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spearhead91

Increase Ratings and New Claims

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Hello all,

I'm back again 3 years later. My situation has gotten worse and hence the increase/new claim request I have just submitted and learning how interwoven my issues are and secondary claims.  I've spent the past few weeks reading off and on. Learning the latest from for the few names I remember. Good to see some familiar names still here and I'm grateful for your wisdom and support to the Veteran(s) and their families and the community as a whole. I wish I could do more and contribute my limited experience to the new members but one of my major disabilities is with my dominant hand and shoulder/neck.

I've been struggling for 3 years now and continuing to work for fear of loosing health benefits that have helped me and my wife(100% SSDI)non veteran with continuing medical care prescription coverage etc. But probably the quick access and no limit to specialist etc. 

That said, I am at a major crossroads with continuing to work with the trade off being the continued use of private health care vs being dependent on the VA all the time. That is one my major concerns since my wife's and my health situations are so complex. I've started the IMO process this time for the professional and expertise because of the complexity and really needing to get it right as possible this time. My first go around with a VSO experience they did the one form for the claim and I did all the rest gathered all the medical info, release forms, ebenefits uploads etc and made it to 50%. I have to give the RO credit though he/she did help me SC something I didn't even think of which got my rating to 50% the first time with a secondary connection. 

I would like to post my current and increase and new claims to compare but I'll hold off for now and see how these first couple of months go.

I do have one major question though for the claim and it's a broad based question. I had let my employer know I was partially disabled from the VA and really nothing was done for my type of work, office work high stress etc, that was over 2 years ago. Long story short new manger understands my limitations and worked with our HR and we now have a reasonable accommodation letter and DR form filled out with bare minimum instructions to my employer. ((I was really upset finding out prior manager did nothing, trusted them because I knew them so long. Yes read EEOC and all that and holding for now)) Back to main question should I upload the reasonable accommodation letter from my employer and DR to the claim? The wording is very generic but implies breaks every 2 hours etc for 10 minutes and some other minor things. Is that a hinder or help in regard to claim overall and the reasonable accommodation? In other words if I'm doing increase and new will that help or rather hurt my claim?

Thanks in advance.

spearhead91

Edited by spearhead91

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This letter, unless written by a "medical professional" is "lay" evidence only.  

I suggest you focus your efforts on meeting the criteria for an increase, because the rest of the stuff is "noise", and kind of fills up your cfile and makes it difficult to read.  

To get an increase, your doctor needs to document that your sc condition has worsened, and document additional symptoms since you were rated at 50 percent.  You also want to show how your sc conditions affected your employment, but remember, this needs to be medical evidence not lay evidence.  

For example, "I" could say that you have  a thyroid condtion and even write a letter to that affect.  However, its meaningless because Im not competent to opine on thyroid conditions as I have no medical training or expertise in that field.  

Here is when "lay evidece" can be useful.  My buddies could write a letter and say something like, "Gee, Broncovet snored so loudly, I had to sleep in another room."   Now, my buddies are competent to be an eyewitness to something like snoring.  It does not take a medical degree to hear a snore.  But it would take a medical degree to diagnose a thyroid condition.  Now, if my buddies wrote this letter, it could establish an "in service event" or aggravation, showing that snoring occurred in service.  A doctor (hopefully a sleep medicine doc) would have to diagnose sleep apnea, and then opine that my current diagnosis of OSA is at least as likely as not began in service with this severe snoring.  

In short, give this letter to your doc, let HIM put it in evidence and this establishes this as "medical evidence" that your work is reduced by a sc condition.  

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Thanks broncovet for some clarity. The form the DR filled out listed that my medical conditions are permanent and for privacy reasons did not list all of them. I have all the ICD codes that I am under care for and prescriptions, MRI reads, uploaded to ebenefits already, one major SC injury being current and shows one of my main SC issues is far worse than first reported based on the MRI read alone and Neuro DR review. VA care agrees and said first thing I was a surgery candidate in first few minutes of most recent appointment but I've chosen conservative care first etc and will do the next level second and surgery last because of location of the SC injury. It's like they say if they are in a rush to operate get a second and third opinion. 

So to stay on point, the letter from the PCP DR says my conditions are permanent in nature, SC connected already, and MRI done after SC granted shows that what I was rated for was lower and has affected other body parts if you will. New secondaries will be tied to SC injuries. But I understand what you say about Lay evidence, I did not do my own statement first go around but I am this time as I feel I need too to help assist the VARO understand the what/why etc to spell it out cleanly the SC for the new and increases. The IMO has also opened my eyes to areas that were underrated and not SCed and why they should be. 

Thanks for the insight and feedback.

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