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Just awarded 90% on my VA claim! :) Question...

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AFgal

Question

This may be a little premature since I am still waiting on the decision packet in the mail which should be today, but my GWI presumptive claim for fibromyalgia was just completed and eBenefits shows my packet as in the mail and my combined disability rating as 90%.

I was granted: 

tinnitus 10%

fibromyalgia 20%

insomnia disorder severe and chronic with nocturnal panic attacks, moderate and periodic (as a secondary to fibro) 70%   Note:  I think the panic attacks are part of diagnosed anxiety with adjustment disorder by Life Skills since mil service but didn't claim that as part of fibro, and the last time I tried in 2004 it was denied. I do wonder tho if I should file for that again now, but I only occasionally see a Dr for it and am not currently on meds either.

chronic migraines (as a secondary to fibro) 30%

I have been over the moon....and then started reading how the VA does reexaminations to try to reduce ones disability, and that took the air right out of my party balloons. My neighbor who just retired and gets 100% says to see if my packet says anything is total and permanent, but then just to make sure I keep going to my appointments regularly. Most examples I see in articles for T&P just mention blindness and missing limbs, what about incurable chronic conditions such as the fibromyalgia, and my records show the chronic insomnia in my records since military service 17 years ago. So I wonder how high on the radar I may be for reexaminations? I mostly keep seeing in articles that it's people with PTSD who keep getting reexamined.

Thoughts? How worried should I be?

 

Edited by AFgal
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As you posted, you need to wait for the packet.  However, unless your disabiities have actually improved, you should have little to worry about reductions.  

I suggest you worry about something else, instead.  Try worrying about America's air, or plastic problem, or who will win the next elections.  Wait!  You dont have a lot of control over those things, either, so try worrying about nothing.  

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Congratulations!

I would not be too worried. Keep in mind that the VA is having trouble keeping up with the claims they currently have and are not typically likely to bring veterans back in just for the fun of it.

When you get the packet in the mail, carefully read it. Sometimes the VA may indicate a disability "is expected to improve", which means they will call you back in for re-exam in the future. Sometimes they may straight up indicate you will have an examination in the future.

If your effective date goes back 5+ years, those disabilities will be considered stabilized. This means that the VA would have to show sustained improvement in order to propose reduction.

Permanent and Total is an enhanced classification for 100% rated veterans.

The panic attacks appear to have been part of your insomnia rating. However, a MH claim might be plausible. It's not unusual for veterans to have anxiety or depression due to their SC disabilities.

If you are not currently employed, consider researching Individual Unemployability due to your 70% rating. If you win, they will bump you up to 100%. TDIU might be in the future if your condition is not expected to improve. It's basically the same thing as P&T, except you can't work.

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Thank you both for the replies. The first envelope (the unofficial notification) did arrive today stating my ratings and my effective dates are all the same at March 23, 2018. My back pay to that date hit my account this morning; I was quite surprised to see it arrive so fast. It was also the amount for a single person for 4 months, so will they send me the difference now that I put in my spouse and two kids for the dependent pay? I noticed yesterday on the site that they said I had no dependents, so although that form was in this envelope I submitted it online yesterday and that approval letter already shows as in the mail now too.

There is nothing else in this letter stating if anything is expected to improve, just attached forms, so I assume it would be in the "official" one that I am still waiting on.

Thanks for explaining P&T.

I was employed part-time over the last year and a half doing medical transcription from home but recently stopped because my tinnitus kept messing with what I was hearing and I was having a hard time with all the sitting. It's an extremely low-paying job anyway (a few hundred a month part time). I regret ever getting into it and would never recommend it to anyone. 

I honestly haven't been thinking about trying to get bumped up to 100%. I thought that maybe I might get lucky and get 30% and was floored when I saw 90%. I just want to cash out my chips, leave the table, and stay out of their way in hopes they don't come across me again to take it back.

I will look into UI for future reference.

Edited by AFgal
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Direct deposit is a wonderful thing.

Regarding your dependency claim, I recommend submitting it via ebenefits, not regular mail. The online submission seems to get completed way before the mailed ones.

The Rating Decision (i.e. BBE or big brown envelope) should be following in the mail soon. That will break down each rated disability and how they came to the rating. I recommend you read it carefully to make sure they didn't screw up. I also advise veterans to compare the findings on their C&P exams to the rating criteria to ensure the VA did in fact rate the condition correctly.

Here is the link to the VA rating criteria: https://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5

P&T/TDIU does come with some additional benefits, such as Chapter 35 dependent educational benefits and CHAMPVA health insurance for dependents only (which is really great).

Thanks for the tip about the medical transcription vocation. Sounds like no fun at all.

If you remain unemployable, another option to research is SSDI (social security disability).

Keep tabs on your disabilities in case they get worse over the years. You may be able to file an increase if they meet the rating criteria for the next higher % level.

Going from 90% to 100% is possible, but it is an uphill climb due to the way the VA calculates 90%. I plugged in your 70/30/20/10 into the Hadit rating calculator and it came back with 84.88%, which I assume rounded up to 85% then up to 90%. If you ever consider going for 100% schedular (combined ratings alone), you would need some significant additional ratings unless you entertain IU.

https://www.hadit.com/disability-calculator

 

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Congratulations.   Yes, you should get back pay for dependents if you fill in the applicable form, along with proof such as birth certificates and marriage license.  You need to not wait too long to do this, or you can lose out on that, too.  

You want your kids on there..its a huge deal when you are 100 percent P and T, because they can get ch 35 DEA benefits and go to college.  I think its around 1000 per month, plus or minus, your kids get to go to college, provided they dot all the I's and cross all the T's when applying for those benefits.  https://www.benefits.va.gov/GIBILL/resources/benefits_resources/rates/ch35/ch35rates100115.asp

Edited by broncovet
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Thanks Vync for all the information. 

Broncovet, I did the dependents form on eBenefits yesterday which says it is already approved and the confirmaion letter is in the mail. 

Yes I like to keep our options open for our kids’ education benefits although I think my husband was considering giving them his GI bill, I already used mine. One daughter is set on going in the AF too so far. They won’t be on my claim as dependents for more than a few years probably as our girls are both teens. 

My husband has 22 yrs in and had a TIA last Dec. We are waiting for the final RILO decision to come in by the end of this week. Turns out he had a PFO they think caused his stroke so now he has a closure device in his heart to go with his arthritis and an APAP machine for sleep apnea. If he is medically retired I bet he will easily be at 100%. If he is returned to duty he will be C coded for now till he decides he’s done. 

Edited by AFgal
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