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Denied Because Dav Rep Mistake, Filed Second Round.

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mav2u

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I've been out since Jan 03 when I was Med boarded from the AF for my back. I had a tumor removed from my spinal cord l4-l5 in 2001. I had nerve pain in the left side since 1998. After the surgery it helped a little but the pain was still there. Pretty much from the left side of the back at the belt line down to my foot all day spiking and throbbing pain. Insomnia because of the pain and the joy of all the meds I have to take to relieve the pain. Not to mention during the service I had a break down because of all the pain and the constant torment from command NCO's and Officers complaining about my condition thinking I was faking, which was then diagnosed as depression and was in treatment.

I got of of the AF and immediately filed at my VA an thru the years have received the following SC ratings.

70& bi-polar

20% cervical spine,

10% post lumbar laminectomy with tumor resection,

10% for radicular symptoms left lower extremity secondary to status post lumbar laminectomy with tumor resection

0% allergic rhinitis ( can't get them to give me anything even though I suffer an take alergy medicine 365 days a year )

0% residual moles removed on back

So I tried school when I got out as I definitely couldn't do Aircraft Maintenance any longer. I tried for about a year in a half when I started to fail miserably. I took a job that a friend got me as a loss prevention person at a store. Watching store cameras for people stealing. Only problem was that I had a hell of a time staying awake with meds and sitting for long periods was torture but I did it. I was always on the edge of being fired for my lack of performance or my anger. So I knew my time was coming short so I hopped over to another store doing the same thing for about another year. I finally figured something isn't right and went in an saw the Mental health. They figured I was having depression again, but after several months they determined it wasn't depression but bi-polar. Which explained a lot. I worked for Ford for about 8 months doing inspections of vehicle claims an was always on the edge for being angry, or because I was out of work so much for my back or headaches. Seeing that my time was coming short their I found another gig from a friend doing photography business for about a year an a half. By this time my back was hurting more, my right arm was burning on fire which it had while I was in service but they never found anything. My bi-polar was getting worse but I still hung in there. Lots of percocet helped through the days and ever changing bi-poplar medicine. Finally in 2008 I was getting worn down and the economy tanked so they let me go and I haven't had work since.

I never knew about TDIU until shortly after in early 2009 my Mental Health doctor told me to re file my Bi-polar for more as it was at 30% as I had gotten worse in condition. I received a 70% bi-polar rating in Nov 2009. My right arm which had become a burning inferno of pain finally got the diagnosis from a doctor outside the VA because I refused to see the VA doctor again or I was going to throw her out the window if she told me for the 5th time that nothing was wrong with my arm. Come to find out, I had a severe ulnar nerve entrapment in my right arm. I got immediate surgery on it after having this pain for 10 years in December 2009.

That was when I heard about TDIU. So I went to DAV at the clinic and told them I wanted to file for it and for my arm now that I had a surgery and they found what was wrong. So I wait until June 2010 and find out the DAV rep filed for some kind of temporary out of work disability like a workmen's comp for my arm that I just had surgery on. I was PISSED that this jackass screwed up that badly! They denied me saying I hadn't tried voc rehab and that my arm was denied as non-SC. Which I have paperwork for an it is in my records for being sent to a neurologist while I was active duty, but I got med boarded before the nueroligist to see more more than a couple times to figure out what was going on.

Thankfully there was another DAV person out there that knew what they were doing and filed my now denied letter for appeal submission stating that it should have been for TDIU and that my arm was a add-on on claim for disability. Filed in August 2010 they finally got all the stupid job history info in from my previous employers in December 2010. Which I had no idea they were waiting on or I would have gotten in to them sooner. So now here I sit, knowing that it is sitting on the desk of some person at the VA to be combed through with a fine tooth comb. At least that is what they said this person is going to do on a appeal like this is that they go through the entire file top to bottom.

Am I being optimistic that I'll get TDIU? Should I be prepared to get a lawyer? I'm just so tired of fighting this paper war with the VA and the incompetent few physcians that they have at the VA I just don't have much fight left. I left a bunch of stuff out in between the years with filing and doctors. I'm just tired of trying to survive on nothing. Blessed that my wife has stayed with me this long. I'm in my 30's an this is all life amounts to an it is pretty sad state of affairs. No friends left as I've pretty much taken care of annoying them or they don't want to hang with a cripple anymore when they go hiking or boating. If TDIU isn't in the mail soon, I'm not sure what else to do....

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Have you formally filed a NOD yet?

You mentioned meds and aspects of your educational difficulties:

"My Mental Health psych person wrote a letter to the college to give me another chance for the 3rd try of a class to I wouldn't have to pay full price as I have severe mental memory and medication issues. They allowed me to take the class again at regular price."

Do you have a copy of that letter?

