brokensoldier244th

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.

VIII.iv.3.A.2.c. Definition: Marginal Employment Marginal employment exists when a Veteran’s earned annual income does not exceed the amount established by the U.S. Department of Commerce, U.S. Census Bureau, as the poverty threshold for one person, or on a facts-found basis, and includes, but is not limited to, employment in a protected environment, such as a family business or sheltered workshop, when earned annual income exceeds the poverty threshold. Important: Marginal employment is by definition not substantially gainful employment. Do not consider amounts received from participation in the Veterans Health Administration’s Compensated Work Therapy Program as income for IU purposes.

Yeah, im not gonna comment much, as I may need one someday for my right (dominant) and it scares me. I play guitar and I'm blessed with weak rotators. My mom had it done (20 yrs ago) and it was a long recovery and she never quite had it back. Now, its probably a lot better now, but when your doctor says "immobilize......" or "no more than 5 lbs..." don't F around and F out. (FAFO)

526. Its just a regular claim. Sometimes the hospital will send an admission report to us if you tell them you are VA disabled, but not always.

Send a request for 100% Temp disability along with copies of the admission report, the surgical reports, and the prognosis/rehab stuff. You can always update or extend it later if your rehab is being less than successful but initially they will usually go off of what your doc says first, i.e. "patient prognosis 6 months to full activity..." or whatever they put in there- or just have your surgeon or your followup doctor write you up something short and sweet with your expected recovery time. Still submit the other stuff but its nice when the doc puts it all on 1 page.

Both tiers are being worked. I don't see real time numbers, though

You have too request them, usually, from the vendors . A VSO has access to VBMS, also, so they can do itt if you know exactly what you are looking for.

That it is

VA math, like insurance or other actuary/disability math, starts at 100% 'whole' and every rating percentage you get takes away from that, but what that means is that every subsequent rating is a percentage of less than 100%, i.e. whatever was left over after the last rating. So, as you get towards 100% into the 80 and 90 percent range it takes something like a 50%, or a combination thereof to get to 100%. 100%-50%= 50% rating and 50% remaining Next rating 10% 10% of 50% (the remaining from the last rating)= 5%, so, now you are 55% 20% of 45% (the remaining "whole") =9% so now you are 65% 20% of 35%=7 so now you are 65+7=72, which rounds down to 70. Etc, etc. The ratings table is online and you can learn to do the calculation yourself, or, punch numbers into one of the many calculators available online, though they don't SHOW you how the math works so you have to trust them. The ratings tables are what the RVSRs still use since its still part of the CFR. https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-A/section-4.25