VA Hospital Injury

[knoxcap]

Hope someone has knowledge. I have been getting treated at a VA hospital for many years pertaining to my back disability. I have a 20% disability. Pain management had been giving me different injections and treatments for 20 years. My last set of injections was last October. I really like my doctor and trusted him. He had another new doctor assisting him and I remember him telling the other doctor to apply the injection to the other side of my spine and how to do it, etc…. As a few months went on, I started having advanced problems to my right leg all the way down to my toes. I saw a personal doctor about the pain in my feet thinking that it was a foot problem. He said it was the back.  I was getting nauseated, whoosie, headaches and thumping in my ears and saw a personal doctor and he wasn’t sure, allergies. I finally couldn’t take the leg pain and got in to see my surgeon thru community care. He did a full work up and concluded we needed to go in and clean the arthritis around L3-S1. When he got in he luckily found a pinhole leaking spinal fluid on a nerve in my spine. The repair he had to do was extensive and painful. I’m two weeks post op and in extreme pain and numbness in my leg. I read the community care surgeons report and he listed the problem as incompetence. All the problems I was having was due to the leak. Should I say something to pain management? What direction should I go?

[brokensoldier244th]

You can file an 1151 claim. 

[knoxcap]

I’m a little confused regarding 1151 claim after reading what I could find. Is this considered an additional claim on top of my 20%? I have a total disability of 80% TDIU already.

[brokensoldier244th]

You could request an increase since you are saying that it is worse. You would add the 1151 to it since you say you have evidence of it being made worse by VA provider(s). Or, you can contest the rating as a supplemental/appeal based on the new evidence of the VA providers making it worse (if it happened before you were rated). If you weren't rated yet at the time it happened it could be filed as an appeal of the prior rating- or you could just file for an increase if you already were rated when it happened. Its really up to you how you want to approach it. 

[knoxcap]

Thank you for responding. There is not a lot of info that I’m finding, I appreciate your info. I’ve been TDIU for 20 years and so it is definitely an old disability. I’m already paid at 100% so I am not seeing that pursuing this is worth it if the max is 100% unless the 1151 works like SMC. 

[brokensoldier244th]

That is doesn't- its just a category of claim that is covered under a CFR (hence, the 1151). Its not topper, though, unless it bumps something over a threshold. 

 

[broncovet]

Broken spoke gave good information.  

    You have nothing to lose by applying for an increase and/or new related claims.  I would go for both.  

While I have not filed for 1151, maybe some have and can chime in.  Since you are at 100 percent, the next step up is likely smc s.  

While we have posted the criteria before, there are 2 ways to get smc s.  

    1.  Statuatory SMC S.   This is when you have a single 100 percent rating (tdiu counts) and additional ratings seperate and distinct that combine to 60 percent or more.  

    2.  Housebound in fact.   This generally requires a c and p exam, and your doctor would need to opine you are substantially confined to your premisis.  This does not mean you never leave your home.  VA thinks it means you dont leave the home except for doc appointments.  However, congress meant for SMCS to be paid for Vets who are unable to leave the home "FOR WORK".  This means you should be getting smc s, because if you are tdiu, you are almost certainly not working and traveling to work.  

    SMC S is about another $450 per month, so I dont recommend you ignore this and not apply.