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Unrelated Stroke After Disability Rating/helpless


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#1 sammy104

 
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Posted 05 November 2010 - 07:17 AM

My husband has had a 20% disability rating for his left arm and hand for over 10 years. Last year he had a huge stroke and almost died. He is age 72 and has been retired for many years. The stroke was at home, not service related. I care for him at home. He cannot speak, his whole right side of body is paralysed. After his stroke tho, his left arm/hand has gotten so bad, he can hardly even lift a spoon to eat meals. He cannot survive without help, period. He is totally helpless. Next week, , we go in for his first rating of his left arm/hand, AFTER his stroke suffered in april 2009. This is NOT the side that was paralysed, by the stroke. How tho, do they calculate a rating now, that he is totally helpless, cannot walk speak etc...but this stroke was not service realted? Stressed here to say the least. Thanks for your help

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#2 Berta

 
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Posted 05 November 2010 - 09:10 AM

The VA would be considering whether the SC arm and hand have been "aggravated" by the NSC stroke or they are disabled now due to a secondary nature.They will only rate the level of "aggravation" or secondary amount of disability.

I assume the claim was filed that way.

"He cannot speak, his whole right side of body is paralysed" My husband was basically in that condition as well after a major CVA.VA gave him speech therapy and he talked again and although the VA said he would be confined to a wheelchair gfor the rest of hs life- I determined they were unwilling to consider therapy,which he got after a battle and he did walk again.But he was 45 at the time. Still CVAs have so many residuals that I know how difficult this is for you and your husband.



My husband's stroke was in 1992 and last year I proved it was directly service connected.So nothing is really impossible.But it can involve a lot of work.

Is it possible his 20% SC disability involves a blood circulation problem that could have caused a clot to form in his blood stream and then cause the stroke?

Is it possible any med he is on for the SC disability has a pronounced clotting factor?

Is it possible his stroke stemmed from HBP that VA failed to treat properly?

Can you give us the exact medical diagnosis of his stroke (such as ischemic or hemmoragic?)
And the exact etiology his medical records show as to the cause of his stroke?

What is the nature of the service connected disability?

Edited by Berta, 05 November 2010 - 09:11 AM.


#3 sammy104

 
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Posted 05 November 2010 - 09:59 AM

Thank you for responding so quickly! My husband originally filed his SC claim approx 1999 or 2000. Just prior to arriving in viet nam, he had military accident which severed his left forearm which affected his arm and hand. there was never a fight to get SC disability. It started at 10% , then in 2006 was re rated at 20%. He was wanting to go in for re rating again prior to his stroke, as he had mild pain in his left arm/hand again. but he said he could live thru it. Personally, I think he did not want to miss work, as the economy was bad and he was so stressed with our finances, so he tried to just work through his problem. This past September I filed to reopen his SC claim.

What is HBP? His stoke stemmed form an a fib heart condition....causing a bloood clot, that went to his brain. You make excellent sense with the questions you asked. I am so grateful to have somebody to talk to about this. He is deteriating very fast on his left side. This morning he was barely even able to feed himself his own breakfast, Mornings are usually his best time of day. He was extremely active prior to his stroke..worked 2 jobs...six days aweek..with the attitude and energy of a 30 year old...even tho he is 72. Thank you for your hep. You went thru alot also with the VA and your husband. Thank you for your reply :)

#4 Berta

 
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Posted 05 November 2010 - 11:10 AM

"What is HBP?" Hypertension (High blood pressure)

"His stoke stemmed form an a fib heart condition....causing a bloood clot, that went to his brain."

Was he being treated by the VA for the atrial Fib heart disease? and/or High blood pressure?

Do you have copy of his medical records?

My husband was found to have had his stroke due to untreated heart disease as well as his high blood pressure had been found to have been inadequately treated by the VA.It was malpractice.Years after that was resolved I re opened due to another condtion they were negligent on and they awarded a direct SC AO death.

If he is a VA patient -have they adequately treated his heart condition-which caused his stroke.

Malpractice sure doesn't happen often in the VA system.

It is always a point to consider when one tries to find a way to service connect a veteran who has no known other service nexus for their disability.

