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toomnyhats

Made 100% P&T - have questions :)

Question

After 30 months I’m finally there!  Of course after the celebratory shock wore off I have lots of questions. On 11/30/2015 I was granted 10% tinnitus and 60% Neurogenic bladder. The bladder was granted because my str contained a notation of bladder spasms several days after having a c-section when in reality it was due to my spinal stenosis (pre-existing and not manifested until after discharge).  We ask for reconsideration for the neck to get the LOU on legs (in wheelchair full time) and the connection to right arm weakness and bilateral shoulder issues. Denied. Filed NOD, received SOC and filed form 9. I already had a “more likely than not” from my VA doc but I obtained an IMO with same conclusion but it contained the magic phrases, “would not expect medical treatment for minor neck pain during service because degeneration doesn’t happen immediately”, “progressed quicker than natural progression”, plus a “more likely than not, condition was aggravated by service”. Bingo...never went to board - they granted locally. 

I’m perplexed that they did not grant Neurogenic Bowel (I have an ileostomy and had to have my colon removed). I’m also wondering why they didn’t put two and two together and realize my Neurogenic bladder should also have been secondary to neck. I suspect my rep will deal with those issues. 

My questions are:

1.  Will I receive retro back to the original 11/15/2015 filing date?

2.  I was granted SMC of M - does that seem right?

3.  My daughter was attending college during that 30 month wait - can we get retro on that?

4. Does receipt of SMC preclude use of standard package home care or is it meant to supplement it?

5. For SMC O, one item listed is “complete paralysis of legs along with loss of bowel and bladder function”  Is LOU considered complete paralysis or do they mean complete as in no capability to move them. I can slide my legs on my W/C foot plates but cannot stand or walk. 

I’m so relieved to be at 100 P&T and appreciate the wealth of knowledge and experience provided by this site. I’ve gotten valuable information during what I consider to be a fairly fast trek.

Thanks in advance for any light shed on my questions and situation.

toomnyhats 🎩

 

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I believe it is an M or M-1/2 based on amount awarded.  I don't have my packet yet.  But once we connect the neurogenic bowel, I believe it will go up to O.  In the meantime, while I've been waiting for my claim, for the last 2 years, I've had home care by contracted providers under the basic non service connected health care benefits.  Can I keep those even though I'm now 100% P&T with an SMC assigned.  I would like to keep those services and supplement by hiring additional help.  Sorry to be so confusing :/    Thanks for you help!

toomnyhats 🎩

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Posted (edited)

   

 This is some great questions and may need help from the elder members on this one  like Asknod and Ms berta broncovet and Gastone.

I'll try to answer some of your questions and just give my opinion.(please realize without researching all of your questions my answers are not written in stone)

1.  Will I receive retro back to the original 11/15/2015 filing date? 

yes= less what you already been paid..so you should get a 30% retro basically speaking.  

2.  I was granted SMC of M - does that seem right?

it is right but I would request the smc 0 for your conditions because you qualify, with the 100% plus the 70% = LOU WITH YOUR LEGS AND THE BLADDER, smc 0 is the highest smc as I understand. Although the refer to LOU Tto the knees  so your legs &right arm would be LOU.

3.  My daughter was attending college during that 30 month wait - can we get retro on that?

I believe you can be refunded IF HER AGE IS BETWEEN 17 & 28 but not exactly sure on this? (other members can chime in)

4. Does receipt of SMC preclude use of standard package home care or is it meant to supplement it?

not sure what you mean here?

  but with what you have stated here and what you been granted  I'd say you qualify for the whole package and the  0 =SMC Benefits for your conditions , you need help with bathing and dressing and the only other thing would be feeding yourself SO IN ESSENCE YOUR COMPLETELY HELPLESS CORRECT?  and if you have problems with that feeding yourself...I'd request every benefit your entitled to by law.

 preclude the LOU ,Loss of hearing and being blind are the only other two SMC Qualifications.