You need to submit any evidence at all that shows them their decision was wrong.I cannot tell here how much time you have left for NOD.

If you apply for and are awarded SSDI and the award is solely for your SC disabilities, this is good evidence for TDIU.

"Now I suppose they didn't read the file or they would have viewed the fact that as soon as I got out in 2003 I went to school on my MGIB and struggled and even took several classes over almost 3 time to pass them and had to have my Mental Health doctor at the end of 2005 finally write a letter to the college to grace my several classes that I was on a third time taking to wave the increased state fee for a 3rd time retake because of my mental health and physical issues impaired my ability to learn an comprehend. Which I finally dropped out "

They have to have their hand held -VA isnt going to search records for evidence that will help you.

You have to highlight this type of evidence to them in the NOD and attach copies of it.

Then you also could seek an attorney who handles VA claims.

Their fee, when you ultimately succeed, will have hopefully saved you some major stress.

Make sure in the NOD you tell them of ANY evidence they overlooked.

I think some lawyers will even help with the NOD. Hope others chime in on that.

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Have you formally filed a NOD yet? Notice Of Disagreement. Yes, the DAV person did that when I filed for the second time. But it was just that we disagreed, pointed out my Ulnar nerve in service treatment and sent a copy of the page with them and said we disagreed with the denial of the TDIU. He said that would be all I needed as the first time around the other DAV person messed up and Filed a TDIU because of my of Ulnar nerve. Which is the way it read. They denied the TDIU and Temporary Disability for being out of work for the surgery of the arm. Which I wasn't even working before that anyways. Basically the DAV person before screwed up the paperwork and what was supposed to be requested.

So, I just called today and it is still on a desk somewhere doing something. I did find my letter from my MH for the school deal. Should I send that in now? Also maybe get another written letter from my MH?

I also spoke with my Primary and she said she would write down this time any facts in my records that I wanted that were true. She wouldn't give any opinions or anything like that. So I guess that is good. I could get a copy of that an send it in also.

Why do you all think? Do I still have time? Will they still accept extra paperwork?

You mentioned meds and aspects of your educational difficulties:

"My Mental Health psych person wrote a letter to the college to give me another chance for the 3rd try of a class to I wouldn't have to pay full price as I have severe mental memory and medication issues. They allowed me to take the class again at regular price."

Do you have a copy of that letter?

You need to submit any evidence at all that shows them their decision was wrong.I cannot tell here how much time you have left for NOD.

If you apply for and are awarded SSDI and the award is solely for your SC disabilities, this is good evidence for TDIU. YEah haven't even tried filing for that yet. I was told TDIU would be easier to get first and then take that to the SS office to get the SSDI and it would be easier.

"Now I suppose they didn't read the file or they would have viewed the fact that as soon as I got out in 2003 I went to school on my MGIB and struggled and even took several classes over almost 3 time to pass them and had to have my Mental Health doctor at the end of 2005 finally write a letter to the college to grace my several classes that I was on a third time taking to wave the increased state fee for a 3rd time retake because of my mental health and physical issues impaired my ability to learn an comprehend. Which I finally dropped out "

They have to have their hand held -VA isnt going to search records for evidence that will help you. They said this records review is by a single case worker who has to go through my entire records front to back on this disagreement appeal. So it would be thorough and the evidence of all my awards and my continued full time care at the VA should be enough.

You have to highlight this type of evidence to them in the NOD and attach copies of it.

Then you also could seek an attorney who handles VA claims.

Their fee, when you ultimately succeed, will have hopefully saved you some major stress.

Make sure in the NOD you tell them of ANY evidence they overlooked.

I think some lawyers will even help with the NOD. Hope others chime in on that. What does an attorney charge or do they agree to take from the award? I don't want to shell out $6000 dollars for them to do something and I might loose. That is crap!!!! Cause they have no motivation to win or not if they are paid the fee up front.

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I believe they all charge 20% of a successful claim's retro bu I am not sure.

This is a list of veteran's attorneys:

http://www.attorneys4veterans.com/

"Why do you all think? Do I still have time? Will they still accept extra paperwork?"

Yes I feel there is still time but have the DAV send copies of it in or submit copies of yourself and use a 21-4138 form as a cover letter-and get proof of mailing it.

I stated:

"They have to have their hand held -VA isnt going to search records for evidence that will help you."

you replied:

" They said this records review is by a single case worker who has to go through my entire records front to back on this disagreement appeal. So it would be thorough and the evidence of all my awards and my continued full time care at the VA should be enough."

Maybe you will be lucky enough to get a thorough review.

I learned for the past 17 years as a VA claimant to never depend on the VA to do a thorough review.(and for a few years years prior to that helping my husband with his claims) He was dead for 3 years before his clinical file ever got any review and it wasn't thorough but they awarded anyhow.

