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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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    • 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.
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    • 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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Thanks for the clarification Buck52.  It sounds like I was low balled on SMC.  I require assistance to dress/undress, bathing/showering, Passive ROM, preparing meals which I must eat 6-8 small meals a day due to slow stomach emptying (I'm told by my doctor this is related to SCI).  I have an ileostomy that came off recently at night and I was covered with muck.  My husband was working nights and I had to wait 2 hours for him to get home to clean me up.  I eat independently but require special utensils because of my hand weakness. My medications (way too many in my book) are set up by a home health nurse every three weeks and she will also eventually be coming every 2 weeks to change my suprapubic catheter since I don't have the dexterity to do it.  I have a van with zero effort controls adapted to me but I have since worsened and can't leave home unless my husband drives me places.

Next year we plan to use the Automobile grant to go totally high tech if I pass the driver's training at the VA.  Our current van, we purchased before my decision came through so we had to pay for all the adaptive equipment except the ramp.  I have Dragon for my computer so basically my days consist of being on my computer, interacting with my husband and children/grandchildren when they visit. I am unable to do much physically.  I do still oversee how the household runs and finances since those items just require my brain not my body.  I do have a service dog who helps with things like opening doors and picking up anything out of my reach or that I dropped but his capabilities are limited.  He can tug my socks off but he can't put them on.  Ditto with shirt sleeves.  

So would you recommend first filing for the items that were missed and new ones that have come up (neurogenic bowel w/loss of control-dealt with by ileostomy and colectomy, suprapubic, worsening weakness and definite worsening of pain) or should I just request an increase in SMC?  To me It would seem more logical to get SC for the above mentioned items and then see how the SMC rolls out.  There are times I need someone here with me for long periods and SMC M isn't enough for me to hire someone for that.

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I would file for everything that your entitled to.  IF your denied on some  you can always Appeal  but it starts your claim date for EED.

NOD the decision that you got and ask for the A&A That the VA Should have inferred that in the first place..... and ask that you be given your  Correct EED.

After we get a decision and don't like it or get low balled  defiantly appeal that decision ,  they are hoping you don't. (jmo)

They are not doing their job right and also can be a CUE in some circumstances when they don't infer a Veteran claims correct.

Edited by Buck52

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Thanks much!! I think right after my suprapubic is placed, I will do just that.  File for the neurogenic bowel/ileostomy, the suprapubic and increase pain which they can't find a drug that will control it.  I suspect they may connect but if they don't calculate the SMC correctly, I'll appeal.  One last question - you've been so much help and encouraging, do you know how the VA defines paralysis in the clause for SMC O?

(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." 

Do they mean complete loss of motion or loss of use?  I can slide my legs a bit, can't hold them up very long against gravity and certainly not at all against resistance.  I can't bear any weight so they are pretty useless.  Just wondering if that rating would apply to me or if you have have a complete - can move them at all or if my circumstances qualify.

Many thanks!!!

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      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)
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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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