NEXUS OPINIONS STATEMENTS

[Dustoff1970]

There is a misconception put forth on some veterans benefits forums that a MD doctor's formal nexus opinion is almost always needed for a vet to be granted disability benefit claims from the VARO and BVA.  This is not correct and misleading to the vet in an important way.

I have since 1985, 1998 to present days successfully won almost a dozen claims and BVA, CAVC court appeals without the benefit of a formal doctors nexus statement and representing myself with only one recent exception.  In all these claims and appeals I have used my extensive file copies of active Army, VA, VAHC, and private medical treatment records, hospital discharge summaries, test and lab results, doctors and nurses notes, medical prescriptions, along with other non medical evidence to win these claims and appeals. This evidence has served as the required nexus connection always.

Out of many dozens of VA C&P Exams over many many years did I receive one exam that gave a favorable opinion to my claim.

Here are just a few of many examples where I did not need a nexus statement from an MD or anyone else to win my claim.

1. PTSD and PTSD increases that were based solely on my Army Vietnam and Japan and VA medical treatment records.

2. TDIU based upon only my VA and VA medical treatment records and my submitted statements and forms

3. P&T TDIU rating since 1998 based mostly on my own submitted evidence, forms and one VA C&P favorable exam

4. VN Agent Orange IHD Ischemic Heart Disease claim based only upon my DD214, DD215 and other evidence of VN service and             private treatment records, test results.

5. VA VOCAB Training for both Accounting Degree and additional civilian helicopter pilot license

6. U.S. CAVC Court CUE appeal I won thru a court remand and based upon many years of VA medical and non medical evidence.

7. Loss of Use Disability Claim based upon medical and non medical records only with no doctor's nexus opinion.

This comment is not legal advice as I am not a lawyer, paralegal or VSO.

https://www.facebook.com/Vietnam-Dustoff-Medevac-112614780575067/?ref=pages_you_manage

BA Degree Finance & Tax Accounting, Former SEC CFP, Former Army Guard and Civilian helicopter pilot to Two Texas Governors, 

Advanced FAA and British CAA/Singapore Helicopter Airline Transport Pilot IFR License, FAA and CAA Helicopter Instrument Instructor Pilot License for all Weather Flight, etc. etc. 

Former volunteer Army medevac Pilot Vietnam with Purple Heart, CMB, DFC medal, AMs 1970,

Former volunteer UN civilian solo helicopter rescue pilot 1980 south China Sea (Saved over 1000 VN boat people)

 

Edited March 31, 2022 by Dustoff 11

[Dustoff1970]

well a few 4 year old vets haven't figured that out yet and keep insisting on always an actual docto 

Someone needs to correct their

just saying as I no longer give 

Edited March 31, 2022 by Dustoff 11

[john999]

For years when I went for VA C&P exams for mental health condition the exam doctor would look at my paperwork for about a minute and then ask me one question:  "Are you working?".....end of exam!  It did not matter about my symptoms or distress.  It was just about "can you work?"  This went on for years back in the 80's and 90's before I went on Hadit and learned a few things.  I can tell you that without very good IMO's I would still be at 30% instead of 100%.  Maybe you can win without an IMO but for a mental health condition it is risky business.  Mental health exams are about 99% subjective.  If the VA exam doctor believes that vets are fakers and free loaders you won't get a good outcome via just a VA exam.  I am not making this up!  Many VA doctors are horribly prejudiced agaist the vets they are supposed to treat.  They work for the VA because they cannot make it on the outside just like the military.

[Vync]

@Dustoff 11

2 hours ago, Dustoff 11 said:

No mention ever made of my 1151 claim but I did receive letter from VA secretary apologizing for my mistreatment and confirming I would be made P&T TDIU by VARO.

Because you never received a formal decision letter on your 1151, would that still be considered an active unadjudicated claim?

I know Berta had mentioned that  Citation: Vet. Aff. Op. Gen Couns. Prec. 8-97, VAOPGCPREC 8-97, 1997 classified 1151 "...may be considered “ancillary” benefits because they are payable in addition to the general compensation benefits...". Once a vet reaches the 100% schedular or TDIU pay level, if the VA causes an additional disability due to negligence, etc..., would pursuit of 1151 be fruitless and not produce any additional payments? I wondered if that might apply to your situation or other vets with similar occurrences.