When they diagnosed his heart condition (I am assuming he got VA health care but could be wrong)some research on your part along with his medical records will show what the 'standard' medical community would do to treat his heart problems.
If that info does not really compare with what VA did-he could possibly have basis for a Section 1151 claim.

I studied Cardiology and cerebravascular disease in 1995 to succeed in my claims and it was long tedious work. The internet today has made this much easier then it was then.

If his heart disease was not medically treated properly, it is most likely the cause of his stroke.

Then again it might well have been properly treated.

I am just looking at every way I can to seek a way for him to attain SC at higher level.

Do I understand he never arrived at Vietnam? Or did he arrive in Vietnam and continue to serve with the left forearm condition?

If he did step on Vietnam soil, was his heart condition described as ischemia by any doctor?

#5 sammy104

 
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Posted 05 November 2010 - 11:33 AM

He was treated by many places...VA and personal doctors as he has medicare and tricare for life., so, he was not ONLY treated by VA. Yes, I have medical records..and can get any records I need. Apparently everybody missed the fact that he hed irregular heartbeat, yes he had HBP. He was at VA for routine office visit 10 days b4 his stroke. The Nurse practitoner said he was fine. They didnt even make him go for big testing...seeing that he has been diabetic and HBP for many years. They didnt even re direct his visit to a doctor. He was seen by NP. What is a section 1151 claim?
Congtars to you and all your long hours of research you spent looking into your claim. It paid off. Yes , Internet today has been huge help. I could not have this great chit chat without it. I am so glad to be able to talk to somebody about this.
He was NEVER on foreign soil. His severed arm kept him here. I dont know if the word ischemia was used by any doctor in any of the diagnosis paperwork. What will that word mean? They always refer to it as an "a fib" condition, it never was a hemerrage.

Question, what if we just made it simple and looked at his SC left arm/hand as it is now/ post stroke, regardless ? He cant do hardly anything..except MAYBE on a good day, feed himself in the mornings..after that..his SC arm/hand goes downhill...and now his hand is a bit deformed. It is odvious he is totally helpless. Hard to even get him to hold a pen. Seems I remember reading somplace "helpless" affects SC ratings. Let me know. thanks so much :)

#6 Berta

 
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Posted 05 November 2010 - 12:25 PM

You are right to keep this simple-

some terms I mentioned would only apply to him if he served in Vietnam.

"What is a section 1151 claim?"

That is a rating by VA if negligence is proven in VA treatment that results in an additional disability caused by the negligence.

He certainly should be able to get a higher rating of the SC with the stroke causing these problems to hs SC condition.I only hope the VA sees it that way.

The term "helpless" usually is involved in claims for Aid and Attendance.

Those regulations are in this BVA decision.

http://www4.va.gov/v...es3/1028010.txt

#7 sammy104

 
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Posted 05 November 2010 - 01:02 PM

Can he get aid and attendance at ANY SC disabilty rating? or does it have to be 100%. I will try to get it possibly....he cannot do anything on his own. I see pension is a prerequisite...? He recieves military retirement AND SC disability each month. Is that the same as pension?



#8 sammy104

 
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Posted 05 November 2010 - 01:35 PM

So, I 'm back to my original question I have been asking myself....Am I way out of line to think VA will give him 100% rating.? The stroke has made worse his SC disability such that he can hardly do anything. In my mind it is a simple "yes" But...help put me back into reality :) what do you think? You have been very involved and dedicatedwith the system, I can tell. I have never had bad experiences with the VA so maybe thats why I so optimistic???? :)

#9 Berta

 
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Posted 05 November 2010 - 03:17 PM

In my 20 years dealing with the VA I cannot say Yes on this-

"In my mind it is a simple "yes" But...help put me back into reality :)"

I do see your logic and agree with it to an extent but claims are controlled by the regulations and not logic.

But I did some research and I can add one thing-

A & A is NOT dependent on a 100% SC rating.There must be a SC rating but it doesn't have to be 100%.

I think you should formally request Aid and Attendance (you could use a 21-4138 form or send them a letter with his C file number on it and then state how his SC disability has been compromised and made worse by the stroke.Give as many details as possible.

