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for those who receive disability

This is a discussion on for those who receive disability within the Veterans Affairs forums, part of the Armed Services category; I've been very fortunate to receive VA disability since my exit from the military. I still have one outstanding claim, which ended up appealing when ...


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Old January 31st, 2009, 11:31 AM   #1
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for those who receive disability

I've been very fortunate to receive VA disability since my exit from the military. I still have one outstanding claim, which ended up appealing when they denied it (based on they sent me to the wrong kind of doctor for the condition).

Now my local VA rep is telling me it takes 2 years for the VA to process an appeal, and they're just going to arbitrarily make the decision, without even LISTENING to my claim. All I wanted them to do was send me to the right kind of doctor for a proper examination, and then I'll be OK with whatever decision they make.

But from I understand, they're not going to do that, they'll just make a decision again (in my opinion) based on incorrect information.

Is there a way for me to get someone to actually put my file in their hands and talk to them so they understand what I'm trying to do? It's so frustrating to just be a case file. I know they have a massive amount of veterans to deal with, but there's got to be a resource for me, right?

Hopefully?

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Old January 31st, 2009, 01:51 PM   #2
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You might want to try working this through Disabled American Vets. I've no experience with them myself but I've heard they are more than willing to take on the VA on behalf of a vet. You should be able to find a local chapter through their website.
Good luck.

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Old January 31st, 2009, 02:59 PM   #3
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I would also try the VFW or American Legion. If all else fails I guess you could start bothering your congressman.

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Old January 31st, 2009, 04:25 PM   #4
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In a nut shell, some VA regional offices (where the people who make your rating decision work) are all unique in regards to their reputation for dealing with veteran’s claims. If your case is being handled by Oklahoma City then you will not hear good things about their performance,

I had a case that was being handled by OK City and they kept denying my disability claim due to it not being service connected, even though I was diagnosed and treated while on active duty for this same issue. They were doing what is called “top sheeting” my review. Basically this is when they are too lazy to review the case in its entirety and they just read the results of the last full review and then reiterate that conclusion. This is NOT supposed to be done but it does happen. It took me several years, three attempts, and a residence change to a new state before I got my disability. The new VA office even responded with a letter acknowledging that the previous denials were incorrect, I did get some back pay but not enough to make up for all of my time and anxiety.

In my final request for an appeal I requested what is known as a “de novo” review from the Board of Veteran’s Appeals (BVA). When you have this kind of review you force them to send the whole record to a new person whose sole purpose is to review the entire record and reevaluate the case in accordance with the evidence and the law. This is the way I finally won my appeal and these are the people who basically said that everybody else before had their heads up their behinds.

You can read some info about appeals at the link below.
http://seawolf.org/va/vdc.pdf


One of the best books I have ever found in regards to how to deal with the VA is;

The Veteran's Survival Guide
How to File and Collect on VA Claims
John D. Roche

You can find a copy at the following link;

http://www.potomacbooksinc.com/Books/BookDetail.aspx?productID=50509

In some cases a procedural error (like not sending you to the proper doctor for an exam) can be appealed due to a Clear and Unmistakable Error (CUE). This forces them to send you to another doctor and then review your evidence all over again. The VA personnel don't like CUEs because these are reported to higher authority and the reviewer gets hammered if they screwed up.

Get the book I mentioned, it really clears things up. I know it is accurate because I have a very close family member who works for the VA (in a position that is connected to these issues) and that person agreed with everything we read in the book.

Also, get help from a veteran's service organization (VFW, American Legion etc.). These guys are not employees of the VA and they are usually veterans themselves. Some of them are not very good at their job but then again some are real fire breathers who wont take no without a fight.



Good Luck and don’t give up.


Last edited by RAMMAC; December 22nd, 2010 at 07:09 AM. Reason: Changed font and updated link
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Old January 31st, 2009, 04:41 PM   #5
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When I was layed up in the VA 19 years ago I was not even aware I was eligable for compensation until one day I woke up and there were two DAV reps with clipboards waiting to process my claim. I stronly suggest getting in touch with them. There is a link on the home page that says "get claim assistance".
http://www.dav.org/ I joined for life. Good luck brother!!!!

