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If You Where Rated 10% for Limited or Painful Motion of the Shoulder Before May 2016, You May Be Due an IncreaseBy marathonjon
The VA raised the minimum rating for diagnostic code 5201, limitation of motion of the arm, from 10% to 20% back in May 2016. If you're still rated 10%, you should request the increase. The VA shouldn't require an exam, unless they have reason to believe your condition has improved. You should also request an effective date of one year prior based on “a liberalizing VA issue approved by the Secretary or by the Secretary’s direction.” Specifically, according to M21-1, III.iv.4.A.1.g. Selecting a DC and Minimum Compensable Evaluation for 38 CFR 4.59 Per Sowers v. McDonald: “- This policy particularly affects painful motion of the shoulder evaluated under 38 CFR 4.71a, DC 5201. Under this DC, painful motion of the shoulder warrants assignment of a 20-percent evaluation. - This decision represents a change in longstanding VA policy in which the minimum compensable evaluation was interpreted as a 10-percent evaluation irrespective of the DC involved. . . . . Effective May 23, 2016, the minimum compensable evaluation refers to the lowest evaluation specified under the DC most applicable to the disability.” Per 38 CFR §3.114 Change of law or Department of Veterans Affairs issue: “(a)(3) If a claim is reviewed at the request of the claimant more than 1 year after the effective date of the law or VA issue, benefits may be authorized for a period of 1 year prior to the date of receipt of such request.”
I was originally rated 10% for both shoulders in 2008 and didn't find out about the increase until last year. I could have been getting the increase for 4 years; not only that, but the bilateral increase to 20% would have raised my overall rating from 80% to 90%. It pisses me off that the VA doesn't notify veterans about changes that might benefit them. I actually think the VA should automatically increase the benefits of every affected veteran effective the date of the change. I've written my senators, congressman, and numerous veterans' organizations about this and urge others to do the same, in addition to requesting any increase that is due to them.
Pursuing initial VA claim after separated 8 years ago, currently using a VSO. Worried - Do I need to provide VA full access to my providers or can I provide them records?By MaxMax
Hi All -
I am new to the community, just found you guys a few days ago, because I had concerns about my initial claims process.
My question is:
Which is better - telling the VA to pull my records, or give them the records and letters I have or will get?
It has been eight years since I separated, and because of my mental health condition (depression, PTSD symptoms, anxiety) and just trying to fit into civilian life, I have been unable to begin my claims process. With the help of friends and family, I have now been able to do things like go through my military records (difficult process, emotionally), pull civilian records, and seek further assistance for my mental and physical health issues.
I have been doing research over several online platforms with regards to how to go about supporting my claim. The VSO that I paired up with seems to be of the idea to just give my list of conditions to the VA along with consent to pull records, and give it to them from there. This seems to conflict with advice given in the communities, who would say that the claimant should just turn over relevant or full records, along with nexus/medical opinion letters from individual doctors. They would say this provides the best chance at an accurate and speedy outcome.
I really can't bear the thought of being tied up with this claims process for another few years, because it already feels like it has been killing me for the last months/years. I want to be able to feel like I did it right the first time.
Also, on the mental health side, I really do not like the idea of giving the VA access to ALL of my mental health sessions and care, because it is very personal and much of it is unrelated to military life.
EDIT: I appreciate all these answers and am reviewing them. I think at this point I am leaning towards giving consent to access all records, as well as perhaps sending the full records on my own, along with my personal statements. My psychiatrist has requested that I basically give her my personal statement for her benefit, so she can review and get a full picture of the timeline and progression of the mental health side. I would like to have a letter from my my psych and therapist with the needed wording.
