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awgv001

SC Claim - from beginning to end.

Question

Hello!

First off, Thank you all! - for this website, your time, and your passion towards helping fellow veterans!

              Started the PEB process on active duty (2012 at the time), so I'm just trying to sort this out and find where things went wrong.

The claims submitted among this process only listed 3 contentions - of which the DoD rated me unfit at 10% W/ severance pay, while the VA rated those conditions (totaled) to 40% upon exiting service.

My story - First, I don't agree with the PEB findings, but I signed off on it at the time without a full understanding of "what I could claim", so once the ball got rolling I found myself trying to correct my own mistakes along the way.

I want to particularly point out to the Experts here that signing off on my PEB, as well as false statements/misquotations made by an off base neurologist has been used against me in regard to denial for SC TBI. In one denial, they took the exam from the off base neuro i saw, and threw the (positive) other out - Denying me the benefit of the doubt, or even the 50-50 rule.... The situation now is that I have a second doctor, who wrote a Nexus concurring with the diagnosis and rationale of the specialist I was treated by. (So 2 doctors post-service vs. the 1 I saw who didn't have all the details, lay statements, and misquoted me or failed to check the appropriate boxes based on my own testimony.

TLDR - I was awarded increase for 1 contention in 2016 to (a total of) 60% - Followed by SC and increase in another (1) contention for an overall rating (total) of 80% in 2017 - Some corrections were made and a rating was re-established with the proper EED and my new total is now 90% (as of late 2019) - it is now 2020 and I have 4 contentions that never made it to SC (yet!) - I experienced narrative changes as to why the VA was denying SC for TBI and 3 other issues - such as "missing diagnosis" - I had included a document from their own specialist specifically stating I was diagnosed with TBI and 2 exams giving extensive detail as to my symptoms/history.

Again, thank you for all you have done, and all you continue to do for all of us. to

Semper Fi !

 

Edited by awgv001
Clarification and cleanup

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First things first, Marine, Semper FI!

Welcome to Hadit!

You did not overlook anything.  IT happened to you this way by design.  What I mean is...the VA automatically denies 85% of all claims as par for the course.  And they low ball everything else nearly 100% of the time as well.

No one gets a fair and honest rate from the Military.  My Dad was rated by the Army as 20%, when he retired, but the VA gave him 70% for the same disabilities.  Dad was initially injured in Vietnam.

Since you have your medical file handy, go over it and write down a list of all possible injuries and illnesses that you experienced.  You can go over your list and see pretty much all that you may be able to file a claim for.

Just a reminder, never EVER give an original to anyone, only give copies of treatment records and so on.

If you don't have your C-file, request a copy ASAP!  This is the file the VA has on any and all info related to your claims, not ongoing treatment and such.  Some of this info can be had through MyHealthyVet blue  button download, but some info in your C-file is only in your C-file.

You can most claims on line through the eBenefits link on VA.gov, yourself.

Semper Fi.

Andyman

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"TBI? (YTBD)"

I assume that is still an open claim in progress. Has VA asked you for more proof of the TBI incident?

Save those buddy statements, but the CO's statement might be enough.

Since they awarded for the ocular migraines and ulnar nerve compression ,without a TBI decision, what did they attribute those disabilities too?

I suggest you read the TBI criteria here to make sure your claim covers it well as to all symptoms.

 

"What made me feel like I was taking the wrong approach with this whole ordeal was when I brought all my files into the VA for the VSO to review, and help to determine what to file a claim for, and what to leave out.

I went to the VFW - they said "call a congressman" - I have not begun to consider this an option but more of a "last resort".

That is what I call a LAVSO (lazy assed VSO) because Congresscritters do not award claims and sure wont be picking out what they think are 'disabilities'.

Then again,the DAV might be a big help to you on that because they will look at your discharge certificate and your SMRs.

(I hope they will) . Andyman is right, best to go over the records carefully yourself too.

I wouldnt be concerned about the PEB rating because it is the VA rating that will give you a proper comp amount.

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You indicate your currently 40% SC, are you on appeal with that rating?

This is not the 1st time you've been the FNG, and there is a learning curve when it comes to VA SC Claims prosecution. Probably one of the most difficult steps, is finding a VSO that can and will meet your needs. Even if you handle filing all your own paper work, you still need the services of a good VSO for advice and tracking. Just keep in mind, not all VSO reps are as knowledgeable or for that matter , still have the "Fire in the Belly;" so to speak.

Give thought to  a personal visit to your RO, you can Recon the different VSO offices and even File a FOIA request for your Complete C-File. A VA lady at the 800# told me recently, that viewing of your C-File at your RO is done on a walk-in basis 8-4 Mon-Fri, no appointment necessary. I doubt it but you could give it a try. As to the VSO offices, your looking for one that is fully staffed M-Fri. Small staffing and/or infrequent hours, presents you with a communication and continuity of follow-up problem.

Semper Fi

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Drew,
Welcome to Hadit!

The above advice is really good.

Regarding going to the RO to view your claims file in person, I was told the same thing as Gastone and showed up at the regional office, but they just laughed at me and told me I had to make an appointment. Different RO's work differently I guess.

Some DAV offices, like the ones here in Alabama, are closed on Friday due to "training". Not sure if they do the same in your area.

In addition, make sure you have a complete copy of your military personnel record, including your DD-214. Information on how to request a copy of your military personnel record can be found in this link: https://www.archives.gov/veterans/military-service-records/.  You might also be able to obtain this via the Blue Button feature, per Andyman's advice.

The reason why you want all the records is to make sure you have everything they have. It is pretty common for the VA to rate disabilities without all of the evidence. For example, if you were in combat and received awards, like a Purple Heart, documents will be in your personnel file and also on your DD-214. There might also be copies of the award application form and the actual award certificate which detail the circumstances which lead to the award. You probably would already have the certificate, but not necessarily the details of the award application form, which is usually more detailed. There likely will be documentation related to the cause of your TBI, but you might already have that. All of this information can be very valuable to your claim.

 

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Welcome aboard and sorry to hear of your hard times. I was Medically Retired in 2013 for Crohns and PTSD, even though I have a ton of health issues. I took the 30% from the Navy as it is a Retirement vs Medical Discharge with Severance.  I am only rated 50% for Migraines and that is attached with TBI, 6 Documented Concussions while in service. I get 30 Injections thru the VA Neuro Doc every 3 months, and I recently had a Brain scan and diagnosed with Post Concussion Syndrome. Started Stuttering, and facial muscles twitching about 6 months back. Sorry for the rambling basically what I am saying is the Medical Evidence will speak for itself. No better evidence then MRIs, Scans and X Rays. Good luck and wish you the best.

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