I'm Lost At Sea In The Paperwork Ocean

[wutzthedeal]

Hey guys; I've used this forum and its information on and off since 2001 and I'm very thankful for all the guys who put in tireless efforts to help veterans. The guy that helped me the most, Flip Heilig, is one I've lost touch with but he was like a VA claim marathon runner; always pushing, pulling new case studies, sending and re-sending requests, he helped me so much.

Anyway, now I'm lost. I'll make this as short as possible (not sure if that's a good idea based on some other posts I've read, but I think this helps get the forum "routing" right): I served AD USAF 1990-94 in support of Desert Shield/Storm. I had hurt my knee before coming in; MEPS made me have it examined to make sure I could still join and the ortho. doc said the knee was completely healed and healthy.

With maybe 2 days left in basic training, I completely blew the knee out, popped the ACL in half, crushed the medial meniscus. They drained and braced it so I could graduate, and told me to get follow up help at my first permanent base after tech school, which was Langley, so I did. 1992: arthroscopic knee surgery with partial, crushed medial meniscus removal; acl deficiency noted. PCS to Eielson AFB, AK, followed docs orders to get ACL reconstruction consult up there. Got that, got the ACL reconstruction at Ft. Wainright Army Base in 1993. Since then, the knee has become gradually worse, with extreme varicose veins popping up on the back of the leg behind the knee, arthritis diagnosed most recently by the VA as "moderate arthritis with degenerative changes." The initial award was 20% less 10% EPTS (I presume that meant injury or episode prior to service, which I have disagreed with since I got out in 1994 since that MEPS doc had called me 100%). Because of Flip's help, I got the knee rating where it should have been and a scar over my eye added in from a butchered cyst removal to take me to 50%. That was around 2001. Around 2006, I was having trouble climbing stairs and filed for an increase, so I got a C&P exam--I made the huge mistake of telling that doctor that I was having a good day and was on my meds, but ended up getting reduced to 20%. I was shocked, as I had not even claimed the huge, painful scar that was over my knee that causes me not to be able to kneel at all. That doctor also was evaluating my flexion/extension and although they are supposed to stop on flexion, I believe (sliding your heel toward your butt) when you experience pain, he rammed my knee into a bent position beyond my groans of pain (even though I was having a good day) and wrote down that %, instead. I had no idea he was doing this.

Of course, I was still working through all of this. I had also blown my back out in 2001 but could never prove that was due to my favoring my left leg for daily use rather than the injured right.

Since then, my conditions evolved, and now I have fibromyalgia, severe spinal arthritis, moderate knee arthritis and a few others that I don't think would affect a VA claim.

When the VA came down with their 20% reduction from 50% decision, they sent a letter to ask if I wanted to appeal. Of course I did, but could not make it to the appeal hearing because I had no transportation and it was 100 + miles away. Since then, I've done some letters to congress and the VA response was pretty much, "He asked for a hearing but didn't show." So I filed again for an increase and the VA said they were processing it. Haven't heard back in a long time. I don't even know if I HAVE an active claim right now. SO, I decided to re-join the American Legion in hopes of getting help (I was a member for some years before but never used my benefits or even coupons) so I got in touch with a rep. for here in Virginia and he referred me to some offices. This just happened over the past couple of days.

1. Given my situation, would your next move be to get the American Legion rep., to get a lawyer, or to do some type of requests/submissions to the VA on your own?

2. I don't ever want to "game the system," so I do not want anymore than the guidelines say I'm entitled to, so I'm not looking for ways to "beat" the VA, yet I feel like they have beaten the hell out of me at this point; judging by my conditions posted, what percentage would you be comfortable with to feel like things were square?

3. Has anybody else gotten so deep into claims/counter-claims and such they they just got lost? That's where I am.

Your help and advice are appreciated and thank you to my fellow vets for your service.

[Berta]

"I don't even know if I HAVE an active claim right now"

If I were you I would join ebennies, and even better, file an IRIS request as to the status and whereabouts of the claim.

The "Contact Us" button at www.va.gov will guide you through the steps to send the request.

I recommend requesting an email reply and not a phone call.

[71M10]

They may have done an improper reduction. If you held a rating for over 5 years they cannot reduce you on the results of 1 exam, any exam that is used to propose a reduction must be as complete as the exam that was used to grant the rating. That is a pretty high bar that is set. If you review the records I suspect you will find they didn't do it correctly.

[wutzthedeal]

To answer both of the last two posts; it had been about 4 years, six months between the increase and the decrease, so I JUST missed that 5 year mark that would have probably saved me. I feel like such an idiot... should have never asked for an increase. And I went to ebenefits online and found out I do not currently have an open claim; they're last decision came down in 2010 (I don't even remember getting a copy of this) based on one exam at another doctor who, once again, rammed my heel up into my butt while I screamed like a little kid. Then called those flexion numbers out for his assistant to write down. So what I'm thinking about doing now is going ahead and opening up a new claim to set the "backpay date" to as early as possible while trying to find good representation this time. Does that make sense? And then go for who; American Legion rep or some type of private VA Lawyer like Rep 4 Vets?

[wutzthedeal]

So it's official; today is the "next" official re-opened claim day (even though I think I should get 10% backpay back to 1994 for the false EPTS claim, and 30% back to the wrongful reduction in 2006; this is why I want representation; don't want to screw this up!).

[john999]

If you are totally lost in VA maze I would hire a lawyer if you have been denied on a claim and have filed a NOD. I have not have had such great luck with lawyers but the DAV, VFW or AL are hopeless. The VFW once argued that my real problem was that I had a personality disorder on top of service connected schizophrenia. I lost that increase. This was about 30 years ago, but I don't think they have improved.

[TiredCoastie]

I agree with John. I'd contact a solid veterans lawyer in your area and at least sit down on a free consultation to see what he has to say.

In terms of VSOs, unless you've got a very good recommendation from someone local who knows the service officer or officers personally, you can get someone stellar or get a stinker. You don't have to join the organization to use their VSOs, by the way.

Because of the way you were reduced, I think starting with an attorney would be the best way ahead. There should be a significant amount of backpay due you which would entice anyone hoping to collect 20% of it to work hard on your behalf if the case is winnable. It sounds challenging, though. With the reduction so far in the past and you unable to appear for the hearing, it's going to be tough.

Could there be a CUE here?

Edited March 15, 2014 by TiredCoastie