Question about compensation rate

[Steve34]

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 May 20, 2018 by Steve34

[Buck52]

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 %

[Steve34]

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

[Gastone]

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?

[Buck52]

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 May 20, 2018 by Buck52

[Steve34]

Back to the original question though. Are the left and right sciatica considered the bilateral factor even though they are both secondary to the lumbosacral rating?

[Buck52]

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 May 21, 2018 by Buck52