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By S. Bruce
I was awarded 30% service connected for sleep apnea when I left the military in 2008. In 2013, I was directed to and took another sleep study. It was found and the VA agreed that I needed to start using the CPAP. VA reviewed the evidence, agreed, paid for and I have been using the CPAP since 2013. In Sep 2019, during a review of my records, my representative informed me that using the CPAP meant that my SA rating should be 50% versus 30%. I filed an increase claim and was increased to 50% with an effective date of Sep 2019. Shouldn't the effective date be April 2013 when the diagnosis was received and approved? I checked and the 50% rating for using a CPAP was in place in 2013. I wasn't aware of the rating difference at that time, so I didn't file a claim at that time. I'm asking because I'm thinking I may be due some back pay...……….
Does claiming a new condition void possible entitlement to an earlier effective date? The new condition (migraines) isn't actually new because it was combined into one 10% rating for TBI to include migraine headaches.By chibears3531
I’m on the verge of filing a large VA claim to include migraines, erectile dysfunction, obstructive sleep apnea, and a few other conditions.
However, I think I may be eligible for an earlier effective date going back to 2008 for the migraines and ED. I’m hesitant to file for the migraines and ED in this claim because I do not want it to nullify my chance at an earlier effective date.
Background (long read, sorry!):
After reviewing my C-File, I'm pretty sure VA underrated and possibly clearly and unmistakably erred (CUE) 11 years ago in their decision based on the detailed evidence from their c&p examination.
Essentially, the VA decision said that I don't have prostrating migraines because I don't have emergency room or sick call visits. They conceded I have cognition issues from all the concussions and awarded 10% for:
“traumatic brain injury with post concussive syndrome (also claimed as migraine headaches)”
This was despite having an in service migraine diagnosis (which was in their possession at the time and in my C-File) and the fact that their C&P examiner said that I have “prostrating migraines 4x per week”.
Unless I’m mistaken, if the VA had in their possession evidence that would warrant a higher rating of the migraines at time of the decision 11 years ago, they violated 38 CFR 4.6.
Additionally, while I did not claim erectile dysfunction, I think this may have been an “inferred claim” seeing as the c&p examiner noted:
“Q22. Sexual functioning?
A22. Yes, problems with achieving and maintaining erection. The veteran has started to use Levitra, which helps. He mentions he has been taking Celexa, had been discontinued, and has less of sex.”
“DIAGNOSIS: Traumatic brain injury with post concussion syndrome and migraine headaches, and erectile dysfunction (with etiology as least as likely as not related to the TBI).”
I've heard that the VA stopped honoring claims to re-open so I'm unsure as to the best way to proceed for establishing an earlier effective date for a migraine rating. I also suspect that it's too late for them to honor the special TBI re-processing rules if the exam was not conducted by a neurologist (he was an internal medicine MD).
Finally, just to re-iterate, I’m hesitant to file a claim for migraines and ed in this new claim because I don’t want to possibly lose my earlier effective date by doing so. My tentative plan is to include them in the new claim anyway and in a statement ask that the “TBI with PCS (also claimed as migraine headaches) be split into “8045 TBI residuals” and “8100 Migraines” with each condition being rated separately.
Then after the decision is rendered, file a supplemental claim with the 2008 c&p exam notes appealing for an effective date to 8/31/2008. If that fails, that’s when I would look toward filing for a CUE.
Does this sound like a solid plan of attack?
So I started my "Fully Developed Claim" 02/08/2019 had my VA Comp and Pen Exam 03/18/2019 . My original completion date was 08/05/2019. Then after my Exam 05/03/2019.
This is my story I've injured both knees, both feet and back while serving In the Army in 2017. progressively my back gave out on me. Now I'm young 25 years, can't work and didn't know about my options until just recently. Lucky for me I was within my year of separation so I got a VSO to work with me and my claim. Still waiting if it's an approval or denial, however today Ebenefits updated status from "Pending of Decision" to "Pending Decision Approval. With a new estimated date 04/30/2019. What happens next. Will I know I'm approved before notification in the mail?
I received a letter from the BVA dated May 24 , 2018 stating that I had been granted service connection for some issues and a remand for other issues. I am still waiting on an effective date and rating. My question is will the VA implement the grant while waiting on the remand? how long does this process usually take? I was ok while my case was on appeal but since I received my grant I have went crazy. I check e benefits 3 times a day and i cannot stop wondering what my new rating is. How long does this process take? I thought I had won my case but nothing has changed. sooo tired of waiting on the VA. Any info on time would be great or any suggestions to speed this up.