PS RAMMAC love the quote

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Old January 31st, 2009, 04:45 PM   #6
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Thanks for all the good advice and links!

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Old January 31st, 2009, 05:36 PM   #7
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Veteran's Service Organizations...

Every VA Clinic and Hospital has Veteran's Service Organization Reps whose job it to provide every veteran who wants it (and who wouldn't) free help in filing claims and appeals. DAV, VFW, American Legion, and others are there to help.

Give one of them a call and ask for their help. Experience shows that those who have VSO assistance usually get higher ratings in quicker turnaround times.

One thing to keep in mind though - Iraq and Afghanistan injured vets receive immediate response (per executive order) and that does delay everyone else's claims. I don't necessarily agree with it completely - but then the military medical system is failing a lot of them in many ways.

Thanks from BoneDawg
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Old January 31st, 2009, 06:55 PM   #8
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Gulf War veterans (which I am) get priority, as well, although I'm sure not as high as the current Iraq/Afghanistan, like you said.

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Old February 1st, 2009, 10:42 AM   #9
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I don't know when you exited the military callktulu but if it was after 9/11 there is a new review board that just started up. At the bottom of the article there is an application.

http://www.armytimes.com/news/2009/0...rdNEW_020209w/

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Old August 4th, 2009, 07:35 AM   #10
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Anyone ever use a lawyer?I was under the impression this wasnt allowed but I see lawyers who do handle va appeals.

Im fed up with em I was rated at 50%, appealed and was awarded another 30% for a seperate condition which the VA figured at 70%??So I asked for unemployability based on just the 70% and was of course denied.First I dont understand the discrepancy in % and then denying unemployability when the vas insurance div gives me INS w/o paying premiums due to assumed unemployability or some such shite?Ive only got maybe 2 months before my 1year appeal is up so I need to move on it,any Ideas?
I dont expect somethin for nuthin but the math in particular has me irked!

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Old August 4th, 2009, 09:35 AM   #11
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Groundpounder----your 70% is actually 65% by VA math but they round up to whole percentages.

VA math is like this.......a 50% disability will make you 50% whole. They then take the next disabilities in size to calcualte the final rating. Yours is 30% so 50 x .30 = 15. Subtract 15 from 50 and you have 35 which gives you 35 % whole and 65% disabled. If your final percentage was 64 you would be rated at 60% but 65 and over gives you a 70% rating.
To receive unemployability you must have at least one rating of 40% and a total of 70%. Keep plugging-----it takes time and strong nerves but is worth the struggle when mission is accomplished.

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Old August 4th, 2009, 10:19 AM   #12
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Originally Posted by grndpndr View Post
Anyone ever use a lawyer?I was under the impression this wasnt allowed but I see lawyers who do handle va appeals.

Im fed up with em I was rated at 50%, appealed and was awarded another 30% for a seperate condition which the VA figured at 70%??So I asked for unemployability based on just the 70% and was of course denied.First I dont understand the discrepancy in % and then denying unemployability when the vas insurance div gives me INS w/o paying premiums due to assumed unemployability or some such $hite?Ive only got maybe 2 months before my 1year appeal is up so I need to move on it,any Ideas?
I dont expect somethin for nuthin but the math in particular has me irked!

Before you spend money and time that will be wasted you need to check out a few things.

VA ratings are calculated by referencing a Combined Ratings Table and not by simply adding the individual rating values together. Basically, according to the table, if your first disability is 50% and then the second was 30% you are lucky because the chart says that you have a combined total of 65%; but they round up when your total ends in a 5 so you got 70%. You can access the Combined Federal Register (CFR), which is the official federal law book for the United States, online. The part you are interested in is the 38 CFR, Chapter 1, part 4 and specifically sub part 4.25 which is the combined ratings table and how to use it. Use this link http://ecfr.gpoaccess.gov/cgi/t/text....97.21&idno=38 to read this information.

