100% p&t exam

[SPO]

Starting a new thread to avoid confusion.  I was awarded 100% p&t on 12/1/2020, effective 7/7/2020 (date of last c&p).  However, in the decision letter it says they are scheduling exams to evaluate my current severity.   What is the point if I’m already 100% p&t. Are they just looking to take away what they just gave me?

[SPO]

No,  I was granted 12 issues by the board, the RO then gave me ratings which then pushed me to 100% p&t for all 12 issues. Those same 12 ratings are still deferred with in person exams requested.   

[pacmanx1]

Best thing to do is wait for your decision and if VA contacts you about exams, just go. Your decision letter will explain a lot more than the generated letter from VA.gov. You can also try to ask your VSO for a preliminary letter.

[Carl the Engineer]

I believe when you get to 100%, and or, TDIU, they do a full look at your VA record and poke around to see if they owe you something more, or you owe them something more, to finalize it, etc.   

I went 100% back in June, I believe, and they poked around and found that I had been paid seperation pay in 2008 and the they (VA) had recouped it, before they started actual payments to me, back in 2011.  This spring, after I got my backpay (retro), they withheld about 900 bucks from my VA comp and started, not one, but two new claims, regards my sep pay.  I requested a hearing and went to the hearing in MIlwaukee a long time ago.  It hasn't gone in front of the judge yet is what the "VFW" is telling me, but it looks good for me to get my 900 bucks, but it's been since June.

However, the most important part is I am still 100 P&T and I am getting my comp deposit every month. 

LOL,

Hamslice

I wouldn't worry too much, and I surely would not miss a C&P exam.  Even if I had a 300% rating.  Just sayin..

 

[pacmanx1]

In my case when the VA granted me 100% scheduler P & T, I had several claims on appeal not deferred but the BVA just recently granted me a separate effective date going back to 1998. When I say separate rating, this particular rating in not included in my 100% combined rating so the VA had to retro pay this award back to my original claim prior to my 100% rating decision.

[pwrslm]

You have been given a lot of good info here. 

Regarding the 0% rating up until 07/20, scour your medical records on this to see if you ever reported painful motion in this condition.  If there is notation of pain that was not addressed, that date should be your effective date. Psoriatic arthritis causes swollen, stiff, and painful joints.

Painful Motion (§4.59): This is the most commonly used principle. Basically, regardless of how much the service member can move their knee (or any joint), if it hurts when they move it, then they will get at least the lowest Compensable rating for the knee–for example, 10% (money) instead of 0% (no money).

You would need to request a HLR on this because if it were already in your records you would not consider that new evidence that is required for a supplemental claim. Alternatively, you could also present them with a lay statement making the claim on painful motion and point out that they ignored evidence on this issue in you medical file. That may work for a supplemental claim.

 

Edited December 8, 2021 by pwrslm

[pacmanx1]

2 hours ago, pwrslm said:

You would need to request a HLR on this because if it were already in your records you would not consider that new evidence that is required for a supplemental claim. Alternatively, you could also present them with a lay statement making the claim on painful motion and point out that they ignored evidence on this issue in you medical file. That may work for a supplemental claim.

In this particular case the veteran's claims/ratings are deferred still pending/open and there is no need to request an HLR or supplemental. The VA is already in the process of determining the veteran's decision by requesting new medical exams/opinions.