Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • 01-2024-stay-online-donate-banner.png

     

  • 0

Question about compensation rate

Rate this question


Steve34

Question

Guys,

So I have a rating of 90% and have some of my other claims submitted again that were denied without good cause.

My question relates to my rating and the breakdown of amounts

PTSD 

tinnitus 

hearing loss 

Lumbo sacral 

—->Secondary right sciatica 

——>Secondary left sciatica 

So, my question is whether or not the bilateral factor is applied for those secondary conditions?  I am currently awaiting decision on MIgraines, Sleep Apnea w/CPAP, and TBI.

I have my C file and it doesn’t look good personally. The sleep Apnea the doctor wrote he feels is not service connected and that my complaints during service and directly after were insomnia and that my Apnea didn’t develop until years after. I left the Army 2006 and my Sleep study was in 2016 even though I went to them many times before but they just told me it was my ptsd and gave me ambien every single time and refused to give me a sleep study. My wife has been complaining of the snoring and stuff since I was even in the military.

Migraines the MD wrote during comp and pen that “Therefore veterans migraine at least as likely as not proximately due to or the result of PTSD”. So i’m Assuming they are just going to lump that into ptsd and not rate me migraines or maybe rate it secondary to migraines. 

The C &P for TBI was only a week ago so that’s not in my Cfile yet I guess but he just asked about migraines the entire time and that was it.

Thanks for any info as usual guys

Steve

Edited by Steve34
Link to comment
Share on other sites

  • Answers 8
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

Recommended Posts

  • 0
  • HadIt.com Elder

You need to get the  TBI C&P EXAM RESULTS  BACK  ASAP. see what the examiner mention?

Depending on who did your C&P Exams?

try the medical records release desk at your VAMC After 3 days sign the FOIA  & Request the C&P Exams  or check in with the VBA (Veterans Benefits Administration) ask for a copy of your last two C&P Exams  especially the TBI

As for as the sleep apnea  you can file a secondary claim to that  due to your PTSD Meds(Names the meds), you need a qualified  sleep specialist Dr to state so'' it is likely as not'' that you have S.A.   that you have been diagnosed  for and require a C-Pap while sleeping due to these medications.

Just be honest

you can say in your lay statment your not claiming you had OSA during your active military  but since you were diagnosed by the VA for PTSD and started taking  the PTSD Meds  that is when your OSA was present and you have a Qualified Dr to give his professional opinion &  please consider this Dr opinion he is licensed and well qualified to render his professional opinion.& lay statment form your spouse.

Just remember what you already mention in your previous OSA Claim. do not contradict yourself.

usually for the sleep apnea with C-PAP is 50%  depending how severe the OSA is as to the rating %

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

Link to comment
Share on other sites

  • 0
2 hours ago, Buck52 said:

You need to get the  TBI C&P EXAM RESULTS  BACK  ASAP. see what the examiner mention?

Depending on who did your C&P Exams?

try the medical records release desk at your VAMC After 3 days sign the FOIA  & Request the C&P Exams  or check in with the VBA (Veterans Benefits Administration) ask for a copy of your last two C&P Exams  especially the TBI

As for as the sleep apnea  you can file a secondary claim to that  due to your PTSD Meds(Names the meds), you need a qualified  sleep specialist Dr to state so'' it is likely as not'' that you have S.A.   that you have been diagnosed  for and require a C-Pap while sleeping due to these medications.

Just be honest

you can say in your lay statment your not claiming you had OSA during your active military  but since you were diagnosed by the VA for PTSD and started taking  the PTSD Meds  that is when your OSA was present and you have a Qualified Dr to give his professional opinion &  please consider this Dr opinion he is licensed and well qualified to render his professional opinion.& lay statment form your spouse.

Just remember what you already mention in your previous OSA Claim. do not contradict yourself.

usually for the sleep apnea with C-PAP is 50%  depending how severe the OSA is as to the rating %

I’m going to the VA in Brooklyn this Monday to ask for it all printed. For the OSA, would the letter come from a mental health doctor stating the side effect from my fluoxetine is causing the OSA or would it be a sleep apnea MD? 

My friend looked at my C file today and he said even though they wrote the migraines are due to the ptsd that they will probably give me a rating for it but make it secondary to ptsd. I didn’t submit it this way but he said they do it sometimes. He said most likely 30% because the examiner checked once a month and completely prostrating effecting my work and life.

