I am at a complete loss for words. I got my denial for TDIU last week. I was too busy fuming to post until now. I was diagnosed with Raynaud's Phenomenom in 2004. I was discharged for this reason and awarded 40%. There is no cure for Raynaud's. I seriously do have Raynaud's attacks every single day. I have stopped bringing it up at doctors appointments due to the fact that many Rheumatologists have explained to me that I have tried all treatment without improvement- so my only course of action is lifestyle change- wearing gloves- even in the house during the winter, not going outside for more than 5 minutes in the winter, holding a napkin when taking a cold can from the fridge. In the summer I avoid tempurature changes such as sun to shade, Showering in luke warm water rather than hot, and air conditioning. I do all these things. I have always noted these lifestyle changes when asked about Raynaud's, but I do not bring it up on my own at appts. It's a dead issue. It's not going away, and they can't help me. They have proposed to take the 40% away do to Raynaud's improving. I have no paper trail to offer. Only old evidence proving that I was tested, poked, and proded by specialists for 3 years before giving up hope of improvement. Each time I was tested, I was diagnosed with Raynaud's. The problem is there is no quick test to go take to prove symptoms are still as severe. Although Raynauds is uncomfortable/painful, I have never claimed that I cannot work due to Raynauds. There are certain jobs out there, inside work, that could be done with this disorder. I did work after medical discharge from the Army until my neck/migraines got worse- which brings me to my second complaint.
I am also service connected for DDD C5 & C6. I had surgery in 2006. They connected migraine headaches to my neck. I claimed in 2006 for connection and was denied. In 2009, due to CUE migraines were connected. I have literally 2 pages of dates where migraines were reported at doc visits, most stating 2 days a week, prostrating, and needing bed rest. I have had a Neurologist confirm (which lead to CUE). I have been on several medications that did not work. My migraines are at 30% currently (percentage stayed the same with new decision).
C&P examiner 10/2010
Employ opinion: It is at least as likely as not that the veteran's service connected disabilities would negatively impact his ability to obtain/maintain gainful employment. Veteran's DDD cervical spine and headaches are severe. Veteran's neck condition would prevent him from doing any heavy physical work, repetative lifting, or a job that requires repetative bending of the neck. The severe headaches would prevent any useful employment. He gets at least two bad headaches each week requiring bedrest all day due to pain, nausea, and emesis.
The C&P examiner did not ask hardly anything about Raynaud's and did no hand testing, other than to say coloring is good at this time. Did however mention the precautions I take to reduce attacks. Also noted Raynaud's happens less than once a week. Really? Who the hell told you THAT? Wasn't me. I would have had to have forgotten that I live with this and it definately happens every single day for some reason or another.
Now for the EVIL raters opinions, where he came up with them? I do not know!
For migraines:
A review of the evidence indicates confirmation of your service connected diagnosis with your subjective reports of weekly headaches with most being prostrating. A review of your VA outpatient reports from September 7, 2004 to the present is negative for any report of your having or needing bedrest other than the October 2010 examiner's statement based on your reported complaints. There was no evidence of any prostrating migraines since 2004 other than your current exam. Based on the evidence considered, the evaluation of service connected migraine headaches assiciated with DDD of the cervical spine, which is currently 30 percent disabling, is confirmed and continued. A higher percent of 50 percent is not warranted unless there are very frequent, completely prostrating, and prolonged attacks productive to severe economic inadaptability.
HUH? According to that I have never had a migraine in 7 years. Wonder how I got 30%, a CUE, tons of medications, Neurologist appointments, and two pages of specific dates where migraines were complained about, with every doctor noting the severity?
DDD was increased and an additional 10% is granted for forward flexion of the cervical spine being 15 degrees or less. (Now DDD is 30%)
Individual Unemployablity:
A small number of you disabilities that were examined were found to warrant a change in the evaluations. Your DDD was determined to meet a higher criteria, however Raynaud's was found to have improved, based on the outpatient treatment reports (meaning I have not had any or complained about an untreatable condition- lessoned learned on that one- it should always be the worst day of your life when dealing with the VA). It should be noted that the evaluation of the migraine headaches disability was not warranted as the objective evidence in your OPTs failed to support the examiner's determination which were based on your subjective reports. All OPTs were reviewed (definately not the case) and none could support claims of prostrating attacks as the result of the weekly migarine headaches claimed.
As stated earlier, in order to be entitled to IU, your combined evaluation must be at least 70% disabling with one of those SC disabilities being at least 40%. Receipt of SSA information strongly support this criteria as it was a condition stated in that SSA decision, it is also service connected, and it is 40% disabling. However, as all service connected conditions needed to be examined, the previous rating, as well as this rating did not warrant that evaluation. If anything, it has been proposed to be 10% disabaling. In accordance with the VA regulations, you are provided 60 days to provide evidence showing that this reduction is not warranted which will also assist your claim for TDIU.
Okay, for starters they claim that both the past two C&P evaluations did not warrant 40% for Raynauds. The 2008 C& P stated "Raynaud's is still problematic and would limit veteran's ability to work. (even though I wasn't saying I could not work due to Raynauds). 2010 C&P all sounded great in my favor until the guy put down an answer of "once a week" to a question he never even asked me!
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.
