Questions Regarding A Possible Claim For Tdiu Options

[LarryJ]

Once upon a time, in a land not so very far away, there was this guy. He turned in a claim for TDIU. He was a chronic pain patient at the local VA and was taking prescribed narcotics. He was denied TDIU.

So........he went down to the local Police Dept. and applied for a job.......of course, first thing they wanted was a urine sample. Okay, so he gives them a urine sample, then he shows up a couple of days later for his "official interview", whereupon they helped him down the hall to the "booking desk".............
He won his TDIU on a de novo review. Something about, "Hell, I can't EVEN show up for a job interview without getting thrown in jail........how the hell am I gonna be able to work?"

not a reccomended method to win a claim, but, HEY.....?

[john999]

If you are getting methadone and vicodin then that indicates severe pain condition. I think this would help a IU claim. One thing for sure driving a car or being around any work conditions where you need sharp attention is out for you. I took vicodine today and left two of my favorite CD's at the mall where I was listening to them. I don't remember what happened until I got home. That is the dope working on my brain. I have chronic pain disorder. It is actually responsible for me losing my job. Both vicodin and methadone can cause depression and mood swings. When I take vicodin I start to get angry. It is chemical with me. I took methadone, morphine, percoset and vicodin. Vicodin and percoset are the most addictive because they are quick acting. Don't mix any of this stuff with alcohol even if it helps the pain. Yes, methadone was a cure for heroin addiction. Heroin is a cure for morphine addiction. Methadone made me itch like crazy.

[carlie]

As for the depression side..... I've been on VA prescribed Zoloft for my OCD since 1995 (SC'ed at 10%, but have a request for increased eval due to worsened condition) , which helps to ease my depression I get from the chronic pain (which I take Vicodin for and have for the past few years). From what I understand, my rating for the OCD covers for depression as well under the ratings guidelines.

Jay

Jay,
So you know - VA only compensates for one Mental Health Disability.
By regs, you should be compensated by the one that would pay
the highest percentage as evidenced in your medical records.

I think that one of these is what you are currently rated under for Mental Health.

OCD is DC 9404
Chronic Pain is DC 9422
MDD is DC 9434

This is the criteria that will pertain to your request for increase
in Mental Health disabilities.

carlie

http://ecfr.gpoaccess.gov/cgi/t/text/text-....73&idno=38


General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name 100


Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships 70


Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships 50


Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events) 30


Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication 10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication 0

[cowgirl]

Looks like you are building good care connections and support. Thats helpful for your claim, and its up to you to ensure the rater 'reads' your current VA clinical notes. I've listed dates, name and conditions on a breif list so the rater would know where in my file to look; honest, fastest NOD I've had.

Sorry to hear about your knee and medications - sure sounds like unrefutable evidence a comp examiner would have to consider. Recently I had an examiner that read clinic notes from my providers, I know only certain information was contained in those, so that was factual.

Good going on the VA records, do you have your Service Records? Read them all for connections and questions for your claim,
Lots of helpers here,
the best to ya,
Cowgirl'up2009!

Well, went today and saw my VA PCP.

For my chronic knee pain he kept me on Vicodin, but also added Methadone. Anyone out here taken this before? Isn't this for heroin addicts? For my OCD, he increased my Zoloft meds and now has me seeing a Psych doctor due to my increasing obsessive rituals. To help take strain off my knees he is prescribing me a cane to help me walk in addition the the two "unloader" knee braces I already wear. ( I'm only 37) And, because of my age, we are going to try Synvisc injections in hopes of extending the time until I need total knee replacements on both knees.

On a sour note, he was not willing to write something indicating that I am 'not employable'. He stated that the raters will be the one to make that decision based on his exam report and the reports of the C+P exams.

And on a happy note, I received a full copy of my VA medical record just 4 days after faxing in the VAF 10-5345a. I can only hope my TDIU claim gets completed as fast! (I know, joke of the year!)

Any opinions on how this may effect my TDIU claim and SC increase claims?

Lyndenrider

[Pete53]

Good for you and you should get an answer in a few weeks to a couple of months. You are on the home stretch.

