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adjudication of an extra-schedular rating

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blahsaysme2u

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i have looked all over this forum for info on this and everything comes up about TDIU . i am not unemployed, though one could argue i probably should be. thats for another discussion. i dont want to sit on my but and have to keep busy...

anywho- i am not one to put all my eggs in one basket. so even though i really appreciate all of the help i get from here, i ask around at other places and try to find other angles to fight the VA. 

i am sure you are tired of hearing about CAPD by now as i have posted a lot the past few days on the topic, but the VA has a research department that studies CAPD and are the ones that linked JP8 as a possible cause of the disorder. VA RR&D National Center for Rehabilitative Auditory Research is located in Oregon. so i reached out to them(multiple emails to multiple people listed there in their directory 🙂 ) i said the below:

Quote

Good afternoon,

I am a veteran seeking a va claim for my recent CAPD diagnosis by my independent audiologist. I am hoping that you might can help me locate the correct DBQ for this condition for my claim as well as the VBA's Schedule of Ratings Code for CAPD(or APD)

i didnt expect to get such fast response, but i guess when you blow up everyones email in the same department, squeaky wheel gets the grease 😉 i just got this response:

Quote

Thanks for contacting me.  Presently, there is no policy or procedure for Compensation & Pension (C&P) exams for CAPD. CAPD is not listed under the Veterans Affairs Schedule for Rating Disabilities (VASRD), and there is no practical application to rate percent disability for CAPD under the U.S. Code of Federal Regulations (38 U.S.C. 1114(k)). However, if there are unique disability symptoms or expert evidence of interference to employment, the case may be referred to the VA Compensation and Pension Service director for adjudication of an extra-schedular rating.  Here is a link with a little more information about extra-schedular ratings in case it’s helpful: https://www.law.cornell.edu/cfr/text/38/3.321

 

BUMMER RIGHT?!?!?!?!

so what do i do next guys. what is this "adjudication of an extra-schedular rating"?  i have seen plenty of appeals cases that have CAPD listed(ie https://www.va.gov/vetapp03/Files/0300474.txt , and this was all the way back in 2003) so i know that people are submitting claims for this but i dont understand this extra-schedular? is she saying TDIU? if so thats not me and need another option. 

let me know what you guys think or point me in the direction of a thread that has discussed this topic before.

thanks guys

Edited by blahsaysme2u
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  • HadIt.com Elder

Okay.

You will need an additional 50% on a single condition to boost you on up to 100% scheduler IF you get your OSA service connected direct or secondary  and a Qualified Dr says it is medically necessary for  you use the C-Pap machine, that should qualify you for the 50% needed to get the 100%  and all your others if they combined to a 60% rating  or if you have one more S.C. Condition rated 60% that is a  separate distinct  stand alone rating of 60% or higher  then you should meet the SMC S H.B. Criteria.

If I was you I would sure check into the TBI   If your DX for a TBI SERVICE CONNECTED @0  % that don't seem right, I bet the NAPD IS caused by or related from your TBI.  AND THE ''LOSS OF USE OF A BODY ORGAN, THAT CAN BE DROP FOOT IF YOU HAVE THAT OR E.D. (YOU MAY WANT TO LOOK INTO THE LOSS OF USE CRITERIA ALSO.

Also if your a combat Veteran  the 50% for the PTSD seems like a lowball rating too, but they give this rating according to all your symptoms.

The conditions you listed are on the normal side of what most Veterans file on  excluding the NAPD AND PTSD. &'DEPRESSION BUT NOTE VETERANS CAN'T HAVE 2 mental health ratings at the same time but can be service connected for more than one and diagnosed for more than one.  but only given a rating for one.

If you have the OSA you should be able to get a secondary s.c. for that from your TBI  or PTSD Meds or the  NAPD

Veterans with loss of hearing are usually caused from noise induced  sensorineural- hearing loss  from hearing loss when the inner ear/ears are damage without wearing ear protection from sudden loud noise  such  incoming mortars rocket attacks and IED's , roadside bombs ,aircraft hovering overhead artillery fire even close range gun fire  depending on your MOS or Temp MOS,,,This is what normally cause of the loss of hearing , it may take months or years  once your a subject to these type noise   it can and will cause the hearing loss later on in life

Tinnitus is usually associated with hearing loss but as broncovet mention the VA Rating criteria to be compensated just at 10% veterans need to be  very hard of hearing.

when you file  please file on all your conditions at once   rather or not they are denied  , it starts your EED when you do win these claims and that can come in handy with retro pay.

you can file Intent to File  (ITF)..this is when you let the VA Know  you intend to file a claim or claims and you have 1 year to file them..if you file within one year lets say the 12th month   and you win these claims or the ones you do win  you get the extra year for filing the intent to file  but you can't go over the allowed year  if you go over 1 day  you will not get the ITF.

