Transcript 0:00 [upbeat music] Hello, and welcome to another Hill & Ponton VA Q&A Live. 0:20 I'm here with Carol Ponton. It's been a while. Carol, how are you? I'm great, and you? I couldn't be better. So summer's heat's here, but football season's around the corner, uh, so excited. [claps] Exciting. Yeah. 0:34 Well, let's just go ahead and jump right into it. Adelia one of three, military EKG, five twenty two shows sinobrachardia. 0:45 Civilian heart echo eight twenty three shows trivial tricuspid, aortic, mitral and pulmonic regurgitation. EF of fifty five, otherwise normal size structure. That was a mouthful for my first question, I'm just gonna say. 1:03 [laughs] Shortness of breath symptoms, palpitations, chest pain, lightheadedness, next ECHO nine oh three, annual follow-ups. Should I claim these heart findings at all? Yes. 1:14 Claim them separately as one condition or file secondary service connection C&P exam? Carol. Both. I think you claim them showing they were there, uh, right away. And, and you can put and/or, that's what... 1:26 Never, never give up on any possible service connection you can get. But definitely you should claim those. Yeah. Let, yeah, uh, both and is, yeah, how I'd say that too. Jay Monk, good to see you. 1:41 [clears throat] What do I need to do to prepare my C&P exam, mental health issues, possible PTSD related? She could write a whole book on this. Yeah. 1:51 Um, one of the things, here's, okay, here's the one thing that I always worry about with PTSD. Remember, for PTSD, you have to prove that you had a stressor. The government doesn't have to prove it, you have to prove it. 2:03 So make sure if it's not obvious, then you may wanna talk about acquired psychiatric disorder. Remember, that's where you show that you didn't have a problem before service, but after prob- after service, you did. 2:15 And that's from a witness statement, and that could be a parent, a brother, sister, cousin, friend, anybody. But remember that trap that the, the VA uses for PTSD. 2:24 It's not only do you prove the stressors, you also need to download the DBQ for PTSD. That's the Disability Benefits Questionnaire. So if you go into the VA and put... They're still up, right? 2:35 They haven't taken this down, I looked there. Ooh, as far as I know, they should still be- They should be still up. 2:40 But, uh, and look at the questionnaire, because remember, I think it's starting on page four, they have a list of questions, and if you don't have a, an appropriate response to each one, no matter who else says you have PTSD, the VA says you d- you don't. 2:56 So remember there are two traps that you have right there. So the first thing is you figure out whether or not you can prove the stressors. 3:03 If not, acquired psychiatric disorder, which can include PTSD, major depressive disorder, anxiety, panic attacks, bipolar, anything. 3:12 The second thing is you look and make sure if you're working on PTSD, that you're gonna have the appropriate response to all of those questions, because if you don't answer every single one, showing you've had, um, something that's positive for PTSD, then you don't have PTSD. 3:28 And then the third thing I would say, at the bottom, when you go down, there's a list of symptoms, and make sure you look at those and are, note each one of those with the, um, examiner that you have. 3:41 The more symptoms you have down the bottom, then the higher your rating will be. So don't leave some out because you think they're not as important as the others. Make sure you list every single one of them. 3:52 A couple notes on that. I, uh, Nate, I think, just posted the, uh, C&P, uh, the DBQ page on the VA site. 4:00 Now, just as Carol's asking that, I realized they do not publish the initial exam for PTSD, meaning they don't publish an exam for service connection. 4:10 They only, the only exam in there is called a review PTSD exam, and that exam is for, uh, your rating, and if that's appropriate. 4:18 So back to what Carol said on, in service, you gotta show, for PTSD, you gotta show a stressor that's something other than just your word, okay? You gotta show something happened. 4:27 It could be in your service record, service medical records. It could be a buddy statement. It could be, y- you know, there's any number of things. It just needs to be evidence in addition to what you're saying. 4:36 Um, other things I would do, this might be more for rating, but I like to have, uh, somebody in there with me, somebody who knows you really well, be it a spouse, be it a, a parent. 4:46 And you know, I, I typically tell those people, um... Well, let me back up. I find that people with PTSD have a hard time understanding how they're relating to the world- Mm-hmm... 4:55 how harsh they can come across, and how abrupt they can come across. 4:59 And so they end up perpetually underrating themselves, 'cause they'll say they're fine, whereas a spouse or, you know, another loved one who sees them every day does not. 5:07 So literally, I tell my spouses, I say, I get them on the phone, I say, "I want you to go in there, and this is a time to tell them about what an asshole your, your husband is." 5:15 [laughs] All the things they do wrong, or all the things that are just so abrupt. Because the vet might not appreciate, frankly, that's part of the PTSD, is you, you lose self-awareness of how 5:24 much you can put others on edge, and that goes to the rating. 5:27 So, um, that's one of my favorite things to do, because then if you have that person and you testifying to that, and you get one of these DBQs where you see the doctor just, you know, just did not note anything you say, the fact that you had two people say it makes it for a stronger appeal. 5:41 We're always, you know, looking to see how we can, uh, undo bad, bad turnouts on appeal. But that's what I'd say. 5:48 I mean, there's, there's a lot to look at.Also look at the, the, uh, Nate, if you throw up the, uh, diagnostic notes themselves. 5:53 But just before, remember, a lot of these examiners are just gonna say that you can't bring anybody into the room. That's not true. Mm-hmm. 6:01 The, the law is you have a right to privacy, and if you wanna waive that so you can have a loved one come in, you have the right to do that. 6:07 So I find the best way to do that is sit down in your chair, and if they say they can't go in, say, "I'm not going in if they don't." And don't get out of your chair. 