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Compensation


Kim Rice

Question

I got out of the Air Force in Dec of 2000.  I'm ashamed to say that before I exited the military, I was not informed that I should file a claim as I was having active issues with an "unknown tummy issue"  at that time. I was overseas (Turkey) and had been referred to several specialist in the area to determine my condition.  No one was able to, other than the fact I was told I had two spleens (LOL).

Just before a PCS, I was told my gallbladder was the cause of all my pain and should be removed upon arriving at my next base.  When I arrived at my next base, the GI doctor there said it wasn't my gallbladder and that he wasn't quite sure what it was.  I was actively dealing with these "unknown tummy issue" upon my exit from the military. 

Once I got out, I was back and forth to the dr. and emergency rooms for 2 years before it was determined that I had a hiatal hernia along with GERD.  I've been on INSAIDS and the gambit of over the counter drugs to combat severe symptoms of heartburn, regurgitation, pain (OMG, the painII), and gas since then. I filed a claim in 2001 and was denied!  Upon appeal, I received 10% for GERD/hiatal hernia.

I have been dealing with issues of PTSD to include depression, anxiety, etc...for many years. As with most mental health patients, the sigma's attached were made it difficult for me to admit first that it was a problem, but then to eventually seek help. In 2018, I filed a claim for PTSD and was awarded 70%.  At this point, however, I had lost my 10%  (Jul 2016) due to not responding to a request from the VA. 

My question:

My claim was decided with 70% PTSD, 10% Tinnitus, and GERD/Hiatal was deferred.  

When I view E-benefits, it appears that GERD and Hiatal Hernia have been separated as if into two separate conditions but still is the only condition, besides recently filed IU, I haven't been rated on .  I'm not sure what to think of this, any ideas?

 

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You posted:

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 At this point, however, I had lost my 10%  (Jul 2016) due to not responding to a request from the VA. 

Do you have this paperwork?   The VA has to give you a proposed reduction...as well as a right to a hearing..or its cue.  Maybe the "information" they 
"asked for" was a proposed reduction??  

Of course, the first step is to get your entire cfile to know exactly what is going on.  

You indicated you "filed for TDIU".  Did one or more of your doctors opine that you are unable to maintain SGE due to SC conditions???

It seems best to take a multi faceted approach:

File for an increase on PTSD, increase on Gerd, increase on hiatial hernia.  

Sometimes the things "we predict" will win beneifts are not the case and its something else.  

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Proposed reduction or a Rating adjustment?

Although I had not received any payments for the 10% GERD/Hiatal Hernia since July of 2016, my award letter indicates the following:

Monthly Entitlement Amount     Payment Start Date           Reason

130.94                                                Jan 1 2014                     Cost of Living Adjustment

133.17                                                Dec 1 2014                     Cost of Living Adjustment

0.00                                                      Jul 1 2016                     Compensation Rating Adjustment

1365.48                                                Apr 1 2018                  Cost of Living Adjustment/Compensation Rating Adjustment

1403.71                                               Dec 1, 2018                  Cost of Living Adjustment

Fortunately, I did receive retro pay for I believe the PTSD per my calculations. I'm not sure what the other numbers are referring to...it's all so confusing!

Also, I have been unemployed since 2015 and have had difficulty securing employment since I got out. I did look for help in 2016 through the VR&E program. The counselor their was able to show that I had a severe employment handicap and was able to get my expired benefit reinstated.  I'm currently not in school because now even that benefit has been suspended because of paperwork not filed.  

So, to answer your question, there was one doctor that did opine that I should look look into applying for Social Security benefits through the state.  Ironically, it was the psych doctor I saw for my initial Psych C&P visit for PTSD. I intend to take her advice and file for SSDI but according to regulation, felt like I qualified for TDIU as well.  

Thanks for any further thoughts you have regarding my claim as its so difficult to maneuver through.

47 minutes ago, broncovet said:

You posted:

Do you have this paperwork?   The VA has to give you a proposed reduction...as well as a right to a hearing..or its cue.  Maybe the "information" they 
"asked for" was a proposed reduction??  

Of course, the first step is to get your entire cfile to know exactly what is going on.  

