Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • 01-2024-stay-online-donate-banner.png

     

  • 0

Claim Done Now The Question

Rate this question


id_firefighter30

Question

Well I finally Got my explanation of benefits and i have a couple of questions so here goes a little bit of the history I am currently rated at 90%, 70% for depression 50% for sleep apnea and 10% for left knee and 10% for Left ankle also 10% for right lateral epicondilitis and 10% for tinnitus so I put in a claim June of last year for increase on L knee and ankle and also new right ankle instability and arthritis new in all lower joints ankles and knees and to reopen my Diabetes that was ruled non SC in 2011 Fast forward to today I have read the explanation many times and i have some questions that I am hopping that you all can help with so here goes.

First question is i know that the knee is the body part that can have more then one SC disability with out pyramiding the disabilities so when i got my letter it explains that the have awarded my arthritis claim and changed the the diagnostic code from 5259 but combined previous rating with the arthritis but if i look up the old code it deals with removal of semilunar cartilage but i thought that the arthritis should be under its own rating.

Second question when you are diagnosed with Arthritis in two or more major joints as diagnosed with X-Ray evidence that the rating would be 20% i was awarded SC for arthritis in both knees and both ankles so i am wondering if this is correct and if so is the 20% for each joint or do they rate them all at a single 20% my right knee was given 10 for arthritis and the ankle was combined together with chronic tearof the talofibular and calconofibular ligaments and DJD and achilles tendonitis and given a 10%.

question 3 is with the Diabetes they still say denied but give me a list of evidence that if i can show was taken before i left service or with in one year that would prove it started while on active duty and at the end of the statement it says the claim for SC is reopened does that mean they are giving me the benefit of the dobt to find the info and send in to get it granted instead of saying the info i sent in to try to get the claim reopened was not new or material evidence

Thanks all for your help My VSO Hasn't answered my Emails so im just trying get all this clear inmy head as to what i need to send in a appeal on thanks again all

70% Depression
50% OSA
10% L knee
10% L Ankle
10% R Elbow
10% Tinnitus

10% R Ankle

10% R knee

10% L ankle scar

10% R ankle scar

100% P&T

Link to comment
Share on other sites

  • Answers 4
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

4 answers to this question

Recommended Posts

  • 0
  • HadIt.com Elder

When in doubt send in your NOD. You have plenty of time to gather more evidence but if you NOD date passes you are pretty much screwed. I spent 7 years finding that out recently. I have 90% also and my ratings look sort of like yours. I need another 50% to get 100% scheduler. That may happen one day but I have TDIU for 12 years anyway. I got a 0% rating bumped up to 60% which gave me "S" by just appealing the bad decision.

Link to comment
Share on other sites

  • 0

I am planning on sending in a NOD im just trying to make sure what i am thinking is correct with the 2 new SC conditions i am rated approximately at 93% but paid at 90% im just wondering if the VA realized that and is trying to get me to take what they gave me with the arthritis even though the info they provided in the decision letter states if i had x-ray evidence that it was two or more major joints it would be 20% well i do all four lower joints x-ray and MRI evidence thanks again for your help i appreciate it

70% Depression
50% OSA
10% L knee
10% L Ankle
10% R Elbow
10% Tinnitus

10% R Ankle

10% R knee

10% L ankle scar

10% R ankle scar

100% P&T

Link to comment
Share on other sites

  • 0

I have never applied been to stubborn and tried to work as long as i could was trying to get to 100% scheduler but i finally broke down and filled for IU with my VSO this am i have been out of work since dec and have applied for ssdi so we will see what happens

70% Depression
50% OSA
10% L knee
10% L Ankle
10% R Elbow
10% Tinnitus

10% R Ankle

10% R knee

10% L ankle scar

10% R ankle scar

100% P&T

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • spazbototto earned a badge
      Week One Done
    • Paul Gretza earned a badge
      Week One Done
    • Troy Spurlock went up a rank
      Community Regular
    • KMac1181 earned a badge
      Week One Done
    • jERRYMCK earned a badge
      Week One Done
  • Our picks

    • 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.

      Rating Issues

      Continue Reading on HadIt.com
      • 0 replies
    • 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.  
      • 4 replies
    • Caluza Triangle defines what is necessary for service connection
      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”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • 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.   
×
×
  • Create New...

Important Information

Guidelines and Terms of Use