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Pro Se All The Way What one man can do another man can do (veterans). Like other vets who received prior poor, hostile or indifferent VSO assistance I learned beginning in 1985 to represent myself pro se in all claims and appeals to the VARO, BVA and even CAVC court. You do not need to put up with sorry VSO representation if like me you are willing to do your own research and learning on the convoluted VA disability system. For me it was challenging, learning and even a fun but time consuming experience over 35 years. Here is my 95% successful score card and you can do it to if you are motivated like me. 50% PTSD 1985 pro se with no help from DAV VSO 70% PTSD TDIU 1998 very limited assist from former DAV VSO P&T TDIU 2000 on my own pro se CAVC court win 2005 pro se own my own partial victory CUE 30% Heart Disea 2017 on my own pro se Agent Orange IHD/CAD 50% Sleep Apnea 2021 pro se BVA Appeal back dated 2017 SMC-S automatic 2021 pro se back dated to 2017 60% GERD 2022 pro se VARO initial claim approval 10% Tinnitus 2022 pro se VARO initial claim approval 100% P&T 2022 automatic from VARO My OSA Sleep Apnea appeal was helped by Dr. David Anaise medical nexus opinion stating my OSA was caused and aggravated by VA diagnosed long term PTSD and PTSD meds. I filed the claim and appeal forms and provided other medical evidence pro se. Only one claim flat out denied in over 35 years with no appeal by me for Hypertension. There is no chicken chit VSO or official VA representative that would have ever done all this for me. Only you really care about your disability claim and no one else. The VVA and Hadit and Lexus Nexus manuals plus BVA and CAVC, Fed Appeals Circuit court decisions are your friends and of tremendous help to me. Beware of misleading info from other vet websites. So cheer up and chin up. My comment is not legal advice as I am not a lawyer, paralegal or VSO.

AS of few days ago I received a 60% rating and 10% rating for GERD (60%), TINNITUS (10%) from a VARO initial claim filing. This is on top of recent OSA Sleep Apnea appeal grant from BVA of 50% due to PTSD and automatic SMC-S rating with 5 years back pay. My GERD 60% rating was secondary to long term PTSD and PTSD medications since 1985 and gerd diagnosis with continuous VA medications since 2000. Although I suffer from serious GERD the 60% rating did surprise me pleasantly. My TINNITUS 10% was direct service connected due 1970 Vietnam combat involving Army medevac helicopter flaming shoot down crash near LZ Uplift resulting in a Purple Heart and Combat Medical Badge for a leg wound and head concussion. Additionally I was almost blown up by a "friendly fire" large nearby explosion from ARVN artillery and near constant exposure without ear protection to 3 GUN ARVN Artillery battery fire within a few feet of a medevac crew quarters at LZ English. According to normal math and not VA math my combined total disabilities are now 220%. My two separate QTC C&P examiners did right by me in these claims. Of the 7 or 8 major claims I have filed pro se since 1985 this is first initial large disability rating I received from VARO rater without having to appeal or file for increase. I am now P&T 100% scheduler and not depending on unprotected P&T TDIU rating anymore. This good news to me will disappoint some watchers from another forum location (not this forum) as they always say an overweight vet who may or may not smoke/drink cannot win an OSA Sleep Apnea claim due to PTSD and by implication not entitled to a service connected OSA rating secondary to PTSD. They also said I did not qualify fro 60% GERD unless I was skin and bones (emaciated) due to Gerd symptoms. Too bad for them. Never give up and file and then appeal if necessary and listen to advice from experienced hands on this form but also do your own research and not rely on only one source for important info. My comment is not legal advice as I am not a lawyer, paralegal or VSO so do not contact me folks for more info.