Hello to all the amazing people who are helping more people than you know,
Looking for help with a few questions so here is the short (longer than intended*)rundown...My ETS was Mar2016.. While still active in 2010 was on my Sr year finishing premed degree with 4.0 gpa had to stop going to college when my second kid was born and wife was very ill the following years missed alot of work but always made up for it (i had very supportive chain of command that made alot of my own med issues go unnoticed or possibly pitty..not sure but love them all miss them all) fast forward to 2016 after ets wife is better all the kids in school and with full post911 benefits left why not try to finish my degree, unfortunately over that time my health had greatly deteriorated and school was not so easy anymore, and it wasnt just school but all areas of life had become to much for me(ALL). Without going to far into a long story I was in two major car accidents in 2014-2015 went into a mental breakdown loosing touch with reality on the reg and it wasnt until this year the "Helpful Psych at VA" actually taking her time to talk with me that we found out it was more than just failing in all areas that was making me act like a different person. Turns out that a blow to my head caused alot more damage than I originally thought, and i hope one day my friends and family can see who i once was again. Towards the end of my enlistment I went to see my pcp a few times and to mental health only once very bad communication between me and anybody from that point in my life to today which I still have trouble seeking/getting help especially when i have to wait months for an appointment and speak maybe 2 min max with the dr who never remembers anything and thinks its the first time we have met almost everytime and being a walk in is even more pointless as they really are already overwhelmed with patients already....so frantically rambling to a dr or dav or vso about a number of issues just trying to get the point across with no useful outcome is how I always leave and I constantly not remembering what im talking about by the time I start talking is why I thought it might be good to get on here and write it down...sorry...so va claim background:
June 2016: First claim filed (4months after ETS)
August 2017: First claim closed rated at 80%
0% for groin > for foot injury> for facial scar> and knees
10% Blood Pressure
10% arthritis wrist
20% back issue
<Denial: Dental> No complaints for dental had unbelievable issues with teeth dont know what or why but by this time next year i wont have ANY left. I have had 2 molars pulled in last year less than a month after dental c&p
Side note* no dental or med exam when I got out no exit exam at all..whatever the exit medical exam is called to show you are healthy and well ready for civilian transition the clinic scheduled the exam the day my orders ended so Dr said he couldnt legally see me as I was no longer in the military. Last conversation I had on base...
<Denial/TREATMENT ONLY: active psychosis/ gw claimed depression, anxiety/stress" (reason: i did not have any evidence or complaints in service but symptoms developing within time limit of leaving service hence treatment only) even though i did go to MH clinic while in service>>>#didnt know the only service records that the VA doesnt get/have access to is mental health! (Found out after calling the MH clinic at my old base with hopes that maybe a past appointment might be in their computer system somewhere...turns out they did have a record of the appointment with the MH Dr notes from the visit! #only one appointment but still #in service treatment record thats good right?
**side note after receiving the "Treatment only" decision by VA and visits and advice from the "Helpful Psych at VA" who told me I should have got service connection "at least deppression 2ndry to chronic pains associated with scd's" which i filed for within a yr of the original notification letter.
<Denial: hemorrhoids> (had/have but owell) no treatment in service prep h worked fine
<Denial: genitourinary condition> #i had a mucosal discharge documented breifly in smr> with Dr visits in service noting possible relation to <Denial: Digestive condition> problems with gallbladder heavily documented in smr which va said existed before service in confusion with an appendectomy prior to entering service. #visits in 2017 to urologist documented discharge havent been back.
<sometime between all of the psych visits from 2017 to now i have a history of TBI of what level is still unclear to me> have met with tbi specialist> still have alot appt scheduled with neurologist and neurosurgeons> TBI not rated as of right now...
June 2018: file for increase in knee rated 0% and groin 0%, and claim Depression secondary to chronic pains associated with service connected disabilities
Beginning of August 2018: Discover missing Mental Health records were available I notified VA of new material evidence to make sure service connection established and to maintain the effective date of original claim (being made available to VA within 1 year of original rating notification). This was done via VA written statement form and uploaded to the supporting documents for the now open claim for depression secondary on ebennies I also called the 1800# to advise VA and statement was taken over phone. I was also told that this would reopen the original claim for deppression.
Mid August 2018 receive notification letter now combined rating is 90% : effective date June 2018
Increase Knee granted: 10%
Increase Groin granted: 10%
Depression secondary basis to chronic pains associated with scd's granted: 50%
August continued>> while the claim was still open I met with the VA TBI specialist provided and she provided me with TDIU form since i have not been able to work due to the severity of my mental health conditions along with the form for spousal support which i faxed to claims intake but the claim closed and 90% rating was assigned but along with the tdiu claim I have a new claim opened for increase for depression and migraines which were the two most severe scds which the tdiu form asks to list on the form. The DAV has not contacted me at all throughout the entire claims process that started back in 2016 so I am not sure what I should be doing if anything more to make sure that i get the earliest effective date. I have been unable to get anything done in my day to day life and typing this has taken an entire day for me. Im failing out of school which means I wont get my post911 housing anymore of which ive used almost all of now, my wife has been taking care of me and our kids and i know its beginning to be to much for her to handle, to put iceing on the cake shes 2 month pregnant which i couldnt be happier to have another child but i dont know what im going to do, if anyone does read this long thing any advice is greatly appreciated. Sorry if it doesnt make much sense.
Thank you to all of you who are doing great things for for the vets on this website it has been a go to place for me for the past 3 years
Much love to my brothers and sisters i miss yall more than you know
Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
Vync posted an answer to a question,I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:
2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis
2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.
"...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.
First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date.
If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues.
I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.
It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.
Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.
Does this help?
Buck52 posted an answer to a question,Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.
The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.
Picked By66 bricks,