it WASNT your file number, but it was.

The BTSSS system started in 2019, y'all. Those topic is not new, or even recent.

This system came out in 2020.

They’ll either rate off that, or they will reschedule the physical part

Oh absolutely! Good luck and hopefully smooth-ish sailing.

That sounds great, Shrek, but, being a lawyer, aren't they paid to sound enthusiastic? When I had to appeal something awhile back mine sure did, for all the good that it did. I ended up doing it myself.

Anxiety is not separately rateable if there is PTSD or other MH rating. It is usually subsumed under the claimed condition rating due to avoiding pyramiding.

Yes, I’m HB for depression, among other things. 100+60 or over- that’s the statutory formula but it also depends on your symptoms overall, no pyramiding. I know lots of depressed people with high ratings that still function pretty well and aren’t HB.

Cervical and lumbar are two different segments and thus can be claimed separately.

Don't say that. It's a murky part of VA regs and also Employment law and policy for everybody. It confounds most people because of the case-by-case basis. You can't just point to 1 part and say "yup, there's the rule" and neither can the adjudicators for DOL, VA, or SSA. It really comes down to the individual person's set of circumstances.

No, they are in congruence with each other. Wade posted a broad definition example of marginal employment. I posted the regulation. Wade's example would fall under VIII.iv.3.A.2.c, bullet 2, under 'facts found' basis. Just be aware that even the Dept of Labor defines "Marginal employment' on a facts-found basis, case by case. Sheltered employment is something that is rarely done anymore, except for places like "Goodwill" which hire developmentally disabled people and are allowed to pay them less than minimum wage under 'sheltered employment'. If you have so many accommodations that you can't work other than 1 place, unless another employer fulfilled the same accommodations, that could be considered marginal employment under a 'facts found' basis. I am not a rater, however, so I don't make those kinds of determinations- they have a lot more training in that area than I do. I can say that I work from home, full time, as an accommodation. If I didn't have that (along with some others) I would not be able to gainfully work with my combination of issues. Still, I am 100% P&T and I can type, and shovel my brain around, so as long as that holds up Ill keep working where I work. For me, there is no point in applying for TDIU, but as an example my workplace supplied me an ergo chair, keyboard, standing desk, and extra monitors for my computer of certain resolutions, and I have a more lenient break policy so long as I get my work done. I work from home, also, and that 'rider' will follow me throughout my employment here even if I change departments or Regional Offices. If I didn't have the above and wasn't 100%, I could not gainfully work, ergo, I would be a candidate for IU (and I have been before my 100% rating was finalized 8 yrs ago).

Yup- if its an issue that is intertwined with the claimed contention, or, say, a TBI that we find evidence of, we can add stuff like that, usually at the RVSR level- I can't unless I ask someone higher up about it. Sometimes, though, the wording on the claim 526 itself is loose enough that I can infer or at least be on the lookout for other related contentions and if nothing else add the symptoms and whatnot to my notes before I request the exam. You can always tell us not to pursue an issue via phone or 21-4138, or even a letter- there is no prescribed form for that.

No, unless you work for the VA (or possibly other fed agencies). If you are a new employee and are listed as a disabled vet you get 104 hrs chargeable to your leave account for 'free' (you don't earn them based on how long you work) that you can use for VA or private appts that are because of something related to your SC conditions. Its use it or lose it, though- you only get it for the first year you work. On your anniversary whatever is left falls off.

LOL. I understand. He wasn't advocating a blanket approval of every claim, but the context was that even if, say, a PACT doesn't apply due to no foreign service or some other thing, we can still award based on Direct basis, or secondary- basically, if we do a search on a veteran for exposure pathways/locations for PACT and don't find anything, just because the veteran submitted under PACT - don't consider it a done deal (this was for both development VSRs, and RVSRs) and deny, or in my case, stop developing, just because 1 thing was found unlikely. There are other pathways to service connection. It was a strong reminder to everyone to maintain situational awareness of other theories that could be explored, at least through an exam, or through a different and varied review of the existing evidence. I got one yesterday where the veteran has been denied multiple times because RMC lost their STRs sometime in the 90s. I have about 8 pages of STR, however what I DO have shows - enlisted sound, a year later suddenly deteriorates, goes to Portsmouth mult times over a 4 month prd, and then is PEB'd as unfit. Denial was based on no MH/BH markers in STRs....which don't exist. However, unexplained multiple sick-calls in a short period of time that corresponds with a claimed MST incident- that is a marker all by itself, and wasn't addressed by the rater. Veteran also has a pos VAMC medical opinion. Veteran submitted a request to withdraw claim- they just don't want to deal with it anymore- that's why I got it. They submit withdraw request, wait 30 days, withdraw claim unless they change their mind- that's the regulation. After reviewing all the above, I think that I can get it in front of a rater to review and possibly grant without an exam (veteran is on SSA for MH, also) and without an exam or further trauma/stress to the veteran. So, I'm sending it to a rater anyway. If its granted AWESOME. If its not, the claim is withdrawn anyway based on veteran's wishes. I have a 30 day window right now to operate within, so I'm going to use it.

...and give out as much/many benefits as possible. This was by the training leader who used to work in Office of Field Operations. While it seems sometimes that the VA is an antagonistic agency, there are those of us within it that do believe in what we do and TRY in our own small ways to get things moving, or out to the veteran. This meeting/training yesterday was a multi-RO level collaborative and continuing training/update for PACT Act and MST. We have it about every month or 2 to keep track of internal or external guidance changes for (mostly) PACT claims review and rating. This call had everyone from Asst directors (RO level), coaches, RVSRs, Authorizers, and peons like me on it. The mentality of the VA is not completely against veterans, although in individual decisions at a micro level it can seem that way, especially when magnified by the internet. Negative decisions for veterans, or VA f*ck ups from years ago are constantly brought to the foreground via forum searches or internet searches, and unless someone is prepared to do some digging and cross-referencing, at the top-level everything reads as 'current' information. Many times it isn't, or prior negative decisions were based on older regulations since changed, and/or VA screwups (exam scheduling, documents shredding) are brought up from years ago, and made seemingly current. Am I blanket apologizing? Hell no, I know the VA screws up- its the basis of my job for the last several months to review specific claims that were denied 2,3,4 times from years ago, and I'm still finding claims that I get overturned. But still, I guess I posted this so that you all can see that there are pockets within the VA where people are trying to do right by veterans. Its part of why I applied to work there 3 yrs ago- I could get as much or more done 'inside' than from just helping people prepare claims on the 'outside'.

that’s because it does. here’s how to order resupply— https://www.va.gov/tampa-health-care/programs/cpap-ordering-distribution-and-supply-information-sheet-and-faqs/

It's normal for claims that are submitted after the initial claim is opened to be summed to 1 claim as long as no decision had been made yet on the initiating claim. Claims can have partial decisions made on them while other issues are pending. Switching back to initial review is normal because you added something to it, meaning new subtasks are now required for the new contentions. The state of the claim is overall, not by contention.