Just finished my C and P for Tinnitus and Hearing loss. And why I most likely will be denied. My appointment was made through LHI. This was June 24, 2021 and the appointment was for September 10, 2021. I called LHI and asked why it would take 11 weeks for an appointment, no answer. My appointment was for 1PM. I arrived at 12:45 to find the location at a small store front in an older strip mall, my first thought was, Dingy and Dirty. No one was at the reception desk so I called out to someone in the back. Turns out it was the Doctor who answered she was with a patient and came to the front and informed me they were out to lunch and to sit down until the receptionist returns. Needless to say she seem a bit miffed that I bothered her. The receptionist arrived and took my info and asked that I take a seat until the Doctor finished with the other patient. I waited until 1:15 when the doctor called me in. Her 1st question was “how are you doing” and my reply was “I’ve been better” she seemed to want to push the issue and I pushed back saying I didn’t know want she wanted me to say. At this point I started to feel this was not going to go well for me. She began interviewing me first about my hearing. It was pretty basic like, are both ears affected, is one side better that the other. When did I notice my hearing lost and what may have caused it. I told her about being in the Artillery in Viet-Nam for a years. I was honest to tell her that age may also be a factor. Then she started asking about my Tinnitus, normal questions like, when did it start, what it sound like to me. I explained besides being in the Artillery there was one incident of a large road land mine that blew up right in front me. I was driving a deuce and half with some replacements from Pleiku to Kon Tum. The deuce and half in front of me hit the mine and it blew off the double dual tires of the deuce and half as well bending the bed as if it was a toy. It was the loudest thing I ever heard. She took notes about it but seemed to want to know about my life after Viet-Nam. At this point she seemed confrontational about my answers. I told her I worked in the accounting department of a large trucking company for about 15 years and then computer work. Nothing in noisy areas or running heavy machinery. She didn’t seem to want to listen how Tinnitus impacted my life. She just seemed to want to find some other reason why I might have Tinnitus. She keep asking about if I go hunting or to a shooting range. Then if I own a motorcycle or loud lawn equipment. I told I didn’t but she asked a second and third time about the same thing at which point I felt she was badgering me. We started the hearing test and to my surprise my hearing was better than I expected. I don’t know if she played with the equipment but it sure didn’t feel right, but the results are the results. So I doubt I would get any rating for hearing loss. As for the Tinnitus I assume it is what opinion she puts in her report but I have little hope it will be in my favor. Overall I didn’t find her to be a very professional and wish that they had choose another doctor to do the testing. Just wondering if anyone has any comment about LHI as a contractor?

What does this mean? Is it good or bad for vets? https://veteranclaims.net/2020/03/08/single-judge-application-delayed-onset-tinnitus-tinnitus-can-manifest-years-after-an-underlying-cause-va-training-letter-10-028/

I have been out of the service for a decade. I claimed tinnitus upon discharge and was denied because I didn't have hearing loss. I gave up on that claim but now the tinnitus is bothering me. I have never gotten any treatment for tinnitus. What is the path to service connection? Note: my MOS is "on the list" for noise exposure.

I have submitted at least two Service Connected Disability claims to the Veterans Administration (VA) for hearing loss, beginning with my initial request in December 4, 2009. Each test was conducted by a company called QTC. Each test was conducted by an evaluator that ran each test at least three times. My last QTC evaluator swapped headsets three times, then told me she would be increasing the volume of the audio "so I could hear better". She also stated that she had to report higher scores. Both QTC exams were "normal", rendering 0% compensation. My hearing tests at three outside ENT facilities stated "Moderate to Severe hearing loss". How many times is an evaluator required to run one complete audiology test?

Afternoon all. I have been doing some research into Tinnitus and claiming secondary for Insomnia and Hypertension. I have a 10% for Tinnitus and 0% for hearing loss (submarine sonar tech), but honestly the lack of sleep is beating me down. I have not gotten a full night in several years. I usually get 5-6 hrs a night, with multiple interruptions due to what I feel is my ears ringing. I did a search on the forum here for tinnitus and Insomnia but the last post was from 2012, hence the new thread. I was able to find 3 cases where the VA ruled in favor of the member for secondary insomnia and secondary hypertension, Case numbers: 1207104, 1522463, and 1600946. The last case was for insomnia only. I also have a study that is an Examination of the relationship between Insomnia and Tinnitus, DOI: 10.1177/1179557318781078 My question is how do I get this all linked together? I plan on going to my primary care and taking this evidence to him (He's a retired commander) and see what his thoughts are, but I was also referred to you guys as the knowledgeable peeps. Thanks Matt

I have a rating for a strange ear disease that is 0% and won't go up without an increase in hearing loss. Is temporary hearing loss enough to get an increase? Its called "autophony." where I hear my own voice very loud and can hardly hear anything outside of my own head. Is this temporary hearing impairment enough to get an increase in rating from 0% or does the hearing test have to show the hearing loss? They rated this disease analogous to perforated ear drum. Does getting rated with a disease open up any type of special treatments you can get for the disease? Such as going to a specialist out side of the VA since only a few specialist in the world try to operate on this type of disease?

Due to my tinnitus being very bad, I was awarded a 70% rating from the VA for anxiety and depression secondary to my tinnitus due to it keeping me from sleeping. I have started my counseling with VA social workers and psych doctors from the VA. I ask my VA primary care doctor does the VA offer any treatment for tinnitus and the answer was, "There is no treatment the VA offers for tinnitus, just wear ear plugs and stay away from loud noises". My question is why would a PA want to test me for sleep apnea to see if that is causing my sleep problems but I can't get treatment for what I know keeps me up at night. I'm just curious if the VA doc is trying create a scenario that if I do have sleep apnea, then that is what is causing my anxiety and depression not my service connected tinnitus. I know sleep apnea is serious and I'm going to get the test but can the VA reduce or take my compensation if the PA opinions that she thinks my depression is due to sleep apnea? Can she override two PHD Psychiatric doctors opinions? One IMO and the other a VA psychiatrist? Thanks for your responses in advance. Elders please chime in.