Good Luck

[Lyndenrider]

Well, went today and saw my VA PCP.

For my chronic knee pain he kept me on Vicodin, but also added Methadone. Anyone out here taken this before? Isn't this for heroin addicts? For my OCD, he increased my Zoloft meds and now has me seeing a Psych doctor due to my increasing obsessive rituals. To help take strain off my knees he is prescribing me a cane to help me walk in addition the the two "unloader" knee braces I already wear. ( I'm only 37) And, because of my age, we are going to try Synvisc injections in hopes of extending the time until I need total knee replacements on both knees.

On a sour note, he was not willing to write something indicating that I am 'not employable'. He stated that the raters will be the one to make that decision based on his exam report and the reports of the C+P exams.

And on a happy note, I received a full copy of my VA medical record just 4 days after faxing in the VAF 10-5345a. I can only hope my TDIU claim gets completed as fast! (I know, joke of the year!)

Any opinions on how this may effect my TDIU claim and SC increase claims?

Lyndenrider

[Lyndenrider]

Thanks everyone for the assistance and support.

On Monday I will be faxing a VAF 21-4138 to add "Pain Disorder, Diagnostic Code #9422" to my existing claim for SC increases and TDIU. I will also be sending VAF 10-5345a to get my complete medical record sent to me in the mail. I was not aware of this form until halos2 stated it. THANKS halos2!

I know this will be a long process, so I do plan on making this my new 'job' since I'm not capable of working a real job.

Thanks again everyone! (IMG:http://www.hadit.com/forums/style_emoticons/default/smile.gif)

[john999]

If you know that your long term prospects to be able to work again are dim you have to begin to treat your VA claims as a job. You have to get in treatment and stay in treatment. You have to begin to build a mountain of documentation and keep building until the day you die. You can't treat your disability as something you can just get, and then walk away from to get on with your life. It is your life now. It is going to pay you and your familiy the rest of their lives once you become P&T. You don't need to become obsessed with the VA, but you need to cultivate the doctors and play the game. If you are compliant and show up these guys at the VA will help you rather than hurt you. Your PCP and your psychiatrist are the ones who will do the most because they deal with people and not just with cutting people open and sewing them back up.

[halos2]

Jay, Have you written to your VAMC under the freedom of information act requesting copies of your records there? I have gone in person, faxed them my requests, and written to them, and have always received all my records. Sometimes I get them immediately, other times they advise me when they will mail them to me.
There is a form you can use to request these too. I'll post form# when I remember it...some others might remember form numbers and give you a shout out on the form # and you can download it to mail/fax to them. They have the form in Medical Records/Medical Information Technology dept too.
You need these copies so you will be able to read what they will be reading. Underline pertinent documentated/validated information that relates to your main issues you are putting in for claim purposes. You will see what you have, what you don't, and what else you need. (IMG:http://www.hadit.com/forums/style_emoticons/default/wink.gif)

Ok form # is 10-5345a It is titled as: Individual's request for a copy of their own Health Information...which the medicalrecords/information dept puts a check in the space (as to how the records were delivered to the veteran) received in person/ or mailed to address.
So request them and they should mail them to you if you can't make it there. Go to www.va.gov/forms and type the form # in the area, or under search the title of the form. Good luck.

This post has been edited by halos2: Nov 6 2009, 01:14 AM

[john999]

I agree with what Larry is saying about claiming chronic pain disorder and depression. The VA can waive the 12 year thing regarding your Voc Rehab. However, if you want to get IU then the only reason you would want Voc Rehab is for them to say you are unemployable. Are you seeing a VA psychiatrist on a regular basis? Do you get your narcotics via the Pain Management at the VA? What is your overall rating? If you have been on vicodin for five years you have chronic pain, and are no doubt physically dependent. It is hard for other psychiatric meds to work when you are dealing with severe chronic pain. My VA shrink tells me the naroctics just overwhelm the other meds. The TDIU thing may take some time unless you are already rated at least 40% for one disability and 60% combined.