And then in this claim -ask the VA to refer your (his) request for A & A to VA Central Office in Washington DC for an Advisory opinion immediately 0 if the VARO cannot make an award of A & A.

Cite: M21-1MR Part IV, subpart ii 2.H.34
and also Veterans Benefits Manual, by National Veterans Legal Services Program,2010 Edition Footnote 471, page 349.

It would be good to have a vet rep on the POA who understands the A & A benefit and will support the need for it as well as support a higher rating for the SC disability. Ask them too for expeditious treatment due to his age and catastrophic illness.

I dont know how this will work out but it is definitely worth trying for the A & A benefit.

I sure hope others will chime in here as they might see something I dont see to help you.

#10 etihwr

 
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Posted 05 November 2010 - 10:25 PM

In order to qualify for A&A, you have to meet three of four criteria. You can't feed yourself, you can't bath yourself, you can't take your own medicine. There is a fourth, but I keep on forgetting it. If your going to apply for A&A, you need to show that you can't do these things. A letter from your doctor will go a long way to getting A&A.

#11 Philip Rogers

 
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Posted 05 November 2010 - 11:19 PM

Personally, I feel he can service connect(SC) the diabetes and stroke, since he had a SC amputation, and eventually win 100% SC, but bear in mind the VA moves very slowly and will probably fight this the whole way. Amputations are known to cause heart disease and circulatory problems like HBP, etc. In the mean time, they would probably award non-service connected(NSC) pension, w/A&A, but that is based on income and assets. You stated he was a military retiree? They don't usually retire unless a 30% rating or more and if so why did he wait until 1999/2000 to apply for VA comp?? Connecting the stroke should be relatively easy. jmo

Is he receiving social security??? If so, retirement or disability?? If not he should apply, now.


pr

Edited by Philip Rogers, 05 November 2010 - 11:21 PM.


#12 Berta

 
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Posted 06 November 2010 - 07:36 AM

Philip- we think alike!

I found some medical links to support exactly what you said as to the amputation -then I realised it appears this was a severed
forearm that did not mean loss of arm and hand:

"severed his left forearm which affected his arm and hand. there was never a fight to get SC disability. It started at 10% , then in 2006 was re rated at 20%. He was wanting to go in for re rating again prior to"

This needs to be clarified by Sammy104.

#13 Philip Rogers

 
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Posted 06 November 2010 - 10:02 AM

Berta, I have a lotta questions on this one. He has tricare for life??? You don't get tricare for life unless you're a military retiree. Usually you'd need 30% or more to be medically retired. I'm not understanding something here. How do you sever a forearm, w/o losing the hand? I'm lost.

pr

#14 sammy104

 
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Posted 06 November 2010 - 10:12 AM

Berta...Phillip...Etihwr....You guys are great!!!!!!!!!!!!!!!! :) Yes...i used the word severed for his left arm/hand.......i see now the confusion....... the SC disability cut so deep into his forearm that it cut apart many nerves and muscles etc....I will write more after I give hubby meds :)
What a wonderful website this is!! So goood to talk to somebody over all this :)

#15 Berta

 
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Posted 06 November 2010 - 10:14 AM

me too- maybe the veteran's nerves were severed and he still has the arm and hand but loss of use of????

"You stated he was a military retiree?" yes- that indicates retiree pay ----

If he gets retiree pay then his SC would have to significantly increase (or be CRDP or CRSC eligible) for any additional award from VA to really be a monetary benefit.

#16 sammy104

 
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Posted 06 November 2010 - 10:16 AM

Phillip...correct...NO medical retirement...just regular retired after 30 years Nat Grd.
He is 72 and also gets social security retirement in addition to his non medical military retiement. ..and of course he also gets his VA compensation each month. :)

#17 sammy104

 
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Posted 06 November 2010 - 12:10 PM

Thinking out loud here...I wonder if the VA should have been watching hiim for years..knowing that he had severed nerves and muscles ...damaged arteries possibly...tons of stitching and 3 months in hospital before he was released.....the accident to the arm...all made for terrible blood flow etc...anyways Berta..this is all your fault due to your WONDERFUL PAGE>>>>INTERNET MEDICAL RESEARCH PRINTOUTS!! I am searching internet more so than ever now....i can see MEDICALLY.how everything could POSSIBLY be related now....to afib heart condition....leading to stroke years later, long after his original SC left arm injury.....very easy to connect the dots...Berta....Im doing my homework now for sure...need to stock up on printer ink!! I feel a wave coming on of internet medical reasearch printouts!! Thank you Berta!

