|
Printer-Friendly Version
JIM STRICKLAND'S MAIL BAG: VOLUME #57 FOR 2008 --
Veterans' Advocate Jim Strickland answers
questions
from VA Watchdog dot Org readers.
Veterans' Advocate Jim Strickland provides
regular columns for VA Watchdog dot Org.
If you would like to contact Jim about his
columns, you can email him here...
The archive of Jim's articles
is here...
To find an answer to a specific VA benefits
question, use the VA Watchdog search engine...
click here...
|
 |
JOIN THE DEBATE
Comment on Jim's Mail Bag and interact
with other readers... below... |
-------------------------
by Jim Strickland
NOTE: Letters in my mailbag are reprinted
just as they come to me. Spelling and grammar are left as is and only
small corrections are made to improve readability, ensure anonymity or
delete expletives that may offend some readers. This is not legal advice.
You should always seek the advice of an attorney who is qualified in
Veterans' law before you make any decisions about your own benefits.
-------------------------
Jim;
I just recently(one day) received my paperwork back from VA which they had
forever checking and checking it twice on the benefits which I had filed
for. The first one of course was PTSD. I was diagnosed at the VA Hospital
along with Diabetes Mellitus Type II. None of this was believed and I was
DENIED ON ALL COUNTS except for HEADACHES which they rated at 0 percent.
What is that,another way to put the screws on a Veteran. I am a Vietnam
 Veteran
and they were talking about the Combat Infantrymans Badge which I received
and they acted as though I was Never in Vietnam. I still have not received
any info.on the Agent Orange testing which they performed so brilliantly
on me,,for what. I can give them all kinds of Stressors if they need to
help them decide anything which would benefit me in the slightest. This VA
thing is a big JOKE, No wonder a lot of Veterans don’t waste their time
with the process It sounds to me like they forgot to ask for the paperwork
from the VA Hospital or they do not believe their own Doctors. Well this
disgruntled Veteran is done. I am going to fire off a letter to the
Congressman, because something is STILL WRONG WITH THE VA. I believe there
were 7-items which I had applied for and because I was denied on the first
two, they all were. You can’t have one without the other. WHERE DO I GO
FROM HERE?
Reply;
Don't bother your Congressman. Chill out, calm down...this is typical.
Everybody is getting denied in the face of the most obvious evidence.
You've just reached the point in your claim where you appeal with a
lawyer's help. I've referred you to an attorney and he'll take your claim
from here.
-------------------------
Jim;
i recently got a rating for copd at 30 percent,not knowing that i could
claim for sleep apnia as it can aggravate the copd condition,do i need a
nexus to establish that the presence of sleep apnia in connection with
copd should be considered as separate and rated separately?.What im having
a hard time understanding is that i have three sleep studies all stating
and documented in my va medical records.its there(obstructive sleep
apnia),theres no doubt,but my service rep at american leigion is telling
me i should get a nexus from a doc since theres nothing in my medical
records from the military service that i ever had sleep apnia while on
active duty.,on one hand im thinking im hearing that my sleep apnia should
be rated as secondary to the copd/emphasema.the only thing a nexus will do
is establish that i had it in the navy which theres no doc i know on the
planet that will make that statement.(do you know one)the other belief i
have is that i see no reason to put alot of energy to get a nexus from a
doc for the sleep apnia being secondary because its already well
established .(i think i might also be misguided.)i(im lost) can you
provide any guidance?????
Reply;
I hope I can shed a little light on a complex question.
What you're trying to do is have your sleep apnea rated as service
connected secondary to the already SC COPD.
Let's discuss how these things work by using another condition that may be
easier to understand.
Adult onset diabetes (DMII) is a common problem among vets and civilians.
As we age our bodies don't produce or utilize out natural insulin as well
as when we were younger. In the veteran population, it's recognized that
exposure to Agent Orange statistically increases the chances that one will
develop DMII. DMII is on the "presumptive list" of conditions that are
rated as service connected for most Vietnam veterans.
DMII is well known to cause or contribute to other conditions. This is so
well documented that as soon as you're diagnosed with DMII you'll probably
get a talk about the issues associated with it if you don't control it.
The first thing you'll hear of is how DMII contributes to vascular (blood
vessel) disease and can lead to heart attack, stroke, peripheral artery
disease and erectile dysfunction.
If you are diagnosed with DMII and subsequently develop coronary artery
(heart) disease, you may file the heart condition as being service
connected secondary to the DMII. One thing connects to the other...there
is a clinical nexus.
You have a diagnosis of Chronic Obstructive Pulmonary Disease or COPD.
That means you have difficulty breathing due to damage that was caused to
your lungs at some time. That you have a rating of 30% for that means that
it is ceded by the VA to have been caused or aggravated by your military
service.
Now you need to prove that the sleep apnea is a separate condition caused
or aggravated by the COPD. A letter from a physician would be a big help.
That letter would have to state very clearly that in the doctor's opinion,
having examined your medical records, he or she believes it is more likely
than not that your sleep apnea is caused by or aggravated by your COPD.
That seems a reasonable assumption. The next thing to do is to search the
medical literature to see if anything is there to support that. On the
Google search engine when we use the search words <sleep apnea COPD> we
get over 400,000 hits.
