VA Disability claims

[DysfunctionalVet]

Took 16 months but 100% schedular for PTSD. Upper airway resistance syndrome and foot injury deferred.

It's odd because I'm working and told the examiner I work but am 7 months behind. I figured 70% max.

[1CavScout]

I just saw a specialist at the VA for an issue I was just service connected on. My regular doc sent me to the specialist. I just got a statement in the mail that they billed my civilian insurance company. I thought the VA was supposed to cover service connected treatment. Am I wrong on this?

[RandyRhoads]

Originally Posted by 1CavScout

I just saw a specialist at the VA for an issue I was just service connected on. My regular doc sent me to the specialist. I just got a statement in the mail that they billed my civilian insurance company. I thought the VA was supposed to cover service connected treatment. Am I wrong on this?

Don't take what I say for fact, but my understanding is they will pay your medical bills, unless you have insurance. Now if it's service connected, you'd think they would pay that regardless. But I don't know. They may have some clause passing it off to your private insurance. Wouldn't surprise me.

Originally Posted by KOOKARMY

Coming up on 2 years.... Just finished a sleep study so thats at least some progression. Also was told i have scoliosis... not sure what % that will translate into but we will see over the next few months hopefully.

My guess would be 0. Seeing as it's normally hereditary, unless you can prove it was service connected. (Good luck)

Originally Posted by CrossedRifles

As a reminder to everyone, make sure you actively seek treatment..

I didn't leave my house much for anxiety reasons and didn't see my shrink or enroll in VA healthcare. Now the VA wants to reduce my 70% that I was just awarded half a year ago. (which I got after a year of fighting)

In the VA's eyes, no treatment = getting better.

I've heard that a lot. I went, I don't know, 3 years without treatment without anything from the VA. I was actively seeking treatment, just not receiving it. They also had no record of me seeking it, despite having family and friends witness it. It's almost like, I don't know, they were intentionally not treating me? (Pretty sure I was one of the ones who's records was systematically destroyed because of an overlogged system).

Once I got away from that VA and to a new one, it was like a whole new world. People actually pursing you for treatment, rather than pushing you away. Amazing.

[cc56]

I just found out my private insurance was charged for labs. I was still covered under the 5 year post deployment thing. I was surprised.

[BoJackUSMC]

Not surprised at all, good luck

[1CavScout]

I think I might need to finally get a lawyer. I took my case all the way to the BVA in DC and won, but they service connected me on a different injury that what the judge ordered (and an injury I don't have). I know they did this because the rating schedule is lower on what they connected me on. It amazes me that a rater at the VA can ignore a Federal Judge at the BVA in DC. The games continue with the ****ing VA...

[rero360]

After over 3 years my claim was finally completed, 20%, tinnitus and TBI, plan on fighting the back denial, yes I have genetically a bad back, but there is no way that the 14 years of combat arms have played no part the deterioration of my back, including the two fractured vertebrae. I plan on having my hearing checked again when I retire, I wouldn't be surprised if my left ears crosses the threshold at that point.

[BoJackUSMC]

I just completed 6 c&p exams for my tbi. They gave me 0% for taking bullet twice, 4x unconscious, and numerous ied exposure.

[1CavScout]

Just have to keep fighting. It's been 8 years for me, and who knows how much longer to fix what they just screwed up.

[BoJackUSMC]

Let see what happens.... I just filed back to increase that rating. ..

[steelrain82]

I have to start my claim. Bilateral osteoarthritis of the knees, sleep apnea, chronic ear infections from blown ear drums. I've been waiting too long to file these. This will be the third time for the ears. Denied twice for those because of no evidence despite all sort of military documentation

[DysfunctionalVet]

Here's what I noticed from my claims:

I had documented injuries in my service records. However, I haven't been having constant or regular medical appointments for those injuries. Subsequently they were denied. In the VA's opinion I did have injuries but since I didn't receive treatment I wasn't having long term effects.

The only item approved was PTSD. I've been seeing my VA doc consistently for 2.5 years. Take 4 meds for it. I work but in reality I just show up and sit in a back room. I was granted 100% schedular.

[BoJackUSMC]

Pending phase now... hoping for best.

[SaintCloud]

Took 26 months to meet a decision on my claim. The large sum of money obtained at the end of the nightmare was nice though.

[Funtimes]

So I did get my decision from the VARO. They denied my claims. I'm really irritated with them pretty much just doing whatever the hell they want. I know it's hard for to really sit back and take an objective look at their evidence and stuff. I like to think with having worked with attorneys and being a law student, I can do so.

To support (1) claim, I had submitted: (2) Private Independent Medical Opinions (IMO), 14 lay statements in support, my wife's statement, my statement, a submission of 20 medical treatise that I used to supplement specifically my two dr's opinions and lay statements from friends.