#18 Berta

 
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Posted 06 November 2010 - 12:12 PM

"in addition to his non medical military retiement. ..and of course he also gets his VA compensation each month. " and is his check from Military retirement reduced by the amount he gets from VA?

#19 Philip Rogers

 
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Posted 06 November 2010 - 12:22 PM

Now I'm thinking did they rate him properly, when he was first rated, at 10%, especially w/the nerve damage, etc??? Just thinking outloud.

pr

#20 sammy104

 
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Posted 06 November 2010 - 05:47 PM

"in addition to his non medical military retiement. ..and of course he also gets his VA compensation each month. " and is his check from Military retirement reduced by the amount he gets from VA?



correct...military retirement reduced by VA amount :)

#21 sammy104

 
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Posted 06 November 2010 - 05:59 PM

Now I'm thinking did they rate him properly, when he was first rated, at 10%, especially w/the nerve damage, etc??? Just thinking outloud.

pr

my thot also..now that I'm thinking about all this...Question>> Is there something special I have to do right now, if I suspect he was improperly rated from the very start? OR do I wait till we go to our firist doctor visit to reopen his claim? Then, at that doctor visit, then tell the rating doctor that I suspect he was never properly rated? Not familiar how the system works Thanks :)

#22 halos2

 
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Posted 06 November 2010 - 09:21 PM

Sammy, Put in his claims for increase now...it will take time for them to get back to you allowing you to gather all copies of his records/exam reports, all documents in his complete medical and C-File records.
You having copies of diagnoses and failure of them acting on these which ultimately resulted in his strokes should be the ammunition you need for proof of their doubt. Get an independent medical opinion evaluation from a physician who can like his problems/diagnoses with the stroke. Perhaps the physician who has been treating him could do this for you.
You have to be his advocate as he is no longer able to for himself. Keep coming here and posting and Berta is very familiar with the problems he is experiencing and she can lead you in the direction you need to travel. She is HIGHLY respected and VERY KNOWLEDGEABLE first hand with similar problems too.
File now and seek everything you need. Get your date in asap. Perhaps they may not retro back when they should so another date is needed while you fight. Good luck Sammy and seek out help that may be available via county health dept or other volunteer site there may be in your area. Are you close to his treatment facility where he goes to the VAMC?

#23 Philip Rogers

 
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Posted 06 November 2010 - 11:30 PM

An improper original rating would be a Clear and Unmistakable Error (CUE) and can be filed anytime. There is much here, at Hadit, on CUE's, if you do a little searching. You'll need to find out exactly what was damaged, in the accident.

pr


my thot also..now that I'm thinking about all this...Question>> Is there something special I have to do right now, if I suspect he was improperly rated from the very start? OR do I wait till we go to our firist doctor visit to reopen his claim? Then, at that doctor visit, then tell the rating doctor that I suspect he was never properly rated? Not familiar how the system works Thanks :)



#24 Berta

 
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Posted 07 November 2010 - 07:43 AM

I really cant add to the great advise here from Halos and Philip-they covered a lot-

file the claim for higher SC rating, and for Aid and Attendance.

During the wait for input for VA you can gather copies of all of his medical records and also obtain an independent doctor who could prepare an IMO for both the higher rating and for the A & A benefit.

There is a possible negligence issue here as well but that would take a strong opinion from an IMO doctor too.

There have been commercials lately on sattelite TV about how atrial fibrillation can lead to strokes.If his atrial Fibrillation was not diagnosed properly or treated properly by the VA there could be a basis for a Section 1151 claims for medical negligence.
Section 1151 claims only cover VA health care.

