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Found 16 results

  1. Hey all, I’m in the reconsideration phase of my SSDI claim. The weird thing is SSA hasn’t sent me to an exam, and the adjudicator already notified my attorney stating she will forward my file to the SSA doctors for review/decision. I have plenty of medical history about my mental health disabilities ranging from in-patient hospitalizations to suicidal thoughts and attempts. I’m just wondering has anyone been approved for SSDI for a mental health disability without going to an exam?
  2. Hi all! Just found this site and from the looks of it there are more answers here than with the VA or with my VSO, so here goes. Several months ago I filed for asbestos exposure issues arising from Naval Service (old snipe on an older no longer existing aircraft carrier). Everything I've read and printed out for future use, notes that evidence of asbestos exposure typically doesn't rear it's ugly head for 30- 50 years. Which it has in my case. Lung fibrosis, calcified and non-calcified pleural plaques and a small lung (possibly benign) lung nodule all revealed initially poorly via an x-ray and later better identified by a CT scan. All on my dime. I thought I'd just have to grin and bear it until a Vet informed me about it being related to my naval background so I filed with the VA using a VSO. (I should point out that as of yet I do not have lung cancer, mesothelioma or asbestosis.) Two things. I get my response from the VA and they tell me that because I didn't file within one year of discharge (1968) I couldn't file for prostate cancer, which I have been operated on for this year, and still have some residuals that I'll probably have for the rest of my life. Then, they inform me they want a C&P exam, by a contractor, performed regarding my "pleural plaques." (Pleural plaques are evidence of asbestos exposure causing the moderate lung fibrosis and the lung nodule. The only concentrated asbestos exposure I had was during my Naval enlistment.) So, I went in to the C&P with print-outs noting asbestos exposure has a long latency period, how it can cause pleural and calcified and non-calcified pleural plaques, as well as a copy of my CT scan. The doctor could have cared less. He actually pushed away the paperwork I had brought with me. He never took vitals. Nothing. I was there to get a chest x-ray (not worth a crap compared to a CT scan) and to take a pulmonary function test. He opted not to do the x-ray when he glanced at my CT scan report, that he had previously pushed away, spoke out loud more to himself than me, stating, "I can use this." And, pretty much dismissed me, stating as he walked out the door that his report would be done in two or three days. Oh, and the chest x-ray was never done. The "nurse" then did my PFT exam. I either flunked it or failed it so miserably, she gave up after administering the test five (not three) times in about as many minutes. Simply put, I ran out of air, I guess, faster than she thought I should. Every time I took the test I happened to cough into the tube as I ran out of air. Twice. She said the machine read that I was coughing not exhaling. I told her that I was out of air by that time and of course I was coughing. So then, she let me hold the machine, I took a deep breathe, exhaled and as I started to cough pushed the machine away from me so I didn't cough (heaven forbid) into the tube. I did that three times and by then I was about to pass out. She ultimately left the room and came back in a few minutes later letting me know I could go. As to the prostate cancer, I have found several internet articles from medical sites that link asbestos exposure and prostate cancer and have proffered them with my Request for Reconsideration. Assuming this request takes months for yet another denial, does the time it take for their reconsideration adversely impact the year I have to file either a NOD or an appeal? Any like cases or suggestions out there?
  3. My husband filed for reconsideration several weeks ago. This was through DAV and the Cleveland VA. We got notice from the DAV that it had been filed and sent to VA. Shouldn't the claim be listed on eBenefits by now or do reconsiderations not show up there? Thanks, Kate
  4. I separated from active duty service in the Air Force with in 2010 and had undiagnosed non-combat military connected PTSD with alcohol use in remission (According to my VA disability paperwork which puts me at 50% for ptsd.) This was granted the beginning of last year. I recently put in to have my discharge upgraded to honorable from general and have yet to hear back from them. (E-benefits say maybe I'll hear about it early February 2018.) There were a few selfmedicated incidents with alcohol that happened while I was active duty that resulted in going into a civilian rehabilitation facility, a perscription to an antidepressant, and a lot of suicidal ideation I recently admitted in my paperwork to the review board that I was afraid to admit to my command because they would do things like write someone up for a sunburn (destruction of government property), or purposefully keep spouses apart by writing one up for something they didn't do and keep them from going during their significant others' PCS (because someone else did it to them for five years and "they turned out fine"(There was no way to prove otherwise.)). I was recently reading about medical retirement from the military. It's a little confusing. I was wondering if there was a way to submit for reconsideration and medically retire from the military after separation?
