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  1. I found Alex on this site almost 4 years ago. I had posted multiple questions as to why VA denied my aid and attendance claim SMC L. Alex contacted me and agreed to help. He filed a new claim for smc l and of course va denied it. He then filed appeal to bva which was subsequently granted and I was awarded smc L. However I have 2 separate and distinct 100% ratings so I should have been awarded smc M. So, Alex submitted appeal to bva which after a year they closed appeal because they thought we were appealing original bva decision. We were not appealing decision just the m versus l. So Alex filed a new claim for m and va denied. Alex filed supplemental claim and va closed the claim without even adjudicating. He filed Again and same result. He made another attempt and that was denied too. Finally Alex contacted the secretary bva, the regional office coaches and raters claiming they had no idea how to adjudicate smc claims. Obviously he ruffled a few feathers and the truth needed to be said. Finally after more than 36 months of fighting, the VA admitted making 2 mistakes. They admitted the effective date for my original l should have been 6 months earlier and they admitted m should have been awarded when aid and attendance was granted. Bottom line- Alex knows more than va when it comes to SMC. Alex is a kind person who always listed to our concerns and always keep us in the loop. If you need thoughtful assistance with your smc and or claims in general, no one knows better than our friend Alex. Andrew & Linda
  2. Pretty stocked and can't wait to get this info and share it. I recently submitted an iris claim asking about the 10 day policy of waiting after letter is sent with a decision and why they can't make it available online immediately and rationale for their policies etc. I've spoken to 2 people so far at the Peggy line and both have said that they are jealous (one actually is asking to have the info sent to their management team) of the information being put together for me and that they hope I like to read. One told me I better share this info with other veterans as well so my hopes are high for some really great information to share. Hopefully more to come by end of next week at latest.
  3. I have attached my denied claim for migraines. I have many docs I can attach. I.e buddy letter from my mother ( fractured skull prior to military), and also squad leader that mentions bad landing on military jump service connection ( knocked out). Military entrance exam showing fractured skull. VA NEUROLOGIST stating service connection. Sick call slip headaches. There is more but post. But I’ll start with the ones attached. I don’t understand the reasoning for denial . They have rated me earlier with SSD. Aalso they show a history of risk factors … and if you look at my disabilities the denied me hypertension , musculosketal pathology of the cervical spine and chronic opioid use (because of my service connection disabilities) … is that not oxymoron.. no pun intended. Did I make a mistake filing as a secondary to ptsd? I could have filed for a Tbi service aggravation.. but if they won’t service connect me for this than who knows. Any input would be great. I won’t post everything I have but this seems to warrant service connection if I did not redact anything please let me know.
  4. Just thought I'd throw my timeline out there for everyone, mine seems kind of weird compared to the norm. Not sure what's going on, or if this is just how AMA is going. July 31, 2020- Supplemental claim denied August 7, 2020 - NOD filed, requested hearing January/February 2021 - Virtual hearing scheduled for May 2021 May 24, 2021 - Virtual Hearing Held, Same day status was changed to "Your appeal was distributed to a Veterans Law Judge" and then "A judge is reviewing your appeal" Status has not changed to "Your appeals file is open for new evidence" June 2, 2021 - submitted the remainder of my evidence and a statement waiving the remainder of my 90 days to submit evidence. No further changes as of today.
  5. I have roughly one million questions but I'll try to keep it simple. This is the first time I am appealing a denied claim (though not my first denied claim - I currently have 50% combined). Almost exactly one year after my C&P exam I finally got a denial for both of my knees). I did a HLR informal conference and now my va.gov status says "The VBA is correcting an error". Here is the decision I received on Dec. 7th after the Higher Level Review (sorry I couldn't figure out how to add image) and below that are my questions. Decision: 1. A duty to assist error has been identified during the Higher Level Review of left knee pain. 2. A duty to assist error has been identified during the Higher Level Review of right knee pain. Evidence: Timeline from intent to file on 10/2/19 to HLR informal conference on 12/2/20 Reasons for Decision: 1. Higher Level Review for left knee pain The issue of left knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of patellofemoral pain syndrome. 2. Higher Level Review for right knee pain The issue of right knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: A nexus or link has been established between your claimed issue and an in-service event or injury. During VA exam dated 11/7/19 the VA examiner provided a positive medical opinion linking your right knee to service. You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of right meniscal tear, right knee instability, and patellofemoral pain syndrome. MY QUESTIONS 1. Am I just out of luck because I didn't seek treatment during Active Duty? 2. Under "favorable findings" it states that "a nexus, or link, has been established between your claimed issue and an in-service event". Isn't that the literal definition of a service connected disability?! 3. What is the error? What have you all seen as timelines and outcomes for this? Thank you to everyone who takes the time to respond and post. Reading these questions/answers over the last year has been both educational and comforting.
