C&P for Scar

[x020574]

I am currently 100% via TDIU and I think.... 94% scheduler (if my VA math is correct?). I ask my VSO to submit a claim for painful scar from a IHD CABG at San Francisco VAMC, for which I was unaware of until a few years ago. My most recent C&P was an increase for hearing from 0% to 10%.... That brought me to 94%, dame, to bad it didn't hit 95% @$#%

Current Service connected: 70% MDD, 60% IHD, 30% Hearing Loss, 10% Tinnitus, 10% DMII  Awarded TDIU 100% Permanent

This morning I had the C&P for Scar and he wrote it up as 'painful'. He also said my last C&P was in 2013 and they should have listed this back then. Although this is the only claim for 'painful scar' I have submitted, if he is correct, does this amount to a mistake or cue? I don't think they are going to backdate the effective date... and if they did, I believe the TDIU was from 2013.

Last question: is my VA math correct and the 10% award for painful scar push me to at least 95%, thereby rounding up to 100%? That's what I'm hoping for.

 

[Whodat]

Greetings,

If I understand you correctly, if this is your first time applying for scars, I do believe your eed will be the date that you have filed. 

Sounds like in 2013, you had a c&p exam for a primary condition but did not claim scar secondary to your primary condition. 

As for as VA math, looks like you are correct. When in doubt, I use Hill & Ponton VA calculator. 

[deedub75]

Did you apply for an increase or a temporary 100% (temporary 100% is also a claim for an increase) after your IHD CABG? If so, you should have had a C&P exam for it and they should have measured the scars and asked you if they were painful. 

What was the C&P exam in 2013 for?

Each time I've had a surgery on something service connected, I always put in a claim for temporary 100%. It basically bumps me up to SMC-S for a month or two for recovery. They would set me up for an exam to get the current severity after the surgery and the always measured all of my scars and then scars. I never had to apply for scars because they always added them to the claim. A have one scar that's 10% and 3 or 4 others that are 0%.

[El Train]

Ya, it won't go back to 2013.  

Here is a link to a VA percentage calculator.

https://www.hillandponton.com/va-disability-calculator/

[Richard1954]

You would think the va would have considered the scars at your prior exam, and they should, but unless you ask for a rating of the scars they are not obligated to consider them.

I had knee surgery at the va in 1997, I never knew I could get a temporary 100% during the recovery period, and I never realized I could be rated for the scars.  It wasn't until 2016, that an examiner measured my scars, and it was not part of my claim. However, the exam form for knees  requires them  to look and measure for scars. In my case my scars are not painful, so while service connected, it didn't increase my compensation. 

I sugest you look at the form that was used for your last exam and see if there is a requirement on the form for them to look at and measure any scars. The new form came out in Jan 2022, so that form will not help you. If there was a requirement for them to measure the scars, and they did not , I suggest you may have a Clear and unmistakable (CUE) based on an inadaquate exam.  If that exam was completed at the VA, it will be in your medical records. If it was done by a contractor, you will have to request a copy from your VA regional office. 

To answer your question, no the effective date of your new rating for the scars will be the date the va Received the new  claim.

Best of luck, I really think you may have a shot at CUE depending on what the examining requirments were.  I say may because, the raters did not have this information in front of them in 2013, and under the rules for cue the information had to be in front of them at that time, and it they missed the information, it would be a cue, it your case,  the information about the scar was not in front of them when they made the decision on the claim in 2013. CUE is not an easy call, but I suggest your try anyway, remember noting ventured nothing gained.

Edited June 12, 2022 by Richard1954

[x020574]

On 6/10/2022 at 10:49 AM, x020574 said:

I am currently 100% via TDIU and I think.... 94% scheduler (if my VA math is correct?). I ask my VSO to submit a claim for painful scar from a IHD CABG at San Francisco VAMC, for which I was unaware of until a few years ago. My most recent C&P was an increase for hearing from 0% to 10%.... That brought me to 94%, dame, to bad it didn't hit 95% @$#%

Current Service connected: 70% MDD, 60% IHD, 30% Hearing Loss, 10% Tinnitus, 10% DMII  Awarded TDIU 100% Permanent

This morning I had the C&P for Scar and he wrote it up as 'painful'. He also said my last C&P was in 2013 and they should have listed this back then. Although this is the only claim for 'painful scar' I have submitted, if he is correct, does this amount to a mistake or cue? I don't think they are going to backdate the effective date... and if they did, I believe the TDIU was from 2013.

Last question: is my VA math correct and the 10% award for painful scar push me to at least 95%, thereby rounding up to 100%? That's what I'm hoping for.

 

 

On 6/10/2022 at 11:14 AM, Whodat said:

Greetings,

If I understand you correctly, if this is your first time applying for scars, I do believe your eed will be the date that you have filed. 

Sounds like in 2013, you had a c&p exam for a primary condition but did not claim scar secondary to your primary condition. 

As for as VA math, looks like you are correct. When in doubt, I use Hill & Ponton VA calculator. 

 

[broncovet]

TDIU or 100 percent schedular wont change your compensation "unless" it puts you eligible for Statuatory SMC S, which is 100 percent, (this will include TDIU), plus an additional combined 60 percent seperate and distinct.  

It may make you feel better not to have to send in the tdiu form each year, which Im not even sure its required anymore anyway.  

You can go ahead and apply, but if i understand fully your post and situation, the only time it could result in additional compensation (other than SmC, already mentioned) would be an eed.  

Since you didnt apply till now, that may not apply.  

As far as effective dates, there are 2 seperate categories..one for SMC and one for everything else.  You see, you should not have to apply for smc and it should be effective the date you met the applicable criteria, even if you applied after that.  

The painful scar "could" mean an earlier effective date and back pay, but not based on what you posted, because your effective date is the later of "the claim date" or facts found (the date the doc said you became disabled).  

Its not a cue for VA to "not consider you" for a scar, until you apply for it, just because its in your records.  A possible exception is because VA is supposed to assume you are seeking the max benefit, and, ignoring a painful scar is not the max benefit.  My advice is to wait on a cue..how are you gonna cue a decision that has not yet been made (in regard to painful scar).  Then, when you get the scar decision, you can decide whether or not to appeal the effective date, arguing you were seeking the max benefit, and it was in your record and VA did not consider it. 

Go ahead and apply, dont worry about cue just yet..you have to have a decision to cue..