Is It Me Or Is This Nuts.

[hedgey]

A letter telling me to come in for a C & P to see if my condition of my original SC problem has improved.

So let me get this straight. I got rated SC in 1984 for chronic metatarsal pain in my left foot. Every couple of years I'd get called in for a review C & P - once they reduced it to 0% but I appealed and got the 10% reinstated. My last condition status evaluation was in 1993.

I've been favoring my left foot for 20+ years, and over the past few have developed problems with my right foot and knee. I finally filed a claim last spring, asking for increase & right foot & knee as secondaries. Got my C&P last month.

So now they're going to evaluate the condition I was rated for over 25 years ago? Why don't the twits just look at the report from the C&P last month?

I don't get it.

B)

[Vync]

From what I read on this board:

SC status = protected after 10 years

SC percent = protected after 20 years

When they reduced your rating to 0%, and your appeal reinstated it, did they give you any retro pay to cover the time you were wrongly reduced to 0%? If so, then it looks like the 20 year rule should apply. Based on that logic, I would assume that the only possible change here would be a potential increase.

I did not know they could request a C&P out of the blue, unless you request one first. I'm still kind of new here...

Also, to me, it sounds like a pretty stupid idea for the VA to be allocating resources to go back and re-evaluate people when they have such a large number of outstanding claims.

Some of the elders here probably have more to say about your situation.

[broncovet]

If the VA is trying to reduce this rating, they are going to have to prove fraud, imho, because not even "material improvement" 26 years later would not make the reduction fly.

There is a remote possibility that your C and P exam results in an INCREASE. The other possibility is they are hoping you wont show for the C and P, and in that case they may try to reduce your ratings.

If the VA is proposing a rating reduction, they have to give you 60 days notice, and a chance to appeal. Is it possible this C and P exam is for something else?

[carlie]

From what I read on this board:

SC status = protected after 10 years

SC percent = protected after 20 years

Vync,

For clarification.

SC status = protected from being severed after 10 years

but NOT PROTECTED from being reduced.

SC percent = protected from being severed and/or reduced after 20 years.

10/20 Year Service Connection/Ratings Protection

The 10 year mark for is for service connection.

A condition that has been service connected for 10 years can not be severed unless fraud is involved. The clock starts ticking for conditions based on the effective date(s). This does not mean compensation can't be reduced.

The 20 year mark protects ratings.

Absent fraud, disability ratings can not be reduced after they have been going 20 years. See your award letter for effective dates on each disability. Combined ratings are also protected after a 20 year period.

Example: You have been rated 50% for Condition A since 1990. You apply for SC for 4 more conditions and VA grants them in 2007. Because of VA granting them your new combined rating is 100% as of 2007. Condition A is protected from severance in the year 2000 and protected from reduction in the year 2010. The new service connected conditions would be protected from severance in 2017 and reduction in 2027. The clock started ticking on your combined 100% in the year 2007 so it would be protected from reduction in the year 2027.

If you apply for an increase for Condition A and are bumped from 50% to 70%, the 50% number is still protected from 1990 but the new 70% would start a new clock ticking (using the dates above). Meaning until you have held that 70% rating for 20 years, the lowest they can reduce you is back to 50% based on the fact that it was in effect for 20 years.

Even if a rater plugged the wrong numbers and wrongly awarded a combined 100%, they still can't reduce. Again, this is all assuming no fraud is involved. You can do the math by using the effective dates on your award letters.

"P&T" can be established at any time regardless of how long ratings have been held (via 100% scheduler or TDIU). If VA plugs all of your conditions and there are no future exams scheduled, then entitlement to Ch. 35 and ChampVA will be granted. If VA determines that there is a chance of improvement, there will be a future exam scheduled and "P&T" will not be established.

[hedgey]

Bronco, I got retro pay, and according to the VA evaluator who did my C&P last month, my file says I've "been SC 10% since 1984". So I think I'm safe on the 20 year thing.

If it was just the VA saying, "hey, there's a vet who's been getting 10% comp for 25 years and we haven't evaluated her since 1993! Let's take a look and see if we can drop her!" I wouldn't really think it was too weird.

What's weird is that I had a Comp & Pen evaluation last month because I'd filed a claim for an increase on my left foot and to add the problems I'm having in my right foot & knee as secondary conditions. I had a C&P evaluation for the same left foot that this new C&P evaluation is for less than a month ago!

I called down to the VAMC just now to ask why they're doing another evaluation. She said the new appt is a Review, because I'm not flagged as P&T. I asked her why they couldn't just use the report from the C&P last month, and she said it's not the same thing.

So.... I guess I have to haul my gimpy self down the 100 miles to the VAMC, and be examined by a NP who will have more authority than my VA podiatrist, and see what happens.

It's not me, this is nuts.

[john999]

If you are smart and can afford it get yourself a private podiatrist who can write you a medical opinion if needs be. You don't want to depend on the VA for disability ratings. I know it is expensive for those without insurance, but I never would have gotten a decent rating just using the VA.

[hedgey]

Thanks for the recommendation, John. I've got the name of a private Podiatrist in front of me and will be making an appointment today.

I was upset about this at first, but I've decided to take it as an opportunity. The C & P examiner I saw last month noted that I can walk 1/4 mile without trouble... I think she really wasn't listening. I'll make an absolute point about clearing that up. Plus, I'll be ready for the questions. I wasn't expecting the question about side effects from the medication, and my poor mind went completely blank. I'm taking gabepentin and I'm sure some of the weirdness I'm dealing with is from that, but I'm also taking 3 other drugs for my PTSD. How should I know which drug is causing which side effect?