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  • Trouble Remembering? This helped me.

    I have memory problems and as some of you may know I highly recommend Evernote and have for years. Though I've found that writing helps me remember more. I ran across Tom's videos on youtube, I'm a bit geeky and I also use an IPad so if you take notes on your IPad or you are thinking of going paperless check it out. I'm really happy with it, I use it with a program called Noteshelf 2.

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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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    • So, my lawyer sent an IME w/ IMO and filed a supplemental claim solely for IU on March 20.

      It was closed on March 25, and va.gov just states claim closed and nothing more.

      Hopefully, I get good news.
    • Thanks for the responses. I am filing a new claim but will continue pushing the NOD. My new question is it stated in law or statute that if during the claims process the VA finds conditions that could possibly rate service connection that was not originally filed for, the VA will “invite” the veteran to file the claim on the claims form. Reason I ask is that my private DBQs, NEXUS letter, and even the VA nurse examiner's DBQs lists bilateral upper radiculopathy as present. If it is written in statute or official guidance it might qualify as a CUE. Just looking at all angles. 
    • Everyone needs to read our stories so they can try to avoid these screws by the va...
      Thank you, everyone contributes, good or bad, all of our stories will help others, and yes, they have been stated by others for ages, over and over, but we just get depressed, and the time turns into years as they screw us..

      Welcome to the department of Veterans Affairs!  I can honestly say, "been there, done that".  

      Even after winning my tdiu in 2017, it was back to the drawing board as VA hornswaggeld my effective date.  (but of course).  

      I finally won my tdiu effective date in Feb. 2020, 18 years after I first applied!!!  

      Here is how they managed to drag mine out 18 years:

      1.  They never adjuticated my decison until 2009, where they called it "moot".  

      2.  I appealed, said it was not moot because it could result in an earlier effective date and SMC S under Bradley vs Peake.  The judge agreed with me, and ordered VARO consider me for extra schedular TDIU, under 4.16 b.  

      3.  The VARO piddles with  the remand for 3 years, and hoped I wouldnt notice.  I noticed and raised cane until they adjuticated it.  (denied of course).  

      4.  Finally, after the baord denied again, I hired a lawyer, in 2014, and appealed to CAVC.   

      5.  The lawyer won a remand, got an IMO and I won tdiu in 2017.  But at the wrong effective date, even after 15 years.  

      6.  I hired another lawyer, Chris Attig, and appealed the effective date, and he won a remand for effective date.  Trip 2 to CAVC.  

      7.  Mr. Attig won a remand, and advised me to get another IMO.  

      8.  The board awarded my earlier effective date in Feb. 2020.  

           So, I do have advice fighting VA for TDIU, they fought and fought and I hung in there and won it all.  

      ADVICE:  Dont count on VA, they could easily throw your fax in the trash.  Follow up!  
    • "Keep in mind that due to the nature of the digestive system, VA would most likely combined your conditions and pay you at the higher rate to avoid pyramiding".    That is one of my main gripes.  They are only listing the GERD with hiatal hernia and ignoring the rest of my gastric issues such as the gastritis which I also had in service.  I included it in my 2007 request for increase and again in 2019.  The info from the civilian dr that stated I had the gastritis with H pylori was not even provided to the examiner in 2007, nor did he have my VA health records. The 2019 request was based on an EGD I had AT THE VA in Jan 2019.   I filed for an increase 6 Mar and they did an ACE on 27 Mar and downgraded to noncompensable on that date.  The only reason I was thinking CUE:  38 CFR § 3.326 - Under Examinations  it states (c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination".  
    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
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ArmygirlRJ

Denied Increase

Question

I recently received my letter of denial for increase on the grounds that I needed to have more than one prostating migraine in 2 months and even though my VA medical records never mentioned the word prostrating the Neurologist does say on multiply times that the patient is unable to work during attacks and he has also stated that I needed to lye down in a dark room. The only problem is that it is a teaching hospital so each time I see a different resident and maybe a different attending also. I have become a test dummy for the Neurologist because I have been on multiple medications and have failed therapy but I still try. My attacks can be from 2-5 headaches a month with each one lasting at least 2 days the only reason I haven't lost my job is that the neurologist filled out a Family Medical leave paper which allow me to miss periods at work without being fired but believe me my job is ready to dismiss me if they can find the loophole. With everything in my medical records I thought I would at least get 30%. Can anyone help me understand what to do? At the C&P the ARNP asked me all the questions and said that she could only write what was in my doctor notes the only thing I could think is that she read the resident notes without reading the attending notes. I have sent back my NOD already highlighting what the attending notes say in my VA medical records for the last two years. Also I have no idea what the C&P notes say because they did not send me that and I can not find it in my medical records. Please Help

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This is my recommendation.

First, get your cfile if you have not yet done so. Read what the docs said, and dont take VA's word for it.

Next, read and understand the "reasons and bases" for denial. Finally, look up the criteria necessary for your desired increase. When you respond with a NOD, cite evidence showing how you met the applicable criteria.

Did they cite favorable evidence? If not, then you can appeal on that bases, that the VARO decision failed to consider Dr. XXX favorable evidence on a medical exam of dd-mm-year.

If VA was incorrect, and misinterpreted or lied about what the medical records, then base your appeal on this evidence.

If you had a C and P exam that was unfavorable, then you can dispute the credentials of the examiner, such as do they have expertise in your malady.

In short, you want to refute the "reasons and bases" for denial with solid medical evidence to the contrary.

If a rookie doc gave unfavorable evidence, you can ask the BVA for a C and P exam.

Edited by broncovet
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Most all VA Hospitals are teaching Hospitals!

