C&P Service Clinician’s Guide
Scheduled For A C & P??? Filing A Claim?
This is a must read for you!!!
I've been posting this again and again over the years
and it's still one of the best ways I know to win
your case. Published in 2002 the principles and much of
the verbiage still applies and is in daily use at the VA.
Gregory M. Rada - A Veteran for Veterans
Focusing on appeals involving psychiatric conditions
and/or individual unemployability (TDIU)
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Veterans PTSD Assessments
Independent Medical Opinions PTSD DBQs
Thomas Grieder, MD, PhD
Twenty five years service as a VA psychiatrist
Assistant Professor and Associate Clinical Professor
UCLA Department of Psychiatry and Biobehavioral Sciences
Lead psychiatrist for the East Los Angeles PTSD Clinical Team
BVA Decisions
THE ISSUE Entitlement to service connection for ulcerative colitis,
to include as secondary to service connected posttraumatic stress disorder (PTSD).
THE ISSUES Entitlement to service connection for a low back disability,
including as secondary to the service-connected left foot disability.
Veterans Psych Evaluations
Brett Valette, Ph.D.
As an expert in psychological evaluations, Dr. Valette
provides Independent Medical Evaluations (IME),
Independent Medical Opinions (IMO), nexus letters,
ratings reviews for all psychological conditions.
Some Wounds Can't Be Seen
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(a) General. Except as provided in §3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.
§4.22 Rating of disabilities aggravated by active service.
In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active service whether the particular condition was noted at the time of entrance into the active service, or it is determined upon the evidence of record to have existed at that time. It is necessary therefore, in all cases of this character to deduct from the present degree of disability the degree, if ascertainable, of the disability existing at the time of entrance into active service, in terms of the rating schedule, except that if the disability is total (100 percent) no deduction will be made. The resulting difference will be recorded on the rating sheet. If the degree of disability at the time of entrance into the service is not ascertainable in terms of the schedule, no deduction will be made.
Thomas J. Seiter, Jr., M.D.
Independent Medical Opinions
Disability Benefit Questionnaires (DBQ's)
Service & Civilian Medical Record Reviews
Nexus Letters
Get In Touch With Dr. Seiter
Hearing Loss and Tinnitus Bringing You Down???
Are you depressed, anxious, angry or moody because of your hearing problems?
Did you know your mental health issues may be secondary to hearing loss or tinnitus?
Dr. Brett Valette is a clinical psychologist specializing in veterans mental health disability. If you're suffering with problems you believe may be caused or aggravated by hearing loss, contact Dr. Valette and ask if you may have a secondary service connected condition.
BVA Decisions
Board of Veterans Appeals decisions are required reading for the veteran involved in a claim or an appeal. You should recognize that BVA decisions do not establish precedent. In legal systems based on common law, a precedent, or authority, is a principle or rule
established in a previous legal case that is either binding on or persuasive for a court or other tribunal when deciding subsequent cases with similar issues or facts. At VA and BVA every case is decided on its own merit. When you find a case similar to yours, you'll want to read it through and learn what that veteran did to win his appeal or if the case was denied, why? If you pattern your case in a way similar to those with positive outcomes, you're likely to prevail.
BVA Decision
THE ISSUES1. Entitlement to service connection for bowel incontinence, to include as secondary to service-connected lumbar disc disease. 2. Entitlement to service connection for bladder incontinence, to include as secondary to service-connected lumbar disc disease. 3. Entitlement to service connection or numbness and tingling of the right upper extremity, to include as secondary to service-connected lumbar disc disease. 4. Entitlement to service connection for numbness and tingling of the left upper extremity, to include as secondary to service-connected lumbar disc disease.
BVA Decision
THE ISSUES 1. Entitlement to service connection for degenerative joint disease, left hip,
secondary to service-connected left hallux valgus, left great toe, status post-bunionectomy and metatarsal osteotomy. 2. Entitlement to service connection for left lower extremity sciatica secondary to service-connected degenerative arthritis of the lumbar spine at L3-L4, L5-L6, and L6-S1. 3. Entitlement to service connection for right lower extremity sciatica secondary to service-connected degenerative arthritis of the lumbar spine at L3-L4, L5-L6, and L6-S1. 4. Entitlement to service connection for an acquired psychiatric disorder to include anxiety and depression, secondary to service-connected disabilities.
