Need some help with VA math

[ShrekTheTank]

Just got off the phone with the VFW rep at the regional office and said my Dercums is now at 60% but said I am not at 100% I have done 3 calculators now and I don't understand

tension headaches	30%	Service Connected		12/10/2018
irritable bowel syndrome (to include claimed fecal incontinence, bowel condition, gastrointestinal problems, chronic hypertrophic gastritis)	30%	Service Connected		03/06/2015
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multiple scars that are tender or unstable such as status post inguinal hernia scars; disfigurement from lipomatosis dolorosa; and upper extremity lipoma scars (previously 7805)	30%	Service Connected		12/02/2013
left chest lateral posttraumatic 8th rib, episodic intercostal myalgia (claimed as left rib pain)	0%	Service Connected	Predischarge Exam	12/02/2013
post-traumatic stress disorder (PTSD) (to include claimed cold sweats)	30%	Service Connected	PTSD - Combat	02/12/2014
tinnitus	10%	Service Connected		02/12/2014
left knee strain (previously rated as left knee retropatellar pain syndrome)	10%	Service Connected	Predischarge Exam	12/02/2013
Dercum disease (lipomatosis dolorosa)	10%	Service Connected		12/04/2014
status post right inguinal hernia repair (claimed as pain and numbness, status post right inguinal hernia repair)	0%	Service Connected	Predischarge Exam	10/02/2004
hypertension	0%	Service Connected	Predischarge Exam	10/02/2004
scars, status post lipoma excision, left arm	0%	Service Connected	Predischarge Exam	10/02/2004
scars, status post lipoma excisions, right arm	0%	Service Connected	Predischarge Exam	10/02/2004
left knee retropatellar pain syndrome	0%	Service Connected	Predischarge Exam	06/01/2010
scar with minimal hypoesthesia, status post right inguinal hernia repair	0%	Service Connected	Predischarge Exam	10/02/2004
left chest lateral posttraumatic 8th rib, episodic intercostal myalgia (claimed as left rib pain)	0%	Service Connected	Predischarge Exam	10/02/2004
fibromyalgia	40%	Service Connected		01/05/2016

[GeekySquid]

3 minutes ago, shrekthetank1 said:

This is not a group it is the director of the vet center.

yeah that job title means nothing in terms of submitting medical records to the VA for Rating purposes. Not putting them down, I just don't want you thinking some random non-medical person is putting records in the raters are using as medical evidence. If they did that, that would be a major Bozo No No.

Just now, shrekthetank1 said:

Drugs are kicking in will do in the morning.

know the feeling..have a good sleep.

[ShrekTheTank]

12/02/13 I filed my claim for the first time since service for Dercum's disease, left knee, painful scaring.  They gave me my left knee denied the other two.

2/12/14 Filed Tinitus, and ptsd.  Got both but lowballed on PTSD.  So I filed for a DRO review at this point.  At other points I Filed for other conditions.

2015 I saw the DRO and got denied.  I then got a IMO for the PTSD and filed a NOD

2018 the appeal for scaring, PTSD, and Dercum's disease go to the board.  

March 2019 the scaring is given the correct EED of 2013 and a 30% rating and is correct.  They also did a new C&P on the scaring earlier that year as I was claiming some new scars and this went back to the original date of 2013.

The remand takes place for the other two issues and the Dercum's takes place at the new date.  

I guess my question is if they just give you the new date then what is the point of fight to keep the EED?  The condition has always been this bad, it has never gotten better just worse.  The issue is they did not know how to rate it and just threw crap at the wall to see what stuck.  

 

 

7 hours ago, GeekySquid said:

yeah that job title means nothing in terms of submitting medical records to the VA for Rating purposes. Not putting them down, I just don't want you thinking some random non-medical person is putting records in the raters are using as medical evidence. If they did that, that would be a major Bozo No No.

know the feeling..have a good sleep.

So after his title is LICSW, ACSW.  found it Licensed Independent Clinical Social Worker  and Academy of Certified Social Workers.

Edited July 26, 2019 by shrekthetank1

[ShrekTheTank]

Also I apologize if I am being an ass.  I just had 12 lipomas removed Tuesday.  Thanks for caring.

[GBArmy]

Shrek, You may be Big, Green and Ugly, but you aint an ass. We all have our burdens to bare. Me for example, I am incredibly hansom. I just try to live with it!

If I read it right, you have 9 combined: I come out with 95.799=100%. So your rep is wrong or we are missing something. Check it again Ty.

 

[GeekySquid]

1 hour ago, shrekthetank1 said:

I guess my question is if they just give you the new date then what is the point of fight to keep the EED?

it keeps sounding like you are misunderstanding the Effective Date as shown in your OP.

The effective date of any issue as shown on Ebenefits or even our Letters is, at the first rating of that SC, the date that it is issued.

