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Please - Need Advice On Filed Claim

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tom91

Question

I'll try to keep this as brief as possible but I'm looking for any advice out there on how my claim will likely be handled.

I was medically discharged in 91 with 20% - 10% right knee and 10% back (herniated disc). In my SMR's there is further notation of medical care for my left knee and hearing test (for which I requested) that states 'soldier demonstrates hearing loss and needs further evaluation'. Neither hearing nor left knee was approved for disability at time of discharge. I filed a new claim to add the hearing and left knee in 2003, with requests to increase the back and right knee due to my conditions progressing. I was denied and without proper guidance, did not file an appeal. I have resubmitted my claim in March of this year and based upon follow up last week, was informed it had gone through the rating board and was approved. During the follow up stages, I received comments that made me even more curious of the outcome --Initially, I contacted the 1-800 # and the rep informed me that the rating board was finished and it had been sent for approval, indicated 'yours will have to be looked at closely' -- not sure what she was trying to say. At that time, I contacted my rep at the regional office who confirmed it was up for approval but he could not see the file but was informed it was 'promising'. This previous Friday is when I confirmed with the 1-800# that approval had been completed earlier in the day but the computer was not updated yet with the details. He went on to inform me that back pay is quick if you are on direct deposit (which I am). I feel it sounds promising but some of you may have experienced this before without a good outcome. Advice?

Background - I included lengthy documentation from my SMR and reports from my personal physicians. For my back, the MRI states multilevel spondylosis with degenerativ disc disease. Based upon various responses on your site, it sounds like they will sustain my 10% rating with no further increase. However, wouldn't spondylosis (arthritis of spine) be a result of the prior injury (heniated disc that was combat related) and be considered for a secondary rating?

My hearing tests both recently and in my SMR reflect tinnitus and hearing loss. Would they not owe me back to 1991? Someone at the 1-800 # indicated it would only go back to my claim in March of this year (if approved) as I did not appeal it in 1991 or 2003. My thought is there was an error on the Army's part. Would that be a CUE?

Same for my left knee? CUE?

Further records show osteoarthritis and cartilage wear in both my left and right knee. How would that be considered? And, do they give you a rating for each knee or combined?

Although I did not claim either, I have been diagnosed as type II diabetic and bipolar. I made reference to the fact I cannot exercise which does not aid in losing weight and improving my diabetes. Should I have claimed it as a secondary condition?

Sorry to be so lengthy but want to be prepared in advance of the outcome. I'm certainly ready this time to fight if necessary.

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Thanks so much Berta for the input, I was hoping you would pick this one up.

The tinnitus and hearing loss was denied in 1991 and 2003. Would they not have to go back to 1991? Would the VA recognize this and maybe go ahead with backpay? The dialogue between me and their offices does seem favorable in some way....could just be ratings though or bs for me to go on. No not unless a CUE exists - depends on why it was denied. If your hearing did not meet the requirement for a rating then it just did not meet the requirements. Once can have considerable hearing loss and it still not meet the requirements for a rating.

This is going to sound really ignorant on my part, but what exactly do we mean by bilateral rating for my knees? My assumption would be seperate ratingx...? If both knees are rated then it is a bilateral rating (bi meaning two). Each knee would be rated then a bilateral rating also applied.

No I was not in Vietnam and I will definately seek a claim for my diabetes. Initially I thought I would go ahead and include it but was concerned they would think I was being overly aggressive which could hurt my case. Any chance the VA may go ahead and recognize this without the need of a another claim? They have been treating me for this at least 2-3 years. No, no no. they will only process what you file a claim for. they follow the law which says if you want it then you have to claim it and prove it (this is a basic definition)

My bipolar was diagnosed in 1998. For anyone out there with bipolar knowledge, it is a disorder that is apparent from childhood up but goes undiagnosed -- often never diagnosed. There is nothing recorded in my records but I did seek medical care at one point for my temper and depression. I was told 'just divorce your wife and everything will be okay'. Unfortunately, I was not able to locate anything in my SMR to substantiate my visit on this topic. the diagnosis was made many years after your discharge. Since there is nothing in your SMR's you will need an IMO from a doctor which provides a nexus to your service backed by a very good rational. Do a search for IMO's and you will find some very good examples. This will be a hard claim to win.

Yes, I'm currently working and actually want to continue as long as possible. That's not to say it hasn't been difficult at times. At the very minimum, I hope to get a rating of 50% as this would cover my extensive co-pays. 100% employable would be wonderful but I don't think likely. I hope you can work for a long time also. While you are working a 100 percent rating based upon unemployability is impossible Hope you do not think I am to negative but some of your issues (posted here) will travel up a very steep hill! good luck

Thanks again Berta!

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