Your VA Disability Rating & The Schedule
Let's spend a few minutes talking about how VA arrives at the rating you'll receive once your claim has been adjudicated. The process isn't (or shouldn't be) complex. You have a medical problem you feel is connected to your honorable military service. You file a claim
seeking compensation for the disabling condition. VA then gathers all pertinent records and any other relevant evidence and schedules you for a C & P exam. Once all that is completed, a Ratings Veterans Service Representative (RVSR) will study all of that and issue a rating.
As the RVSR reviews the evidence, your condition and the amount of disability the condition is causing will be derived from
38 CFR Book C, Schedule for Rating Disabilities .
Much of what you'll find there is in need of updating to reflect a more modern medical approach to illness and injury but for now, The Schedule is what we have to work with. As you file your disability benefits claim you'll want to look at the language VA uses to define different ratings for your specific malady. If you have a knee problem, you'll go to
4.40 - 4.73 - The Musculoskeletal System
and then explore until you learn all you ever wanted to know about how VA rates knee injuries. The same holds true for any illness or injury you believe is connected to your service. If your specific condition isn't listed, that's not unusual and VA allows for symptoms of a like kind to be rated by similar symptoms of similar conditions. As you perfect your benefits portfolio, you should become familiar with The Schedule. The more you know, the more control you have over your benefits.
Secondary Conditions
PTSD, MST, TBI, Agent Orange Exposure, Back Injuries, Gulf War Syndrome, Migraines, Heart & Vascular Disease, DIC, Unemployability TDIU
Free Veterans Disability Consultation! Call Now! (800) 742-5035
Other examples that may be secondary are:
If you have a rated hip condition and it affects your back, you may want to file for the back pain as a secondary
condition. If you take medications for service connected PTSD, you may be eligible to file for erectile dysfunction.
Many psychiatric medicines will cause or contribute to ED. If you are rated (service connected) for hearing loss,
don't overlook the tinnitus that may accompany acoustic trauma. Severe hearing loss may also lead to mental health
conditions like depression. If you have a condition that has caused significant disability to a leg, that injury
may affect the other leg, the hip or your back.
The VA will almost certainly deny your claim for a secondary condition. That's why we have expert doctors for IMOs and
veterans law attorneys to manage appeals. Appeal is just a part of the process...go for it.
You should consider obtaining an IME/IMO at your earliest convenience.
Diabetes (DMII) as a primary condition
Diabetes is known to be very hard on the human vascular system. The veteran who has diabetes will be monitored for diseases of the arteries of the heart, the neck, the kidneys and the legs. If diabetes affects those arteries the veteran may develop ischemic heart disease, carotid artery disease, renal artery disease or peripheral artery disease.Those diagnoses may lead to heart attack, stroke, kidney failure and difficulty in walking or even loss of a leg. If there is a diagnosis of DMI and that diagnosis is rated by VA as service connected, vascular diseases that are diagnosed later will be viewed as secondary conditions and will deserve an award of compensation. Interestingly, the diagnosis of service connected DMII must come first. If a veteran claims carotid artery disease in 2006 and is denied and then in 2009 he is diagnosed as having service connected DMII, the original denial is likely to remain as is. For a claim of a secondary condition, the primary service connected condition must be of record first. If the veteran has service connected diabetes, he or she may consider filing for;
Peripheral Artery Disease
Ischemic Heart Disease
Carotid Artery Disease
Stroke
Kidney Disease
Hypertension
Diseases of the Eye
There are many more conditions that may be caused by service connected diabetes.
In our example of DMII, not all other conditions can be successfully claimed. This is a common error made by many veterans.Veterans who have a service connected condition like DMII will often begin to try to claim all other conditions as secondary to that DMII.
