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I got a tooth extracted. Before the extraction I saw a note of the desk — didn’t know what it meant or even if it was related to me. This was an outside dentist that the VA has assigned me to — as I can no longer get to VA dental clinic due to driving-anxiety issues. Previous VA dentist sent me message: “this dentist will take care of your comprehensive dental needs.” I’m Class IV.
The note said: “No bone.”
since then I have looked all of the stuff up. And I realize now that I think it was quite cruel to not authorize “bone.” The dentist made a comment while doing this extraction, that again I didn’t understand until I studied up on it all later. And I didn’t ask the dentist any questions until a week after that. But during the extraction the dentist mumbled something about that they weren’t going to not put bone in there. A week later I went back for a check up and I asked the dentist why they didn’t “not put bone“ as the note said. First the dentist started explaining how it wasn’t going to bankrupt them. But then I started talking or asking questions and I said well did you do that because you thought it was “unethical“ not to? The dentist shook their head and said, “well, yes.”
obviously the dentist didn’t just do it for the heck of it.
since learning all of the stuff now I realize that three other teeth that the VA pulled there was never any bone grafting. And now I know about this melting jaw and now I know about how much bone is missing and how fast it goes. If you haven’t researched the stuff you should because it happens fast.
now perhaps the VA says all of this can be done later. Perhaps they believe that you could be missing a whole lot more bone than you are now and it can all be repaired later. Of course the problem with this is getting it done and all the time that passes trying to get something approved. There’s really no excuse for them not doing it like most dentist do and that is at the time of extraction. They still might have to do more later if you were to get implants or something like that — I’ve been told “good luck” getting implants by a VA dental tech. I’ve also been told “well you get it for free.” Which I reported to the lead dentist who said nothing about it and made no apology. The VA lead dentist also told me I should buy dental insurance through the VA — the lead dentist wrote that to me in a secured message so all of this as well documented.
Furthermore in seeking the treatment I desperately needed for years because I realize the VA wasn’t doing it they were taking way too long to do it. And I was using all those over-the-counter pain medications for year approximately a tube day on about three or four different teeth! So what I did was I went around to a bunch of free dentist who gave you a complete work up for free x-rays and everything. I went to five dentist in one endodontist. Two of them I paid $100. The endodontist wrote a three page report and he thought I was going to be back really soon because I needed three or four route canals badly.
The VA assigned me to an outside dentist to get some of the stuff done finally after I twisted their arm With my reports. I went and saw their first outside guy and he did a complete work up of course I didn’t say very much because you know, it’s a dental exam! about a week after that I saw the plan he worked up and he had one root canal in it. So I sent him an email asking listen I need about three root canal‘s really quickly and I can’t wait months for the VA to approve your entire plan. And also, you only had one root canal in your plan, why was that when I need at least four?
this dentist wrote me back a letter saying he would not comment on what these other dentist had told me and that he would have the endodontist when he sent me to the endodontist look at those other reported teeth. And then he went on to say in his letter that if I had been seeing all these other dentist for the last few years that this indeed was, and I quote, “neglect.“
I wrote back thank you very much your number six I haven’t been seeing any deaths except the VA for the last 10 years. I went and got these letters and examinations to get the VA to act.
I think with a lot of people including the damn doctors at the VA don’t realize is that all this time that goes by your body is deteriorating your losing bone and losing it fast.
I’m writing this post to talk about that dental stuff. I don’t know what to do about this dentist I could pay $350 for the bone the dentist said was unethical not to put in. The dentist is not gonna even try to build the VA for it. I guess because they feel like they won’t get it because it was an authorized in the first place. No I can’t really ask the dentist to go through that billing the VA and being refused because they probably don’t want to get involved. But if they did do that and the VA refused and then I paid then perhaps I could try to get it back from the VA my case would be stronger for that particular Money. Or maybe it would be the same strength.
I have at least three other cases with the VA of either failure to diagnose or failure to treat. And those things are part of what constitutes malpractice as far as I’ve understood recently as I had to become Joe Junior lawyer.
I had no idea about all of the stuff and how fast these deterioration‘s and bone loss could occur and what could happen to your face until afterwards. Years afterwards.