If after that date a change in PERCENTAGE of SC occurs the ED of that NEW PERCENTAGE is what is shown on paperwork as the Effective Date. This reflects the NEW Percentage NOT the date the issue was originally SC'd.

So for example if you got a 30% for PTSD in 2014, but in 2018 you were increased to 70% your current ED for the 70% is 2018 NOT 2014.

Now in that same example, the veteran is bumped from 30 to 70 in a 2018 decision. In reviewing that decision the vet realizes that they should have been 70% back in 2014. They file for an Earlier Effective Date for the 70%.

Assume the VA accepts the evidence without arguing (that of course is a joke). The Effective Date for the 70% is reset to the 2014 date and gets paid retroactively for the difference between the 30 and 70 for the years in between.

It would make no sense to say a vet rated at 30 in 2014 but bumped to 70 in 2018 to have an Effective Date of the be the same as the Effective Date of the 30. Doing so would imply that the veteran was actually 70% in 2014 when they were only really 30% in 2014.

This also applies to the date differences between a P&T rating and a non-P&T rating. Once you move to P&T the effective date changes but it is only talking about the P&T not the underlying illness or harm. The detailed records still reflect the Service Connection all the way back to the date of the original Award.

In most cases you don't "need" to fight to keep the Earlier Effective Date, you fight to GET the EED. You would fight to keep the Earlier Award Percentage but only in a motion to reduce initiated by the VA.

2 hours ago, shrekthetank1 said:

The condition has always been this bad, it has never gotten better just worse.  The issue is they did not know how to rate it and just threw crap at the wall to see what stuck.  

if your condition was this bad back in 2013, and in your mind the evidence says it should have been rated at the higher percentage back then, your recourse is to file for an EED for that percentage.  You will just have to prove that it was that bad back in 2013. How you do that is through your medical records, pictures, and lay statements.

Maybe  personal example will help clarify this issue for you.

When I was first rated, the VA ordered testing for Vertigo, including a VNG and an MRI. I did the tests and never heard about them again. This was done under the same control and reporting as the people who ignored half my service record for my hearing loss and did not SC that loss based on only half of my record...less than half but you get it.

I was so tired of the VA by that time I just ran from having to deal with them. In 2018 i went for a 5 year re-eval on my PTSD. In triggering that event I got my C-File and found they knew and documented my hearing loss based on half my record and that they knew I had Vertigo and a Partially Crushed Sella but never informed me.

I filed for the Vertigo and was granted 30% as of 2019. Two problems are the Doctor ignored data in my record of Cerebellar Gait and frequency of attacks which should bump the rating to 60 or 100 percent when taken into account. The second problem is the Effective Date. They did not back date even the 30% to my original rating date when they SHOULD have notified me of the possible claim and should have assisted me in getting that rating. you should note all these tests and results occurred prior to my initial rating decision and the information was in my files that they had under their control.

So now I am doing two things.1) NOD the rating percentage and 2) File for an EED.

I will have to force the VA to "find" the records they lost. Records that were under the same shoddy control of the department that ignored the evidence in my STR's on hearing loss. It is a long fight for me to get that EED on vertigo and I am not sure I will win. But I will try because if they "find" those records and I get the EED on that alone, along with an EED on my hearing loss (which I am filing CUE on), my initial 70 & 10 percent ratings will actually bump my original rating to 81 or 89 percent which means retro pay. If they follow the DSM then my vertigo, tinnitus and hearing loss should be grouped as Meneire's Disease at 100% which would also give me retro pay at 100% and SMC(s).

so in my case fighting for the EED is essential to get a very large chunk of change that was denied me by the VA staff losing/hiding/ignoring my records.

2 hours ago, shrekthetank1 said:

So after his title is LICSW, ACSW.  found it Licensed Independent Clinical Social Worker  and Academy of Certified Social Workers.

that is good for mental health reasons, but it does not mean session records from them about you are being put in your VAMC record. I am not saying they are not; I am saying it depends on whether they are allowed by the VA to do so, it is not an automatic thing.

Assuming they are allowed to put that information into your record as a treatment provider. It also matters what areas of specialty as a LICSW they are certified in and if the VA accepts that Cert. Not bad mouthing your SW, just saying that like everything else a general job title/degree does not make one trained in specialized areas and if not trained the VA may not accept their diagnosis or medical statements as being equal to those of a VA or C&P Doc.

[GeekySquid]

2 hours ago, shrekthetank1 said:

Also I apologize if I am being an ass.  I just had 12 lipomas removed Tuesday.  Thanks for caring.

I for one don't thing you are being an ass. I think you just caught up in VA crap and it is twisting your head up a bit with minutia and keeping you from looking at your effective course of action. I don't begin to know what having 12 lipomas exist much less removed involves pain and psych wise. I just have empathy and concern that it will drive you battier than you may already be   JK.