I was just diagnosed with Meniere's after years of having periodic dizziness and vertigo that has gotten progressively worse and more frequent. I am already service connected for bilateral hearing loss and tinnitus. (Ironically I had never even heard of Meniere's until about a year ago when I was doing the exams to get the service connection for the tinnitus and when I mentioned the dizziness to the audiologist she said I should have more testing to see if it was Meniere's). My question is when I file the claim, should I file it as primary, secondary to the hearing loss and tinnitus, or both?

I submitted my supplemental claim 3 days ago for the following diagnosis with evidence: - Flat Feet (Primary) - Bilateral Plantar Fasciitis (Secondary) - Bilateral Pronation to mid and rear foot (Secondary) - Intra-articular Hip Pain (Primary) - Femoroacetabular Impingement (Secondary) - Right Adductor Groin Pain (Tertiary) - Athletic Pubalgia (Tertiary) - Osteitis Pubis (Tertiary) - Right Knee Pain - Low Back Pain - Left Tennis Elbow - Bilateral Tinnitus The VA updated va.gov 2 days ago with these pending diagnosis: - Impairment of femur - Flatfoot - Limitation of leg motion (flexion) - Lumbosacral or cervical strain - Limitation of forearm motion (flexion) - Tinnitus Through my own insurance, for all of the injuries listed in the first group of injuries above, I got doctors to diagnose me with them and they added, "More than 51% probable that the injuries occurred during military service" since the same injuries got denied in the past. I used those evidences to file my supplemental claim. I called the VA today to request for them to change what they put back to how I had it. The missing items like "Pronation", I had them annotate where to find the diagnosis on the doctors notes so that they can add it. I think they overlooked it. They also left out my right adductor pain. For the hip injury, it's not just, "Impairment of femur" as they put it. Why did they do this? Are they trying to gyp me? Why didn't they annotate the secondaries and the tertiaries like I annotated it? Instead of "Right Knee Pain" they put "Limitation of leg motion (flexion)". For "Low Back Pain" they put "Lumbosacral of Cervical Strain." For "Left Tennis Elbow" they put "Limitation of forearm motion (flexion)". Are they trying to gyp me or did I make the mistake of calling them asking them to change it back to how I had it?

I originally filed a claim for bilateral hearing loss for both my left and right ear, but 2 years ago was only awarded Service Connection for my Left Ear, but only at 0%. The VA said that it was at 0% due to my Right Ear being at normal hearing at the time of my hearing test. But I just now filed a claim for an increase in my Left Ear hearing loss. I went for another C&P hearing exam. I told the Hearing Doctor that now my Right Ear was getting bad too and could she test me for hearing loss in my right ear this time. When the test was all over she told me that I did have some Right Ear hearing loss this time, but it was no where near as bad as my Left Ear. So I left there thinking I would be awarded something for my Right Ear now that the Hearing Test showed Right Ear hearing loss. But on Ebenefits it still shows Not Service Connected. How can you have your left ear service connected for hearing loss and not your right ear, if you were exposed to an explosion? It doesn't make any sense. That was the whole reason they service connected my Left Ear to begin with. Now that the hearing exam shows hearing loss in my Right Ear, the VA gives the excuse that my Right Ear hearing loss isn't Service Connected, because whenever they originally tested my Ears 2 years ago for my original claim the hearing exam didn't show any Right Ear hearing loss. But everyone knows that Hearing Loss can occur many years after the fact. My Dad served in Vietnam and was exposed to explosions on a daily basis, but he didn't show any immediate signs of hearing loss for decades. It wasn't until the last few years that we've noticed his hearing getting worse, and so now he filed a VA claim and was awarded for Hearing Loss and that was from back in 1969. So Hearing Loss doesn't have to happen overnight. Just because I didn't have it 2 years ago, but I now do, doesn't mean it isn't being caused from the same explosions from whenever I was in the service and what caused my Left Ear hearing loss. Has anyone else been through anything like this before? Any suggestions as to what I might be able to do to help? Thanks.