6:15 And believe me, they'll let you in, because they don't get paid unless they do the exam. So don't let them push you around on that. Yeah. Good luck on that. Let us know how it goes. 6:25 I mean, again, this is one where you wanna be prepared. 6:28 You wanna know what questions are important ahead of time because, y- you know, so these guys can spend 10 minutes with you, write a very poor report, and then you're faced trying to fight that. 6:37 Make up their own answers. Yeah, yeah. We got another question coming up. Monroe, "Hello. 6:52 I had two C&P exams, one for asthma, one for multiple sclerosis, with the same doctor. The first one were fave, and then the VA sent them back for clarity, and they were completely different." Hmm. 7:06 "I submitted them as new and relevant evidence. Should they accept the favorable ones as new and relevant evidence?" 7:11 That's interesting, but I think not, because they were already in the record at the time you received the decision. I would wanna know, you can FOIA this, and you can request this. 7:21 I'd wanna know what the, uh, what the rater said when they sent them back. What was inadequate about those two favorable exams? 7:29 Because I'm always suspicious of their, you know, taking their duty to assist and turning it to a duty to sabotage. Yes. Or duty to denial, to deny. So I, I would wanna know what they said there. 7:40 Um, to reopen it, I mean, the bar is low. I would just write, you know- I would, I would file a CAR HLR- Okay... 7:48 and argue that there was evidence favorable to your case, and the VA didn't consider that, and show why it shouldn't have been considered versus the other. 7:56 Because frankly, when I get favorable, I see a C&P exam that's favorable and they want clarification, it's just like Matt says, they want evidence to deny it. 8:04 And they will ask questions that are so pointed, that it's clear to the examiner what they want from them. So I would, that's what I'd do. I'd say that, "Look at this favorable exam. 8:14 Why is it not taking over the other exam that denied me?" I'd do that first before I'd go into new evidence. So- Because that's not new evidence. That was there before- Right... the decision. 8:24 So CAR is a higher level review that's within 30 days and is- Of the decision... of the decision, and it's pretty clear error. E- even if you aren't within 30 days right now, I would s- I'm with Carol. 8:35 I'd still go higher level review and say, "Look, I want you to re-weigh this evidence. You know, there was favorable evidence in here. Why, why was that, um, not given the primitive value of this other evidence?" 8:45 And if you see on the second exam that there were errors in the answers they put down- Mm-hmm... I would also do a statement on a 4138 pointing out, uh, everything that was not accurate in what this examiner said. 9:04 Five, Matt. There's one, one of five. It's good to see you, but woo, you're pushing us today. [laughs] Timeline. Uh, "August '98, completed VA form 9:15 21-526, lower back, left knee, and beta thalassemia minor during military separation under BBD. 9:25 4/4/01, military sent my service treatment records and the f- 21-526 to the VA two and a half years after my separation." That's interesting. "5/31/01, I filed another claim through my VSO for back conditions, 9:42 but forgot to include BTM. 2022, I filed service connection for beta thalassemia minor, which has caused several other health issues. VA never acted on my original claim from '98, 9:56 which they received in '01 before I f- filed my second claim. In '01, I received 10% for low back. No mention of BTM. Does VA b- failure to act on the, uh, '98 claim constitute clear and unmistakable error? 10:11 Should the effective date for the BTM and my 10% lower back granted in '01 be '98 or '01 or BTM 2022? I appreciate all you do for veterans and pray for your continued success." Hmm. Thank you. Can you go back? 10:25 Uh, 'cause I'm not sure. Nate, would you go back to the first one? Okay, '98, lower back, left knee, BTM. Okay, next one. Military. Uh, is there something 25401? 10:43 Okay, so I got a first question. Did, were your service treatment records in the first decision that you got? If not, remember everything gets reopened. 10:53 Um, and then you put, you send in the same form again two and a half years later, 2001, but you, you... See, I'm not sure. Okay. Go to- So the, the, he did the, uh, BDD, he did it at discharge. Uh-huh. 11:09 And when he did it at discharge, that was done by the DOD. Right. So the DOD is supposed to transfer that right away. Right. So his claim starts in '98. Right. 11:18 Um, the fact that VA didn't get it for, what, three years, that doesn't matter. Okay, so that's what he's saying, the whole claim they didn't get. Okay. And the service tre- treatment records? Yeah. 11:26 Uh, go to the second to last one. Crap. All right, go to the last one. Huh, okay. Go to the very first one. Next one. What was- [laughs] I'm, I'm lost on the... 11:42 Remember, I don't know if it's queue, if it's an open claim. I, I'm not sure on all of these which they did make a decision on and which they didn't. 11:50 Yeah.So if you filed a claim and they didn't make a decision, that's an open claim. Okay? 11:58 But if you filed the exact same claim later and they made a decision, and you're out of the appeal date, then that claim is no longer open. Okay? So- Uh, and that's why I'm not sure of what you've done. 12:11 For the BT, so they never, they never made a decision on BTM. That was an open claim. Yeah. 12:16 An open claim can be implicitly denial by a later claim if the later claim, this is, this is just crazy, crazy case law basically, but if the, if the later claim should have informed the veteran that it included the prior claim. 12:29 I don't think BTM, uh, you know, it's, it's anemia related, and I don't think it is, uh, something that a back claim would cover. Back or a left knee would, yeah. 12:39 So I think that claim goes all the way back to when you filed it in '98. And, and to what Carol said, we're not talking queue here, we're talking an open claim. Which is much better. 12:49 Much better because you can submit new evidence, the, the, the evidentiary standard is as likely as not, versus clear and unmistakable error. 