100% P&T, should I still appeal?

[glashutte]

I have received 100% P&T. However some very black and white conditions were denied completely.

Should I still appeal the denied claims even though I am 100% P&T?  (it has been over 1 year since my claims were denied).

I have 2 fears:

1. VA will eventually one day reduce my 100% P&T randomly and I will regret NOT filing an appeal 

2. I file an appeal for the denied claims and then the VA digs deeper into my 100% and 'changes' their mind and then reduces me. Basically I don't want to wake up the sleeping giant and would rather fly under the radar

Edited February 4, 2021 by glashutte

[ShrekTheTank]

There are many reasons why flying under the radar will hurt you in the long run.  You could be eligible for SMC-S.  There is a reason they give Permanent and Total Disability.  Meaning they will not schedule future exams as they do not see you getting better.

So say you have an exam and the VA does this and you did not fight your other claims which are an easy win.  Then you will kick yourself for not taking care of it right now.

I am 100% P&T and I have 3 things I am still fighting.  Once I have them completed I am done fighting the VA for now.  

Another thing which I am always fighting for is making sure those who come to fight this fight after have someone who already fought it. Meaning I have a rare condition which had only bee rated 3 times before me and was very hard to find.  I also thank those who fought for the presumptive conditions which have helped me a ton!

The VA is not going to reduce you as long as you tell the truth.  With that being said, I always want to cover my 4 points of contact, so I will keep moving forward with these just incase they want to come back and try to reduce one of them.  

It also will help with A&A if you ever need it and need a higher level of SMC.

My advice is to keep going and don't stop until you cover everything.  I have been fighting since 2012.  

[Buck52]

I agree with shrek,

If you have a condition you need to get service connected for rather or not its a secondary condition or not

File for them.  like shrek mention your 100% P&T   they usually leave 100% P&T Veterans Alone.

If your over 55 that's another reason they leave us alone.

I was TDIU  T&P  FOR ABOUT 14 YEARS   getting the 100% payment and I filed for another claim...had all my evidence and filed the correct application (va form)  because if you file the wrong  form application  they will send it back  and you need to file the correct app  just a lot of time waisted there.

Edited February 4, 2021 by Buck52

[broncovet]

While Chris Attig recommends "keep going after you are 100 percent", I humbly disagree most of the time.  Exception:

If the claimed condition (denied) is likely to contribute to your death.  The reason is simple:  Take care of your family. 

DIC goes to a spouse of a Vet when the Vet dies "of a service connected condition" or from "any condtion" after then Veteran has been 100 percent p and T for 10 years.  

So, if you have diabetes or CHD, apply for them.  

But, if you are unlikely to die from the condition, I say, dont clog up they system for other Vets.  VA has enough backlog now.  If you wont get any extra money, that extra disability "probably" wont prevent a reduction.  Its hard for the VA to reduce you at 100 percent P and T, you get the 5 year protections, such as:

1.  They cant reduce you unless you have "actual improvement under ordinary conditions of life", that is, working.  

2.  The exam to try to reduce you has to be "at least as thorough" as the one which granted benefits.

3.  There are other restrictions on VA reducing you, I have posted these multiple times.  For example, if your condition is one of many which varies from day to day, they cant reduce you unless there is "sustained" improvement over time, not just one good day at the c and p exam office.  

     Frankly, fighting VA isnt fun for me, I would not do it UNLESS there was a good chance I got paid for it. I would rather go get a root canal every week than fight VA.   You would be better off volunteering your time helping others.  

Edited February 4, 2021 by broncovet

[glashutte]

Very good points thank you all. 

To better understand the picture:

-I am satisfied with 100% P&T

-I do not qualify for SMC and even if I did I rather not wake up the giant to get this as I am good with P&T compensation

-The claims that were denied I will not die from. One of the big ones I thought would be service connected was GERD 

 

So if I am satisfied with 100% P&T and will not get paid anymore even if I fought the extra denied claims - is there any reason from knowing this that yall would still recommend fighting the denied claims?

[GBArmy]

glashutte If you're comfortable where you're at, let the giant sleep. If you will not die from a disease or disability that you are thinking of claiming, going after it and not getting any $ for it doesn't work for a lot of people. If you can't get any SMC's, if you're ok with it, let it ride. I'm at 80% and have two additional disabilities I believe I can win, but my symptoms right now would be rated at 0%. So just for laughs, I'm working on them just in case something changes. Since I'm not P&T although meet some of the other criteria for being left alone on future exams, I'm ok with not submitting. Neither disability will ever be something I will die from (I don't think), so why wake up the giant, as you say. Very little reward, but risk exposure to rescheduled C&P's on my existing disabilities. To me, just not worth it. Others, well they enjoy the tussle.

[glashutte]

58 minutes ago, GBArmy said:

glashutte If you're comfortable where you're at, let the giant sleep. If you will not die from a disease or disability that you are thinking of claiming, going after it and not getting any $ for it doesn't work for a lot of people. If you can't get any SMC's, if you're ok with it, let it ride. I'm at 80% and have two additional disabilities I believe I can win, but my symptoms right now would be rated at 0%. So just for laughs, I'm working on them just in case something changes. Since I'm not P&T although meet some of the other criteria for being left alone on future exams, I'm ok with not submitting. Neither disability will ever be something I will die from (I don't think), so why wake up the giant, as you say. Very little reward, but risk exposure to rescheduled C&P's on my existing disabilities. To me, just not worth it. Others, well they enjoy the tussle.

Thanks. You're the first to suggest this and I will take this into heavy account. 

Everything from youtube videos to forum discussion suggests fight the claim even at 100% but it seems like it is case specific. In this case, I really don't have anything to gain....