  6. My battle with the VA continues. Got some appeals at the CAVC. I have other appeals at the Board. Looks like my attorneys are fighting hard for me at the CAVC I wonder how long it takes to get a CAVC decision? Daniels Rule 33 Summary of the Issues.pdf
  7. I am looking for a little advice on how to proceed with my current claim. After several years of TBI treatment with the local VA hospital, I filed for a TBI claim. I am still awaiting the decision but just received my C-File that I requested a few months ago. From what I can tell, my DBQ DR did a horrible job and I am going to get underrated when the final decision comes. I was in and out within 25 minutes and no testing was performed. Once I told the DR that I had already done Neuropsych testing with the VA hospital the exam ended shortly after. When viewing my C-File and the record of the TBI DBQ exam I noticed that the DR service connected my TBI but didn't accurately record the symptoms identified in the Neuropsych exam. The DR just cut and pasted the Neuropsych summary but missed some ptretty big details from the rest of the report. My DBQ DR listed my TBI symptoms as; - Memory, attention, concentration, executive functions - A complaint of mild memory loss (such as having difficulty following a conversation, recalling recent conversations, remembering names of new acquaintances, or finding words, or often misplacing items), attention, concentration, or executive functions, but without objective evidence on testing. - Motor activity (with intact motor and sensory system) - Motor activity normal - Visual spatial orientation - Normal These results were drastically different from my neuropsych exam which listed the following issues; My neuropsych exam listed severe impairment of several memory functions, processing speed, visual spatial orientation. It also listed mild impairment of motor functioning. I am not able to cut and paste the records I have for the Neuyropsych so I can't give the full report without showing my name. Does anyone have experience with a DBQ that is different from VA treatment records? What should my next steps be? Should i do a higher level review? Hire an appeal lawyer?
  8. I want to appeal for an larger increase but it's possible that they could decrease what they already gave me.
  9. I'm going to file an appeal for my TDIU and was wondering which will be my best option. My old claim is a legacy and I've never used this newer version. What are the pro's and con's of these 2.
  10. Thanks Berta I'll get right on the information you provided me. Should I have my lawyer file the cue now or wait to see how my supplemental claim is resolved?
  11. John ask if I had SSDI before I filed for TDIU, I do. I was denied my first try. My attorney filed an appeal which includes a vocational expert opinion. Will the VA access my SSDI records. I sent them a copy of my decision letter on my first application, but it didn't show in the evidence on my denial letter. The reason I received SSDI is because of service connected disability exclusively. I was under the impression that they would consider the SSDI vocational expert also. I guess I was wrong.
  12. Broken soldier they didn't have to pull my SSDI information on my claim. I included my award letter with my claim packet. On my denial letter nothing about SSDI was referred to in the evidence section. How can I make sure they look at it this time since its included in my initial claim and wouldn't be new and relevant in my supplemental claim. That's why I thought I could mention it in the remarks section of the 21-8940 they are requesting again. Because in block 19 they ask if you left your job because of your disability and if yes comment or remark in block 26. I thought I could mention it here.
  13. So under AMA vets get 90 days after a hearing to submit additional evidence. My appeal status has not changed to "Your appeals file is open for new evidence", it is currently "A judge is reviewing your appeal" . My question is, if I presented enough evidence to warrant a full grant, are they required to hold the case open for 90 days or can they issue a favorable decision?
