Veldrina - A Couple Of Questions

[Philip Rogers]

I've just found out I've been awarded the same new 10% disability for each of my legs. It also states the bilateral factor is "1.9", which I assume to mean an actual award of 19%, combined, which would round up to 20%. Am I correct, and if not what is the total??? Also, when considering the 100% + 60%, required for SMC, do they use VA math, or normal math, when combining to meet the 60% required???

Thank you!!

pr

[Berta]

"The VA denied my housebound and A&A yrs ago and have fought me all the way."

And the denials hold the keys to how to succeed now.

It is certainly possibe that VA logic was correct years ago Philip-but in time almost every disability we have gets worse and could put a vet into a SMC criteria.

Do you have an older decision for 100%SC plus 60% Independent SC disability and they denied you in that decisions for SMC at "S" level?

[Berta]

I am with Veldrina here on the post from Pete as to agoraphobia in this way-

VA will consider agora[hobia as part of a mental disorder:

. Resolving reasonable doubt in the Veteran's favor, the

criteria for a rating of 70 percent, but no more, for panic

disorder with agoraphobia and depression, were met as of March

24, 2005. 38 U.S.C.A. § 1155 (West 2002); 38 C.F.R. § 4.130,

Code 9912 (2010).

http://www4.va.gov/vetapp10/files4/1039955.txt

I think she might have wondered how Pete could have 100% for anxiety or PTSD and then 60 % SMC S for agoraphobia too- as this is not an independent separate disability.

I feel that this is difficult to understand as a rating .I also have never seen agoraphobia stand alone as a ratable disability.

Edited February 1, 2011 by Berta

[Philip Rogers]

Berta - I was originally rated 100% schedular, for PTSD, by the BVA, retro 10 yrs, but the infered issue of HB and A&A was originally missed but I corrected them and it was denied. I had applied for HB and/or A&A within one yr of the decision but was denied. It has been under appeal since. It even went to the court where my atty won a remand. At this point I qualify for the SMC "S" award under 100+60, as I now have other disabilities. The VA has taken so long, w/this case, that even I question whether I qualify for HB, at this point. I should have been awarded it, way back, as it was believed to be permanent, then. The BVA has even requested that they decide whether my PTSD disability kept me from going to work. The C&P doc wouldn't speculate, so I expect the case to be remanded, once again. I'm about to secure an IMO and submit it. If I won they'd owe me about $60k but I doubt it'll win.

pr

"The VA denied my housebound and A&A yrs ago and have fought me all the way."

And the denials hold the keys to how to succeed now.

It is certainly possibe that VA logic was correct years ago Philip-but in time almost every disability we have gets worse and could put a vet into a SMC criteria.

Do you have an older decision for 100%SC plus 60% Independent SC disability and they denied you in that decisions for SMC at "S" level?

Edited February 2, 2011 by Philip Rogers

[Philip Rogers]

In Pete's case, I believe he's getting the SMC "S" award for agoraphobia due to being HB, not due to an additional 60%, as that's what agoraphobia does. I don't think it's 2 mental ratings. But that's jmo! Doesn't really matter as long as he gets it, right?

pr

I am with Veldrina here on the post from Pete as to agoraphobia in this way-

VA will consider agora[hobia as part of a mental disorder:

. Resolving reasonable doubt in the Veteran's favor, the

criteria for a rating of 70 percent, but no more, for panic

disorder with agoraphobia and depression, were met as of March

24, 2005. 38 U.S.C.A. § 1155 (West 2002); 38 C.F.R. § 4.130,

Code 9912 (2010).

http://www4.va.gov/vetapp10/files4/1039955.txt

I think she might have wondered how Pete could have 100% for anxiety or PTSD and then 60 % SMC S for agoraphobia too- as this is not an independent separate disability.

I feel that this is difficult to understand as a rating .I also have never seen agoraphobia stand alone as a ratable disability.

[Berta]

Yes-I think that must be what Pete means too.

"Berta - I was originally rated 100% schedular, for PTSD, by the BVA, retro 10 yrs, but the infered issue of HB and A&A was originally missed but I corrected them and it was denied. I had applied for HB and/or A&A within one yr of the decision but was denied."

If your medical evidence warranted either A & A or HB at that time Philip- and if they had the evidence in their possession at that time-they should have awarded this benefit.

As you know I have CUE on SMC regarding my deceased husband.

When they made my 1151 DIC award in 1998 they said it was due to myocardial ischemia, and cerebral vascular ischemia (from the IHD) causing death directly from the VA malpractice of the IHD and the CVA and HBP etc etc

The decision had no SMC statement (1151ers get SMC if the med evidence warrants it)

Nor did it have a IHD rating.They have still failed to rate his IHD (all above are now AOs (BVA award last year)

I realised that the VA could have said they denied SMC possibly due to the fact that although the VA OGC reports contain considerable evidence of his IHD and CVA etc-

that they did not know of the IHD disability and therefore no SMC.

But they did know of the CVA -still no SMC-

My point is that the VA must be aware of and have in ther possession medical evidence to warrant SMC.

I wonder if they definitely had it in your case and simply ignored it.

Did you receive SSDI during the older claim? and could the SSA records reveal need for A & A or HB?

In my case the FTCA was resolved in July 1997 and I sent the RO my settlement papers as proof of the 1151 claim.

They actually denied again- can you believe it? Proof of malpractice causing death from the highest lawyers in the VA.

I got on the horn with the OGC real fast. I got my 1151 award very soon after that- but still NO SMC consideration at all.

My long point here is my CUE raises this fact.

The VA had in their possession whether at the VA Central, or the OIG, evidence that warranted a SMC statement in their numerous past denials as well as the award letters.

Is there some documented records somewhere at VA (Voc Rehab) or any therapy treatments that might not be in your regular med rec file (Possible too)

that was in VA's "possession" at that time but yet had not made it into your formal med rec file?

My husband's final PTSD therapy records, as well as his hypnosis records and numerous psychological tests he had to separate his PTSD from his CVA (they were both 100%)

were NOT in his regular VA Med Rec file.

I had to ask his VA shrink for copies of them to submit and the shrink wrote a letter to them too.

They were crucial and I am glad I went to see his shrink after he died.

His other VA shrink documented nothing because he was VA employee shrink (my husband was VA employee) and this doc didnt trust documenting anything employees told him.

My long point here is that as long as evidence is in the VA's possession-it could be somewhere other than the actual med rec files or C file and even not in the specific VARO as in my FTCA case but finding where it is and then telling them that -could help.

Edited February 2, 2011 by Berta