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What Should I Appeal?

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OIFVet

Question

I am rated 90% (combined), with a 60, 30, 20, five 10's, and five 0's.

I do not believe I was rated appropriately on a few of the items and a couple of them are clear cut.

Should I appeal everything I believe I got rated low on or should I focus on the couple items that are clear cut?

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6 answers to this question

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IMHO...If you have the evidence to prove a disability, caused by or aggrivated by your service, you should contest their decision. Re-examine what the VA requires to prove each rating at the different percentage levels and submit a NOD. Have you looked into filing a TDIU claim? That should've been done "yesterday" but it's never too late! Without knowing what conditions you were rated for, it's difficult to speculate if you'd be successful. It would benefit you to read-up on what TDIU is and what the burden of proof needs to be. Not sure if you are currently working, etc. so hard to guess. Check out the topics here on Hadit that discuss TDIU...then you will be able to make a more informed decision.

Good luck friend!

LC

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IMHO...If you have the evidence to prove a disability, caused by or aggrivated by your service, you should contest their decision. Re-examine what the VA requires to prove each rating at the different percentage levels and submit a NOD. Have you looked into filing a TDIU claim? That should've been done "yesterday" but it's never too late! Without knowing what conditions you were rated for, it's difficult to speculate if you'd be successful. It would benefit you to read-up on what TDIU is and what the burden of proof needs to be. Not sure if you are currently working, etc. so hard to guess. Check out the topics here on Hadit that discuss TDIU...then you will be able to make a more informed decision.

Good luck friend!

LC

Yeah, I probably should appeal everything, but still wonder...

However, the clear cut things to me are Varicocele and GERD with Hiatal Hernia.

I got 0 for Varicocele but found many on appeal that got 20% with persistent inflammation and pain, which I have.

I got 10 for GERD with Hiatal Hernia. I got low balled because the provider (PA) did not check the 'frequent episodes of epigastric distress' box. He said he didn't know what they meant by that and that I should be good since everything else was checked. I have all GERD issues/symptoms and diagnosed with Hiatal Hernia. Had multiple EGD's in service, etc. My records are pretty extensive on this and also document my reflux as severe.

These are the clear cut issues to me.

The ones that get into shades of gray are the joint issues (Chondromalacia and Deg Disc). Their ratings don't reflect the amount of limitation the joint issues give me. The problem is I pretty much have full range of motion...it's just painful range of motion with weakness associated with periodic locking and giving out and audible cracking, grinding, popping, etc sounds. So, I got low-balled based on the range of motion tests...

If I got rated properly for the GERD and Varicocele though, I would reach 100% combined.

I don't know if TDIU is right for me yet. I am using my GI Bill and then hope to find a job that strikes the right balance between sedentary and active work. Too much of either causes issues for me.

Edited by OIFVet
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I totally understand. It is a very personal decision and one you must be comfortable with. I can remember several years ago when a doc was evaluating a scar I have by pushing down on it. I about came out of my chair and yelled out in pain! Yet this "contracted moron doctor" submitted his report and listed the scar as not being painful to the touch! WTF!!??

So years later and after a different doc examined me, I finally got the rating I should have. That's not a fun process for anyone to have to go through for compensation. If you're like me you just want to wake up one day and not have to fight the VA on stuff like this anymore. For me that day will come soon enough I hope. I hope whatever your decision is, that you find happiness in life. Best of luck to you going forward OIFVet.

LC

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  • HadIt.com Elder

It is very hard to get 100% scheduler unless you get it for one condition. I am 90% and I got one 70%, 60% and five 10%'s. I need another 50% to get to 100% due to VA math.

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It is very hard to get 100% scheduler unless you get it for one condition. I am 90% and I got one 70%, 60% and five 10%'s. I need another 50% to get to 100% due to VA math.

Actually, you only need one of your 10's to become a 30...or two 10's to become two 20's. :)

But I do wonder if they low ball ratings to avoid 100% combined...curious what will happen with mine on appeal.

Edited by OIFVet
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519, 283 Veterans in 2012 on full pay-- 100% (268,384) and TDIU (250,919). That's out of 2,983,256 from 0% to 100% combined. http://asknod.wordpress.com/2013/03/20/disabled-veterans-by-rating-and-state/

One major consideration to mull over. Many try to get TDIU. Just having the magic numbers is not the end. VA has hunkered down as more and more Afgan Vets come home with chips and dents. If it can be categorically proven that your injuries or illnesses preclude you from meaningful employment, you may prevail. If your highest rating is 60% for a back disorder or 70% for PTSD, VA will fight you to the mat to try to prove you can work. They're even promulgating new regulations for it http://asknod.wordpress.com/2013/06/21/fast-letter-13-13-regarding-tdiu-read-and-heed/

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cp

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