However, you have to start some place and it might as well be right now. I would make the claim for IU as soon as I could fill out the form. You will no doubt be sent for C&P exams for all the conditions you claim, so it will take time. Is your knee injury a service connected problem? You might need a IMO for the psychiatric problems to get a higher rating. The SSD may be a problem because of your age, but you have to file to find out.

[Lyndenrider]

BTW, anytime you send the VA any type of "personal statement of fact" as you put it, make sure that it has the proper ending, just above where you sign it.
It goes something to the effect that "all statements contained herein are true and correct to the best of my knowledge and belief".

I did this exactly this on the ending of my Personal Statement. (IMG:http://www.hadit.com/forums/style_emoticons/default/biggrin.gif) I'm trying to make it as easy as possible for the VA to grant me what I deserve... and want.

[Lyndenrider]

Cowgirl,

I do not have any updated VA medical records at this time since you have to request them in person at a VA hospital. My nearest VAMC is in Seattle, nearly three hours away. I do plan on getting them once I go and see Othro regarding my "likely" knee replacements (hopefully by the end of the year).

As for VocRehab... In June 2009 my VA PCP submitted a request for me for VocRehab eval. Two weeks later VocRehab called me, told me that the 12 yr limit for applying had passed for me, and then directed me to websites and other things to help me find work that I could do. Problem is, I CAN'T WORK due to my SC'ed issues, which is my I filed for TDIU and for a complete reevaluation of my SC'ed disabilities. To my own fault, I'm the type of person that deals with what I have until it "breaks", which tends to make things worse for me then if I had been more proactive. Well, proactive I am becoming, and quickly!


LarryJ,

Thanks for the advice. I see my VA PCP at the CBOC in 10 days and will bring up the "pain disorder" thing. Maybe he can write something up for me and I can attach it as well to VAF 21-4138. I'll submit to the DAV and have it added to my TDIU claim.

As for the depression side..... I've been on VA prescribed Zoloft for my OCD since 1995 (SC'ed at 10%, but have a request for increased eval due to worsened condition) , which helps to ease my depression I get from the chronic pain (which I take Vicodin for and have for the past few years). From what I understand, my rating for the OCD covers for depression as well under the ratings guidelines.

I can see my claim getting very messy and complicated for the VA. A resolution may take some time. (IMG:http://www.hadit.com/forums/style_emoticons/default/wink.gif)

Jay

[LarryJ]

BTW, anytime you send the VA any type of "personal statement of fact" as you put it, make sure that it has the proper ending, just above where you sign it.
It goes something to the effect that "all statements contained herein are true and correct to the best of my knowledge and belief".
I just use the standard VA "Statement In Support of Claim" in all my messages to the VA, that way you are covered.
After you have sent in your very first "official claim" (I use the PDF fillable claim, VONAPPS, from the VA websit) then you do not have to file another "official claim using the 20 or 30 pages it takes for your very first claim (they already have all that info, right?), so a simple Statement In Support Of form will work just fine for any new and different claims, other than your first.
I know that you knew this, but, I just thought I'd chip in with that info, seein' as how your post will attract some "readers and lookers". Thanks.

[cowgirl]

Do you have a current copy of your VA medical treatment records? your C-claims file? Reading and rereading help to see what is 'recorded' versus what is 'mentioned'. Would be good to see 'mention' of IU.

Have you filled out the VA form 28-1902 Counseling Record form? If not, take your time and describe Disability Limitations and support your statements. Remember its 'your' request for help from 'them'. (I felt my counselor rushed me to complete the form. For a redo, I'd take it with me and return it soonest.)

Glad to see you at Hadit, looks like your're proactive for yourself, family to get available benefits result of your military health conditions.

If I had redo vocrehab, I'd claim my depression right in front of my pain, honestly. My personal experience was time consuming and not helpful.

Sometimes vocrehab gives a vet a denial, which isnt necessarily bad and maybe help with ssdi or iu. Some denials I've read say something to the effect of
"we've determined the veteran 'cannot succeed in a program of training or education, and get a job occupation that matchs their skills, talents and interests.' The evidence used shows vet was unable to pursue higher education because 'inability' to work with other people (individually or a group of people). Or unable to physically attend a regularly scheduled program of courses due to debilitating SC health issues."

