Got my Ratings back!

SERE0002

SERE0002

PEB Forum Regular Member
PEB Forum Veteran
OK here it goes, posting in spine and back, as this was my main reason for MEB.
DOD 30% and VA 100%

My unfitting service disabling condition was cervicalgia---my neck Claimed as neck condition (referred to as antier cervical discectomy and fusion with persistant pain/weakness---30%

So that was it for my boarded item, enough to be medically retired!!

But the pot gets sweeter, with everything else.---the VA claimed disabilities

Spondylosis and disk disease of lumbar spine---50%
Adjustment disorder, with depression and insomnia---30%
Right carpal tunnel with ulner neuropathy---30%
Left Carpal tunnel with ulner neuropathy---20%
Slap tear of glenoid labrum right shoulder--10%
Left shoulder strain---10%
Radiculopathy sciatica left lower extremity sacral nerve condition---10%
Radiculopathy sciatica right lower extremity sacral nerve condition--10%
tinnitus--10%
degenerative disease of the left knee---10%
degenerative disease of the right knee---10%
Skin condition, residual burn scar---10%

So the total between my unfitting and claimed conditions is 100% VA. All I got to say is do the range of motion tests only till you feel pain, and when you go to fill out the form where they ask you to list conditions, be thorough, and if you think it could possibly be rated include it!!! obviously i got a bunch of 10%'rs because of this. YOU ARE IN CONTROL OF YOUR FUTURE IF YOU ARE INVOLVED. If you choose to sit back and just let the system do its thing you will get screwed. I will now collect over $3000 tax free from the VA be medically retired from the Air Force, and I will also be entitled to all the extra state benefits that go with being 100% disabled! This is still not over, as i am waiting on AFPC med people to approve the VA findings, but I am damn close.. MEB started October 2011.
 
Congrats on the ratings! I hope all goes well for you in the future!
 
SERE0002 said:
Spondylosis and disk disease of lumbar spine---50%
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Sere- why wasnt the above listed considered unfit by the DOD, this is a high rating for a back issue and if you were able to get it considered unfitting by the DOD it would bring your overall DoD rating up to 70%.


to be frank your post scares the crap out of me, my back and neck injuries are similar and i would be greatly diappointed if i got such a high rating from the VA but it was not considered unfitting from the DoD side. Iin the past the PEBs has minimized the ratings by not using the VASRD. Now i feel conditions are just being considered fitting (even though there are really unfitting) by the DoD in a way to keep your retirement lower.

sorry for the rant.
 
I feel your right but there could be many reason that I don't agree with. First off I was under the DES (Legacy) program. The AF felt that since many of my issues were so old and I had been living with them that they were not disqualifying. I felt that was bull but with everything I did get through, I was at 78%.

Would like to know why your back was not disqualifying.
Unfavorable ankylosis of the entire thoracolumbar spine --- 50%
Certainly sounds disqualifying.
 
The process is not final yet, so i am sure there is still possibility of it changing... But this is what was on the VA proposal letter..... From the sounds of it, I was not even suposed to get the letter, but i called the VA after my claim said complete on e-benefits, as well it said decision notification sent. So when I called the VA the first lady said I was not allowed to have the letter, and i would just have to wait for the PEBLO to tell me. I immediatly called back got a different operator and he faxed it to me... Gotta love the continuity at the VA!!! But either way it is now at Randolph and i suppose the can change things if they view them as service disabling.... I also was told at the begining of the board the only condition that would be used to determine if i get retired was the one condition i was boarded for and the rest was only for the VA. I agree and already noticed myself that this is bullshit if they don't add it, but in the long run for me...I will get over $3000 a month tax free from the VA, and that is more than any $$ I could get if i was rated high for retirement. i.e. I am a TSgt with 13 years....my average of my high 3 at 70% DOD does not pay me more than $3000 a month......And the cap for retirement pay no matter what is 75% right?
So really is there any benefit in me fighting the DOD side being I got enough to be retired? and collect the tax free va money from the VA?
 
Right off the top, I would have agreed with you because you are getting the retirement. Maybe things will never change but the VA could reevaluate you in the future and it might decress. The DoD will always remain the same. I am thinking nothing is combat related and concurrent receipt isn't a question now, could change someday.

I don't know where to begin with the VA. I still can't believe they called me asking where in my medical records was the OSA testing. You got to love the people to lazy to do their jobs.
 
So that raises a question.....does the VA do reevaluations? I was under the assumption what you get is what you get. How often does a re-eval happen? in that case yes it is worth the fight to get it added!
 