I have been dealing with a rep from the state of TN, who has been working with me after my first Total Knee Replacement. This was in 2018. I have since had 2 revision surgeries on the SAME KNEE due to the implant loosening. 2nd claim for the temp 100% went well. When I sent him all the paperwork THIS year, he filed all the current paperwork EXCEPT the actual comp form from my community care doc. He sent the 2019 form instead of the one from this year, so my claim is all screwed up!!! I attempted to contact this rep, and either due to COVID or just him being lazy, he has not responded to either email or phone calls, so after he filed the wrong paperwork, we have had no contact. I called the VA, and asked what I needed to do, and I sent in the correct paperwork, but now the VA is requesting a C&P exam, and I've been waiting 2 months to even get notification that I even HAVE an appointment!!! In the meantime, I'm stuck still in rehab with this knee(which is AGAIN loose!!), and I cannot work.
Is there ANYTHING I can do to make this move any faster?? I have contacted the company that is supposed to do the C&P, and the lady I spoke with said she would try to expedite my appointment, but that was 3 weeks ago, and I still have no appointment or info...
I'm so frustrated that the rep who is supposed to know how to do all this paperwork did it wrong, and that is why I can't pay my bills right now!!! How are us vets supposed to live when the reps that are hired to help us screw up their job???
i was told to look into something called smc l. i dont know if i qualify or not.
i was given a 100% permanent and total rating in 2015. here are my ailments.
biploar disorder 70%
Asthma due to jet fuel exposure 60%
cystic acne due to jet fuel exposure 30%
carpal, allergies, tinnitus each at 10%
i also get ssdi 100% and they require me to use my sister to manage my finances.
my sister also basically serves as my caregiver. without her i dont believe i can function. she does everything for me from finances, to taking me to appts, to reminding me and sometimes helping me clean. and more.
would i be able to apply for smc-l and if so how would i go about doing it. i overheard a family member discussing it with my sister and mom the other day. and it sounds very helpful.
I needed some advice in regards to my current VA battle for an effective date change.
THANK YOU IN ADVANCE
April 2013: (During Service) I was taken to the emergency room for headaches and nausea where CT scans were taken. This occurred during training on active duty.
- ever since then they have only worsened
Feb 12 ,2018: Filed Claim for headaches
May 4,2018: Claim DENIED for headaches
I was unaware of supplemental claims and truly didn't think I had anything to prove the decision was incorrect so years went by.
October 20,2020: Opened claim for headaches again (no new evidence, and didnt know a supplemental was needed) However, somehow I was granted a C&P exam. During the C&P exam with a VES Neurologist, he was able to pin point the incident that occurred in 2013 during Active Duty where I was sent to the ER for headaches. He confirmed it was service connected.
October 21,2020: Claim closed (denied), The VA closed it and told me that I had to submit a Supplemental since I had already been denied for headaches previously (2018). So I submitted a Supplemental Claim, stating that I would like to have the same C&P report that was most recently done to support my claim for service connection. (Again nothing in my file changed in 2018-2020 in regards to headaches, this VES Neurologist (2020) was able to locate the incident that occurred during my service whereas in 2018 it seemed like they just didn't catch that incident.
October 23,2020: Claim for headaches approved 30% (effective 11/1/2020)
Nov 6,2020: VA received my HLR for effective date change.
My decision letter from 2018 states:
"Service connection for headaches is denied since this condition neither occurred in nor was caused by service."
Service connection for headaches.
Service connection for headaches has been established as directly related to military service. (38 CFR 3.303, 38 CFR 3.304) The effective date of this grant is October 20, 2020. Service connection has been established from the day VA received your claim. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA received the claim. (38 CFR 3.400) An evaluation of 30 percent is assigned from October 20, 2020. We have assigned a 30 percent evaluation for your headaches based on: - Characteristic prostrating attacks occurring on an average once a month over last several months
rebabevets posted a question in VA Disability Compensation Benefits Claims Research Forum,I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently
Ddsr posted a question in VA Disability Compensation Benefits Claims Research Forum,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)
broncovet posted an answer to a question,While the BVA has some discretion here, often they "chop up claims". For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.
I hate that its that way. The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.
Ztmiller8 posted a question in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC,Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!
My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.
Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
Joey Ross posted an answer to a question,I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and nothing about stressor,
Picked ByJoey Ross,