We receive frequent emails asking if we think that a claim of arthritis, mental conditions like depression, various cancers and so on can be claimed as secondary to the DMII. The answer is always "No". Veterans are allowed to make any claim they believe is appropriate. Our answers are based on whether or not we believe the veteran will be awarded the benefit or if he is wasting his time. Many claims of a secondary condition may be won with an expert Independent Medical Opinion.
Secondary Conditions are disabling injuries, illnesses or diseases that may be caused or aggravated by your existing service connected conditions. Nomenclature is very important when working with VA so it helps for you to understand the language.
The term "condition" is used to describe any physical or mental health problem you may have. A condition is an injury or an illness that occurred during your military service. The condition may be disabling or not. You may have had a condition like a fungal infection that was treated and cleared up with treatment. That isn't disabling but it may be rated as service connected at 0% disabling. Or you may have had a significant injury such as a gunshot wound. Even though it was treated, that wound may have left you with only a
partial use of the affected limb and a big scar. That's a disabling condition and will likely be awarded an appropriate rating for purposes of compensation.
The term "service connected" implies that the illness or injury occurred during your service or if it shows up later in your life, was caused, contributed to or aggravated by your service.The condition doesn't have to be from combat or even while you're performing a military duty. You're military 24 x 7 so anything that happens before you have that DD 214 in hand counts. These conditions can be physical illnesses or mental health problems. Some service connected conditions are pretty easy to understand. If you lose a finger or a toe in an accident or in combat, you'll get a clear cut rating for the loss of the digit. That loss isn't pleasant but it isn't very likely to disrupt your life to any great extent and it won't lead to any other physical problems for you. Then again, you may be diagnosed with an illness or incur an injury that can cause other problems. If you have a service connected condition and that condition leads to other physically or mentally disabling conditions, you may have a reason to file a claim for a secondary condition.
Veterans who served in Vietnam are known to have been exposed to agent orange.
Agent orange is known to cause or contribute to a variety of health problems. Your VA cedes that many health problems that occur in Vietnam veterans may be caused by the exposure to agent orange. In fact, there's a well defined list of these presumptive conditions.One of the common conditions that may be seen in the Vietnam veteran is adult onset diabetes, often called Type 2 Diabetes or DMII. Any Vietnam veteran who receives a diagnosis of DMII should file a claim for disability compensation. The claim is likely to be awarded without too much fuss if the veteran has his paperwork in proper order. Once an individual is diagnosed
with DMII his health care team will begin to watch for conditions that are known to be secondary to the diabetes. Medical science recognizes that diabetes can be a brutal disease and it may cause other physical health problems. Many of these problems may be avoided or minimized with good medical care like a proper diet and medicines. Some manifestations of DMII will come up for some veterans though. These may be viewed as secondary conditions and when they occur, they should be claimed as service connected and secondary to the primary DMII.
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Key findings about America’s military veterans
The experiences of post-9/11 veterans differ from
those who served in previous eras. Post-9/11
veterans more likely to have been deployed,
seen combat, experienced emotional trauma
Why You Need An IMO!
Accuracy of Claims Decisions Involving
The OIG determined that VBA incorrectly
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What you won't find here is unending chat or opinions from strangers who like to think of themselves as experts.
Our goal is to ensure that you are awarded the benefits you earned with your service to our country.
We're here to help you take charge of your benefits, and that is all.
Medical Malpractice - Veterans 1151 Claims
VA Malpractice Attorneys Helping Veterans Harmed By The VA
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VA Medical Malpractice Claims, Misdiagnosis, Hospital Negligence, Medical Errors
For a review of your VA malpractice case contact our lawyers today. Our firm serves throughout the nation, and is one of the few firms to have specialized experience in VA malpractice cases.
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and Claims All Go Here
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Military Records DD 214
Official Military Personnel Files (OMPFs)
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Should I file a claim?
Potential VA claims?
What am I missing in the VA claims process?
Best way to check on a supplemental claim online?
Confused on what to do with claim.
Dependent status with education benefits.
Suing the VA for negligence and malpractice.
Just who do you think you are?
Stats about veterans.
