Va Claim Tips:

[TinCanMan]

Three things that will help a veteran with a claim are to know the process; to know how to find info about your illness or injury; and to determine how the VA has handled cases like yours in the past.

1.) A web site where you can see the C&P Exam the VA uses, and print it out, and can show it to your private doctor. www.vba.va.gov/bln/21/Benefits/exams/index.htm. These 57 Disability Examination Worksheets are in use both by the doctors of VHA (Veterans Health Administration) who do the disability examinations and by the rating specialists, hearing officers, and Decision Review Officers of VBA (Veterans Benefits Administration) who do the disability evaluations.

2.) A web site you can search, review and print out various pages of regulations, etc about the VA system and claims is www.warms.vba.va.gov/TOCindex.htm, which includes:
== Compensation and Pension - 21
== 38 Code of Federal Regulations - REGS
== Book A - General
== Book B - Adjudication
== Book C - Schedule for Rating Disabilities

3.) A web site where you can search Veteran Board of Appeals to see how the VA has handled your illness or injury, what they were looking for, and what paragraphs in VA regs apply is http://www.index.va.gov/search/va/bva.html. Decisions are current through 31 AUG 07.

[1968 Tet Vet]

Yes, those references are good to know. But, you need to know what will make the difference in your VA claim(s):

1) a current diagnosis of your illness or injury
2) a NEXUS (or connection) of the problem to your military service
3) an impact statement from your MD as to how your illness has effected your life, socially and industrially
4) a prognosis as to the likeihood of your recovery

All of the above must come from a MD. None can be left-out. Then, you must make sure the VARO has this documentation and is being considered in your claim(s). Followup is very important.

[TinCanMan]

Items 1 and 2 are definately required and have been published here dozens of times over the years. Items 3 is not required at all, although it might help. I can't imagine item 4 being usefull at all.

Oh, by the way, do you recognize the username "1968 Nam Vet?"?

[1968 Tet Vet]

Items 3 and 4 has to do with your Rating, being high or low, and permanent or temporary. For me, 3 and 4 are the most important since the VA has conceded 1 and 2. 3 and 4 makes all the difference in the world.

Originally Posted by TinCanMan

Items 1 and 2 are definately required and have been published here dozens of times over the years. Items 3 is not required at all, although it might help. I can't imagine item 4 being usefull at all.

Oh, by the way, do you recognize the username "1968 Nam Vet?"?

[TinCanMan]

Your rating will be based on the criteria laid out in the VASRD. How your condition affects you socially and industrially is only of consideration to certain mental conditions. Any competent specialist will include them as part of Axis 4 and 5. Otherwise it is generally unimportant to the vast majority of conditions. Item 4 is only of importance in the event a veteran is 100% disabled. Neither are of general import to all claims or the average veteran. KISS always applies. You cannot baffle the decisionmakers with BS.

[1968 Tet Vet]

I guess, we agree to disagree... and thats OK, not a problem with me, at least. Disagreement is healthy. The impact of your disability, be it physical or mental, on your social and industrial (occupation) well-being is extremely important on the level of your disability rating. After all, VA disabilities are gauged on your lessened ability to earn a substancial financial income.... be it dramatic or minimal. Thats what its all about.

No BS here, just... VA reality.

[Vike17]

The impact of your disability, be it physical or mental, on your social and industrial (occupation) well-being is extremely important on the level of your disability rating. After all, VA disabilities are gauged on your lessened ability to earn a substancial financial income.... be it dramatic or minimal. Thats what its all about

That is why the rating schedule for physical disabilities is set up the way it is. The percentage for each disability already has the "social and occupational well-being" figured in! For mental disabilities, as TinCanMan said, the individual percentage is dependent on the actual occupational and social impairment suffered by the veteran.

For example, if you have DDD of the lumbar spine and have foward flexion of 25 degrees, and further state "I can't work because my back hurts," you won't get any more compansation than the 40% that the rating schedule provides for the forward flexion.

Vike 17

[1968 Tet Vet]

But, if you have a statement from a MD Specialist that states that because of your disability that you are no longer able to work.... then, you may qualify to IU that is paid at 100% of the rating schedule.

