So Confused

[sovereign]

Hello everyone- I just discovered this site and am wondering if anyone could offer some guidance. While stationed in Sicily in 1979, I was in a head-on auto collision. Since Sigonella didn't have a hospital, I was medivac-ed to Naples where I had surgery for broken feet (with surgical screw) and broken knee. After a week, the nurse threatened me with a feeding tube if I didn't eat. I told her I couldn't open my jaws. They x-rayed and found both jaws broken. They didn't do ct scan or anything for my head injury. I was sent to Germany for my teeth to get wired. 

In 1991 a friend encouraged me to file a claim, which I did and was awarded 20% for ankle, 20% for knee and 0% for misaligned jaw. I didn't file a NOD or anything at the time. I also started having panic attacks in 1991 and agoraphobia (in my record) and subsequently had to quit my job in 1996. Since I lost my insurance, I haven't been to a doctor (except for a few minor things) in over 20 years. I've been reading a lot and see so many things I am eligible for file a claim for. Even things they put in their own c&p exam-- like TMJ and painful scars, etc.

I have recently started going to the VA for medical and would like to make several claims. I have hep c from the blood transfusions in Naples, I just had a CT Scan and EEG (both with abnormalities) and I can not walk more than half a block without extreme pain in my feet, legs and hips. I have serious depression and rarely sleep or leave my home. I have much trouble with memory, cognition, etc., so it's hard for me to figure out where to begin. 

Any guidance or suggestions would help tremendously.

 

[Gastone]

Do you believe you're capable of Filing your own Claims?

[sovereign]

Yes, I probably could. I just don't know where to start. Like, when I file a claim do I need outside medical proof even though the VA has EEG, CT Scan and vision field tests indicating a brain trauma. Do I need outside evidence showing progression of my HEP C? It's in my file that I have it and also that I had blood transfusions from their surgeries. Do I file for sleep apnea, depression/ptsd, hep c, TBI, lateral pain in my hips, back from broken feet and limited mobility and use of my arms from the head/jaw/neck injury all at once?

I just get really overwhelmed. I just had a vision exam by a VA Optometrist last week and explained to him that my right eye leaks fluid and that's consistent with a brain trauma. I have chronic redness and swelling from it. He said I had dry eye and allergies (in one eye?). Then he wants to see me in two months after doing the field test that I failed. Why, if it's only dry eye and allergies--eye exams are annual? I need an ophthalmologist and there aren't any there.  Anyway, my point is, I don't have insurance and this is the first time I've used VA medical care. It seems the VA lies or evades about what's wrong. 

I can't even get action on a FOIA request for my C-file. Don't get me wrong, I'm not a victim mentality. I'm getting started and trying to gather information before I take action so the claims are solid. 

Hope this makes sense. But yes, I can file the claim(s).

 

[Vync]

This might be a bit lengthy, but here are some additional tips which might help you out.

Try to obtain as many official records as you can get. This can really be helpful in a number of ways. I keep mine stored in a fireproof box, and I also scanned in everything to my computer for easy reference (it took me forever), but do what is convenient for you.

1. VA claims file (C-file), which should contain everything the VA has pertaining to you. These requests can often take months to fulfill. Having this can help greatly.

2. Military personnel record. You may be able to get this online via ebenefits or the my health e vet's Blue Button feature.

3. Any medical treatment records, regardless of in-service, VA or otherwise, and potentially any in-patient treatment records if you stayed in the hospital while in the service (sometimes those are stored at those hospitals). If imaging was done at a VAMC, the radiology department may have a separate records department and can give you a CD or DVD with the actual imaging and possibly the radiologist report.

As you get information from each source, take your time and go through it a bit at a time. It can be helpful to create a master list or index of key topics or events to help you find them later. If you have original copies of anything (typical back then), be sure to check the front and back of all pages so nothing gets overlooked. Based on your current diagnosed conditions, see if you can match any of it up to your in-service injuries and treatment. This would be a helpful basis for any new claims.

Regarding your hepatitis claim, if you never received a response from the VA, that could be a special case. Sometimes the VA never receives claim requests (i.e. lost in mail). However, if they received it, your submission should be in your C-file. If they responded, but never heard back from you, they would just close the claim as nonresponsive. There are cases where a veteran moves and never updates the address with the VA, which is not good. If they never developed the claim and never closed it, then that claim may still be considered open and would be beneficial to you.

Given you have 20% for ankle and 20% for knee, you may be able to file secondary claims related to those injuries. For example, if you now suffer from hip or spine issues, it could all be related to your SC ankle and/or knee. The 0% for misaligned jaw, if SC (as opposed to non-service connected 0%), could cause other problems with your neck, headaches, etc..., which potentially can be explored as secondary also. You can also file secondary claims for additional disabilities caused by medication used to treat your SC conditions. One examples is digestive problems due to NSAIDs (ibuprofen, naproxen, etc...).

