Need Advice Regarding Skull Injury

[Gena]

Hello Fellow Vets,

I've read the posts for a while but this is my first post. I hope I'm putting this in the correct topic area. I need some advice about an issue that is bouncing back and forth between VA and myself. The issue is regarding a skull injury I received while on active duty. The injury resulted in 20 square centimeters of skull being removed from the crown of my head by Air Force surgeons at Wilford Hall in San Antonio. I've never quite understood why, but they didn't put any type of plate or protection back in that area and as a result I have a depressed area about the size of the palm of my hand on one side of the crown of my head (where I have unfortunately since balded). It has always been an embarrasement to me as I have a rather large depressed flat spot where my skull should be rounded. I retired in 2007 and made claim for the skull loss + disfiguration. I even sent in a separate SSOC specifically asking that they consider the disfigurement. There is a table in the rating schedules for skull loss and it's stricly by amount lost. In January of 2010, I finally received a rating decision from VA and they gave me the 50% rating that 20 sq cm of skull loss calls for. However, there wasn't any mention made of the disfigurement, in spite of the fact that the VA examiner made note of and measured the disfigured area in his report. So, I sent in a notice of disagreement asking why the disfigurement wasn't considered. I received a letter back from VA asking me "What am I claiming, a skin disfigurement? The letter was basically asking, "How are we supposed to rate this?" My initial reaction was "Why are they asking me?" ,"Isn't figuring this out their job?" I sent in another SSOC re-describing the disfigurement and stating that I don't know which rating schedule applies here. Now, I have received another letter back from VA telling me that they don't understand and asking if I am claiming a skin disfigurement. I'm stuck here and don't know how to respond. I feel like their question is a set-up. If I answer, yes, that I am claiming a skin disfigurement, then they'll deny stating that there is nothing wrong with the skin in that area. If I respond, no, they'll deny stating that that was the only way they knew how to rate the disfigurement. DAV supposedly "represents" me, but they have done less than nothing for me. I can't ever get through to my rep, he doesn't return calls and even if I do get to speak with him, he won't give any advice. In my experience, DAV has been nothing more than a glorified forwarding service for my letters. It was actually easier when I used to try to deal with VA directly. So, I need some advice how to respond to VA. And can somebody please tell me, isn't this their job to figure out? Sorry for the length and thanks in advance.

Edited September 18, 2010 by Gena

[Gena]

Hi Berta and thanks for the reply. VA has ignored my claim on this issue for over two years now. They've only recently acknowledged my claim and are asking me what exactly I'm claiming. So, I don't have a SOC or even a rating decision yet. I took the advice pf Pete and dug into the regs to be specific about what I'm asking. Unfortunately my digging didn't turn up much. There is no way to rate a skull disfigurement other than addressing the skin covering the area. I ended up using the exact reg that you listed. Unfortunately, I can only try for one of the characteristics of disfigurement: "Underlying soft tissue missing in an area exceeding six square inches". It seems a bit unfair to me that VA is so constrained to the regs with seemingly no liberty to rate something unusual. Well, I've tried to shoehorn it into an existing reg which may or may not yield 10%. Either way, it's a bit dissatisfying.

[stillhere]

The VA in their last letter is really trying to help you with closing this claim for disfiguring of the skull. Point they are using is what is it you want to claim? In other words what do you want? You if I read correctly have been granted 50% already and you are not satisfied and do not feel that is enough. Tell them what % you feel it should be and then hopefully they will get this moving along.

I would submit a statement such as how the disfigurement effects your day to day life and what you have to go through and end it with you feel this is worth a comp of 80% or whatever you feel and then let the VA move on this.

What do you consider should be your rating??