I see I have other instances. For example my clinic got a new PCP to take the place of mine of 15 years. My first experience was that I went to the hospital overnight we don’t know why but if that time they discovered an aortic aneurysm. later I was sent to some imaging place six months later and I suppose it was to get another look at that. And as I learned about those things I found out that they monitor the size and the growth rate. When I got the report from my PCP it said I had an AAA and that an AAA ultrasound would be given again in a year to monitor it for size. I looked up AAA, it said abdominal aortic aneurysm. I also looked up how you monitor these things. I found out that for abdominal aneurysms you use the ultrasound. I also found out that there’s thoracic aneurysm’s and for that they use CT scans due to the chest cavity. OK so I learned about aneurysms.
then I decided wouldn’t it be cool to see a picture of that. So I contacted the imaging place which was an outside place. And I got the images in the reports. Of course the pictures didn’t look like anything to me. But the written reports were there. The report said I had an ascending thoracic aneurysm, Not an abdominal aneurysm. And I never been curious I’ve never known that I don’t have an abdominal aneurysm. And had they used an ultrasound on my abdomen a year later I would not of known that they’re not only in the wrong place but using the wrong tool.
and I never been curious I’ve never known that I don’t have an abdominal aneurysm. And had they used an ultrasound on my abdomen a year later I would not of known that they’re not only in the wrong place but using the wrong tool.
I wrote the doctor and asked her to explain this misdiagnosis. she would not do it she stayed on that I had an AAA aneurysm. this went on for a month and I finally forced her to telephone me. She still wouldn’t cop to the mistake. And said I should get all my VA records and that I would find it there. She also didn’t bother to tell me that that scan showed gallstones no one had ever diagnosed me with gallstones I only knew it from myself reading the report. That explains a lot of problems I’ve been having too.
finally I complained and it took a long time and I got a lot of back talk about it, I finally got a call from the second in charge of primary care from the VA regional hospital. This man called me belligerent and referred to Secure messages that had nothing to do with my complaint and that he was miss reading completely. And then finally after his 15 minute diatribe I said and yes and what about the AAA? and he said very quickly and continue talking, “oh that was a mistake.“ And continue talking and I went wait wait... what? you say “that was a mistake.“ I said so that’s what I’m contacting you about. He said oh I’ll have a talk with the doctor. I said yes and I’ll have another doctor please. I never got one the doctor has never admitted the mistake and I don’t know anything about anything.
Here’s one more I’ve been getting steroid shots in my shoulders at the VA for probably 10 years but they last me a long time perhaps a year. I went through the whole rigmarole with them about calling ortho and getting fresh shots… And once a long time ago I got one of the medical directors involved because they were constantly telling me I had to go get new x-rays. And that was an overuse of x-ray just for more steroid shots. And the VA agreed they said you don’t have to get more x-rays like they already knew that. Of course perhaps sometimes you do but in my case not.
here’s one more I’ve been getting steroid shots in my shoulders at the VA for probably 10 years but they last me a long time perhaps a year. I went through the whole rigmarole with them about calling ortho and getting fresh shots… And once a long time ago I got one of the medical directors involved because they were constantly telling me I had to go get new x-rays. And that was an overuse of x-ray just for more steroid shots. And the VA agreed they said you don’t have to get more x-rays like they already knew that. Of course perhaps sometimes you do but in my case not.
so I’m trying to currently get more shots in my shoulders. I called the ortho as I always do when I want more shots and they said oh you need to contact your PCP. I said no I don’t think so I think I just call you guys like I’ve been doing in the past. They said no you need to contact your PCP. So I said OK I’m just gonna go along this time. And I did about a month or so later I got sent to some outside place for x-rays. — this is ridiculous and a waste— I still haven’t gotten the shots they’re still telling me that they haven’t received the order from the doctor even though I’ve had the x-rays a month ago. So I called ortho again last week. And the person who answered the phone and these are people I’ve been dealing with for years, said “let me tell you how do you get your shots, Who was the doctor they gave you the shots before.?“ I said I don’t know you guys have changed around. But I immediately became extremely upset because this is not what they had just told me two months ago I got really pissed off and hung up the phone. Oh now you’re gonna tell me the right way to do it after I’ve been exposed to more x-ray and I’m still sitting here waiting for months.