12:56 You get all the benefits of the laws today versus what was just enacted back then. So I think you're looking at going all the way back on that. I, I don't... Did he, uh, go to the very last one again? 13:06 I've got a, what happened to the left knee condition? I can't see that you ever got a decision on that. And if not, that's open. The lower back was granted in one. 13:18 If, if it was granted in 2001, I can't see that that's open unless the, well, even the service and medical records are- Mm-hmm. That would be a, um, queue claim. Yeah. 13:27 So if it was opened in '01, but I think that's a pretty straightforward queue claim if you got a C&P exam during the BBD. That means they have the medical evidence they need to grant. 13:36 You're talking about purely a legal issue. Right. So yeah, I think you can do a queue claim for that and get it from '01 to '98, go back. 13:44 And then with Carol, I'm sorry, I don't remember where the, the knee claim was, but the knee claim, if that was granted in '01, that should go back. Uh, if, if, uh, 13:54 y- you know, if it wasn't granted, then it, that is closed at that time. But I'd, if I were, if I'm you, I'm taking the BTM all the way back to '98. Right. And even if you get... Sorry, one last thing. 14:07 Even if you just get a 0% going back to '98, that's a 20-year rating, meaning they can't, sorry, 20-year service connection, so they can't take that away from you. You only need 10, don't you? No. 20? 14:16 For the rating it's 20, but- For the r- for the rating, but, but it's for the service. Yeah. Anyhow, I, I would want that just so they can't strip you of service connection now- Right... 14:24 'cause you have that, um, uh, c- continuity of rating there. Or, and, and then if you do get a rating, whatever rating you get back to then is also, um, you know, permanent. It's frozen. All right. 14:35 [laughs] And remember, the VA does not like to do that. Often we've not only had to go to the BVA, but the Court of Appeals. For whatever reason, they just don't like to give you those benefits. Yeah. It's hard life. 14:47 Tiny Tiny, good to see you. "I want to understand how the VA denies claims when there's evidence in military records and continued care post-service, uh, post military service. 14:58 Is mentioned depression in my military a marker enough to prove PTSD to 18:02 So you should at least be at an M if you can get the L, 'cause you should get two bumps. Right. But one with the migraines and one at least with the lumbar and radiculopathy. Yep, and arm. And arm, yep. Yep. Arm's 30%. 18:17 I'm also wondering if there's a loss of use of hands there, that, or hand. Yeah. Absolutely. 30 percent's pretty high for an arm. For an arm, yeah. Yolanda First-Adams, good to see you. 100% P and T. 18:31 PTSD 100, sleep apnea 50, second to PTSD via weight, plus planus 50, TMJ 30, second to PTSD, migraines 30, rhinitis 30, diabetes 20, hypertension 10, tinnitus 10, ILD 10, GERD 10, right hip 10, right knee 10. Got a lot. 18:49 Left hip 10, with back, left knee, cervical spine radiculopathy, IBS, diverticulitis, pancreatitis, bilateral plantar fasciitis, bilateral sciatica, bil- or, sorry, shin splints, still on review or appeal. 19:03 VA decision when increased PTSD to 100% listed every single condition I was service connected for for SMCS justification. Yeah, that, that's, if you're SMCS. Does that mean I cannot- No... use any of them for NA? 19:16 Yeah, no, no. No. Also, when increased give effective date of 4/15/25 instead of... Yep, that's wrong. Yeah. Instead of the date, that, that's them saying that they're taking tens of thousands of dollars from you. Yes. 19:28 So you are appealing that. Continued, did higher level supplemental planning to fight this, but VA paid me back to date of claim. How do I handle? Do I send it back, set it aside? You mean they paid you incorrectly? 19:40 They paid you as if it was the date of claim? That money is yours. Yeah. They- You're, you're not... They don't get to appeal the grant they gave, okay? So that money's yours. 19:50 You're, you're going for the, uh, from what we understood, the, the 12/22 is when you filed these claims to get you to 100% for PTSD, so that's where you need to go back to. That's your real date of claim. 20:01 That's, what, almost three years. That's a lot of money. So if they paid you, they paid you, it, they did it. That's their error, and there's no way you could have known. 20:10 You don't have to pay that money back, but they're gonna figure that out. I find even years later they'll come back and figure that out. 20:16 But, and why that's important to you is you want to go ahead and get the effective date that you're entitled to it approved, okay? You're not gonna lose anything, 'cause they're gonna... You've got that money. 20:27 But at least that gets you back to those dates when you start moving up the scale, okay? Um, and as far as SMC, if, if you have reason 20:37 that you would need aid and attendance for PTSD, that's one I would go for, because just- Oh, wow... looking at all your disabilities, you should at least be two, two half bumps, if not three half bumps up. Yeah. 20:47 You may get all the way to O, which gives you R1. Mm. Because you've got a lot of disability benefits, and that's the whole point of the Berry case, is that you get paid for those. Move it on up. Yeah. Good work. 21:03 Uh, Cassius, good to see you. At the Veterans Aid, I could be wrong, I Google it and it says it has to be related to TBI. Oh, this is, uh, yeah. Oh. I had TBI, severe PTSD, can go either way, head trauma, small. 21:16 Yeah, the, uh, for SMCT, you gotta have, you gotta have a rating of TBI. It does not have to be 100% rating TBI- No... but you gotta have a rating for TBI. 21:28 Rogan, I had a copy of a favorable one, so I submitted them as new evidence. The one for asthma was denied in, in '14, but that is what I did for med board. Service-connected for PTSD second to my breathing problems. 21:44 Okay. So remember, you can be med boarded out for something, so you had it, but if they say you don't have it now- Mm... that's the only way they could have denied you. 21:54 If they said you never had it, you need a present, remember, you need a present diagnosis, so I'm guessing that's the only way that they could have denied your claim. I mean- Legally... legally. Yeah. 22:10 Tiny Tiny, if you're on today, Carol, I just wanted to mention that you know two people now who live in a barn- [laughs] A barn-daminium... A barn-daminium. Oh my gosh, that's hilarious. Wow. Wow. Okay, that is funny. 