Hope your vocational rehabilitation process goes smoothly and they offer you direct help, expect good things! (IMG:http://www.hadit.com/forums/style_emoticons/default/smile.gif)

Second Yes, on Carlie's note, point the VA in the right direction - to the strongest evidence in your records/file to support your claim.

A thought, if you are on those meds, ask or even tell your PCP or specialist directly - to validate that you have chronic pain disorder or have them explain why or why not. Also pain management class is good fodder as well as helpful to many.

All the best to ya,
Cowgirl'up2009!

Well, last year at my 2008 annual exam my VA PCP mentioned to me about IU, but I had just stopped working and figured I'd find something I could do. 1.5 years later, still no job. I saw him again in June 2009 and he suggested VocRehab as a way to get training for a job that allows me to sit all day. All VocRehab did was direct me to other employment resources. Needless to say, I have an appt. on Nov 16 with him again to discuss IU and see if he will write up something for me to submit along with VAF 21-8490. I have no plans to submit any medical documentation from my surgeries or other docs since the VA already has this inside my VA medical record.

Should I submit the IU form right now WITHOUT documentation from my VA PCP or should I wait til I see him on Nov. 16????

Also, is the VA likely to schedule me to see more docs to support my claim? Or should I do that myself BEFORE submitting VAF 21-8490???

Thanks again for any and all advice.
Jay

[LarryJ]

On a Statement In Support of Claim, simply state that you would like to make a formal claim for "Pain Disorder, Diagnostic Code #9422". Attach your list of narcotic medications (get this from your MyHealthEVet) and any of your VA MedRecs that will support the claim. If you can get your VA doctor(s) to state that you have "Pain Disorder", the more the merrier!

BTW, I'm one of carlie's "chronic pain disorder pro's", I guess?

BTW, MOST patients in chronic pain ALSO suffer with depression..................just sayin'.

[carlie]

Lynden,
I'll send a shout out to a chronic pain disorder pro.
carlie

[Lyndenrider]

Carlie,

In my personal letter that was attached to VAF 21-8940 I put the relevent dates of surgeries performed, clinics attended, dates when my knee braces were made by the VA, etc... I just have never seen a private doctor regarding my SC injuries, only the VA.

As for filing for SSD, I am sending that in to the SSA next week.

As for filing for any hardship, I think I'll just wait for now. Kinda don't wanna go from the middle of one stack to the very bottom of another. I managed to save some money a few years back when I knew my SC problems were going south on me. I've got maybe a year left before I'm completely broke and cannot make my mortgage, etc. Hopefully will have something good from either the VA or the SSA by then.

Being 37 yrs old with two young kids and having medical problems sure sucks. At least I'm not using a wheelchair.....yet.

I noticed on a previous post on hadit.com that the VA can rate you for chronic pain disorder. How would I go about this? Bring it up on a C+P exam? I've been on prescribed opiates for years now for my knee and back pain, but they don't work near like they did a few years ago.

Thanks for any followup to my questions.

Jay

[carlie]

This is gonna suck since I've not worked since September 2008 and have a family of four to take care of. Now this letter makes it seem like many YEARS before I see any results....... Don't they have a 'hardship' clause or something like that? (I know, they don't. But I sure wish they did!) Do they have a priority list like the actual VA hospitals have?


Thanks, Jay

Jay,
Have you considered applying for SSA benefits of SSD ?

Yes, you can apply for hardship consideration during the Rating process.

One needs to include things like:

Proof of impending terminal illness
Letter from Hospice
Proof of advanced age
Mortgage Foreclosure papers
Eviction notices
Cut off notice's from Power Company
Cut off notice's from Water & Sewer
Banking Statements

These are some of the issues covered in a hardship request
and even that has it's own line to get in.

Have you checked on any benefits that may be available in your state ?

carlie

[carlie]

I have no plans to submit any medical documentation from my surgeries or other docs since the VA already has this inside my VA medical record.