SERE0002 said:
So that raises a question.....does the VA do reevaluations? I was under the assumption what you get is what you get. How often does a re-eval happen? in that case yes it is worth the fight to get it added!
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You have to keep up and do yearly visits to keep a current status of your claims. From what I have gathered is that if you don't keep up and/or stop your meds the VA can drop your rating because they assume you got better.
 
grizz13 said:
You have to keep up and do yearly visits to keep a current status of your claims. From what I have gathered is that if you don't keep up and/or stop your meds the VA can drop your rating because they assume you got better.
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It is not so simple as this...as a starting point, generally, the VA can reduce ratings. However, depending on how long your condition has been rated, the rules (and the evidence needed to accomplish a reduction) are different.


Before any existing disability evaluation can be reduced, the VA is obligated to satisfy a variety of legal requirements. In addition, the VA bears the burden of proof,, by a preponderance of the evidence, that a reduction is warranted under the relevant regulations.
In certain situations, the veteran's rating, or the service-connected status of a disability, is "protected." In these situations, the VA is entirely prohibited by statute or regulation from reducing a rating unless fraud was involved. A veteran with a protected rating that was obtained without fraud is guaranteed benefits at a certain minimum level for the rest of the veteran's life.
In other situations, the VA must ensure that certain requirements are met before it may lawfully reduce a disability rating level. If the requirements are not met, the improperly reduced benefits must be reinstated. For example, veterans who have been assigned 100 percent schedular evaluations or 100 percent evaluations based on individual unemployability, or veterans who have had ratings that have been in effect for five years or more, receive special protection.
Any rating evaluation that has "stabilized," that is, "continued for a long period at the same level (five years or more)," whether it is at the 10 percent or 100 percent level, may not be reduced unless all the evidence of record shows sustained improvement in the disability.38 CFR § 3.344(a).
Because 38 C.F.R. 3.344(a) requires that "all the evidence of record" support the conclusion that sustained improvement in the disability has occurred, the VA cannot view the single examination upon which the reduction is proposed "in isolation from the rest of the record." In other words, the entire medical history of the disability must always be considered in conjunction with any rating examination upon which a reduction is proposed. In Schafrath v. Derwinski, the court explained the purpose of this rule as follows:
"These requirements for evaluation of the complete medical history of the claimant's condition operate to protect claimants against adverse decisions based on a single, incomplete or inaccurate report and to enable VA to make a more precise evaluation of the level of the disability and of any changes in the condition. These considerations are especially strong in a ratings reduction case."
It is because a disability is stabilized that the VA must take care when proposing to reduce the rating evaluation assigned to it. Because "uch disabilities are considered "stabilized,' . . . the regulation requires a high degree of accuracy in decisions reducing those ratings."5 Vet. App. at 421.
There are several other rules the VA must follow before reducing a rating that has been in effect for five years or more. The VA must review "the entire record of examinations and the medical-industrial history . . . to ascertain whether the recent examination [upon which the VA is relying to reduce the rating] is full and complete." Brown, 5 Vet. App. at 419 (citing 38 C.F.R. § 3.344(a)).
Any examination that is less full and complete than that examination on which payments were authorized or continued may not be used as a basis of reduction.Id. If the disability is subject to temporary and episodic improvement, it will not be reduced on any one examination, except in those circumstances in which all the evidence of record "clearly warrants the conclusion that sustained improvement has been demonstrated."Brown, 5 Vet. App. at 419. Even though material improvement in the physical or mental condition is clearly demonstrated, the VA "will [consider] whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life."38 C.F.R. 3.344(a) (2009)
If a disability has been continuously rated at or above a particular rating level for twenty or more years, the VA cannot reduce the rating below that level unless it discovers that the rating was based on fraud. 38 U.S.C.S. § 110; 38 C.F.R. § 3.951(b)(2009); See Colayong, 12 Vet. App. at 531-32.
There are many other issues and requirements to reduce 100% ratings or to sever service connection
 
There is a thread on the forum that covers the VA's re-evaluations. The thread is titled "VA 5 year stability," or something like that. It explains the many VA rules. To summarize the VA's options, they can re-evaluate anyone at any given time. That doesn't mean your percentages are going to change, but no matter what you can be re-evaluated. Some people stay completely out of the VA system forever and are never re-evaluated, while others use the VA system frequently and are re-evaluted often.

When you look at DoD money.........think of it as a back up incase the VA isn't in existence tomorrow. The difference between 30% and 75% is huge, but you would have to decide if appealing is worth it and consult with an attorney to see if you have a strong case.

Also, once you receive a 100% rating from the VA it's harder for them to reduce that rating than someone rated lower.

Personally, I don't like the VA medical system and have two other health insurance policies; I use them instead. I don't turn my records over to the VA because I am done mailing, faxing and hand delivering records to anyone and everyone out of fear. I keep my own records incase I need them in the future and would turn them into the VA at that point, but that's just me. I decided to let me fax machine sleep for a while.

Best of luck man and congrats!!!
 
green594 said:
sere- were any of these injuries combat related
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No none were combat related. Now my job is training and conducting operations of simulated war etc etc. But I am sure they hardly every approve that as combat related even though it says they do.

