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What is going on at the VA?

Posted on March 2, 2018 by WPTangerine

Sabotage and Subversion: Secretary Shulkin’s Struggle at VA

I’ve not been a big fan of Sec. Shulkin, however what is going on at VA by “subversive” staff is wrong and should be dealt with swiftly. You cannot lead with staff that is plotting against you to implement their own agenda. Sec. Shulkin must act and get the focus back on veterans.
Highlights from the article:

CVA Concerned Veterans for America – The motives of the Koch brothers, the CVA’s backers, are more likely to be ideological than financial. The industrialists, whose business interests are concentrated in energy rather than health care, have a long-standing antipathy towards socialized medicine, of which the VA health system is the prime example in America.
The VA has long paid for such services, usually for those who live far away from specialists or who are unable to obtain an appointment fast enough. But the cost of purchased care has surged 500% from 2002 to 2014, and a lack of data makes quality assessment impossible. Unsurprisingly, a review in 2016 shows significant cost mark-ups. The cost of diabetes treatment nearly tripled, the cost of prostate-cancer treatment almost doubled.

Read the full article on The Economist

What is going on at the VA?

DAVID SHULKIN, the secretary of veterans’ affairs, did a dim-witted thing when he took a leisurely trip to Europe in July 2017 at taxpayers’ expense. The government paid his wife’s travel costs while the pair toured Westminster Abbey, cruised down the Thames, improperly accepted tickets to Wimbledon and went shopping in Denmark.

14 Questions: VA Disability Benefits Claims

Posted on January 1, 2018July 25, 2022 by WPTangerine

When a Veteran starts considering whether or not to file a VA Disability Claim, they tend to ask many questions. Over the last ten years, the following are the 14 most common basic questions I am asked about when it comes to filing Veterans Affairs Disability Claims. [Reprinted here with permission from Veterans Law Blog]

1. What benefits do you get from a VA Disability claim?

You can get several major categories of VA benefits when you file a VA Disability claim.

One category is the “Non-Service Connected Pension,” available to extremely low-income veterans with disabilities.
Another category is education benefits.
A third category is burial benefits.
A fourth category is health care benefits.
And the category that is the focus of this post – and the Veterans Law Blog – is disability compensation for diseases, conditions, and disabilities that originated in military service.

(Note that you do not need to show that military service CAUSED the disability – Congress long ago recognized that Veterans should get benefits even if a disease or disability that wasn’t caused BY service has its origins IN service.

When it comes to a VA Disability claim for service-connected disabilities, the primary benefit is financial. Once you prove to the VA that your current medical condition, disease, or disability is related to your military service, they will assign a percentage of disability to that condition – using a complicated table and formulas. That percentage of disability translates to a monthly dollar amount. 10% equals one amount….20%, another amount, and so on and so forth.
You can look at the current VA Disability claim compensation amounts by clicking here (assuming the Department of Veterans Affairs hasn’t restructured their website, as they commonly do when it gets a little too easy to navigate).
In addition to the basic rates of compensation mentioned above, you can get additional compensation for different scenarios you raise in your VA Disability claim.

Here are just a few:

A veteran with specific percentage ratings for multiple disabilities can be eligible for additional Special Monthly Compensation. This Special Monthly Compensation is also available to Veterans with specific disabilities that limit the use of, or that resulted in the loss of, their extremities, their reproductive organs, and organs of special sense (vision, etc.).
Veterans unable to work because of their service-connected disabilities are entitled to a 100% total rating under a benefits program called Total Disability for Individual Unemployability, or TDIU.
Veterans who need special aid and assistance with certain activities of daily living are entitled to an additional amount of compensation.
And Veterans with a spouse or certain dependents are also entitled to higher rates of compensation.
There are certain vocational rehabilitation benefits available to Veterans with service-connected disabilities.
The total percent rating of your service-connected disabilities can play a role in the ease you get VA Healthcare or the Priority Group you are assigned to.
There are grants available for special adaptations to housing or automobiles that can grow out of your service-connected disabilities.
Survivors of Veterans are entitled to non-service connected survivors’ pensions – also limited to the lowest income survivors. These survivors are typically spouses or children, but in some cases include parents and adult children who were permanently incapable of support before they turned 18.

2. How do I file a VA Disability claim?

It used to be that you could file a VA Disability claim for a service-connected condition, disease, or disability just by writing your claim on a piece of paper – a famous anecdote that floats around the Veterans’ community is the Veteran who wrote his claim on a square of toilet paper while in prison.

This is no longer the case: filing a VA Disability claim has become increasingly complicated, like many other things in this world.

Generally, filing a VA Disability claim requires a series of actions:

Step 1: Filing Phase

You can first file an informal claim for benefits using the required Veterans Affairs Form. If you formalize your claim within one year of that informal claim, the Veterans Affairs treats your informal claim as a formal claim. (You can see where this is headed. One of the things that the Veterans Law Blog works really hard to do is to show you a way to cut through all of this fog and file a VA disability claim that is more likely to get granted, award you the proper benefits, and do so in the shortest time possible.) The rules and steps get goofier and goofier as we go through the steps.

