VA Claims: Disabled Veterans Community|Hadit.com

Don’t poke the bear.

I went to file a claim for ED connected to neuropathy and PTSD medications. I had a DBQ from my doctor and medical studies that neuropathy can cause ED. My VSO actually to me not to poke the bear. I was floored. I wonder how many other veterans are being told this. He said I could lose my 100% and SMC S for filing for ED. He said that they were at a meeting with raters in the Nashville and were given this advice. It makes me wonder who my VSO is working for. I know they are paid by the state and not the VA but I seriously wonder who’s best interests they have at heart. I filed my claim anyway.

SMP housebound

As many of you know there are “2” housebounds:
1. SMC S housebound. There are 2 ways to get here: Have a single 100 percent plus an additional 60 percent seperate and distinct from each other. OR, be “housebound in fact”, which means your are substantially confined to the premisis.
2. Pension (SMP) housebound. It sounds like there are 2 ways to get there, also, and are the same as above.
But wait..this does not make sense!!! Here is why:
Veterans are eligible for the greater of “compensation” or pension, but not both. So, if you have 100 percent “compensation” then you are not eligible for pension, because the greater amount is compensation. So, why do the regulations for SMP housebound include “100 percent” if that makes you ineligible for it???
Has anyone out there been rated 100 percent AND get SMP pension housbound???

Understanding how to get to SMC M

I presently have SMC L 1/2 based on a 100% rating for Lung disease, and an additional rating of 60% for my lower back.
To get a half step increase from L veteran must have
Other Disabilities Combine to 50%
If you have separate, service-connected conditions that combine to 50 percent, then the level is bumped up to the next ½ level. That is, a veteran whose SMC condition was found in Level L would be moved up to compensation rates for Level L ½ (Level L ½ would move up to M, M to M ½, etc.).
For example, say a veteran has both feet amputated (100 percent rating), arthritis in the right hand (30 percent), and PTSD (30 percent). The loss of both feet qualify for SMC under Level L. The arthritis and PTSD do not qualify for SMC, but combined, they equal at least a 50 percent rating. (Note: VA calculates combined ratings using a Combined Ratings Table – ratings are not simply added together. Read our post on the VA Rating Schedule to learn how to combine ratings on your own.) So, the original Level L for the amputated feet would be moved up to Level L ½.
In the above situation, note that the additional disabilities combine to 50 percent on their own – i.e. not including the SMC-eligible condition. Also, the additional disabilities are not taken into consideration under another SMC level. That is, the above disabilities qualify for this special rule because there is no SMC level that specifies “both feet amputated and arthritis of the hand” or something similar.
Ok… so if I have additional disabilities that combine at 50% or more am I then entitled to an additional 1/2 step increase up to SMC M. In my case, I have 7 additional ratings that combine at 68.11 rounded to 70%. ….
The rules also state:
Another Disability at 100%
If you have a separate, service-connected disability rated at 100 percent, then the level is bumped up an entire step instead of a half step. Unlike the 50 percent situation, you just have to have one disability rated at 100 percent (not multiple disabilities that combine to 100 percent).
If the conditions that qualify you for Special Monthly Compensation are caused by a disease (for example, if your amputations were caused by service-connected diabetes), then that disease cannot count toward the 50-percent combined rating or single 100-percent rating necessary to move up to the next SMC level.
SO what does all this mean? Can I get to SMC M by having more than one list of disabilities rated at least 50% each ( in my case one 60% rating – L 1/2 and 7 additional ratings combined at 70% = M )
or must I have one separate rating at 100%…….to get to step M…..
The rules are confusing

OSA secondary to PTSD round 2

Has anyone here had a favorable rating from this claim? My private psychiatrist said he is seeing this approved quite a bit now. I was initially denied and they stated that a phone interview was conducted with me.. it wasn’t. I am rated at 70% for PTSD after being a combat door gunner in the USMC. I had submitted letters from my Dr stating 50% at least as likely than not that the OSA is 2nd to the PTSD. I also had the same letter from my psychologist, and he also stated case studies proving this and how the PTSD is aggravated by the OSA.. and how the OSA is aggravated by the PTSD. I had been diagnosed with OSA and prescribed a CPAP machine after a home sleep study was done and I have a letter from my Dr stating that this machine is medically necessary. I have a BDQ from my private DR stating all the same stuff too and again stating the 50% more likely than not..
After it was denied I appealed and was then sent to my 1st C&P exam for OSA. I drove 50 miles to a chiropractor’s office where I met a DR that drives around from place to place just doing these exams. He was renting an office space there for the day. After I got there he asked me like 4 or 5 questions. I have all my paperwork with me. Every letter, studies, etc. He didn’t want to see any of them. He typed and studied his laptop and is was silence for minutes with nothing… then he said we were done. I told him, you are kidding me right? I told him I drove 50 miles to get here and he is going to ask me a few questions and I am leaving? no exam? So I asked him what he thought about OSA being 2nd to PTSD. He said since he was working for the VA, he could not discuss his opinion. I told him I was scheduled through the VA for a sleep study next month at a hospital. Should I even go to the exam. It appeared he had already made up his mind. He said, yes go to the sleep study and after that info was entered into my records he could make a final decision.. Also in my initial denial letter, they stated that the CPAP machine was not medically necessary.. I asked him about that and he shook his head stating he didn’t know where that came from .He said a CPAP is the correct prescription for OSA and it was medically necessary.
So I don’t know where I stand with the C&P. I got really mixed feelings about it. I will post the results from the sleep study and what happens next. If I can get the rating I deserve, I will be glad to share the info, DBQ, letters etc.. and show the steps taken to get there.

I Can’t Figure out my Compensation

Still waiting for a final determination on my Compensation. I’ve had a radical prostatectomy , rated at 100% (temporary) and have a diagnosed surgical scar and ED since following the operation mid-2017. I also have tinnitus at 10%
Currently here is there wording:
Total Combined Disability
You have a 100% final degree of disability. This percentage determines the amount of benefit pay you will receive.
And I have been receiving the amount for 17 months so far. So when I get a Permanent rating, if its not 100%…..
My question is if they remove the 100% radical prostatectomy payment, will I not be able to keep the SMC (K-1) for scar and ED?
And if so how will that calculate out?