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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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  • Most Common VA Disabilities Claimed for Compensation:   

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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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      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
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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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AshMur

Correcting Ostomy Rating

Question

Hello! Long-time lurker, first-time poster. I've gained a lot of valuable information from this site in the past, and I am hoping to gain some insight on my particular issue/question.

I went through an MEB in 2013/2014. I was found UNFIT for a neurogenic bladder condition (complication during a total colectomy) and rated at 40%. I had several other conditions claimed and rated as part of the MEB. Ulcerative Colitis (they combined it with GERD and a permanent ileostomy) rated at 20% and many other minor conditions related to my joints and scars at 10% each. This all added up to 80% (a year later, I was summoned for a C&P exam to check on my bladder which resulted in an increase from 40% to 60% which raised my overall rating to 90%). At the time, I was confused as to why my UC was only rated at 20% since it led to me losing my colon completely, but I was urged by a Senior Chief working alongside my PEBLO to accept the findings since it granted me a medical retirement and to appeal anything after I was out of the military. Hindsight 20/20--I probably should have appealed the findings when I was still active duty and made sure things were correct before signing anything. However, I didn't know anything about the Schedule for Rating Disabilities/VASRD/38 CFR, so I didn't know any better back then.

Fast forward several months, and I now realize that the VA may have made a mistake in my claim (or that there was important information missing from my medical records). According to the VASRD, ostomies are rated under code 7333 (which is for colostomies) making it look like my permanent ostomy should have been rated at 100% from the start. I met with a DAV rep at the North Chicago VA who helped me submit a claim including a DBQ filled out by a GI noting the reason for my ostomy, the fact that it's permanent, and the date that I had it created. My rep didn't seem interested in hearing about how I felt the original rating was probably incorrect. He kept interrupting me to tell me to just get the DBQ filled out and that we would submit the claim. "Let's keep this simple," he kept saying. He either knows that the VA will see my claim for an ostomy, review my current ratings and see that I have had this ostomy for a while, and will notice the error (is this likely? I'm asking honestly), or he didn't understand what I was saying. I haven't received a return call from him in weeks and he is always out of the office when I make the 45-minute drive up to the VA where he works. I have been following my claim on eBenefits and taking the info with a grain of salt. It's being worked on in the National Work Queue (mostly out of San Diego), and I've been at PFD since the end of June and it's past the ECD of July 15, 2016, with no new ECD listed. It would have surprised me to have a closed claim by July 15th, so I am trying to be patient and see how long this takes.

Anyway, my main question is this: since I've had this ostomy since the original award letter, do I have a reason to make sure the results of this current claim has an effective date of that original rating decision from 2014? Or, have I missed that window because I didn't appeal the VA's decision within one year? Also, I'm curious to know if there are any other veterans with ostomies here and how the VA rated theirs.

Thanks in advance for any info/discussion on this topic!

Edited by AshMur

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Welcome to Hadit.

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I think you are right and that they made an error.

"According to the VASRD, ostomies are rated under code 7333 (which is for colostomies) making it look like my permanent ostomy should have been rated at 100% from the start. "

I helped a friend with a colostomy claim. He was rated 100% P & T right off the bat

Are you employed? If not have you applied for SSDI?

Can you scan and attach their Reasons and Bases part of their last decision as to their rationale for the 60%  Ostomy rating?

Do you have a copy of the C & P exam that warranted the 60 but not 100%?

"He ( DAV reps)either knows that the VA will see my claim for an ostomy, review my current ratings and see that I have had this ostomy for a while, and will notice the error (is this likely? I'm asking honestly)"That is highly unlikely in my opinion , unless this was a re -opened claim or a CUE claim. "or he didn't understand what I was saying." Possible.

Maybe he filed a re-opened claim for you? 

He could have filed, from what I see here, a CUE claim for you.

CUE Clear and unmistakable error in a past VA decision...lots of info on CUE here.

 

"DAV rep at the North Chicago VA who helped me submit a claim including a DBQ filled out by a GI noting the reason for my ostomy, the fact that it's permanent, and the date that I had it created."

Did the GI ( is this a non VA doctor who is familiar with your type of disability?) Did this doctor also make the point that this is a total disability?

What was the new claim actually for....to re-open the older claim? or was it a TDIU claim?

Cover your C file, name, address prior to scanning and attaching the documents here.

 

Edited by Berta

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I would not trust your REP, and he sounds a lot like the one I have, every time I needed him he would be out of the office  GRrrrr

I agree with Ms berta

send copy of the reason & bases...that will give us more information to help you.

black out your name and claim No.  and any personal info.

 

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

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Thanks for the replies so far! Wanted to check in quickly to let you know I've read your responses and am going to be working on getting my C file and reading up on CUE claims and such. Ebenefits won't load my dashboard today so that I can check my status today, but a few days ago I was still sitting at PFD. Letters still say 90% with date of last increase I received so no change there it seems.

Thanks again!

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You had stated:

 

"DAV rep at the North Chicago VA who helped me submit a claim including a DBQ filled out by a GI noting the reason for my ostomy, the fact that it's permanent, and the date that I had it created."

Are you sure VA got this info?

If you need a CUE claim on this, we can help prepare the wording ,as so far it seems like a no brainer, but still we would need to see the  C&P exam and the decision that rendered only 60%.

 

 

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      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’.


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      • 2 replies
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