Step 2: Development Phase

You can let the Veterans Affairs develop the evidence to support your claim – officially; they have a Duty to Assist the Veteran in developing certain claims in limited situations. Or, you can be more proactive and develop your OWN claim, filing what is called a “Fully Developed Claim” for VA Benefits. Theoretically, these claims are supposed to be decided more quickly, and for the most part, they are. But by developing your own claim and using the knowledge, information, and tools I share on the Veterans Law Blog, you can set your claim up for more thorough decisions, more proper decisions, quicker decisions, and worst case scenario, if you have to appeal, a better chance at winning your claim on appeal.

Step 3: The Decision Phase

Veterans Affairs will decide C&P (Compensation & Pension) Examiner medical doctor that will decide if your diagnosed condition how bad your condition is, percentage-wise
denial or a grant of benefits

4 Pillars of a VA Claim:

Pillar 1: Are you eligible to file a VA Disability claim for compensation benefits
Pillar 2: is the medical condition – or conditions – in your VA Disability claim related to your military service? (This pillar is often called the “service connection” or “nexus” element of your VA Disability claim)
Pillar 3: To what degree does your disability impair your ability to seek and hold work or engage in average daily living activities? I call this pillar the “Impairment Rating.”
Pillar 4: What effective date are you entitled to (it is the effective date that governs how far back in the past your benefits will be retroactive). Some Veterans call this “back-pay” or “past-due benefits,” depending on how long you have been battling the VA. They can often go back decades. A colleague of mine just won a case for a Veteran with service connection granted all the way back to the 1950s, for example.

Step 4: The Administrative Appeal Phase

If you are not satisfied with the VA’s decision in step 3, you can appeal. The first step in the administrative appeal is optional: you can seek a review of your VA Disability Claim by a DRO (Decision Review Officer), or you can “perfect your appeal” by filing several forms in a particular sequence and on a specific timeline. You can get a review by a Veterans Law Judge (VLJ) at the BVA (Board of Veterans Appeals).

You can have that review in an in-person hearing in DC, a video conference hearing from a VA facility near you, or submit a “brief” with “exhibits” and have the VLJ review your claim “on the record” before it.

- - The BVA Judge can do one or more of the following – reverse, remand, grant, or any combination of those 3. By far, a combination of the 3 is most common. After that, these are the different things the BVA VLJ can do, in order of most to least common:
  - Remand the claim for development of more evidence;

1. 1. 1. Deny your appeal (also known as affirming the VA Denial of your VA Disability claim);
    2. Grant your appeal (also known as reversing the VA Denial of your VA Disability claim).

Step 5: The Court Appeal Phase

- If you are not satisfied with your BVA Decision, so long as it is not a remand, you can appeal to the Court of Appeals for Veterans Claims (aka, the “CAVC” or the “Veterans Court”). That Court only decides whether a BVA decision is proper under the law or properly applied the law to fact….it cannot make factual findings.
- On average, between 70-80% of BVA Decisions contain a reversible or remandable legal error, so if you have a BVA Decision, please talk to an attorney with experience at the Veterans Court to discuss appealing it.
- Veterans do not pay out-of-pocket for lawyers at the CAVC…if the Veteran wins at the CAVC, the VA has to pay the lawyer out of IT’S pocket and NOT out of the Veteran’s past-due benefits.
- The CAVC can do any of the following: affirm (uphold) a BVA Decision, reverse (reject) a BVA decision, vacate (erase) a BVA decision, and remand (send a decision back to the BVA for the repair of legal errors. Depending on the case, it can also combine two or more relief types.

Step 6: Judicial Review phase

Suppose you are not satisfied with your CAVC Decision. In that case, you have a limited opportunity for judicial review at the Federal Circuit Court of Appeals (Fed Circuit) and then the Supreme Court of the United States. The Fed Circuit only has the ability to decide PURE questions of law… I’d be willing to bet that 80-90% of Fed Circuit decisions in Board cases are “Rule 36’s”….decisions without a written opinion, typically because the Court does not have jurisdiction over the appeal.

Getting review at the Supreme Court is much harder, and appeals to both courts can be costly filing fees alone at the Federal Circuit cost $500, and the cost of copying and filing the brief and the record of proceedings below costs between $2,000 and $5,000. Hence, attorneys and Veterans tend to be more conservative about appeals to these courts.

3. When do I file a VA Disability Claim?

Ideally, you want to file your VA disability claim within the first year after leaving service. (Learn about the one VA Program I like – the Benefits at Discharge Delivery, or BDD, Program)

However, most conditions do not get diagnosed for years or decades after service. In those cases, if you are filing an original VA Disability claim (i.e., for the first time), you should file at least the informal claim mentioned above as soon as you suspect your condition is related to military service.

This protects the earliest possible effective date for your VA Disability benefits.

If you are filing a claim for increased compensation, you want to file the claim for increased rating as soon as you believe your condition is worsening.

4. Where do I file a VA Disability claim?

Technically, your VA Disability claim is filed with the VA Regional Office for your geographic area.

However, you can file your VA Disability claim online through the eBenefits portal for Veterans, or, if you want to be sure that you create a paper trail for your claim to make sure the VA does not lose it, you can file it by sending it to the Evidence Intake Center (also known as the VA’s EIC in Janesville, Wisconsin).

5. Who Can Help Me with a VA Disability Claim?

Anyone that you trust can help you with a VA Disability claim.

However, nobody can charge you a fee for filing your VA Disability claim – attorneys and accredited agents are only allowed to charge a fee for filing or helping you in your VA Disability claim after the VA has denied the claim.

So, while an illegal immigrant can hire an attorney to fight deportation whenever they can afford it, Veterans who served our country in uniform are not legally allowed to pay for an attorney or experienced professional accredited agent’s help until the VA denies them a benefit.