I submitted a claim for Sinusitis, OSA,, and Tinnitus. My claim was denied for all 3. The tinnitus they claim was neither occurred in nor was caused by service. My job on active duty exposed me to gun fire, explosions, tanks, and tracked vehicles. I submitted the Duty Noise Exposure Spreadsheet that displayed my AFSC was rated as highly likely to be exposed to loud noise. In the first Exam they claimed I said my hearing loss was from jets flying overhead. Never said that, so they scheduled a second exam. This one they acknowledged the correct job but I was still denied. The evidence listed on the second decision dd not include the MOS Noise exposure chart I included on the first claim. I never went to sick call for ringing ears because that is just silly (had I known then) and was not something you did. I have had quiet office jobs since separating from The Air Force. What am I missing? For the OSA claim, I submitted Lay statements from my current wife and my ex-wife as well as explained to the doctor my symptoms and that when I was on Active Duty i had no idea sleep apnea was a thing. I assumed I just snored and was tired because I was working hard. I had a sleep study this past year and was deemed to have severe OSA. In my claim I listed that I believed my osa was related to my cluster headache disability. They responded Cluster headaches do not cause OSA even if there are many people with cluster headaches and also OSA. I experienced a stuffy nose during my headaches on the left side. This was completely different from the closing of my airway when I would sleep. It was just worst if both occurred at the same time. They claimed I have other risk factors such as being male, obesity, and advancing age. Something I did not include in my claim was the fact that I was on the Fat Boy program at one point on Active Duty and my SMR made a reference to obesity. Would this help support my claim. Also in the second decision they said I was a 73 year old male and I am no where near 73 so they probably mixed my records with someone else. What can I do about this? And Sinusitis, I have a couple diagnosis in my SMR's specifically listing sinusitis. I have had sinus issues since I was on Active Duty. I use a Netti Pot and have been diagnosed post active duty with sinusitis. The DBQ from the QTC Medical Doc claims I have rebound sinusitis because I mentioned using Afrin. I have always been aware of the danger of over use and in my VA records I discussed this concern whenever the VA would prescribe a nasal spray. What am I missing and how can I get this corrected. The errors on the 2 decisions make it seem as if they are not very organized and I have to suffer from their disorganization. Are they supposed to review all of the evidence from the initial claim when you submit a supplemental, or should I have resubmitted all the documents from the initial claim. Are the documents that contain research that supports your claim supposed to be on the evidence list as well? They were not on there and if they did not give those documents equal consideration what is my recourse. Any assistance would be appreciated Thanks for listening.

My husband was just denied SC for hearing loss and tinnitus. I would have expected 0% hearing loss for left ear and 10% tinnitus. I attached the C&P resultsAudiology DBQ.docx - it seems to me like the audiologist contradicts herself in her rationale - or maybe I am just confused? But overall it does seem to say he has tinnitus and its linked to service? Not sure what to think of this. Any insight would be appreciated! Thank you!

Hi, Asking any vet in the Richmond, Va area for doctor recommendations. I was diagnosed by my audiologist with hearing loss and tinnitus. I'm in the process of gathering all my paperwork to file a claim. Problem is this doc doesn't want to write up a letter for me. Sorry if it sounds excessive...this would be my first VA claim I have filed. I figured if I submit as much as possible...less likely to get denied? So any help would be appreciated! Tks

Greetings all, I served from 1988 to 2009, roughly 18 of those 21 years were as an Army CID Special Agent. In 2001, I was shot in the leg, which destroy the femur. This occurred on a US military installation, however I was taken to a civilian hospital for the surgery and was later transferred to a MEDDAC. The bullet traveled through the femur, so a rod was inserted with two lower and two upper screws. I lost not only length in the leg (2cm) but my hamstring atrophied. Since then, I've encountered continued pain in my knee and hip. All was documented in my military medical records. Often times, the pain would have me seek medical attention about 2 times per year, which again is documented. I underwent surgery last year to remove one of the screws (all are now broken) that was pressing against a tendon causing extreme pain. The surgeon explained the others will need be replaced and I will also need a hip replacement in the coming years. The pain continues. My VA exam was in 2009 and at that time the length difference in my legs was disclosed to me for the first time and as xrays were obtained, the screws were discovered to be broken. The VA Rating Decision gave me 0%. Unknown to me was the appeal process. Last year, I found someone who is helping me with the appeal. I live in a remote part of southern Germany, so connection to other retirees and vets is nil. This week, through my appeal representative, the VA has contacted me. They want all the background information on the shooting. They require the who, what, when, where, why, and how of this incident. I am also to supply them with records I have that they don't. First, they have a copy of my entire medical record. How am I to know what they don't have? Second, the Rating Decision states that this injury was service connected and in the line of duty, so why is the background information required? Had I been shot while in Afghanistan would they be asking the same questions? Perhaps I simply do not know exactly how the VA adjudicates the claims. As this is not a presumptive matter, evidence of the injury must be presented. They have that in the form of my military medical records. Do the circumstances behind the shooting hold weight on determining the extent of either the injury or the level and percentage of my disability? Does the background on an injury play some part of the adjudication process and awarded disability to which I am unaware? Thank you in advance for any insight into this.

