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Secondary Ratings ?

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Buck52

Question

  • HadIt.com Elder

Based on these CFR's

§§3.955-3.956 [Reserved]

§3.957 Service connection.

Service connection for any disability or death granted or continued under title 38 U.S.C., which has been in effect for 10 or more years will not be severed except upon a showing that the original grant was based on fraud or it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge. The 10-year period will be computed from the effective date of the Department of Veterans Affairs finding of service connection to the effective date of the rating decision severing service connection, after compliance with §3.105(d). The protection afforded in this section extends to claims for dependency and indemnity compensation or death compensation.

(Authority: 38 U.S.C. 1159)

Questions?

If a veteran files secondary to his alredy SC 90% disability, TDIU P&T under these CFR'S the veteran can not be reduced or sent to a C&P exam Based on he has 10 years and more on the original disability,

so if the veteran files for a secondary disability that arose from his SC Disibility, then that can't touch his P&T Disability if he files for the secondary. > is this correct?

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

Edited by Buck52

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

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Buck,

If a veteran files a clam for a secondary condition to an already established service connected condition. VA will most likely request a C & P exam for both the primary and secondary condition. Even if the veteran is already TDIU P & T. It does not mean that the veteran will lose his TDIU P & T and it does not mean he will keep it. VA can not reduce a rating based on one C & P exam. Also keep in mind that the veteran is requesting a secondary service connection which means that the primary service connected condition has caused it in some way or form. Also keep in mind that once a veteran is rated P & T, that rating basically states that those conditions will most likely last until the veterans death. The bottom line is you never know what VA will do or will not do or even try to do.

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  • HadIt.com Elder

You must have 20 years in at a specific rating for that rating to be protected. However, if you are P&T due to TDIU and you have a secondary condition that will get you HB or some higher level of SMC I would not hesitate to file. For secondary conditions you almost always need a medical opinion explaining the secondary condition and how it is secondary to the primary condition. I have DMII. I also have/cataracts. These conditions are often related but not unless you have a doctor to say so and rule out other causes. I have been p&t since 2001. I have filed about 8 claims since then and many were secondary to DMII. If you are TDIU the only way they can actually reduce you is if you go back to work full time. That is about the only way they can say you are improved enough to reduce your TDIU. TDIU is a case specific type rating.

John

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I agree with all of the above, and again remember that the VA can always reduce a Condition if treatment is not attained or the Veteran is good enough to work. I personally know a Vet that just lost his P&T for PTSD that he had for 13 yrs, due to the VA saying that he had not seeked treatment thru the VA for that condition in over 5 years, there fore it was assumed that his PTSD had cured. Veteran pulled every loop hole and policy he could and in the end the PTSD was knocked back down from 100% to 70%.

100% PTSD

100% Back

60% Bladder Issues

50% Migraines 
30% Crohn's Disease

30% R Shoulder

20% Radiculopathy, Left lower    10% Radiculopathy, Right lower 
10% L Knee  10% R Knee Surgery 2005&2007
10% Asthma
10% Tinnitus
10% Damage of Cranial Nerve II

10% Scars

SMC S

SMC K

OEF/OIF VET     100% VA P&T, Post 911 Caregiver, SSDI

 

 

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  • HadIt.com Elder

Your probably correct PR, but basically what I was referring to is if the veteran had to take a C&P for his disability that he has had for over 10 years.

when he files for a secondary that was caused form his existing SC Disability?

Well I always thought if I read in the CFR's correct (some where?) I can't remember what the previsions numbers are? I look them up when carlie got her letter/phone call to have C&P.

but they can't use your existing evidence against you (on record) if it was award out right when the veteran got this rating P&T and the disability is static or of nature with no future exams and will not get any better only worse.

if they use your evidence they should use the evidence that you was awarded from...that's the way I understand it? Not any evidence that they disputed and claim not true! from a bad C&P examiner. but unfortunately that evidence is still in the veterans c-file

P& T Is a permanent rating meaning the veteran is total disabled.

So when a veteran files for a secondary that does not mean he is filing for an increase although they should rate the veteran on his medical evidence that states his new disability is likely as the cause of his current disability.

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

Edited by Buck52

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

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  • HadIt.com Elder

Navy04

I agree when a veteran does not keep going to the VA for His/Her medical care yes they can call him/her up for an C&P. but this veteran does and basically goes by the Book!

Example in this > when the disability of the veteran has been current for 10 years or more and the veterans age is 55 or over & disability is static or shows of nature the disability's will not get better with no future exams scheduled. ( based on 100% P&T)

This was carlie argument , However she emailed the VA's Under Secretary Allison Hickey or VA Secretary ''Robert Bob McDonald and they called her RO and the exam was canceled.

I believe that's what happen or close to it!

Matter of Fact When carlie went to her VAMC for her check-up's (I believe) or had been in the VA Hospital for treatment of some sort, that is what got the RO to call and give her a C&P.

Notes from her Dr's that she had a increase in her disability or a new disability had arose or something like that? I'm not sure ?, and carlie never filed for increase or secondary and did nothing to warrant the new C&P

Don't you guys remember that...it scared the fire out of her!

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

Edited by Buck52

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

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