diabetes Denied For Higher Level Of Aa

[Berta]

Our SVR radio show guest tonight is Carrie Weletz from a well known law firm that represents vets.

http://www.vetlawyers.com/about_attorneys_weletz.htm

They have an area at their site where they can do a consult.

You can always consider giving your POA to another veteran's organization,too.

If you google veterans disabilty lawyers there are sure many that will pop up. Also the National Organizations of Veterans Advocates has a list of vet attorneys.Many here in the claims research forum have sought lawyers too.

A NOD has to be filed before a lawyer can formally take the case.

There is a lot a lawyer can do for a claim and a lot they cannot do.

Claims like yours are awarded on medical evidence that fits into VA specific criteria.

If you can determine exactly what VA said was lacking in your claim, and then obtain the medical evidence to satisfy what the VA and the regulations call for-then you don't need a vet rep or attorney.

If you post in the laims Research forum here maybe someone with SMC experience and info on VA lawyers will respond to you.

This show should be good and I hope many listen in to it.

By the way -is the SMC "S" award for A & A or Housebound incorporated into the compensation you receive now?

You can always change a POA vet rep by rescinding the POA and then aquiring another vet org to help you.Here in rural NY. some of the vet reps even make housecalls to vets whose disabilities make it difficult for them to get to a rep's office.

Please print out and show them my suggestions here -

that you possibly could be eligible for additional K awards and/or possibly the SMC "M" award.

Then again the VA could qustion loss of use of your hands if they see you can use a PC.If that is difficult for you make that point too.

My husband lost normal use of his hands from a stroke and could only type with one finger after that.He could not determine by feel- pocket change nor write his name on a check legibily anymore.He had difficult with using telephones do to loss of dexterity and I dicumented to VA o with a bill- that in attempt to fix our heater (he had PHVAC license prior to stroke) he broke something in the motor because he could not handle tools properly.

These are things both SSA and VA considers for loos of use "K" awards.

Yo might find more suggestions in the main Claims Research Forum here.

[Pete53]

Dolphin

I am 100% with SMC S award and the Dallas VA provide me with an aide who comes twice a week its my choice she told me she could come every day. She can stay up to 1 hour and does many things to assist as they will bath you and do light house cleaning, make beds and a whole lot of stuff. They also send a nurse who takes my blood pressure and temperature and checks my medications.

What I am saying is you should ask your social worker at the VA to help you and this could help your claim. Working on an advanced claim takes determination and I think the advise you have received from Berta is on the mark.

One more thing is to get a lawyer who will work on a contingency basis you have to pretty much lay this out so they can see a winner. Just cause you get turned down by a lawyer does not mean that you don't have a claim that could win.

Good Luck

[Berta]

This case might explain better what I meant :

http://www4.va.gov/vetapp10/files2/1017808.txt

Reaching a A & A level beyond the "S" award means a step progression- in other words from "L" your evidence has to warranr "M", then the additional steps before the VA will award under R-1 and R-1 -the highest SMC A & A levels.

I cannot tell if your extremities all should warrant separate K awards or if in fact that is part of your SMC "L" level award.

I asked Ms Weletz at SVR radio last if they can access a claim without the formal NOD being filed yet and she said yes as long as the veteran has a recent denial and still is within one year NOD appeal period.

The firm's contact info is at this site:

http://www.vetlawyers.com/about_attorneys_weletz.htm

[Dolphin25]

I have contacted that firm but as of yet have heard nothing...I will give you a heads up should they respond.

I have some really good cases from the BVA and also memo's and other resources about AA and a higher entitlement to AA and from what I have read they awarded Vets who were in much better

shape than I am...I know it is because of how I wrote it up and the way the Dr. wrote the summary otherwise I should have received a higher award. They think I can transfer to a wheelchair with ease, they don't realize sometimes I have to literally crawl to get to where I need and it is hard for me to even breathe because I cannot straightened up and it cuts my breath off. When I was in Vietnam I was a door gunner on a Huey, before than I was a grunt but in one crash we were shot down and crashed I ended up breaking my back or fracturing it in 5 different spots along my spine and today I am suffering the results of ignoring the injury for so long, my bad I know, I have to live with it and I'm not whining, all I want is to be able to clean up and live decently. Another thing I don't understand why the Dr. didn't mention I have to use a catheter or I take injections that I need help on and that requires a nurse or someone trained but no mention at all.

This has taken a long time to write and I am very tired so let me know what I could possibly do to get this back to the RO. Thank you Berta..

Is this what you wanted me to send..this is denial of a higher level of AA..I have another RO Decision for the Bladder Incontinence. Remember when you read this what they state are things I use

to have but the sole reason for me filing for a higher level was b/c I didn't have the money to bring someone in or pay for some rehab or pay for transportation. I use to have someone but the girl stole

my pain medication and I have been afraid to hire someone unless they are licensed and they cost more money.

REASONS FOR DECISION

Entitlement to special monthly compensation based on a hither level of aid and

attendance.

We have denied entitlement to a higher level of special monthly compensation for aid and

attendance.

