ptsd Manilla Envelope

[Slick]

Thanks all. Dr B did the IMO.

Wouldn't consider myself a lifer, just didn't get the memo and stuck around for 36 yrs. Pvt - Col.

90% is current. This brought it up from 80%

Breakdown as follows:

9411-POST-TRAUMATIC STRESS DISORDER(50% SC)

5255-IMPAIRMENT OF FEMUR(10% SC)

7101-HYPERTENSIVE VASCULAR DISEP,SE(10% SC)

5003-ARTHRITIS, DEGENERATIVE(10% SC)

5003-ARTHRITIS, DEGENERATIVE(10% SC)

5242-DEGENERATIVE ARTHRITIS OF THE SPINE(10%

5255-IMPAIRMENT OF FEMUR(10% SC)

Recent-

Sleep Apnea 50%

Tinnitus 10%

scars 10%

degenerative joint- rt knee 10%

Couldn't get scanner to reduce size so I could upload so here's a cut and paste

DEPARTMENT OF VETERANS AFFAIRS
Roanoke Regional Office
116 N. Jefferson St.
Roanoke, VA 24016

VA File Number

Represented By:

Rating Decision
December 09, 2013

INTRODUCTION

The records reflect that you are a veteran of the Vietnam Era, Peacetime and Gulf War Era. You served in the Marine Corps from June 22, 1968 to October 31, 2004. You filed a new claim for benefits that was received on January 24, 2012. Based on a review of the evidence listed below, we have made the following decision(s) on your claim.

DECISION

1. Service connection for obstructive sleep apnea is granted with an evaluation of 50 percent effective April 18, 2012.
2. Service connection for painful scars bilateral lower legs is granted with an evaluation of 10 percent effective November 27, 2012.
3. Service connection for tinnitus is granted with an evaluation of 10 percent effective January 24, 2012.

Page 2 of 11

1. Service connection for gastro esophageal reflux disease is granted with an evaluation of 0 percent effective November 27, 2012.
2. Service connection for right apical pleural thickening (claimed as lung fibrosis) is granted with an evaluation of 0 percent effective November 27, 2012.
3. Service connection for scar left lower leg is granted with an evaluation of 0 percent effective November 27, 2012.
4. Service connection for scar right lower leg is granted with an evaluation of 0 percent effective November 27, 2012.
5. Service connection for scar, right knee status post arthroscopy is granted with an evaluation of 0 percent effective November 27, 2012.
6. Evaluation of degenerative joint disease, right knee with residuals of debridement (previously rated as right knee sprain (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips, lumbar spine, thoracic spine, knees, ankle, and feet)), which is currently 0 percent disabling, is increased to 10 percent effective November 27, 2012.
7. Evaluation of degenerative joint disease of the cervical spine (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips, lumbar spine, thoracic spine, knees, ankle, and feet), which is currently 10 percent disabling, is continued.
8. Evaluation of hypertension, which is currently 10 percent disabling, is continued. 12_ Evaluation of bilateral hearing loss, which is currently 0 percent disabling, is continued. 13. Service connection for diabetes is denied.

EVIDENCE

• VA Form 21-526, Veteran's Application for Compensation and/or Pension, received January 24, 2012
• VA Form 21-4138, Statement in Support of Claim, accepted as your claim for benefits, received January 30, 2012
• Private Treatment Records, Dr. Ann Parro, dated November 21, 2011
• Your written statement, received January 30, 2012
• Written statement, from ellMilli, dated April 16, 2012

ELLIOT S. KATZ

28 577 750 Page 3 of 11

• VA Form 21-526, Veteran's Application for Compensation and/or Pension, received April 18, 2012
• Your written statement, received February 10, 2012
• Private Treatment Records, Arlington Sleep Medicine, dated January 10, 2010
• Veterans Claims Assistance Act (VCAA) Letter, dated October 25, 2012
• DBQ AUDIO Hearing loss &Tinnitus, dated November 14, 2012
• Your written statement, received November 20, 2012
• VCAA Notice Response, received November 5, 2012
• Private Treatment Records, Dr. Craig Bash, dated November 21, 2012
• Your written statement, received November 13, 2012
• VA Form 21-4138, Statement in Support of Claim, accepted as your claim for benefits, received November 27, 2012
• VA letter concerning your claim, dated October 22, 2013
• DBQ DERM Scars, dated November 8, 2013
• DBQ MUSC Neck (cervical spine), dated November 8, 2013
• DBQ RESP Respiratory conditions, dated November 8, 2013