You indicated you "filed for TDIU".  Did one or more of your doctors opine that you are unable to maintain SGE due to SC conditions???

It seems best to take a multi faceted approach:

File for an increase on PTSD, increase on Gerd, increase on hiatial hernia.  

Sometimes the things "we predict" will win beneifts are not the case and its something else.  

 

Edited by Kim Rice (see edit history)
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1 hour ago, broncovet said:

You posted:

Do you have this paperwork?   The VA has to give you a proposed reduction...as well as a right to a hearing..or its cue.  Maybe the "information" they 
"asked for" was a proposed reduction??  

Of course, the first step is to get your entire cfile to know exactly what is going on.  

You indicated you "filed for TDIU".  Did one or more of your doctors opine that you are unable to maintain SGE due to SC conditions???

It seems best to take a multi faceted approach:

File for an increase on PTSD, increase on Gerd, increase on hiatial hernia.  

Sometimes the things "we predict" will win beneifts are not the case and its something else.  

Proposed reduction or a Rating adjustment?

Although I had not received any payments for the 10% GERD/Hiatal Hernia since July of 2017, my award letter indicates the following:

Monthly Entitlement Amount     Payment Start Date           Reason

130.94                                                Jan 1 2014                     Cost of Living Adjustment

133.17                                                Dec 1 2014                     Cost of Living Adjustment

0.00                                                      Jul 1 2016                     Compensation Rating Adjustment

1365.48                                                Apr 1 2018                  Cost of Living Adjustment/Compensation Rating Adjustment

1403.71                                               Dec 1, 2018                  Cost of Living Adjustment

Fortunately, I did receive retro pay for I believe the PTSD only per my calculations.

Also, I have been unemployed since 2015 and have had difficulty securing employment since I got out. I did look for help in 2016 through the VR&E program. The counselor their was able to show that I had a severe employment handicap and was able to get my expired benefit reinstated.  I'm currently not in school because now even that benefit has been suspended because of paperwork not filed.  

So, to answer your question, there was one doctor that did opine that I should look look into applying for Social Security benefits through the state.  Ironically, it was the psych doctor I saw for my initial Psych C&P visit for PTSD. I intend to take her advice and file for SSDI but according to regulation, felt like I qualified for TDIU as well.  

Thanks for any further thoughts you have regarding my claim as its so difficult to maneuver through.

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You say you have recently filed for IU.  Where is that case at this point?  I will also echo broncovet's recommendation to get your cfile.  It contains all of the information on your case and all examinations for your case.

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What you posted looks like a VARO decision, its not a proposed reduction.  However, this does suggest you got (a proposed reduction).  Since they did it at the same time as an increase (PTSD), maybe they hoped you would not notice.  

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On 3/22/2019 at 8:51 AM, broncovet said:

What you posted looks like a VARO decision, its not a proposed reduction.  However, this does suggest you got (a proposed reduction).  Since they did it at the same time as an increase (PTSD), maybe they hoped you would not notice.  

In the reward letter, they said Gets was deferred? Can that mean a proposed reduction?

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No.  A Proposed reduction is not the same as "deferred".  

I see it you have 3 choices:

1.  Do nothing.  

2.  Ask for an increase, to include tdiu. 

3.  Consider getting a representative.  (attorney) He may File a Cue, disputing the (10 percent) reduction.  Its CUE for VA to reduce you without giving you a chance (due diligence) to dispute it.  You have a right to a hearing on proposed reductions.  You can also file a cue yourself, but it would not hurt to take your file to an attorney and seek his advice.  He wont charge you to review your file and recommend a course of action.  You only get charged if you sign a fee agreement AND the attorney wins benefits (retro) for you.   

      They have, according to your posts, reduce your rating 10 percent.  Its true that the VA "MAY" have sent you the proposed reduction letter, but you either did not receive it, or ignored it, perhaps by not bothering to read it. 

Chris Attig (attorney representing Vets against the VA) has this to say about it:  

      https://www.veteranslawblog.org/va-benefits-reduction/

I recommend item number 2 and 3, above.  

Edited by broncovet (see edit history)
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