Still Loosing It, Help Please.

[livingrock21]

Hello To All Again,

I haven't posted here for a while! I'm still in the same boat and on my last appeal. Here is a link from my original post http://www.hadit.com/forums/index.php?showtopic=15124&hl= .

A little background. I got medically retired from the Navy August of 07. Filed my BDD claim July of 07. Got my findings in Nov. of 07. When I got my findings I immediately saw an error on the VA's part. They rated me per a condition that I didn't have, nor was it even really related. They had me rated under "Paralysis of the median nerve" (unsure of the VASRD code, believe it was 8517). I should have been rated under Erythromelalgia, diagnostic code 7119.

I've been appealing this since. I'm on my third and final appeal and am very discouraged. At one point I thought I was going to recieve help from a VFW Service Officer. He said he would take my claim to the STAR Review, and it would be fixed there. Seemed as though he was going to be very helpful, only to have him come back and say they were no help.

On my last Statement of the case, they agreed they made an error rating me under paralysis of the median nerve and agreed to rate me under erythromelalgia, but didn't change my percentage as they should have.

_____________________________________________________________________

Here's an excerpt from the VASRD on this particular condition (this pertains to my questions:

7119 Erythromelalgia:

Characteristic attacks that occur more than once a day, last an average

of more than two hours each, respond poorly to treatment, and that

restrict most routine daily activities.................................................................. 100

Characteristic attacks that occur more than once a day, last an average of

more than two hours each, and respond poorly to treatment, but that

do not restrict most routine daily activities........................................................ 60

Characteristic attacks that occur daily or more often but that respond to

treatment.......................................................................

...................................... 30

Characteristic attacks that occur less than daily but at least three times

a week and that respond to treatment................................................................ 10

Note: For purposes of this section, a characteristic attack of erythromelalgia consists of burning pain in the hands, feet, or both, usually bilateral and symmetrical, with increased skin temperature and redness, occurring at warm ambient temperatures. These evaluations are for the disease as a whole, regardless of the number of extremities involved.

________________________________________________________________________________

_______________

My questions:

Is there anything else I could be doing? I'm so scared their going to come back and say everythings fine and deny my appeal to correct the percentage.

I have a letter from my active duty dr, in my medical record, stating that the attacks occur daily. They last more than two hours, and do not respond to treatment. So how could they have me rated at 30%?

Also, while in the appeals process, I have been granted Social Security Disability due to this condition. If you look at the rating criteria, the diference in 60% and 100% is the ability to perform daily activities. I can't do the most daily activity, work. Should I submit evidence as to the fact that SSD found me disabled? I called today and my appeal is in the DRO's hands. I was told it's been there for atleast the past 5 months.

This is off topic with the VA claims processing, but.... I don't get SSI because they include my VA compensation. I'm rated at 40%. Are they allowed to use this as income? I've seen people on here that are 100%, getting SSD and SSI. What am I doing wrong? I'm only at 40% and can only get SSD?

Thanks for your help in advance. Hopefully someone can point me in the right direction.

[Berta]

If the rep's idea for a STAR review would work- then I think we would all have reps requesting Stars Reviews.

If he wants to go this way- great-maybe he is right -BUT

"I would have thought as soon as I mentioned getting SSD a bell would have went off in his head if I was elligible for TDIU"

Me too!!!!- I was at the local VAMC one day waiting to see a vet rep I knew for some time as I was going to send a vet's widow to him for help-

as I waited I could not help hear the vet in his office talking about hoping his rating for PTSD would go up due to his appeal that the rep helped with-then I heard him tell this rep that he just got SSA award for PTSD (Vietnam Vet) and the rep said "interesting" and nothing else.I was shocked that the rep never told him to apply for TDIU-I managed to catch the vet a little while later in the VA parking lot and told him to send in a TDIU form.

Maybe I was too tough on what I said about your rep-but it is that bell that should have rang- just as you said-

The earliest effective date for TDIU is the date the VA receives that TDIU form- VA can certainly make a TDIU award-as they did for my husband- using the most favoprable date- but only one year prior to receipt of the TDIU claim.

I think TDIU claim forms should be filed YESTERDAY-meaning ASAP to protect th date of the EED if the TDIU is awarded.

But the SSA award must be solely for the same SC claimed condition.

Many SSA awards consider multiple conditions that determine total disability-

maybe he just wants to be sure of the award before he considers the TDIU.

[livingrock21]

Berta,

The SSD has to be from service connected disabilities. I believe it's primarly for the erythromelalgia, but may also be partly from my hypertension and tachycardia also (all three service connected). Irreguardless, the only medical evidence SSA had to make their determination was my Service Medical Record. They didn't even examine me, just granted it. They could have also requested info from the VAMC and VA out patient clinic I see, but it's all service connected.

I want to see what SSA specifically has it for though. To do that, I have to go into my local office and get a letter from them stating what they have me listed as.