He also said the sciatica pain since rated separately for both right leg and left left at 40% should be rated by the bilateral factor.

i will work toward going to an MD to get the nexus letter ASAP once I figure out what MD it is. Maybe even get it in before this rating is complete.

what sucks is that they did an MRI that shows white matter and stuff. They said it could cause migraines but that was prior to and for the TBI exam. The TBI examiner only asked me about migraines for 5 minutes then tested my reflexes and it was over. Don’t want to sound petty but I needed to correct him several times due to his broken English and is not entirely understanding eachother. I also provided buddy statements from 2 seperate IED blasts I was in and how I was thrown due to a Chinese 105 landing within a short distance of me while at my firebase.

ok gents my rant is over. Thanks again for any advice.

steve

Link to comment
Share on other sites

  • 0

How about posting a redacted copy of your Rating Decisions?

Is there anything mentioned in your MHV SA Treatment Notes regarding the possible etiology of your 2016 DX'd OSA? How do you comport with the OSA "Likely Suspects,"  Neck 17+, BMI 28%+, Large Tongue and sizable stomach?

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

Well a Dr that is qualified to render an opinion in this field of medicine, so I'd ask a  sleep specialist  they have went to schools and study the OSA and the causes, you might ask both Dr's to opein on it.

 if either Dr 's are VA and won't help you?  then seek a private IMO from the sleep specialist 

The VA won't doubt you have the Sleep Apnea  you have a diagnosis for it,   it's the service connection or linking it  secondary to your PTSD Meds that is your burden to prove &  once the VA does that   then the sleep apnea becomes in part of your PTSD ''per say''

 

Like Gastone mention above check your MHV SA Treatment Notes  GET ALL FAVORABLE MEDICAL NOTES YOU CAN.

I am not that familiar with TBI Claims  check here on hadit for the claims procedure.

THERE NOT SUPPOSE TO RATE TWO MH CONDITIONS TOGETHER BUT FOR TBI's THEY MAKE AN EXCEPTION OR WRAP THE TBI IN WITH YOUR PTSD...THIS IS THE PARTS I DON'T UNDERSTAND.

On the IED's  you need to get all your service records *medical records to when/where it happen what happen and how long you were knock out (Minutes) was you medevac out to a hospital & medical care you recieved ect,,ect,, that matters a great deal when they go to rate you for TBI (how long you were knock out from the blast) it stops oxygen to the brain and they have a way to rate that  some how?

I think with MRI Readings? you need to get your hands on that MRI Test that showed white matter in your brain...ask a Qualified TBI Dr to to let you know in layman's terms what it means and his/her opinion on it  this is crucial evidence to help your TBI Claim.

Edited by Buck52

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

A secondary condition becomes part of the original condition once its connected as a secondary condition so in my opinion yes they should be bilateral connected at least to a 10% rating or to what the degree of rating warrants.... check your EOB on e benefits.   they tend to low-ball the veteran on bilateral ratings so check them close.

check this link out to see how the bilateral factor is presented

https://veterans.perkinslawtalk.com/post/the-bilateral-factor-in-va-ratings/

Edited by Buck52

I am not an Attorney or VSO, any advice I provide is not to be construed as legal advice, therefore not to be held out for liable BUCK!!!

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • kidva earned a badge
      First Post
    • kidva earned a badge
      Conversation Starter
    • Lebro earned a badge
      Week One Done
    • spazbototto earned a badge
      Week One Done
    • Paul Gretza earned a badge
      Week One Done
  • Our picks

    • These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.

      Service Connection

      Frost v. Shulkin (2017)
      This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected. 

      Saunders v. Wilkie (2018)
      The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.

      Effective Dates

      Martinez v. McDonough (2023)
      This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.

      Rating Issues

      Continue Reading on HadIt.com
      • 0 replies
    • I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful.  We decided I should submit a few new claims which we did.  He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims.  He said that the VA now has entire military medical record on file and would find the record(s) in their own file.  It seemed odd to me as my service dates back to  1981 and spans 34 years through my retirement in 2015.  It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me.  He didn't want my copies.  Anyone have any information on this.  Much thanks in advance.  
      • 4 replies
    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
×
×
  • Create New...

Important Information

Guidelines and Terms of Use