There is significant Sec 1151 info here at hadit.

#25 Berta

 
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Posted 07 November 2010 - 09:54 AM

http://americanheart...identifier=4451


“Treating atrial fibrillation is an important way to help prevent stroke. That's why the American Heart Association recommends aggressive treatment of this heart arrhythmia. “


In Section 1151 claims one must clearly associate VA health care records with any charge of negligence under Section 1151, 38 USC or the FTCA.

In a successful award of compensation under 1151, the VA will rate and pay comp “as if” service connected for the level of additional disability that the VA negligence caused.

If the VA causes a veteran's death and it is proven- they will award DIC under Section 1151 to the surviving spouse.
This type of DIC is not the same as regular SC death DIC and has limited ancillary benefits.

The VA care of the veteran has to raise to a level that was not consistent with the care that would have come from the "usual and standard" medical community.Or as in my case-I proved there was complete omission of proper medical care that the non VA medical community would have given him.

What the VA did or did not do can be the basis of these types of claims.

For my FTCA and 1151 claims- the lack of usual and standard care consistent with the regular non VA medical community was the criteria I had to prove was lacking in my husband's care,along with medical records that supported medical malpractice had occurred.

If your husband was not treated aggressively (as a VA patient) for his At fib condition, then his care was not up to the aggressive standards in the usual medical community.

However I cannot determine if he had full VA health care after his discharge = Were his Tri care doctors all from the VA?
Were his meds all from the VA?

Have you been able to determine if his meds were appropriate for aggressive At Fib treatment prior to his stroke?

Did the VA fully consider his blood flow and/or normal clotting ability was compromised by his severed arteries? I am, assuming this is the type of injury he had which is service connected now.
If they didnt , then his VA treatment might well not have been proper.

Any good vet rep should be able to help with the A & A and higher rating claim.
They too might well suggest getting an IMO however.

Any Section 1151 claim or FTCA claim should definitely have an IMO.

It is difficult to determine if an IMO will in fact support a malpractice or negligence issue.
An IMO doctor will need to thoroughly review the entire clinical record.

It pays however to do this yourself -if you can-to be able to highlight for the IMO doctor anything in the record they must focus on.

For my last claim (another malpracticed issue but completely different claim basis)I did obtain 3 IMos and spent $4000 on them which was well spent.

I knew beyond any doubt before I contacted the IMO doctor that his opinion would support my claim because my evidence was solid for the additional claim.IMOs can be very expensive.


If there could be any possibility at all that VA care caused your husband's stroke, this is something that should be pursued.He could file a FTCA claim as well. FTCA info is here in the FTCA forum.

My evidence for both 1151 and FTCA claims was the same.
VA wanted to settle with me within a few months after they got the FTCA claim.They had pbtained a medical report from a VA cardiologist that supported my case completely.

Then the VA lawyer and the cardiologist retired and the critical malpractice report disappeared.
VA told me it had never even existed.

I spent 3 more years of fighting with them to prove my cases. Years after I won I asked for additional copy of my C file and the critical malpractice report (that never existed)was right in the C file.

I used it as evidence for my present claim.

I cannot determine with limited info here if your husband was malpractice on.

But if there is any possibility of that, he should definitely pursue it.

I will be checking the FTCA forum today to see if there is ample Section 1151 info.

The format is pretty cut and dried.

Documented proof of malpractice (not easy to find for laypeople)
and a documented disability directly caused by the malpractice.

My cases were similiar to what you might have same basis for.

My husband had a heart attack while employed at the VA and was misdiagnosed.They said he had sinus condition.
He also showed signs of untreated diabetes and trancient ischemia.misdiagnosed by VA same year.
Four years later he had Major CVA (also misdiagnosed for 3 weeks and then improperly treated)
After giving him an ECHO the Cardiologist told me he had nothing wrong with his heart.Sept 1992.
He dropped dead 2 years later in our barn.

I proved the VA had caused his death by misdiagnosing and maltreating all of the above far below any usual standard of medical care consistent with the non VA medical community.
It was the initial misdiagnosis of his ischemic heart disease and the lack of proper medication and treatment for it that was the basis of my past claims.

