Left Knee rating decision under ramp 7 months to decision

[Richard1954]

Normally I would post this under winning claims, but because this was a claim rated under the ramp system I am listing the results here.

First , I don't actually have the envelope in my hands, I am going by what shows on Ebenefits, which in my case has been consistent when listing actual service connected disability.

I submitted my left knee claim secondary to my service connected right knee claim on Sept 2016, under the legacy system. I had provided an Independence medical opinion which indicated more likely than not. The C/P examiner  however indicated it was less likely than not, and  in fact went back ( I think it was ) 32 days later and come up with a different reasoning for more likely than not.  The VA is required to give the benefit to the veteran if the evidence is equally balanced, but in this case they ignored the IMO, and denied the claim in May 2017. Needless to say i appealed the decision, citing the IMO, and destroying the opinion of the C/P examiner who was a NP and had no business doing C/P exams.  I requested a DeNovo review.  In Sept 2018, against my initial decision, I reluctantly opted into ramp for this and other claims.  In Jan 2019 I was given another C/P exam, this time by a local Chiropractor,  who is also a Nurse Practitioner.  (I will never understand why the VA thinks anyone with a medical degree is qualified to do a c/p exam) I must admit I felt good about the exam and the examiner, but I have felt good in the past about other exams, and the examiner only to be denied, so I was expecting another denial regardless. ( The VA has us questioning our own feelings about many things this is just one).  I found on ebenfits that a decision was made and I was granted 10% for my torn meniscus. The effective date  was back to the Sept 2016 claim date. Until I actually receive the brown envelope I have not idea how the rater came to his conclusion, I suspect the IMO together with the new C/P examination results both indicated more likely than not.  So from the time I opted into ramp Sept 2018, to March 2019, seven months have passed.  I find that amazing, but this was not a hard case to decide, in fact, I also received a denial on my request for an compensated rating for my hearing loss presently rated 0%. 

Once I receive the brown envelope,  I will let the board know how and why it was approved.  

Most of you know that I am rated 100% just for my lung disease, because of use of oxygen. At one point I was also rated TDIU for my back disability that is rated 60%. The TDIU was revoked when I received my 100% rating in 2017.   If I were to lose my 100% rating on my lungs,  my ratings combined would still put me at 97 rounded up to 100%.  Yes I have a lot of medical issues. In fact I was admitted to the Hospital on 14 Feb 2019  for Blood clots in my lungs, and  I just go out of the Hospital again  ( 20 Mar)  after 6 days for a gall bladder surgery,   I still live on to fight the good fight.  And I give thanks every day for the Medical Professions of Darnell Army Medical Center, and Brook Army Medical Center.  My doctor actually saved my life when he discovered multiple blood clots in my lungs. And they went way out on a limb doing surgery on me because, of my lung disease, minor heart condition, and being overweight, They are my true heroes and my grandchildren love them for it......What a wake up call,  Now its time for a serious diet and to become more responsible for my eating habits.

 Some of you might ask why would I put myself thru the anguish of a new claim for a lousy 10% rating ( does not include the bilateral factor). The answer is simple, I do not believe the VA raters are out to get me, or any veteran,   all of my rating come from actual disability incurred  in  service or secondary to a service connected issue. I firmly believe  if you have a disability that you honestly believe should be service connected you should make the claim and see what happens.  I have never trusted the "so Called" expert Service officers, who  say lay low, the VA could decrease your rating.  I have never seen the VA go back and re-rate something that was not requested by the veteran.   I think most Service Officers are over worked, and under educated to actually understand the rating system. My case is complex, from TBI, to lung diseases , to back issues,  and many other small issues rated at 10%. If I had listened to Service officers, I would never have received my adapted housing grant, or increases in my A&A.  I advocate that any veteran no matter how small the rating may be, file the claim if you have faith that it is valid. 

Edited March 24, 2019 by Richard1954
spelling

[vetquest]

Richard, you said "I have never seen the VA go back and re-rate something that was not requested by the veteran."

I am in exactly that position.  I requested an earlier EED on my TDIU condition and they decided to reconsider my neuropathy rating.  It is at the DRO level and I am curious to see if they are going to try to reduce me.  I do not believe in the "don't rock the boat attitude" but never put anything past the VA.  This is the same RO that tried to sever one condition and reduce another when I was in appeals for a higher rating.

