ptsd Confused On My Disability Rate %

[Lce]

I am a Gulf War Veteran (USMC) 1986-1991. I am also S/C 30% disability for asthma. I originally put my claim in for asthma, allegric rhinitis and ptsd back in 1998. It was denied for allegric rhinitis and ptsd. I just recently put in a claim for PTSD again and an increase on my asthma because it has worsen over time with more prescripition medication and immuntherapy. These symptoms along with many others that has developed over time was due to the burning oil fields, the hazards airborne particles and the burn pits near our unit. These were just the common elements being exposed to in Kuwait.

I recently had a C&P evaluation on my asthma and that went pretty well. the VA doctor even recommended for me to put in a new claim for Allergy and resubmit my claim for allegric rhinitis stating that it was related to the Gulf War. I'm a little confused because my award letter from 1998 denied me allegric rhinitis and Ptsd. Now when I go to review my claim status on Ebenefit it states that I am 0% s/c on both A/R and Ptsd. Which one should I go on? Is there any retro pay IF i do get awarded a % for A/R , Ptsd or any Gulf War undiagnose illness? Any assistance would be greatly appreciated.

[Philip Rogers]

It sounds to me that you may/could have a claim for a CUE, but would need to see your award/denial letter(s) and the evidence that "they used," to actually give an opinion. Service connection, even at 0%, is a major, major, major,(did I say major) win!!! jmo

pr

[Fat]

Good advice by all.

[Guest]

Is there any retro pay IF i do get awarded a % for A/R , Ptsd or any Gulf War undiagnose illness?

If and I say if you can prove with medical evidence that your Allergic Rhinitis and your PTSD had reached a certain level before your last rating decision then there could be retro pay due you. You would have to prove that VA had medical evidence that your Allergic Rhinitis and PTSD was in fact at a compensable rating. Here are the criteria's. Match your symptoms to your 1998 rating decision to see if you should have been given a higher rating.

4.129 Mental disorders due to traumatic stress.

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name....................... 100

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships........................... 70

Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships........... 50

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)........................................... 30

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication............... 10

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication..................... 0

Schedule of Ratings tables for Sinusitis and Allergic Rhinitis:


6510 Sinusitis, pansinusitis, chronic.
6511 Sinusitis, ethmoid, chronic.
6512 Sinusitis, frontal, chronic.
6513 Sinusitis, maxillary, chronic.
6514 Sinusitis, sphenoid, chronic.

General Rating Formula for Sinusitis (DC’s 6510 through 6514):
50% Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries

30% Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting

One or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting 10

0% Detected by X-ray only

Note: An incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician.




6522 Allergic or vasomotor rhinitis:

30% With polyps

10% Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side

Edited July 5, 2015 by pete992

[USN_HM_VSR]

Is there any retro pay IF i do get awarded a % for A/R , Ptsd or any Gulf War undiagnose illness?

If and I say if you can prove with medical evidence that your Allergic Rhinitis and your PTSD had reached a certain level before your last rating decision then there could be retro pay due you. You would have to prove that VA had medical evidence that your Allergic Rhinitis and PTSD was in fact at a compensable rating. Here are the criteria's. Match your symptoms to your 1998 rating decision to see if you should have been given a higher rating.

4.129 Mental disorders due to traumatic stress.

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name....................... 100

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships........................... 70

Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships........... 50

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)........................................... 30

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication............... 10

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication..................... 0

Schedule of Ratings tables for Sinusitis and Allergic Rhinitis:

6510 Sinusitis, pansinusitis, chronic.

6511 Sinusitis, ethmoid, chronic.

6512 Sinusitis, frontal, chronic.

6513 Sinusitis, maxillary, chronic.

6514 Sinusitis, sphenoid, chronic.

General Rating Formula for Sinusitis (DC’s 6510 through 6514):

50% Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries

30% Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting

One or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting 10

0% Detected by X-ray only

Note: An incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician.

6522 Allergic or vasomotor rhinitis:

30% With polyps

10% Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side

Yes I suppose you could for the 0% SC conditions, if you were to get a MO that contradicted it and you had the medical evidence dates to back it up. But as far as the previous denial you had 1 year to do the reconsideration to get the retro on your date of claim in 98. Now it will be a reopen claim and retro would be based on the date of claim that you submitted of that INF.

[Guest]

Yes I suppose you could for the 0% SC conditions, if you were to get a MO that contradicted it and you had the medical evidence dates to back it up. But as far as the previous denial you had 1 year to do the reconsideration to get the retro on your date of claim in 98. Now it will be a reopen claim and retro would be based on the date of claim that you submitted of that INF.

A new IMO will not help. The veteran can file a CUE claim or a veteran can file a NOD under 38 CFR 3.156 with medical evidence that he should have been granted a higher rating in his original decision. To get a retro payment and an earlier effective date, the veteran must attack the original decision with evidence that VA had at the time of that rating. VA is notorious for low balling or stating that a condition does not warrant compensation due to the fact that the rater did not review the entire C-file or the rater did request all the veterans medical evidence to support his claim.

[broncovet]

Yes, you will likely get retro if your 0 percent is increased, but only if its increased. You fell victim to one of the many VA traps designed to snare Vets. You apply for benefits, denied, then appeal. The BVA grants service connection, then the Ro "awards" you zero percent. You have to appeal the implementation of the board decsion.(The RO decision awarding 0 percent).

The trap is you file for an increase. Then, you will get your (increase) only when "its factually ascertainable that an increase occurred".