  5. Hello all. I would like to submit a request for reconsideration for a two contentions that were rated at SC at 0% in September 2017. I have everything (new medical evidence, VA Form 21-4138, etc.) loaded into e-benefits ready to send but was not sure requesting a reconsideration through e-benefits was the right process. My question is......can a request for reconsideration be submitted through e-benefits? Thanks again.
  6. My claims were closed on 5 Jun. It was obvious that lot of evidence was completely overlooked so I did a letter to request reconsideration. The claims all opened back up the following week. Does this mean I do not need to worry about a NOD date at this time? In other words, if my claims are not decided by Jun 2018, will I need to file a NOD, or does getting the claim re-opened reset the NOD deadline to one year from the date they are closed out in the future? The new estimated completion dates are Jan - Aug 2018. Thanks, JustGettingStarted
  7. Ok, in Nov '16, I sent in a letter requesting a reconsideration with new material and evidence on a decision that was denied in Dec '15. I sent this information to the Intake Center, well Dec 23, I finally just sent information again on ebenefits so I would not lose my 1 year date, but on Ebennie, I also included new claims that I was told I needed to submit. I completed the NOD form and included it with documents for the claims I disagreed. At the beginning of March claimed moved to prep for decision, then 2 weeks later it was sent back to review of evidence, the next day it moved back to review of evidence. They hadn't rated any of the claims, but they sent me a letter stating they needed a NOD form from me, but I had already sent one. So now I am waiting in Gathering of evidence. So any ideas as to why they requested that form again?
  8. In my recent denial for sleep apnea secondary to service-connected asthma, the medical opinions stated that OSA has several primary causes, such as obesity, advancing age, sinus congestion etc... The VA provider referenced the many events of sinus congestion in my medial records and initial sleep apena diagnosis and implied is was more likely sinus congestion than asthma... I am now looking to file a reconsideration and am thinking to service-connect the sinus congestion/post nasal drip with OSA as a residual. Essentially, OSA secondary to Sinus congestion. I would be interested in thoughts about this strategy: 1. Does this seem like a viable or potentially helpful strategy? 2. Does this nexus letter seem appropriate to try and connect sinus congestion? Here is the Nexus Letter Draft: XXXXXXXXXXX -- Sinus Congestion and Post Nasal Drip. To whom it may concem, I am wrriting this VA Nexus letter at the request of Mr. XXXXX has been under my care since 9/29/2015 for asthma and allergic rhinitis with clu·onic sinus congestion, and clu·onic post nasal drip . Mr. XXXXXX's moderate to severe clu·onic sinus congestion and moderate to severe clu·onic post nasal drip are currently treated daily with maxintal medication therapy including saline sinus rinse, fluticasone and azelastine as well as salt water gargle. I have examined Mr. XXXXX's VA Claims File (cfile) and service medical records. I am familiar with his medical history and have also performed physical exarninations over the course of his 8 visits to om clinic, most recently on 10/17/l 6. It is my medical opinion that the veteran's sinus congestions and post nasal drip is more likely that not related to his military service and associated with his service-connected asthma; the rationale being that. Mr. XXXXX demonstrated no prior history of asthma or allergic rhinitis including sinus congestion, and post nasal drip prior to military service, as annotated on his medical entrance exam, and was while in military service diagnosed with "reactive airway disease" in 1992 and noted to have a positive methacholine challenge in 1994 consistent with an asthma diagnosis, and was seen on multiple occasions for sinus congestion, post nasal drip, acute rhinitis, and upper respfratory infections. Mr. XXXXX reports recurring symptoms since leaving service and often patients that develop astluna also develop other atopic conditions such as allergic rhinitis with symptoms or clu·onic sinus congestion and clu·onic post nasal drip. Mr. XXXXX's medical record demonstrates that these sinus congestion and post nasal drip symptoms manifested in service and have been clu·onic ongoing medical conditions up to the present time. Please do not hesitate to contact us if you have any additional questions or needs. Sincerely, XXXXXX, MD Board certified in Adult and Pediatric Allergy & Immunology, The American Board of Allergy and Immunology Board certified in Internal Medicine, The American Board of Internal Medicine Redacted Nexus Letter.pdf