We first read, "Sleep is the period of greatest physiologic disturbance in
chronic obstructive pulmonary disease (COPD) and the time of greatest
danger to these individuals." But this article doesn't conclude that any
relationship exists.
http://ajrccm.atsjournals.org/cgi/content/full/167/1/3
In another article the author says, "In conclusion, COPD without daytime
hypoxemia was not a risk factor for sleep apnea or nocturnal
hypoventilation in this study."
http://www.dovepress.com/articles.php?article_id=546
A third article tells us that the health risks for patients who have both
conditions are significantly higher than those who don't but it doesn't
conclude that the 2 conditions are related or causative.
http://books.google.com/books?id=SmDPeJ-_IA
gC&pg=PA455&lpg=PA455&dq=sleep+apnea+
copd&source=web&ots=CsaPvYm-zh&si
g=J5_Pn2FFby3rikFAGJUNUgPctHQ&hl=e
n&sa=X&oi=book_result&resnum=2&ct=result
The results of the search aren't encouraging to support your claim. That
doesn't necessarily mean that you shouldn't proceed to file but it does
mean that a nexus letter from a physician is likely to be required to win
the award. You should speak to your physician about whether or not he or
she would consider such a statement and go from there.
-------------------------
Jim;
can I requested a reopened claim for temporary 100% rating during the
period of convalescence for SC and if so, what are the procedures for
reopened claim?
History: I didn't complete my appeal by submitting VA F 9 in which my
appeal period has expired.
inquiry: Filed appeals through DRO dated 01/22/07: however; DRO overlooked
surgeon physician's statement specifying outpatient treatment time for
temporary 100% rating during the period of convalescence for SC. - at VA
regional office in my state;
Gulf Veteran
Reply;
The answer is "yes", you may ask to reopen the case and keep the original
date of filing. About all you need to do is to write a letter to the VARO
stating that you wish to reopen the case and why. Drop that in the mail
using certified mail, return receipt requested and they'll respond.
Unfortunately, that's the easy part. It doesn't mean that they'll allow
it.
If you've been denied up through the DRO process your claim has been given
a pretty good look. I use the DRO process often and I haven't had any
issues such as an overlooked document. As a rule, the temporary 100%
ratings are pretty specific and are only awarded for that specific period
of time unless there is compelling evidence otherwise. Most often, at the
end of that period of time there is a repeat C & P exam or the medical
record is reviewed to determine whether the patient should be continued at
100%.
A statement by a physician is not an absolute at the VA, physicians only
give input, decisions are made at the VARO. The Ratings Veterans Service
Representative (RSVR) may glance at it and decide it doesn't have enough
weight to affect the decision to reduce the rating.
That you didn't timely file a form 9 is given a lot of weight. VA takes
timeliness very seriously...yours, not their own.
Your option seems to be that if you are convinced that you truly have an
issue that is worthy of the effort, you should proceed to ask for
reconsideration. If that is denied, it's time to lawyer up. At this point,
you really can't retain a lawyer until you have the next denial.
If and when that happens, there are many fine attorneys advertising on VA
Watchdog.
-------------------------
Jim;
one last question about hearing compensation.
Stopped in at the my VA med center today and got a copy of my hearing test
and doctors opinion to the regional VA on her findings. She stated that I
do have severe hearing loss and tinnitus and that it could have been form
combat sounds, however, because I did not complain about it after military
service she does not feel it is service connected. So question is will the
claim officer disallow my claim because I did not notice it or report it
after discharge in 1967? Or is this something that can take time to
develop.
Reply;
I don't understand why providers say such things. Most providers at VA
Medical Centers don't have any real clue about the disability compensation
process.
If you were in combat or had other "acoustic trauma" as a young man, it's
likely that it wasn't very apparent then. As you aged it got worse. That
is a typical path for hearing loss and is seen all the time.
There is no time limit for filing. While it can make a favorable
difference if there is documentation in the Service Medical Record or
within one year of discharge, you can file later in life.
However, if you are denied, don't sweat it. Return here to learn about the
appeals process. Today an appeal of a flawed decision is just a part of
the process and isn't a major obstacle.
-------------------------
Jim;
I have had no help with dav vfw how do you file 21-526? I have nurophty in
my feet and ptsd
Reply;
It couldn't be easier! Are you pretty well able to use your computer? If
you are, you're set.
Let's begin by having you click here
http://www.vba.va.gov/bln/21/Topics/claims.htm
and take a few minutes to read that page. OK...good, now you
understand the process a bit more. Let's get to work.
Click here
http://www.vba.va.gov/pubs/forms/VBA-21-526-ARE.pdf
Now print the form. Follow the instructions carefully and fill it in.
Now go here
http://www1.va.gov/directory/guide/home.asp?isFlash=1
and determine the address of the VA Regional Office for your
territory.
Put your completed form in an envelope. Make sure you signed and dated it
and keep a copy for yourself.
Now...this part is important so don't deviate here.
Mail it using Certified Mail and Return Receipt Requested. Don't fax it or
hand deliver it or FedEx it, do the Certified Mail. Any other
communication you'll have should be done that same way. It goes to the
VARO and the process is under way.
-------------------------
-------------------------
TIPS FOR COMMENTING ON JIM'S MAIL
BAG:
Please use this section for comments only. Post your comment
once only. If you post a comment
Jim believes to be vulgar, inaccurate, misleading, false or that may cause
another veteran to participate in an act that could cause them trouble,
your comment will be removed. There won't be an explanation or an
argument, it will be gone. If you have a question for Jim Strickland...
go here...
-------------------------
posted by Larry
Scott
Founder and Editor
VA Watchdog dot Org
Don't forget to read all of today's VA
News Flashes (click here)
Click here to make VA Watchdog dot Org your homepage
email Larry
(go
back to VA Watchdog dot Org Home Page) |