Facts regarding claim: Sleep Apnea secondary to insomnia Date of diagnosis: 7/18/2014 Current disabilities relevant to claim: Tinnitus – Service Connected - 6/5/2017 Insomnia – Servicee Connected - 4/13/2018 Facts regarding claim: Sleep Apnea secondary to insomnia Date of diagnosis: 7/18/2014 Current disabilities relevant to claim: Tinnitus – Service Connected - 6/5/2017 Insomnia – Servicee Connected - 4/13/2018 Status of claim: CUE submitted due to errors in claim by Rater Status of Cue: In process. Mistakes accepted as grounds for CUE Purpose of claim: Establish to VA my service connected disabilities Insomnia and tinnitus are aggravating the symptoms of my non-service connected disability sleep apnea. Sleep Apnea Symptoms: Hypersomnolence & Fatigue Service Connection Justification: Per CFE > Title 38 > Chapter I > Part 3 > Subpart A > Section 3.310: Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. Narrative: My service connected secondary insomnia and my service connected tinnitus are responsible for my sleep deprivation which is aggravating my sleep apnea symptoms: hypersomnolence and fatigue. Incident: On 27 September 2018, I went to my scheduled C&P examination expecting to answer questions about my sleep apnea symptoms (hypersomnolence and fatigue) being aggravated by the sleep deprivation I am experiencing due to my service connected tinnitus and insomnia disorder. When I got to my appointment, the C&P doctor just wanted to see my 2014 sleep study. There were no questions asked. I asked what was the reason for this C&P exam? The doctor stated he just needed dates from my sleep study. Since the VA already has this information, I was very confused as to why I was asked to attend an appointment to gather information that they already possess. I then contacted QTC who notified me of my appointment and according to the claim specialist the one question that the C&P doctor was tasked to answer was "Is the veterans sleep apnea at least likely or not proximately due to or the result of tinnitus" This question the C&P physician was tasked to answer has nothing to do with what my claim is even about. My tinnitus didn’t exist when my sleep apnea was discovered. The CUE for which was created because of a mistake made much like this one on the original claim clearly states: Because of the constant ringing in my ears that never changes in volume or goes away at any time (severe tinnitus), I am suffering chronic secondary insomnia as well as chronic migraine with tension headaches. My service connected secondary insomnia is responsible for my sleep deprivation which is aggravating my sleep apnea symptoms (hypersomnolence and fatigue). Request compensation for the aggravation of my sleep apnea symptoms (hypersomnolence and fatigue) from my service connected tinnitus and insomnia disorder. I submitted a VA Form 21-4138 and said stated: The question you tasked the C&P doctor to respond to does not at all pertain to the purpose of the claim you are evaluating. Since my sleep apnea was diagnosed in 2014, and my tinnitus was service connected 6/5/2017, how would you expect this doctor to provide a credible response to your question? My tinnitus didn’t exist in 2014. I stated: Did you not thoroughly examine the CUE (clear and un-mistakable error) and claim you are responsible re-evaluating? Are you not supposed to do this before sending someone to a C&P examination appointment for apparently nothing? Did you not check the service connection dates of my disabilities: tinnitus and insomnia along with the date of my sleep study? Doing this would have provided you vital information about my claim in that my sleep apnea was present before I was awarded my tinnitus service connection. This is a secondary service connection by aggravation claim. Please read carefully the Claim and then the CUE created because of how badly the original claim was handled. It states the circumstances leading up to my sleep deprivation I am experiencing which is causing the aggravation of my sleep apnea symptoms hypersomnolence and fatigue. I ended it with this question. How could anyone expect to get a fair claim decision if the VA representative handling their claim doesn’t bother to examine all information pertaining to the claim they are evaluating? There it is. I also put in a complaint using IRIS including everything you see on this post. I am expecting to do another CUE. My question after all of this. Is my claim valid?

I was awarded 10% for Tinnitus but turned down for hearing loss. How can that be?