Percent of U.S. adult population who are veterans in 2017, by state
Employment Data for Veterans With Disabilities
Employment Situation of Veterans Summary
Immigrant Veterans in the United States
Demographics of the U.S. Military
Veterans and Military Documents
Military Programs and Benefits
Research A Veteran
Tobacco Use in the Military
Facts on Veterans and Entrepreneurship
American War and Military Operations Casualties: Lists and Statistics
Tinnitus and hearing loss among
Veteran Social Security Beneficiaries
Veteran-Owned Businesses and Their Owners
48 Interesting U.S. Military Facts
The American Veteran Experience and the Post-9/11 Generation
National Center for Veterans Analysis and Statistics - Quick Facts
Global Firepower - 2019 World Military Strength Rankings
Can VA Disability Compensation Be Used
to Calculate Child Support or Income?
Veterans' disability benefits are compensation
for the veteran's impaired earning capacity and are intended
to "provide reasonable and adequate compensation for
disabled veterans and their families." They are not
supposed to be for the sole support of the veteran, but
can be counted in child support calculations to provide
for the veteran's dependents as well. If the veteran wasn't disabled, he would be earning an income upon which the
court would base child support; since disability benefits replace that income, child support can be based upon it.
Extra schedular ratings under
How can I get an extra schedular rating?
To receive an extra schedular rating the veteran
must first show that the veteran’s
conditions result in a disability picture
that is not covered by the schedule of ratings.
How Do You Apply For Social Security Disability Benefits?
Information on social security disability benefits
Presumptive Benefits...what are they?
When you claim that a disabling condition is caused by military service, you have to prove that allegation.
Or do you?
Disclosure of Certain Protected Records
Without Written Consent - (VA) proposes to amend its regulations on disclosure of certain records. now authorize VA to disclose certain protected records to non-VA
entities (including private entities and other Federal agencies) for purposes of providing health care or performing other health care-related activities or functions.
How to ensure seamless care while traveling
How To File a VA Disability Appeal
You have the right to appeal any benefits decision made by the Veterans Benefits Administration. The VA appeals process is set in law and is different from other judicial appeals processes. Find out how to file an appeal.
The Schedule For Rating Disabilities
If you're thinking of filing a claim or initiating an appeal of a denied claim, this is your new best friend. The details of exactly what you need to meet a rating are here and in use every day. Yes, it's complex. Yes, it's cumbersome. Yes, knowing how to use The Schedule is a necessity if you want to file a successful claim. Go for it!
your disability claim
If you’ve filed a claim for disability compensation, you can continue uploading more evidence for up to one year to support your claim. Evidence may include supporting documents like medical test results, doctor’s reports, and other records. Upload your evidence online now.
Vets being duped by Social Security rumor mill
VA launches online patient portal for veterans
The U.S. Department of Veterans Affairs
announced the launch of an online patient portal
this month that will provide service veterans
with digital access to their patient statements.
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Veterans Who Apply for Social Security Disabled-Worker Benefits After Receiving a Department of Veterans Affairs Rating of “Total Disability” for Service-Connected Impairments: Characteristics and Outcomes
A Few Of The Most Common Processes You Need To Know To DIY Your Claim
Other-than-honorable discharge?
You’re still eligible for VA mental health care
What You Should Know about Disability and Debt
There Are Protections...When it comes to debt collection, disability income enjoys special status.
An IMO by an expert often makes the difference!
Overpayment? VA proposing to claw back
money from your benefits? Submit a Compromise
Offer to the Debt Management Center.
Jim Strickland is a Vietnam era Army veteran and nationally recognized expert on VA disability benefits
and a member of the Stateside Legal Website Advisory Board. Jim's Mailbag, is a regular column where veterans,
servicemembers, and family members can ask Jim their questions about VA and Social Security disability benefits.
You can browse all of these Q&As here, and search the Jim's Mailbag archives for helpful answers.
Urgent Care Centers
One of the most important benefits you have today is
the authorization to use an urgent care center
near to you. But first, you have to
to take with you. Don't wait until you need this
benefit to prepare for it. Read this now,
print your papers and be prepared!