"Notice Of Disagreement. Yes, the DAV person did that when I filed for the second time. But it was just that we disagreed, pointed out my Ulnar nerve in service treatment and sent a copy of the page with them and said we disagreed with the denial of the TDIU. He said that would be all I needed as the first time around the other DAV person messed up and Filed a TDIU because of my of Ulnar nerve. Which is the way it read. They denied the TDIU and Temporary Disability for being out of work for the surgery of the arm. Which I wasn't even working before that anyways. Basically the DAV person before screwed up the paperwork and what was supposed to be requested."

I dont see this as a mess up by the DAV rep who filed for TDIU. But

I cannot determine if you have a TDIU claim pending or not.

I am lost here-others will help.

Just my opinion.

I won my claims by being proactive and getting my evidence in their face.

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mav2u,

Your PCP stating they won't write anything for you is pure BS.

Here's a link and the relevant information.

If necessary go to the link - highlight what the doc IS SUPPOSED to do,

print it out and take it to your doc's.

Another thing - I notice your profile shows 80% SC.

I noticed you posted money is too tight so you can't get an IMO/IME.

Getting an IMO/IME is not an expense - it is an investment in meeting your goals.

Many times no matter how tight money is we CAN'T AFFORD - NOT to get an IMO/IME.

Sometimes life calls for canned tuna and PB&J :-)

Anyway - here's that link and info.

http://www1.va.gov/v...asp?pub_ID=1790

d. Medical Statements to Support VA Benefits Claims.

When honoring requests for medical statements by veterans for VA claims adjudication,

care must be taken to avoid conflict of interest or ambiguity.

(1) Determination of causality and disability ratings for VA benefits is exclusively a function of the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure.

As a result, they may not feel comfortable in stating causality of a current condition.

However, this does not preclude VHA providers from recording any observations on the current medical status of the veteran found in the medical record,including their current functional status.

All pertinent medical records must be available for review by VBA.

NOTE: VHA continues to provide compensation and pension (C&P) examinations and reports as requested by VBA, as part of any new disability claims or review process.

(2) Requests by a veteran for assistance in completing a VA disability claim are to be referred to VBA through official channels;

however, the clinician, if requested by the veteran, must place a descriptive statement in the veteran’s medical record regarding

the current status of the veteran’s existing medical condition, disease, or injury, including prognosis and degree of function.

This may then be requested by VBA for the purposes of making a claim determination.

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Well it has been a full year now since I submitted my appeal to the VA for review. In January it will be a year since they stated that it actually made it to a VA person for review. I haven't heard a thing an I can't get any kind of status update from them other than the canned response that " It is in review and we'll send you a letter when it has been decided! ".

Yet my Stepbrother who was in the army just got his stuff through the entire process an is coming back to him very soon an he only waited about 8 months from the time he filed until he got his answer back. It was his first time filing since he was still active reserve at the time which I think helped speed his along since he has ptsd from his time in service on active during the IRAQ war.

Why it takes so long with no information is killing me. I'm just scraping by. Bill collectors are knocking, one vehicle is broken and another is just barely running. I have to go every week to the VA to get my allergy shots an my other appointments for my nerves and back pain appointments are still going on. They are now talking about sending me to a surgeon to see if relief from the pain may be solved by surgery.

I just went a month ago to an outside nerve conduction specialist after a year from my previous surgery for my arm to remove the pain from my ulnar nerve on my right arm but the pain still persisteded so I got sent back for another nerve test. This time I had a small chance of carpal tunnel and nerve compaction on the C-8 or somthing vertibrae. But when sent to the Orlando MRI specialist who read the MRI info and the Nerve info they didn't find anything out of ordinary. Like somebody who looks at hundreds of MRI's and nerve tests a day is going to look to deep into each one that comes across their desk. Obviously I have pain, I keep coming back every month complaining about the pain and I'm on several pain meds an other drugs.

What is they come back from this TDIU an deny my claim again? What am I to do then? Can I still file an get a lawer involved? Am I dead in the water if they don't approve me this time? Battling this crap for 8 years is getting pretty old and struggling like this is no fun fest for my wife I'm sure. I can tell she is getting tired of dealing with this crap an at times I'm sure she would just like to leave me an move on with her life and not have to be so damned broke all the time. It is a huge strain on our marriage an I'm not sure if she is going to keep fighting with me if their isn't a light an the end of the tunnel soon. Perhaps I should file for the Social Security stuff an see if I can get that also. But I've heard it is even harder getting that!

I'm about to give up on this stuff.

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  • HadIt.com Elder

Yes, you can hire a lawyer. We need more facts regarding your claim. What is it you are claiming and what evidence do you have for service connection? Have you had a C&P exam? Did you file with the BVA or VARO?

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