I'm working on preparing my brief to the CAVC on my appeal having received the Record Before the Agency (RBA). Searching for the initial EENT consult in the RBA now. Have it in a CD sent to me by the VA Records Management Center earlier. Does anyone know the date of "liberalization" of tinnitus allowing the rating of 10% for noise induced loss instead of only as secondary to a TBI? Is there a reference? Docket 17-2990 The following is in the RBA. 1) RBA Pages 4255 & 4254; The Rating Decision of 2-25-76, RO did not do investigation of injuries medically, only for “in line of duty” determination. a) CUE: RBA page 4365 dated 4/5/65; 4/4/65. “Patient took exam to operate a forklift and was noted to have a moderate hearing deficit. Please see and evaluate.” 4/5/65, “tinnitus ® ear & vertigo.” (tinnitus subsequent to exposure to 5” naval gunnery practice in the battle dressing station under the gun mount during the USS Sperry AS-12 gunnery practice during my tour on that ship aggravating a pre service mild hearing deficit with an incident of losing most of hearing for a period of 3 days not recorded or complained about on the record as an HN E3 when told it would come back.) b) RBA page 4309, Audiogram at Guam Memorial Hospital dated 7/31/75 noting “poor speech discrimination both ears.” But without noting the claim of tinnitus which is at least partially contributing to that. And the AOJ, given the EENT consult of 4/5/65 above and the other earlier Audiograms failed to send the examination back for a clarification on whether the tinnitus had subsided or was omitted from the report. c) RBA page 476, Audiology consult dated June 18, 2013. Please include the audiology report and notes on tinnitus and word discrimination. d) RBA page 3106, Rating Decision date 1/22/92: i) “F. Service medical records show complaints of recurrent tinnitus in April 1965 and January 1968. The audiometrics done on current VA examination show average pure tone thresholds as 48 in the right ear and 63 in the left ear, with speech recognition as 88 percent and 76 percent respectively. Also shown is periodic bilateral tinnitus.” ii) D. Service connection is warranted for a separate diagnosis Of tinnitus at a compensable level with application of 38 CFR 3.114 (A). iii) 2016 38 CFR 3.114(a) “…or a liberalizing VA issue approved by the Secretary or by the Secretary's direction, the effective date of such award or increase shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the act or administrative issue.” iv) 1974 38 CFR § 3.114 Change of law or Veterans Administration issue. (1) (a) Effective date of awards. Where pension, compensation, or dependency and indemnity compensation is awarded or increased pursuant to a liberalizing law or a liberalizing Veterans Administration issue, approved by the Administrator or by his direction, the effective date of such award or increase shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the act or administrative Issue. v) 1974 38 CFR 4.84(b) 6260 Tinnitus ---------------------- 0 (See diagnostic codes 8045 and 8046.) vi) 1974 38 CFR 4.124(a) 8045 Brain disease due to trauma Purely neurological disabilities, such as hemiplegia, epileptiform seizures, facial' nerve paralysis, etc., following trauma to the brain, will be rated under the diagnostic codes specifically dealing with such disabilities, with citation of a hyphenated diagnostic code (e.g., 8045-8207). Purely subjective complaints, such as headache, dizziness, insomnia, tinnitus, etc., recognized as symptomatic of brain trauma, will be rated 10 percent and no more under diagnostic code 9304. This 10 percent rating will not be combined with any other rating for a disability due to brain trauma. Ratings in excess of 10 percent for brain disease due to trauma under diagnostic code 9304 are not assignable in the absence of a diagnosis of chronic brain syndrome associated with brain trauma. vii) RBA page 844, Periods of steady tone were greater in Japan because of the constant additional background noise but still the 20 per day of the steady high-pitched tone seems a bit exaggerated. Probably something lost in the translation to the Audiologist. However, even with the translation, this is the clearest and best history of my tinnitus reported in the record. viii) RBA pages 3149 & 3150, Audiogram dated 8/21/91, recording tinnitus but inaccurately. My tinnitus has been constant with the bird chirping, with an intermittent steady high-pitched tone that more grossly interferes with hearing especially in a circumstance like an audiogram, since it first appeared in late 1964 during my tour on the USS Sperry AS-12 following gunnery practice and a temporary hearing deficit of everyone sounding like they were down in a well which off the record, after the practice, by a physician I was told would go away in a day or two. As an HN E-3, at the time, all I was concerned about was getting my hearing back which I did except for the tinnitus interference which wasn’t too severe except when trying to intently listen to soft sounds when it becomes a high pitched steady tone. So, it is intermittent in nature of interference. Otherwise it is like a soft background noise unless competing with soft sounds. This is the way I always describe it, but it has never been recorded in the long version except on RBA 844. ix) RBA page 3202, Claim on my behalf by representative with no mention of tinnitus. Given that it was granted on the review of the record under 38 CFR 3.114(a) it should have been dated from Mar 18, 1976 per the 1976 38 CFR 4.85b and the cited, in the 1/22/92 Rating Decision, 38 CFR 3.114(a). x) RBA pages 3484 & 3485 Audiological Case History, dated 5/24/88, recording tinnitus but with errors. Not “since taking Elavil” as the record shows. Worse since taking Elavil. And not intermittent as stated above except for the difference in tone. It is there when I wake up and when I go to sleep and probably keeps me from dreaming most of the time. And it has been like that since the 1963 or 1964 USS Sperry AS-12 gunnery practice. xi) RBA pages 3955 & 3956, Audiology Case History dated 5/14/85, also reporting tinnitus but erroneously. Is the reporting of “intermittent” because that is the usual? Where did the “2 episodes come from” Perhaps 2 episodes of the change in tone to a high-pitched tone. Should be mild constant with intermittent severe. xii) RBA pages 3965 & 3966, Audiology Case History dated 7/14/83 recording tinnitus moderate with errors as above. xiii) RBA pages 3987 & 3988. Audiology Case History dated 12/13/83, tinnitus reported, correctly as not in ears, incorrectly as periodic and just in morning (louder when first awakening). Appears to include both high pitched and “birds” (high pitched; “birds.”) xiv) RBA pages 4328 & 4329, Audiogram dated 22 Jan 67, Audiologist did not fill out history on back. Similar Beltone reports back was not copied. xv) RBA page 4462, Rating Decision dated June 25, 2015; “We determined that the following condition was not related to your military service, so service connection couldn't be granted: Medical Description Tinnitus” This goes to the authenticity of the June 25, 2015 Rating Decision and its sloppiness. e) Several audiograms listing tinnitus in boxes provided on VA and Military audiogram report forms are not included in the record. Some but not all are on the CD provided to me dated 02/15/2017.