The only thing I'm worried about, and as far as I'm concerned shouldn't be the case. Like an idiot, there are a lot more things I can claim in my SMR. I know when I filled out my application for SSA I only put those three things, but they could have thumbed through and listed alot of other conditions in my medical record, that I haven't claimed yet. I still plan on it(claiming all the other stuff in my medical record). Like I said, I was dumb and naive when I filed originally filed my claim. I had a DAV rep thumb through my medical record and said what I should and shouldn't claim.

Like I said, I'm pretty confident it would go in my favor, as the VA would be able to see that the only evidence SSA used was my service medical records.

Opinions?

Also, about the STAR review. I may not go this route for a few reasons. Most of yun'z(pittsburgh talk for y'all) think it isn't worth it. I haven't heard any positives about it. I also can't really find any info about it on here, so more likely than not it isn't going to work. It sounded good when my VSO told me about it, he made it sound like a VA quality and assurance program that can decide a claim on the spot if it verifies there is a clear error. He made it sound like it wouldn't take long.

Any opinions as to if I can claim TDIU while this appeal is in process? Would I have to withdraw my appeal?

Thanks again, you guys really are great!

If the rep's idea for a STAR review would work- then I think we would all have reps requesting Stars Reviews.

If he wants to go this way- great-maybe he is right -BUT

"I would have thought as soon as I mentioned getting SSD a bell would have went off in his head if I was elligible for TDIU"

Me too!!!!- I was at the local VAMC one day waiting to see a vet rep I knew for some time as I was going to send a vet's widow to him for help-

as I waited I could not help hear the vet in his office talking about hoping his rating for PTSD would go up due to his appeal that the rep helped with-then I heard him tell this rep that he just got SSA award for PTSD (Vietnam Vet) and the rep said "interesting" and nothing else.I was shocked that the rep never told him to apply for TDIU-I managed to catch the vet a little while later in the VA parking lot and told him to send in a TDIU form.

Maybe I was too tough on what I said about your rep-but it is that bell that should have rang- just as you said-

The earliest effective date for TDIU is the date the VA receives that TDIU form- VA can certainly make a TDIU award-as they did for my husband- using the most favoprable date- but only one year prior to receipt of the TDIU claim.

I think TDIU claim forms should be filed YESTERDAY-meaning ASAP to protect th date of the EED if the TDIU is awarded.

But the SSA award must be solely for the same SC claimed condition.

Many SSA awards consider multiple conditions that determine total disability-

maybe he just wants to be sure of the award before he considers the TDIU.

[cowgirl]

Hello Living, do you have current copy of your Cfiles? I havent looked at your other posts, but learned so much when I got mine. Think copy of form 9 should be right there. HOWEVER if your claim is active and you do not have a copy; this isnt a good time to request a copy.

Next, I have only been here a few years, am not medically trained, just an ole vet trying to get whats due also. Thats my cya.

My thoughts, A claim for increase with eed well supported. You should be offered Iu.

I dont knw about Star, you seem proactive, yes ask the vso for help but recall, you are the one needs to get the claim in or worked on. You can get the information, the vso guides.

Best to ya,

Cg'up2009

Edited January 23, 2009 by cowgirl

[livingrock21]

Also, what is the P&T of 100% P&T? Would I be eligible? Is it more than just 100%? lol.. I'm learning, but am also very much still new to the proccess(only been in it for a little over a year and a half).

Thank you.

[cowgirl]

total disability individual unemployment = tdiu (total&perm is the top slot with best benefits) see Hadit acronyms/abbreviations for help too!

gd'luck,

Cg'up2009

Also, what is the P&T of 100% P&T? Would I be eligible? Is it more than just 100%? lol.. I'm learning, but am also very much still new to the proccess(only been in it for a little over a year and a half).

Thank you.

[livingrock21]

Hello Living, do you have current copy of your Cfiles? I havent looked at your other posts, but learned so much when I got mine. Think copy of form 9 should be right there. HOWEVER if your claim is active and you do not have a copy; this isnt a good time to request a copy.

Next, I have only been here a few years, am not medically trained, just an ole vet trying to get whats due also. Thats my cya.

My thoughts, A claim for increase with eed well supported. You should be offered Iu.

I dont knw about Star, you seem proactive, yes ask the vso for help but recall, you are the one needs to get the claim in or worked on. You can get the information, the vso guides.

Best to ya,

Cg'up2009

No, I don't have a copy of my C-file.

Also, I understand what every one is saying that it may be better to withdraw the appeal, and file claim for increase. Then try to get the date pushed back to original claim date due to errors. What is the EED everyone keeps talking about, is that like a CUE? If i were to go this route, I think that's how I would do it. Request the VA CUE them selves for the effectiveness date. lol. I think I maybe have just answered my question. The EED has something to do with the Effective date?

I really am trying to learn and understand. Thank you all for being there for me, and helping me through this! I've said it once or twice already, but you guys really are awesome.