Question
ferris7060
I am at a complete loss for words. I got my denial for TDIU last week. I was too busy fuming to post until now. I was diagnosed with Raynaud's Phenomenom in 2004. I was discharged for this reason and awarded 40%. There is no cure for Raynaud's. I seriously do have Raynaud's attacks every single day. I have stopped bringing it up at doctors appointments due to the fact that many Rheumatologists have explained to me that I have tried all treatment without improvement- so my only course of action is lifestyle change- wearing gloves- even in the house during the winter, not going outside for more than 5 minutes in the winter, holding a napkin when taking a cold can from the fridge. In the summer I avoid tempurature changes such as sun to shade, Showering in luke warm water rather than hot, and air conditioning. I do all these things. I have always noted these lifestyle changes when asked about Raynaud's, but I do not bring it up on my own at appts. It's a dead issue. It's not going away, and they can't help me. They have proposed to take the 40% away do to Raynaud's improving. I have no paper trail to offer. Only old evidence proving that I was tested, poked, and proded by specialists for 3 years before giving up hope of improvement. Each time I was tested, I was diagnosed with Raynaud's. The problem is there is no quick test to go take to prove symptoms are still as severe. Although Raynauds is uncomfortable/painful, I have never claimed that I cannot work due to Raynauds. There are certain jobs out there, inside work, that could be done with this disorder. I did work after medical discharge from the Army until my neck/migraines got worse- which brings me to my second complaint.
I am also service connected for DDD C5 & C6. I had surgery in 2006. They connected migraine headaches to my neck. I claimed in 2006 for connection and was denied. In 2009, due to CUE migraines were connected. I have literally 2 pages of dates where migraines were reported at doc visits, most stating 2 days a week, prostrating, and needing bed rest. I have had a Neurologist confirm (which lead to CUE). I have been on several medications that did not work. My migraines are at 30% currently (percentage stayed the same with new decision).
C&P examiner 10/2010
Employ opinion: It is at least as likely as not that the veteran's service connected disabilities would negatively impact his ability to obtain/maintain gainful employment. Veteran's DDD cervical spine and headaches are severe. Veteran's neck condition would prevent him from doing any heavy physical work, repetative lifting, or a job that requires repetative bending of the neck. The severe headaches would prevent any useful employment. He gets at least two bad headaches each week requiring bedrest all day due to pain, nausea, and emesis.
The C&P examiner did not ask hardly anything about Raynaud's and did no hand testing, other than to say coloring is good at this time. Did however mention the precautions I take to reduce attacks. Also noted Raynaud's happens less than once a week. Really? Who the hell told you THAT? Wasn't me. I would have had to have forgotten that I live with this and it definately happens every single day for some reason or another.
Now for the EVIL raters opinions, where he came up with them? I do not know!
For migraines:
A review of the evidence indicates confirmation of your service connected diagnosis with your subjective reports of weekly headaches with most being prostrating. A review of your VA outpatient reports from September 7, 2004 to the present is negative for any report of your having or needing bedrest other than the October 2010 examiner's statement based on your reported complaints. There was no evidence of any prostrating migraines since 2004 other than your current exam. Based on the evidence considered, the evaluation of service connected migraine headaches assiciated with DDD of the cervical spine, which is currently 30 percent disabling, is confirmed and continued. A higher percent of 50 percent is not warranted unless there are very frequent, completely prostrating, and prolonged attacks productive to severe economic inadaptability.
HUH? According to that I have never had a migraine in 7 years. Wonder how I got 30%, a CUE, tons of medications, Neurologist appointments, and two pages of specific dates where migraines were complained about, with every doctor noting the severity?
DDD was increased and an additional 10% is granted for forward flexion of the cervical spine being 15 degrees or less. (Now DDD is 30%)
Individual Unemployablity:
A small number of you disabilities that were examined were found to warrant a change in the evaluations. Your DDD was determined to meet a higher criteria, however Raynaud's was found to have improved, based on the outpatient treatment reports (meaning I have not had any or complained about an untreatable condition- lessoned learned on that one- it should always be the worst day of your life when dealing with the VA). It should be noted that the evaluation of the migraine headaches disability was not warranted as the objective evidence in your OPTs failed to support the examiner's determination which were based on your subjective reports. All OPTs were reviewed (definately not the case) and none could support claims of prostrating attacks as the result of the weekly migarine headaches claimed.
As stated earlier, in order to be entitled to IU, your combined evaluation must be at least 70% disabling with one of those SC disabilities being at least 40%. Receipt of SSA information strongly support this criteria as it was a condition stated in that SSA decision, it is also service connected, and it is 40% disabling. However, as all service connected conditions needed to be examined, the previous rating, as well as this rating did not warrant that evaluation. If anything, it has been proposed to be 10% disabaling. In accordance with the VA regulations, you are provided 60 days to provide evidence showing that this reduction is not warranted which will also assist your claim for TDIU.
Okay, for starters they claim that both the past two C&P evaluations did not warrant 40% for Raynauds. The 2008 C& P stated "Raynaud's is still problematic and would limit veteran's ability to work. (even though I wasn't saying I could not work due to Raynauds). 2010 C&P all sounded great in my favor until the guy put down an answer of "once a week" to a question he never even asked me!
Okay...HELP! What to do?
Link to comment
Share on other sites
Top Posters For This Question
12
4
3
1
Popular Days
Sep 14
14
Sep 15
6
Sep 16
5
Sep 17
2
Top Posters For This Question
ferris7060 12 posts
carlie 4 posts
Hoppy 3 posts
Pete53 1 post
Popular Days
Sep 14 2011
14 posts
Sep 15 2011
6 posts
Sep 16 2011
5 posts
Sep 17 2011
2 posts
26 answers to this question
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now