I’m a psychiatric patient and I have major anxiety problems. We have a new psychiatrist at our clinic and I made an appointment with him because I wanted to try it if he was a makeable to a trial of clonazepam, that I had had before many years ago but never really tried. He told me that, and I have this in writing, “all veterans are being weaned off of all control substances.“ There by cutting that conversation off completely there by me not receiving the treatment I desperately needed. Whether he gave me the pills or not there was no discussion about it Eyeview that is a denial of treatment not because he didn’t wanna try the pills but because he lied to me. This carried on for four months. I asked him to cite his source of that information because I knew it was wrong. He wrote me back a month later saying FDA federal government to be precise. Again I knew he was wrong. I wrote back yes but can you send me a copy can you show me where that is so I can read it. Another month passes and he writes back one one word answer or one acronym answer, “PDR.”
well, I know what a PDR is. indeed the PDR has the drug we were talking about or I was talking about in it and exactly what it’s used for which exactly the symptoms I was describing. I have a long history of this it’s not like I’m making something up. so I wrote back to the psychiatrist “what page?“ He was lying again. After I wrote that at 10:30 at night I got a message from him saying that I have “harassed” him and I “have been reported to the appropriate authorities there will be consequences.” I almost had a heart attack. I didn’t know if the police were coming. If the men in white suits were coming. If I was going to be kicked out of the VA. I almost SHIT myself.
The next day or the next day I went to a phone booth so I could be anonymous and I called the director of the regional office at the regional hospital. They said oh no way is the secure messaging system should that be used for to like report people or something. They were all on my side until I identified myself and gave them all the messages. Then they sent me some letter of warning. I stayed on it. Eventually the lead psychiatrist called me and apologized for something he didn’t even know what he’s talking about. This is like almost 4 years later. Not interrupted him halfway through and I said you don’t even know what it is you’re apologizing for do you? The patient advocate had put him up to it and I told the patient advocate later that that was a terrible terrible harmful idea.
The patient advocate had put him up to it and I told the patient advocate later that that was a terrible terrible harmful idea.
I told that doctor when you called me that you need to understand we’re not equals I’m a patient you’re the doctor!
he said that the previous psychiatrist who told me that stuff was no longer working at “our clinic.“ I hadn’t wanted to go anywhere near my clinic for any medical item for fear I would even see the guy. he didn’t last there very long, a former captain in the army, and so I called my clinic to make an appointment with the other psychiatrist. Of course now I need really needed one. When I called to make the appointment I asked if the previous guy was still there. They said oh yes he still here. I am mediately called the lead dentist who never return my call I left several messages with the secretary saying why did you tell me the guy was gone when he’s not?
I think I should sue the VA. I have all of this documented in messages and a lot of them I printed out I’ve been through a lot more than this with the VA. My compensation claim or the main body of it shall we say was just decided this past summer, I filed it in 1998. I have all the documents I have everything. to be clear, that date just for the whole case to finish. I’ve been receiving VA dental since 2014.
I have been deemed P&T since 1998.
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?
By Wendy Ramirez
Has anyone won a pigment dispersion or macular degeneration case that can assist me in filing an appeal?
I was just denied for this claim on 10/26/19. I do not have any new records to provide. I am waiting to pick up my C&P exam. I provided 3 years of STRs for these conditions, 5 years of DOD dependent military treatment records, 15 years of post service treatment records, a buddy statement, a nexus letter and a DBQ. The only thing that was listed at MEPS entrance exam in 1994 was vision defect correct with glasses. The first year of service in 1995, second year in 1996 did not show any of these conditions. It wasn't until 1997 while deployed to Bosnia that I started having occasional double vision, photo-sensitivity, frequent dry eyes, tearing, spikes, halos, floaters and night vision issues. When I returned to Germany, I had an eye exam where I was diagnosed with pigment dispersion syndrome, bilateral acute iris transillumination, grade 2 Krukenberg's spindles, macular disease and cystoid macular edema. I was followed every month for progression, then every 6-mo, then to every year where I also received new glasses or contacts.
Since the denial (below) states that my conditions are congenital defects, am I wrong to think that these conditions should have been detected pre-enlistment, at enlistment and at every yearly eye exam up until 1997? Then, there would be reason to believe that the issues would have progressed or appeared to finally be seen on an eye exam 3 years later, while in service. It is my understanding from reading the CFRs that if it is a "defect" then there would be no changes or progression of issues/symptoms, therefore no compensation. If it is a disease, there would be progression or symptoms and can be compensated. If the disease was found during military service, then it can be compensated.