  14. Hi, Last week, I was awarded P&T TDIU for a claim that was previously awarded 70% mental health disability rating. Should I now appeal the 70% mental health rating? The word "total" is difference between a 70% and 100% mental health rating, as I read the information. Is P&T unemployable possibly considered as a 100% disability rating? Thanks
  15. I had my appeal hearing on Monday and I am gathering the remainder of my evidence to submit. I was denied for no diagnosis, which I submitted extra evidence for and spelled it all out to the judge. I am wondering if a buddy statement providing some kind of objective evidence of painful motion would be helpful, even though its not useful for diagnosis purposes. Based on my feel from the hearing, I am hoping for a grant, not remand, and I'm trying to make sure any evidence to get me rated at least the minimum is in the file. 2 of my buddies who I have known as long as my condition has been going on agreed to write buddy statements reflecting severity and hopefully objective evidence of painful motion. A lot of my C&P's notate pain on various ranges of motion, but I don't know if that is sufficient under CFR 4.59 when it relates to diagnostic code 5002. 5002 says there must be objective evidence of pain to grant the minimum under the painful motion rule. Here is a link to a court ruling saying that lay statements from someone other than the veteran is acceptable, if I am reading that correctly. I am just trying to get ahead of the game and not have to appeal again if I get rated with a bunch of 0%. I realize service connection comes first, but I'd like to avoid going back to the board if at all possible. I I also attached a copy of one of my C&P exams for you guys to see, the are all pretty similar. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000056749/Petitti-v.-McDonald,-Oct-28,-2015,-27-Vet.App.-415-(2015) Wrist C&P.pdf
  16. So I had my appeal hearing with a BVA judge this morning. Aside from all the trouble I had with DAV it seemed to go well. (DAV didn’t contact me until 10 minutes before the hearing. Thought I was going to be going it alone.) i wanted to see if anyone wanted to weigh in on what the judge said. After I presented all the reason it should be granted she said the case was “pretty straight forward” and I “should have a decision soon”. She didn’t ask any specifics about my case, my condition, or how I believe they are connected to service , just if documents I referenced were in my file from previous portions of this claim. it sounds pretty good to me, but I know this stuff is always with a grain of salt.
  17. My Appeal is a legacy and at the bva. December 2016 is when it was filed. On va.gov it says my appeal was updated in July 2020. On va.gov it says they are working on claims from September 2017 and later. Shouldn't my Appeal be seen quickly. Va.gov says there are 85000 ahead of me. Just seems like December 2016 should be seen before September 2017. Also my claim was remanded to director of comp. And then sent back to RO and now is back at bva. Wasn't sure what to do.
  18. Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process! My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status. Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
  19. I know I ask a lot of questions, but DAV and VA never want to give any answers. I have a virtual appeal hearing next month and I have 2 questions not related to each other. 1. If my claims are granted will the VARO use the existing C&P to implement the decision, or are new C&P's likely? for reference, when the hearing occurs it will be less than 1 year since the last exam. 2. Has anyone had recent experience in the timeframe after the hearing to get a decision?
  20. I searched the forums but did not see this in the appeals section. I have a pending appeal for my right foot for service connection, and I'm in the process of sending a statement to the Board of Appeals. My question is can I ask the Appeals Board for a percentage rating prior to winning the appeal for right foot service connection. My reasoning is, if I just send the Appeals Board my statement without requesting a percentage and I win the appeal for right foot service connection, then I might have to file another appeal if the RO gives me a lower percentage, and wait another 5 years for that appeal. I'm unable to find any information on filing an appeal for service connection, and at the same time requesting a percentage. Any information would be appreciated. Thanks
  21. I filed a claim for Sleep Apnea secondary to my PTSD, which is service connected. I have been diagnosed from the VA as having sleep apnea, and given a CPAP to wear at night. I used Carpenter Chartered Law Firm to do the claim, but got this denial letter (attached is an excerpt). In it, it says "In the absence of other major risk factors such as obesity it would be reasonable to attribute OSA to PTSD as this is considered a risk factor for OSA from uptodate.com". My thought is that if both obesity and PTSD are considered risk factors, shouldn't it be a 50% chance that it could be either obesity or PTSD, and go to the veteran's favor? And doesn't that mean that attributing OSA to obesity is just as speculative as attributing it to my PTSD? I had Carpenter Chartered start an appeal, so I am hopeful to get it approved.
