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Insufficient C&P exam, supplemental claim, TDIU, and other strategy
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By XIbodybag
Anyone have an idea why supplemental claims dont show status updates on VA.gov? It continually will just say "We dont know your status" until the claim is closed.
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By shrekthetank1
Now that i have reached P&T how does it work for the veteran with vision and dental? Do we go to the VA for this or how does this work?
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By XIbodybag
Filed a supplemental claim 12 days ago. Sent a current diagnosis from VHA of combat related PTSD (they diagnosed me with other stressor related disorder at 30%) and evidence of symptoms and interactions with police that should put me at 50 or 70% in like 50 pages of evidence via . Called 1800 number today to check on status and they said that it had already been decided for 10/20/2020 (tomorrow???) and no new C&P was given. Does this seem a bit fast to you? Does that mean its unfavorable or have you seen favorable decisions made that quickly?
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By scooter318
Hi Everyone
I want to file a supplemental claim but I was told that I have to fill out form 20-0995 and fax it to the office that sent me my denial letter. But I also wanted to know when I fax in the form do I also fax in the IMO the lay statement and the case law that I have as new evidence in support of my claim.
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By MMTOTZ
Good morning all.
Hoping someone could shed some light on a couple things. I’m on second go around with Supplemental claim on the same issues, but this time, actually got to see a doctor through QTC that listened, and looked at everything with me.
Tried for a higher level review, but missed the second phone call to schedule appointment, was in VA appt.
I called Peggy last week and they explained the DRO is requesting a records review from the doctor?
Last night I received a package from QTC explaining that a different nurse practitioner will be reviewing my records ? I’m a little confused and wondering if this will bode well for my claim as this person did not see or speak with me.
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Defense Bill Passage and Bladder Cancer
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-
- 10 replies
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5,10, 20 Rule
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.
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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)-
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- 41 replies
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Post in New BVA Grants
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. -
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Finally Won...NOW WHAT?
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!-
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Post in Higher level review
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 By
Joey Ross, -
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Willypete 0
Hi, new member here, longterm lurker.
I'm seeking advice on moving forward with my claim regarding loss of peripheral vision (code 6080), TDIU as a result. Specifically, I'm wondering if I should file the supplemental reopen to include EED, SC, and the TDIU? Here's the timeline:
Initial VA claim in 2015 for numerous things including field of vision loss, back pain, lower leg numbness, etc. This resulted in only 30% service connected lower back arthritis, but denial on the vision issue. By 2018, the back worsened and a few other issues arose, so I submitted another claim resulting in the back increasing to 40% SC, hemorrhoids 20% SC, lower limb radiculopathy 20% for 70% total.
I did not appeal the vision due to lack of education on the VA claims process. However, I've done my research and found that my initial vision C&P exam was insufficient. Per 38 CFR § 4.77 - Visual fields., the exam must be conducted using Goldman kinetic perimetry or Humphrey/Octopus automated. Neither of those occurred during my test. My vision test was outsourced via LSI (?) to a local optometry store. After meeting the doctor, he was informed that the "machine" was broken, so my test was performed manually using a tangent screen skipping Goldman. This is the basis for the insufficient exam.
After receiving my initial 30% in 2015 I entered into the VA for my medical care, as a part of that I indicated I had vision issues and thus began annual visits at the VA to get an exam and meet the ophthalmologist. My initial Humphrey scans did show significant loss of peripheral vision and I was transferred to the head of the department for follow on analysis. She did a full eye exam, could not find anything physical in the eye that might be causing the loss and recommended annual visits to track the progress. Fine.
3 years passed and each year the Humphrey test showed continued loss of peripheral vision. In 2019 I started seeing the neuro-ophthalmologist who decided it was time to do more investigating and ordered a MRI and then later a CT Angiogram. The results of those tests was that once again no physical cause could be seen for the vision loss. I'm a Gulf War vet with 42 combat missions in the aircraft in 1991 and then a 2nd tour in the Gulf during Southern Watch during 1992. Additionally, our airwing was based and I lived at NAF Atsugi which has been highlighted for issues regarding a dioxin incinerator just south of base. I was going to name these issues to garner a SC but recognize that may be weak sauce.
My left eye concentric contraction is around 15% and the right eye is around 20%. Based on the better eye this translates to 50% rating.
The TDIU is something I've only recently thought about. I have issues with driving and going into busy stores is extremely stressful as I cannot see people coming from the sides so I avoid them. Previously, I owned my own business but prior to Covid I had already shut one location and sold another as I was reducing my workload due to my back and vision. In March I closed my last location and do not anticipate reopening because I don't think I can handle it. Physical labor is out of the question and the back/hemorrhoid precludes extending sitting and the vision is making driving near impossible and headaches are an issue.
Thanks for any advice on how best to further the vision claim and perhaps include some of those issues I've talked about. Any problems with reopening a claim based on an insufficient initial exam?
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broncovet
Yes, you can challenge the competency of the examiner. https://cck-law.com/blog/how-to-challenge-va-cp-exam/ However, if you are seeking "back" benefits on an unappealed claim, its more comp
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