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14 Questions about VA Disability Compensation Benefits Claims
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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Most Common VA Disabilities Claimed for Compensation:
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Can a 100 percent Disabled Veteran Work and Earn an Income?
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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Commonly Claimed Disabilities
Tinnitus | PTS(D) | Lumbosacral Cervical Strain | Scars | Limitation of flexion, knee | Diabetes | Paralysis of Siatic Nerve | Limitation of motion, ankle | Degenerative Arthritis Spine | TBI – Traumatic Brain Injury
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By Matt Birchfield
Afternoon all.
I have been doing some research into Tinnitus and claiming secondary for Insomnia and Hypertension. I have a 10% for Tinnitus and 0% for hearing loss (submarine sonar tech), but honestly the lack of sleep is beating me down. I have not gotten a full night in several years. I usually get 5-6 hrs a night, with multiple interruptions due to what I feel is my ears ringing.
I did a search on the forum here for tinnitus and Insomnia but the last post was from 2012, hence the new thread.
I was able to find 3 cases where the VA ruled in favor of the member for secondary insomnia and secondary hypertension, Case numbers: 1207104, 1522463, and 1600946. The last case was for insomnia only. I also have a study that is an Examination of the relationship between Insomnia and Tinnitus, DOI: 10.1177/1179557318781078
My question is how do I get this all linked together? I plan on going to my primary care and taking this evidence to him (He's a retired commander) and see what his thoughts are, but I was also referred to you guys as the knowledgeable peeps.
Thanks
Matt
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By Pastor Kodiak
Yesterday, I received the Judgment from the Administrative Law Judge that handled my appeal. I am using a VA-trained/approved attorney and the judge found in our favor. After 40 years of fighting with the VA. I filed my original claim the second day after my discharge. It was denied over and over again for all these years.
I think what made a difference this time was the attorney pointing out that my VA psychologist that I'd been seeing for years, had diagnosed me and then the VA sent me to a specific non-VA psychologist for my C&P and she diagnosed me the exact same way and advised that I should receive a 100% rating for my PTSD.
They denied the claim (again) and when I got the decision letter explaining all the evidence they used to make their decision, they didn't include the report from my shrink or the C&P shrink.
So, now that service-connection is founded and they've already determined my rating (from the C&P already done), do I too have to go back to sleep for months and months? Sadly, my attorney is on vacation (of all the times to go on vacation...) and his paralegal doesn't feel comfortable telling me what to expect next...
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By VietnamVetSis
Has anyone had any luck with claiming Sleep Apnea as secondary to Hypertension and/or Arteriosclerotic Heart Disease ? My husband has service connection for both hypertension and heart disease and now a current diagnosis and medical equipment for sleep apnea. I've read where VA has approved hypertension secondary to sleep apnea and heart disease secondary to sleep apnea, but not the other way around. If anyone has an archived VA citation in this regard, or personal experience, would greatly appreciate hearing about it. Thanks all.
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By Shake-n-Bake
I am still awaiting the notification letter with full details but, according to eBenefits, they have denied my claim for hypertension secondary to PTSD. The basis of my claim was not so much that the PTSD caused the hypertension (although I suspect it may have), but that my PTSD aggravates the hypertension. It looks like the decision was based on the C&P examiners opinion that my hypertension is caused by my weight, rather than my PTSD. His notes do not address the issue of the one aggravating the other. I guess I'll appeal the decision, although I'm not sure how that process works, or really what I'll be able to say, or do, differently to help my case. Below is a redacted copy of the C&P exam notes, if anyone would be so kind as to offer an opinion and/or advice. It bears noting that in his remarks, he states that in 2009 I weighed 160 pounds and my blood pressure was normal. However, I thought 140/90 was the upper threshold of normal. The evidence he is citing reflects a reading of 142/86. Does the VA use a different criteria, because 142 is not normal by generally accepted hypertension parameters. Also, he states that the BP readings used to diagnose are not present, but I did the medical records from when I was diagnosed and they show a reading of 150/110 at that time. So, I would have to say that his statement is factually untrue, based on that the evidence that I submitted.
