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How Do I Nod For Housebound

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MikeS

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Hi all:

I posted about my case before, but I am now ready to appeal.

Housebound denied because I keep my VA medical appointments.

Also, housebound denied because a recent Progress Note said that I go to a gym.

1. Does keeping VA medical appointments disqualify me from the housebound benefit?

2. The Progress Note that the VA claims person referred to does not say that I go to a gym. My VA Doc was simply describing the mental and physical difficulties that happen to me when I "used" to go to a gym once in a while over a year before the date of this Progress Note. I told my VA Doc about his misinterpreted Progress Note. He made a new Progress Note explaining that I had not gone to a gym in a year and a half, and that I stay isolated. He also wrote that it became a financial burden for me to buy a home a few blocks from the VA outpatient clinic. He also noted that I moved so close to the VA because being out in public has become so horribly difficult for me.

Is this new Progress Note considered new material?

Any thoughts?

Mikes

100% ptsd, panic disorder with agoraphobia

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  • HadIt.com Elder

Nod it and get a statement from the GYM saying you no longer go there. Most gyms have a tracking system and they can prove your issue. They may even print out a copy of the attendance record. Mine did.

What about statutory housebound. Do you have any other ratings besides the 100 percent PTSD?

Basser

A Veteran is a person who served this country. Treat them with respect.

A Disabled Veteran is a person who served this country and bears the scars of that service regardless of when or where they served.

Treat them with the upmost respect. I do. Rejection is not a sign of failure. Failure is not an option, Medical opinions and evidence wins claims. Trust in others is a virtue but you take the T out of Trust and you are left with Rust so be wise about who you are dealing with.

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  • HadIt.com Elder

Here is a quote from the M21 about leaving home to get medical treatment.

46. Entitlement to Housebound Benefits, Continued

b. Determining Whether the Veteran is Permanently Housebound in Fact If entitlement is based on the veteran being housebound in fact, the law requires the housebound state to be permanent.

Consider a veteran permanently housebound if, as a result of a single, total disability, by itself or in combination with other SC disabilities, the veteran is permanently and substantially confined to

• his/her place of residence and immediate premises, or

• ward or clinical areas, if institutionalized under 38 CFR 3.350(i)(2).

Important:

There is no requirement that either the single disability, rated totally disabling, or the additional disability(ies), independently ratable as 60- percent or more disabling, be permanent in nature.

• Leaving home for medical purposes cannot, by itself, serve as the basis for finding that a veteran is not substantially confined for purposes of SMC Housebound benefits.

Reference: For more information on substantial confinement to home, see Howell v. Nicholson, March 23, 2006, No. 04-0624.

A Veteran is a person who served this country. Treat them with respect.

A Disabled Veteran is a person who served this country and bears the scars of that service regardless of when or where they served.

Treat them with the upmost respect. I do. Rejection is not a sign of failure. Failure is not an option, Medical opinions and evidence wins claims. Trust in others is a virtue but you take the T out of Trust and you are left with Rust so be wise about who you are dealing with.

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  • HadIt.com Elder

The main problem is there is no legal definition of the word substantially. I've looked everywhere. They keep using the same reasoning when denying my HB claim. I attend weekly VA groups and other appointments, on an as needed basis. To me substantially would mean more than 50% of the time. More like 80% of the time but the VA doesn't see it that way. jmo

pr

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  • HadIt.com Elder

If they used the words substantially, then they are mis quoting the regs. Predonimant is the key word which means most or more then. SO if your BP readings fluctuate (Which they do), a chart could be made of past readings and one can show the actual readings per number of readings and it more are compensable than not then it should be a 10 percent rating.

It drove me up the wall when I was fighting my HTN claim. The VA said I had no complaints, diagnosis or treatment for HTN in service when 14 out of 17 in service BP readings were over 100 Diastolic.

That in itself is another issue.

Hang in there.

J

A Veteran is a person who served this country. Treat them with respect.

A Disabled Veteran is a person who served this country and bears the scars of that service regardless of when or where they served.

Treat them with the upmost respect. I do. Rejection is not a sign of failure. Failure is not an option, Medical opinions and evidence wins claims. Trust in others is a virtue but you take the T out of Trust and you are left with Rust so be wise about who you are dealing with.

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Nod it and get a statement from the GYM saying you no longer go there. Most gyms have a tracking system and they can prove your issue. They may even print out a copy of the attendance record. Mine did.

What about statutory housebound. Do you have any other ratings besides the 100 percent PTSD?

Basser

No. It's 100% ptsd with panic disorder with agoraphobia and depression.

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Here is a quote from the M21 about leaving home to get medical treatment.

46. Entitlement to Housebound Benefits, Continued

b. Determining Whether the Veteran is Permanently Housebound in Fact If entitlement is based on the veteran being housebound in fact, the law requires the housebound state to be permanent.

Consider a veteran permanently housebound if, as a result of a single, total disability, by itself or in combination with other SC disabilities, the veteran is permanently and substantially confined to

• his/her place of residence and immediate premises, or

• ward or clinical areas, if institutionalized under 38 CFR 3.350(i)(2).

Important:

There is no requirement that either the single disability, rated totally disabling, or the additional disability(ies), independently ratable as 60- percent or more disabling, be permanent in nature.

• Leaving home for medical purposes cannot, by itself, serve as the basis for finding that a veteran is not substantially confined for purposes of SMC Housebound benefits.

Reference: For more information on substantial confinement to home, see Howell v. Nicholson, March 23, 2006, No. 04-0624.

Thanks.

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