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I Was Denied Again?

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Let me first start off by saying thank you to all the veterans no matter how long ago it was you served. Thank you for you sacrifice and heart for this country. May God bless you all!!!

Well my name is Joshua Holm let me first start by saying I am a proud Iraqi freedom of 03-04 with 4ID. I am a father of two wonderful children and today is my eighth wedding Aniversary to my gem my wife Crystal who has literally been there for me through thick and thin. Well I am almost 27 and I went to Iraq in 2003 with 4ID in June 2003 we were doing house to house raids and there was someone in the roof of clay hut. I was shot with a double barrel shot gun two slug to the center mass of my chest. I was told that two to five more pounds of pressure would have broken my sternum which would have then splintered into my heart which would have then killed me instantly. In Sept 2003 I was on a detail of burning poop we had to take shifts doing this due to lack of plumbing. We began to take enemy mortar rounds they were using the light of the fire to walk the rounds into our camp. I was on the OP and was not aware of the incoming mortars until it was almost to late. I flipped the crap and began to run after first letting one of my soldiers go about a minute ahead of me. Well to make a long story short I never made it to the bunker. I was running and took light shrapnel wounds to my the side of my right leg. While running from the incoming mortars i fell in a spider hole right before I made it to the bunker. It was about 10 to 12 ft deep. I was knocked out for 30min + ?. when i woke up there were no more mortars and they had already called all clear. I was pulled out of the hole and taken to the medics. They just gave me motrin or (skittles) and put me on light duty for 2 weeks. I didn't know I took shrapnel until about 3-4 weeks after it happened. I was cut up from head to toe from the fall. My feet and legs began to swell i thought it was from the constant on the go. When we returned from Iraq the legs got even worse and I was put in leg braces and a wheelchair. i was prideful so i never wanted to use the chair. I was in a MVA in Sept of 04 on post. I was T-boned at a 4way stop the truck was going 47 mph. I was put into a neck brace for about 4mths. After being messed around by the medical I got fed up of the run around and ETS ed in June of 2005. I was already making more money with my maintenance company then i was making in the military. I learned how to walk again and was only using a cane on bad days but used both knee and ankle braces almost everyday. I went to the VA right away for headaches/ and pain in my feet and legs. By 12-05 I was given 10% for flat feet due to the fall in 03. I was happy with that until I found people that where getting disability for just about nothing. By DEC 2006 I was getting 60% for feet/ sleep apnea. In 2007 I got a increase of 90% for headaches/ lower back pain/ both knee / ankle and left soulder.

In the fall of 2007 I was told by the VA to either let my maintenance company up or they would stop all my benefits. So I did as they told me to and started going to VRE or Chapter 31. In June of 2008 I got a call from a social worker at the VA she called to tell me I missed a follow up appointment for TBI this the first time I ever heard of this. Later she found out back in 2005 I was given a Cat scan and a doctor prognoised TBI but never scheduled a follow up exam. They began to do diffrent brain test. On July 15, 2008 I fell in the middle of the grocery store and had my first seizure it was a grand mal. I losed control of my bowels and everthing. Since then I was hospitalized a few times I am on lots of seizure/ migraine meds. My wife drives me. On May 1st 2009 I was at my house making koolade for the kids when I passed out in a sezuire state and was hospitalized for seven days. my head bonced of my countertop then hit the floor. I had blood of my brain and lots of fluid build up. I was told by one doctor i had a slight anurysum. I had partial pralisses on my left side. I have been in a wheel chair since May I use a wheelchair on a daily basis. I have a custom manual ultra light wheelchair. I can't feel my entire right leg when i feel it it stings like pens and needles. In late 2008 I put in for SSA a was granted within 24 days after i put in for I fell under

