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Not Sure - Would Really Like a Consensus


harry59

Question

Fellow Veterans,

A couple of days ago I found out that I was awarded 100% P&T. I was at 80%, but my mental health claim (that was finally decided on) pushed me over the line. I do not have my Decision Letter yet so I do not know any specifics. Now that I'm P&T, I'm really on the fence as to whether or not I should fight for my denied secondary claims of Hypertension and Obstructive Sleep Apnea (OSA). I'm not sure for a couple of reasons:

1. I'm not sure if, at my age (62), I will ever be reevaluated for mental health, which could possibly lead to a rating reduction in a future C&P exam. Is there an age limit where the VA will not reevaluate mental health claims? I know the M-21, Part IV, states that "with only rare exceptions, veterans over the age of 55 will not be recalled for reexamination." but I'm not sure if that pertains to mental health claims.

2. As you know, DIC can be awarded to a spouse if the veteran had been P&T for at least 10 years, or if the veteran dies from a service-connected illness or injury. DIC for my spouse is the primary reason I would fight for my denied secondaries as it is likely that hypertension and/or OSA could likely be a contributing factor in death. I know the VA is looking at changing the rating schedule for OSA, which will not benefit veterans.

So, should I continue my fight???

 

Thank you to all repliers!

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  • HadIt.com Elder

55, Generally yes, and P&t are usually left alone. These ages are for any contention not just physical ones .
 

You aren’t going to get reevaluated so soon after just winning your claim and you aren’t claiming anything that is MH related. We don’t automatically look at every single contention and reevaluate it. We don’t have time to do the claims we have now. 

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I say to always go after it. 

If you are leaving anyone behind, you want them SC so they can get some benefits if something happens to you

If you pass away from something that is not SC they can deny DIC to your family.  

I fought everyone of mine and won.  I have never had another review of other things and if they did, we would go at it again.

Always tell the truth and you will be fine.  

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  • HadIt.com Elder

When I was just starting out on my claims, I read that in order for my wife to receive DIC, I would have to die from a service connected condition.  So, with that said, I kept adding conditions related to my service time as they come up and trying to get them service connected.

I was service connected for hypertension, HBP, in 2008 at 0%, but the knowledge my wife would be taken care of was worth more than the monthly stipend at that point.

I am now 100 P&T, but with that win I was denied on one condition that could lead to my demise, so there will be an appeal.

I have worked my case harder and have a bunch more in the basket since I started in '08.

Carl

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10 hours ago, brokensoldier244th said:

You aren’t going to get reevaluated so soon after just winning your claim and you aren’t claiming anything that is MH related. We don’t automatically look at every single contention and reevaluate it. We don’t have time to do the claims we have now

An if you believe this i got a bridge for sale.lol

Now we have many posted to show that when you apply let say for smc benfits

The VA treat it as a increase rating claim on all your disabilities.

An try to order exam for all your disabilities

This has been proven.

Now I am not saying that that will happen in your case.

But it is something to be aware of.

There is a chance.

 

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  • HadIt.com Elder
Posted (edited)

He’s not applying for Smc/housebound or aid and attendance, or IU, he’s applying for single contentions, and he’s already at 100%, and he recently got rated.
 

We don’t have endless money, we can’t just authorize exams for the hell of it. 
 

 

 

Edited by brokensoldier244th
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Mostly, I agree.  Go for it, if it will or could benefit you OR your family.  

In fact, since you are apparently 100 percent, you could easily qualify for an additional 380 or so per month, if you are awarded 50 percent for OSA.  

In a nutshell, statuatory SMC S  (housebound). is awarded when you have a single 100 percent rating and additional ratings which combine to 60 percent or more, which are seperate and distinct.    (You dont have to prove you cant leave the home with Statuatory SMC S (housebound).  

There is a specific criteria for reductions, in the regulations, and "applying for an increase" is NOT a criteria for reduction.  They cant reduce you "unless you meet certain criteria", which generally means your disabilites have "actually improved under ordinary conditions of life".  

Sometimes, the VA "tries to reduce you anyway", but, "it wont stick" unless you meet the criteria.  https://www.law.cornell.edu/cfr/text/38/3.951. and

https://www.law.cornell.edu/cfr/text/38/3.344

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