• DBQ Sleep apnea, dated November 8, 2013

• DBQ CARDIO dated November 8, 2013
• DBQ Medical Opinion, dated November 8, 2013
• DBQ MUSC Knee & lower leg, dated November 8, 2013
• DBQ GI Esophagus (including GERD & hiatal hernia), dated November 8, 2013

REASONS FOR DECISION

1. Service connection for obstructive sleep apnea.

Service connection for obstructive sleep apnea has been established as directly related to military service.

An evaluation of 50 percent is assigned from April 18, 2012, effective the date we received your claim for benefits.

We have assigned a 50 percent evaluation for your sleep apnea based on:

• Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine

A higher evaluation of 100 percent is not warranted unless the evidence shows:

• Carbon dioxide retention; or,
• Chronic respiratory failure; or,
• Corpulmonale; or,

Page 4 of 11

• Tracheostomy required.

2. Service connection for painful scars bilateral lower legs a$ secondary to the service-connected disability of residual of bilateral compartment syndrome of lower extremities.

Service connection for painful scars bilateral lower legs has been established as related to the service-connected disability of residual of bilateral compartment syndrome of lower extremities.

An evaluation of 10 percent is assigned from November 27, 2012, effective the date we received your claim for benefits.

The law allows additional compensation based on scars, which are painful or unstable even if compensable based on other factors. An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar.

We have assigned a 10 percent evaluation based on two painful scars of the left lower extremity, right lower extremity.

A higher evaluation of 20 percent is not warranted unless there are three or four painful or unstable scars; or one or two painful or unstable scars with at least one scar being both painful and unstable.

3. Service connection for tinnitus as secondary to the service-connected disability of bilateral hearing loss.

Service connection for tinnitus has been established as related to the service-connected disability of bilateral hearing loss.

An evaluation of 10 percent is assigned from January 24, 2012, effective the date we received your claim for benefits.

We have assigned a 10 percent evaluation for your tinnitus based on:

• Recurrent tinnitus

A single evaluation for recurrent tinnitus is assigned whether the sound is perceived in one ear, both ears, or in the head.

This is the highest schedular evaluation allowed under the law for this condition.

Page 5 of 1 I

4. Service connection for gastro esophageal reflux disease.

Service connection for gastro esophageal reflux disease has been established as directly related to military service.

A noncompensable evaluation is assigned from November 27, 2012, effective the date we received your claim for benefit&

We have assigned a noncompensable evaluation for your gerd based on:

• Pyrosis (Reflux)

A higher evaluation of 10 percent is not warranted unless the evidence shows two or more of the symptoms for the 30 percent evaluation of less severity. (A higher evaluation of 30 percent is not warranted unless there is persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health.).

This disability' is not specifically listed in the rating schedule; therefore, it is rated analogous to a disability in which not only the functions affected, but anatomical localization and symptoms, are closely, related.

5. Service connection for right apical pleural thickening (claimed as lung fibrosis).

Service connection for right apical pleural thickening (claimed as lung fibrosis) has been established as directly related to military service.

A noncompensable evaluation is assigned from November 27, 2012, effective the date we received your claim for benefits.