It only takes one misdiagnosis to have a snow ball affect and cause other misdiagnoses and improper medical meds and treatment.

VA saves thousands of lives a day.But still they have malpracticed on some veterans too.Even the non VA medical community does.

All vet reps are trained in handling Section 1151 claims as well as the other claims you are filing.
It would good to find a vet rep to help you on these claims.

Edited by Berta, 07 November 2010 - 10:12 AM.


#26 Berta

 
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Posted 08 November 2010 - 07:36 AM

My earlier suggestion as to the stroke aggravating his SC arm injury is incorrect.It wont fit into the regulations.

The claim on that basis would have to show that his SC disability aggravated the NSC disability.Which is possible.It is one point that could be raised in applying for a higher SC rating. He cannot fed himself or do other things with the SC arm because it is aggravating his NSC condition.

There is good discussion on 'aggravation' here:
http://www.hadit.com...dary-condition/

Please read the CRDP and CRSC info here available under a search because his SC would have to get to- at least 50% I believe- before there would be any monetary gain regarding his SC compensation.

http://www.military....aring-crsc-crdp

I posted some more info in the FTCA forum as to Section 1151 claims.

If he had both VA and non VA health care under Tricare, the Section 1151 claim would only apply to any VA medical errors in treating his Atrial fibrillation.

#27 Berta

 
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Posted 08 November 2010 - 07:38 AM

My earlier suggestion as to the stroke aggravating his SC arm injury is incorrect.It wont fit into the regulations.

The claim on that basis would have to show that his SC disability aggravated the NSC disability.Which is possible.It is one point that could be raised in applying for a higher SC rating. He cannot fed himself or do other things with the SC arm because it is aggravating his NSC condition.(which will not allow him to use the right hand and arm)

There is good discussion on 'aggravation' here:
http://www.hadit.com...dary-condition/

Please read the CRDP and CRSC info here available under a search because his SC would have to get to- at least 50% I believe- before there would be any monetary gain regarding his SC compensation.

The CRSC CRDP criteria is here:

http://www.military....aring-crsc-crdp

I posted some more info in the FTCA forum as to Section 1151 claims.

If he had both VA and non VA health care under Tricare, the Section 1151 claim would only apply to any VA medical errors in treating his Atrial fibrillation that could have been possibly mitigated by non VA doctors at some point.

#28 sammy104

 
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Posted 08 November 2010 - 08:32 AM

Berta, GREAT INFO! I will research in spare time! I do have a question. I seen last night that he has huge buldge in what could possibly be strained shoulder muscle between nexk and shoulder. If VA dr says he has bad muscle and needs therapy, is rating still assigned at that time of visit? Or ratings are assigned later...to see if therapy worked? Again, this is all new to me this VA system Thank you again :) What a blessing have you been Berta and everybody...I had been so alone before hadit.com :)

#29 Berta

 
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Posted 08 November 2010 - 09:28 AM

VA doctors have nothing to do with ratings,

The VA raters ,when they receive a claim, rate on the medical evidence.

#30 sammy104

 
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Posted 08 November 2010 - 10:58 AM

I spoke with VA by fone to find out it can take as long as 6-8 months before we get in for Va doctor visit regarding his SC disability...apparently there is huge wait due to so many claims being submitted....
In the meantime...if we go to our local doctor and he sees hubby needs physical therapy on his arm asap..can we just start pt. thru our local MD? I am not a military person/ so in my mind i don't see how this MAY or may NOT mess up a VA dr vist months later...pleade advise :) thank you :)

#31 sammy104

 
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Posted 08 November 2010 - 11:03 AM

So... just to be clear..to see if I understand correctly...hubby will go to VA SC doctor visit....then, after that first visit...to reopen SC claim...that doctor will submitt his findings to a rating person, who will make a rating, Eventually, pay changes go into efect. If I am not happy with the new rating, I keep going back and keep challenging them until we are happy with rating, correct?

#32 Berta

 
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Posted 08 November 2010 - 11:56 AM

If he re -opens his claim, he will receive a VCAA letter telling him what evidence the VA needs.He will then be scheduled for a VA C & P exam.

