Transcript 0:00 [upbeat music] Hello and welcome to another Hill and Ponton VA Benefits live Q&A. 0:21 Matt Hill here with Carol Ponton. Hey, Matt. Hey, Carol. We haven't got to do this in a while. I know. You've been out and about. I've been, [laughs] I've been doing a lot of traveling. Yep. 0:29 So just glad to be back, excited to be back here. Excited to get into some questions and just seeing what's going on in the community. Good. Well, let's hit it. First question. 0:40 Oh, okay, so this was something that made my day. We got- And mine... a note from, uh, from somebody who watched this, saying, "Mr. Hill, I believe you said VBA's denial of SMCT under circumstances was horseshit." 0:54 That was a technical term, folks. [laughs] "Yes, sir, you're correct. Ms. Ponton, you suggested HLR. You were right. 1:01 I wanted to let you both know that not only is today our wedding anniversary, the day- Happy anniversary... the HLR decision came back reversing the denial and granting her husband SMCT." Wonderful. 1:10 "We're going to get the effective date reviewed and corrected," I love that, "but I want to thank you both for answering my questions, letting me know it's possible to get SMCT through HLR." And that is awesome. 1:21 Great getting HLR reviewed, apply a statute and disregard the, the regulations in the M21. They actually applied LASGO. Oh, good. That is fabulous. And that's so good to know, 'cause we're not, I'm not seeing that. 1:31 It's only the board that's been granting so far, so hopefully this is gonna be a trend. Yeah, that's great, because it's a lot faster to get a HLR- Yes... typically than, than having to take it all the way to the board. 1:40 So we're happy to see that. 1:41 And folks, you know, we talk about this with, we talk about special monthly comp all the time here, but with that special monthly compensation for TBIs, that's a SMCT, I mean, that's a $10,000 a month benefit. 11. 11. 1:53 Oh, God. And, you know, they're not gonna grant that right away. A- and so, you know, they had done their homework. They had done a great job getting medical opinions, and did what they need. 2:04 And, and, you know, I'm just so glad that with this community- Me too... uh, they were able to get those on their own and at the regional office. So that was a great way to start our day. Um, but let's jump on. 2:13 I think Cynthia had the first question. What was... Where were we? All right. "Thanks for all you do. 2:18 After a recent Senate meeting and Washington Post story claiming fraud, even though data shows fraud is actually minimal, do you guys..." Say more of this. 2:28 "Think this could lead to reforms that end up reducing or even removing V- VA disabilities for legit vets? Curious what your take is, and if there's anything else that in the discussion we should be watching for." 2:40 So- My answer is yes. Okay, I'll let her go first. She's gonna- Yes... she's gonna start pointing her finger, 'cause she- I, I feel really, if you listened to me last week, you realize I feel very strongly. 2:48 I think this is a, this is a on-purpose, um, attack against veterans, and I think you need to realize that. 2:59 They are coming after you, and they did it with the Social Security disability benefits, and they're gonna do it with you if they can. 3:05 You have something that's really important, your vote, and you need to contact your congressman, your senator, and tell them, "This is a bunch of baloney," or Matt may have another word for it. 3:15 [laughs] This is not the sensationalism that the Post wants to, to, people to know. The sensationalism is how poorly the vets are treated, how many legitimate claims are denied, denied, denied. 3:28 You know, I told you last week, a client, I, I think I did, I had him 10 years, and he finally got his benefits and died the next day. That's not right. He lived in poverty waiting for those benefits. 3:39 You need to tell them. You all have stories. You need to tell them, and, and we need you out there, because this is, this is a, a, a, an attack on you, and you need to recognize it. 3:50 I think it's slow, but remember I told you, where are they doing it? In Washington, where the Board of Veterans' Appeals judges are. They're the ones who give the best benefits to our veterans. 4:00 The regional office follows their own rules, but many times the board will go with the law, and that's what's getting you these big benefits. So don't let them... 4:10 What they're doing is they're trying to change their mind and say, "These veterans are all malingerers. They don't deserve these benefits." They're really... 4:18 And the crazy thing is how minimal these fraud things were in my mind. They were like nothing. So yes, this is important. I'm calling you to arms. You need to get out there. Okay, that's all I had to say. 4:30 It took her all the way to the very end for her to start pointing. [laughs] I don't know if anybody else saw that, but she was grasping her arms like this so that she wouldn't start her pointing thing. 