22:22 For those who weren't there, Kerry built himself a, uh, dream house, which is basically a barn with a condo in it. So- [laughs]... 22:31 the, the bigger space is actually the barn or the- The barn, and he's got- What do you call that? I mean, it's, it's more of a garage- I mean, it's a barn-... but it's massive, and he- It's a garage and a barn... 22:40 pulls all his tractors and everything else in there. It's, it's a dream for him. Every toy a guy could love- Yeah... is back there. So his house is like a barn-dominium because it's so small compared to the rest of it. 22:49 So congratulations, Tiny Tim. You're really, you're in there with the- Yeah, that's funny... with the up-and-coming group. Love to hear what you have in your barn. 22:57 [laughs] Cassius, I have a question about supplemental claim. If you're at SMC level, do you receive retroactive pay from the effective date when you first filed the claim? Yes. Also, is there a ruling in Haskell v. 23:08 McDonald concerning TBI? I don't know. I don't know. Do you? Is that, that's... No, that's, that's the case. I don't, yeah, I don't know that either. I'm sorry. We'll have to look that up. Hmm. 23:22 Alma, if 100% TDIU can get addit- can get additional compensation for your home health through incapacity. Um, so- If 100% TDIU can get... Is that the question, can 100% T... 23:39 I, the VA, uh, we don't, you know, the, remember, we're the VA benefits section. There's a VA health section, and their rules, we don't know what they are, and they seem to be different from every different VA. 23:50 Because some of my veterans will get home healthcare, where other veterans who have the same problem, their VA healthcare is denying them that. 23:59 So, yes, depending on the, the limitations of your ability to do activities of daily living, yes, it's possible to get home healthcare, but it depends on the VAa health system you're through. 24:10 Frankly, they all seem to be a little different. There's no uniformity that I've found. And, and I think you could also look for a caregiver there though too, right? Couldn't- Well, that's a separate thing. Oh, okay. 24:19 So, caregiver is when you have a person who actually is there caring for you, and they would get the money directly, but so there are three different things. 24:26 You apply for aid and attendance, you also apply for caregiver if somebody's helping you, but then there's the VA home healthcare, and I find that they're sending people in to clean the house or to help them buy groceries or things like that- Mm... 24:38 depending on their disability, and depending on the region you're in. But I, I would definitely go in and apply for that to see what you can get. All right. Linda, six years Vietnam-era vet. 24:53 I tried to obtain my active duty medical records, along with my C file. After completing the necessary form, after waiting several months, I was told they do not have those records. 25:04 How do I obtain them, and how do I obtain entrance exam? I'm currently 90% combo. Do you have, have you asked for your milit- military personnel record? 25:13 Remember, those, the military personal re- personnel record is not necessarily in the C file. Should be, but most of the time it's not. So, if you have a pending claim, you can write to the office in St. 25:24 Louis and ask them for a copy of your military personnel service file, and in almost all of those they have the entrance and exit exams. 25:33 That's probably the only medical they'd have in there, unless there was a board hearing. Uh, but they might have those for you. Otherwise, if they've lost the service medical records, they've lost them. 25:42 But this is a second way to try and see if you can find out if they have anything for you. Just going back to Cassie's question about the Haskell case, the Haskell case was the accompanying case of the Laska case. 25:54 The Laska case is the one that defined SMCT only requiring the SNTR1 requirements of aid and attendance. Okay, so that's the case, we know it. Yeah. 26:04 Yeah, so we, sorry, we, we go by the Laska, but that, those cases do- How do you spell that? L-A- L-A, it's like Alaska without the A. L-A- L-A-S-K-A. Yeah. Laska case. Yeah, I didn't realize the other one. 26:15 But it's, those, those cases were joined, and sorry, I didn't realize that, but Has- that's what Haskell stands for is that SMCT, to get that when you have a TBI, um, you only have to meet the requirements of SMC(R1) 26:27 aid and attendance. Super, super complicated, but basically what that means is you don't need somebody in the house, uh, giving you medical treatment that otherwise would only be done by a doctor. So... 26:39 Yeah, they made it much easier to get SMCT. So, if you have SM... If you have T- TBI, apply for aid and attendance, and then apply for the SMCT, or maybe both the same time. Mm. Lerner, good to see you. 26:57 Going for a C&P tomorrow. Should I bring a copy of my Nexus letter with me and show a new nurse practitioner with four years experience? Yeah. Yes. Kindly hand it to her and say, "Hey, this is to help you." 27:08 "This may not be in the record, so I want to make sure you have it." Yeah, yeah. Exactly. 27:14 Grace, how do you know what effective date for back pay if intent to file was 11/24, C&P was June 25, received letter dated 7/25 granting 50%, was 40% since 06, now combined 70. 27:27 Am I entitled to percentage of my military pension, retired Navy? Yes, because you're over... Because I was receiving both, now what? Yes, because you are over, what is it, 50% now? 27:38 They, they keep on changing that, but go back to the first part. The effective date of the 70% should be the intent to file, the 11/24. Right. And remember, they miss that quite a bit. Yeah, uh, it's like a rule. 27:50 They'll, they'll... Yeah [laughs]. I'm gonna, I'm not gonna see that. But they, they pick up either the 526 form, the POU, the claim you formed, or the 0995 date, not the intent to file, and that's wrong. 28:01 You're entitled to that date. Marine, will hammer toes be included in plus planus and plus plan- in plantar fasciitis, or is it separately rated? I've seen it separately rated. I think it should be. Yeah. 28:20 Richard, part one, although there is a record of treatment and service for knee problems left, no permanent residual or chronic disability subject to service connection as shown by the service medical records. 