We have assigned a noncompensable evaluation for your lung fibrosis based on:

• Forced Expiratory Volume in One Second (FEV-1): 101 (Not considered for compensable evaluation)
• Ratio of Forced Expiratory Volume m One Second (FEV-1) to Forced Vital Capacity (FEV-1/FVC) greater than 80 percent of predicted value (104%)

Note: In every Instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met {38 CFR §4.31}

6 of 11

When there is a disparity between the results of different Pulmonary Function Tests (PFTs), so that the level of evaluation would differ depending on which test result is used, the test result that the examiner states most accurately reflects the level of disability shall be used. In your case, the examiner has indicated that your FEV-1/FVC ratio most accurately reflects your level of disability

A higher evaluation of 10 percent is not warranted unless the evidence shows:

• Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) of 66 to 80 percent predicted; or,
• FEV-1 to Forced Vital Capacity (FVC) (FEV-1/FVC) of 71 to 80 percent; or,
• Forced Expiratory Volume in One Second (FEV-1) of 71 to 80 percent predicted.

6. Service connection for scar left lower leg as secondary to the service-connected disability of residual of bilateral compartment syndrome of lower extremities.

Service connection for scar left lower leg has been established as related to the service-connected disability of residual of bilateral compartment syndrome of lower extremities.

A noncompensable evaluation is assigned from November 27, 2012, effective the date we received your claim for benefits.

We have assigned a noncompensable evaluation based on one or more linear scars_

A scar, located on your left lower extremity, measures 3.3 in² (21.0 cit, ²) and is superficial and linear.

The scar is painful, but not unstable.

Note: In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met {38 CFR §4.31}

A higher evaluation is not warranted unless scars are considered disabling because of limitation of function of the affected part.

7. Service connection for scar right lower leg as secondary to the service-connected disability of residual of bilateral compartment syndrome of lower extremities.

Service connection for scar right lower leg has been established as related to the service-connected disability of residual of bilateral compartment syndrome of lower extremities.

Page 7 of 11

A noncompensable evaluation is assigned from November 27, 2012, effective the date we received your claim for benefits.

We have assigned a noncompensable evaluation based on one or more linear scars.

A scar, located on your right lower extremity, measures 2.9 in² (19.0 cm²) and is superficial and linear.

The scar is painful, but not unstable.

Note: In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met {38 CFR §4.31}

A higher evaluation is not warranted unless scars are considered disabling because of limitation of function of the affected part.

S. Service connection for scar, right knee status post arthroscopy as secondary to the service-connected disability of degenerative joint disease, right knee with residuals of debridement (previously rated as right knee sprain (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips lumbar spine, thoracic spine, knees, ankle, and feet)).

Service connection for scar, right knee status post arthroscopy has been established as related to the service-connected disability of degenerative joint disease, right knee with residuals of debridetnent

A noncompensable evaluation is assigned from November 27, 2012, effective the date we received your claim for benefit&

We have assigned a noncompensable evaluation based on one or more linear scars.

A scar, located on your right lower extremity, measures 0.02 in² (0.1 cm²) and is superficial and linear.

The scar is neither painful nor unstable.

Note: In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. {38 CFR §4.31}

A higher evaluation is not warranted unless scars are considered disabling because of limitation of function of the affected part.

9. Evaluation of degenerative joint disease, right knee with residuals of debridement (previously rated as right knee sprain (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips, lumbar spine, thoracic spine, knees, ankle, and feet)) currently evaluated as 0 percent disabling.

The evaluation of degenerative joint disease, right knee with residuals of debridement

(previously rated as right knee sprain (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips, lumbar spine, thoracic spine, knees, ankle, and feet)) is increased to 10 percent disabling effective November 27, 2012.

An evaluation of 10 percent is assigned from November 27, 2012, effective the date we received your claim for benefits.

We have assigned a 10 percent evaluation for your right knee: based on:

- Painful motion of the knee (38 CPR §4.59 allows consideration of functional loss due to painful motion to be rated to at least the minimum compensable rating for a particular joint. Since you demonstrate painful motion of the knee, the minimum compensable evaluation of 10 percent is assigned)

Additional symptom(s) include:

- X-ray evidence of degenerative arthritis

The provisions of 38 CFR §§4.40 and 4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown, 8 Vet. App. 202 (1995), have been considered and applied under 38 CFR §4.59.

