hypertension Recieved Tdiu Decision, Need Adice On Appealing

[dav_marine72]

Hi Everyone,

Finally received my award letter yesterday. Here is what they decided:

A temporary evaluation of 100% was assigned effective month day, 2009 based on surgical or other treatment necessitating convalescence. A 40% evaluation is assigned from 3 months after surgery.

Entitlement to special monthly compensation based on housebound criteria being met is granted during the 3-month convalescent leave period.

Entitlement to individual unemployability is granted effective month date, 2009. This was the date I received the letter from the company I worked at stating since I could not return to work I was fired.

There were some other increases that they denied for but I want to focus on the back and TDIU. I know what I need to do with those.

Now mind the decision summary given to my SO was a little different. He had stated it said I was entitled to continue receiving SMC and my total monthly payout would be $3700 a month for the convalescent leave based on housebound and regular aid and attendance and then $3400 a month moving forward with some sort of SMC.

He also said I was awarded P&T. He said there was a statement to the accord that my wife couldn't work based on the fact that she had to stay home and take care of our children who aren't in school yet and myself. Now they did include language under the TDIU award reasons that says "You experience episodes of your back locking up which requires your wife to stay home from work in order to care for you."

Now let's go back to the temp 100% with SMC. They based this on my back being 100% and having mental (50%) and asthma (30%). They also state my surgeon ordered a 3 month convalescent leave period. This was flat out lie. My surgeon from the get go gave me a form that stated I was to be on no duty for six months after the surgery. This would only be important if I can't get SMC moving forward. If that's the case the VA should have put me on 100% back and SMC for six months and not three. It may seem trivial based on TDIU but it's about $900 to me. Right now waiting to go to the SS judge in 11 months, $900 is $900.

Now on to TDIU. No verbiage on P&T. The award was based on my back (50%) and mental (50%) combined mostly it sounds. Although I have sc asthma (30%), sc lower extremity weakness (10%), sc right foot injury (10%), sc left foot injury (0%), sc chronic right testicle pain (0%), hypertension (0%), and eczema (0%).

Mind you above my back (20%), chronic testicle pain (0%), left (0%) and right feet (10%) conditions were at the BVA in which they were all denied higher ratings and they awarded lower extremity weakness (10%) based on the neurological aspect of my back. The BVA's decision was just thrown out at the U.S. court and we will be going back to the BVA on remands.

My asthma, hypertension, eczema, entitlement to service connection of GERD 2nd to all the pills I take for sc aliments and entitlement to service connection for erectile dysfunction 2nd to my spine condition are all on appeal at the RO.

I'm 80% by the schedule and will likely get 100% on the schedule with 1-2 years. So that will be my 2nd 100% counting TDIU. I need P&T because I need to carry insurance for my family. I can't watch the kids and my wife going to work doesn't make sense because the daycare would cost more. I am paying for cobra now and since the economy took a dive my monthly payment is only $350. However, come February it will jump to $1100 a month. My wife and kids also deserve the education benefits based on having to deal with the VA and me.

Game plan:

I know I need to ask for P&T from the RO. What can I do increase the likelihood I get it? I am 37 and my back condition has been severe since 1997 so we are going on 13 years. I have had two failed surgeries including (L3-L4, L4-L5 discectomies and laminectomies, 2000) the latest (L3-S1 fusion with cages, rods, and screws, 2009). The surgeon thinks I will not get any pain relief from the surgery or I would have felt it already now that I am six months + post-op. He is recommending a spinal stimulator that I am not too keen on, giving my history with back surgeries. I have failed water PT, failed a spinal stimulator trail, failed nerve blocks, failed facet joint injections, had an exam done that showed unsymmetrical muscle groups in my lower extremities to include atrophy and muscle wasting from my sc L3-S1 condition, I have been prescribed a cane, I can’t sit for more than 5-10 minutes without getting nauseous and wanting to throw up, I can’t stand for more than 15 minutes, I can only walk so far, I can’t help out around the house at all, I can’t hold my kids or help with them, I can’t get dressed by myself most of the time, I’m on 3 Oxycontin 40mg and 3 roxicodone 30mg per day for my pain and they don’t work well.

So what can I do to help get P&T? Am I missing anything here I should be getting, SMC, etc.? I would think I would meet the need for regular aid and attendance based on the fact that my wife has to take care of me. Some of the tasks they describe I can do myself sometimes but the reg states that to get it you don’t have to need someone to do all the daily tasks for you.

[john999]

I have had good luck with DRO process. I believe that the DRO's want to settle claims. If they simply pass on denied claims to the BVA what is the purpose of their job? I am sure being a DRO is a better job than being a claims examiner doing five or six claims a day with no contact with the veterans.

[dav_marine72]

Update!!!!!!!!!!!!!!!!!!!

Sorry I kept this thread going.

I was temp from March to July with SMC based on a sc at 100% and another at 50% and another at 30%.

I got TDIU from May 2009 - on

I was missing a page from my award letter. They did gibve me P&T with chapt 35 and ChampVA. The SO had it on his. I called the 800 number and they said yes you are 100% P&T.

[Testvet]

Update!!!!!!!!!!!!!!!!!!!

Sorry I kept this thread going.

I was temp from March to July with SMC based on a sc at 100% and another at 50% and another at 30%.

I got TDIU from May 2009 - on

I was missing a page from my award letter. They did gibve me P&T with chapt 35 and ChampVA. The SO had it on his. I called the 800 number and they said yes you are 100% P&T.

Congrats did they say why they ended the SMC S award? or was that just for the temporary rating?

[dav_marine72]

Well here is the thing. They said it was just for the temp 100%. Then they put a statement in my TDIU reasons as my wife can't work and needs to stay home to take care of me...............So we are filing for A&A....................................

They also denied erectile dysfunction from my back and Zoloft. I let my guard down and didn't get a nexus for that. So off to get a nexus letter. Even the examiner put in her exam that I haven't been able to have sex since late 2006............."is this retrograde?".........................

Then of course they said it was subjective and no doctors had given me a nexus. Of course they know that it's quite typical from a severe back issue with neurological damage (not to mention I am 0% for right testicle pain with torsion) that sex just doesn't happen anymore. Then you have Zoloft which I take the max daily is known to cause ED and or erections without climax. Either one takes my sex wife away. I'll keep playing though because it's $89 a month!

[dav_marine72]

LOL did I say wife or life? Same thing right LOL.

[Testvet]

LOL did I say wife or life? Same thing right LOL.

I don't know my ex kind of liked it when I was on zoloft about ten years ago she could go for hours kinds of reminds me of that commercial if after 4 hours call your doctor heck why call everyone you know why call a doctor rofl just call me the enegizer bunny back then now my heart won't play that game no more lol