Ask Your VA Claims Questions | Read Current Posts
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules
- 0
-
Tell a friend
-
Recent Achievements
-
Our picks
-
VA Disability Claims: 5 Game-Changing Precedential Decisions You Need to Know
Tbird posted a record in VA Claims and Benefits Information,
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
Rating Issues
Continue Reading on HadIt.com-
- 0 replies
Picked By
Tbird, -
-
Are all military medical records on file at the VA?
RichardZ posted a topic in How to's on filing a Claim,
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.-
- 4 replies
Picked By
RichardZ, -
-
Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
- 0 replies
Picked By
Tbird, -
-
Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
-
Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
-
Question
dennis simpson
I am going with a claim to try and increase my current rating of 60% ischemic heart disease to 100%. I am basing this on testing that I feel VA Medical reports which are vague and are not telling the the entire and accurate
story of my condition. Has anyone experienced the same thing with the VA? Also, can anyone offer advise before I file this claim as to what I may need to add to the letter below.All my medical reports are in my VA history, so C & P examiner can get what ever they need. I have just pulled small segments from certain reports to emphasize my points in this letter. Please read and offer your comments. All will be appreciated, whether positive or negative.
Department of Veterans Affairs
Evidence Intake Center
P.O. Box 4444
Janesville, Wisconsin 53547-4444
Dear Sir/Madam,
**Subject: Request for Re-Evaluation of METs and Disability Rating Increase**
I am writing to respectfully request a re-evaluation of my current disability rating due to observed inconsistencies in recent assessments and the need for a more accurate measurement of my METs level. My ischemic heart disease, a service-connected condition, has significantly impacted my daily functioning, and I believe the current evaluation does not fully capture the severity of my worsening condition.
**1. Inconsistencies in Testing and VA Reports:**
Upon reviewing the recent test results and VA reports, it is apparent that there are discrepancies needing resolution. The METs rating, determined through an interview-based assessment, appears vague and not reflective of my current physical capabilities. And definitely outdated. Given the serious nature of my heart disease, I am concerned that these estimations do not adequately reflect my daily experiences and struggles.
**2. Concerns Over Interview-Based METs Testing:**
The decision to estimate my METs based on an interview, rather than a physical test such as a treadmill exam—which I was denied due to perceived risk factors—leads me to question the accuracy of this estimation. Despite my ejection fraction being noted near 40%, the reliance on non-physical testing means critical aspects of my condition may not have been fully captured.
**3. Detailed Observations Contradicting Current VA METs Rating:**
- **Physical Limitations:** My daily life is severely restricted by my condition, with significant
changes in my abilities compared to four years ago, including:
· Excessive weight loss.
· Inability to perform any yard work whatsoever. Light or otherwise.
· Severe dyspnea and fatigue when walking even half a block at a slow pace.
· Shortness of breath
· Take baths instead of showers, due to standing exertion.
· Frequent breaks needed while eating due to tiredness.
· Difficulty changing clothes due to fatigue.
· Occasional chest tightness with minimal exertion. (Angina)
· Experience of chest pain and dyspnea during my most recent non-treadmill stress test, as documented in my VA records.
· Resignation from my job due to lack of stamina; inability to be productive for even several hours.
· Sleep Apnea diagnosed - Extreme Sleep issues- cpap use
· Relocation to a one-level home due to inability to manage stairs.
· My third major heart attack in 2019 occurred during light yard work, not involving strenuous activity. I was not even mowing lawn, just picking up sticks.
· Frequent extreme dizziness, sometimes feeling like I'm about to faint.
· Equilibrium unstable. Persistent unbalanced feeling, leading to frequent stumbles against walls.
· Need for multiple rest stops from the car to the appointment area at every VA hospital visit.
· Requirement for several daily naps due to overwhelming weakness.
· Leg and body weakness when walking short distances.
· Driving limited to very short durations; fatigue sets in after an hour of driving.
· Full-time care is provided by my daughter, and has been for almost three years now. She manages all household chores and maintenance. This includes cooking, cleaning, yard work, grocery shopping, taking out trash, and other personal tasks. This is on a 24/7 basis, and she lives with me.