Managing Risks and Improving VA Health Care
The Department of Veterans Affairs (VA) has taken
steps to maintain its leadership commitment and develop its action plan, but still needs to demonstrate capacity
and establish metrics to monitor and demonstrate
progress addressing VA health care concerns.
Medical Marijuana Card
Tell the doctor you saw it on VAWatchdog
and ask about veterans discounts!
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Healthcare directives,
proxies, living wills and durable financial power of attorney.
All are free to use.
Is your disability pay fair game in a divorce?
(Yeah, it is...)
Chronic Pain Is an Impossible Problem
A “safe” alternative to opioid painkillers
turns out to be not so safe.
Hello Jim...
Can you help me with....
Family Medical Leave Act problems after husband's deployment
Vet being harassed at work
VA doctor malpractice
Child support arrears create hardship
68 year old veteran with cancer
When did the Vietnam era start
Radiation treatment for prostate cancer and now C& P exam
Diabetes claim secondary to OSA
Revisiting child support order
Gulf War veteran behavior found to be willful misconduct
All these and many more answers to your questions can be found at
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the best thing ever. Get
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Do You Need
Medical Care
RIGHT NOW?
You are already authorized
to use an urgent
care clinic!
Owe VA Money???
November 19th 2019
'How To Lie With Statistics'
How to file a VA disability claim
Find out how to file a claim for disability compensation
or increased disability compensation.
Has VA medical care caused you an injury or other harm?
You can sue the VA for medical malpractice but it's a complex process and you'll want lawyers who have
done this successfully in the past. There are strict time limits and draconian regulations to follow.
Get some advice today...call now!
Why Getting a Diagnosis Matters
A diagnosis does so much more than get noted in your medical history. It also can help you apply for programs like Social Security Disability and medical marijuana cards. And maybe even more importantly, it can help you explain yourself to friends, colleagues and family.
To Loneliness And Isolation For Seniors
Did you know that hearing loss and tinnitus are the
most commonly rated veterans disabilities? Did you
know that hearing loss and tinnitus can cause
other secondary conditions, particularly mental
health problems like depression and loneliness?
Give veterans more health care options!
Tell your lawmaker
Veterans deserve more choice
The Department of Veterans Affairs (VA) Launchpad
App for Veterans (VA Launchpad) contains select VA applications (apps) for Veterans and their Caregivers.
New apps will automatically appear in the VA Launchpad when they become available. Organizing VA health information and resources into five categories, it quickly accesses and launches the VA app of your choice. With VA Launchpad, VA intends to save you time and help you better integrate available VA apps into your life.
How to download VA benefit letters
To receive some benefits, Veterans need
a letter proving their status. Access and
download your VA Benefit Summary Letter (sometimes called a VA award letter) and
other benefit letters and documents online.
The Google IT Support Professional Certificate
The IT Support Professional Certificate, developed by Google and hosted on Coursera, can help you become ready for an entry-level job in IT support in under six months. No experience is necessary.
Government Accountability Office
Focus Needed to Prevent Disqualified Providers from Delivering
VA Releases Survivors Quick Start Guide
Reference guide to help during final
arrangements planning
Veteran Disability Claims: Nexus and IMO Letters
To meet the nexus requirement, the veteran must have an evaluation by a physician that will establish that the veteran is indeed disabled and also that his disability is as likely as not caused by his military service. There are two methods used to establish such a nexus; one is independent medical examination and the other is independent medical opinion.
Your 2020 Guide to Social Security Benefits
Whether you’re claiming Social Security in 2020, have been collecting benefits for years, or are still decades away, here’s what you need to know about this critically important retirement program.
For Better Brain Health, Preserve Your Hearing
Hearing loss is the largest modifiable risk factor for developing dementia, exceeding that of smoking, high blood pressure, lack of exercise and social isolation.
Google Tracks You
and we don't.
DuckDuckGo apps block
Google's hidden trackers.
The world needs an alternative
Robert Wilkie <robert.wilkie@va.gov> 855-948-2311
How Divorce, Alimony, and Child Support
Affect Veterans' VA Benefits
VA benefits can be garnished only for spousal
or child support, and only under certain conditions.