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Found 3 results

  1. Hey All, This is posted just as information and to put a clock on the claim since the AMA process that started Feb 19, 2019. I don't believe AMA will affect this claim. I am also posting this so when I do get a decision I can come back here and review my thinking and rationalizations that I will list below. sorry it is so long. As a note anyone with an ED award secondary to PTSD, and who has any type of leaking, might consider a claim for Voiding Dysfunction or other related Genitourinary problem. I filed this claim today, May 8, 2019. This claim is a Secondary Claim suggested by an existing SC award for PTSD. In a 2018 Award for SMC (K), ED secondary to ptsd, I was notified of another potential claim for Voiding Dysfunction. I filed an Intent to File in 2018. This was all under the Legacy system, not RAMP. Things I don't know about Claims processing since AMA went into effect: 1) I don't know how this claim will process since AMA seems to deal mainly with Appeals instead of a new claim filing or secondary claim filing. 2) I don't know if this will go into the national queue or be done directly by my local RO, which is Seattle. 3) I don't know for sure how the VA will view this claim, meaning will I need a C&P, since they suggested the claim and I submitted a very detailed Statement in Support of Claim form vba-21-4138-are. I know that some consider this the most useless form in the VA library, but since I want to test the process in their suggested way I will use this form. I used the DBQ criteria and Rating criteria to write the factual information for the claim. I was truthful and exact as possible. 4) To upload that vba-21-4138-are, I had to select Buddy/Lay statement as the type of document. 5) I uploaded the Award letter that contained the recommendation to file for Voiding Dysfunction. 6) Voiding Dysfunction did not exist in the category of Secondary claim I had to select from so I chose genitourinary as that is the broadest related category they showed me related to this condition and the ratings table for genitourinary contains Voiding dysfunction ratings. ------ I am going to guess, and this is probably really just wishful thinking, that this will be a rocket docket process for this claim. I think that because I am already SC for a known related condition that this is claimed secondary too. The VA has lots of medical literature connecting the two. I think since they suggested it as part of their Duty to Assist/Notify, that will ease the processing/decision time I think giving a detailed State. in Sup. of Claim (vba-21-4138-are) using the information from the Rating Table and DBQ, they may not even need a C&P. This is because in my case, my Primary Care Doc has ordered appropriate pads for me. I have a diagnosis of BPH. I am awarded SMC (K) for ED as a secondary, and I am 100% SC for PTSD. I explicitly stated pad usage, urinary frequency for day and night times and the effect it has on my life. All of which are part of the Rating Table and DBQ. I think I will get rated at the max, 60% but there is a path that puts it as SMC (K) and I think (but am not sure) that we can get multiple SMC (K) awards but I don't know if they will just 0% it and award SMC (K) or rate it at 20, 40 or 60 and award SMC (K) or bump me to SMC (S) which I have found is met with a single 100% coupled to a 60% rating (even combined I believe). Either way, if an award is granted I end up with more money each month. The third rating outcome would be 0% SC without SMC (K) or (s) and that would be depressing. ------------ I am also wondering if @Tbird will consider creating a user-contributed database of Secondary Conditions Connections. It could be a very helpful resource and would be a unique resource for Veterans trying to figure out what their conditions might extend too if the medical facts concur. The SEO value would be huge if done right. Veterans are searching the internet for SC conditions every single day by the thousands. I don't now who hosts Hadit, but they should have a free SQL database engine and interface available and the design is literally the most basic. For example the user Selects from a list, I am Rated X%, then selects for Y condition from another list, and Secondary to that I am rated Z. This last could be a combo of user input and list. The ability to input could easily be condition on membership, free or paid or allow both. Indexing the Y condition would allow displaying the listed secondaries reported by the users and even could say when they were input into the datebase to give a time reference. Indexing the Secondaries would display possible primary conditions to associate to. The search could be that the user selects " I am primary for Y what are possible secondaries." The other search is "I have Z what is it secondary too." Only two public searches (queries) needed. 3 basic public tables (4 of date included in database is shown). Output would be a simple HTML list. If anyone else thinks that DB would be helpful please chime in. I will update this as I find things out. That advent of the AMA and cancellation of RAMP changes things in ways we just don't know yet.
  2. Okay so my C-file arrived, and did so amazingly fast. Less than two months, not bad time. Going through all the files and sorting them but one of the first things I need to get together is the claim on OSA. I know the rules have changed about OSA ratings and now the med file must have a doctors saying specifically OSA is a medical condition From the MR21-1MR “When determining whether the 50-percent criteria are met, the key consideration is whether use of a qualifying breathing assistance device is required by the severity of the sleep apnea.” “Use absent a medical determination that the device is necessary does not qualify. The regulation requires that the device be necessary and this is a medical question.” So here is my situation. On 07/07/2013 I had my initial PTSD C&P which noted serious sleep problems, chronic fatigue, hypersomulance but it did NOT mention the SLEEP STUDY diagnosis given on 4/13/13 At that time the simple issuance of a CPAP was considered sufficient to getting a 50% rating for OSA, but as the change listed above notes that is not the case now. I have already filed a claim for OSA secondary to my PTSD. I did this before my Review C&P for PTSD exam, which resulted in getting bumped to 100% PTSD P&T. With the change in MR21, I suspect they may disapprove the OSA claim. If they do, would my path be to file a CUE because the record showed the apnea existed and a cpap was issued when they rated me for PTSD. The retro pay would be awesome! That would seem to be an error on their part and under the old standard I would have gotten a 50% rating for OSA as well as my 70% for PTSD and 10% for Tinnitus. The 70+50+10 calculation is 87 which rounds up to 90 for pay purposes and getting that retro 20% difference for 60+ months would be a nice holiday or new years present to me In the alternative, would I submit a NOD with the same information? or would I have to get a DOC to say that the CPA was medically necessary and would that mean I needed another Sleep Study? Thanks in advance. I am just trying to get things ready for whenever they make a determination on the existing claim.
  3. I just recently was told by my provider that I have fibromyalgia with the onset caused by my PTSD. Can I file for that as secondary to my PTSD? Has anyone had any expierence in filing for fibromyalgia secondary to PTSD? Any help would be greatly appreciated.
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