Thank You in advance! (First question after reviewing this book I wrote here should probably be, do i need to separate all of these questions into the different subject forums or is this OK ?) I've been procrastinating now for almost 10 years (mainly because of denial, I volunteered, tough guy, I know guys that seen/did worse and horror stories with the VA) and have just this year decided to attack this VA Claims Process. Putting it off for too long and ready to get the information needed to hopefully (fingers crossed) have a smooth process. I have not filed for anything, have no medical records or injuries documented while active or since (I have just requested my military records from the right place after all these years, because I assumed the VA would have them and keep them safe, so I didn't need a copy. MISTAKE #1, Naive I know) and have not been to see a private doctor for anything. I medicate with over the counter and always have, but have never been officially diagnosed with anything. Just last month I made an appointment with advice from an amazing local veteran group with a psychologist outside of the VA and she diagnosed me with PTSD. It was extremely hard to even talk to her, I've never talked to anyone about it just denied it or pushed it back. (I know I'll still need a VA exam). I was also seen by an outside, but VA referred hearing specialist and was diagnosed with tinnitus in the 3k range and hearing loss. 6 months after release from active duty in 2007 I was seen at the local VA for hemorrhoids and treated. I have had issues with roids, constipation, diarrhea etc ever since. This is also the only thing I have ever been seen for at the VA. My wife has also complained for years about sleep apnea and me startling her in the middle of the night when I sleep, should I get an evaluation for sleep apnea. She doesn't remember ifI did it when active or not, but does that matter for service connection ? I have already made the intent to file as of last month and am wondering how I should proceed from the above mentioned. I have not been seen for IBS, by any professional but it reads like that is a high possibility, so do I need a diagnosis from outside of the VA or should I get one prior to filing? Should I file IBS, if diagnosed under "presumptive illness" (BALAD IRAQ 2005-2006) ? Should I get on the Burn Pit or Gulf War Registry (Is there anything I should know prior to going to these registry appts) ? Should I file for PTSD with just an outside evaluation (How are stressors confirmed, all mine are personal accounts and encounters) ? Should I file for hearing loss or tinnitus or both I served as a firefighter and have read that as being on some list hearing related jobs ? And finally, Should I file for all of these now at one time or should I wait and do them individually ? My main concern is going into this and not being fully prepared, if there is anything you believe would aid in the above filings please let me know. I know there is a long road ahead, but I don't see any point in going alone and appreciate you all. Thanks again!