· Recent VA tests categorized me as "frail" with a level 4 risk factor, yet supposedly according to their assessment of my functional capacity (interview based), I can perform fairly normal activities without many issues. This conflicts with one another.
- **Reports and Testing:** The interpretations of tests such as myocardial perfusion images and low-dose CT scans suggest the need for more definitive data to accurately determine my left ventricular ejection fraction (LVEF). There are too many uncertainties in these reports. For example, one report states as follows:
> ["Moderate sized, moderate to marked severity fixed perfusion abnormality involving the basal to mid inferolateral and basal inferior wall... The left ventricular ejection fraction is probably close to 40% based on visual assessment, though the calculated left ventricular ejection fraction of 32% might be slightly low due to contouring errors." Clearly his ejection fraction is depressed as it has been documented in the past but we need more data to know exactly what his LVEF is. In the meantime without evidence of ischemia on a stress test or angina clinically we would not recommend cardiac catheterization."] <
There are two points here I wish to make concerning reports, testing, and conflicting information.
Point 1: The statement above from the VA says in the last sentence; "In the meantime without evidence of ischemia on a stress test or angina clinically we would not recommend cardiac catheterization." Whereas, the report on my stress test shown below clearly indicates that I experienced dyspnea and chest pain during this exam, and this was not on a treadmill;
> ["Subsequently, an intravenous infusion of regadenoson was performed. Standard myocardial perfusion images were obtained after tracer injection at the peak effect of the pharmacologic stress agent. Low-dose CT images spanning the heart were obtained for attenuation correction. The patient experienced dyspnea and chest pain during the exam." ]<
Point 2: If the ejection fraction cannot be determined with any degree of accuracies using sophisticated equipment, how can my METS be considered accurate with a few questions in an interview. Not enough questions have been asked to evaluate my cardiovascular functional capacity in regards to METS. Previously my rating was 3-5 Mets. As of now the VA has updated my METS as less than 4. Not 4, less than 4. VA Ratings in regards to METS are 1-3, 3-5, 5-7, & 7-10. So, what does less than 4 actually mean? If dealing in whole numbers, to me it means 3, at the most. This is what I mean by vague analysis.
This is one comment taken from my latest medical files;
> ["CARDIAC FUNCTIONAL ASSESSMENT:
Functional Status less than 4 mets limits activity due to DOE.]<
**4. Request for a New METs Rating Interview or Evaulation:**
In light of these observations, I urgently request a new, comprehensive interview that accurately reflects my current health status and functional capabilities related to my METS, because I am experiencing severe limitations, and debilitating symptoms appear with very minimal exertion. With what I have listed above, I believe my MET rating should be between 1 and 3, and that I should be considered 100% disabled in regards to my Ischemic Heart Disease.
It is essential that this new assessment address the noted inconsistencies and involve a detailed examination of my actual physical capabilities, regardless of ejection fraction findings.
**5. Application of VA Policy on Reasonable Doubt (38 CFR 3.102):**
Given the balance of positive and negative evidence regarding the extent of my disability, I request that any reasonable doubt be resolved in my favor, as stipulated by VA policy found within (38 CFR 3.102). This supports the need for a fair re-evaluation, given the significant potential for underestimating the impact of my condition based on current evidence.
**Conclusion:**
I am committed to providing any additional information or participating in further assessments required to accurately determine my condition. Your attention to this matter is crucial for adjusting my disability rating from 60% to 100% and ensuring that I can continue to manage my health with the appropriate support and resources.
Thank you for considering this request for re-evaluation. I look forward to your timely response and am available for any further information, testing, or clarification needed.
Sincerely,
Link to comment
Share on other sites
Top Posters For This Question
5
3
1
Popular Days
Jul 29
6
Jul 26
1
Jul 30
1
Aug 2
1
Top Posters For This Question
dennis simpson 5 posts
broncovet 3 posts
ShrekTheTank 1 post
Popular Days
Jul 29 2024
6 posts
Jul 26 2024
1 post
Jul 30 2024
1 post
Aug 2 2024
1 post
8 answers to this question
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now