4:37 A couple other things on this. This is the first of three articles, so there's two more to come. 4:43 You know, I read this and I was, uh, I was impressed with how well-researched this and how much time they spent on this, and I was irate in that they spent all their time on one side, sensationalizing abuse. Yes. 4:57 I, I mean, abuse is [laughs] okay, great. Th- there's abuse in, in that, sure. But as Carol said, there's, to me, uh, 10 times, 100 times more abuse on them denying rightful benefits, waiting for people to die. 5:10 You know, w- seeing the list go away 'cause they get discouraged. Uh, so I, I was really, really angry at that. And, you know, I, I would be, as she said, your congressmen know you vote, so I'd reach out there. 5:22 But I'd also be reaching out, y- you know, um, I'm thinking about calling, um, different d- different journalists or radio stations just to put the other word out there. 5:31 'Cause I, I just really can't believe this major news organization went out of its way to show the VA being this overly generous organization. I mean, that, it, it just really, really angered me as well. 5:43 I mean, I- Me too... I, I, I don't get it. Um, you know, Carol, Carol's seeing conspiracy here. I don't know that I- It is a conspiracy. I mean, who, who reads that paper anymore? What else would they do? 5:53 The Board of Veterans' Appeal Judges. Okay. Well, I, okay, I won't argue with that, but I, but yeah, I, I think this is ridiculous, and I do agree with Carol that you can't sit on this. No. 6:02 You need to, you tell your story where you can, because, you know, everybody here has a story that's heartbreaking and frustrating and, and, um, yeah, when I read that, I was thinking, "Okay, that's fine you did this research," but the fact that you didn't even look on the other side and see what kind of abuse there is in not granting benefits isIt's really, I, I think that's poor journalism. 6:20 I, I think it's substandard at best, if not sensationalist- [laughs]... which they claim they don't wanna be. So, um, we're, we're with each other on the rightness as far as the conspiracy thing. I don't know. 6:31 I, I think it's- Watch out for the next article. You wanna know what to watch out for? Okay. Yeah. So- We need to get the truth out there. I a- I agree with that. 6:41 I think, I think they're releasing one Sunday, so maybe the Sunday it comes out, but it's, it's really, it was really disappointing. But, all right. Darwin. Carolyn Madden. Darwin, "You serve, you deserve." [laughs] Yes. 6:56 "I was awarded SMCL A and A due to PTSD and ADLs, then I was awarded 50% for migraines, but remained SMCL. Filed for HLR to re-eval SMC. The HLR was a nine. 7:09 Instead of being rightfully awarded H- uh, uh, SMCL and a half, I received a letter from VA that said, 'Improper grant of SMCL,' since I didn't have a condition rated 100%." Oh, "Carol, you're correct. 7:20 I got caught up in the language of not having the condition rated 100%. I am P&T and TDIU rated 100%, uh, for PTSD at 70. I sent a direct appeal to the, uh, to the, uh, Board of Veterans' Appeals, 7:33 and the reason for decision, it states, 'Evidence must show aid and attendance is required to perform routine activities of daily living.' My Nexus in 2680 clearly indicates the need for ADLs, activities of daily living. 7:45 I'm awaiting decision on chronic fatigue syndrome, diabetes, Meniere's, lumbosacral spine, bilateral interior- [laughs]... joint pain with radiculopathy. What are your thoughts? The real fraud- [laughs]... 7:55 is the VA incompetence." Amen, Darwin. That might be her next T-shirt. [laughs] "You serve, you deserve, and the real fraud is VA's incompetence." I love that. You are great. I, I, I, yeah, I agree with that. 8:06 Um, first of all, my thoughts are, great job. You're fighting, you understand the benefits you deserve. VA obviously doesn't, but you're sticking with it, you're putting your, you know, your work in. 8:17 I think that's great. Carol, what do you think on substance, though? I, I agree, and I think that going to the board is important. 8:22 And, okay, remember what I learned last week from Kerry is that only the people in Seattle are doing the Berry, uh, SMC claims, okay? And I was saying, "Well, I'm getting these denied all over the place, especially St. 8:36 Petersburg." And he said, and I, and, and we both said, "That's because St. Petersburg doesn't recognize Berry." Mm. So I think we need to put Berry in there. 8:46 Under the Berry case, I'm entitled to a half step, a full step, or whatever it is, so that we're alerting them, this goes to Seattle. Mm-hmm. That's the first thing that I am going, I'm doing from now on. 8:56 The second thing is, you did it right. You go to the board, you explain to the board. They will under- So hold on. Uh, let's, let's break it down a little bit. 9:02 You get a decision from the regional office, and then it's through the HLR system, right, that it's gonna go to Seattle or to St. Pete. Right. And so it's when you do HLR, you're saying, "This is Berry"- Right... 