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      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

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AFCop2016

No NOD filed but w/in 1 yr claim for increase w/ new and material evidence / Claim for TDIU

Question

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% tinnitus 

10% Blood Pressure 

10% arthritis wrist

20% back issue

30% migraine 

30% maxillary 

<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

-c

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You are in the right place to make sure of your effective date.  

You posted:

Quote

The DAV has not contacted me at all throughout the entire claims process that started back in 2016 

In my post, "Ten ways your VSO can sabatoge your claim", it sounds like you have had several of these.  At a minimum, your VSO did not return your calls or at least contact you in regard to appeal deadlines.  Even tho your appeal deadline has came and went, you are correct that 38 CFR 3.156 (C) Reopening due to new and material evidence, should yield you an earlier effective date, if/when benefits are awarded.  

Now, make sure you have ALL the Caluza elements, as your VSO obviously was "0" help with this.  

1.  Current diagnosis.  

2.  In service event or aggravation

3.  Nexus, or doc opinion that 1 and 2 are related.  

      It sounds like you have TBI...have you been diagnosed with same?  

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My same question too-

"TBI not rated as of right now.."

"Turns out that a blow to my head caused alot more damage than I originally thought," was this an inservice event? 

Is it documented in your SMRs or 201 file?

Are you sure the VA is still working on your TDIU claim?

Did the award -taking you up to 90% -state that the TDIU claim had been deferred?

and did they mention TDIU im the August  2017 80%  award?

June 2016: First claim filed (4months after ETS)

August 2017: First claim closed rated at 80%

I am not a doctor but I believe the TBI you had is the most serious condition you have, as to the affects yuou have from it.

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."

The EED should go back to your discharge date, as I understand this- I assume these were all claimed within that first year after service:

 

"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% tinnitus 

10% Blood Pressure 

10% arthritis wrist

20% back issue

30% migraine 

30% maxillary "

But claims filed after that first year after service will 99% of the time have the EED, if granted, back to the filing date of those claims.

Have you ever applied for Social Security Disability?

The maxillary SC - was this for Temporal mandable joint syndrome ( gnashing of teeth while asleep)?

You have done very well so far....it would not hurt to request a copy of your VA medical Records at some point, maybe after you see the Neuro doctors. The VAMC that treats you should have a Records Access officer who also handles FOIAs, who would have a simple form to fill out, so you could get a copy of your  VA records the records and better determine what is what with the TBI, so that they rate it correctly. 

 

 

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PS, would someone add up this vets %s? They are paying him at the 90% rate but I wonder if that is right?

"August 2017: First claim closed rated at 80%

0% for groin > for foot injury> for facial scar> and knees

10% tinnitus 

10% Blood Pressure 

10% arthritis wrist

20% back issue

30% migraine 

30% maxillary "    and then

"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%"

 

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Great minds think alike, Berta.  TBI is serious, and can impair the Vets judgment.  Please understand, Im not trying to judge AFCop2016, but TBI and other mental health disorders can lead to poor judgement.  

For that reason, I recommend AFcop get some help:  His spouse is a likely candidate, because she has a dog in the fight also.  A trusted friend is also a source.  

You can also consider a "paid" help, normally an attorney or non attorney practioner.  

I dont even do all my claims myself, nor does Alex Graham.  Both of us have won significant benefits with the use of an attorney, and both of us have 10 or more years experience answering Vets questions.  As does Berta.  

It would not cost you anything to take your claim to an attorney and ask his opinion, especially if you get denied at the BVA.  

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Please find out now what your last date to file an NOD is.  If you are still within that date you are good, just make sure your NOD is filed and delivered to the VA by the time that date expires.  Broncovet is correct that you cannot hurt yourself by speaking to a qualified VA lawyer.  They will usually get what evidence you have and tell you upfront if they will represent you.

I just cannot tell you enough how important your NOD date is.  My case was closed when a VSO did not file my NOD by that date and I would have lost all back pay I would have received.  Fortunately at that time you could file anything and it was considered an NOD and I had filed an answer and challenge to an SOC.

Request TDIU in your appeal also.  If you need help with your NOD ask and someone here should be able to give you some advice.

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      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 2 replies
    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
      • 7 replies
    • Mere speculation in your VA C and P exam

      M21-1, Part III, Subpart iv, Chapter 3, Section D – Examination Reports III.iv.3.D.2.r. Examiner Statements that an Opinion Would be Speculative Pay careful attention to any conclusion by the examiner that an opinion could not be provided without resorting to mere speculation (or any similar language to that effect). VA may only accept a medical examiner’s … Continue reading
      • 0 replies
    • A favor please - just changed servers so if you have a moment...
      A favor please - just changed servers so if you have a moment go to https://www.hadit.com I'd like to see how the server handles a lot of traffic. So if you have a moment click the link and i can see how things are going on the back end.
      • 11 replies
    • It's time to ask for help from the community. If you can help with a gift it would be very appreciated.

      Fund HadIt.com Veteran to Veteran LLC


      Give a financial gift to help with the upkeep of HadIt.com. HadIt.com is NOT a non profit. Gifts are not tax deductible, they are just gifts. 
      • 11 replies
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