28:32 Part two, demonstrated by evidence following service. Service connection for knee problem left remains denied since this condition neither occurred in nor was caused by service. 28:43 Favorable findings identified in decision, you have been diagnosed with a disability. Private medical records show treatment for osteoarthritis, left knee. The evidence shows a qualifying event [laughs] 28:55 Had its onset during your service. Service treatment record dated 09/24 show that you had a complaint of left knee. Would this be higher level review, or should I get a Nexus letter? I want the higher level review. 29:08 What do you, what do you... And then this is CAR to me. I mean, literally CAR. I'd do CAR because it's quicker, but I think you're probably gonna get, need a Nexus letter. Why? He had all three favorable findings, right? 29:16 Because they're probably saying what they usually say, that it ended and this is a new problem. Okay. Yeah, I, I'd try CAR first, and then go from there. Yeah. Oh, good. Oh, here we go. Here we go. All right. 29:32 I'm getting my information. Now, none of this is happy, okay? Um, and a lot of this, because y'all work really hard to know what's going on, you know. 29:41 But I have found there's so many people out there who don't, and my own clients, I had a conversation today with one of them about there's no more than 100% because he had a lot of people tell him that. Mm. 29:52 That's, that is what the VA wants you to think. There is so mu- 100% is, like, $3,800 a month for just the veteran. Some veterans get $11,000 or more. 30:04 I have veterans, Matt has veterans, who are getting that, so it's not just this pie in the sky type thing. I, we both have veterans who are getting a lot more than the 3,800, in between 3,800 and 11,000. 30:16 In fact, most of my veterans, that's my goal for them, to get five, six, $7,000 a month. 30:23 So, there is so much more than that, and please, if you could, if you could dissuade people from thinking that, every time you hear somebody say that, tell them, "This is wrong. There's special monthly compensation. 30:35 Look it up." Some of the people are confused, like my veteran said, "Well, I don't have any dependents, and that's why my friend thinks he gets $9,000 a month." Mm. He doesn't even understand what he's getting. 30:46 So, that's what I'm saying. There has been-I don't know why, but there's just like this effort out there to make sure veterans know they only get 100%. 30:53 So number one, I know a lot of you because you are really good at SMCs, but everybody out there, you need to know there is so much... $3,800 is nothing compared to six, seven, $8,000 a month. Okay? 31:07 I will say, this show's kinda skewed towards SMC, because we have such an informed audience. It is rare, I mean, not everybody's gonna get 100%, and just like not everybody's getting 100% is not, not gonna get SMC. 31:18 Now, but I, so I'll say with what Carol says, if you're at 100%, don't stop, be curious as to if there is more. But I mean, if you're applying for stuff and you, you know, you're only getting 30%, that's fine. 31:28 If you have PTSD, you have a mental disorder, and it's significant, and you have other problems, you're probably already, you already should be getting SMC-S, which is the first. 31:38 If you need help because of these service connected problems, that's aid and attendance, that's another thousand. You're up to almost 5,000 right away. 31:46 So that's what we're saying, that most of you really end up needing more than 100%. It just depends on, there's, it's rare to have a person with one thing. Okay. All right. 31:58 Here's a, here's a horrible thing that happened to my client. He was called by the VA, and they asked him a lot of questions. "What's your Social Security number? What's your VA claim number? What's your full name? 32:11 What was your rank in the service? What service were you in?" On and on. This was not the VA. Mm-hmm. The VA does not do that. 32:20 If anybody calls and says they're from the VA, and they start asking your date of birth, things like that, hang up. The V- if you call the VA, they will tell you, "We would never do that." 32:31 Now, this person, I am so afraid, is now going to have somebody getting credit cards, loans, everything on his name. I told him he needs to get an Equifax or some kind of credit- Mm-hmm... 32:41 uh, a company that he can see if people are inquiring to get a credit card. But be aware, the VA never does that, okay? So if somebody calls you, hang up. 32:51 It's better to hang up and get it right, than keep going and end up in a terrible position like this, okay? Better to hang up than get it wrong. Hang... [laughs] Okay. All right. 33:03 The second is, and I've gone over this before, is C&P exams. This continues to be a terrible problem. Remember when the VA did them, they were all done at the VA. 33:12 And then they started contracting out to private contractors, and now we have maybe eight different companies. So this is a business, and when they say, "I'm sending you these heart, 33:23 MS, PTSD claims to be evaluated," they want to get the money from all three claims. So if you, if they don't have a doctor under contract that's near you, they want you to drive wherever they have one. 33:35 You have a right to have the exam near you. If you don't have a way to get there, they have to give you a Zoom, in-home, or something very close to where you can get there. They are not gonna tell you that. 33:46 They're gonna tell you that you're gonna be denied for failure to cooperate. Y- you need to tell them right up front, "This is where I live. 33:54 If you can't find somebody close to me, and I mean close to me, I'm gonna hang up and call the VA and get them to refer my case to another company." 34:01 And if the people say, "I'll get back to you," and they don't within a day or two, call the VA right away. 800-827-1000. Ask to speak to the compensation and pension section, and tell them, "I am disabled. 