9:13 and hoping that they direct that the right way. Right. Because obviously many of the VA people don't know what Berry is, okay? 9:21 So we realize we have to, again, educate them, and I need, you need to put Berry in big letters. Anything you want explained, "Berry allows half or full steps up," and, "Under Berry I'm entitled to..." 9:31 So make sure that's prominent in your appeal. So, yes, you were right. You went to the BVA. They should not only give you your aid and attendance back, they should, uh, also give you that half step. 9:41 And then if you get awarded these others- Yeah... that's great. Remember, you only have to get to O to get to R1, which is the nine and a half thousand a month. Yeah. This is, the, and again, great work here. 9:52 And I, and I try to say this every show. If you notice the first two questions were on special monthly compensation. This is deep-end stuff. 9:58 I mean, most of the listeners here understand this better than the VA regional office. So if you're looking at this and you're like, "Oh, my God, I don't understand that. 10:05 I have a question on just how I get this, you know, my knee service connected," don't worry, you know, please ask us that as well. Um, but you'll notice here that people are invested in their claims. They learn the law. 10:16 They understand the medicine, and, uh, you know, unbeknownst to the Washington Post- [laughs]... that's actually what you have to do to get the right amount of benefits you deserve, so. 10:25 Right, 'cause the VA's not gonna give them to you. Uh, the real fraud is VA's incompetence. [laughs] I love that. I gotta write that down. She's gonna have another T-shirt, people. [laughs] Okay, next question. 10:36 Next question. "I served, I deserve." Okay, you guys- I love that guy. Oh, my God, you guys are just kissing up here. "Hey there. I have a C&P tomorrow regarding urinary frequency. 10:48 I need to know if I should tell the examiner that I have lumbar stenosis and PTSD. Forgot to mention both PTSD and lumbar stenosis can affect urinary frequency, but the LS is more prevalent." 11:00 Right, and I would try to relate that- Well, I mean- The lumbar- Are, are, are they service connected? That's my first question, actually. I'm assuming you are service connected. Okay. Okay? 11:09 So, yes, if you're service connected, and, uh, veterans will say, "When I'm having pain, when I'm having trouble bending, I might accidentally urinate." You know, show how that relates to that. 11:20 But yes, uh, you would say, "I have both of those, but I think the, the problem that's really bothering me is my lumbar," and explain. Make sure you look- Go back to the first part of this question. 11:28 Uh, I'm thinking this is related to the prostate, 'cause it, he- He doesn't say he has prostate... tell the examiner I have lumbar, yeah. Well, whatever. Okay, you're right. 11:37 Remember, make sure you looked at the rating decision, because if you're incontinent or if y- how many, how many times you have to change a pad every day, or how many times you have to get up at night, or how frequently during the day you urinate, all of those are gonna decide what rating you get, okay? 11:52 So you wanna work on the rating as well as the service connection. Um, 11:58 yeah, and, and I was gonna say, uh, Nate, if you could throw up the regulations, 38 CFR, uh, Chapter 4, and, uh, I serve, I deserve, you look under there for, uh, is it called urinary? It's not called urinary. Voiding. 12:12 It's voiding dysfunction. What, what, what, what's the chapter, though? It's on- I don't know, but if you go to AI and ask for voiding dysfunction rating- Yeah. Okay, do that, yeah... 12:19 it'll, it'll pull it upUm, 'cause you wanna look at that. 12:22 You know, you go see a doctor for this, but the doctor is supposed to just take what you say, meaning, like, he's not gonna give you some exam and say, "Oh, you can bore... You have forward flexion of 30%. 12:31 That's what this... You know, that equals this rating." 12:33 He's supposed to listen to you saying, how many times you urinate a night, how many times do you have to change pads, what's your daily, you know, during the day, frequency of urination. So, 12:42 look at the rating code, figure out which one of those is the worst, you know, of those three I just named on the rating code, and make sure you're there tomorrow to deliver that information. 12:52 And remember, don't think about how many times I have to change a pad when I'm at home sitting right next to the bathroom. Yeah. 12:58 Think about what it would be like when you're trying to go work, when you're out in the public. That's, that's the real key, okay? Yeah. Great question. 13:09 Constitutional immunity 2.0, 90% back, third time denied for mental secondary to back. Should I get a Nexus or find treating doctor with Nexus? Thank you. Back denied for mental secondary to back. 13:26 One Nexus of finding treat- so is your mental secondary to your back? Is that what he's saying? Yeah. I mean, that's crazy they're denying that. I know. That's, that's one that they often, uh, approve. 