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.

[cowgirl]

EED earlier effective date. Say, if you are sc from date of discharge then diagnosis code is updated.corrected now, it may read the same on rating charts from earliest claim date, months or year(s) back. Then eed is more likely, I think. If you are talking years, well, then you are. Keep at it within date limits and relax between submissions. Toss out questions here, you, we can learn, relearn things here at Hadit school.

cg'up2009 :D

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.

[livingrock21]

Anyone else have any input as to my questions? Or my options?

Any, and all input is greatly appreciated.

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!

[broncovet]

I will add my 2cents worth. Unless I am crazy, you can get SSD (social security disability) and TDIU, because: you were disabled and unable to work from military conditions and you were also disabled and unable to work in your civilian life. I think the confusion may be the different types of VA compensation and also social security. Please correct me but I think its like this:

VA Pension..needs based..social security is an "offset" to VA pension..if you get $500 per month social security then your VA pension will be reduced by $500.

VA disability compensation: NOT needs based, but based on level of disability. In theory, you could be 100% disabled but operate a successful busines from a wheelchair and still collect disability compensation.

VA TDIU..You have to show you are unable to obtain and maintain substantial gainfull employment. So, if you were earning 50 grand a year even if it was from a wheel chair, then you would not be eligible for TDIU, but you would be eligible for disability compensation.

SSI..needs based... other incomes, such as VA could make you ineligible

SSD (Social Security Disability) NOT needs based. You paid premiums, while you worked, and were disabled from work and are entitled to this benefit.

SS (Retirement) Sort of a blend of needs based and not needs based. You paid premiums, but SS counts as income for other things, such as VA pension, etc.

If someone can correct this, especially with a link showing otherwise, then I will admit I am wrong.

[livingrock21]

That sounds right to me.

I'm disabled(SSD), and since the disability was due to the military(service connected) I should get TDIU. I'm going to fill out that form from Berta, and soon as I find out fo sure that the SSD is comming from the three service connected conditions. Even if not, the only medical evidence they used was my SMR so that should be enough, correct? Probably not in the VA world.

Thanks for all your input. Any and all input is def. welcome.

I will add my 2cents worth. Unless I am crazy, you can get SSD (social security disability) and TDIU, because: you were disabled and unable to work from military conditions and you were also disabled and unable to work in your civilian life. I think the confusion may be the different types of VA compensation and also social security. Please correct me but I think its like this:

VA Pension..needs based..social security is an "offset" to VA pension..if you get $500 per month social security then your VA pension will be reduced by $500.

VA disability compensation: NOT needs based, but based on level of disability. In theory, you could be 100% disabled but operate a successful busines from a wheelchair and still collect disability compensation.

VA TDIU..You have to show you are unable to obtain and maintain substantial gainfull employment. So, if you were earning 50 grand a year even if it was from a wheel chair, then you would not be eligible for TDIU, but you would be eligible for disability compensation.

SSI..needs based... other incomes, such as VA could make you ineligible

SSD (Social Security Disability) NOT needs based. You paid premiums, while you worked, and were disabled from work and are entitled to this benefit.

SS (Retirement) Sort of a blend of needs based and not needs based. You paid premiums, but SS counts as income for other things, such as VA pension, etc.

If someone can correct this, especially with a link showing otherwise, then I will admit I am wrong.

[broncovet]

Living rock..Yours is a great example of how the VA system is "broken". You are between a rock and a hard place. If you continue your appeal..it could take years. On the the other hand, if you drop the appeal, you still may well not get the benefit you want quickly anyway as there is no guarntee the next RO decision, or DRO review will net you the desired benefit.

It is absolutely ridiculous that, when you appeal, the other stuff comes to a halt. That is because the VA is currently on a "one paper system", so your cfile can only be at one place at a time. It cant be at the BVA for your appeal and also at development for your new condition. That is just wrong, and, is a big, big part of these long delays. It is kind of like the VA saying that you are not allowed to have two things going on at once. If you go to the doctor, and you have a broken arm and are bleeding from the head, is he gonna say, "NOPE..I only fix broken arms. You have to go to the back of the line again for your bleeding head".

It is certainly reasonable that you could have an appeal at the BVA, for example, and, since that takes a couple years, concurrently have another condition flare up and need to apply for that benefit at the same time.

This is one reason why we need an electronic, not paper disability system. In that case, the BVA would have the record, and the development team could be working on your claim at the same time. Right now, that does not happen.

If it were me, knowing what I know, I WOULD NOT DROP THE APPEAL because there is only a small chance that asking for an increase will "bear fruit" faster than an appeal. Heck, there is even a chance that an appeal is done faster than an application for increase!

I can speak from experience. I "dropped" an appeal, thinking it was holding up a claim for benefits. Big mistake. I got denied, and then, guess what, the VA used me dropping an appeal against me. I wont do it again. The reason I consider it was because I naievely thought they would grant me benefits quickly. Wrong. The VA will fight you tooth and nail for every dime, almost every single time. JMHO

[broncovet]

You got that right...about the VA having their own "world". even its own numbering system. Just one example, which "stiffs" Veterans:

100% married disabled Veteran gets $2823 per month. So, a 50% married Veteran should get

$1411 per month right? Wrong. You have to apply the VA fuzzy math, and TAKE AWAY $566 dollars a month and pay the 50% disabled Vet only $845 per month or 29.9%.

50% does not equal "half" with the VA, it equals 29.9%. Is it any wonder why VETS are angry?

If you and I were 50/50 business partners and I gave you "half" of $2800 profit

of $800, you probably would punch me and get your other $600 bucks.

Edited January 23, 2009 by broncovet