A higher evaluation of 20 percent is not warranted unless the evidence shows: - Limitation of flexion of 16 to 30 degrees.

10. Evaluation of degenerative joint disease of the cervical spine (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips lumbar spine, thoracic spine, knees ankle. and feet) currently evaluated as 10 percent disabling.

The evaluation of degenerative joint disease of the cervical spine (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips, lumbar spine, thoracic spine, knees, ankle, and feet) is continued as 10 percent disabling {38 CFR 3.321(a); 38 CFR 3.321(b) (1)}

We reviewed the evidence received and determined your service-connected condition(s) hasn't/ haven't increased in severity sufficiently to warrant a higher evaluation.

We have assigned a 10 percent evaluation for your degenerative joint disease of the cervical spine (claimed as degenerative joint disease multiple joints, bilateral shoulders, hips, lumbar spine, thoracic spine, knees, ankle, and feet) based on

• Combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees

Additional symptom(s) include:

• Painful motion upon examination

The provisions of 38 CFR §§4.40 and 4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown, 8 Vet. App. 202 (1995), have been considered and are not warranted.

A higher evaluation of 20 percent is not warranted unless the evidence shows forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis.

11. Evaluation of hypertension currently evaluated as 10 percent disabling.

The evaluation of hypertension is continued as 10 percent disabling. {38 CFR 3321(a); 38 CFR 3.321(b) (1)}

We reviewed the evidence received and determined your service-connected condition(s) hasn't/ haven't increased in severity sufficiently to warrant a higher evaluation.

We have assigned a 10 percent evaluation for your hypertension based on:

Page 10 all

• A history of diastolic pressure predominantly 100 or more and there is ^-a requirement for continuous medication for control

A higher evaluation of 20 percent is not warranted unless the evidence shows:

• Diastolic pressure predominantly 110 or more; or,

• Systolic pressure predominantly 200 or more.

1. Evaluation of bilateral hearing loss currently evaluated as 0 percent disabling. The evaluation of bilateral hearing loss is continued as 0 percent disabling.

VA examination findings show the left ear with 94 percent discrimination_ Decibel (dB) loss at the pure tone threshold of 500 Hertz (Hz) is 10 with a 10 dB loss at 1000 Hz, a 25 dB loss at 2000 Hz, a 65 dB loss at 3000 Hz, and a 65 dB loss at 4000 Hz. The average decibel loss is 41 in the left ear. The right ear shows a speech discrimination of 94 percent. Decibel (dB) loss at the pure tone threshold of 500 Hertz (Hz) is 15 with a 5 dB loss at 1000 Hz, a 15 dB loss at 2000 Hz, a 30 dB loss at 3000 Hz, and a 70 dB loss at 4000 Hz. The average decibel loss is 30 in the right ear.

An evaluation of 0 percent is assigned because your right ear has a speech discrimination of 94 with an average decibel loss of 30 and your left ear has a speech discrimination of 94 with an average decibel loss of 41. The evaluation for hearing loss is based on objective testing. Higher evaluations are assigned for more severe hearing impairment

REFERENCES:

Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our web site, www.va.gov.

[killemall]

Well played sir

[Computer Tech]

Congratulations.

Rick

[Berta]

I think you might be eligible for CRDP:

http://www.military.com/benefits/military-pay/concurrent-retirement-and-disability-pay-crdp-overview.html

"Concurrent Receipt Overview

Qualified disabled military retirees will now get paid both their full military retirement pay and their VA disability compensation. This recently passed law phases out (over 9 years) the VA disability offset, which means that military retirees with 20 or more years of service and a 50% (or higher) VA rated disability will no longer have their military retirement pay reduced by the amount of their VA disability compensation.

CRDP is supposed to be sort of automatic but Mil.com has the application at that link.

36 YEARS? USMC?????? Holy Cow

Thank You Colonel ,for those very long years of service!!!!!!

Edited December 17, 2013 by Berta

[MRRRR5]

Congrats to you sir.

[63SIERRA]

congratulations and thanks for your service sir. I salute you! you deserve all they can give, and then some.