The VA Submitted: (1), three paragraph medical "examination," which was done without me present, without questioning me, or looking at evidence recently obtained medical evidence, and had "medical" *conclusion* of "the Veteran didn't complain about it in service, so the reasonable medical conclusion is that the condition did not exist."

The VA's statement was found to be more persuasive.

[boltmopar]

Originally Posted by BoJackUSMC

Pending phase now... hoping for best.

Good Luck Bud, I know you been fighting for awhile.

[1CavScout]

I hired an attorney. I already won my claim, but they screwed me with the rating. I am done dealing with the VA by myself. My lawyer was actually surprised I got as far as I did on my own. If I had to do it over again, I probably would not have even bothered. I definitely would not do it again by myself.

[USMCbassman]

Took me 4 months from beginning to end and a rating of 80%. Overall it was 6 months and that's because I was initially put in the "slow track" the DAV rep told me and I was suppose to be in the "fast track". I waited until I was under 60 days from EAS/Retirement. Once I was moved over it went rather fast. SD VA seems to move pretty quick and efficient.

While I'm good with my percentage I'm not thrilled with a lot of the crap they didn't pick up (e.g. my hearing, broken bones, and back). They did give me a percentage for degenerative joints (I'm assuming they are lumping my spine/back issues in to that).

I'm sorry to hear it is taking a majority of you all months/years to get your claims settled.

[laabstract]

Originally Posted by USMCbassman

Took me 4 months from beginning to end and a rating of 80%. Overall it was 6 months and that's because I was initially put in the "slow track" the DAV rep told me and I was suppose to be in the "fast track". I waited until I was under 60 days from EAS/Retirement. Once I was moved over it went rather fast. SD VA seems to move pretty quick and efficient.

While I'm good with my percentage I'm not thrilled with a lot of the crap they didn't pick up (e.g. my hearing, broken bones, and back). They did give me a percentage for degenerative joints (I'm assuming they are lumping my spine/back issues in to that).

I'm sorry to hear it is taking a majority of you all months/years to get your claims settled.

That is pretty quick!

[Funtimes]

Originally Posted by 1CavScout

I hired an attorney. I already won my claim, but they screwed me with the rating. I am done dealing with the VA by myself. My lawyer was actually surprised I got as far as I did on my own. If I had to do it over again, I probably would not have even bothered. I definitely would not do it again by myself.

I think I did pretty damn good. I took my stuff to the local county and dav reps and they were fairly impressed. Kind of sucks, because I prepped the documents for like an appeal to the BVA. Pretty sure the RO didn't read half of it.

Some of the stuff I don't get at all. At least the 2nd time I will have to appeal they looked at my medical records. They didn't even do that the first time!

[1CavScout]

Originally Posted by Funtimes

I think I did pretty damn good. I took my stuff to the local county and dav reps and they were fairly impressed. Kind of sucks, because I prepped the documents for like an appeal to the BVA. Pretty sure the RO didn't read half of it.

Some of the stuff I don't get at all. At least the 2nd time I will have to appeal they looked at my medical records. They didn't even do that the first time!

I won my claim at the BVA. The BVA judge that granted my claim had some interesting things to say about my local VA and how they handled my claim. It's all just a game IMO (although my new attorney has the same opinion). String everything out as long as possible and hope you go away.

[Funtimes]

Originally Posted by 1CavScout

I won my claim at the BVA. The BVA judge that granted my claim had some interesting things to say about my local VA and how they handled my claim. It's all just a game IMO (although my new attorney has the same opinion). String everything out as long as possible and hope you go away.

I can only hope for this. We are going with DRO initiallly before the BVA appeal is requested.

In my opinion, I had a landslide of evidence and supporting documentation for my claim. I've spoken with a few people "off the record" and they pretty much told me at the regional office level, these examiners are kind of just doing whatever the hell they want to do with the claims. When asked about the proper application of the burden of proof (50/50) going to the veteran - I was told "hardly ever" is that done. The individual also told me that they (the RO) don't really give weight to private doctor statements, but that practice would be different at the DRO / BVA level.

Oddly enough, one of the doctors who did my IMO is a licensed attorney as well. He has agreed to take my case to the DRO / BVA / and CAVAC if necessary.

What really frustrates me is that I have a huge benefit over many others in preparing a claim. I have the practice manuals; I have Westlaw access; I had enough funding to cover private IMO's (which were about $1500 dollars a piece), and I had time to prep the work. I probably spent about 103 or so hours working on just two claims. That's not something most support organizations can do. I still didn't prevail at the RO! If they are doing this to me on this claim, I can *only imagine* what they are doing to everyone else.