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  • HadIt.com Elder

Also if you have not yet  request your C-File from your R.O. DO SO ASAP.

and once you get it look into it very close  for any medical records or notes from past Drs to see what all they have said about your health   or any health problems while in service  also they may be records in it to help you substantiate  some claims that are pending or have been foolishly denied.

NEVER GIVE UP  KEEP FIGHTING THEM UNTIL YOU'RE SATISFIED AND GET WHAT YOU SO WELL DESERVE.

Good Luck

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  • HadIt.com Elder

As for as not wanting the IU   why? some veterans get the IU and keep filing claims and get up there to the 100% scheduler  and then ask the IU TO BE moot Because of your now 100% scheduler rating.

but do keep in mind once you file for all these claims  if you go as high as to have a couple 100% ratings  and other smaller ratings  combined that bring you up to the 100% level   then this is when you may or may not meet the Special Monthly Compensation (SMC)   These SMC awards are given to the veterans with severe conditions such as amputations of both legs arms  ect,,ect,, and the severity of each conditions  like some conditions may land you to be bedridden and need help from another person just for general every day task such as getting dressed someone to feed you  ect,,,most of these veterans are very sick and bad off  it's an awful sight  to witness but the MORE SEVERE AND HELPLESS A VETERAN IS THE HIGHER ON UP THE SMC LATTER (SO-TO-SPEAK)

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buck thanks for your insight. i did already have a good idea of most of this but good to see it all laid out and to have verification on some assumptions i had. especially about SMC. i dont want to get very personal here but yeah 

ill post why they said my TBI was 0% later but basically it boils down to the symptoms i have are so similar to PTSD(even though i spelled out very specific symptoms that are not the same with PTSD) they put them together in one rating and marked TBI 0%. i believe since i work that the PTSD symptoms dont seem as debilitating as they actually are. if i ever stopped working i am posistive this would get bumped to 70%.

as far as making it to 100%, when i do the calcs, 50% does not get me there(if SA is awarded with my CUE). i am currently right at 86%. 50 would only get me to 93. by my calcs i would still need some additional ratings. i would need 3 more 10%  ratings to get to 100%.

1 hour ago, Buck52 said:

As for as not wanting the IU   why? some veterans get the IU and keep filing claims and get up there to the 100% scheduler  and then ask the IU TO BE moot Because of your now 100% scheduler rating.

I am not unemployable. i have a good job that is very accommodating. its an office job that i work from home a lot and is very schedule flexible. the best part is its a quiet place and i am left to self manage for the most part. i am a draftsman so most of my disabilities are not reflecting in my job performance. the worst part is keeping up with different SOP and codes for plans, but i am a sticky not feind and very well organized with emails. 

all that aside, like i said in my original post on this thead, one could argue i should be TDIU. if i ever lost this job i wouldnt be able to find another one like it. i would then really be unemployable with my disabilities. but as it stands i hope to retire with this company and with my current job.

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2 hours ago, Buck52 said:

Also if you have not yet  request your C-File from your R.O. DO SO ASAP.

and once you get it look into it very close  for any medical records or notes from past Drs to see what all they have said about your health   or any health problems while in service  also they may be records in it to help you substantiate  some claims that are pending or have been foolishly denied.

NEVER GIVE UP  KEEP FIGHTING THEM UNTIL YOU'RE SATISFIED AND GET WHAT YOU SO WELL DESERVE.

Good Luck

i have requested it and it is showing as a pending "claim" in bennies. i cant wait to get a hold of it. i will never give up bc i am so stubborn. but it has been very stressful to get this far. when i first filed my claims back in 2008 i never thought i would make it to 90%. they denied me for everything when i first started. i was so disheartened that i did give up and just tried to go to work. it took years to get where i am now, not just with my SC claims but thats more of personal story than questions about claims, so i wont post all that malarky here.

thank you to you and to Bravo. i know its all good info and i really do appreciate everyones help here. i never knew how helpful this place could be!

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  • HadIt.com Elder

as far as making it to 100%, when i do the calcs, 50% does not get me there(if SA is awarded with my CUE). i am currently right at 86%. 50 would only get me to 93. by my calcs i would still need some additional ratings. i would need 3 more 10%  ratings to get to 100%.

well ok then.

I had thought you were rated at 90%??

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