Living The Claim

[spike]

Listen,

I am giving a piece of advice here. I understand many veterans find something that is 'wrong' with them, but if you are 100% P&T I would advise against living the claim. Let it be. Let yourself work on your health. One of my friends have said a good metaphor about this....."It's like poking a bear with a stick"-Hadit member (formerly) Jay Johnson. Your asking for the VA to re-investigate your claims. If you are 100 % PT, don't start making all kinds of different claims right away. Think about it this way and I hate to say it this way. What if the person at the VA Claims office, just got in a fight with his wife, slept in the car, back is hurting, and your the first claim he or she gets. Think that they might not 'dig' into your C-file to see if every I is dotted and T is crossed?. I have heard of some vets, losing their ratings because they started a new claim and something in the time that they had the new C&P exam (something they said or did) in the exam triggered the Rating Officer to change their rating for one of their previous ratings. Maybe because the new doctors opinion was different. Take this with a grain of salt. If you don't believe it happens, I am sorry but it does.

[cowgirl]

Spike, nice to hear you post that. With all the paperwork research, we each are trying for compensation and health care, I do believe it can take over our time, effort and anticiping positive or negative results, thats for sure. As far as benefits are considered, I find it more satisfying to share a slow cooked pot roast meal at home versus on-demand fast food warmovered on the go. I have to set aside claim work at times to benefit from my efforts with a fresh view over time. (like this edited email!)Have a good one and don't forget, during the holidays kiddos like to make long paper chains to decorate the house! *note, Sunday comics and sale inserts ar really colorful, simply cut or rip to same length, glue, enjoy! God Bless, cg

Edited December 19, 2007 by cowgirl

[Pete53]

Many Veterans tried to narrow down the focus of our claim so that VA could work it faster. It does not mean that you should forget any valid claims that you are entitled to. Also many when lowballed by VA do not get Insurance and goes past 2 years so if they want insurance waiver they need to win a new claim a backdoor so to speak.

[recruiterrick]

the way i understand spike, he is referencing 100% P&T veterans. getting a 10% rating for GERD could result in you getting reevaluated for the 100% condition, and may indeed, cause you to lose it.

the way i understand it, is the VA medical will take care of your GERD anyways. i think the only time filing a new claim for an additional condition may be be wise is in case of a terminal disease, which if fatal may have DIC benefit entitlements.

for example, a vet is 100% P&T for PTSD. then he is diagnosed for AO exposure which has caused incurable cancer. this veteran should file a new claim because if granted, it will pay benefits to his surviving spouse and young children.

just my opinion. but i've seen people lose 100% P&T over a new claim. boy that really would suck!!!

[rentalguy1]

If something is wrong with you and it is due to something that happened in the service, and you have the nexus, then file it. If you are 100% for a musculoskelatal condition, and you take NSAID's for 10 years and develop GERD and IBS, then file for it. If you have done your part and had a few visits to your VA PCP annually, ordered and taken your meds, and everything else you are supposed to do, then you will not loose your 100%. They may try, and you will have to fight for it, but you will win, because the evidence is on your side. Suppose you did not file for GERD, and a few years later you devoloped esophogeal cancer due to the constant reflux. Within a few months you're going to be dead. You don't have time to file, fight, and win the claim at that point. Your spouse just lost out on additional benefits that she could have had because you were afraid of having another run in with the VA. Now, imagine that you did file for the GERD and IBS. You were just awarded enough to bring your schedular total up to 160%. Now you are eligible for SMC, and a whole lot more money. Your spouse can enjoy the additional benefits should you die from the SC condition, and even if they did reduce your original SC condition from 100%, chances are you'd still have a schedular rating over 100%. If not, you'd most likely get TDIU anyway.

Point is, don't be afraid of the VA. Do your part to keep up the unwritten requirements that we all know the raters look at, and you'll be fine if you file additional claims. Just don't let the claims you are working consume your life. Limit yourself to a few hours a day of working your claims and enjoy the rest of your life for the rest of the time.

[even_flow]

What if you have a change of address out of state? Will that cause them to review your file even if you don't request the file be moved or file any claims?

[even_flow]

"If you have done your part and had a few visits to your VA PCP annually, ordered and taken your meds, and everything else you are supposed to do, then you will not loose your 100%."

I don't know about that. I can tell you from experience one C and P exam may differ from another. I filed a NOD on one claim WITH NO ADDITIONAL EVIDENCE, as it was denied the first time. The second C and P examiner made a different assesment and it was service connected second time around. Seriously...I filed it thinking it would most likely get shot down. I was very surprised they service connected it. All I could figure was it was due to a particular statement the C and P examiner wrote.

If one has a bunch of ratings that are not likely to be reduced maybe filing isn't a bad idea. But if a veteran is 100 percent P and T and they want to file again...? I'd rather take my chances in Vegas.