The VA will then consider the results of the C & P exam as to whether his rating should be higher or not.

Then the VARO will prepare a decision.

This all takes a significant amount of time.

The VCAA letter will require a response. Any medical evidence that can help the claim should be copied and sent to the RO (Regional Office)along with the response form.

If a non VA doctor feels his present condition now is stemming from his SC condition this would be good evidence to have the VA consider.If the doctor would be willing to prepare an IMO (the criteria is in our IMO forum here) this would possibly help his claim and the VA would consider it -if this is his service connected arm.

8 months is about right for C & P time frame.or longer.

Once the claim is filed then they will at some point schedule the C & P.

"Eventually, pay changes go into efect." That will depend on the CRDP CRSC criteria I posted a link to.

A change could happen- but it might have no monetary benefit at all.Maybe larger check from VA and then Retirement check reduced by same amount.

Edited by Berta, 08 November 2010 - 11:57 AM.


#33 sammy104

 
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Posted 09 November 2010 - 08:24 AM

I was able to fax in a "hardship" note to the VA Regional office. With medical copies prooving his stroke etc., ...and it sounds like they can move him up in the line to be seen quicker, than 8 months. In the meanwhile, I'm filling out form # 21-4142 to get ALL his medical info released since his stroke. We go to many medical places as we are not restricted to VA care only. I am correct to think the only records they have are the ones thru VA care only?.

Do harship notes really work in getting in quicker? Wondering if anybody has experience with hardship request....in a way it seems all Va Sc claims are hardships......what have any of you guys experienced? :)

#34 Commander Bob

 
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Posted 10 November 2010 - 10:34 AM

My husband has had a 20% disability rating for his left arm and hand for over 10 years. Last year he had a huge stroke and almost died. He is age 72 and has been retired for many years. The stroke was at home, not service related. I care for him at home. He cannot speak, his whole right side of body is paralysed. After his stroke tho, his left arm/hand has gotten so bad, he can hardly even lift a spoon to eat meals. He cannot survive without help, period. He is totally helpless. Next week, , we go in for his first rating of his left arm/hand, AFTER his stroke suffered in april 2009. This is NOT the side that was paralysed, by the stroke. How tho, do they calculate a rating now, that he is totally helpless, cannot walk speak etc...but this stroke was not service realted? Stressed here to say the least. Thanks for your help



My most positive thoughts are with you, 'sammy104', and your husband, as you go through this ordeal. He is a fortunate vet to have a loving spouse such as you.

Thank you.

A fellow Vet...

#35 sammy104

 
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Posted 13 November 2010 - 08:27 AM

My most positive thoughts are with you, 'sammy104', and your husband, as you go through this ordeal. He is a fortunate vet to have a loving spouse such as you.

Thank you.

A fellow Vet...



Thank you for your kind words Commander Bob. Big challenges, faced head on.... bring big blessings!!! :)

#36 sammy104

 
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Posted 17 November 2010 - 11:25 AM

Berta/ RE:IMO....I've learned much from so many of your postings/replies from this website. I feel I am really doing MY BEST now, and am doing things in an "orderly and timly manner". Since filing hubbys claim to re open his SC file back in Sept 2010, I have ALSO updated our regional VA office by fax...he is now on the "hardship" list..in hopes to move his claim faster ...as since after his stroke...his whole body has deteriorated beyond words.... I also faxed in form 21-4142 ...to release all other med records outside VA.....very important as he has 11 outside medical contacts. I also am in the process of getting 2, possibly 3 of hubbys doctors to submitt their IMO to VA in near future.. I will also submitt something in writing myself, as spouse who is with him 24/7 . I will go into EVERY DETAIL, to outlinee SC deteriation, especially post stroke. I feel positive today! I'm doing my best , to help hubbys claim. He cannot speak nor write, but he is totally coherant. So I tell him the steps i'm going through...he has had big smile the last few days. He knows I'm on this web site for help. Im happy, as I see hubby is happy with all the help the military has given me, as I go through this process which is "all greek to me". I cannot thank you enough!!!!!!1 :)
PS PLEASE LET ME KNOW IF I HAVE LEFT OUT ANYTHING THAT I SHOULD ALSO BE DOING AS WE WAIT.....ANYBODY? what has worked for you? PLEASE CHIME IN :)