Noise and Military Service; Implications for Hearing Loss and Tinnitus (2006) is the Institute of Medicines findings and presentation to the VA Secretary which deals with a lot of history throughout the DOD, addressing such things as "whisper exams" that fail to register the upper frequency ranges or loss thereof which is what Bilateral SNHL is all about. Lack of documentation, and a wealth of other information. Did you know that prior to 1978 a bonafide DOD Hearing Conservation Program to safeguard hearing loss did not exist. One exception the USAF did in fact conduct audiograms on select personnel from the late 50s forward. Do not be surprised in your VA Denial letters to find those serving prior to 1978 to have had an audiogram during their induction physical, but a whisper exam upon separation. The VA C&P examiners frequently refer to your hearing being normal upon separation, therefore the military did not cause your hearing loss. The VARO will concede your traumatic acoustic events and further noise environments, but will side with the medical evidence (by law) each and every time. Solution? Private Audiology Medical Opinions, the doctor will review all information in your VA Claims folder, and list the items they reviewed on their office letterhead, with the statement they have reviewed, then have the doctor remark as to "as least as likely as not" (equal to or greater than 50%) or "more likely than not" (greater than 50%) due to traumatic acoustic events endured during his/her military service, followed by medical reasoning as to why. The doctor will date and sign their letter and insert their credentials behind their name. (You may want to request copies of your military treatment records if you don't already have copies in order to challenge the VARO decision) Today I get the private medical opinions before submitting the claims. That way if the VA C&P Examiner determines the military didn't cause your hearing loss (negative opinion), I have the Private Medical Opinion (positive) and they cancel each other out. Then the RVSR within VARO is left with reviewing the remaining positive evidence in your claims folder, if available, and provide the veteran the benefit of doubt. 38 U.S. Code § 5107 - Claimant responsibility; benefit of the doubt Hearing protection devices; there are various designs, based on noise levels in your work environment; that have what are referred to as Noise Reduction Ratings to preclude hearing loss. These did not exist, in my case prior to 1979. Years ago, while in the Navy, I noticed engineers would wear what we called Mickey Mouse ears, to help attenuate the noise in their work space. These items were shared, gaskets wore out after extensive use and personnel continued wearing them without a proper seal. Their workspace would require at least a double flange and ideally a triple flange hearing protection device along with the ear muffs to preclude hearing loss. Problem being, they had to be removed in order to communicate, receive orders in conventional engineering spaces due to noise levels. News flash! There is no test for Tinnitus. VA will attempt to state otherwise, but the American Tinnitus Association and their very own DOVA JRRD Vol 46, number 5, 2009 pages 619-632 states "Special audiological tests are effective in detecting deliberate exaggeration of hearing loss, but no documented test exists that is capable of detecting the presence or absence of tinnitus." Furthermore, you are authorized to diagnose Tinnitus; for this very reason. Define the traumatic acoustic event you were exposed to that caused your Tinnitus since military service. 105mm Howitzers 185dB, M-16 156dB, flight deck on aircraft carriers 136dB are but just a few areas of impulse noise levels that exceed OSHA 90dB exposure in an eight hour period. Here is a further recommendation by Veterans Law Blog: Draft a Sworn Declaration – do not use VA Form 21-4138 – with the following information: (I've used the 21-4138 with success) List each and every incident of significant noise exposure you can remember – and give enough detail to show that the exposure was significant and credible Grenade blasts, artillery rounds, simulators, constant machine-gun fire, years around loud jet or tank engines, you get the idea. Don’t OVERDO it…1-3 sentences should suffice, but identify if you can the approximate month and year of the noise exposure. State approximately when you remember the tinnitus starting. If it started in service, explain why you didn’t seek medical treatment in service (for most Veterans, explaining the reality of military service to bureaucrats will suffice: no soldier, sailor, or airmen is going to stop a mission or training to seek treatment for a condition that everybody has and that there is no cure for. True Story). Identify the chronicity of your tinnitus – has it been continuous since exposure to the noise? If yes, explain that you have had this ringing since the exposure to noise. Identify the frequency of your tinnitus – how often do you have ringing in the ears? Every day? Twice a week? 4 times a month? Identify the severity of your tinnitus. I think you need only do this if your tinnitus is so severe that it is debilitating, prevents you from working, or in very rare cases, is “objective tinnitus”, meaning it can be heard by other people standing next to you. In these cases, you might be able to seek an extra-schedular rating for the tinnitus in excess of the 10% limit in the Schedule of Impairment Ratings.

First post... I read some posts recommending Dr. Nash to do an opinion letter. For just a medical opinion letter for hearing loss/tinnitus appeal... any other recommendations on who to contact. THANKS.

Hello, Army OIF/OEF vet here. In 10/2015 I initially filed for claims with little/no evidence. Most were of course denied. Through appeals I am now at 40% SC for IBS and tinnitus. I appealed my anxiety denial and was given a C&P exam in 06/2016, fast forward to 01/2017 and the VA sends me an SOC along with the VA form 9. I hired Vet Comp and Pen to help me gather supporting documents. (I think they did an excellent job) and submitted my VA for 9 along with new documents (02/2017) and waived my hearing before the BVA to help expedite things. Much to my surprise I was told I should still expect to wait about a year or so for the BVA's decision. In the meantime I have been developing a FDC for sleep apnea. Should I go ahead and file it even though the BVA currently has my anxiety claim or should I wait until it is decided? Thanks, and hopefully my post wasn't too lengthy.

Hello, Background information: 35 Years old, 70% SC for Anxiety and Depression as well as 10% for tinnitus, no other medical issues. Living in Japan. I have recently been diagnosed with chronic prostatitis. I did not have the problem when I was in, it is a recent development with a high anxiety/stress load. The doctor told me it was likely caused by stress. I asked for a written diagnosis but the Doctor would not opine as to the cause, only diagnosis what was wrong. This is not unusual in Japan I think it has to do with insurance laws, because I experienced the same thing a few years ago with a another matter for the Foreign Medical Program. If I understand the process right I need to get a diagnosis that says something to the effect of likely being caused by stress and anxiety. I have a couple of options I can talk to my primary care physician who consults for Veteran Evaluation Services (CnP exam for those who dont live near a VA), and he might provide me with the diagnosis since he is familiar with my anxiety. Option two I could see if the Navy Hospital has a urologist and try to get a diagnosis there but I do not like going there. Or should I just file the claim with the diagnosis I have, along with statements from my wife and people who know me and hope? Since the Chronic Prostatitis I have erectile dysfunction or rather a painful climax which is common from this. How do I incorporate this into my claim?

Back in1961 I was pushed backwards and fell on the frozen ground. Records showed "concussion", Infirmary and Hospitalized with loss of consciousness. Had C&P and got 40% for TBI and 30% for chronic headaches. My neck has been acting up for years. Can I ask for an MRI or Xray to find out what it is? If it's osteoarthritis neck or some other thing can I claim it as secondary to the TBI? Also have 10% for tinnitus for a total of their math at 60%.