Here are the details from my denial letter:
1) Service connection for bilateral eye condition is denied (claimed as pigment dispersion syndrome, bilateral acute iris transillumination, grade 2 Krukenberg's spindles, retinal condition to include scars, atrophy and irregularities, vision problem and macular disease
The current claim for bilateral eye condition and conditions identified as pigment dispersion syndrome, bilateral acute iris transillumination, grade 2 krukenburg's spindles, retinal condition to include scar, atrophy and irregularities, vision problem, and macular disease are considered congenital or developmental defects which are unrelated to military service and not subject to service connection. (38 CFR 3.303, CFR 4.9)
Your conditions are considered congenital or developmental defects, which are unrelated to military service and are not aggravated by it. Additionally refractive errors are due to anomalies in the shape and conformation of the eye structures, and generally of congenital or developmental origin. Defects of form of structure of the eye that are congenital or developmental origin may not be considered disabilities or service connected on the basis of incurrence or aggravation beyond natural progress during service. The fact that a Veteran was supplied with glasses for correcting refractive errors (such as astigmatism, myopia, hyperopia and presbyopia) is not, in itself considered indicative of aggravation by service that would warrant compensation (38 CFR 3.303, 38 CFR 4.9).
Therefore, service connection is denied.
Favorable findings identified in this decision:
Findings of pigment dispersion syndrome, macular disease, and cystoid macular edema are noted in service treatment records.
Your private treatment records and VA examination show treatment and diagnosis of pigment dispersion syndrome, dry macular degeneration, lattice degeneration and esophoria.
Your service treatment records show findings of pigment dispersion syndrome, macular disease and cystoid macular edema and treatment for conjunctivitis.
2) Service connection for glaucoma, bilateral is denied
They fail to mention that these conditions were also found in my STRs (not all issues claimed and in records are congenital):
bilateral acute iris transillumination, congenital opacities, grade 2 Krukenberg's spindles (which progressed to grade 3+ in records) , eye strain, problems with peripheral vision, headaches, blurred vision, drusen, macular DISEASE, peri-macular pigmentary DISEASE, pigmentary keratitis, macular retinal pigment epithelium (RPE) etiology unknown, macular mottling, congenital cataracts and their "diagnosis" of conjunctivitis that was actually diagnosed later on by a civilian as lagophthalmos.
What should I provide in my appeal? Can I provide court cases where the claim for the conditions were won?
Service connection is available for congenital diseases, but not defects, that are aggravated in service. Quirin v. Shinseki, 22 Vet. App. 390, 394 (2009); Monroe v. Brown, 4 Vet. App. 513, 515 (1993). In cases where the appellant seeks service connection for a congenital condition, the Board must indicate whether the condition is a disease or defect and discuss the presumption of soundness. Quirin, 22 Vet. App. at 394-97. It follows that in such cases where a congenital condition is at issue, a VA medical opinion may be needed to determine whether the condition is a disease or defect, whether the presumption of soundness has been rebutted, and if so whether there was aggravation during service. Id. at 395
In this regard, the presumption of soundness does not apply to congenital defects because such defects "are not diseases or injuries" within the meaning of 38 U.S.C.A. §§ 1110 and 1111. See 38 C.F.R. § 3.303(c); see also Quirin at 390 (holding that the presumption of soundness does not apply to congenital defects); Winn v. Brown, 8 Vet. App. 510, 516 (1996) (holding that a non-disease or non-injury entity such as a congenital defect is "not the type of disease- or injury-related defect to which the presumption of soundness can apply").
For purposes of determining whether a disorder is a congenital defect or a familiar disease, VA interprets the term "disease" in 38 U.S.C. §§ 310, 331, and the term "defects" in 38 C.F.R. § 3.303(c), as being mutually exclusive. "Disease" is broadly defined as any deviation from or interruption of the normal structure or function of any part, organ, or system of the body that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown. See VAOPGCPREC 82-90 (citing DORLAND'S ILLUSTRATED MEDICAL DICTIONARY 385 (26th Ed. 1974)). On the other hand, the term "defect," viewed in the context of 38 C.F.R. § 3.303(c), is defined as a structural or inherent abnormality or conditions which are more or less stationary in nature. As noted in VAOPGCPREC 82-90, a Federal court, in drawing a distinction between "disease" and "defect," indicated that disease referred to a condition considered capable of improving or deteriorating, whereas defect referred to a condition not considered capable of improving or deteriorating. See Durham v. United States, 214 F.2d 862, 875 (D.C. Cir. 1954); see also United States v. Shorter, 343 A.2d 569, 572 (D.C. 1975).