Your statements/letters/medical records were reviewed. You indicated that you have assistance from

basic sitters and relatives two to four times per week. You receive care from another (this is what I use to have, not anymore)

person who helps you one day a week and prepares your meals at the beginning of the

week. You reported that she helps you dress/undress, care for the needs of nature, and

assist you with getting out of your wheelchair. You indicated that you need help getting

into and out of bed. You also reported the use of a walker and a cane that you use with

your wheelchair when you need extra support when rising up out of your chair.

Statement from Mary Anderson was reviewed. She reported she's an independent health

care provider providing basic assistance for you on average of twice per week. She

reports that she prepares meals, keep your area clean, clothes washed, and provide

bathing assistance. She also indicates that she helps you with dressing/undressing and

bringing you to your appointments. There is no indication that Ms. Anderson is a licensed (This is all before I filed for a higher level of AA, it is worse now and it was bad then)

medical provider.

VA examination of March 10, 2010 was reviewed. You reported that you are unable to

leave your house and that you only leave when you need to see the doctor. You indicated

that you've hired someone to help you fix your meals and dress. You reported being

permanently bedridden but not currently hospitalized. You are able to travel beyond your

domicile, and you attended the VA examination with assistance of a VA attendant. You

reported that you mostly stay in bed. You denied dizziness and memory loss. Physical (I did report dizzyness and bad memory loss, why she said no is beyond me because it is in the letters I wrote)

examination revealed a frail build with stooped posture. You were unable to walk. The

examiner noted you are able to walk without assistance of another person only within the

home. You require a walker for ambulation. Your functional impairments are

permanent. The cervical spine has very limited range of motion. You were unable to (First they say I can't walk then they say I can, this should have been so obvious to the RO of the contradictions)

straighten up in your chair and the examiner was unable to get you to a standing position.

There was evidence of severe impairment to the upper extremities. There is marked

difficulty for self feeding, toileting, and dressing/undressing. You are unable to selfbathe

or self-groom. There was evidence of muscle weakness and numbness in the lower

extremities. You reported that your hands are so weak you can't open bottle tops or take

the plastic wrap off of microwavable foods. The examiner diagnosed you with severe

Page 2

degenerative disease of the entire spine, peripheral neuropathy of the lower extremities,(why didn't they hear award me for peripheral neuropathy, I read even if you write in a letter they have to examine you for what you claim you have)

radiculopathy of the upper extremities, and bladder incontinence. The examiner noted

you have someone come every other day to fix your meals and help you bathe, dress, and

buy groceries.

The evidence of record does not show a higher level of care 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 you would require hospitalization, nursing home

care, or other residential institutional care. Furthermore, the evidence of record does not

show that you require daily substantial care from a licensed medical provider due to your

service connected disabilities. Therefore, entitlement to a higher level of special monthly

compensation based on Aid and Attendance is denied.

Entitlement to an additional payment of compensation is established when serviceconnected

impairment imposes a special level of disability. Entitlement to special

monthly compensation is not warranted in this case because the criteria regarding a

higher level of aid and attendance have not been met. {38 CFR 3.3501

Entitlement to an additional payment of compensation is established when serviceconnected

impairment imposes a special level of disability. Special monthly

compensation under 38 U. S. C. 1114® is payable for a veteran receiving the maximum

rate under 38 U.S.C. 1114(o) or (p) who is in need of a higher level of care. 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:

(1) 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. ii 14(p); (2) The veteran

meets the requirements for entitlement to the regular aid and attendance allowance; (3) (What does 2 and 3 of this statement mean to you, interpret this for me)

The veteran needs a higher level of care 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; (4) The veteran's need for a higher level of care required to

establish entitlement to the regular aid and attendance allowance is determined by a

Department of Veterans Affairs physician or, in areas where no Department of Veterans

Affairs physician is available, by a physician carrying out such function under contract or

fee arrangement based on an examination by such physician.

[Berta]

The law firm I am mentioning here to all reading this

is:

Bergmann & Moore, LLC!

We are a full service veterans law firm with former Department of Veterans Affairs Attorneys. We are devoted to providing unparalleled representation in VA benefits to disabled veterans and their dependents including spouse and widows. Our clients, who live all over the country (including California, Florida, Washington State, Texas, Alaska, Wisconsin), trust our services to secure the maximum veteran benefits under the law.

http://www.vetlawyers.com/about_attorneys_weletz.htm

Ms. Weletz was our SVR Guest Wednesday and a click on the home page in this link gives you all more info and contact number for this reknown veterans' law firm.

One of the law firm members Doug Rohde - has just joined hadit.

Edited August 13, 2010 by Berta

[Berta]

I was unable to delete or edit the post I made.I think I was wrong.

because I cannot determine if the VA, in fact, has already considered the 3 PN awards in your overall SMC L rating.

If they did I am completely incorrect in thinking they owe you K awards if that is part of the L you get now.

Is it?

"The examiner diagnosed you with severe

Page 2

degenerative disease of the entire spine,"

What is the rating you get now for this disability % wise?

By reading BVA decisions that is a very good idea in your case, to see how the VA determines those higher SMC levels.

I do feel they need to have current evidence that the care taker no longer provides you with any help.

SMC is a complex issue and I hope one of SMC experts will respond here.