Thanks again for any and all advice.
Jay

Jay,
I would not take for granted that VA will read all of your medical documentation
that is "supposed" to be of record.
If you have dates of specific medical evidence, do not hesitate to point
them in the right direction.
jmho,
carlie

[john999]

The VA could decide your claim next week or next year. Have you had your C&P exam? Usually the decision comes pretty quick after the exam. I would love to be a fly on the wall and see exactly what happens at the VARO. I know I would be mad because to them it is just a paper shuffling job, but to us it is our lives.

[LarryJ]

I've got a stack of those "sincere desire" letters from the VA. I wad one up occasionally for my cat to play with.

[Lyndenrider]

Got a letter today from the Seattle VARO Veterans Service Center Manager. It states, ".......It is our sincere desire to decide your case promptly. However, as we have a great number of claims, action on yours may be delayed...........". (IMG:http://www.hadit.com/forums/style_emoticons/default/mad.gif)

Has anyone else gotten a letter like this? I NEVER have in all of my dealings with the VA and disability issues/claims.

Is the Seattle VARO really that busy? Has anyone else had a LOOOOONG wait thru the Seattle VARO for their benefits decision?

This is gonna suck since I've not worked since September 2008 and have a family of four to take care of. Now this letter makes it seem like many YEARS before I see any results....... Don't they have a 'hardship' clause or something like that? (I know, they don't. But I sure wish they did!) Do they have a priority list like the actual VA hospitals have?

Sorry, just had to vent off some steam. Granted, my claim was just received by them, but I was hoping no more then 6 months, but I might have years to wait. (IMG:http://www.hadit.com/forums/style_emoticons/default/sad.gif)

Thanks, Jay

[cowgirl]

Feel free to come back with questions or read. The facts - medical opinions win benefits due you. All the best - Cg'up2009!

Well, my body and mind could not wait, so I decided not to wait for my appointment on November 16th. They can get that information once my PCP enters it into my VA medical records. This morning I faxed all of my info to the DAV, which holds my Power of Attorney, in the Seattle VARO. Not two hours later they stated that it was turned into the appropriate department within the VA.

I submitted a 21-8940, a 21-4192 that I hand delivered and got completed by my previous employer, a personal letter of fact from my previous employer as well as a personal letter of fact from myself.

Now I just wait to hear when my appointments are with all the doctors they want me to see at the VA hospital.

Thanks for all the information and advice that I received on this forum. Hopefully I'll be able to reply back in a few months with some good news.

Jay

[Lyndenrider]

Well, my body and mind could not wait, so I decided not to wait for my appointment on November 16th. They can get that information once my PCP enters it into my VA medical records. This morning I faxed all of my info to the DAV, which holds my Power of Attorney, in the Seattle VARO. Not two hours later they stated that it was turned into the appropriate department within the VA.

I submitted a 21-8940, a 21-4192 that I hand delivered and got completed by my previous employer, a personal letter of fact from my previous employer as well as a personal letter of fact from myself.

Now I just wait to hear when my appointments are with all the doctors they want me to see at the VA hospital.

Thanks for all the information and advice that I received on this forum. Hopefully I'll be able to reply back in a few months with some good news.

Jay

[LarryJ]

First, Welcome to Hadit.

Second, IF your PCP will write you a statement that you are unemployed due to your SC conditions and the medication that you must take to control your pain from your SC conditions and that you will be unemployed, that you are not going to be any better and that your condition is permanent, etc., then I would most assuredly wait the 3 or 4 weeks for that, and staple it to the 21-8490 and send it in. If you have a VSO at the DAV, then make sure that they have a copy and make sure that they get it sent in (tell 'em it'd be just fine with you if they FAX'd it) but that they need to get you an acknowledgment that the VA received it.
That should pretty well cover it.
I would say "a slam-dunk" but, I've been around too long to EVER say that about the VA and what they might do.
(IMG:http://www.hadit.com/forums/style_emoticons/default/rolleyes.gif)

[Pete53]

Welcome to Hadit.