While a criminal charged with a crime has a constitutional right to an attorney, veterans who fought and bled to preserve the Constitution are prohibited from exercising their right to hire and pay an attorney or experienced professional until the VA screws them over first.

Some national organizations, like the Disabled American Veterans (DAV), Veterans of Foreign Wars (VFW), and the American Legion (Legion or AL), have what are called “Veteran’s service representatives” or VSOs that volunteer to help with filing initial claims. The quality of work or help you get varies widely, and I’ve seen both extremes: VSOs that do amazing work for free and VSOs that pull the rug out from under their “client” or “member.

Organizations like the Paralyzed Veterans Association (PVA) and the Vietnam Veterans of America (VVA) get consistently high marks for the work they do for their members.

6. How Long Does a VA Disability Claim Take?

The amount of time that it takes for the VA to decide on a VA Disability claim can vary greatly and depends on a lot of variables: how difficult your claim is, how many conditions you include in the VA Disability claim, how well your claim is prepared, whether your claim is a Fully Developed Claim or not, how big your VA Regional Office is, etc.

Here are some general rules:

If you click here, the VA says that time is 114 days (ish) for a Fully Developed Claim and 121 days (ish) for a non-FDC claim. In 10 years of representing hundreds of Veterans and talking with tens of thousands more, I’ve never met a Veteran that got a decision in 125 or fewer days. I’ve met a couple that had a decision within 3-6 months. Most Veterans should plan on the process taking about 12-18 months, from file to decision. And that’s not counting the appeals.
If you are bored or like looking at small numbers on mind-numbingly complicated spreadsheets, click here to see how long claims are currently taking in your geographic region. These spreadsheets are consistent with everything the VA does….hard to understand, loaded with jargon, and obvious number juggling to hide problems in the system. Pour a scotch or glass of wine.
Claims for VA disability benefits that are filed with smaller urban and rural VA Regional Offices are faster than VA Disability claims filed with larger metropolitan VA Regional Offices.
Once you file an appeal, it can take 3-10 years to get a decision, depending on variables that are too numerous to list here.
Veterans can speed up the timeframe by filing well-developed and well-documented Fully Developed Claims, as we teach here on the Veterans Law Blog.

7. How Do I Check the Status of My VA Disability Claim?

That, right there, is the million-dollar question.

The VA will tell you to call their VA toll-free number 1-800-827-1000 to get the status. Veterans that use this approach find that they can enjoy their favorite hobby while waiting to talk to someone at the VA: some Veterans relax and enjoy 2-3 hours of hold “muzak,” others read the week’s newspapers or a few magazines, and others have actually written a book while waiting on hold. If you are among the patient and lucky few that get through to a human being on the 1-800 line, here are some tips and pointers on how to get more value and information out of the call.

The VA also suggests that you check your status on eBenefits. Be forewarned, though – eBenefits is a glitchy and inaccurate tool. For example, if you log into my eBenefits account, it shows that the VA held a hearing on my VA Disability Claim 2 years before I filed it. That’s a true story, folks. Now that is efficiency – maybe the VA will start a new pilot program: the pre-claim denial process.

Be careful what you see on eBenefits it’s not always your claim status, it’s not always accurate, and it’s rarely up to date.

8. How Are Benefits in a VA Disability Claim Calculated?

I wish I could tell you that the VA simply added up your disability ratings from individual conditions to reach your total disability rating and paid you according to that rating.

But the VA doesn’t do it that way. They use a unique “VA Math” system to “combine” your individual disability ratings into a total. Then they award a monthly compensation amount corresponding to the resulting total impairment rating.

You can read more about impairment ratings here – Veterans have much more control over these ratings than they have been led to believe. I teach Veterans how to improve or maximize their ratings for a TON of conditions – knee/arthritis, sleep apnea, PTSD, Tinnitus, Hearing Loss, Fibromyalgia and Chronic Fatigue, Gulf War, Migraines, Diabetes, Parkinson’s Disease, and many more!

In my 5+ hour video training course, “How to Prove the 4 Pillars of a VA Claim “, I teach Veterans how to prove the 4 Pillars of a VA Claim, including a lot of specific ways to prove the degree of disability you experience and get the highest rating possible.

9. Are VA Disability Benefits Retroactive?

Yes, they are. The question is, “how far do they go back”?

There is a whole set of rules that helps the VA decide how far back in time to go to pay retroactive benefits. These rules are called the effective date rules, and there are hundreds of them.

There are a few general guidelines; it’s not all the rules for every type of VA Disability Claim effective date, but it should give you an idea of how much you have NOT been told about VA disability benefits over the years.