As for your unemployability, you have to remember that you need to meet 3 basic requirements for a disability; was your problem incurred while in service or was it made worse by your service?, has the problem been continuous since service?, and does the problem actually cause you issues at work or in your everyday life? For unemployability you need to prove that you can not maintain employment due to your rated disabilities. See sub part 4.18 of the CFR, Chapter 1 for the definition of unemployability, http://ecfr.gpoaccess.gov/cgi/t/text...dno=38;cc=ecfr. The bottom line is that you have to prove that you have lost a full time job due to your rated disabilities. Part time work does not count. A letter from a doctor that states that you can no longer work due to your disabilities and why this is so would prove your claim. Also if you were ever justifiably fired due to your disabilities (the employer met his legal requirements for disabled workers but you still could not perform the duties of the job) and the employer stated so in writing then that would prove your claim also.

I would go to your local service rep (AMVETS, VFW, etc.) and start there. You are not going to fight the combined rating value, that is specified by the combined rating table and you can't change that. But, you might have a possibility of obtaining unemployability. If you get advice from the service reps that says you have a case then pursue it and yes you can hire a lawyer. Use the appeals process. There are several ways to appeal and the most useful to me was a De Novo review.

Unemployability is one of those things that I wouldn't want. Usually a veteran that has unemployability has some VERY severe issues. I'm rated at a combined 50% and consider myself lucky since all I have to put up with is annoying pain that isn't excruciating and maintenance drugs. My wife works for the VA and she has seen some pretty sad cases, and yet most of these people keep a pretty positive outlook about themselves. The most memorable was a Viet Nam vet that had cancer due to agent orange. This guy lost both legs and every few years they have to amputate farther up to remove cancerous tissue. Last time my wife saw him he joked that eventually he would be just his head in a wheelchair. This guy worked full time at the VA hospital. Some people are just phenomenal in regards to their positive spirit.

Good Luck,
Semper Fi

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Old April 24th, 2010, 10:47 PM   #13
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Thanks for the heads up on the rating system,Ill need to read up on it a bit.Results of the last appeal was an increase of 10%
for increased loss of motion or some such nonsense.Didnt affect the overall rating whatever.All 3 of the basic requirements unemployability are met,if all the different disabilitty ratings were added together were talking 110% now but as you now ther are maximuns allowed say for a leg injury.Im missing a large part of my foot which contributed to arthritis in ankle joint and knee joint then add scarring also compensable, all SC, by simple addition the scfoot/ leg injury ratings alone would add to 80%.But as I can still ambulate approx. hundred/2hundred meters on that leg despite considerable pain. The max rating for it(leg/foot) I was told was 50%.
The other 30% is also SC related to the original injury.Well it is what it is and the way things are these days Im grateful for the 70% compensation I do get.

Thanks again for the tips men, could be worse hey.Aquaintance down the streets battlin va over a lung issue (cancer) .But for the grace of god....


Last edited by grndpndr; April 25th, 2010 at 05:14 AM.
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Old December 16th, 2010, 08:08 AM   #14
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It's an old post, but what the heck.

Battling with the VA is a pain in the a$$. I call their treatment of veterans who file for disability (s) the Big triple D and it is not the size of her breast either.

DDD = Delay , Deny, & hope you Die.
The VA likes to Delay so you get frustrated and give up
They like to also Deny your claim, you get pissed off and quit
They keep repeating the first two in hopes that you Die soon. So that they don't have to pay you. It's all about money period.

Think about it, you go see your Doctor about your ailments, but when you submit a claim a Lawyer reviews the case and rebuts what the doctors wrote up on you. What kind of crap is that?

DON'T quit keep going to your doctor and complain about your ailments. It will take time.

Who is you VA rep? keep in mind you can't go from one rep to another, for example if the DAV is helping you, you can not go to the American Legion for assistance if you have a case pending. There are attorneys out there who are familiar with the VA system and the results could be day and night.

Good luck


Last edited by BrokenVet; December 16th, 2010 at 08:17 AM. Reason: r's
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Old December 16th, 2010, 11:23 AM   #15
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Sometimes you'll get a regional office that just drops the ball. I'm rated 100% now but it took a lawyer to do it. My VA rep at the local VA did his job but Detroit kept me waiting for almost 20 mos. The lawyer got it for me in 6 weeks. Go figure.

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