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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Most Common VA Disabilities Claimed for Compensation:   

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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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    • The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
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      Our traffic is going up and so are our expenses, however revenues have gone down and so I am reaching out to you to see if you can help me keep Hadit.com up and running.
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    • https://community.hadit.com/searching-for-va-claims-information-on-hadit.com/

       

      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
      • 3 replies
    • How to get your questions answered...


      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.

      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.
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toomnyhats

More Health Issues - question about claim

Question

My original decision is attached.  I posted later regarding the lack of connection for my neurogenic bowel (ileostomy with colectomy).  My VSO advised me not to rock the boat since my STRs didn't have any neck documentation.  That was dealt with in the IMO I submitted and was successful in getting the neck connected and the cascade with it.  My health has been up and down and I have not gotten around to filing for the neurogenic bowel. We're in the process of the Specially Adapted Housing grant right now...long process to get bid from contractor but not complaining at all!! Feel blessed to have it.  However, I talked to my VSO once again, about my concerns of my neurogenic bowel not being rated and I was told not to worry because if I had a bowel obstruction, rupture and died from sepsis, the Death Certificate would link it to the spinal cord injury.  I think that was a crock but...now I have other issues and am ready to take them on.  

 Issues I would like to file for are:

  1. Neurogenic bowel requiring ileostomy and subsequent colectomy due to disuse syndrome.
  2. Gastroparesis.  This has been brewing for awhile along with my GERD but it is to the point now where I'm losing weight too quickly and sometimes can't get anymore than 600 calories in a day even using high calorie supplements recommended by the dietician.  I feel as if I've eaten a Thanksgiving dinner all the time.  A few weeks ago, it resulted in a hospitalization and my small intestine had ileus for a couple of days where nothing moved.  Not sure if Gastroparesis is a ratable and connectable condition to my SCI.
  3. I'm scheduled for a suprapubic catheter to be placed on November 14 because I leak around my foley. I can no longer Cath intermittently because my hand is getting to weak to manipulate clothing and I don't have 24 hour help.  Am I correct that a suprapubic is ratable at 100% especially since I already have a 60% Neurogenic bladder rating (not related to my neck issues)
  4. Is is worth it to file.  My husband is 60 and taking care of me is becoming very taxing.  The VA covers some home care/homemaker through the standard care but not near enough.  So I don't know if these issues, if granted would bump me higher than an M w/K.  
  5. Also does anybody know if Loss of use of both bowel and bladder sphincter control plus paralysis requires the paralysis to be complete (as in ASIA A) or does it also apply to incomplete. I'm listed as a C1 ASIA C SCI. It is not clear in the regs which state,  "(2)Paraplegia. Paralysis of both lower extremities together with loss of anal and bladder sphincter control will entitle to the maximum rate under 38 U.S.C. 1114(o), through the combination of loss of use of both legs and helplessness. The requirement of loss of anal and bladder sphincter control is met even though incontinence has been overcome under a strict regimen of rehabilitation of bowel and bladder training and other auxiliary measures." 

Any advice or thoughts would be greatly appreciated.

Blessings,

toomnyhats

toomnyhatsRedacted.pdf

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VSO's will almost always tell you to not rock the boat, unless they are county VSO's.  Remember that they are paid by the VA. 

Your condition is not going to improve so I cannot see the VA reducing your benefits if you apply for more but we never know what the VA will do.  You are P&T for your currently received benefits so that is a plus.  With my limited knowledge I would believe that the conditions you wish to apply for are related or secondary to your disabilities.  I would apply for aid and attendance if you are having problems with daily activities, especially if you can no longer cath independently.  Your situation seems intense and my best wishes for you.

There will be others who will give you advice that are much more eloquent than me.

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Thanks vetquest!  I am rated an M for SMC - is aid and attendance a separate thing?  I definitely need it.  I am receiving some help from the standard medical package (Homehealth/Homemaker) but it is not near enough.  I need help with my morning routine and my nightly routine along with additional things like PROM, FES hook up, and the homemaking.  My husband is definitely becoming over taxed (he is 60).  We would consider him retiring early but don't have enough trust in the VA to do that.

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I AGREE WITH VETQUEST

YOU CAN SEND IN WHAT MEDICAL RECORDS YOU HAVE AND GET YOUR DR TO STATE YOU CAN'T DO GENERAL THINGS IN LIFE  LIKE COOK OR DRESS YOURSELF AND THAT YOU DO NEED THE AID OF ANOTHER PERSON TO HELP YOU MEET THE GENERAL DAILY THINGS OF LIFE TO HELP MAKE YOUR LIFE  A BETTER LIFE  ECT,,ECT,,

you can write out your lay statment and let them know just how big struggle you have   I mean tell them everything that happens with you on your bad days.

but the main thing is a letter in detail from your Dr opine telling why you need the Aid.