  9. Hello all, first post here. I have a question about the reconsideration process, and possible outcomes. Ill also post my timeline for reference. I was initially denied TBI due to not being service connected, even though I suffered 5 concussions while in service. I have cognitive effects, memory loss. I found some of the older medical records from before everything went digital, and at the advisement of my VSO, I filed for a reconsideration. Right now Im in the gathering of evidence phase, and my VSO old me that it "needs rating board attention".So my questions are 1,is it a possible positive that it needs rating board attention, and 2, with my current ratings, is it possible for them to grant me 100% scheduler, or will they reduce one of my other ratings if I get granted SC for TBI? 11/22/14-original claim filed 11/16/15- decision received 90% combined rating 50% sleep apnea 50% severe tension headaches 20% chronic lower lumbar sprains 10% tinnitus 10% right knee loss of strength after surgery 10% right hip condition TBI DENIED not Service Connected 12/22/15- reconsideration for TBI filed 1/13/16- moved to "pending decision approval" 1/14/16- moved back to under review and then to gathering of evidence
  10. Thanks to all of you for being so informative. I read and reread many of the posts and decided to be my own advocate...best advice I learned, and I am a huge advocate of. Submitted 11 conditions on 1DEC14, which was my retirement date as an FDC. Claim completed 11APR15 (just past the 125 day mark). Came out to 92%, rounded down to 90%. I will be appealing/asking for reconsideration for the following: Awarded 20% for degenerative arthritis of the lumbar spine also claimed as spondylolisthesis. Explanation: "Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees." Rationale for disagreeing: During my retirement physical, forward flexion was rated at 30 degrees with a geniometer (sp?). During C+P, PA wanted me to push past initial point of pain until it hurt too much (my mistake, I know) and he eyeballed 60% flexion. Currently on muscle relaxers. Justification of 38CFR3.102 Awarded 10% for rectal prolapse. Explanation: "We have assigned a 10% evaluation for your rectal prolapse based on mild prolapse, occasional moderate leakage." Rationale for disagreeing: During my C+P, explained to the PA about frequency of 95% of bowel movements results in prolapse, which I believe meets the higher evaluation of 30% due to frequently recurring - "A higher evaluation of 30% is not warranted for prolapse of rectum unless the evidence shows symptoms are moderate, persistent, or frequently recurring." Awarded non-SC for internal hemorrhoids. Explanation: "SC for hemorrhoids, internal is denied because the medical evidence of record fails to show that this disability has been clinically diagnosed." Rationale for disagreeing: Clinically diagnosed while I was on active duty, noted on retirement physical, continues to occur. Awarded non-SC for right and left knee disability. Explanation: SC..is denied becasue the medical evidence of record fails to show that this disability has been clinically diagnosed. Rationale for disagreeing: Full range of motion, but pain upon bearing weight (no, I am not overweight). I will be filing a NOD, and asking for DRO hearing. Comments, recommendations, etc.? My ratings: 70%: PTSD 21%: Bilateral lower extremity radiculopathy (10% each side) 50%: Sleep Apnea 20%: Back 10%: Rear end blowout (recurrent) - sorry my attempt at a joke at a serious problem 10%: Tinnitus 0%: Left elbow arthritis 0%: Junctional escape rhythm 0%: right elbow epicondylitis No SC: Internal Hemorrhoids No SC: Left knee disability No SC: Right knee disability 4wheeler
  11. DAV told my husband today that he needs to file his NOD soon as the one year mark is coming up on Sept 19. He currently has a reconsideration in that we had hoped would be decided by now. We were waiting as long as possible so as not to mess up the reconsideration. DAV said that even after filing the NOD, the reconsideration would continue and it wouldn't have to go into that 2 year or so that is common for a DRO. That's not the impression I have gotten from reading here. Is DAV hopefully right about this? There are some contentions that he did not put into the reconsideration due to waiting on an IMO so they will go into a DRO. So, can he have a reconsideration active on some things and a DRO on others at the same time while still keeping the original date on the ones in the reconsideration due to filing the NOD on time? All contentions were originally on the same claim. Thanks Kate
