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brokensoldier244th
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Posts posted by brokensoldier244th
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We are never "just looking at one someone's claim " on its own. It's either waiting for something internally, externally, a tiebreaker opinion, or it's in a queue getting electronically shuffled to the next smallest workload. A vso can look at it and tell you. The phone people can't see much, they don't have the same access level that we so.
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The steps for a supplemental are the same as for a regular claim. A VSR develops the new evidence, submits it for an exam if needed, or sends it to a rater. Sometimes the rater determines that something needs to still be done, so they send it back to a vsr. Vsr completes whatever "it" was, then sends to the ratings queue. After that it's dependent on what station pulls it down and how backed up they are. If it was waiting for a VA c&p result then it's also dependent on getting the results of that, too.
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You dont need witnesses statements (buddy statements, 21-4138, 21-10210, whatever) but they help, in the absence of a memo or day orders or something that says"I burned stuff...". They aren't required to filte a claim, and you can file now and gather the stuff up afterwards.
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It is because we use centralized posting and most claim mail comes into or goes out of that location.
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At 15 yrs the amount of effort and documentation it would take to reduce would be considerable- at worst, and nigh impossible, other than fraud, at best.
Plus, much if the time if your claimed contention doesn't span across other contentions we don't go digging anyway, no time and no reason.
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If one of your SC conditions is 100 then a combined rating of 60 or higher for things not part of that 100% would be statutory SMC-S. Look up SMCs and you'll see that in some circumstances more that 100% is possible.
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45 minutes ago, broncovet said:
I agree with Shrek. If you are a mult Billionaire, the wait as long as you want to file, or never.
However, for the rest of us, our retro (based on effective date) will almost never be earlier than the date applied.
File EARLY = More Retro
File Later = Less retro.
Each month you delay, if awarded 100 percent (and I have no idea what your award will be), will cost around $3300 per month. How many months do you want to throw away $3300? 10 months is about $33,000 or about enough to buy a mid size sedan.
You get paid for a full month or none of the month..no partial month. So, if at all possible, get your application ASAP. If you can, hand carry it to VARO today, and ask them to stamp it. If VARO gets it on Monday, May 1, that is one month less retro than today.
Also, you posted:
Im not gonna post the regulations again, but 38 CFR explains that there are only special circumstances where you cang be reduced. https://www.law.cornell.edu/cfr/text/38/3.344
Mostly, unless you committed fraud (no, IM not accusing you), the VA can only reduce you if you have a temp rating or if YOU "actaually improved under ordinary conditions of life".
Mostly, the VA does not "revisit" old decisions, just like the courts dont put criminals on trial for the same crime over and over, until they get a conviction.
Generally, we don't. I don't look at older decisions on a regular claim unless it somehow impacts whatever the current contention might be (secondary) or, IU/Housebound/A and A. Otherwise we pretty much stay in our lane. RFE (requests for examinations) is still a thing, but highly reduced, because the computer sets the date 2,3,5 yrs out from when you get rated but now it comes to one of us for review before it just kicks out an exam letter. Keep in mind if I am looking through things for 1 contention and I find something egregiously incorrect (good or bad) I have to kick it up to a rater or quality to be reviewed to make sure the appropriate regulations in M21/38CFR were applied correctly- that's what I'm doing now on the subproject that I am working on.
If we look at your PMR (private medical- if you have submitted- we don't just have access to that) or Capri (VAMC stuff) and you haven't improved, we cancel the exam. We aren't doctors but it doesn't take whiz kid to look at a range of several months or a few years of VAMC record, CFR38 Part 4 (ratings schedule), your current rating, and connect the dots to see if there has been a serious and sustained improvement over time and not just a 'good day'.
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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.
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1 minute ago, tk123456789 said:
Wow all good comments here thank you. Brokensoldier244 thank you also for offering to take a look for me through direct message. My PTSD claim was denied in 2019, and I am not sure if it was because it was MST and at the time they didn't rate that.
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.
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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.
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Just now, shrekthetank1 said:
I don't think chronic pain bring on PTSD. Now can it make it worse? I think so.
Unless there is pyramiding, they would not look at them as one in the same. Chronic pain and PTSD are two seperate ratings.
I currently have more than 10 ratable items
1 of them they put in for pyramiding way later in the claim, but it did fall under the issue.
I have: PTSD-IBS-headaches-Dercums disease-scaring-fibro-high blood pressure-Knee injury-tinitues and hearing loss-Sinitus-Left rib brake-Sleep apnea-and other ones at 0.
So they combined the Dercum's disease with the scaring as it was a result of it. Now they did give me a higher rating, but not as high as I though they should go.
As for the rest they are all rated seperatly.
Now if I tried to do depresson-MST-PTSD-Anxitey, they will not rate these seperatly as they would be rated under the same thing.
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.
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9 minutes ago, tk123456789 said:
So the VA won't look at the diagnosis from the chronic pain and then try to reduce the rating if their diagnosis of the PTSD or MST is less severe?
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.
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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.
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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.
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This system came out in 2020.
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They’ll either rate off that, or they will reschedule the physical part
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Oh absolutely! Good luck and hopefully smooth-ish sailing.
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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.
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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.
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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.
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Audtime-frame and procedures
in VA Disability Claims Research
Posted · Edited by brokensoldier244th
Hey, Carson
Basically, the fiduciary hub (a subset of the VBA/VSRs that deals with things like pension, fiduciaries, and check retrievals for errant direct deposits, among other things) will get with DFAS to figure out what was initially sent as severance, then go back through their own records to see what was sent out to you as disability compensation. It can take a while.
How long is awhile? I can't really say- because I don't know, I don't work as a fiduciary and I never have, at least yet. Sometimes your DD214 lists severance in the remarks block. I think you can also go through the DFAS website and request pay records, but I know how far back. I have to do it sometimes in my capacity as a VSR to determine things like "Were you on AD as a reservist/NG when XYZ happened" if you or DoD/Dept of [Insert Service Here] doesn't have a complete record set of your duty weekends, ATs, Active Reserve or Guard, or deployments. I can usually get an answer back in about a week but it's just a printout of whatever date range I told them I was interested in. No editorializing or commentary, and it's often not columnized very well so it's a pain to read. Excel to the rescue!