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Hey all. Hoping you guys can help me out with what to expect.
In 2010 while I was active duty I went to medical over what I thought was a potential hernia. They did an ultrasound and felt around but told me they didn't see anything and that if it continued to hurt come back. I got my honorable in January of 2011.
A couple months ago, the pain occasionally still persisted so I filed a claim for a hernia/groin condition and they scheduled me within a few weeks. I just went to my appointment and the Dr. asked me if I had the hernia taken care of yet. I told him that I was never diagnosed with a hernia which is why I also choose "groin condition" on the drop down menu. He help up a paper from my file and said that back in 2010 I was diagnosed with a inguinal hernia and that It says that I never made an appointment to meet with a surgeon. I told him that wasn't the way that I remember the scenario going, I believe I was told they found nothing and to come back if it still consisted or got worse. So we spoke for a few moments and he said that he's going to put that it is service connected, as I WAS diagnosed while I was still active duty. He also said since it's considered elective surgery if I wanted to have it taken care of I would need to talk to my private doctor.
Has anybody had any experience in how this would be rated? He told me that it is service connected but he wasn't sure how the rating would go.
I'm currently at 30% disability. I also recently received my C-file so I put it in my computer and found the page the doctor referenced and yes, it does say that I was diagnosed back in 2010.
I would really appreciate some guidance on next steps. Please let me know if I forget any useful information. I had 2 items go to the BVA. I had a claim for tenosynovitis of right hand/wrist/forearm which was originally denied connection and the other issue was for scar.
The BVA said my tenosynovitis was service connected so that was taken care of.
The scar was remanded because of a incomplete c&p exam. Pretty sure when I filed NOD I also said I did not agree with the exam because I complained of scar pain and the examiner never mentioned it at all. So my initial rating for scar was 0%.
Like I said I filed NOD after initial 0% assignment. Couple weeks back they gave me another c&p exam like the BVA ordered. This time the examiner actually wrote down that I complained of pain so they rated me at 10%. However they changed my effective date from 2013 to Oct this year because the previous exam didn't mention pain
I'm obviously going to appeal this again but what do I say? What's best way to go about it?
Second part of question is about VA duty to assist. I had no idea there was a rating possible for hernias. Because of the surgery for tenosynovitis which is service connected and where the scar is which is service connected I have a hernia where muscle bulges through and raises the skin. That hernia has always been there. Should the VA have included that? Any examiner can see it clearly when looking at forearm and my last c&p examiner for scar said she would note it. Can I get that connected with a effective date of 2013 which is when the tenosynovitis is and my original 0% scar was?
I was hoping to get a second opinion on a potential claim. While in service I had a radical tenosynovectomy which is service connected. I am also service connected for the scar from said surgery. That surgery caused a hernia on my forearm. The size of muscle coming through is about 2.5 inches long by about 1 inch wide.
I was wondering if this should be a pretty straight forward claim or what I might need to consider or prepare for?
I believe this claim would fall under 38 CFR § 4.73, Schedule of Ratings – Muscle Injuries, Diagnostic Code 5326.
Seems pretty straight forward to me but again it's the VA and there always seems to be something to complicate things.
Hello all, A bit about my situation. I was rated TDIU and recently filed for an increase on some issues that the BVA denied. I was increased from 10% to 40% each knee, and 10% to 20% for lower back. This put me in the 100% P&T threshold. I also filed for an increase with my Hiatal Hernia. Below is there reasoning for denying an increase of GERD. They list all but one contention that would need to be met, but what they fail to understand is I have constant arm/ shoulder/ upper chest pain from an AC separation which I am also service connected for. So when asked my symptoms I would have never guessed besides having upper chest pains that my arms and shoulder would be effected by my GURD considering I had considerable pain there regularly. My question is should I file an NOD or just let it go and not "rock the boat" considering I am at 100 P&T?
By LT Haylo
I thought I should finally share my story... I separated from the Navy in June of 2014. I started my first VA claim as a quick start ( I was still active duty) claim but it was anything but quick. I went through a rep at MCRD in San Diego who helped people separating the military file initial claims. I claimed/filed for migraines, TMJ, neck scar, lower back pain and shooting pains down left and right leg. I submitted copies of my AD medical records and went to all my CP exams. After waiting close to a year, I got my BBE that contained my claim award that I very much needed and expected a good outcome. I got a big fat 0%. Migraines- 0%, scar- 0%, Tmj 0% and denied completely on my lower back pain condition and shooting pains down left/right leg. I was so angered by my outcome that I lost all faith in the VA and threw my BBE in a drawer and decided to forget the VA and move on with my life.
Fast forward to two years later something got me fired up again about the process/original outcome I received from the VA. I began to do my homework and stumbled across this site. The stories I read gave me hope and personal insight into others who had filed for the same conditions I did. I got smart and marched straight into the San Diego Regional office and joined a Veteran's Organization. I personally went with AMVETS as they were the first group to reach out to me and I like what the rep had to say. I could tell he was really there to help me with my claim. I filed for increases on Migraines, scar and TMJ. I also started a new claim for my lower back pain and shooting pains down left/right leg since I was past the one year mark to file an appeal. We also filed new claims for depression/anxiety, acne and tinnitus. I gave him all my medical records from AD and my separation physical that was missing from my original claim. To better my claim outcome my VO suggested I get DBQs filled out by my personal doctor and dentist for my Migraines and TMJ. I once again attended all CP exams the VA requested. My outcome this time was a small victory. I received: Migraines- 0%, Scar- 10% and TMJ 10% conditions for acne and my back had been deferred. From doing my homework I knew I was being low balled on my migraines and TMJ. My rep filed for a reconsideration on my Migraines and TMJ and resubmitted the DBQs from my personal doctors that had been overlooked by the VA ( they only considered the cp exam results).
I then went for my next round of CP exams for my acne and lower back condition. My new rating came shortly after:
Neck Scar- 10%
Lower Back Pain- 10%
Sciatica Left Leg- 20%
Sciatica Right Leg- 10%
Allergic Rhintis- 0%
Depression/Anxiety- Denied because doctor had stated it "resolved" in service.
Combined Rating- 80%
Without the help of Hadit.com I would have never been able to go through this process again and get this outcome! I went from 0% to 80% within 6 months. I'm so thankful to everyone who has posted here and I'm hoping I can help out another Vet by contributing! My fight with the VA is not over! I'm beginning the process to file a CUE claim on my lower back pain and left/right shooting pains down leg to get my effective date pushed back to my separation date. The VA originally denied my back claim stating that there was no medical evidence in my file. They were wrong. Best wishes to everyone and keep fighting!!!
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,