Thanks Jason for the VA info...
 
Wow, thanks Jason!
 
You do know that it doesn't have to be in combat any more, as long as it was called by a instrument of war (truck so on and so forth) simulated war conditions and a couple other reasons you are qualified to collect crsc which will give you both va and dod
 
SERE0002 said:
The process is not final yet, so i am sure there is still possibility of it changing... But this is what was on the VA proposal letter..... From the sounds of it, I was not even suposed to get the letter, but i called the VA after my claim said complete on e-benefits, as well it said decision notification sent. So when I called the VA the first lady said I was not allowed to have the letter, and i would just have to wait for the PEBLO to tell me. I immediatly called back got a different operator and he faxed it to me... Gotta love the continuity at the VA!!! But either way it is now at Randolph and i suppose the can change things if they view them as service disabling.... I also was told at the begining of the board the only condition that would be used to determine if i get retired was the one condition i was boarded for and the rest was only for the VA. I agree and already noticed myself that this is bullshit if they don't add it, but in the long run for me...I will get over $3000 a month tax free from the VA, and that is more than any $$ I could get if i was rated high for retirement. i.e. I am a TSgt with 13 years....my average of my high 3 at 70% DOD does not pay me more than $3000 a month......And the cap for retirement pay no matter what is 75% right?
So really is there any benefit in me fighting the DOD side being I got enough to be retired? and collect the tax free va money from the VA?
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It may be too late now but, if it isn't, you should go talk to the MEB counsel on your post. I had a situation where they only listed my back condition as unfitting and had my Major Depression (Severe) listed as fitting! The attorney took one look at that and said; "WTF?!?! Did they even read your file?? This needs to be changed!" So he wrote a rebuttal for me and it WORKED! They are changing my NARSUM as I write this. Now, my DoD rating will include both my spinal fusion and my MDD which should end up being around 70-80% if I am reading the VASRD correctly.
 
I got out of the Marines March of 2010, been to Iraq and Afghanistan seen stuff done stuff and got blown up twice but no shrapnel, just two concussions. As a result I was diagnosed with TBI, PTSD, depression, shoulder injury, insomnia, fractured back and some bulging disk along with other things. Now when I first got out all of these were listed. Well it wasn't until now that I realized how much of an effect these medical conditions have on me and my everyday living. I cant stand up or sit for long periods of time due to back pain and I'm always anxious and on guard. Don't really want to get into detail about my personal life. I had recently just got an MRI along with some psych appointments done and from what some people are telling me along with my primary care doctor is that I should get re evaluated. Im at 50% right now and was wondering what you guys would do in my position, I'm new to all of this and don't really know what to do. Is it worth it? because I have been reading up on some forums and some people say its useless trying to get re evaluated for a higher rating.
 
stvaldez226 said:
I got out of the Marines March of 2010, been to Iraq and Afghanistan seen stuff done stuff and got blown up twice but no shrapnel, just two concussions. As a result I was diagnosed with TBI, PTSD, depression, shoulder injury, insomnia, fractured back and some bulging disk along with other things. Now when I first got out all of these were listed. Well it wasn't until now that I realized how much of an effect these medical conditions have on me and my everyday living. I cant stand up or sit for long periods of time due to back pain and I'm always anxious and on guard. Don't really want to get into detail about my personal life. I had recently just got an MRI along with some psych appointments done and from what some people are telling me along with my primary care doctor is that I should get re evaluated. Im at 50% right now and was wondering what you guys would do in my position, I'm new to all of this and don't really know what to do. Is it worth it? because I have been reading up on some forums and some people say its useless trying to get re evaluated for a higher rating.
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Whoever told you it's useless to fight for higher ratings has got to be anti-rights! Since your life style has been affected negatively by your injuries, you need to get re-evaluated and go for the higher ratings the difference between 50% and lets just say oh... 70%. The difference in benefits are huge for VA benefits!!! GO FOR IT!!!
 
grizz13 said:
Whoever told you it's useless to fight for higher ratings has got to be anti-rights! Since your life style has been affected negatively by your injuries, you need to get re-evaluated and go for the higher ratings the difference between 50% and lets just say oh... 70%. The difference in benefits are huge for VA benefits!!! GO FOR IT!!!
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Do you know the most effective way to do that? Would I have to hire an attorney?
 
SERE0002 said:
No none were combat related. Now my job is training and conducting operations of simulated war etc etc. But I am sure they hardly every approve that as combat related even though it says they do.

Thanks Jason for the VA info...
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You are pre disapproving yourself? All it takes is a little work to put together your CRSC packet. Worst case scenario, they say no. Best case they say yes and you then get your DOD pay too.

It's a no brainer in my opinion. Why throw a opportunity away because you think "they hardly ever approve it"

Just my .02
 
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