If it is determined during service that a veteran suffers from a congenital disease, as opposed to a defect, VA cannot simply assume that, because of its congenital nature, the disease must have preexisted service. That is, the presumption of soundness still applies to congenital diseases that are not noted at entry. Quirin at 396-97. VA must then show by clear and unmistakable evidence that the congenital disease preexisted service and was not aggravated thereby in order to rebut the presumption of soundness. Monroe v. Brown, 4 Vet. App. 513, 515 (1993). VA may not rely on a regulation as a substitute for the requirement that it rely on independent medical evidence. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). VA's Office of General Counsel has also confirmed that the existence of a congenital hereditary disease under 38 C.F.R. § 3.303(c) does not always rebut the presumption of soundness, and that service connection may be granted for congenital hereditary diseases which either first manifest themselves during service or which preexist service and progressed at an abnormally high rate during service. See VAOPGCPREC 67-90.
The C&P Director referred to General Counsel Opinion (OGC 82- 90) dated on July 18, 1990, which held that service connection may be granted for diseases of congenital, developmental, or familial origin provided that the evidence as a whole establishes that the condition was incurred in or aggravated during service.
=============== Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). ===============
The veteran’s pigmentary dispersion syndrome with pigmentary
glaucoma is currently rated as 10 percent disabling, the
minimum rating allowed under 38 U.S.C.A. § 4.84a, Diagnostic
Code 6013 (for simple, primary, noncongestive glaucoma).
Under this provision, the disability may be given a higher
rating based on impairment due to related loss of visual
acuity (Diagnostic Codes 6061-6079) or related field loss
(Diagnostic Code 6080).
A bilateral eye disorder, diagnosed as pigment dispersion
syndrome, was incurred by veteran during active military
service, and service connection for the manifestations of
that condition, to include increased intraocular pressure, is
warranted. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R.
§§ 3.303, 4.9 (1996).
Any help is greatly appreciated.
I am so grateful for all the assistance and helpful advice that I have received from the many caring people on this site. Approximately a year ago, I was finally awarded TDIU (IU) through the VA after a long six year battle. As a result I am entitled to all the "bells and whistles," it provides. Fast forward to May 17th of 2017, when I was scheduled to receive my much needed dental implants. I went in for the procedure and met a young dental intern "doctor" who looked to be around 23 years of age. In spite of my nervousness, I allowed her to proceed with the surgery. These medical students typically work at the VA for one year or so for the experience, then leave to jockey for real jobs in the medical field. After the surgery was over, I discovered that it would take approximately six months for the appliance to adhere to my jawbone prior to them installing the caps. The "doctor" informed me that she would not be around in six months and that the next intern would install the two caps.
It wasn't until approximately July or so that I was informed by the new intern that my implant on the right side had been put in improperly and as a result would leave a gaping space between my teeth. She determined this from the x-rays. Just as predicted, this past November 2017, I was called in to have the appliances installed just to discover the new intern was right. When asked what could be done to correct the situation, I was told that nothing could be done. As a result of the placement of the implant, I now experience discomfort and the inconvenience of having to remove food deposits from between the one implanted molar and my real tooth. I am so distressed about this situation. I may have been better off leaving well enough alone. I guess everything that is free isn't really free, huh?
What if anything can I do about this situation. Please advise.
I am S/C for my Eating Disorder.....I have numerous fainting spells documented which is what helped get me S/C for Anorexia Nervosa....
In November 2014 I passed out and was rushed to the VA hospital. I damaged both front teeth due to my eating disorder. I was treated for other issues while at the ER and released. I had two consults to the VA dental denied due to no S/C for my teeth.
I had to get over $4,500 in dental work done on the outside. I had both my dentist and specialist dentist fill out DBQ's and I submitted them along with all receipts and I did an FDC. I filled out everything needed and submitted in Feb 2015...
QUESTION...Can you get your teeth S/C(secondary) if you already have a S/C disability (Anorexia Nervosa) that attributed to the secondary issue?
I noticed on the VA site for FDC claim's it states:
Who Can File an FDC? Veterans may file an FDC for disability compensation for the following reasons:
An injury, disability, or condition believed to have occurred or been aggravated by military service. A condition caused or aggravated by an existing service-related condition.
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,