#37 sammy104

 
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Posted 11 May 2012 - 11:06 AM

HOW COME Nobody told me to file for a&a? i have no idea whats available for hubby....since sept 2010....did anybody mention a&a? help please thanks

#38 sammy104

 
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Posted 11 May 2012 - 11:07 AM

SORRY..........A&A SUGGESTIONI SEE IT NOW :) THANK U SO VERY MUCH! :)

#39 Berta

 
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Posted 11 May 2012 - 01:30 PM

At first I thought we did overlook some advise here on the A & A but then again-
it is often impossible here to really know every nuance to advise on-
this site keeps growing, so many questions daily----

so I am glad the info you needed was here anyhow.

VA recently (January)awarded my husband the HB award due to a stroke (I had thought they would award A & A instead) but since he had been dead for almost 17 years it was a victory. (result of a successful CUE claim)

I prepared my evidence geared toward A & A however .

I used the A & A regs here and in 38 CFR, gave a detailed lay statement as his caretaker, referred directly to his VA Day Treatment records, and other documentation VA had, his original SSA award (He had 2 SSDI awards) and I also had an IMO from a past awarded claim that also came into play again I think on the SMC S award.

Also he had been given (after I gave VA some heat) a new shrink and a battery of psychological tests that took most of 2 days at the VA in which the results assessment fully separated his 100% PTSD SC from his then NSC, and now 1151, and then in January direct SC Stroke due to AO, which VA recently granted 100% for as well as the SMC S.

So I experienced Stroke disabilities as to how VA rates them but.....does your husband expect to get TDIU or 100% SC? or does he get that now and has additional claims pending?????

It can be a long road to the SMC S award because the veteran first has to establish either TDIU or 100% SC first.
In my husband's case, as an example, VA had rated him at 80% NSC for the stroke in a 1998 decision I called a CUE on.

The Nehmer award letter rated him posthumously at 100% for 6 months then for residuals and awarded the SMC S (HB/A&A) for those 6 months of 100% then continued the residual rating up to his death.

If the VA does award your husband TDIU or 100% SC, then the VA itself should consider the SMC S award along with the TDIU or 100% SC decision.
Part of my CUE was that ,in my husband's case, they knew the 1998 award was for multiple malpracticed disabilities to include his stroke and failed to rate the stroke properly, failed to grant the stroke as SC under 1151,38 USC and worse of all they failed to even consider him for SMC, even though the medical evidence warranted that they use this mandated statute of SMC, as every medical statement in their 1998 decision legally warranted it.

It was clearly spelled out in the decision ( all this might help someone else out there) that even with an inaccurate 80% stroke rating ,on the rating sheet he already had established 100% P & T SC solely for his PTSD.

Thus SMC was granted under 1151, and subsequently under Nehmer AO ,direct SC for his major disabling stroke.







Unless this regards a wartime pension instead of Service connection?

Going back to one of your older posts:

"My husband has had a 20% disability rating for his left arm and hand for over 10 years"

You mentioned the stroke was NSC.

It is possible his medical issue with the SC he as now has caused or contributed to the NSC stroke and they would have to consider that.

However what I mean is if a circulatory problem in the SC extremity could have caused a clot that caused the stroke.

I am not a doctor but this is the only way I foresee getting the stroke service connected as secondary and it would take strong medical evidence from an IMO doctor.

Is that the basis of the claim???? To attempt to get the stroke SCed?

If he is seeking a wartime pension and if he is eligible for one, that might be higher than the SC rating he has now.

There are income limits regarding wartime pensions but medical costs can impact a pension claim favorably .


I am not explaining the pension well here- we have concise NSC Wartime pension info here under a search.

Maybe you are claiming a SC disability has aggravated a NSC disability? That too will take strong medical evidence.

Do you have a veteran's service rep helping you?

Edited by Berta, 11 May 2012 - 01:47 PM.





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