In most VA disability claims, the effective date will be the LATER of the date you filed your claim and the date the entitlement arose. Click here to learn more about what that means.
If you file your VA disability claim within one year of leaving service, your effective date will typically be your date of separation from military service.
Claims for Increased compensation rates follow the general effective date rule, except that if you can show that the worsening of your condition started to occur BEFORE you filed your claim, you can get up to 1 year earlier.
In some cases, if the law changes while you are trying to prove a claim or after you’ve been denied a claim, and your claim is granted pursuant to that change in the law, that makes it easier for you to win (in other words, the change in the law is a “claim liberalizing rule”) you may be able to get up to 1 year prior to the date of your claim as your effective date.
Suppose you reopen a previously denied claim by submitting New and Material Evidence, and you win the reopened VA Disability claim based on military records, military service records, or military medical records that were previously unavailable to the VA or that the VA neglected to get in the prior claim. In that case, you can use the effective date rule in 38 CFR 3.156(c) to get an effective date of your original VA Disability claim date.
Suppose you submit New and Material evidence within one year of the date your rating decision denied your VA Disability claim. In that case, your claim is “open and pending” until the VA issues a new ratings decision. If your benefits are granted based on that new and material evidence, your effective date could be the original date of your claim. This is a dangerous path to take, though, because if the VA denies your claim because the evidence wasn’t New and Material, then you may have lost your original effective date if you did not file an appeal within that same year after the VA Ratings Decision.
If you are a “Nehmer Class Member,” meaning a veteran exposed to dioxin (aka, Agent Orange in Thailand, Vietnam, Korea, or other places), a whole set of effective date rules apply due to the VA’s settlement of a class action lawsuit in the 1980s. These are called the “Nehmer Rules,” and they can get pretty complicated pretty quick.
A survivor who files a claim for survivor benefits (DIC, service connection of the cause of death and substitution, for example) will get survivor benefits retroactive to the date of the Veteran’s death if they filed their VA Form 21-534 within one (1) year of the Veteran’s death. If they file the claim for accrued benefits within that year, they may be able to get retroactive benefits paid to the date of any VA Disability claim or appeal pending on the date of the Veteran’s death.

10. Are VA Disability benefits permanent?

I’ll answer this question along with #11.

11. Are VA Disability Benefits Permanent?

Generally speaking, they can be.

If a medical condition substantially improves, the VA can propose to reduce your disability compensation benefits to different levels. The rules that they have to follow to do this can differ depending on certain factors, but here are a few considerations; you can click here to learn more about how the VA tries to pick Veterans’ pockets by reducing benefits and get an idea how to stop it.

The VA can only reduce “continuous ratings” (those that have been in effect for 20 years or more) after showing that they were awarded based on actual fraud by the Veteran.
There are three types of ratings in VA Disability claims that are considered “protected” ratings, which the VA cannot reduce without showing first a “substantial improvement” in your medical condition.
Suppose a VA Disability rating is considered “unprotected.” In that case, the VA can reduce it, but they have to send you notice of their intent to respond, give you an opportunity to respond and submit evidence and, if you request it, provide a hearing. The timelines on this type of reduction are pretty friendly to the VA and pretty hard for the person filing the VA Disability claim to understand, no less follow, so be ready to move quickly and do plenty of legwork to understand what is happening and how to stop it.
If you are incarcerated for more than 60 days, on the 61st day, the VA can reduce your VA Disability compensation to no less than 10% and must reinstate it after your release from jail. Click here to learn more about each time of rating and how long they stay in effect.

12. Are VA Disability Benefits Subject to Child Support?

Yes.

In every state I am aware of, VA Disability benefits are considered income for calculating child support.

Child support laws differ in each state, so there may be nuances from state to state how much is subject to child support, particularly when military retirement payments offset a portion of your VA Disability benefits. The best thing to do is get out ahead of this situation by talking to a local family law attorney and making sure you do right by your kids, state law, and federal law.

If you need a referral to a family law attorney in Texas or Arkansas, fill out a support ticket. I know a lot of family law attorneys in both states and may be able to give you a couple of referrals.

13. Are Benefits From My VA Disability Compensation Claim Taxable?

Nope.

At least not under Federal law. Amounts paid to Veterans or their families for education, training, subsistence allowances, clothing allowances, disability compensation, and/or pension payments are not taxable by the Feds.

As to whether these benefits are taxable at the State level, consult your state’s income tax agency, as the answer will vary state by state.

14. What Conditions Are Most Common in a VA Disability Claim?

The VA actually publishes a report of the conditions it service connects, the average ratings for each, and more. Click here to check out the report.

If you don’t have the stomach to read MORE VA propaganda – and honestly, who can blame you – here are the Top 10 conditions that the VA reports as being part of most original VA Disability Claims ((click on the links to see information published on the Veterans Law Blog about these conditions common to VA Disability claims)

Here are some other conditions that I see very frequently in many a VA Disability Claim (click on the links to see information published on the Veterans Law Blog about these conditions common to VA Disability claims)

Sleep Apnea
Fibromyalgia
Peripheral Neuropathy
Diabetes
Parkinson’s Disease
Particulate Matter in the lungs
Gulf War Illness (aka, Chronic Multi-Symptom Illnesses)
Traumatic Brain Injury1.

Most Common VA Disabilities Claimed for Compensation:

List By Symptom – VA Disability Compensation

Posted on September 5, 2017August 7, 2022 by WPTangerine

In March 2020 the VA removed the DBQ’s from their website. NVLSP.org has made them available to the public here
See above, the links below currently are broken, since the VA removed the DBQ’s
Disability Benefits Questionnaire (DBQ) Veterans now have more control over the disability claims process. Veterans have the option of visiting a private health care provider instead of a VA facility to complete their disability evaluation form.
Veterans can have their providers fill out any of the more than 70 DBQs that are appropriate for their conditions and submit them to us. It’s that easy!
Source: www.benefits.va.gov
Current as of 09/05/207 Check here for the latest Disability Benefits Questionnaire (DBQ)

