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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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jefmil50

Am I Sol On This Claim Or What?

Question

Last year I filed a claim for A&A after being discharged from hospital for a Multiple Sclerosis exacerbation. Now a year later I had my C&P exam and the decision. The claim was denied pretty much because my current rating is above the A&A level I was seeking. This is my conclusion after reading several opinions between members of a few forums on my case. I have asked a few times of where to go next and I have been told file a NOD, SOC what ever.

Well now I am wondering if I should have just asked for an increase or reevaluation instead of A&A? So on the issue of a NOD, what am I disagreeing with if my claim for A&A was turned down because I am already at or above that level? I am currently rated at smc m+k, and that rating was given to me back in 2008. Unfortunately my condition has deteriorated since then and probably need to be reevaluated.

My big question is, is it possible to save the original claim time considering I asked for something that was never going fly? Am I just SOL on that claim and just need to start a new claim? Any ideas would be greatly appreciated?

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When you ask for A&A is that a claim for an increase? If it is then file the NOD and state that your overall condition has gotten worse and you are seeking the highest level of evaluation you can possibly get via A&A or SMC. If you can work this so you don't give up EED that would be best. When the VA evaluates you they are supposed to award the highest possible rating given the facts. If a higher level of SMC is available and you qualify then you should get that. If a higher level of A&A exists that you qualify for then you should get that. Your claim may not fly without new evidence and the VA may grant an effective date that matches the date they get the new evidence. A&A and SMC rules are complicated. Somebody here knows exactly what you should do. I am basing my advice on general VA benefit of doubt and rules that say you are entitled to the highest rating possible if you qualify. If they deny A&A and you qualify for higher level of SMC they you should have it or vice versa.

John

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With any Neurological disease like MS, ALS, SMA, Huntingtons, The effects of these diseases attack the nerves. Each one is a little different but keep in mind that MS lesions on nerves can cause loss of use on limbs. The VA has to be able to figure that out. The SMC's are based on the severity of the condition such as loss of use, blindness, Aphonia. Remember this scale goes up to R2.

This same thing applies to stroke victims who do not get the proper treatment with TPA in time. Loss os use of body parts due to paralysis is pretty common.

Hang in there. It my benefit you to get an outside IME by a trained Neuro doc to explain it to the VA

Basser

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My original claim was for A&A not knowing that I should have just asked for a higher rating than the m+k that I am at now. Here is my decision from 2008.


SUBJECT TO COMPENSATION (1. SC)

5110 LOSS OF USE OF BOTH LOWER EXTREMITIES DUE TO MULTIPLE
SCLEROSIS
Service Connected, Peacetime, Presumptive
100% from 06/15/2007

5125 LOSS OF USE OF RIGHT ARM DUE TO MULTIPLE SCLEROSIS
Service Connected, Peacetime, Presumptive
20% from 03/13/1992
70% from 01/16/2001

8018-8520 MULTIPLE SCLEROSIS WITH LEFT LOWER EXTREMITY WEAKNESS
AND STATUS POST DEEP VEIN THROMBOSIS WITH PULMONARY
EMBOLISM
Service Connected, Peacetime, Presumptive
10% from 08/29/1986
30% from 06/18/1990
40% from 03/13/1992
60% from 01/16/2001 to 06/15/2007

8520 RIGHT LOWER EXTREMITY WEEKNESS AND SPASTICITY, DUE TO MULTIPLE
SCLEROSIS
Service Connected Peacetime, Presumptive
40% from 03/13/1992
60% from 03/29/2002 to 06/15/20007

7599-7542 URINARY URGENCY DUE TO MULTIPLE SCLEROSIS
Service connected, Peacetime, Presumptive
20% from 01/16/2001
6090 DIPLOPIA DUE TO MULTIPLE SCLEROSIS
Service Connected, Peacetime, Presumptive
0% from 03/13/1992


COMBINED EVALUATION FOR COMPENSATION


10% from 8/29/1986
30% from 06/18/1990
80% from 03/13/1992 (Bilateral factor 6.4 Percent for diagnostic codes 8520, 8520)
100% from 01/16/2001 (Bilateral factor 7.6 Percent for diagnostic codes 8520, 8520)
100% from 03/29/2002 (Bilateral factor of 8.4 Percent for diagnostic codes 8520,8520)
100% from 06/15/2007
Individual Unemployability Granted from March 13, 1992 to January 15, 2001 (Grant IU
under 38 CFR 4 .16(b)




SPECIAL MONTHLY COMPENSATION

K-1 Entitled to special monthly compensation under 38 U.S.C 1114, subsection (k) and
38 CFR 3.350(a) on account of loss of use of one hand from 01/16/2001.

L-1 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection(1) and
38 CFR 3.35(b) on account of loss of use of both feet from 06/15/2007

P-1 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (p) and
38 CFR 3.350 (f) (3) at the rate equal to subsection (m) on account of loss of use of both
lower extremities due to multiple sclerosis with additional disability, loss of use of right
arm due to multiple sclerosis independently ratable at 50 percent or more from
06/15/2007

P-3 Entitled to special monthly compensation under 38 U.S.C. 1114 subsection (p) and
38 CFR 3.350(f)(5) at the next higher rate or intermediate rate of subsection (p) due to
the loss of use of three extremities from 06/15/2007

So the new decision came back ad said: The level of SMC is confirmed and continued at its current level. I remember being in my wheelchair and the examiner turned around to me and said yep 100 there 100 there and blah blah. She kept asking about me handling my finances. So after a half hour we went home and in 2 days this was final.

This is pretty crazy but hopefully I can figure it out. I have no idea about saving that EED or even going forward? Jbasser yes my Neuro is pretty good and knows alot about these deseases so hopefully he can follow through.

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Ok filling out the NOD today and see where we go. I am assuming the AOJ is St. Pete RO, and not Louisville Kentucky where the final decision letter came from?

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