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Hypertension Disability Benefits Questionnaire Name of patient/Veteran: Shake-N-Bank Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with hypertension or isolated systolic hypertension based on the following criteria: [X] Yes [ ] No [X] Hypertension ICD code: 00 Date of diagnosis: 2013 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's hypertension condition (brief summary): noted to have high blood pressure and begun on medication on 2013. Had normal pressure in 2009 and weight of 160 pounds. b. Does the Veteran's treatment plan include taking continuous medication for hypertension or isolated systolic hypertension? [X] Yes [ ] No If yes, list only those medications used for the diagnosed conditions: lisinopril c. Was the Veteran's initial diagnosis of hypertension or isolated systolic hypertension confirmed by blood pressure (BP) readings taken 2 or more times on at least 3 different days? [ ] Yes [ ] No [X] Unknown d. Does the Veteran have a history of a diastolic BP elevation to predominantly 100 or more? [ ] Yes [X] No 3. Current blood pressure readings ---------------------------------- Systolic Diastolic Blood pressure reading 1: 138 / 82 Date: 8/23/2017 Blood pressure reading 2: 122 / 78 Date: 8/23/2017 Blood pressure reading 3: 126 / 80 Date: 8/2017 Average Blood Pressure Reading: 128 / 80 4. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ----------------------------------------------------------------------- a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to the conditions listed in the Diagnosis Section above? [X] Yes [ ] No If yes, describe (brief summary): 8/11/2017 209 lb b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No c. Comments, if any: No response provided 5. Functional impact -------------------- Does the Veteran's hypertension or isolated systolic hypertension impact his or her ability to work? [ ] Yes [X] No 6. Remarks, if any ------------------ No remarks provided. **************************************************************************** Medical Opinion Disability Benefits Questionnaire Name of patient/Veteran: Shake-N-Bake ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: relation of hypertension to PTSD b. Indicate type of exam for which opinion has been requested: hypertension TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] b. The condition claimed is less likely than not (less than 50% probability) proximately due to or the result of the Veteran's service connected condition. c. Rationale: The pressures used to diagnose hypertension are not available but apparently were there in 2013 when he was started on medication. He has gained nearly 40 pounds of weight since 23009. This is the most likely caused of his hypertension and the PTSD is less likely than not. ************************************************************************* /es/ FRANCIS M REMBERT MD -
By Shake-n-Bake
I just had two C&P exams this morning and am trying to keep a positive mindset, but the glass looks half empty to me. Maybe someone else can offer some insight on my situation.
Since April, I have been rated at 60%; 50% for PTSD and 10% for tinnitus. The claims process for those went pretty smoothly, really, and I was awarded my disability ratings in very short time. I have since then filed three additional claims. My intent to file was back in April, but I submitted the claims on July 25. These three claims are for hypertension secondary to PTSD, sleep apnea secondary to PTSD and for hearing loss. Today I had my C&P exams for the hearing loss and hypertension. I have heard nothing about scheduling a C&P for the sleep apnea.
My first exam this morning was for hypertension. I was diagnosed with hypertension, by a private doctor, about 4 years ago and have been on medication since then and am currently being treated by the VA for my hypertension. My hypertension isn't very severe, but it is outside of normal parameters and has been this way consistently for quite a few years. Even though I wasn't officially diagnosed until 2013, I have (and submitted) evidence of prior medical records that show high blood pressure readings well before my actual diagnosis. I don't think I meet the criteria for anything more than a 0% rating, but that's all I really want, or need. I believe I have bradycardia (abnormally low pulse), as a result of my high blood pressure. My blood pressure has always fluctuated and spiked in relation to my PTSD symptoms, so I certainly think the PTSD aggravates my blood pressure, but I don't feel good about my C&P exam from this morning. The doctor was one of the weirdest people I've come across at the VA, so it was hard to get a good read on him. All he did was take my blood pressure 3, or maybe 4, times, all from my right arm, while I was seated. He wanted to know when I was first diagnosed and how many times they had taken my blood pressure during the visit in which I was diagnosed. I told him it was in 2013 and, although I didn't recall how many times they took a blood pressure reading, I did remember how high it was when I was diagnosed. I tried to discuss the evidence I had submitted to support my having actually had high blood pressure before my 2013 diagnosis, but he shut me down. He said anything that I sent in with my claim wasn't his concern. All he was doing was "checking the boxes" on my blood pressure exam and someone else would look at everything that was submitted. This doesn't make sense to me. Isn't the purpose of the C&P exam to look at the evidence, as well render an opinion? I have already been diagnosed with hypertension and am receiving treatment. I'm guessing my blood pressure readings from the C&P exam are within normal parameters...that's what the medication is for. I don't understand the point of putting me through this dog and pony show, but I certainly didn't walk out of there feeling good about it.