  22. So I am getting juggled a bit between VSO since my awesome last one retired so would appreciate the proper route to take. I was just rated at at 50% Pes Planus with Plantar Fasciitis under 5276. This was a supplemental claim for only pes planus that was filed on 02/01/21 with a decision made on 03/12/21. After speaking with a VSO, who read me the decision letter and raters notes, he said there is no doubt the 50% for pronounced pes planus was justified, but was not sure why they arbitrarily added plantar fasciitis to the decision. I mentioned to the VSO that effective 02/04/21, a diagnostic code of 5269 - Plantar Fasciitis was added to the schedule of ratings - musculoskeletal system and if it was possible that they combined them under diagnostic code 5676, because that was how it was always done before and the rater did not read or know about the new diagnostic code. He said that could be the reason. Just to note, I was diagnosed at the VA with bilateral pes planus in 2017 and given insoles. I was again seen by the VA for foot pain and bilateral pes planus was again affirmed in 2018 with a different set of insoles. This last January I again went in with foot pain where pes planus was again affirmed, had another set of insoles cast, and was diagnosed for the first time with bilateral plantar fasciitis and given steroid injections in each foot. Ultimately I am looking to get the plantar fasciitis rated separately from the pes planus under the new diagnostic code of 5269, which due to the severity and being bilateral would be at 30%. In fact, my VSO had already submitted an intent to file for bilateral plantar fasciitis, arthritis of both great toes, patellar tendinosis of both knees, arthritis of both knees, and ITB syndrome as being secondary to the pes planus once it was service-connected. The history of my pes planus dates back to my final physical and I have been receiving treatment for it since 2017 in the form of insoles when it was originally diagnosed with the VA. It was only this last year that I was diagnosed with plantar fasciitis as a result of the pes planus. So what route do I take on this supplemental claim? I feel like a High level Review won't allow me to submit the VA medical records showing that I have been treated unsuccessfully for pes planus since 2017. Is that something I can bring up in the phone conversation with the reviewer to get the plantar fasciitis rated separately under 5269? I am not submitting any new evidence so to speak, but literally VA medical records that were already in the system for years. The other question is, does the new diagnostic rating for plantar fasciitis even apply to me? I filed on 02/01/21 and the new rating schedule went into effect on 02/04/21. I want to fight this decision because I am already rated at 70% with CAD, DMII, and Tinnitus. Getting the plantar fasciitis rated separately would be the difference between an 86% rating rounding up to 90% and 92% rounding down to 90%. This does not include the issues secondary to the pes planus like the arthritis and tendinosis that are under my current intent to file.
  23. Kind of wondering if anyone has seen this before on my appeal for sleep apnea, I am confused. I had my hearing by virtual and it say the VA law judge is reviewing you claim, under compensation issues it has the following: Appeal received March 2020 Up to date as of March 16, 2021, at 5:25 a.m. ET Status Issues Issues Closed Granted Compensation issue
  24. Hey folks, just wanted to share some info. I was waiting for a hearing and got some info from DAV. If you want a virtual hearing you must call your representative and ask for it, if va.gov says video conference it won’t be scheduled until the DAV/va offices re-open. I called and my DAV rep contacted the hearing coordinator and within a couple hours I was scheduled for a hearing in May. I sent my NOD in August 2020. I don’t know of this applies to legacy appeals.
  25. I have received 100% P&T. However some very black and white conditions were denied completely. Should I still appeal the denied claims even though I am 100% P&T? (it has been over 1 year since my claims were denied). I have 2 fears: 1. VA will eventually one day reduce my 100% P&T randomly and I will regret NOT filing an appeal 2. I file an appeal for the denied claims and then the VA digs deeper into my 100% and 'changes' their mind and then reduces me. Basically I don't want to wake up the sleeping giant and would rather fly under the radar
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