34:15 I have all these problems. These people want me to go 100 miles, 50 miles. I don't have a way to get there. I can't do that. I have asked them for closer, and now they're not responding to me. 34:27 I want the record clear that I am ready, willing, and able to go, but I can't go this far. Please assign me to another company." Okay? 34:36 That will, what's really important about that is, if they get a letter from these compensation and pension exam people, which they're doing, say, "Failed to show up at exam," you've already proved that they're lying, okay? 34:48 Mm-hmm. Don't put up with it. Don't argue and argue with them. Don't spend any time with them. If they can't right away give you what you need, go to the VA, okay? 34:56 This is a real problem, because they are all reporting that you're failing to cooperate, you're failing to show up, and they deny you based on that. 35:04 So even if you get denied, you now have this, and you file a duty to assist appeal saying, "This is what happened. Please send me to another contractor who can have an exam near me." 35:14 I bet we spend, every day I spend three or four letters sending out saying, "This is what happened," because the client didn't know what was gonna happen to him, and he's been denied. 35:24 So before you get denied, do that, okay? And so like I said, it's not good news, but it's stuff you really need to do. Damn good Carol's Corner right there. Whoo. That was some good info. And she didn't even yell. 35:36 She was serious, but there was- But I-... no finger pointing or yelling or anything. Yeah. But those, those were good. All right. Back to the main event. Richard. Oh, we already did Richard. 35:50 No, I don't under- We did that one. Oh. Uh, "I don't understand how they could say that my PTSD is secondary to my breathing problem, but it doesn't have a rating." That's bizarre. 36:02 Um, if they're, if they're not rating them separately, then somehow they're saying your PTSD is non-compensable, which- Oh, I, I see how they could say it don't have a rating. 36:11 I've had how many BVA approved saying you have servi- you are service connected for PTSD, not even secondary to breathing, and they give them a 0%. That's, that's the VA, they're trying to lowball you. 36:22 So you need to appeal that right away, and you need to mention the, the, all of the records that are already in the file that show PTSD and how it affects you. Okay? 36:32 You can always, I would do that first to see if you can get that, especially a CAR 30-day appeal. 36:38 If that doesn't work, you wanna put in a statement from yourself, from a witness who knows you about your PTSD, any medical records you have that show, "This is why I should be rated 50%, 70%," or whatever. 36:50 But no, I see that all the time. That's their latest little- I'm giving...Win the battle, they win the war- Yeah... by keeping your money. Remy86, good to see you. "Hello. 37:03 I have SMCS for multiple service-connected-" Multiple sclerosis? No, multiple SC- Oh, service connections. Okay. [sighs] Sorry. See what I have to deal with here, guys? [laughs] This is constant. 37:14 "Major depressive disorder, 70, migraines, 50, peripheral neuropathy, 20, right leg, bilateral shin splints, MTSS, 10% both legs, but I have two extra service conditions, service-connected conditions, that aren't included, GERD and OSA. 37:29 If I was to get to SMCL, would I get an extra step?" Can you go back so I count? Remember, you need... What are you gonna get, uh, what are you going to get- Right... it for? 37:39 If you get it for the major depressive disorder, then you can use all of these others. So you have migraines and you have sleep apnea. 37:45 If they're not related to the major depressive disorder, so then you'd get a full step, plus you have peripheral neuropathy, two legs, that's 20, shin splints, so that's another step up. No, that's only one leg. 37:56 Oh, right leg, bilateral splints, 10 both. Yep. And two extra if you can add those to the- Well, two, one of them. Go to the next page, one of them's sleep apnea, which is the 50. GERD, 10. 38:06 So you're close to a third one. Yeah. Yeah. S- but as Carol said- It'd be L, M, M, or M and a half... 38:12 as Carol said, though, this is all predicated on you showing that the PTSD or the major depressive disorder causes your need for aid and attendance. And not the other. Yeah. It has to be just on that. Yeah. 38:24 James: "Thank you for all. Thank you all. Finally 100% P&T, but I have 50, four 40s, two 30s, two 20s, five 10s, all PD. It's a brain tumor." I'm going- SMC. Well, no. "I'm going to poke the bear asking for L and a half. 38:41 Thoughts?" No, y- okay. What is the 100% for? I think it's the combo. The combo? See, remember, well, you can... He's just asking for L and a half, so do you already have aid and attendance? 38:59 You gotta get aid and attendance first, so that's what we need to work on. So what's the underlying disability? If we could use that 50, that would be the best to get you 100%. I'd like to know what they're for too. 39:11 Yeah. It says it's secondary to brain tumor, so brain tumor must be rated at zero. Brain tumor would be zero or 100% of in itself, then- then you would rate the residuals. 39:23 So I'm- I'm imagining most of those ratings are residuals from the brain tumor. Um- So, yes, you should file for aid and attendance, because you clearly need help, and limit it to as few- Yeah, yeah... 39:36 uh, service-connected conditions as possible. And then when you look at that, you don't, you don't say, "Give me L and a half." You say, "Give me aid and attendance." 39:43 And then if they give you aid and attendance and they don't give you these other steps, then you ask for a higher SMC rating and see what they give you, 'cause it should be a lot more than L and a half- Mm-hmm... 39:52 if you only have to use one of those ratings. Wayne: 100% P&T SMCS, hearing loss 100%. Other disabilities: heart- Whoa... mental health, 70, OSA, 50, headache, 30, tinnitus, 10, sinusitis, 10. 40:10 Do I qualify for higher SMC, and how do I do this? You need to, you need to file- Well, he says, "I don't qualify for any." So no. How can you not qualify at 100% hearing, how can you not qualify for aid and attendance? 40:21 Can you go on the phone and make all your appointments? Can you, can you tell what people are saying to you over the phone? I mean, that's a big handicap when you can't communicate. 