Next, I had my audiology exam for my hearing loss claim. I just had a audiology exam a little less than 2 months ago from a VA contractor and was subsequently issued hearing aids from the VA about a month ago. As I mentioned earlier, I already receive compensation for tinnitus, so part of me feels like the VA has already conceded that I had sufficient noise exposure in-service to cause damage, but I have also heard of people winning on tinnitus and losing on hearing loss. Since I had just recently had an audiology exam, I was only given an abbreviated C&P exam for my hearing. The audiologist stated that the contractor had not "submitted a full report", or something to that effect, so she only needed to do a partial test today. She asked me a little about my in-service noise exposure, as well as about my civilian occupations. It was over pretty quickly. I didn't feel quite as bad, or confused about that one as the hypertension C&P, but both of them seemed rushed and indifferent.
When I got home, I logged in to eBenefits to check on something unrelated and decided to look at my claim status. It had gone from Gathering Evidence to Preparation for Decision, since the last time I had checked on it. How could it be in Preparation for Decision? Mind you, I just had two C&P exams a couple of hours before. There is no way those reports had been sent in and considered already, so it had to have moved to Preparation for Decision a day, or more ago. Since I have not been scheduled for a C&P exam for my SA secondary to PTSD, I suspect now that they don't plan to give me an exam for the sleep apnea. The fact that they'd already moved my claim to Preparation for Decision before my exams leaves me with the impression that my claims are doomed to denial. Realistically, both the hypertension and hearing loss should each be rated at 0%, so that won't get me an increase in disability pay anyway, but a positive decision on the SA would. I also need the 0% ones, though, because of their relationship to other problems I have.
I'm a little confused by all of this and am certainly not feeling hopeful about my prospects at this point. Am I jumping to conclusion prematurely, or am I making a reasonable conclusion that things aren't going my way? It's been less than 30 days since my claims were filed and it's already been moved to Preparation for Decision before my C&P exams. I don't know what that means, but it doesn't seem good.
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Defense Bill Passage and Bladder Cancer
rebabevets posted a question in VA Disability Compensation Benefits Claims Research Forum,
I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently-
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5,10, 20 Rule
Ddsr posted a question in VA Disability Compensation Benefits Claims Research Forum,
The 5, 10, 20 year rules...
Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.
Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.
Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.
If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"
At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.
NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.
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Example for 2020 using the same disability rating
1998 - Initially Service Connected @ 10%
RESULT: Service Connection Protected in 2008
RESULT: 10% Protected from reduction in 2018 (20 years)
2020 - Service Connection Increased @ 30%
RESULT: 30% is Protected from reduction in 2040 (20 years)-
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Post in New BVA Grants
broncovet posted an answer to a question,
While the BVA has some discretion here, often they "chop up claims". For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.
I hate that its that way. The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.
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Finally Won...NOW WHAT?
Ztmiller8 posted a question in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC,
Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!
My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.
Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!-
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Post in Higher level review
Joey Ross posted an answer to a question,
I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and nothing about stressor,
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rootbeer22 254
Folks:
Today I went and did my Gulf War Exam. I provided everything that was relevant to the case in an additional package just in case my records did not get digitized into the system? So, when I went in to the exam room the doctor had a package that consisted of no more than 3 documents? Also, I had studied the questionnaire in depth just to know how to respond to the questions based upon the relevant data in my SMRs. But, during the exam I had a quick cursory exam, and only a handful of questions had been asked while he typed and typed for some time? It appeared that the examiner may have already made up his mind based upon those 3 pages that he was already provided? Anyway, I provided my own package with over 100 key documents to make my case with very specific data? I provided a record of about 120 Blood Pressure Readings over my army career which shows that my significant hypertension started and when I had a kidney issue in Kuwait and after my hospitalization there? Also, in an accusatory tone said that my blood pressure was very high today and wanted to know if I had skipped my BP Meds? Frankly, I was very offended by that and said why would I risk a stroke or heart attack when my records already showed a detailed pattern of HBP while taking meds? So, we'll see how it goes because these were supposed to be my last C & P Exams? However, the jury is still out on that and the outcome of this as well. Mostly, I've been treated with respect but some of the attitudes are disappointing when I did my duty without question and with complete loyalty.
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rootbeer22
Folks: Today I went and did my Gulf War Exam. I provided everything that was relevant to the case in an additional package just in case my records did not get digitized into the system? So, when I w
Navy04
I am glad we both made it thru the exams, and I hope we both get good news soon. Good luck
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