You need to go get a Private IME/IMO and give the Dr your history and ask him to give his opine to your disability and use the VA guidelines here on hadit

Its good you filed your NOD you have one year, to re-gather your evidence or New & Material Evidence

You should receive a SOC from the VA ''Statement of the Case''

You need to get your last C&P report usually you can get that at the VAMC where your exam was.

And like broncovet mention you NEED to get your C-File.

There's other ways to prove your claim but we need to know what the reasons and bases of the denial.

if you can copy & paste that here on hadit and be sure to cover your name and SS No. be sure there's no personal ID on it.

Remember if your SC disability precludes you from working or doing any type of sendetary work you will be eligible for the 100%TDIU Rates. and SSDI

Thank you for your service and I'm glad you came to Hadit, things will get better for you now.

.....................Buck

Edited by Buck52
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The VA usually needs "in your face" documentation that makes it more than obvious that the severity of a condition is sufficient to grant the rating sought.

The question at the heart of your problem is how to get the medical provider(s) to generate it.

It sounds like you will need to coach the provider as to what is needed. An option is to get an independent medical opinion that backs up and summarizes

your condition and it's severity in language that the VA accepts. From what you wrote concerning the VA's refusal of an increase, you have an understanding

of what is needed, but not exactly how to obtain it. We all have this sort of problem at times, since most doctors and providers have a limited knowledge of what the VA wants to see.

Explaining your VA related problem to the provider(s), along with what you need, is usually effective. Occasionally, I've had to go back to a provider, and explain why the provider's

statements need to be re-worded, or amplified to meet the VA's druthers. In one case, a provider originally agreed to write an opinion, then wanted to back out. I pointed out that

they had agreed, and that was a significant part of why I chose the provider, and made it clear that I expected them to fully honor the commitment if they wanted to retain me as a patient..

Many veterans face the provider "only game in town" issue, due to cost, or other considerations. When this happens, the veteran must deal with the problem, and often be politely persuasive.

"The only problem is that it is a teaching hospital so each time I see a different resident and maybe a different attending also"

Based upon this, it sounds like you will need to talk to the supervising physician, and explain the problem/difficulty you are encountering. Since this is evidently the VA,

it may be easy or not to accomplish. In a private setting, the physician would usually cause a more complete evaluation to be made from the individual inputs of the various

providers you have seen. Who knows what the VA would do, but it's worth a try.

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Here are some older post from the elders of hadit, read them to get a better insight.

.............Buck

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Thank you to everyone for responding and providing me with help. Reason for Descision: We have assaigned a 10 percent evaluation for your migraine headaches based on Characteristic prostrating attacks averaging one in 2 months over the last several months. A higher evaluation of 30 percent is not warrent for migraine unless the evidence shows characteristic prostating attacks occuring on an average once a month over the last several months. When you mention C-file would that be my VA medical records? If so I enclosed them with my NOD highlighted with the Doctors stating that my migraines does not allow me to work if that is not my c-file how do I attain it?

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    • So, my lawyer sent an IME w/ IMO and filed a supplemental claim solely for IU on March 20.

      It was closed on March 25, and va.gov just states claim closed and nothing more.

      Hopefully, I get good news.
    • Thanks for the responses. I am filing a new claim but will continue pushing the NOD. My new question is it stated in law or statute that if during the claims process the VA finds conditions that could possibly rate service connection that was not originally filed for, the VA will “invite” the veteran to file the claim on the claims form. Reason I ask is that my private DBQs, NEXUS letter, and even the VA nurse examiner's DBQs lists bilateral upper radiculopathy as present. If it is written in statute or official guidance it might qualify as a CUE. Just looking at all angles. 
    • Everyone needs to read our stories so they can try to avoid these screws by the va...
      Thank you, everyone contributes, good or bad, all of our stories will help others, and yes, they have been stated by others for ages, over and over, but we just get depressed, and the time turns into years as they screw us..

      Welcome to the department of Veterans Affairs!  I can honestly say, "been there, done that".  

      Even after winning my tdiu in 2017, it was back to the drawing board as VA hornswaggeld my effective date.  (but of course).  

      I finally won my tdiu effective date in Feb. 2020, 18 years after I first applied!!!  

      Here is how they managed to drag mine out 18 years:

      1.  They never adjuticated my decison until 2009, where they called it "moot".  

      2.  I appealed, said it was not moot because it could result in an earlier effective date and SMC S under Bradley vs Peake.  The judge agreed with me, and ordered VARO consider me for extra schedular TDIU, under 4.16 b.  

      3.  The VARO piddles with  the remand for 3 years, and hoped I wouldnt notice.  I noticed and raised cane until they adjuticated it.  (denied of course).  

      4.  Finally, after the baord denied again, I hired a lawyer, in 2014, and appealed to CAVC.   

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      6.  I hired another lawyer, Chris Attig, and appealed the effective date, and he won a remand for effective date.  Trip 2 to CAVC.  

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      8.  The board awarded my earlier effective date in Feb. 2020.  

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    • "Keep in mind that due to the nature of the digestive system, VA would most likely combined your conditions and pay you at the higher rate to avoid pyramiding".    That is one of my main gripes.  They are only listing the GERD with hiatal hernia and ignoring the rest of my gastric issues such as the gastritis which I also had in service.  I included it in my 2007 request for increase and again in 2019.  The info from the civilian dr that stated I had the gastritis with H pylori was not even provided to the examiner in 2007, nor did he have my VA health records. The 2019 request was based on an EGD I had AT THE VA in Jan 2019.   I filed for an increase 6 Mar and they did an ACE on 27 Mar and downgraded to noncompensable on that date.  The only reason I was thinking CUE:  38 CFR § 3.326 - Under Examinations  it states (c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination".  
    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
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