You can always file for an increase for your current SC conditions if they have worsened. In many cases, you don't need a medical opinion, but merely need to have proof you meet the higher % rating. However, if you do not have any recent treatment records then the VA may send you for a C&P exam so they can evaluate how bad things are now. I believe it is always a good idea to compare the VA rating criteria against your medical records because it can help you decide if you should file and what to expect. I also have TMJ and was originally rated at 10%, but over the years as my records warranted higher ratings, I increased from 10% to 20% and then later from 20% to 30%. Here is a link to the VA rating criteria: https://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5

I hope this helps.

 

 

 

[sovereign]

Thank you VYNC-- very helpful for sure!

[Vync]

8 minutes ago, sovereign said:

Yes, I probably could. I just don't know where to start. Like, when I file a claim do I need outside medical proof even though the VA has EEG, CT Scan and vision field tests indicating a brain trauma. Do I need outside evidence showing progression of my HEP C? It's in my file that I have it and also that I had blood transfusions from their surgeries. Do I file for sleep apnea, depression/ptsd, hep c, TBI, lateral pain in my hips, back from broken feet and limited mobility and use of my arms from the head/jaw/neck injury all at once?

I just get really overwhelmed. I just had a vision exam by a VA Optometrist last week and explained to him that my right eye leaks fluid and that's consistent with a brain trauma. I have chronic redness and swelling from it. He said I had dry eye and allergies (in one eye?). Then he wants to see me in two months after doing the field test that I failed. Why, if it's only dry eye and allergies--eye exams are annual? I need an ophthalmologist and there aren't any there.  Anyway, my point is, I don't have insurance and this is the first time I've used VA medical care. It seems the VA lies or evades about what's wrong. 

I can't even get action on a FOIA request for my C-file. Don't get me wrong, I'm not a victim mentality. I'm getting started and trying to gather information before I take action so the claims are solid. 

Hope this makes sense. But yes, I can file the claim(s).

Any beneficial medical evidence can help.

Proof of Hep C progression can really help. Many service members were exposed to Hep C via jet gun immunizations, which is why the military stopped using them. However, the blood transfusion evidence can really help. They didn't have the ability to test for Hep C until years after many were exposed.

You can file for as few or many conditions as you like. Gastone made a great recommendation that you go ahead and start a claim on ebenefits. You should have plenty of time to gather evidence in the mean time. This would preserve the effective date of your claims, which is important. If you can spoon feed everything the VA needs, or as much of it as possible, it would help greatly because they would be able to verify more accurately. In many cases, the only thing needed would be a medical opinion to connect everything together. If you can get your doc to do that, it can help, but sometimes the VA likes to defer to C&P exam docs for that.

Regarding your eye question, as you know, the VA will cover treatment of your SC disabilities. If your combined rating reaches 50% or more, they will treat everything (except dental in some cases). If you are currently below 50% and have no reasonable income, ask the VA for help and they may treat you for non-SC conditions via co-pay. If your income is below a certain threshold, they can look into approving treatment of many things (at a lower priority, meaning you might have to wait a bit longer). For example, I had a family who served in the Korean War and was not SC for anything. His only income was social security. We filed and got him a small VA pension and medical care to help out. If the VA does not have an eye doctor, they may be able to outsource you to a non-VA provider. However, dry eye and allergies can be a factor in some conditions. The VA does tend to try their own remedies before sending you to a specialist. If what they recommend doesn't help, then they will bounce you along to a specialist eventually.

My C-file request took almost a year, but it can vary based on which VARO you use. Some are much more busy than others. You should at least get a form letter every couple of months saying something like, "We received your requests, but are overwhelmed working other claims, get to you eventually, blah blah blah..."

You're making perfect sense. I think you are doing the right thing by asking for help. The only bad questions tend to be the ones that never get asked. You'll probably get a variety of responses, which is helpful to make your decision on how to move forward.

Try to learn more about how the system works. Search the articles and forums and you may very well find others with similar concerns.

[sovereign]

Thank you VYNC for the info. I got a letter today that I'm being referred to a VA Neurologist (abnormal eeg/ct scan). I also had a series of x-rays and sonograms for neck/feet/hip pain. I have a letter from an Orthopedic Surgeon from 1991 that says I have a flattened talar dome with advanced arthritis and should have a fusion. Currently I only get 20% for range of motion. I also have very painful scaring that's noted in the first c&p exam. Can an old letter be used to reopen a claim? Thanks again for your suggestions.