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Thanks Buck52 but I'm somewhat confused.  I thought aid & attendance was the SMC I receive...I am classified as SMC M.  I may be misunderstanding terminology??

Is aid and attendance something entirely different.  I also don't understand why I wasn't assigned an SMC of O (paralysis with loss of both sphincter control) or do they only look at paralysis if you are a complete versus incomplete SCI patient?  And how would the 100% for suprapubic and 100% for neurogenic bowel w/ileostomy & colectomy play into things if granted. (I believe those are both rated at 100% from the regs I looked at).

Just when I think I have it figured out...I realize I only know a tiny speck of the big picture!

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toomanyhats

They are 25 Years experinced VSO that do not fully understand how the SMC are  met.SMC is very complicated for even the Best Claims adjudicators.

 

''There are different levels of Special Monthly Compensation. First there are basic levels, ranging from (k) to (s) that are the building blocks to the higher levels, ranging from (l) to (o). One must first establish entitlement to basic Special Monthly Compensation before being considered for higher rates of SMC.

Some of the basic levels of SMC are loss or loss of use of a creative organ, loss or loss of use of a hand or a foot, blindness of one eye, deafness of both ears, loss of voice, housebound, or aid and attendance.

There is a difference between the loss of use and the loss of the body part itself, as explained here.

The different level of SMC that a veteran is entitled to corresponds to a different level of compensation well above the 100% rating. For example, a single veteran rated at 100% receives $2,906.83 per month, but at the highest level of SMC benefits for aid and attendance, the compensation would be $8,179.89 per month.

The VA has a duty to maximize a veteran’s benefits; they are supposed to render a decision that grants every benefit to which the veteran is entitled to.

It is generally presumed that when filing a claim for disability, the veteran is seeking the maximum benefit allowed by law that corresponds to their disability.

Therefore , SMC is not something a veteran has to formally request of the VA. It is inferred when a claim for disability is submitted.

The VA is supposed to consider it when making a decision on the claim, whether the veteran is entitled to SMC benefits if the evidence in the claims file indicates that they are.

The VA often fails to do this though, so you will want to know when you are entitled to these benefits so you make sure the VA is not paying you less than you deserve.

If a veteran is erroneously denied SMC benefits or not granted the full amount of SMC benefits they are entitled to, they could be entitled to retroactive benefits or even make a claim for clear and unmistakable error.

Aid and attendance is a type of SMC that provides additional compensation for veterans who need assistance in tending to their daily needs due to their service connected disability.

SMC can then be awarded, depending on the level of care the veteran needs, in order to alleviate the need for a caretaker. The caretaker does not have to be a medical professional, but can even be a member of the family helping with everyday tasks.

Some of the factors the VA considers as everyday tasks that would qualify the veteran for additional compensation are the inability to dress or undress, bathe, take care of one’s personal hygiene, feed oneself, or being unable to avoid injuring oneself with everyday tasks.

Housebound status is another example of a type of SMC that entitles a veteran to additional compensation when they are substantially confined to their home because of their service connected disability, and it is reasonably certain that the disability will continue throughout their lifetime.

Each of these types of SMC’s also have different levels that qualify veterans for different amounts of compensation.''

 

:Source Hill & Ponton Disability Attorneys

 

 

 

Edited by Buck52

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  • Similar Content

    • By AshMur
      Hello! Long-time lurker, first-time poster. I've gained a lot of valuable information from this site in the past, and I am hoping to gain some insight on my particular issue/question.
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    • The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
        • Like
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    • Wonderful news way to hang in. I hope this gives you some well deserved peace. 
    • If HadIt.com has helped you or you believe in it’s mission then please donate even $1 helps. I hope HadIt.com has provided $1’s worth of help to you. Imagine waking up and there is no HadIt.com it could happen and that is why I’m asking for your help now.



       



      Our traffic is going up and so are our expenses, however revenues have gone down and so I am reaching out to you to see if you can help me keep Hadit.com up and running.
      • 4 replies
    • https://community.hadit.com/searching-for-va-claims-information-on-hadit.com/

       

      Your question has probably been asked before so the fastest way to find the information you need is to search for it.
      • 3 replies
    • How to get your questions answered...


      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.

      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
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