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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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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
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    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
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    • Mere speculation in your VA C and P exam

      M21-1, Part III, Subpart iv, Chapter 3, Section D – Examination Reports III.iv.3.D.2.r. Examiner Statements that an Opinion Would be Speculative Pay careful attention to any conclusion by the examiner that an opinion could not be provided without resorting to mere speculation (or any similar language to that effect). VA may only accept a medical examiner’s … Continue reading
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Navy4life

OMG please help me with this mess for NOD hearing this Friday

Question

Okay so most of you know my situation...

I have my NOD this Friday and I got my C-File in the mail today!  Nothing like getting it at the last minute but I am sure glad I did!!!!  

Here is my issues and I need help please for my hearing on Friday!

My NOD hearing is for right ankle sprain DENIED; right 5th metatarsal fracture DENIED; and left foot/toe condition.  The issues surrounding this are the following:

June 2014 Award Letter stated Morton's Neuroma w/status post avulsion fracture, 5th metatarsal, right foot - THAT WAS WRONG - it was actually for my left foot/2nd toe 

My November 2014 Award Letter - stated my status post avulsion fracture, 5th metatarsal, right foot as DENIED; right ankle sprain DENIED; left toe condition DENIED.

Now fast forward to this mess on my floor - my C-File!

I see this in my C-File which pertains to my current FDC claim that is in Preparation For Decision.  Notice the "temporary convalescence for right broken foot secondary to left ankle comment.  What does "Issue is RTR"????rater letter 1_Redacted.pdf - Do you think they are holding off on my FDC until after the NOD????

Next is the Ankle DBQ from July 2013.ankle _Redacted.pdf - I uploaded the two pages of concern.  Look at question #1 Diagnosis and tell me if you see the error for Diagnosis #2 - This the issue I am stressing about!  The doctor notes ICD code for right 5th metatarsal  with date of 1993.  He notes it affects left side?  Is this not a direct diagnosis for me?  I also have right ankle sprain diagnosis and left ankle synovitis diagnosis yet I was only S/C for Left ankle synovitis?????  Is this not sufficient enough to have had me S/C for right ankle sprain and right foot fracture?

Next is the Foot DBQ from July 2013.foot 1_Redacted.pdf - Again look at #1 Diagnosis - Morton's Neuroma ICD 355.6 as of 1992.  Look at the foot injury and see the date of diagnosis for fracture of 6/23/13.  That is wrong!  That is the date of an MRI I had of that foot but the fracture was already noted on Ankle DBQ

How did I not get rated?  So many screw ups with this!

This is already evidence but should I bring it and POINT out the CUE's????????

Here is the picture of my entire C-File!!!! Gotta love it!  It still doesn't have my medical records from the 90's but I think I have enough ammo just need advice!!!

IMG_1983.thumb.JPG.5a46ba29abe9ab375b0c7

 

 

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Vinsky54

What do you mean by this statement

1 hour ago, Navy4life said:

 

The more time I spend on this website, the more I fear my claim will likely never get a positive result.  ??

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Meaning i

13 minutes ago, Buck52 said:

Vinsky54

What do you mean by this statement

The more time I spend on this website, the more I fear my claim will likely never get a positive result.  ??

Meaning that I am rapidly losing what little faith I had in the VA. The more I learn, the less I think I will ever survive the process. Certainly no offense to the fabulous resource I have discovered here. I am grateful - more than I can describe at this point.

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Okay I am back in DALLAS and able to post!

DAV told me that the DRO Hearing Officer that was supposed to hear my appeals was out!  Great that doesn't sound good...He said the guy that is "stepping in" likes to go rather quickly.  I said "okay is this good or bad?" He said "it was fine and let's move forward".  Granted this rater/hearing officer didn't have a whole lotta time to review my file.  So we walk in and I greet him with a warm smile and firm hand shake.  I thank him for taking the time to hear my appeals.  He asks "informal or formal" - I told him informal and we got right down to it.  He said this matter was before him for Right 5th MT fracture; Right ankle sprain; Morton's Nueroma 2nd MT.  I said yes and he said great let's get started.

I provided him my binder I created for him and we went 'step by step' through it.  The DAV rep was good for me and mentioned several times throughout the hearing that the IME is the key evidence for my case.  As we were going through the hearing the DRO reviewed the letter my VA Podiatrist doctor provided on my behalf (attached above in original post) and I referred him to the highlighted paragraph at the end of the letter where my doctor directly links my three contentions to my active service and furthermore stated I had continuous issues. I then pointed out to him the fact that both DBQ's filled out by the QTC doctor in July 2013 diagnosed me with Right 5th MT fracture; right ankle sprain; and morton's nueroma 2nd toe on the left foot.  I showed him all my evidence to include the picture of me holding my daughter with my left foot/ankle in a cast, the layman statement from my oldest daughter at the time who specifically remembered the event; two additional SMR's indicating chronic feet/ankle issue to the right; and the issues I found with the medical opinion from November 2014.  I told him that there was no way the medical opinion matched the evidence.  I think he agreed, because he stated that the rater goes by the medical opinion and after that negative medical opinion was presented the rater didn't pursue any further.  Well that is why I am here today LOL....

He mentioned to me that even a fracture to a body part without every having any residuals warrants a minimum of 0% S/C.  Meaning since I broke both my feet/ankles and fractured them that if I had no residuals or problems after the healing I would and should have been warranted at a minimum 0%.  That made me feel better.

We went over the entire binder that I provided and it was all about 30 minutes total.  He said that he would take everything into consideration, review the entire file and have a decision within 60 days.

We briefly talked about my FDC claim and he said he saw that and knew that it was "RTR" ready to rate....I believe the FDC is waiting on the decision of the NOD.

I felt pretty good about it and so did my DAV rep!

Now the waiting begins.......

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Glad you got through it  sounds promising to me, I hope you get a rating that you so deserve.

to bad a rating specialist was not at your hearing, the DRO could ask the rater to look at the % for him and usually they expedite the issue at hand.

Oh well 60 days is not to bad  and they usually decide sooner than that.

DRO Hearings seem to speed up things or at least shake the tree.

since you had a informal hearing...let us know if you get a transcript of your hearing with their decision.

Relax now :)

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

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I am again so grateful for what I learn here. My dismay has turned to hope. Navy4life's post about "continuation of treatment" really had me worried. But it had the effect of driving me back to my AF medical records, and there it is! Something I had missed. I went to the clinic about a year and a half after my surgery complaining of the very symptoms of Dumping Syndrome. Though not diagnosed as such, it is clear as day due to the documentation of my complaint.

That was the VA's main justification for my first denial in 2003. That there was no record of the syndrome during my service. But now, I beg to differ.

Hope is back. Thanks again for the insight.

And Buck52, I meant no offense when I made that comment about "the more time I spend on this site..." I hope I cleared that up above. Y'all are very much appreciated.

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