the wounded warrior act. I finally put in for 100 ui but was denied b/c i was trying to do vre. I appealed it in fed 2009 in may my dr put in for A&A and they also put me n for PTSD, depression, seizures, and dental trama I am still waiting. Ok considering my condition what will I probably get for A&A and how is it configured? What should i do almost all my field records were lost by the miltary. i got lay statement written by my platoon sgt and my crpl who was the one who pulled me out of the hole and took me to the medics. The medic that removed the shrapnel from my leg/ knee didn't make it back there second tour. My old battery commander is dead, the medic, my supply sgt dead. All I have left is the crpl who is now a ssg and is still active. I never even got a purple heart. I have the scars from the light shrapnel wounds. I just did what i was taught suck it up and drive on, adapt and over come. I thought I was superman but did norelize I had crytonte in my pockets.I just got a rating decision from the VA giving me 50% for PTSD. I am still waiting on a decision for Sezuiers and tbi (which i think that they may combine),depression,and A&A. So without this other stuff I have 210% disability which they still rate me at 90% how? Also I am in a wheelchair due to my tbi and seziuers and my wife takes care of me i am not helpless but I can't perform my duties as a husband without a little help. They have put me in for reg A&A after a decision is made how would I get this increased to R1? My doctor filed out th form my wife has to drive me, the va just told me I can't manage my finaces, can't own a firearm and etc. I am tired of them ripping my family off of all the beniefits they deserve. I don't care about the money but if i am eleigable I want to get. I just found out about the VA house grant and auto. Can anyone help me to understand how to even apply for a A&A increase and who has to do it I just got an decision giving me 50% for PTSD and a denial on TBI, UI or 100%. Still waiting on A&A decesion, depression and i was also denied dental truma. Any advice on what i should do? It has been a two yrs since i first put in for TBI, and UI. Thanks Joshua Holm

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"In the fall of 2007 I was told by the VA to either let my maintenance company up or they would stop all my benefits."

Who said that? Is it documented?

Why did they make that statement? What reason did they give for this ?

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Hey Josh,

You make me feel like a crook for going after A&A and I believe I rate it. Your going to have to get something 100% first. Even though they say for A&A you don't need it going for higher levels of A&A your going to need it. I had what I thought was a lock on my A&A exam and they denied me on BS. They even stated I'm not 100% service connected and I'm TDIU 100%.

You definitely need to be 100% somehow. This 90% for you is BS. They either need to get you TDIU or rate one of your connections 100%. The problem with going after higher levels of A&A is that you need to have SMC at a high level. I've studied the regs because I basically quailify for SMC (s) and SMC (l) but that keep denying me. So you need to get 100% first.

Once you get 100% you will need some SMC higher than (l). I think you need to have (m) or (n). I can look it up though. You may be better off getting a lawyer now that they are allowed at the VAROs. Even if you have to pay them something going from 90% to 100% is over $1000. So if you already have 24 months on your appeal the lawyers fee will be well worth it.

I keep running into OIF vets that are 90%. They must have some hidden directive to stop you there. You have a complex case here with many different avenues. I have used an attorney at the CAVC and have one for the BVA right now. Do you want me to get you some names of lawyers that operate at the VARO?

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Okay I found the regs for the higher levels of A&A:

So it looks like you have to be SMC (o) or (p) and meet all the other requirements. It seems in your case you probably meet the requirements for regular A&A based on the dangers of your environment with your seizures etc. The problem is when they consider the criteria there is a part that states they need to consider your disability picture as a whole or something like that. That is where they will come in and say since your not 100% that your disability is not that bad. This is crap but it seems without 100% you wont get it. I hope this helps. (;) Basic criteria for the higher level aid and attendance allowance. (1) A veteran is entitled to the higher level aid and attendance allowance authorized by §3.350(h) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) The veteran is entitled to the compensation authorized under 38 U.S.C. 1114(o), or the maximum rate of compensation authorized under 38 U.S.C. 1114(p).

(ii) The veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(iii) The veteran needs a “higher level of care” (as defined in paragraph (:D(2) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(2) Need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran's home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which require professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional includes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.

(3) The term “under the regular supervision of a licensed health-care professional”, as used in paragraph (B)(2) of this section, means that an unlicensed person performing personal health-care services is following a regimen of personal health-care services prescribed by a health-care professional, and that the health-care professional consults with the unlicensed person providing the health-care services at least once each month to monitor the prescribed regimen. The consultation need not be in person; a telephone call will suffice.

(4) A person performing personal health-care services who is a relative or other member of the veteran's household is not exempted from the requirement that he or she be a licensed health-care professional or be providing such care under the regular supervision of a licensed health-care professional.

(5) The provisions of paragraph (B) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran's need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

(Authority: 38 U.S.C. 501, 1114®(2)) © Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

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Hey Josh,

You make me feel like a crook for going after A&A and I believe I rate it. Your going to have to get something 100% first. Even though they say for A&A you don't need it going for higher levels of A&A your going to need it. I had what I thought was a lock on my A&A exam and they denied me on BS. They even stated I'm not 100% service connected and I'm TDIU 100%.

Any Veteran has the right to ask the VA to look at and approve or disapprove on any issue. Since the VA is not going to help any of us we need to remember that until you ask and go through the whole process than its on us and not them.

I wonder how much of the giant caseload could be cut if the VA was preemptive and not reactive.I wonder how many lives would be made better. So many promises and yet the VA sucks at really helping.

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