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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
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Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
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Lemuel, -
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
BAM_
Hello Vets. Long time reader, first time posting. I hope I can get some advice on my situation as many of you have helped me over the years without even knowing. Thank you!
History - I submitted a claim January 19, 2016 for Increase to SC Ankylosing Spondylitis (Thoracolumbar) Rated at 20%, New Claim - Hip Pain secondary to Ankylosing Spondylitis and Leg Pain secondary ankylosing spondylitis. C&P March 11, 2016, Decision March 24, 2016. No increase for AS (20%) and denied for all secondary claims
Filed NOD February 03, 2017
Opted in to RAMP July 27, 2018 with the RAMP Claim Nov, 25, 2018. C&P January 30, 2019, Decision March 8, 2019. Granted 50% Unfavorable Thoracolumbar Spine, 10% Right Hip, 10% Left Hip secondary to Ankylosing, denied leg / knee pain. My EED of January 30, 2019, not what I was expecting
Present - I was going over my C&P exams trying to understand why my EED wasn't January 19, 2016, since that is when I put in the original claim. I also wanted to know what was the difference between the March 11, 2016 exam and the January 30th, 2019 exam that got me the increase for my Thoracolumbar and both Hips being rated since they used the same XRAYS and MRI in both exams.
Well I noticed that on the March 11, 2016 exam the examiner answered:
9. Ankylosis ----------- Is there ankylosis of the spine? [X] Yes [ ] No [X] Favorable ankylosis of the entire thoracolumbar spine
This is from the January 30th, 2019 exam and I was awarded 50%
9. Ankylosis ----------- Is there ankylosis of the spine? [X] Yes [ ] No [X] Unfavorable ankylosis of the entire thoracolumbar spine
It seems like they should have at the very least increased my SC Ankylosing Spondylitis to 40% from 20% on the March 24, 2016 decision based on the spine ratings. But they didn't give me an increase.
So I wasn't sure what to do and took this information to my County Veteran service organization and they put in an NOD BVA appeal. When I didn't see my appeal showing up on VA.GOV I called them and they said they gave my appeal form my POA VFW, ok so I call the VFW and they confirm they submitted it, fine.
My BVA appeal shows up and I had a question about it so I called my VSO at the VFW and ask my question and then say: "Oh you don't want a BVA appeal for this, we need to cancel this appeal and put in for a Higher Review request"
This is where I'm at two weeks ago they had me sign a form VA FORM 21-4138 canceling my BVA appeal and submitted VA FORM 20-0996 Decision Review Request: Higher Level Review.
I'm so confused if this was the right approach. Any advice would be much appreciated. If you all think I should post my decision letters to really help, I can do that as well.
Here are the spine ratings:
Rating
Cervical Spine
Thoracolumbar Spine
100%
Entire spine frozen in an unfavorable
position.
50%
Entire thoracolumbar spine frozen in an unfavorable
position.
40%
Entire cervical spine frozen in an unfavorable
position.
Flexion measures 30° or less.
-OR-
Entire thoracolumbar spine frozen in a favorable
position.
30%
Flexion measures 15° or less.
-OR-
Entire cervical spine is frozen in a favorable
position.
20%
Flexion measures more than 15° but not more than 30°.
-OR-
Combined ROM is 170° or less.
Flexion measures more than 30° but not more than 60°.
-OR-
Combined ROM is 120° or less.
10%
Flexion measures more than 30° but less than 45°.
-OR-
Combined ROM is between 175° and 340°.
Flexion measures more than 60° but less than 90°.
-OR-
Combined ROM is between 125° and 240°.
0%
Flexion measure 45° or more.
-OR-
Combined ROM measures 340° or more.
Flexion measures 90° or more.
-OR-
Combined ROM measures 240° or more.
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