Cardiovascular

Conditions – Symptoms	Form Name
Evaluation of varicose veins, arterial diseases, producing swelling, claudication of legs, or pain on walking, skin/nail changes	Artery and Vein Conditions (Vascular Diseases including varicose veins)
Evaluation of high blood pressure (BP): how to determine significance of BP readings or BP reading abnormalities.	Hypertension
Conditions including: heart attack (MI), irregular rhythm, heart murmurs and heart surgery.	Heart Conditions (Including IHD, Non-IHD, Arrhythmias Valvular Disease and Cardiac Surgery)

Dental and Oral

Conditions – Symptoms	Form Name
Evaluation of all dental and oral conditions, except TMJ Conditions.	Dental and Oral Conditions
Evaluation of conditions affecting the TMJ joint with pain in the jaw when biting and clicks and sounds in the jaw.	Temporomandibular Joint (TMJ) Conditions

Dermatological

Conditions – Symptoms	Form Name
Evaluation for infectious and non-infectious diseases of the skin: how to evaluate rashes, spots, athlete’s foot, sweating, and acne skin lesions.	Skin Diseases
Evaluation of palpable or disfiguring scars, producing distortion or asymmetry.	Scars and Disfigurement

Ear, Nose, and Throat

Conditions – Symptoms	Form Name
Evaluation of various conditions of the ear including: infections, dizziness, vertigo, acoustic tumors and other conditions with ringing in the ears (tinnitus).	Ear Condition (including: Vestibular and Infectious Conditions)
Evaluation of Anosmia (inability to detect any odor), Hyposmia (reduced ability to detect odors), Ageusia (complete lack of taste), Hypogeusia (decrease in sense of taste) and other conditions affecting the sense of smell and taste.	Loss of Sense of Smell and/or Taste
Evaluation of conditions affecting, the sinuses, nose, throat, larynx, and pharynx, including, but not limited to deviated nasal septum and organic aphonia, vocal chord problems.	Sinusitis, Rhinitis, and other Conditions of the Nose, Throat, Larynx, and Pharynx

Endocrinological

Conditions – Symptoms	Form Name
Evaluation of DM Type I or II, with alteration of blood sugar regulation, abnormal Glucose Tolerance Test (GTT), requiring medication or hospitalization or complications.	Diabetes Mellitus (DM)
Evaluation of conditions affecting the hormone glands, including, but not limited to Cushing’s syndrome, Acromegaly, and Addison’s Disease.	Endocrine Diseases (other than Thyroid and Parathyroid, or Diabetes Mellitus)
Evaluation of conditions affecting the functions regulated by the thyroid and parathyroid glands, including, but not limited to growth and metabolism.	Thyroid and Parathyroid Conditions

Gastrointestinal

Conditions – Symptoms	Form Name
Evaluation of conditions affecting the esophagus such as stricture, spasm, or other conditions with lump in throat or chest, pain on swallowing, or regurgitation.	Esophageal Conditions (including GERD, Hiatal Hernia, and Other Esophageal Disorders)
Evaluation of gallbladder disease, with inflammation, gallstones, pain after eating fatty food, or pancreatic conditions including pancreatitis that manifests as severe recurrent abdominal pain.	Gallbladder and Pancreas Conditions
Evaluation of Irritable Bowel Syndrome (IBS) (chronic recurrent diarrhea or constipation). Ulcerative colitis (chronic inflammatory bowel condition leading to erosions and bleeding) and other conditions with Bloody stools, fistulas, and/or abscess.	Intestinal Conditions (other than surgical or infectious) including Irritable Bowel Syndrome, Crohn’s Disease, Ulcerative Colitis, and Diverticulits
Evaluation of hepatitis (which refers to a variety of inflammatory and infectious conditions) and Cirrhosis (chronic liver disease resulting from liver injury leading to degeneration of the liver)and other conditions characterized by jaundice, ascitis, fluid retention.	Hepatitis, Cirrhosis and Other Liver Conditions
Evaluation of peritoneal adhesions, which are scars of the visceral lining of the abdominal structures that produces episodes of partial or complete bowel obstruction.	Peritoneal Adhesions
Evaluation of stomach and duodenum conditions such as peptic ulcer disease, recurrent pain relieved by antacids, bloody stools, nausea or vomiting, indigestion.	Stomach and Duodenum Conditions (not including GERD or Esophageal Disorders)
Evaluation of Amebiasis, dysentery, and various types of intestinal parasites with recurrent diarrhea, alteration in stool consistency or foul smell.	Infectious Intestinal Disorders, including Bacterial and Parasitic Infections
Evaluation of removal of portions of the intestine and reconstruction and diversion of the intestinal tract: bowel diversion that requires use of external bags to collect stool.	Intestinal Surgery (Bowel Resection, Colostomy, and Ileostomy)

Genitourinary

Conditions – Symptoms	Form Name
Evaluation of renal diseases including Nephritis, renal insufficiency, and other diseases of the kidney: kidney failure, abnormal kidney function tests, protein in the urine, edema, kidney stones.	Kidney Conditions (Nephrology)
Evaluation of diseases of the urethra, penis, testes, and scrotum, producing pain on urination, swelling, blood in urine or incontinence.	Male Reproductive Organ Conditions
Evaluation of malignant lesions of the prostate gland with frequent diurnal or nocturnal urination.	Prostate Cancer
Evaluation of conditions affecting the bladder and urethra, including, but not limited to voiding dysfunctions and infections.	Urinary Tract (Bladder and Urethra)

