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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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GatorNavy

will it fly?

Question

Trying to figure out if this is a valid claim for TDIU housebound:

Nerve impingement cervical 20% (Primary)

mood disorder 50% (secondary)

THE ABOVE DESCRIBED IN THE DECISION AS TOTAL

RA 40%

DDD 20%

HCV 20%

Thanks in Advance!

 

 

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I am sure the answer to your question is here:

Just scroll down to the SMC article

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GatorNavy

They don't add each S.C. Disability or secondary to qualify for SMC.

You need one  Seperate S.C. disability that is 60% or higher  on top of your 100%

If you have a 100% S.C. disability  now and you file another claim on a totally separate disability, you will need a rating on that separate disability to add up to 60%

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Or a letter from a doctor on VAF 21-2680 stating you are effectively housebound medically (i.e. no driver's license, incapable of driving/ambulation). Of course, if you are in a wheelchair and on A&A this is a moot question. You'd already be on SMC L. Proving medical housebound using a medical hypothesis instead of the normal 100% plus 60% for other disabilities unrelated to the 100% ratings is not hard. You just have  to have an IMO letter saying as much.

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The VA would rather close its doors, and turn its operation over to drug dealers than award TDIU to 100% ers.  They deny such applications as "moot".   In 2009, my VARO decision denied TDIU as moot as it awarded 100 percent for MDD.  

I appealed, arguing TDIu was "not moot" because:

1.  It could enable SMC S, statuatory.  

2.  It could mean earlier effective date for 100% benefits. 

    The board agreed with me and specifically stated the issue of TDIU was "not moot", and remanded it.  On remand, you guessed it, it was denied.  

    I appealed to the CAVC.  Last week, the CAVC attorney's agreed to a JMR on the issue of TDIU.  (I applied for IU in July, 2002.)  So, after 14 years, we are not close to being done yet.  I know several VA employees stated, "Gee, Mr. Vet, you are already 100%, so what do you want TDIU for?"  

     Its a common misconception that benefits "max out" at 100%, and, once there, the Veteran should go away and leave everything alone, not appeal anything, not persue SMC, etc., etc.  

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I see a wide disparity of information here. Housebound seems simple to comprehend however the arguments and ways that it is adjudicated seems to be quite complex. There seems to be three avenues a Vet could take to argue the benefit before the ROJ.

TDIU

100% schedular

Medical state indicating housebound

The first two are classified in the adjudication manual as "Statutory" whilst the 3rd is deemed Housebound in Fact (fill out the form loleeedah).

Some of us can't work at some point after service because of our SC disabilities. We aren't at 100% so we ride the IU pony and draw SSDI for a number of years until the VA gets around to rating us at 100% schedular. IU P&T translates into 100% schedular P&T. We still can't work and are considered "Total". So then the entire thrust of the argument is that we cannot leave home to go to work. All of this high order rating math that Congress tried to do for Housebound is just a canary in the cage (to me anyway). Filling out the form and then having a C&P examiner proceed to report to a rater that I can do cartwheels along and out of my driveway doesn't seem like a very good way to get the claim approved. And what about 5 years ago when that one disability just kicked my buttocks and caused me not to be able to work when I went on IU? 

The adjudication manual tells the story of how not to tally up the disabilities for housebound that make up the TOTAL single disability for IU: 

§4.16   Total disability ratings for compensation based on unemployability of the individual.

(1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war.

However a primary and a secondary disability are not listed above. 38 CFR considers a primary and it's secondaries as one or (still holding up one finger) a single disability in order to avoid pyramiding. I'm still confused.....

 

.

Edited by GatorNavy

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