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I’ve done the VA claim-bit on my own. I don’t know if this is a mistake or not.
I went to a c&p exam recently. I left somewhat confused. I never had a doctor tell me directly that she was recommending an increase as well as IU. She said though it was ultimately up to the rater. I don’t have her report because 30 days has not passed. I was at 50% for ptsd and 10% hearing loss. During the appointment the c&p doctor quoted a couple other reports where VA doctors I’ve seen at various clinics said that I had “long term, chronic and severe...” (Don’t want to get into the what). I find myself now obsessing if:
1. The c&p dr was lying to about her recommendations;
2. The c&p dr was telling the truth about the recommendations;
3. The rater will decrease my %
4. The rater will increase my%
Ultimately it boils down to: How much weight does the rater put into the C&P dr recommendations? Could I really get IU if that dr did actually recommend it? what are the chances? The IU could help a lot, I’ve not been able to work much the past few years.
I filed for tdiu and ptsd claim in Oct of 18, I didn't have all my medical files lined up and was given service connection for unspecified anxiety at 30% in March 19, and denied tdiu for failed scheduled rating needed and they mentioned that I had work experince and helped for a year with my niece , weird mention in the paperwork for why tdiu was denied but whatever. So I filed supplemental claim in april and had a highly regarded univeristy brain department and psychiatrist department diagnosis me for ptsd as a referral from the VA. So boom got another c&p in June and was given 70 % rating for ptsd but didn't file anything for the tdiu, at this time hired a va lawyer before I got my 70% rating thinking id have to appeal if they denied my ptsd again but they didn't so then I kept the lawyers on as they looked at my files for more things to be done and then they had me file tdiu paper work again but then on OCT 31st they filed a higher level review for my TDIU decision going back to march when it was denied. My two questions are how does HLR handle tdiu claims and cause I was denied originally for it for lack of rating and lack of medical evidence does my new c&p in June and my medical diagnosis with recommendation that got me to 70% now, will that evidence be included in the review of the tdiu or is the Review just of the evidence that was available at the time of the original denial back in march? I've been out of work for over a year as well but haven't kept a job down for a decade though I've tried for sure. OIF 08-09 1-22 INF, 1 BCT, 4th I.D. Also do granted my tdiu effective date should be Oct 2018 right as my intent to file date? Thanks
What is depressive disorder (SCT 59212011)? I found that code in my healthevet record.
Also I requested a hard copy of my medical record and part of it was blank. It was pertaining to a psychiatric admission back in 2011 it's part of my HealtheVet is also blank.
I think at one time I had access to the information because I have a stack of papers from back then in a file somewhere.
I wanted to put a situation out to you all and get your feedback as it would relate to a potential presumption of soundess cue claim.
Back story: 1983 - In high school I tried out for varsity football (note I am 5'5" and 135lbs at that time) so I could have some level of social life. First day of practice a kid ran into my left side and hurt my knee. I DID NOT seek medical attention, never went to the doctor and was fine the next day (though I did decide not to try out for football any longer).
Fast Forward: 1985 - I joined the Army National Guard and NO MEDICAL ISSUES were noted on my entrance exam. I transitioned from ARNG to RA in 1987 and did not have anything listed on the exam for that either. I was Airborne and have STR entries for strained MCL, Achilles and Twisted knee.
1991 - I got out of the service with a lumbosacral strain issue with 20% disability at that time.
1996 - I had meniscal surgery on left knee
1997 - I had surgery on my right knee was going to physical therapy. During the review the physical therapist did to get medical history they asked me about injury history and so I told them the only issue I ever had was the issue in high school which was really a non issue but I was being honest and the meniscus surgery the prior year. They incorrectly annotated on my record that the high school knee injury was "torn meniscus" by combining my two statements into their notes to read high school knee injury (torn meniscus).
1999 - I filed a claim for bilateral knee issues and was denied because the rater read that note and said that I had a pre-existing condition. There is no medical evidence of my high school knee issue because I never went to the doctor and the next day it was fine.
I was finally able to get a rater who service connected and rated for both knees and ankles and nexus was established for marching/jumping in service. I didn't know exactly why I was originally denied but after getting my c-file I figured out that it was all because of a physical therapist not taking proper notes.
My question is that I don't think they properly applied the presumption of soundness rule in my case because the rater had no direct medical evidence to prove that I had a pre-existing condition and the entrance exam(s) were negative for any medical conditions. I'd like to get your thoughts.
Yesterday my claim moved to Prep for decision, this was a week after my latest C&P, I was feeling optimistic that the estimated completion date of 9/4 was reasonable. Today it moved back to review of evidence and my date oushed to 9/14. This is a claim with 1 increase, 2 new, 2 secondary. I filed my claim 9/24/18 it seems like a long time for a claim.
Anyway, my question is: have any of you had the claim move from "prep for Decision" only to regress to review of evidence? If so, what was the timeline like?
Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
Vync posted an answer to a question,I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:
2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis
2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.
"...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.
First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date.
If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues.
I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.
It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.
Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.
Does this help?
Buck52 posted an answer to a question,Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.
The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.
Picked By66 bricks,
JKWilliamsSr posted a question in VA Disability Compensation Benefits Claims Research Forum,A couple months back before I received my decision I started preparing for the appeal I knew I would be filing. That is how little faith I had in the VA caring about we the veteran.
One of the things I did is I went through the entire M21-1 and documented every CAVC precedent case that the VA cited. I did this because I wanted to see what the rater was seeing. I could not understand for the life of me why so many obviously bad decisions were being handed down. I think the bottom line is that the wrong type of people are hired as raters. I think raters should have some kind of legal background. They do not need to be lawyers but I think paralegals would be a good idea.
There have been more than 3500 precedent setting decisions from the CAVC since 1989. Now we need to concede that all of them are not favorable to the veteran but I have learned that in a lot of cases even though the veteran lost a case it some rules were established that assisted other veterans.
The document I created has about 200 or so decisions cited in the M21-1. Considering the fact that there are more than 3500 precedent cases out there I think it is safe to assume the VA purposely left out decisions that would make it almost impossible to deny veteran claims. Case in point. I know of 14 precedent setting decisions that state the VA cannot ignore or give no weight to outside doctors without providing valid medical reasons as to why. Most of these decision are not cited by the M21.
It is important that we do our due diligence to make sure we do not get screwed. I think the M21-1 is incomplete because there is too much information we veterans are finding on our own to get the benefits we deserve
M21-1 Precedent setting decisions .docx