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gemsurf

Seaman
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About gemsurf

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  • Service Connected Disability
    10%
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    Love Golf but can't play :-(

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  1. Was able to download one this morning finally! Here ya go. disexm53a.pdf
  2. I was doing a little research this morning and came across this directive. I have seen previously where others have had problems finding the Spinal Exam (disexm53.pdf) Worksheet. I believe this directive is why. If you read the entire thing, there are some encouraging directives to VA Med Centers to have your own VA Primary Care or Specialty doctors fill out the same exam sheets that the C&P examiners use, but for our use in filing or substatiating a claim with VA, SSDI or whatever. I may be wrong, but this seems huge to me? I've had doctors be reluctant to fill anything out for me in the past and I suspect it's because they're afraid or just don't know what their allowed to do? A copy of this directive along with VA Directive 2008-071 will have all the language needed for them to do an exam and/or provide a statement. Thoughts from anyone? Here is a link to the new page at the VA also- http://www.vba.va.gov/disabilityexams/ . There are only three of the new exams listed so far but they claim more will be added soon. I suspect that the spinal will pop up any day... The attached file is a flow chart from the VA for this directive.
  3. I found it in the below reg. I take this to mean that they can be combined to meet the minimum requirements of 60% for a single disability, or to reach the 70% or more, for purposes of qualifying for TDIU, but not for your total rating. It makes more sense now. TITLE 38 - PENSIONS, BONUSES, AND VETERANS' RELIEF CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS PART 4 - SCHEDULE FOR RATING DISABILITIES subpart a - GENERAL POLICY IN RATING 4.16 - Total disability ratings for compensation based on unemployability of the individual. (a) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (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. Consideration shall be given in all claims to the nature of the employment and the reason for termination. (Authority: 38 U.S.C. 501) (b) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation and Pension Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue. [40 FR 42535, Sept. 15, 1975, as amended at 54 FR 4281, Jan. 30, 1989; 55 FR 31580, Aug. 3, 1990; 58 FR 39664, July 26, 1993; 61 FR 52700, Oct. 8, 1996]
  4. I have a 10% rating for the past 35 years on my left knee. I "anticipate"(I know...) getting a favorable ruling for both hips (DJD), my low back(DDD) and my right knee(DJD) being secondary to my left knee at some point in the near future. It seems I read somewhere that when all the disabilities are of the same etiology (ie- caused by left knee) that the percentages are added normally instead of the normal VA fuzzy math. For instance- 40 low back 30 left knee 10 Rt. hip 10 Lt. hip 10 Rt Knee 69% Rounded to 70% with Fuzzy Math or 100% using normal math because the disabilities are of a common etiology. This is correct, isn't it?
  5. Thanks john999. I have already requested the original exam on iris and will do it again after this exam. The nexus opinions I have are part of my VA Medical record(which is why I wanted the doc to have them). Do you think copying and offering the select pages from the records with highlighted opinions be to bold of a step with a QTC doctor?
  6. I was rated 10% for a reconstructed left knee in 1975. Over the years of walking with a limp, I have developed low back and hip pain primarily due to arthritis and DDD/DJD. I have been recieving medical treatment via the VA since 2000 for all of these conditions and they are well documented with several unsolicited VA Doc nexus opinions that they were caused by my antalgic gait.. So in September I applied for disablilty ratings for the hips, back and right knee secondary to my left knee as well as TDIU. I had my original QTC exam three weeks ago which was for my left knee. When I was being examined the Dr said she would go ahead and check out the secondary claimed disabilities too. She even had my hips, back, and right knee xrayed as well as she did the range of motion tests, etc..etc... . Having read many of the stories here, I was kinda prepared for the worst and was really pleasantly suprised with this dr. She seemed to be very receptive to when and where the pain began with motion etc.. so I felt confident. Although I didn't ask and the Dr didn't tell, I really feel I will get very favorable results from this exam because it was on a particularly painful day compared to most. I specifically asked if she had my VA Medical records and she didn't. I offered her an extra 5 inch binder with mine and/or a CDrom with those same records converted to PDFs and she refused them which I felt was odd since she didn't have anything? Overall I felt the exam went well and was accurate of my limitations. Fast forward and I get another appt letter from QTC for another appointment (with the same doctor) but it doesn't say what it's for. I call the number and they tell me it is for a "follow up" to the original exam? When I tried to drill down further, she repeated that it was "just a followup" and I will be getting more xrays including my chest too? Should this be of any concern? Should I bring the medical records again and offer them? The original exam was pretty thorough relating to all of my claims so I'm wondering what is up with this?
  7. Thanks BroncoVet (Is that Denver or Boise State?) I have an entry in my med records from 2004 after I asked a VA doctor about disability that reads- " Pt needs to apply for disability -- needs basic disability exam and has no insurance to get on outside- talked w/ Chreyl VSO who told him that C&P was only for VA purposes. "
  8. Thanks everyone for the comments. I have asked for the ratings to be retroactive to Oct 2000, but realize there is little chance of that happening. Once I get my ratings I might file an appeal and give it a run anyway. I have plenty of time to wrestle with them and from what I read in these boards, they deserve to get the butt whoomped whenever possible!
  9. If tried many different searchs here and on the Board of Veteran Appeals search site but haven't been able to find a situation similar to mine. I have been 10% disabled since I left the Army in 1975 for residuals of a left knee injury. I applied because of pain and a permenant limp that was all documented in the original file. Fast forward to the 1990s and I develop low back and hip pain and begin being treated at the Boise VAMC. Eventually diagnosed with spinal stenosis, DDD, and DJD in both hips. I have 5 doctor entries in my records stating or strongly insinuating that these conditions are caused by my Antalgic Gait (Limp) caused by my left knee. I had no idea VA would consider these conditions secondary to my knee until my knee worsened and I began research to apply for an increase from the original 10% and stumbled into secondary disability references. I have been extremely disabled since Oct 2000, and unemployed since 2003 directly because of my back and hip problems and my VA medical records show the timeline and conditions and their severity in complete detail. I have little doubt that I will be rated enough to atleast qualify for Individual Unemployability from my file date, but I am preparing everything as strongly as I can just in case. I do have a C&P exam monday thru QTC. My question is, if they find I am in fact disabled, and that it had it's start in 2000 or 2003, will the payments be retroactive to those dates or am I just out of luck for being ignorant? My records have 2 absolute nexus opinions and 3 others that infer they were caused by my limp dating back to Oct of 2000. Thanks
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