In the end I'm sufficiently confident that I will prevail at the BVA. The fact that it may have to get that far is mind blowing though.

[1CavScout]

Originally Posted by Funtimes

I can only hope for this. We are going with DRO initiallly before the BVA appeal is requested.

In my opinion, I had a landslide of evidence and supporting documentation for my claim. I've spoken with a few people "off the record" and they pretty much told me at the regional office level, these examiners are kind of just doing whatever the hell they want to do with the claims. When asked about the proper application of the burden of proof (50/50) going to the veteran - I was told "hardly ever" is that done. The individual also told me that they (the RO) don't really give weight to private doctor statements, but that practice would be different at the DRO / BVA level.

Oddly enough, one of the doctors who did my IMO is a licensed attorney as well. He has agreed to take my case to the DRO / BVA / and CAVAC if necessary.

What really frustrates me is that I have a huge benefit over many others in preparing a claim. I have the practice manuals; I have Westlaw access; I had enough funding to cover private IMO's (which were about $1500 dollars a piece), and I had time to prep the work. I probably spent about 103 or so hours working on just two claims. That's not something most support organizations can do. I still didn't prevail at the RO! If they are doing this to me on this claim, I can *only imagine* what they are doing to everyone else.

In the end I'm sufficiently confident that I will prevail at the BVA. The fact that it may have to get that far is mind blowing though.

Good luck. I never intended to take my case to the BVA. I actually never intended to go the the VA at all, but a Vietnam Vet I know kept pushing me. Once the local VA started playing games with me, it actually pissed me off to the point that I kept pushing it. One thing lead to another, and after several years my case was in front of the BVA. If you keep pushing you will more than likely be successfull.

[DysfunctionalVet]

I did everything on my own. 20 months total time.

100% PTSD
50% upper airway resistance syndrome
30% migraines
10% ankle sprain (just had some screws put in and bones fused together but I'm not going to get greedy)
10% GERD
10% arthtitis
0% Hypertension

+ SMC-S

[YCBAPAYL]

2nd time sending back disagreement papers. 2 years down who knows what left....

[BoJackUSMC]

Pending decision approval to back to gathering evidence. ... sigh.....

[Funtimes]

Originally Posted by BoJackUSMC

Pending decision approval to back to gathering evidence. ... sigh.....

Im with you man... every time it feels like 2 steps forward, then 3 steps back lol. Had my C&P for Tinnitus today, so we will see what kind of random stuff they come up with from that now.

[Funtimes]

Started my appeals process with an attorney. I figure I've sued enough people already - might as well keep the court games going.

Let the wins begin!

[coryhenry]

I finally got my claim approved after two years, nice back pay check....woohoo

[Funtimes]

Originally Posted by coryhenry

I finally got my claim approved after two years, nice back pay check....woohoo

Congrats man!

[cc56]

Filed Nov 2013 and received money in my account today. Looking at e-benefits it claim section itstill says gathering evidence. When I go to the section called "Va letters" It told me my percent and payment amount.

[BoJackUSMC]

Just finished my c&p exam two days ago, i think i done more than 14 c&p exams so far... went back to pending decision phase again.. hoping for best....

[uxo2]

Originally Posted by Gun-Diapers

I did everything on my own. 20 months total time.

100% PTSD
50% upper airway resistance syndrome
30% migraines
10% ankle sprain (just had some screws put in and bones fused together but I'm not going to get greedy)
10% GERD
10% arthtitis
0% Hypertension

+ SMC-S

How did you get
210% ?????

Never heard of such a rating

[BoJackUSMC]

People could get like 200%, but VA will do their rating math and Bring it down to like 60 to 70% total...
it's weird.....

[laabstract]

Originally Posted by Gun-Diapers

I did everything on my own. 20 months total time.

100% PTSD
50% upper airway resistance syndrome
30% migraines
10% ankle sprain (just had some screws put in and bones fused together but I'm not going to get greedy)
10% GERD
10% arthtitis
0% Hypertension

+ SMC-S

You can not get 200% they will just cap him out at 100%

[BoJackUSMC]

Yes, max is 100%

[DysfunctionalVet]

Late response but yes, I'm capped out at 100%. I do get a small extra amount called SMC-S (special monthly compensation) because of the 1 item that is 100% schedular and other items that are equal to 60% or more combined.

[BoJackUSMC]

Congratulations.... it's taking over 10 months just to add my parents into my file. ..cant believe it takes that long just to add someone, not claim issue either.

[steelrain82]

Just had a re-examine for ptsd. Has anyone had one? How long does it take to hear back on the re-exam?

[rero360]

Just a heads up, if you are going to school and using your GI Bill, and have a rating of 20% or more, look into applying for the Vocational Rehab program.