Gynecological

Conditions – Symptoms	Form Name
Evaluation of inflammatory neoplastic and cystic lesions of the breast: Breast mass or lumps.	Breast Conditions and Disorders
Evaluation of diseases of the female genital tract including: uterus, vagina, cervix, ovaries, endometriosis, complications of pregnancy, and other conditions.	Gynecological Conditions

Hematologic and Lymphatic

Conditions – Symptoms	Form Name
Evaluation of conditions of red and white blood cells, producing anemias, leukemias on tumors such as lymphomas.	Hematologic and Lymphatic Conditions

Infectious Diseases

Conditions – Symptoms	Form Name
Evaluation of conditions associated with the Human Immunodeficiency Virus (HIV) and its treatment.	HIV-Related Illnesses
Evaluation of infectious diseases not specifically-associated with either HIV or military service in a tropical area, the Persian Gulf, or Afghanistan.	Infectious Diseases
Evaluation of infectious diseases associated with military service in tropical areas with exposure to salmonella, shigella, etc. producing symptoms such as chronic diarrhea.	Persian Gulf and Afghanistan Infectious Diseases
Evaluation of conditions in which the immune system begins attacking healthy body tissues, including, but not limited to, Goodpasture’s syndrome and Guillain-Barre syndrome.	Systemic Lupus Erthematosus (SLE) and Other Autoimmune Diseases
Evaluation of pulmonary and extrapulmonary tuberculosis symptoms.	Tuberculosis (TB)
For use in evaluation of vitamin deficiencies (Beriberi, Pellagra, syndromes of dermatitis, diarrhea dementia in POW, post-GI surgery, bypass procedures, undernutrition and malabsorption.)	Nutritional Deficiencies

Musculoskeletal

Conditions – Symptoms	Form Name
Evaluation of extremity, limb or digit (complete or partial amputation), and complications. Evaluation of stumps.	Amputations
Evaluation of ankle pain, persistent deformity (ankylosis), ankle injuries, reduction of movement, and use of assistive device.	Ankle Conditions
Evaluation for non-degenerative arthritic conditions such as Gout and Rheumatoid Arthritis: recurrent painful and swollen joints.	Non-degenerative Arthritis (including Inflammatory, Autoimmune, Crystalline, and Infectious Arthritis) and Dysbaric Osteonecrosis
Evaluation of injuries, deformities, loss of elbow and forearm producing motion limitation.	Elbow and Forearm Conditions
Evaluation of reduction or loss of toe function and motion, and alteration in mobility.	Foot conditions including flatfoot (pes planus)
Evaluation of alteration in motion of the wrists or digits due to tendon or muscle injuries, and alteration in motion and function of the hand including ankylosis, trigger finger, loss of finger movement.	Hand and Finger Conditions
Evaluation of alteration in extension and flexion, poor postural and body support, and alteration of rotation of the hip.	Hip and Thigh Conditions
Evaluation of ankylosis of the knee, subluxation of the knee, knee instability, meniscus lesions, and functional limitations knee cartilage problems, locked knee.	Knee and Lower Leg Conditions
Evaluation of traumatic and other injuries resulting in loss or alteration of function, location, type, tears, and weakness: torn scarred muscles.	Muscle Injuries
Evaluation of bone infections producing fever, local alteration of function, residuals from a bone infection with persistent drainage or bone alteration	Osteomyelitis
Evaluation of arm limitation of function, dislocation, alteration in joint function, incomplete movements, deformity, dislocation, nonunion, and fracture complications : frozen shoulder.	Shoulder and Arm Conditions
Evaluation of arthritis and neck deformities.	Neck (Cervical Spine) Conditions
Evaluation of unfavorable or incomplete wrist motion due to ankylosis (limitation in range), painful or other alteration in function, resulting from traumatic or other injury complications, joint replacement.	Wrist Conditions
Evaluation of chronic low back pain, arthritis and back injuries, spinal conditions or disc disease: low back pain with sciatica.	Back (Thoracolumbar Spine) Conditions

Neurological

Conditions – Symptoms	Form Name
Evaluation of progressive degenerative disease of the brain and spinal cord with progressive muscle weakness and wasting, speech, swallowing and breathing problems.	Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease)
Evaluation of alteration of the function of the nerves (motor and sensory), related to Diabetes Mellitus: weakness, numbness, tingling of legs and arms related to diabetes.	Diabetic Sensory-Motor Peripheral Neuropathy
Evaluation of numerous other neurologic conditions such as: meningitis, HIV, brain abscess, Lyme Disease, encephalitis, stroke, brain tumor, and spinal cord injury.	Central Nervous System and Neuromuscular Diseases (except TBI, ALS, Parkinson’s Disease, MS, Headaches, TMJ, Epilepsy, Narcolepsy, Peripheral Nerves, Sleep Apnea, Cranial Nerves, Fibromyalgia, and Chronic Fatigue Syndrome)
Evaluation of conditions affecting the following nerves in the Cranium: V (trigeminal, VII (facial), IX (glossopharyngeal), X (vagus), XI (spinal accessory), and XII (hypoglossal). (Conditions affecting cranial nerves I (olfactory), II (optic), III (oculomotor), IV (trochlear), VI(abducens), and VIII (vestibulocochlear (auditory)) are addressed in other DBQs.)	Cranial Nerve Conditions
Evaluation of recurrent episodes of head pain producing work limitation or incapacitation: with other symptoms such as nausea, vomiting, tearing etc.	Headaches (including Migraine Headaches)
Evaluation of fibromyalgia components, including, but not limited to sleep problems, muscle and joint pain, and altered affect.	Fibromyalgia
Evaluation of disorders of the myelin sheath of the central nervous systems producing recurrent alterations of neurological function: such as weakness, numbness, urine incontinence, visual symptoms.	Multiple Sclerosis (MS)
Evaluation of symptoms that may include tremors, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.	Parkinson’s Disease
Evaluation of narcolepsy components, including, but not limited to, sleep attacks, sleepiness, paralysis, and cataplexy.	Narcolepsy
Evaluation of alteration of the function of Nerves associated with metabolic disorders, exposure to toxins, infections, immunological disorders, or inflammation and other conditions.	Peripheral Nerve Conditions (not including Diabetes Sensory-Motor peripheral Neuropathy)
Evaluation of seizure conditions including epilepsy.	Seizure Disorders

