ptsd I Won! Woo Hoo! But I Still Have Questions.

[Quint7]

I won!!!!!!!!!!!!

Got my brown envelope today!

My appeal from a DRO hearing to raise my SC knee from 10% to 20% was approved and so was

SC for my IVDS/DDD w stenosis. The IVDS/DDD was rated at 40%.

That takes me up to 90%!!!!!!!

BUT, I still have a few questions.

I was SC @ 0% for the knee since my service. VA put me at 0% because I "failed to show" for an exam in 1994. Long story short, they screwed up, I would have shown up back then, but I won't get into that.

I was also denied for "lumbar strain" in 1994 immediately post service for the same reason, "failure to show" for a C&P.

So here are my issues:

Both ratings have re-exams listed. The back is shown as having a re-exam in April 2011 because "it is expected to improve" (I had a fusion, don't know how it will improve) and the knee says 'a exam will be shceduled to see if the knee rates a higher rating".

I had a knee C&P last friday which I'm assuming was this 'exam for a higher rating", so I think that the 20% is a lock. Since the 20% is retro'ed back to Dec. 2006 is that when the 10 year rule starts or whatever that is?

The back is dated from Feb. 2007. It approves me for IVDS/DDD with stenosis. It lists that I had a fusion but doesn't rate me for that. 2011 is a long way off but not that long.

I guess I'm wondering if I can request that these ratings be made P&T since they originated (though honestly not as severely, I would say at a max 10% for the knee and back each back then) during my one year post-service time period? Like I said, the knee looks like it might be P&T since they only wanted to increase above the 20%, but the back still has IVDS/DDD at the next level below my fusion and a spinal fusion is a separate listing under the DX codes. I know that Rentalguy and I have chatted on here that for a fusion DX rating it "looks" like you need an entire segment of the back fused (not just 2 or 3 vertebre), but we weren't sure.

My final issue is the temp. convalesant rating. They approved me for 3 months at 100%. I have been out of work post-fusion surgery for 4 months and will be out until June 22nd which would put me at 5 months and 15 days post-op. Should I fight this and request the 100% for the entire time?

Also, without pushing it too much, after my DRO hearing the service rep I had suggested that if I get the 20% for the knee that I should then fight to get the 0% from 1994-2006 changed to a 10% from 1994-2006 as the VA used the supposed "failure to appear" as the only reason for rating me 0% even though my SMR's showed that I had long term knee problems for 5 of the 6 years I was in the Marines and if it is currently 20% , it HAD to have been 10% before.

I meet with my service rep tomorrow.

So, I'm happy. I have no clue how to figure my retro out since I got the 10% for the knee, then 70% for PTSD 14 months later and the knee increase and back both fall inbetween the two claims.

For what it's worth, I have been down on Dr. Bash before for the service I got from him. The claim does list him, along with all of the other back docs but doesn't specifically list his opinions as the one that made the claim stick. As for my knee, it doesn't even mention that Dr. Bash was involved in that claim. So, was he worth it? I don't know and I will leave it at that.

I can say, without a doubt, that HadIt helped me. Period. Without this site I would be another 'casualty" in the VA's war against Vets. I wish I had known about this site when my step-dad was still alive and fighting the VA for Agent Orange issues. He might have at least been able to die in his own house instead of losing everything.

Thank you, thank you all for everything. I'm actually getting choked up as I type this because I was going down a path of destruction before I found this site.

Jason

[Berta]

WOW !!!!!!!!!!!!!!!!!!!!!!!!!!!

I feel you had two hands tied behind your back Jason-

I know your RO and I know your reps-

But it is EVIDENCE that makes claims succeed !!! This is GREAT and after you enjoy this victory for a while time to consider another possible avenue of attack if the decision is wrong as to EED etc.

[Quint7]

Thanks Berta! Yep, I was surprised too.

I just got back from meeting with my Service Rep and he agreed that they should be paying the 100% until I go back to work so he submitted it along with my back docs address so VA can get records that show June 20th as a return to work date.

He also asked about "radiculopathy"(hope I got that right! Sciatica I say). He said that since the C&P examiner stated that my sciatica is due to the SC back that they are supposed to open a claim for that as an "implied claim". He said that since the other stuff was an appeal I should expect paperwork on the sciatica issue once it works it's way through the regular claim system and if I don't get anything to start questioning why.

I also ran the EED CUE issue by him and he said it was a very interesting issue, but that I should let the 100% temp and sciatica (if it actually is started by VA on their own) issues to finish. I actually agree with him for once, but more out of me wanting to learn more about the issue, etc. before I take that on.

As I said, I am in debt to this site and the members here who have helped and the fight isn't over. I have a couple of vet friends that I am helping develop claims and of course I'm using what I learned here!

[cowgirl]

Quint Cooonnngratulations!

Saw in one of your posts here, you told the va examiner you 'wouldnt' go back to work until June. Hope that isnt used against you. Do you have a copy of your comp exams? Just cover those bases when ya can. Your rep sounds like they have their stuff together. I am glad you arent sleeping on your claim just now, keep at it while the burner is hot.

In my opinion, your Eed may or may not be a CUE. I was sc for a condition after discharge at 0%, but rated correctly later at 60%. Thanks to Hadit, much research and my rep, I put in for increase due to EED. That worked, the examination results then and now were same. So, the va backdated my increase to discharge. Hope that makes sense. Made 'cents' to me!

God Bless, '

Cg'up2009!

[Quint7]

Cowgirl, thanks for the reply.

Actually my 0% went to 20%. The only reason it was at 0% was that I "failed to appear for an exam". Otherwise I am quite sure that it would've rated 10%. I originally was thinking along the lines that "it isn't my fault the Post Office didn't deliver the mail. I have proof that I got mail 2 weeks either side of the letter that was returned to them." But Berta (I believe....) noted that in that case it isn't the VA's fault either and I lose. It was then suggested that the CUE would be in VA failing to use the evidence it DID have (my SMR's) and rate it as best it could off of those. The decision clearly states that the failure to get examined is the reason that 0% was assigned.

As for the return to work, I will check my C&P. I know that it wasn't a matter of would or won't, the Dr. flat out said that he would NOT sign a return to work slip until 6 months after the operation. My rep said that when I start phys. therapy this Monday it will help my case by showing that "I'm still in treatment for this condition", not just sitting home trying to get 100%. I worried that VA would then say they wanted a re-examination after that and he said that since my award states that I will be re-examined in April 2011 to not worry that they would immediately try to reduce me.

On convalesant 100%, I read the 38 CFR listing and it actually doesn't state that I "rate" 100%. It says that a 100% rating "may" be granted for 1,2, or 3 months and that this can be extended for another 1,2, or 3 months. Well following VA math, Jan. and June are both out since I wasn't out of work for the entire month for either, so the best I could get is 4 months which would probably be pushing it. I would be satisfied with a total of 3 months (2 more than they gave me already).

[luvHIM]

This is great news. I am glad for you. Congratulations!!

[Ricky]

Quint - What did the surgeon say about the convalesant time? VA's payment of the temp 100 percent will be based upon his determination..

They are normally made for 1,2 or 3 months - however can be extended for another 1,2 or three months - and then for 1 to 6 months beyond the first 6 months IF JUSTIFIED BY YOUR DOC!! go gettem!!!!