Originally Posted by Vike17

That is why the rating schedule for physical disabilities is set up the way it is. The percentage for each disability already has the "social and occupational well-being" figured in! For mental disabilities, as TinCanMan said, the individual percentage is dependent on the actual occupational and social impairment suffered by the veteran.

For example, if you have DDD of the lumbar spine and have foward flexion of 25 degrees, and further state "I can't work because my back hurts," you won't get any more compansation than the 40% that the rating schedule provides for the forward flexion.

Vike 17

[Vike17]

But, if you have a statement from a MD Specialist that states that because of your disability that you are no longer able to work.... then, you may qualify to IU that is paid at 100% of the rating schedule

Not if that's your sole service-connected disability and its rated at 40%. If this is the case, you don't meet the schedular requirements of IU in §4.16(a). Furthermore, if this is the case, the RVSR will not submit your case to the Central Office in Washington, D.C. for extra-schedular consideration under §4.16(b). To do so is purely a judgmental call on the decision maker. If they think you are able to due some sort of substantial gainful work, then they will not submit the claim for extra-schedular consideration. In the senario stated above, if one can flex their back to 25 degrees, then they more than likely than not can do some sort of seditary job. Yes, this is still considered a severe back disability, but the rational is that this alone as a 40% evaluation will not preclude the average person from obtaining and maintaining a substantial gainful occupation.

Generally, if the condition is so severe to warrant someone IU, then there is a schedular rating in the rating schedule that would bring that evaluation in line with the requirements of §4.16(a). Taking the senario above, if the veteran has a total incapacitating episodes (bed rest prescribed by a doctor and treatment by a doctor) of at least 6 weeks over the last 12 months, then that would more than likely preclude the average person from holding a substantial, gainful occupation. This criteria allows for a 60% rating for the spine and would then qualify the veteran for IU due to §4.16(a).

Vike 17

[TinCanMan]

The impact of your disability, be it physical or mental, on your social and industrial (occupation) well-being is extremely important on the level of your disability rating

1968Army:
Baloney!!! You are full of it. Please stop posting misleading information. It's quite clear from the way you handled your own claim you have a lot to learn.

[1968 Tet Vet]

Thank you Vike17. I agree.

TinCanMan: why do you want to provoke others on this webboard?

Originally Posted by Vike17

Not if that's your sole service-connected disability and its rated at 40%. If this is the case, you don't meet the schedular requirements of IU in §4.16(a). Furthermore, if this is the case, the RVSR will not submit your case to the Central Office in Washington, D.C. for extra-schedular consideration under §4.16(b). To do so is purely a judgmental call on the decision maker. If they think you are able to due some sort of substantial gainful work, then they will not submit the claim for extra-schedular consideration. In the senario stated above, if one can flex their back to 25 degrees, then they more than likely than not can do some sort of seditary job. Yes, this is still considered a severe back disability, but the rational is that this alone as a 40% evaluation will not preclude the average person from obtaining and maintaining a substantial gainful occupation.

Generally, if the condition is so severe to warrant someone IU, then there is a schedular rating in the rating schedule that would bring that evaluation in line with the requirements of §4.16(a). Taking the senario above, if the veteran has a total incapacitating episodes (bed rest prescribed by a doctor and treatment by a doctor) of at least 6 weeks over the last 12 months, then that would more than likely preclude the average person from holding a substantial, gainful occupation. This criteria allows for a 60% rating for the spine and would then qualify the veteran for IU due to §4.16(a).

Vike 17

[TinCanMan]

TinCanMan: why do you want to provoke others on this webboard?

Because you are misleading others. Your social and occupational impairment is irrelevant to your award in the vast majority of instances. All of this is either included in the VASRD or is part of it in certain mental conditions. Your doctor can say whatever he wants wrt social/occupational impairment and it won't make one bit of difference to your award if your condition doesn't otherwise warrant it on the VASRD. The decision maker has no authority to make an extra-schedular award.

Clearly from your own post here: http://www.veteransresources.org/for...0514#post10514
you lack understanding of the process and have mishandled it.