Ophthalmological

Conditions – Symptoms	Form Name
Evaluation of various diseases of the eye, such as inflammation, infection, glaucoma, deformities, alteration of tear ducts, cataracts, retina disease, and other conditions.	Eye Conditions

Psychological

Conditions – Symptoms	Form Name
Evaluation for anorexia, bulimia, and other eating disorders.	Eating Disorders
Evaluation of symptoms, history, and impact related to mental disorders: depression, mood and affective disorders, psychosis, etc.	Mental Disorders (other than PTSD)
Evaluation of beginning and extent of symptoms (acute – length of symptoms is usually less than 3 months, chronic – symptoms usually last 3 months or more, with delayed onset – usually at least 6 months have passed between the traumatic experience and the beginning of symptoms). Symptoms may include: recurrent experiences of a traumatic event, avoiding an excitant or irritant associated with the trauma, deadening of general responsiveness, increased arousal, including insomnia, recurrent nightmares, and extreme caution; exhibiting an inflated frightened response; and experiencing changes in hostility..	Review Evaluation of PTSD

Respiratory

Conditions – Symptoms	Form Name
Evaluation of the respiratory system except Sleep Apnea and Tuberculosis.	Respiratory Conditions (other than TB and Sleep Apnea)
Evaluation of disorder characterized by cessation of breathing during sleep and provides information necessary to determine functional impact (sleep apnea, snoring) daytime complications.	Sleep Apnea

Rheumatological Diseases

Conditions – Symptoms	Form Name
Evaluation of Chronic Fatigue Syndrome. Components including but not limited to tiredness, loss of memory or concentration and enlarged lymph nodes.	Chronic Fatigue Syndrome

General Surgical

Conditions – Symptoms	Form Name
Evaluation of conditions involving internal organs bulging through the muscle, except hiatal hernia.	Hernias (including Abdominal, Inguinal, and Femoral Hernias)
Evaluation of rectum and anus conditions causing alteration of sphincter control, stricture of prolapse, fistula, and other symptoms. Bowel incontinence or severe constipation blood in stools.	Rectum and Anus Conditions (including Hemorrhoids)

4 Things Veterans Should Know about VA Sleep Apnea Disability Claims

Posted on December 12, 2015July 25, 2022 by WPTangerine

True story. And I’ve been getting asked these questions for years. On top of that, for about two years, I noticed at my VA Benefits law firm and on the Veterans Law Blog that Veterans of all eras were seeking my help – from Vietnam to Cold War to Afghanistan and beyond – appealing their VA Sleep Apnea disability denials. In short, I was seeing the sleep apnea disability hit the Veterans community like a typhoon! So a couple of years ago, I started trying to figure out WHY the sleep apnea disability was such a problem in the Veterans community. – Chris Attig Veterans Law Blog

I get asked more questions about how to file and win a Veterans Affairs sleep apnea disability claim than almost any other topic in all of VA Benefits Law.
Chris Attig Founder: Veterans Law Blog

Trust me when I tell you this: a VA Sleep Apnea disability diagnosis has little or nothing to do with obesity and neck girth. In the end, I wrote a book about how to claim and service connect the sleep apnea disability through the VA. But I also learned a few extra things that I would like to share with you about the VA Sleep Apnea Disability claim. And that’s what today’s video is all about:

I asked:

Why were so many Veterans seeking service connection for sleep apnea?
Why was sleep apnea affecting Veterans across all generations
Why was it so hard for so many Veterans to win their VA sleep apnea disability claims?
I talked to doctors (cardiologists, pulmonologists, sleep specialists, and more) about the three different types of sleep apnea disability diagnoses.
I talked to hundreds of Veterans (from just about every era) and looked at dozens of their C-Files to see if I could figure out why some Veterans won their VA Sleep apnea disability claims, and others did not.
I read just about every BVA Decision I could find on VA Sleep Apnea Disability appeals for a whole year.

Do you have questions about how to service connect sleep apnea claims?

You aren’t alone. Winning a VA claim to service connect sleep apnea is hard. Winning a VA Sleep Apnea is much harder. In fact, winning your VA sleep apnea claim can feel like you just led your team to victory in the World Cup.

It’s almost as much work and can often take as much dedication. Veterans ask me more about sleep apnea than any other question about VA Benefits Law. Closely followed by PTSD, Hearing Loss, Tinnitus, and TDIU.* Can I service connect sleep apnea without a sleep study in service?

