Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • 01-2024-stay-online-donate-banner.png

     

I' m in the 90% Club

Rate this topic


NavyCorpsman950

Recommended Posts

Hi All

I am officialIy in the 90% club! Just a quick run down: I filed an Intent to File for OSA secondary to Anxiety/Depression in May 2019. A non-VA MH provider did an exam and a followup exam, and then wrote a nexus saying that my OSA was aggrevated by anxiety and increased it, and anxiety aggrevated OSA and made it worse. He also used the key words "at least as likely as not". We also cited a couple of similar, favorable VBA court cases to support the matter.

Low and behold, I was pleasantly shocked to see that my OSA claim had closed this past Friday with a 50% OSA win on the very first try. It had bounced around from Gathering Evidence to Prepping Decision for a month. I'm still in shock that it was approved so fast, and that it was approved on the first try. I still have a few items on appeal. Prayerfully, those will be approved and get me into the 100% schedular club. 

Still not sure why the QTC examiner checked my knees and ROM during my OSA exam though. I also have a knee claim in though, so maybe that's why. Guess that's a discussion for another thread. 

Thanks for all the tips here on Had It and best wishes on your claims, everyone!

 

Edited by NavyCorpsman950
Link to comment
Share on other sites

  • HadIt.com Elder

Congrats to you, NavyCorpsman950. Watch you payment account on line and see what you get. You'll probably see that before your decision letter. For sure, actually, if you have another claim in. Did they measure your flex during that exam? Reason I ask is they have to to properly eval your disability; if they didn't and he just posted some numbers without a through exam, you have an appeal in the waiting. At 90%, it is very hard to get over the hump to 100, or 95%=100%. A low-ball on your knees will hurt your math, unless you have a bunch more disabilities in your back pocket.

Link to comment
Share on other sites

Navy,

I, too, am a member of the ninety %'s group.  My highest single rating is 30, so, it took quite a while to get to 90.

As GB says, its a challenge to go from 90 to 100 while playing small ball.

Right now I'm at 91 and need a 20 and 2 10's to get to 95 ^ 100.  Or a bilat 20 and a 10, etc..

All of my disabilities are static, so that's a good thing,

Just keep plugin along, and congratulations,

Hamslice

In the meantime, I got a reopen and a increase to plot now.

 

 

“There is no hook my friend. There's only what we do.”  Doc Holiday 

Link to comment
Share on other sites

Thanks GBArmy and Hamslice!

I checked my account and nothing extra is showing. I'm thinking the back pay missed this cycle's cut off day and will post in November.

Guys, I wonder if the examiner's write-up played the chronic pain or restless legs angle to support his OSA nexus. Before the exam, he asked me to put on a gown and asked if I needed help from the nurse to get undressed- which I did. That through me for a loop though. So I asked him what I was there for,  and he said an OSA eval.

When he came back in, we discussed OSA symptoms for about 1 minute tops. The rest of the discussion was on pain, medications and surgeries- mainly the knees.

As he was leaving the room, I asked if he had any more questions about my OSA. He said, "No. I have everything I need. You are not productive at work because you are always sleepy. You are always tired. Your snoring wakes your husband. The VA prescribed you a CPAP." Then, he smiled. I took that as a good sign, but then with the VA, you just never know.

Like I said earlier, it was weird that he checked my knee flexion and ROM, and inquired about my knee surgery and injuries more so than OSA. Not sure what all of that had to do with OSA. Perhaps a more seasoned vet can fill me in on possible angles?

I did the math, and I agree, guys! Getting over the 90 to 94.5 hump is crazy. I have two appeals that date back to 2012 and 3 that date back to 2014, so we will see. I filed NODs for all of them back in August 2019. Thanks to tips I read on this blog, they all have nexus statements attached to them. 

I'm happy to finally have my 90 though. It seems surreal. I left the Navy with 10 back in 1996. Had it not been for other veterans pushing me to fight the system, giving me valuable info and tips, and encouraging me along the way, I would have just suffered in silence and not fought the 10. 

Thanks Had It!

Link to comment
Share on other sites

Depending on the exact date your claim closed it may take up to a week or more to get the back pay. Depending on what the effective date is going from 30% to 90% is a big chunk $428 single vet at 30% and $1,833 for 90% - approximately $1,400 per month in back pay (if it is over $25K it takes an extra signature). So depending on how far back the effective date goes it could be a large amount of money and it takes a while.

Congratulations on hitting the 90% mark.

 

I am not an attorney or an a credited VA rep. These are my personal opinions and experiences, always remember what worked for me may not work for you.

You as the veteran are your own best advocate and no one knows your disabilities better than you. It is highly recommended that you as the veteran research and verify that any opinion given meets your specific situation.

Link to comment
Share on other sites



  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • Lebro earned a badge
      First Post
    • stuart55 earned a badge
      Week One Done
    • stuart55 earned a badge
      One Month Later
    • Lebro earned a badge
      Conversation Starter
    • Sparklinger earned a badge
      First Post
  • Our picks

    • Caluza Triangle defines what is necessary for service connection
      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”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • 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.   
    • 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

       
    • 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. 
×
×
  • Create New...

Important Information

Guidelines and Terms of Use