2 hours ago, Dustoff 11 said:

Some ****** vets will be quick to jump in and say they did not have go thru all this drama to get their P&T benefits and I congratulate these braggarts on their good fortune as they have not walked in my shoes.  I have not for a very long time worried about any of my benefits ever being reduced as I still have all those letters and the 1151 claim plus well over 20 year of the P&T rating.

Reaching 100% P&T took 18 years and was a literal nightmare for me. My initial rating was 40%, but took two trips to the BVA over five years. It was recently corrected to 50% after I filed CUE for not following the regs and I have another at the BVA which could further increase that. The "Presumption of Regularity" was repeatedly disproved every time I filed a NOD or appealed because someone failed to read the evidence or failed to properly apply laws and regs, effectively repeating the same errors over and over. 

[brokensoldier244th]

3 minutes ago, Vync said:

@Dustoff 11

Because you never received a formal decision letter on your 1151, would that still be considered an active unadjudicated claim?

I know Berta had mentioned that  Citation: Vet. Aff. Op. Gen Couns. Prec. 8-97, VAOPGCPREC 8-97, 1997 classified 1151 "...may be considered “ancillary” benefits because they are payable in addition to the general compensation benefits...". Once a vet reaches the 100% schedular or TDIU pay level, if the VA causes an additional disability due to negligence, etc..., would pursuit of 1151 be fruitless and not produce any additional payments? I wondered if that might apply to your situation or other vets with similar occurrences.

Reaching 100% P&T took 18 years and was a literal nightmare for me. My initial rating was 40%, but took two trips to the BVA over five years. It was recently corrected to 50% after I filed CUE for not following the regs and I have another at the BVA which could further increase that. The "Presumption of Regularity" was repeatedly disproved every time I filed a NOD or appealed because someone failed to read the evidence or failed to properly apply laws and regs, effectively repeating the same errors over and over. 

 

If its rated 60% or more it would put him into SMC S territory. 

 

SMC-S

One type of SMC which is particularly advantageous to veterans is SMC(s). SMC(s) is available to veterans who:

have a 100 percent rating and an additional disability rated at or combining to 60 percent or more, or

who are substantially confined to his or her dwelling or immediate premises as a result of a service-connected disability.

The current SMC-S rate for veterans without dependents is $3,486.65 per month. This rate increases depending on the veteran’s marital status and other circumstances.

Housebound status is the main criteria that apply to SMC-S. Veterans who are housebound may live at home or in a care facility. Veterans who qualify for SMC-S may also be in a hospital ward. Typically, veterans who are housebound are unable to leave their dwelling due to their service-connected disabilities. This is typically a permanent circumstance.

[Vync]

31 minutes ago, john999 said:

For years when I went for VA C&P exams for mental health condition the exam doctor would look at my paperwork for about a minute and then ask me one question:  "Are you working?".....end of exam!  It did not matter about my symptoms or distress.  It was just about "can you work?"  This went on for years back in the 80's and 90's before I went on Hadit and learned a few things.  I can tell you that without very good IMO's I would still be at 30% instead of 100%.  Maybe you can win without an IMO but for a mental health condition it is risky business.  Mental health exams are about 99% subjective.  If the VA exam doctor believes that vets are fakers and free loaders you won't get a good outcome via just a VA exam.  I am not making this up!  Many VA doctors are horribly prejudiced agaist the vets they are supposed to treat.  They work for the VA because they cannot make it on the outside just like the military.

That's just sad. My MH exam took an hour and was well documented. Their opinion was vague "mere speculation" because depression might have been due to SC pain or non-SC pain, but I won on DRO review via relative equipoise. Of course, the non-SC pain was also granted SC at the same time.

[Vync]

12 minutes ago, brokensoldier244th said:

Housebound status is the main criteria that apply to SMC-S. Veterans who are housebound may live at home or in a care facility. Veterans who qualify for SMC-S may also be in a hospital ward. Typically, veterans who are housebound are unable to leave their dwelling due to their service-connected disabilities. This is typically a permanent circumstance.

After winning SC for heart attack after two botched VA C&P exams, I was granted a single 100% rating for three months per rating criteria, plus already had a separate and distinct 60% rating for something else. The VA granted me SMC-S housebound until the re-eval which dropped the 100% rating to 60%. I did not have an additional separate 100% rating to maintain SMC-S status. It's a shame that the lawmakers and VA consider P&T status in lieu of the 100% like they do for TDIU vets.