  12. I am confused about how things were filed on my husband's claim. He got a denial on several contentions in Sept. 2013. Should have been denied, was filed horribly incomplete. Anyway, my husband filed a reconsideration on two of the claims, PTSD and Tinnitus through DAV in May. The original claim was filed as irritability and anxiety. When the reconsideration with new evidence was done, there was a new diagnosis of PTSD and it was included in the claim for anxiety and irritability. DAV sent everything to Cleveland which is the normal VA for our area but, since his claim was originally heard in Louisville due to part of it being a Camp Lejeune water issue, it apparently should have gone back there. Just last week, it seems to have finally landed in the right place. It is now showing on eBenefits. First went in to "Preparing for Decision", then fell back to "Review of Evidence." There was already a claim in for unemployability which was just recently denied (we were told) but we never received any notification or anything on eBenefits saying so. I understand the denial due to the fact that there were no service connected conditions awarded. Now the current contentions are listed as Unemployability (new) and PTSD (new). So, apparently they threw the unemployability claim back into the mix with the PTSD claim. But, should the PTSD say "new" since it was a reconsideration? They give the date of the original claim as Aug. 1, 2013 which is correct for the unemployability but the PTSD claim was originally filed in 2011, although it was filed as anxiety and irritability which are now symptoms of the PTSD. With the "new" tag, it doesn't sound like reconsideration. BTW, tinnitus is not listed as a contention although it was included in the reconsideration. We are hoping he will at least get an actual C&P this time, since the first time they only looked at the records and decided. I guess what I am asking is does it seem that they should be listed as "new" contentions when it was filed as a reconsideration? Thanks, Kate
  13. I filed a claim in Aug 2012 and got the decsion letter in Jun 2013, but 1 of the claims was totolly overlooked. When I when through the QTC the doctor did the DBQ and it was included in my file. I was told by a VARO supervisor that I would need to submit a Reconsideration for the remaining claim. I filed a FDC Reconsideration and elevated to Hardship in Jul 2013 and have not heard anything; still stuck in Decision phase. Any ideas? Thanks for the consideration.
  14. Hello all. I retired from the Army this past February. I've been following this forum since I received my initial compensation letter from the VA in July. I've learned a lot here, but I'd like to throw out a few questions, as well as post a letter for your review. I've been rated at 60%. (30% post hysterectomy, 30% PTSD, 10% right hip tendonitis, 10% thoracic spondylosis with scoliosis, and 10% tinnitus.) I also was SC at 0% for ten other conditions. The VA denied SC for eight more conditions. I do not feel I need to appeal every condition denied, but I would like to appeal some of them, specifically the ones related to my chronic skin condition. Here are my questions: 1. How can the VA deny SC, when conditions are clearly diagnosed many times in my active duty medical record? Shouldn't I, at least, be given SC on these conditions with 0%? 2. I sent in a huge amount of my active duty military medical records (2 copier paper boxes full), with all diagnosed conditions highlighted. Does the case worker not even review these records? 3. The VA claimed they did not have the SS#s of my two daughters and could only pay me with one dependent (husband). So I immediately sent in a 21-4138 upon receipt of my rating decision, to include the missing SS#s and also to request reconsideration for one of the denied conditions (Coccydynia). The reason for the reconsideration on this particular condition, is because it was denied based on "The evidence does not show an event, disease or injury in service."... "Your service treatment records do not contain complaints, treatment, or diagnosis for this condition". The VA obviously missed this or it was not included in the evidence. I had a two page report from my active duty records that clearly diagnoses the injury, so I asked for reconsideration and attached a copy of the report. Was this the right thing to do? 4. I am considering appealing a chronic skin condition. The doctors throughout the years could never agree on a single diagnosis. It was called eczema, atopic dermatitis, neurodermatitis, contact dermatits, and simply rash. The VA denied all of those stated conditions, saying "The evidence does not show a current diagnosed disability." "While your service records reflect complaints, treatment or a diagnosis similar to that claimed, the medical evidence supports the conclusion that a persistent disability was not present in service." These skin outbreaks were documented at least 30 times in my active duty medical