 

Congratulation on this Big Win  you certainly deserve all the benefits your entitled too and I believe you should be entitled to the SMC 0.

Edited by Buck52

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Posted (edited)

This is WONDERFUL News!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I can try to answer 2 of your questions

3.  My daughter was attending college during that 30 month wait - can we get retro on that?

Possibly Yes-if she has been attending a VA approved college , but how old is she-

Chapter 35 usually ends at age 26 but that can be an extended date but ony under limited circumstances, unless she has military service- and if so they will extend her eligibility date by the years of her  military service.

Her eligibility date is not the date of the award but the date the VA first determined you were 100% P & T.

I have more info here (I am a Chapter 35er) and will  find and post it later - as to what she will need for any potential reimbursement of her past tuition.

 

"I’m perplexed that they did not grant Neurogenic Bowel (I have an ileostomy and had to have my colon removed). I’m also wondering why they didn’t put two and two together and realize my Neurogenic bladder should also have been secondary to neck. I suspect my rep will deal with those issues. "

I am wondering too on the neutrogenic bowel- I assume y0u claimed that specifically-

"and realize my Neurogenic bladder should also have been secondary to neck." I dont understand that part

but in any event can you scan and attch the award here as to their reason and bases and the evidence list?

(Cover Cfile #, name, address prior to scanning it)

BUT , do RELAX first and let this all sink in........

30 months  is not bad at all-one claim I had took 9 years (IHD CUE) ,one took 8 years years SMC CUE, (RO awards finally)and another took  almost 10- BVA award 9 years later but my VARO didnt want to pay me and I had to raise Hell- so almost 10 years.

My daughter ,when she enlisted, ( USAF INTEL) had to go to VA Buffalo  NY for lots of USAF tests and med stuff- she asked the DAV to give her a tour of my RO but she really only could peek into rooms FILLED with stacks of files. She did take some photos of my RO  building , that ended up in the center of my War plan I made for each claim (my plans of attack-( legally and with more probative medical evidence) and I would roll up the War plan and do my "FU VA" dance ,shaking it and my award letter ,in front of the RO photo every time I succeeded.

(I know it sounds nuts- the RO photo is still on my PC desk)

Our Victorys can come with joy, but even with  sorrow, and overwhelming fatique-after long battles-

Good for you!  A RO award! This is GREAT news!!!!!!!!!!!!!

 

 

 

 

Edited by Berta
added more

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Could you post a redacted copy of the complete Award Letter? What is "standard package home care"?

As to your legs, in the SMC Description for "Loss of Use" of different appendages, generally; a comparison to the appendage being Amputated is the Rating Standard. From your description, I'd say your legs are of no better use in mobility; then if they had been amputated.

AskNod is the SMC Encyclopedia, he's posted here on Hadit and on his AskNod.com site; a very thorough and understandable in-depth discussion of SMC Awards and their respective Rating Criteria.

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Congratulations!  

    I will answer questions but not to repeat what others say, as I agree with Berta and Buck.  

1.  Your retro is the "later" of the date of claim, or date the doc said you were disabled (aka known as facts found) , with some exceptions.  When you get your effective date, we can try to help further to see if its correct or not, but we can not tell you what date the doc said.  

2.  The SMC you are eligible for mostly depends on what the doc says you have "loss of use", and whether or not you need "aid and attendance".  You can check the criteria for SMC as you know your health records better than I do:  https://www.law.cornell.edu/cfr/text/38/3.350

3.  What the VA did a few years ago, (I dont think it changed) is to offer the depenedent the choice of the "effective date" of ch. 35.  It could be your depenedent is offered either option..to get back pay for college already completed, or to start now.  Your dependendent would need to send in the election form, promptly, when they send it to you.  

4.  I think some forms of SMC wont pay both.  For example, I dont think you get A and A if you are a resident of a VA nursing home.  (In other words, VA wont pay you twice for A and A, once by paying your nursing home bill and again by paying someone else to care for you.  

     However, a spouse or family member can provide care for you and still get paid.  

 

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