13:36 So hopefully you will get a doctor and just go, that understands this. 13:41 I would make sure that I talk about the pain, the fact you can't do any of the things you wanna do, you're not reliable, you feel bad because your spouse has to do everything because of the back pain, and it makes you depressed. 13:52 Um, make su- just talk about what's happening in your life, and you might wanna write some examples down. Yeah, I, I mean, so that would be, if you can't find the Nexus, you go to the next C&P exam and you say all that. 14:03 And, and you know, basically what Carol said, your whole identity has changed because of this back pain. 14:08 I mean, who you were, what you used to be, the standard you kept yourself to, it's no longer there, and, and that is, that's crushing. So, as Carol said, we usually see these granted because- I know... 14:20 back can just be so devastating, so- You may wanna ask, m- you may wanna get all the medical articles that support that. 14:26 You may wanna write a statement that talks about, just go through your day and things, how it affects, and try another, uh, supplemental claim just to see, because these are pretty routinely awarded. 14:37 You know, I think if you get the medical articles that they're gonna have to contradict, and you go through in detail how it makes you feel, I think you may have a better chance. I don't know what you've done before. 14:46 Mm-hmm. But if you don't, then definitely you need to get a Nexus. A- and I will say, if they're saying that there's some preexisting depression or PTSD or schizophrenia or something, okay, how we deal with that is, 14:59 we need to show what the baseline was. You know, were you anxious all the time before the back problem? And then what changed? 15:04 You know, you went from being anxious all the time to just depressed, can't get out of bed, don't wanna be around people, don't bother investing in your friendships. You know, ta- i- if there is something there, there... 15:13 'Cause that's the only reason I see this denied. I know. This is three times this I've seen. So if they're saying that it's due to something else, show where the change happened post back pain. 15:28 Echo Ranger, would filing right knee, left knee pain, right knee, left knee, sorry, like radiculopathy, lower mid back pain secondary to my service connection, right leg, left leg shin splints, 20% right leg peripheral neuropathy be a good claim? 15:42 I use and wear VA s- prescribed cane and bilateral supportive knee braces. 15:49 Yeah, I, I mean, you're, you're doing all these, and frankly, having the VA, through its doctors, figure out which ones are rated the highest and which ones do not overlap in pyramiding. 16:00 So you probably will not get, um, ratings for all of those, but, uh- Go back to one, please, Nate. Like the radiculopathy and peripheral neuropathy. He ought to get all of those. Not, not neuropathy, radiculopathy. 16:12 If he's getting sh- well, peripheral, but the shin splints are not gonna be overlying. Right. 16:16 Right leg peripheral neuropathy and radiculopathy, that may be the one thing that over- uh, overlaps, but I think the lower body, which throws off the, the body parts above it, causes these problems, and most of the time you can get this. 16:31 Once again, it's so easy to get medical treatises that show this connection. 16:36 I would, from now on, put those in when you file a claim so that they should be contradicting something that all the medical community agrees with, other than the C&P examiner's opinion. Right. 16:48 So, so what she's saying is, a lot of times examiners will like to just say, "Because I said so." Right. 16:52 And if you put in medical, you know, treatises or basically research papers or whatever, showing that the medical community believes there's a strong connection between the knees and the back or the knees and the hip, so the ankles and the hips or whatever, um, [clears throat] then, then it, then the VA examiner has to do an extra step. 17:10 They actually have to address that evidence, and if they don't, that's a duty to assist remand, you ask for an appeal. Right. Charles Shell, "What does a VA audit entail? Could a rating be reopened?" 17:25 The audits are usually basically to see if you were paid the rout- right amount of money. I have yet to have an audit come back that said anything other than, yes, I paid the right around money. 17:36 So yes, it, it could be reopened. I've just never seen it before. The one thing they seem to get right is the past due benefits. 17:43 One of the things that make you s- feel like it's wrong is, say there was an offset, maybe you owed the IRS some money, or maybe you owed for student loans or something. They will take that out and not tell you. 17:55 So you get less money than you think you're entitled to, but you never know why. Mm. That's, that's a big problem, and they don't address it, and we have no way of knowing. Yeah. C. Knights, good to see you. 18:09 "Diagnosed and treated many times in service for plantar fasciitis. 