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Bare with me as I have done all this work myself, so if I don't have a specific answer or know an abbreviation. All I ask is you give me some time to look it up cause I am not well versed in VA lingo.
I completed a Higher level review (This apparently means sometimes you get a more experienced person, I explained to her all the issues I have been having and she basically said, I will send this back down so they can fix it and she said she has everything she needs to increase my Bell's Palsy which was at 0% and she changed it to 10% She told me she would have to issue me a couple more exams. They are specifically for IBS and Mental Health.
The exam package from QTC for the Psychology exam does not mention a specific condition. (This would be my third mental health exam) The initial application was in 2019 and included depression and anxiety. I submitted a 2900-0659 as my stressor. The second exam from qtc came back and said "PTSD with ADHD" so my claim for "PTSD" was denied. On the latest Denial letter, I have the following line items.
Depression,anxiety and sleep problems (listed as one condition)
Post traumatic stress disorder with attention-deficit hyperactivity disorder, predominantly inattentive type. (VA Doctor thinks I must have seen a child psychologist cause he said and I quote "That's the most insane diagnosis I've ever heard of)
The QTC package for IBS is with a nurse practitioner at a clinic in town.
So is the duty to assist for all of my conditions based on the fact that the previous examiners did not do there job?
I have attached my denied claim for migraines. I have many docs I can attach. I.e buddy letter from my mother ( fractured skull prior to military), and also squad leader that mentions bad landing on military jump service connection ( knocked out). Military entrance exam showing fractured skull. VA NEUROLOGIST stating service connection. Sick call slip headaches. There is more but
post. But I’ll start with the ones attached. I don’t understand the reasoning for denial . They have rated me earlier with SSD. Aalso they show a history of risk factors … and if you look at my disabilities the denied me hypertension , musculosketal pathology of the cervical spine and chronic opioid use (because of my service connection disabilities) … is that not oxymoron.. no pun intended. Did I make a mistake filing as a secondary to ptsd? I could have filed for a Tbi service aggravation.. but if they won’t service connect me for this than who knows.
Any input would be great. I won’t post everything I have but this seems to warrant service connection
if I did not redact anything please let me know.
I was wondering if anyone else has experienced this, but I have email chains with a veterans claim representative where they refused to SUBMIT my claim because they said it would not be something I could claim. I ended up submitting my claim myself, then submitting to higher level review and it looks like my claim is getting approved. If I had not been tenacious and listened to the VA rep that wouldn't even submit my claim, I'd be out thousands in backpay and a rating. Has anyone experienced having the VA refuse to file the claim? I started thinking about how many vets this could have happened to...shut down before they even submit!
I got a denial for headaches and I'm not sure what it is saying. When I read it I think it's contradicting itself. Could someone please help me understand what it says? Also there are a lot of other times I reported headaches after service which are all in my VA medical records that they did not mention in denial so I'm thinking they didn't actually read my file?
This is from the letter.
Service connection for headache condition.
Service connection may be granted for a disability which began in military service or was caused
by some event or experience in service. (38 CFR 3.303)
While your service treatment records reflect complaints, treatment, or a diagnosis similar to that
claimed, the medical evidence supports the conclusion that a persistent disability was not present
in service. (38 CFR 3.303)
We did not find a link between your medical condition and military service. (38 CFR 3.303)
The evidence does not show that your disease developed to a compensable degree within the
specified time period after release from service to qualify for the presumption of service
connection. (38 CFR 3.307, 38 CFR 3.309)
Service connection for headache condition is denied since this condition neither occurred in nor
was caused by service. (38 CFR 3.303, 38 CFR 3.304)
Favorable findings identified in this decision: Service treatment record dated January 26, 2005
and July 25, 2007 shows headaches. Medical record dated January 13, 2020 from Canandaigua
VA Medical Center shows headaches. You have sufficient service to meet the minimum
requirements for presumptive service connection. The claimed disability is a chronic disease
which may be presumptively linked to your military service.
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,