40:30 If there's a fire in your house, do you know, can you get out of it? I mean, it c- you know, 100% hearing loss I would think would qualify you for aid and attendance, and if it doesn't, pick mental health. Mm. 40:41 I mean, with all those things you're telling me, and this is my men, women are a little bit more honest about this. 40:47 Men hate to say that they need any help at all, or they say, "Well, I don't have a trouble buttoning my shirt, 'cause now I use pull-ons." That's not the answer. You have trouble, that's why you have to use pull-ons. 40:59 Think about all the things you get help with, things you need help with, things other people do for you. I mean, I can't believe you don't need aid and attendance. Can you remember to take your medications? Mm. 41:10 Can you tell what the doctor's telling you about what you sh- need to do to take care of yourself? Do you mix up your medications? Do you forget to go to the doctor? Do you forget and leave things on the stove? 41:20 With your heart at 60%, do you get exhausted- Mm... so you can't take a shower, have trouble cleaning or, uh, dr- clothing or... Think about all these things. You do need... 41:30 Aid and attendance is not someone's going to come in your home. They're gonna pay you another $1,000 for you to get any help you need, okay? And it's not a daily thing. 41:39 It's regular aid and attendance, so meaning it could be every week, it could be every 10 days. Right. The, the- It doesn't have to be constantly that you need all these things. 41:47 And remember, if you don't think you need it, ask the people you love, "What do you help me with? What do you think I need help with?" Because I, I put money on that. She's better, though. She's a gambler. It's a gamble. 41:59 I would also say that you can still combo here. 42:03 You can take the 100% s- hearing loss, combo it with the heart, or 100% hearing loss, combo it with the mental health and say that, "These two together prevent me from doing whatever." 42:12 You do that, you still have a half step for the heart, and you still have a half step for the OSA, so that would still get you all the way up to- M... M. 42:21 So there is, there's a path here that doesn't have to just be service connection, sorry, uh, aid and attendance based on the hearing loss. I- How about driving? 42:30 I- I've gotten aid and attendance for hearing loss before, that's why I know that's a really devastating disability. 100% for hearing loss is- Very hard to get... 42:37 I've been doing this a long time, and I can count on my hand how many times I've seen that. Yeah. That's, that's pretty bad. 42:45 Kent: "When filing a 21-0996 for high-level review, do you attach a 2140, uh, 214138 to list your contentions. Yes, you can. You can, yes. Or you can put it right on the 0996. 43:01 I mean, I like to put it on the 0996, one, to keep it brief, two, to know that they have the form, they told me they have the form, they're not gonna lose it. Right. If you, if it's a separate form- Mm-hmm... 43:09 they may not connect it with the appeal, and that's why we put ours all together in one. Mm-hmm. Colette, "Do you have to submit a claim for bilateral factors?" No. Nope. They should automatically do that. Yeah. 43:27 Victor, "Just got denied for chronic fatigue syndrome on an appeal that was remanded. I was approved 10% for tinnitus. 43:33 I was never diagnosed with chronic fatigue syndrome or tinnitus, but I have the symptoms of chronic fatigue syndrome for years. What should I do?" 43:42 Definitely go out and get a diagnosis, 'cause remember, you have to have service connection possibility plus a current diagnosis. If you don't have the current diagnosis, you can't win. 43:52 Except if you served in the Gulf, then you've got 38 C.F.R. 3.117, which says that you can have an unknown, what is it? Mulkey or whatever. Unknown etiology. Yeah. 44:05 But I'm just saying, they, how often do those people win? I mean, they should. But that's a hard case, but I mean, it's one worth fighting for. If you don't have a diagnosis- Right... 44:12 but you have the symptoms, you can objectively point to the symptoms, then, and you served in the Gulf, they've recognized that there's something that you all went through that causes mysterious illnesses that are not diagnosed. 44:22 That's the only place where you can get- Right... service connected without having a diagnosis. But, but try to get a diagnosis. 44:28 I mean, you're telling your doctor, what do they think you have if you don't have chronic fatigue syndrome? Yeah. Tell him what you're missing, though, to- Right... to give that diagnosis. 44:36 And I'd go to the VA doctor and say, "I have this and this. Do I have chronic fatigue? If not, why not? Tell me why I don't have it." McDoodle, "Hi, I'm SMCM 44:49 for RI 60% of hands, 40 for TMJ, 20 for each knee, 30 for left foot. They rated me N and a half. Is that right?" M for that. So he, he's talking about three additional ratings. I don't, I don't see that. 45:06 No, I don't either. 20 for each knee. Well, uh, 30 for left foot, unless the left foot, they're considering there's- 30, well, he could get... 45:16 Okay, so he puts TMJ, oh, 20, and 20 for each knee, and then he could put for each foot, that's 60, right? Yeah, but he needs three, so he's got three half steps right there. But the- Okay, SMC-M. 45:27 He, so he's got M for the loss of use of hands. That's why they're giving him M. Ah, okay. Uh, but, um- Yeah, he ought to get, that's only a half, yeah, in- 30 for the left foot. 45:39 I'm curious if there's foot drop or they even considered that to be loss of use. Right. If that's in play, then, then I do see you getting up to N, and then these other ones would combine. Right. 45:49 I mean, we're not telling you that that's not right. We're just saying from this math, we would need more information. Right. But definitely, that foot loss could really- Yeah. 45:58 Foot drop, remember, that could give you a great, that could give you what you need. Foot drop is when you can't pick up your foot when you walk, it sort of drags. Uh, and th- those are really high ratings. 46:10 So if any of you have that, you should go to the VA, make sure that they, they diagnose it, and then get an AFO. 46:17 That's, uh, it's a brace that keeps your foot straight so that it doesn't drag when you go to walk, and that's further proof that you have foot drop. But you have to claim that. 46:26 They're not gonna, they're not gonna look for it and say, "Oh, you have foot drop." It's just a higher level, uh, rating for your foot. Sherman, "Do you need a lawyer for a CUE claim?" No. Nope. 46:40 Um, you know, I will say, Carol files a lot more than I do. It's rare that I file CUE claims 'cause they're, they're not an everyday occurrence. 