[Lyndenrider]

Well, last year at my 2008 annual exam my VA PCP mentioned to me about IU, but I had just stopped working and figured I'd find something I could do. 1.5 years later, still no job. I saw him again in June 2009 and he suggested VocRehab as a way to get training for a job that allows me to sit all day. All VocRehab did was direct me to other employment resources. Needless to say, I have an appt. on Nov 16 with him again to discuss IU and see if he will write up something for me to submit along with VAF 21-8490. I have no plans to submit any medical documentation from my surgeries or other docs since the VA already has this inside my VA medical record.

Should I submit the IU form right now WITHOUT documentation from my VA PCP or should I wait til I see him on Nov. 16????

Also, is the VA likely to schedule me to see more docs to support my claim? Or should I do that myself BEFORE submitting VAF 21-8490???

Thanks again for any and all advice.
Jay

[john999]

The VA can't require you to have any medical treatment. That is up to you. I think you should file for IU and SSD. Like Berta says you need a doctor to say you are IU because of your SC conditions. If you have been on vicodin for 5 years you also have a drug dependency . You find this out when you try and stop taking it. The dose you are taking is probably just enough for you to stay normal. Pain relief went out the window years ago unless you have been constantly increasing your dose.
If you take the vicodin as the doctor prescribes every eight hours you become dependent in a matter of months. If the VA suddenly decided they would not prescribe narcotics to out patients the street price of drugs like vicodin would soar. They have created tens of thousands of vets with drug dependency. They need to take responsibility for that. If you take the drug exactly as prescribed you will become dependent (physically addicted). This is just a chemical fact.

[Berta]

"This medication makes driving a vehicle to work everyday somewhat dangerous."

If you havent filled out the TDIU form yet-I suggest you state Yes to # 18 and then apply for SSA disability benefits. and then under # 25 refer them to a separate page with your C file number, name and address on it and tell them any other info such as the vicodin side affects as you mentioned here.

"could the VA possibly require me to have bi-lateral knee replacement" that is a good question- but with
multiple sutgeries on your knees already maybe you are not a candidate for knee replacement.

Let them know how the OCD interferes with your employment too-

Has any VA doctor stated yet that your SCs prevent you from working? This is what the VA will need-
medical evidence that due to your SCs -you are unemployable.



This post has been edited by Berta: Oct 22 2009, 09:20 AM

[Lyndenrider]

Let me begin by saying that this forum is a great resource for disabled vets like ourselves to get assistance. Thanks!

I was just approached by a neighbor last week regarding TDIU for myself.
I am rated 60% SC and have been for over 10 years. I'm 40% left knee [had three surgeries], 20% right knee [had two surgeries], 10% back pain [no surgeries....yet], 10% OCD [VA prescribed medication] plus 0%-10% for other SC ailments.

I have been unemployed since September 2008. I had to stop working my last job due to the fact I could not continue working due to the stress and strain on my knees and back. I have made NUMEROUS attempts over the last 1.5 years at finding other employment but have had no luck. Prolonged standing or frequent lifting causes me "issues". A few years back I was given custom-made knee braces from the VA for both knees for stability, which I wear almost daily. I have also been on daily pain meds (Vicodin) for the last 4-5 years, also VA prescribed by my VA PCP. This medication makes driving a vehicle to work everyday somewhat dangerous. Also, three years ago I was told by VA orthopedic surgeons that I am a candidate for bi-lateral knee replacements, but I declined having it done due to my younger age [I'm currently 37].

As for seeing doctors, I have only gone to VA doc's in the last 12 years since I have had a hard time getting health insurance from other resources. So, I only have documentation from the VA, not from other resources.

My questions for this forum are...

Besides filling out VAF 21-8940, what other things should I send with this form to help support my claim?

By submitting a TDIU claim, could the VA possibly require me to have bi-lateral knee replacement?

Am I just asking for trouble for myself by submitting a TDIU claim?

I'm a lifetime DAV member, but is there any other resources for help with this that I can get?

Thanks to anyone for assisting me with my questions and for any advice!

Jay