[Buck52]

Actually My VA Audiologist  filed a claim for increase  he seen I was s.c. for hearing loss but at 0%   so I guess he put in the increase for me? I never did .

only I had Appeal the 0%  so I guess the VA Audiologist  the guy who tested my hearing and word discrimination test did it.....I was increase form 0% to 50%   I had Appeal the 0% .....so yeah if you get a good friendly caring VA Doc they can put in for your increase if you meet the increase criteria.

[Richard1954]

Ok as I said I would post the information my letter contains when received.

It really says nothing or much of anything:

Left Knee found to be secondary of right knee injury,  10%

Compensable  rating for hearing denied remains at 0%

It really doesn't give a statement of the case and how they came to the decision,  only what the decision was

so I have requested copies of the C/P exams to see what the examiners said. 

 

I have already sent the appeal for my hearing off  to the BVA 

[broncovet]

As for me, I would not even consider filing for benefits where the best result would be to stay at the same compensation.  And I certainly would not appeal it.  You see, when you dont have a "single" 100 percent, that makes you ineligible for SMC S, statuatory.  So, adding another 10, 20, or even 50 percent wont increase your compensation, when you are already at 100 percent.  

It also would not appear to help your spouse get DIC either because you are unlikely to die of the SC conditions of hearing loss or a bad knee.  

In other words, it appears to be "moot" applying for or appealing knee issues or hearing loss when you are already at 100 percent.  

[Buck52]

I would appeal both and go get an IMO from A LICENSE CERTIFIED AUDIOLOGIST   use the VA Guidelines, and Maryland CNC Word test.

if your word test meets the VA Criteria  that will help but its very hard to get any degree rating for Hearing loss unless your darn near deaf,  but if you have bad word discrimination  (not understand what people said)   will help,  also if you have a ringing in your ears   this is known as Tinnitus   it pays 10% for both ears.

Same with your Knee...As Broncovet mention  there's not any more $$ in the pot  but if you get these rated now it can help you later on in the future for SMC.s ,

These small 10%/20%All % Add up   even if your 100%.at present.

Remember if your 100% and can get another  rating of 60% or combined ratings  you can meet the SMC Criteria.

[Richard1954]

2 hours ago, broncovet said:

As for me, I would not even consider filing for benefits where the best result would be to stay at the same compensation.  And I certainly would not appeal it.  You see, when you dont have a "single" 100 percent, that makes you ineligible for SMC S, statuatory.  So, adding another 10, 20, or even 50 percent wont increase your compensation, when you are already at 100 percent.  

It also would not appear to help your spouse get DIC either because you are unlikely to die of the SC conditions of hearing loss or a bad knee.  

In other words, it appears to be "moot" applying for or appealing knee issues or hearing loss when you are already at 100 percent.  

I guess this is were we will agree to disagree.  First to be sure I actually have 3 ways to get to a 100% rating.  One is a straight out 100% and if I were to lose it I would go back to  TDIU  or they would combined  me at 100% because of all my ratings.  I was automatically awarded Housebound with +60, then I applied for and got A&A at  L 1/2 . If I took your advice I would not have A&A @ L 1/2  right now. I also would never have gotten my Adapted Housing grant because it was denied the first time around. These 10% ratings add up fast, and in this case I also got the bilateral rating.  Let  me be specific. I have been rated 100% since Feb 2005 for my Lungs, from Nov 1999 until Feb 2005 I was TDIU my back issue.  Since my 100% rating, I have  received a 50% rating for apnea,  40% for a TBI, 30% for my eyes,  and 10% for my left Knee.  These added up real quick,  and  I was  already rated 60% for Asthma, 60% for my back, and  6 additional 10% ratings,  I have managed to go from a 80% rating with TDIU to a straight 100% rating.  All those other ratings add up to more compensation in SMC.   I had always advocated and will continue to advocate that if you have a condition that you think should be service connected apply regardless of your current rating. Since I am already 100% over 10 years, my spouse qualifies for DIC. When I went from TDIU to 100% my wife was awarded a second round of Chapter 35 benefits,  that is 8 years of college benefits paid for by Uncle Sam.  So even when you don't think you can benefit from the small ratings  in the present, they will add up to something in the future.  The bottom line, is that my military service really screwed me up and over the years I get worse and worse, and I have been medically retired from civil service because of my service connected disabilities. Damn if I am not going to try to get every little thing I can squeeze our of the government  especially since I gave them the best  years in my life from 17 years old on.  Also one other point, we never know when the VA or congress with change the rules  they  keep talking about taking away TDIU from those over 65,  eventually they will . It just makes sense to add up as many ratings as possible if you can regardless of your present rating.