Award Letter Need Help

[javlin90]

I rec'd my award letter today, Va said I couldn't have rec'd it yet. Well bottom line I have it in my hand. I was hoping to get an answer here since the Va can't answer my question. Hope you folks can help

Retired 26yrs/ Air force/ 31 Aug 2005

My question is this :

1. Service connection for asthma is granted with an evaluation of 100 percent effective 1 Sep 2005

2. Cervical spine fusion 20% c-3 c-4

3. removal of knee cartiliage 10%

Under #1 for asthma it states since their is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review examination. What does this mean?

Also award amounts?

total award amt withheld monthly entitlement payment start date reason for change

2299 2299 0.00 oct 1, 2005

serv. connec bene. retired pay adjustment begins

2393 2393 0.00 dec 1 , 2005

legislation increase/ret pay adj continues

2393 0.00 2393 mar 1, 2006

retirement pay adjustment complete

Can someone explain this mess to me. I would greatly appreciate it

[Guest jstacy]

Under #1 for asthma it states since their is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review examination. What does this mean?

The RO feels your condition may improve. The Permenent and total rating is not assigned. They reserve the right to later examine you and if there is improvement, Then they will try to reduce the 100 percent.

I would Send a Notice of disagreement with that one. Appeal if needed.

The VA adjusted your comp as offsetting to your retirement pay. Check the effective dates closely.

[Guest Morgan]

I agree. I would submit your NOD (notice of disagreement)on the asthma rating and appeal if not settled at the VARO (VA Regional Office). Try to get your doctor to give you a statement that the asthma is unlikely to improve, and I think you will have a good chance of getting P&T (permanent and total). VA slips these things in, thinking the veteran will go away happy with what he or she gets. I, for one, think it is absolutely unconscionable that disabled retirees don't get full retirement pay and disability pay. Simply put, you earned one and "paid" for the other; both should be yours without question.

Another point about the exams: disabilities subject to periodic exacerbations are to be examined during flare ups. Insist on that if reexams become an issue.

Here's an excerpt from the M21-1 Adjudication Procedure Manual. I find this peculiar, though, because I understand the regs to say elsewhere that after a condition has been rated 5 years, it is not to be reduced lower than it has been rated (outside of finding fraud). If I'm understanding that correctly, it's reasonable to anticipate that veterans' diaries are marked for examination no later than 4 years and 300 days after the original rating.

(Sorry about any weird formatting or smilies that show up randomly. I'm having problems with this board doing that to my posts. I hope you don't have a problem reading past them.)

SUBCHAPTER III. REVIEW EXAMINATIONS

1.11 SCHEDULING REVIEW EXAMINATIONS

Base the dates of review examinations on the facts and circumstances

in each case; however, schedule the examination as far in the future as

possible, preferably five years from the date of the last (or initial) VA

examination. Consider whether the veteran's current condition is an acute

exacerbation or whether the veteran is still recuperating following

hospitalization. Consider whether improvement or recovery can be anticipated.

If not, do not schedule a future review examination. Medical evidence from any of the sources listed in 38 CFR 3.326© may satisfy the need for reexamination.

a. Compensation Cases. Exercise prudent judgment and refer to 38

CFR 3.327(:) in determining the need for reexamination. For information on

scheduling review examinations following periods of convalescence, see chapter

10.

b. Pension Cases. Do not routinely request reexamination in

disability pension cases. If a reexamination is scheduled, fully explain the

reason for reexamination in the reasons and bases section of the rating

decision. See 38 CFR 3.327c.

c. Disabilities Subject to Periodic Exacerbation and Improvement.

See subpar. 1.01d.

1.12 RESCHEDULING REVIEW EXAMINATIONS

If the date of a currently-scheduled review examination is less than

five years from the date of the last (or initial) VA examination, consider

rescheduling the examination when the diary expires. Annotate VA Form 21-2507

and the rating decision that the examination is being rescheduled for a future date, and refer the case to authorization activity to have the old diary

canceled and the new one established.

1.13 CANCELING UNNECESSARY REVIEW EXAMINATIONS

a. General. Do not request an examination solely to confirm evidence listed in 38 CFR 3.326© that is otherwise adequate for rating. The criteria for requesting a reexamination are contained in 38 CFR 3.327(B) and ©. If it is determined that a future examination is to be canceled, a rating specialist must annotate VA Form 21-2507a to this effect and sign and date this form.

b. Total Disability Rating. Take the following action if the veteran is receiving total compensation, either by reason of a 100 percent schedular evaluation or by entitlement to individual unemployability, and it is determined that a future examination should be canceled:

(1) Prepare a rating under paragraph 4.14d if there are eligible or

potentially eligible claimants for Dependents' Educational Assistance (DEA).

Action will then be taken to provide notice of potential entitlement to DEA

under part IV, paragraph 14.09.

If there are no eligible or potentially eligible claimants for

DEA, annotate VA Form 21-2507a that the examination is canceled. Sign and date the annotation.

Edited March 7, 2006 by Morgan