* What if it wasn’t diagnosed until years after service – can I service connect it then?* Can Agent Orange cause Sleep Apnea? What about PTSD?* How do I appeal the VA’s denial of my Sleep Apnea? I got so many questions that I began to do a lot of research into how to service connect Sleep Apnea claims and what is happening with Sleep Apnea in the Veteran’s community.

Here’s 4 lessons I learned that I want to pass on to you – if you can really learn and understand these lessons, you will have the power to really improve and service connect sleep apnea claims and appeals.
1: Sleep Apnea is a Killer
2: Sleep Apnea is affecting a LOT of Veterans
3: The VA & BVA really struggle to Service Connect Sleep Apnea claims
4: More Veterans Should be Able to Service Connect Sleep Apnea

Lesson #1: Sleep Apnea is a Killer.

There are three things that the human body cannot live – or function – without Blood/Oxygen, Food/Water, and Sleep.

You can lose a kidney and live a full and complete life. You can lose your arms and legs and still survive.

But if your body cannot get sleep, you will die. In fact, sleep deprivation is a common form of torture, as many of us know all too well. That’s what Sleep Apnea does – while you are sleeping, you stop breathing.

You cut off oxygen to the brain and blood, and other body systems break down.

If you are lucky, you start breathing again. Not a lot of VSOs or advocates get this when helping a Veteran file aVA Claim. They think of Sleep Apnea as a disease of the obese, and then they tell them one of the big Fairy Tales about VA Claims.

Lesson #2: Sleep Apnea is affecting a LOT of Veterans.

In the year I spent researching the Sleep Apnea Field Manual, I learned that 39 medical conditions – common among Veterans – can cause or aggravate sleep apnea.

39 Medical Conditions!!

Here are just a few:

* Damage to the brain from a TBI (Traumatic Brain Injury)
* Heart conditions
* Post-Traumatic Stress (PTSD)
* Nerve conditions
* Rhinitis
* Diabetes

Here are a few examples of how Sleep Apnea has affected Veterans from all different eras of service:*. Don D. (he asked me not to use his real name) served mostly during the Cold War and was in the best physical shape of his life – he was an avid weight-lifter. That is until he damaged his knees in service and had to get a knee replacement at a military hospital. After that knee replacement, he could no longer lift weights; the sudden weight gain that resulted caused his obstructive sleep apnea.* Several Desert Storm, OIF, and OEF Clients have had Traumatic Brain Injuries which interfere with how their Nervous System works and as a result, have a different kind of Sleep Apnea (oversimplified, where the brain’s signals to breathe don’t make it through to the lungs).* Many Vietnam Veterans exposed to Agent Orange suffer from sleep apnea. They are ALL experiencing a “Perfect Storm” of Sleep Apnea problems: breathing disorders, mental health conditions, heart conditions, and diabetes are all causing an epidemic of Sleep Apnea in our Vietnam Veterans.No wonder Sleep Apnea is affecting so many Veterans – sleep apnea can be the result of other disorders or medical conditions.

Lesson #3: The VA & BVA really struggle to Service Connect Sleep Apnea claims.

I believe that the VA and BVA do not take Sleep Apnea seriously. I think that far too many raters and BVA judges think of sleep apnea as “made-up medicine.”

Perhaps they’ll have to spend a night with someone who suffers from obstructive sleep apnea, hear the suffocating snoring, experience the fear that the person will stop breathing altogether, and continue to not take seriously claims for sleep apnea. Or perhaps when they realize that Sleep Apnea is going to be as big an issue for our current generation of Veterans as Agent Orange-related conditions are to Vietnam Veterans, they will take it seriously. Either way, Veterans have an uphill fight to connect their sleep apnea service.

Here’s a Statistic that will shock you:

From April 2013 to April 2014, the BVA denied 76% of Veterans’ Sleep Apnea appeals. Translation: 3 out of every 4 of you will see your sleep apnea claims and appeals denied…unless you learn how to prove your Sleep Apnea Claim the right way.

Lesson #4: More Veterans Should be Able to Service Connect Sleep Apnea.

I spent nearly a year researching Veterans and their Sleep Apnea claims. I talked to several doctors and sleep experts. I read hundreds of cases. I talked to hundreds of Veterans and read their C-Files to see where they went wrong.I learned that to win your Sleep Apnea claim, you are going to have to put your Sleep Apnea Claim together right.

This is where I come in. I can teach you how to do that. I can teach you:* HOW to prove your Sleep Apnea Claim – for any of the three types of Sleep Apnea you have.* The EASIEST Way to prove Sleep Apnea.* WHAT evidence to use and which path to Service Connection to use.* WHERE to get the Lay Evidence that will give REAL POWER to your Sleep Apnea Claim.* To prove your Sleep Apnea is service connected… without a sleep study in the military?* The importance of a medical expert opinion in your Sleep Apnea claim. (In many cases, a medical expert report or opinion may be crucial to success).* The SPECIFIC EVIDENCE you will need to prove another medical condition caused your sleep apnea* How the VA will rate your sleep apnea condition after granting Service Connection.

How can you learn more about these things? Check out the Sleep Apnea Field Manual. There are three ways to get it:

Get an eBook version of the Sleep Apnea Field Manual
Get a paperback real book version of the Sleep Apnea Field Manual
Check out this VA Sleep Apnea Field Manual Package and get the knowledge you’ll need to take back the power in your VA Sleep Apnea claim.

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