The folks who have been on this board for a while know me, and know what my last VA battle entailed. A quick rundown for new folks, or the old ones that have forgotten, though:
I am 90/ TDIU/ P&T since October 2008. I have not had any C&P's scheduled, and it is written in my last decision letter that no more will be scheduled. I've been around the VA long enough to know that what is written in that decision letter and a dollar will get you a cup of coffee, though. I have several conditions that are currently SC'd and rated. The list is:
Neurogenic Bladder - 60%
Intervertebral Disc Syndrome - 40%
Mood Disorder Due to a General Medical Condition - 30%
Sciatica - 10%
Left Knee - 10%
Right Knee - 10%
Hearing Loss - 10%
Tinitus - 10%
Left Foot Plantar Fascitis - 10%
I have moderate to severe central canal and foraminal spinal stenosis, facet joint arthritis, and degenerative disc disease in my entire lumber spine. I also have healed compression fractures at T-11, T-12, and L1. This has led to a foot drop on the right side that I have to wear a AFO brace for. I have a torn meniscus and sctretched PCL in the right knee, and "runner's knee" in the left knee. I have to take about 30 pills a day in order to function at a minimal level, and have been doing so for many years.
In the last 2 years, I have started to go downhill in many areas. The medicaations have caused me to have chronic abnormal liver enzymes and chronic gastritis type symptoms. I took a fall in 2010 when I tripped over my droopy foot and injured my right shoulder. Last winter I started developing sciatica on the left side, and last month I was diagnosed with bursitis in my left hip, which is every bit as debilitating as the back pain.
While researching on Hadit for a friends claim, I found a Fast Letter from 2010 regarding TDIU. It states that if a veteran is rated as IU based on a single issue, then that issue is considered a total (100%) rating for the purpose of assigning SMC - S. I am thinking about filing a claim for the S award based upon my IU for IVDS (the condition used in the VA's decision to grant me TDIU) and having a 60% award in addition. I am also thinking of filing a claim for a K award based upon the right side foot drop. Since I would already be filing, I am thinking I might as well ask for SC for the shoulder injury, hip bursitis, left side sciatica, digestive issues, and elevated liver enzymes. I would also seek a increased rating for the right side sciatica, due to the foot drop and possibly attempt to reopen a claim for GERD that they have denied a few times, but I almost got overturned on a DRO review in 2009 (they wanted to scope me for the C&P when the findings of that test weren't pertitnent to the rating criteria in any way, so I said no).
The thing is, I know I am already considered 100% P&T. I know I may get a schedular 100%, but I don't know if it would effect my P&T status. I know the additional schedular ratings would not increase my monthly compensation amount, but the two SMC awards would. However, I don't really need the extra money, since we are doing fine right now. My main points for wanting to do this is 1) I have legitimately earned the ratings, and feel I should be compensated for them, and 2) I want to have the digestive system, liver abnormalities, and GERD SC'd, because any one of them could turn into a life threatening condition down the road (should I die of a SC'd condition my family would still have some benefits).
My head is telling me to file these claims for the main reasons I just stated. My gut is telling me that I am currently off their radar screen and will be for a long time because of the OIF/OEF vets filing their claims, and the enormous backlog of claims that the VA is currently dealing with. Knowing that, my gut says to let sleeping dogs lie until they wake up on their own. In other words, my gut is saying when the VA decides that they didn't really mean P&T when they put it in writing, and call me in for a C&P, I could file the claims then. What do you guys and gals think? Go for it, or leave it be?
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
rentalguy1
The folks who have been on this board for a while know me, and know what my last VA battle entailed. A quick rundown for new folks, or the old ones that have forgotten, though:
I am 90/ TDIU/ P&T since October 2008. I have not had any C&P's scheduled, and it is written in my last decision letter that no more will be scheduled. I've been around the VA long enough to know that what is written in that decision letter and a dollar will get you a cup of coffee, though. I have several conditions that are currently SC'd and rated. The list is:
Neurogenic Bladder - 60%
Intervertebral Disc Syndrome - 40%
Mood Disorder Due to a General Medical Condition - 30%
Sciatica - 10%
Left Knee - 10%
Right Knee - 10%
Hearing Loss - 10%
Tinitus - 10%
Left Foot Plantar Fascitis - 10%
I have moderate to severe central canal and foraminal spinal stenosis, facet joint arthritis, and degenerative disc disease in my entire lumber spine. I also have healed compression fractures at T-11, T-12, and L1. This has led to a foot drop on the right side that I have to wear a AFO brace for. I have a torn meniscus and sctretched PCL in the right knee, and "runner's knee" in the left knee. I have to take about 30 pills a day in order to function at a minimal level, and have been doing so for many years.
In the last 2 years, I have started to go downhill in many areas. The medicaations have caused me to have chronic abnormal liver enzymes and chronic gastritis type symptoms. I took a fall in 2010 when I tripped over my droopy foot and injured my right shoulder. Last winter I started developing sciatica on the left side, and last month I was diagnosed with bursitis in my left hip, which is every bit as debilitating as the back pain.
While researching on Hadit for a friends claim, I found a Fast Letter from 2010 regarding TDIU. It states that if a veteran is rated as IU based on a single issue, then that issue is considered a total (100%) rating for the purpose of assigning SMC - S. I am thinking about filing a claim for the S award based upon my IU for IVDS (the condition used in the VA's decision to grant me TDIU) and having a 60% award in addition. I am also thinking of filing a claim for a K award based upon the right side foot drop. Since I would already be filing, I am thinking I might as well ask for SC for the shoulder injury, hip bursitis, left side sciatica, digestive issues, and elevated liver enzymes. I would also seek a increased rating for the right side sciatica, due to the foot drop and possibly attempt to reopen a claim for GERD that they have denied a few times, but I almost got overturned on a DRO review in 2009 (they wanted to scope me for the C&P when the findings of that test weren't pertitnent to the rating criteria in any way, so I said no).
The thing is, I know I am already considered 100% P&T. I know I may get a schedular 100%, but I don't know if it would effect my P&T status. I know the additional schedular ratings would not increase my monthly compensation amount, but the two SMC awards would. However, I don't really need the extra money, since we are doing fine right now. My main points for wanting to do this is 1) I have legitimately earned the ratings, and feel I should be compensated for them, and 2) I want to have the digestive system, liver abnormalities, and GERD SC'd, because any one of them could turn into a life threatening condition down the road (should I die of a SC'd condition my family would still have some benefits).
My head is telling me to file these claims for the main reasons I just stated. My gut is telling me that I am currently off their radar screen and will be for a long time because of the OIF/OEF vets filing their claims, and the enormous backlog of claims that the VA is currently dealing with. Knowing that, my gut says to let sleeping dogs lie until they wake up on their own. In other words, my gut is saying when the VA decides that they didn't really mean P&T when they put it in writing, and call me in for a C&P, I could file the claims then. What do you guys and gals think? Go for it, or leave it be?
90%, TDIU P&T
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