Hey guys; I would have posted in a more specific forum but my question covers a rather wide range of topics (from TDIU to ratings time limitations to legal reps).
Long story very short; served USAF 1990-94. Blew knee out in basic. Had 2 surgeries:
1st: partial crushed medial meniscus removal and notation of acl deficient (snapped) knee Langley, 1992
2nd: full bone-tendon-bone graft acl reconstruction, Ft. Wainright, 1993.
Although I was on a 6 year enlistment, my surgeon wrote up the paperwork that made me 4t (not worldwide deployable) and offered me an out with a small severance pay and a "20% less 10% EPTS" rating, because they say I injured it before enlisting, which is true. And there is the first problem; a private doctor, orthopedic, paid by the VA, checked me out at MEPS and called the knee 100% healthy, and that's in my records. Doesn't that make any new injury a NEW injury? So why the 10% subtraction? Been fighting that on and off since 1999.
Around 2002, with help from this forum and a close friend, I get my C&P and jumped to 50% with the VA doctor claiming that I had major arthritis in the knee and the condition was degenerative (which I always took to mean "doesn't get better; might stay the same if you're lucky"). I was happy.
2006 or so, the pain got a lot worse and the bone grinding started. I went for an increase, thinking I could at least get 60 or 70 and maybe take a shot at TDIU. I got reduced to 20%, and if that isn't bad enough, here's the fun part...
I have a scar over my eye from a hasty cyst removal; that got me 10% in both cases. The other scar is sensitive and painful (on my knee) yet I didn't get anything the last time as the rating suggests. The doctor for that C&P seemed like a bitter guy. I'm honest, and I had recently been given some pretty good pain medication for my back which helped with my knee. I told him that; I told him that that day was a good day. I had letters of support from people that had witnessed how my leg had affected my life. Even while on the pain medication, when he went to bend my knee by pushing my heel toward my butt, I let out the predictable yell almost the second he started, but he kept pushing until I tried to jump off of the table using my left leg; he then used that as the ROM (range of motion).
My degenerative condition had somehow been healed by the angels. The other tests involving flexibility and laxity and that type of thing were apparently all normal, according to him. All any human needs is one look at an MRI of mine to know that's all wrong. The first sign is the bones making contact in the knee joint.
So I appealed, but couldn't get to the hearing (had no money, no car). Over the past few years I've written a few letters and otherwise grown very tired with the fight. Finally, most recently, I got in touch with Alpha Veteran's Disability but had a bad experience with an employee there who blamed me for not getting in contact with him when I had received no calls or letters after 6 months and finally complained; least professional person I have ever dealt with in the business world. Now, I've filed with Rep4Vets and I don't know how that's going to go.
So that's about it: 20%-10% (10%) raised to 50 for degenerative conditions that magically turned regenerative and dropped me to 20. I hope I haven't put too much out at once. I read other posts and believed that getting the whole story out, in as few words as possible, was the best way to go. Please let me know what you would do next or what I've done wrong so far.
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
wutzthedeal
Hey guys; I would have posted in a more specific forum but my question covers a rather wide range of topics (from TDIU to ratings time limitations to legal reps).
Long story very short; served USAF 1990-94. Blew knee out in basic. Had 2 surgeries:
1st: partial crushed medial meniscus removal and notation of acl deficient (snapped) knee Langley, 1992
2nd: full bone-tendon-bone graft acl reconstruction, Ft. Wainright, 1993.
Although I was on a 6 year enlistment, my surgeon wrote up the paperwork that made me 4t (not worldwide deployable) and offered me an out with a small severance pay and a "20% less 10% EPTS" rating, because they say I injured it before enlisting, which is true. And there is the first problem; a private doctor, orthopedic, paid by the VA, checked me out at MEPS and called the knee 100% healthy, and that's in my records. Doesn't that make any new injury a NEW injury? So why the 10% subtraction? Been fighting that on and off since 1999.
Around 2002, with help from this forum and a close friend, I get my C&P and jumped to 50% with the VA doctor claiming that I had major arthritis in the knee and the condition was degenerative (which I always took to mean "doesn't get better; might stay the same if you're lucky"). I was happy.
2006 or so, the pain got a lot worse and the bone grinding started. I went for an increase, thinking I could at least get 60 or 70 and maybe take a shot at TDIU. I got reduced to 20%, and if that isn't bad enough, here's the fun part...
I have a scar over my eye from a hasty cyst removal; that got me 10% in both cases. The other scar is sensitive and painful (on my knee) yet I didn't get anything the last time as the rating suggests. The doctor for that C&P seemed like a bitter guy. I'm honest, and I had recently been given some pretty good pain medication for my back which helped with my knee. I told him that; I told him that that day was a good day. I had letters of support from people that had witnessed how my leg had affected my life. Even while on the pain medication, when he went to bend my knee by pushing my heel toward my butt, I let out the predictable yell almost the second he started, but he kept pushing until I tried to jump off of the table using my left leg; he then used that as the ROM (range of motion).
My degenerative condition had somehow been healed by the angels. The other tests involving flexibility and laxity and that type of thing were apparently all normal, according to him. All any human needs is one look at an MRI of mine to know that's all wrong. The first sign is the bones making contact in the knee joint.
So I appealed, but couldn't get to the hearing (had no money, no car). Over the past few years I've written a few letters and otherwise grown very tired with the fight. Finally, most recently, I got in touch with Alpha Veteran's Disability but had a bad experience with an employee there who blamed me for not getting in contact with him when I had received no calls or letters after 6 months and finally complained; least professional person I have ever dealt with in the business world. Now, I've filed with Rep4Vets and I don't know how that's going to go.
So that's about it: 20%-10% (10%) raised to 50 for degenerative conditions that magically turned regenerative and dropped me to 20. I hope I haven't put too much out at once. I read other posts and believed that getting the whole story out, in as few words as possible, was the best way to go. Please let me know what you would do next or what I've done wrong so far.
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