...Consider the need for SMC and A&A

[chris_2pher]

Hello everyone. First post here. Hope all is well.

Currently 70% PTSD with TBI and on IU since 2010. I also have 40% total of other ailments (back, neck, knees). My wife is my official VA caregiver and on the Post 9-11 Cargiver program.

In 2018, I made attempts to get a higher rating but was denied not long after the OTC appointments. I then submitted an appeal to the BVA.

In Feb of 2024, I received a letter from the VBA that a 100% rating for PTSD with TBI residuals was granted. A few more pages in the letter regarding Diagnostic Code 8045. It is written that the 'VA should consider the need for Special Monthly Compensation for such problems....."

It also states a remand for sleep apnea.

I have searched the internet about this topic but still don't understand. I did not apply for SMC at all. Does this mean they are going to switch me? What do they mean about remand?

Please chime in if you have any insight. I would love to hear from you. Thank you in advance.

[Lemuel]

14 minutes ago, chris_2pher said:

First off, I'm so sorry to hear about your wife. My heart goes out to you and your family.

My wife is a former Medical Assistant at Kaiser and my caregiver with the VA Caregiver Program.

I don't have space-outs but I do have episodes where I don't realize where I am or remember how I got there. But I do snap out of it and say, "Nooooow I remember!". Then I continue my day.

My wife does my meds from ordering and administering, as well as food prep. I burned my parent's kitchen. lol. Pretty much keeps me out of danger.

I do not have representation yet. Depending on some outcomes, it may be beneficial.

I'm wondering if I should regret simply applying for an increase. Now that they mention SMC and A&A as a possible result.

 

Those episodes are probably complex partial seizures.  You need to tell your primary care about them in writing via my health and ask for a neurology consult.  An EEG is what I would expect the neurologist to order.  Perhaps by in home telemetry like my last one.  And I would expect it to show tracings similar to those in the 2010 study published in "THE BRAIN"; "Cortical Slowing in Temporal Lobe Epilepsy".  Assuming from your episodes you had a frontal TBI or frontal injury by countercoup.  Have you read your neuropsychological test report?  Mine shows occipital lobe injury by countercoup from the frontal TBI.  Because of the type of MVA I had, I could have had blows to the head from both directions bouncing around.

The problem with epilepsy is that your first Grand Mall Seizure may be your last.  That is what happened to my wife after several "colonic seizures" which stressed the heart and then lead to status epilepticus and death by heart failure with epilepsy as a contributing factor.  All because a cardiologist reduced her seizure medicine without doing that EEG telemetry to improve her pulmonary function.

This is why I insist on a nurse monitoring my seizure medication.  If I get interrupted by a phone call or someone, I forget to take my meds.  With this dispenser, the alarm interrupts whatever and I take the med, if necessary, apologizing for the interruption.

You are exactly in the position of Mr. Haskell.  His wife was medically trained but not a nurse.  Even me, the social worker asked me if I could not get my wife to do that for me.  And the nurse said it was "easy".  But it is not easy.  Even the Nurses who are trained to do it get it off track at times.  But at least I still have it together enough to recognize that and call them to correct the situation.

I am not saying you need the Nurse over your wife.  It is just not fair to put the responsibility on your wife that may lead to your unexpected early demise.  Think about how she would feel.  Better to have someone not related to you taking that responsibility.  It would not mess up their lives nearly as badly as it would weigh on your wife.  Her effort is well meaning and commendable.  But think about it together.  Make the decision together and on solid information.

Nothing was said about Mr. Haskell's cause of death.  All we know is that he had a severe TBI and was home bound.  You and I are not that severe.  And yet I am having to consider selling my house to go into higher level of care.  And, without your wife you might also soon even though you recover from your episodes fairly quickly now.

CTE is diagnosed in autopsy.  But we have the pre autopsy symptoms.  It is just that you have to have severe encephalopathy for it to show well on an MRI of the brain.  That does not mean they do not look for signs on the MRI screens.  It is just they do not have as good of MRI reading software as Japan, China and some of the other 19 industrialized nations that are above the 3rd world in medicine.  We are not above.  There are another 19 3rd world countries above us in WHO health care ratings.  In the 50s, 60s and into the 70s we were tops.  Now we are riding on our history reputation not our current productivity in health care. 

The last MRI I had in Japan, the neurologist pointed out 4 damage spots on my brain where there was shrinking.  Japan's reading software is the 20 years ahead of ours that we were ahead of theirs the first MRI of the spine I had in 1994 in Japan.  The U S software could show the shreds of the blowout of the spinal disc capsule.  The Japanese read the desiccated discs as being herniated discs needing orthoscopic surgery.  I had to explain to the physician that what was causing my sciatica was another fragment of the already ruptured disc or another ruptured disc and what I had seen on UCLA Medical Center reading software I had been shown.

All Japanese physicians have the best reading software available.  Only the richest neurosurgeons in the U S can afford the best and probably they would have to buy it from Japan instead of GE.

 

[Lemuel]

On 3/17/2024 at 12:31 PM, chris_2pher said:

Hello everyone. First post here. Hope all is well.

Currently 70% PTSD with TBI and on IU since 2010. I also have 40% total of other ailments (back, neck, knees). My wife is my official VA caregiver and on the Post 9-11 Cargiver program.

In 2018, I made attempts to get a higher rating but was denied not long after the OTC appointments. I then submitted an appeal to the BVA.

In Feb of 2024, I received a letter from the VBA that a 100% rating for PTSD with TBI residuals was granted. A few more pages in the letter regarding Diagnostic Code 8045. It is written that the 'VA should consider the need for Special Monthly Compensation for such problems....."

It also states a remand for sleep apnea.

I have searched the internet about this topic but still don't understand. I did not apply for SMC at all. Does this mean they are going to switch me? What do they mean about remand?

 

The "remand" means the Agency of Original Jurisdiction (AOJ), your VARO probably, has to redo your rating and consider SMC.  Which means your date of SMC will probably from you claim for increase.  Depending on the Laska v McDonough outcome, it could be SMC-T, paid at SMC-R2 or lower.

I skipped the questions that appear most important to you and went off on my rant.  I apologize.  This should have been my first post to you.  And then I could have done the rant.

[Rattler]

Lemuel

I am so glade to see you back on the site and contributing. 

[Lemuel]

9 minutes ago, Rattler said:

Lemuel

I am so glade to see you back on the site and contributing. 

I am up and down.  Symptoms of CTE.  There are days I am off and cannot contribute.  Sometimes days in a row.  I think I am getting regulated to oxygen therapy and doing better.  Seems like I am improving with physical therapy, I hope.