record. One other diagnosis for this skin condition was papular urticaria. The VA has deferred a decision on the papular urticara. The letter stated that they would be sending me to an additional C&P exam, but I never received an appointment time/place. On ebenefits, it says my claim is back in evaluation of evidence, so I'm assuming they are not going to send me to another exam after all. Should I go ahead and file an appeal on the conditions denied and have my doctor write a letter explaining that all the different diagnoses are referring to the same skin condition or should I wait for a decision on the one deferred condition? (I am having an outbreak now and am scheduled to see my PCP on Monday, at the time of my first C&P I was not having an outbreak, so the doctor had nothing to evaluate.) 5. The other thing I'd like to appeal is my rating for PTSD. They rated me at 30%, but I clearly meet the criteria for a 50% rating. Would I get a letter from my current therapist to support this? She is a licensed social worker and specializes in PTSD and EMDR treatment. What documentation should be included to support and help me win an appeal? Sorry this was so long of a post. I hope some of you seasoned posters with lots of experience can give me some good answers on my specific issues. I dread the future fight with the VA, but I'm betting this forum will be an encouragment to keep going. Thanks in advance.
  15. Hope everyone is getting through their week and staying warm. Had yet another rough night followed by an appointment down at the Denver Regional Office. Need some clarification if any of you have the time and would truly be appreciated. 1. Decision on my PTSD from the VA was dated in May of 2011 (Woman I speak with in regards to these issues and daily struggles recommended me around 50-60%) was awarded 10% 2. (please no acronyms, haha, very confused) I am under a year since the decision and very very much so disagree with the decision the system came to. The Woman that conducted my C&P Exam was rude and judgmental thus I no longer wanted to speak to her. In addition my misconceptions of how the whole thing works did not understand that during this exam it was my time to open up to the things that I struggle with. (odd thought on this one- PTSD= mistrust, so why does the VA think we will just open up our dark world to a stranger....beyond me) 3. The DAV has requested for a reconsideration in my behalf. (what is the difference between an appeal and reconsideration?) My service officer said based on my evidence I submitted in Nov of 2011 I should have a new rating in 30-60 days based on the regional offices average rate of addressing these issues. Am I mistaken or reading in to this in any way? 4. Today I did submit documentation regarding my use of a service dog to help me cope with crowds and my both physical and emotional reaction to situations. I wish you all well. The dreams have recently become more vivid and daily activities seem to be harder for some reason. Had a huge break down over the weekend but trying to stay strong. Semper Fidelis, Mike and Colt
  16. I have a few claims in but my reconsideration is what my concern is. I call that 1-800-827-1000 number to find out what the status of my reconsideration is. A few months ago there was some confusion if I had put in for a appeal or a reconsideration. A NOD was sent to me requesting exactly what system I wanted to go with. I had the choice between a reconsideration, DRO or a traditional appeal. I choose the reconsideration. I had already notified them of that decision months ago. I just excepted the fact it did not happen even though I had already requested reconsideration and had received a letter from the VA saying they received the request. I have everything in as far as evidence and ready to have my claim reviewed. Well when I call the answer I get is that my "records are ready for review". Then I ask ready to be reviewed by who? I promise I can not get a answer to that question. Today the answer was "their handling your claim at the regional office in Columbia SC. Then I ask who is going to handle it? What is the next step, then i get the answer is "its ready to be reviewed" I can not get a answer as to who is going to review it. Its like a circle question. Can anyone tell me what may be happening. My reconsideration has been in since May 2011. I had a C&P exam for it in August 2011. My initial claim goes back to Jan 2010. I know these time frame is nothing compared to some people but my case has been cut and dry and ready for movement without any confusion or addtional informtion required. (Open, eviedence submitted, ready for review) Case closed or should I say case still open. Where and who is my claim ready to be reviewed by?
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