[1968 Tet Vet]

I guess, again, we agree to disagree and thats OK. No, I am not misleading other vets. I have my opinion as to what a vet should do in a particular situation and if I don't know... I will not make a suggestion. Its that simple.... and not a personal issue, at all.

I have the Veterans Benefits Manual on CD ROM, LexisNexis, and refer to it regularly.

PS. My claim(s) are EXACTLY where I want them to be, on target. The only problem is with the VA... because they are soooo slow in processing them in a timely manner.

[TinCanMan]

I guess, again, we agree to disagree and thats OK.

Whether you agree or not is irrelevant. Your girlfriends opinion on your social impairment is irrelevant to any award in the vast majority of instances. A few mental conditions excepted. Show me a statute or regulation that enables a decision maker to make an extra schedular award on the basis of lay observation. Your opinion in this matter is also irrelevant. It is only the law that matters.

I have the Veterans Benefits Manual on CD ROM, LexisNexis, and refer to it regularly

Oh, big deal. Anyone with a couple of dollars laying around can squander it on that kind of material. All the information necessary to a successful claim is available for free.

[1968 Tet Vet]

WHERE did you get the topic, as in red, below ? I didn't make such a suggestion. The issue is to file or not to file. That is whats important, now. Anyway, you are getting way off the subject and not good for "open discussion".

Originally Posted by TinCanMan

Whether you agree or not is irrelevant. Your girlfriends opinion on your social impairment is irrelevant to any award in the vast majority of instances. A few mental conditions excepted. Show me a statute or regulation that enables a decision maker to make an extra schedular award on the basis of lay observation. Your opinion in this matter is also irrelevant. It is only the law that matters.

Oh, big deal. Anyone with a couple of dollars laying around can squander it on that kind of material. All the information necessary to a successful claim is available for free.

[TinCanMan]

No, it isn't about filing or not filing. It is about the need to have a statement by your MD outlining the social and industrial impact on your life. The following is what you said:

3) an impact statement from your MD as to how your illness has effected your life, socially and industrially

It is not extremely important and is only relevant to a very few mental conditions. The VASRD lays out measurable requirements for each rating. Your MD's opinion of impact is pretty much useless in most instances because the decision maker .MUST. follow the objective criteria in the VASRD.

Now show me that citation that makes this necessary?

[1968 Tet Vet]

OK. Here it is:

§ 3.102 Reasonable doubt.

It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. It is not a means of reconciling actual conflict or a contradiction in the evidence. Mere suspicion or doubt as to the truth of any statements submitted, as distinguished from impeachment or contradiction by evidence or known facts, is not justifiable basis for denying the application of the reasonable doubt doctrine if the entire, complete record otherwise warrants invoking this doctrine. The reasonable doubt doctrine is also applicable even in the absence of official records, particularly if the basic incident allegedly arose under combat, or similarly strenuous conditions, and is consistent with the probable results of such known hardships.

Surely, you can understand this, can't you? A private MD's opinion is VERY important. It comes down to... the C&P opinion versus your private MD's opinion. Get it?

Originally Posted by TinCanMan

Now show me that citation that makes this necessary?

[TinCanMan]

A private MD's opinion is VERY important.

Am I supposed to be stupid or something? That is not what you said at all. Of course your doctors opinion is importent. It just isn't important to the social and industrial impact your condition might impose with limited exception for a few mental conditions. Get it, yet?

What you said was:

The impact of your disability, be it physical or mental, on your social and industrial (occupation) well-being is extremely important on the level of your disability rating

This is entirely different from what you are now saying.

OK, now go edit your post like you've done in the past. Too bad VRO has no Group "A" provision.

[1968 Tet Vet]

TinCanMan: I guess its just a misunderstanding of what we are saying. We are all here to help fellow Vets. NOTHING else matters.

[TinCanMan]

I guess its just a misunderstanding of what we are saying.

There is no misunderstanding on my part

We are all here to help fellow Vets

Some one else told you: "I find hardly any of your posts helpful." Based on your performance here, I would agree. I would recommend you devote more time to managing your own claim. You are personally responsible for the delays because you failed to understand the process. I find that to be a fairly common denominator in you comments.