46:47 I mean, there's some things the VA messes up, gunshot wounds from the '70s, uh, knee ratings from the early 2000s, we've seen them mess that up a lot. 46:55 But i- it's, it's a tough claim, and so, you know, as one rater one time told me, "The CUE claim is so bad that my grandmother can spot it." It's kind of- [laughs] 47:05 Kind of, kind of obnoxious, but at the same time, it's like you're, you're not gonna win a lot of those. But remember, do you have a CUE claim or do you have an open claim? Yeah. That's what you want. 47:13 And that, we have a lot of open claims that we win, and if you file for a CUE claim, you put yourself in a hole. So you need to know, what are you really filing for? Is this a claim that never was decided? 47:24 A claim where additional evidence was put in within a year? A claim where the service medical records weren't in? So those are open claims. They're not CUE claims. 47:32 And yes, no, you don't need a lawyer, but they're great claims. Yeah. K9 USA, "Higher level resulted in duty to assist. Now I've seen PDRO stated the shoulder is now warranted for service connection in the 29999. 47:49 However, an exam request to BES, the VA wrote exam for service connection. Higher level review resulted..." Oh, wait. Okay, that, is that it, I guess? Um. 48:08 That's the same. Yeah. Hmm. I don't know what's going on there. Um- I'm not sure what the question is. Do you know? I, so if you get a duty to assist error from the DRO, it goes back to the person who made the error. 48:23 They send it out again. If the, if the DRO said that you are service connected, it went back to that person, and they say, "Well, give us another service connection opinion." That to me is another duty to assist error. 48:33 That's duty to, that's, duty to sabotage is what they just did to you. 48:36 So I would, if they deny you again, I would take that back to the DRO and say, "They asked the examiner an inappropriate question because I've already, you already said I should have been granted service connection." 48:46 Right, and I see that too. They, they're clearly, the first one was not, exam was not right, so they had no duty to assist. 48:53 They send them out, and that says, "Yes, you'd be service connected," and they send them to another one 'cause they want evidence to deny you. Uh, they're not, that's against the law. 49:01 They're not supposed to do that, and they do it all the time.Junior Aroos, "My father has recently filed intent to file. What should he be doing in this process?" I mean, he's got a year, uh, but he needs to... Uh, 49:18 y- the important thing to me is that when he files the 526 or the claim to, you know, the supplemental claim, everything needs to be filed at the same time. 49:27 So make sure you file all claims at the same time, because if you file one claim and then two days later file the rest, well, those rest, the effective date is the day they file versus the all the way back to your intent to file. 49:37 That's the biggest thing. Otherwise, I'd be gathering whatever evidence you need, buddy statements, service records, medical records. Right. That's what I'd be doing. 49:47 [clears throat] Kerry, "What's the biggest challenge facing veterans who developed Parkinson's disease?" Dealing with the disease. Oof. Yeah. It's so multifaceted. It's, it's a horrible disease, and this is- 50:00 And their care partners. Oh. [laughs] My Siri, Siri wanted to talk about Parkinson's, sorry. [laughs] Um, i- it's, it's just such a difficult disease. 50:10 This is definitely one where Carol's gonna hammer home, you should probably be getting service, but you should probably get an SMC for this because it, it can take away the use of hands, feet- Ultimately, you're gonna get R1- Cognition... 50:19 and maybe R2. Yeah. It's- And, and you should be- It's gotta be service connected... setting out your claim for that. Yeah. 50:23 And a lot of times, depending on when they come to me, I do the loss of use of feet, loss of use of hands, all of that right away. 50:31 The VA is not gonna approve those until they give you 100%, until they rate you for service connection for Parkinson's. But then the effective date's gonna go back. All the way back, yeah. Yeah. 50:40 So, uh, file for everything, 'cause it's a terrible disease. This is one where I totally agree with Carol. I would, 100% is, is the starting point. Yeah. You are, you are not settling for that. 50:51 All right, let's take three more. "Leanne Spring, Vietnam vet. Can I file CKD secondary to initial hypertension claim at the same time?" Please do. Yeah, at the same time. Can, yes. At the same time. 51:06 "Ronald, how may you force VA to treat you when you're a 100% disabled war veteran?" [laughs] How can you force VA to treat you? Huh. That's oof. I don't know. 51:17 Are, are you, if you're service connected, they have to treat you. Yeah, that's- Um, that's the key. 51:22 You have to be service connected, and if you're not getting the treatment, I tell people, "Stop dealing with the clerk who's making the appointment or not making the appointment. 51:30 Go up to the head of the health department." I- Go in. Yeah. Go in, and go to whoever's in charge of that entire medical facility and say, "I want an appointment." And they'll say, "Why do you want an appointment?" 51:39 And you'll talk about, "I'm not getting treatment," and I, 10 to 1, they're gonna make sure you get treatment because the person's not gonna wanna talk to you. Right. 51:46 And they don't want a complaint, so you're, you're much more likely- Especially from a 100% disabled war veteran. Yeah. You're much more likely to get the treatment you need if you do that. 51:54 Stop dealing with people who can't help you. They're gonna tell you, "No, no, no," and if you go to the person up top, he's gonna have to give you a reason why, and he doesn't have one. 52:03 [clears throat] All right, last one. "Bob, do you take cases of denials?" Yep. Yep. That's basically the only case we do take. All right, folks. We appreciate you coming here today. Had some great SMC questions again. 52:20 Love that. We had some good just regular questions too. So thanks for being with us. It was a joy to get to be in person with Carol again. And we hope to see you next week. Thanks for our new time, Tuesdays. Bye. Bye. 52:33 [outro music]