18:13 '05 C&P exam for ankles noted it's related to a service-connected feet and service-connected plus planus, left bunionectomy and painful heels."All of which could cause faulty gait pattern. 18:28 Twenty twenty-three applied for plantar fasciitis, second to pes planus. Plantar fasciitis was added to pes planus, already fifty percent. Painful heel symptoms never mentioned. 18:39 In any BVA decision or service connection, in any BVA decisions or service connection until applied in twenty twenty-three on appeal for separate pes planus because of separate symptoms, if approved, can I have plantar fasciitis backdated to '05? 18:55 Uh, two thousand and fifteen exam for flat feet increase has listed arthritis from x-ray. Increase approved ten to thirty percent with no mention of symptoms of arthritis and decision. 19:05 Twenty eighteen increased to t- fifty percent, no mention of arthritis symptoms in C&P exam or decision letter. 19:13 In twenty twenty-three, claimed arthritis secondary to service-connected hallux valgus, uh, arthritis granted, but included in flat feet, already fifty percent max. Have appeal arthritis separate from flat feet. 19:27 If arthritis is not approved separate from HV, can fifty percent flat feet be backdated to fifteen? My HV is rated ten percent, operated with recession of metal tarsal head. Would that be an inferred claim? 19:43 If not, can you give an example of an inferred claim? Thank you for all your help. I'd wanna know when did you get out. Um, if you had arthritis diagnosed within a year- Mm-hmm... that's clear, uh, that's Q right there. 19:56 Um, yeah, an inferred claim, basically the, um, I think it's 4.1, thirty-eight CFR 4.1 basically says th- the VA must maximize your ratings. 20:07 And to maximize your ratings, they look at not only what you applied for, but what the evidence says, uh, states, meaning... 20:15 So if this two thousand and five claim, where you're applying for pes planus, and the VA e- uh, examiner gives us a great opinion, says, "Oh, and by the way, he has pes planus or plantar plan- plantar fa- well, plantar fasciitis." 20:31 I, um- Plantar fasciitis... plantar fasciitis that is service connected, that is an open claim. Yeah, it's an open claim. That, that goes all the way back. It's not inferred, it's open. 20:39 Um, I guess what I would say, though, is if there were an intervening decision on that issue that decided it, that would close the claim, even if it doesn't address it all the way back. 20:48 So that, uh, I know that you had it- That is so complicated. I, you know- Yeah, these are ones where we spend hours- Hours looking over the medical... 20:57 studying the medical, yeah, medical and the, and then what happened afterwards. 20:59 So it, it sounds to me like it was addressed later, and if that later decision is not still open, the first decision after which it addressed it, if that closed and then you reopen, I don't know that you have an inferred claim there. 21:12 Um, with the arthritis, though, I, I, I think you do. 21:14 I mean, if the arthritis was noted in the joint for which you're service connected and you weren't given a ten percent rating or twenty percent, whatever it would entail, if it's a major joint, then yeah, I, I think, I think you should be able to open that. 21:27 Yeah. Um, if- But this is a very complicated case. Yeah. And like Matt said, I would spend hours going through all the medical, the dates of filing, things like that, and looking at the ratings. 21:37 So I don't feel comfortable feeling like I can fully answer your question. Yeah. What I would say, and what I, I applaud you on, is you're understanding the concept of pyramiding. 21:46 Bas- basically meaning that if you have two different ratings for two different issues, if the symptoms are the same, then they're not gonna pay you. They're gonna pay you the greater of the two. 21:54 So I like the fact that you're doing this. You're, you're, you know, you're talking about the heel, you're parsing out what is different o- on that new claim that shouldn't be absorbed in the fifty percent. 22:04 So that to me is the bigger issue for you to keep forward on, just to make sure you're pressing that, because it sounds like you're having a ton of pain, and- Right... 22:11 honestly, w- what I'd wanna know here is how are your knees? How are your hips? I mean, if your feet are that bad, the, the, the secondary issues that they cause are, are, are awful. And loss of use of feet. Yeah. Yeah. 22:24 'Cause I think the maximum you can get for feet is sixty percent, right? Because of the- I know... uh, what do you call it? The amputation rule. He's got so much. 22:30 Yeah, the amputation rule, but he's got so much going on, and I don't know, are his knees connected or his hips, like you said? Yeah. You'd need to get those, and you're looking at loss of use of feet. Great question. 22:43 RB, "Went for increase for mental health, but the examiner spent most of the time talking about my pre and during military service, even though I'm [chuckles] already rated. 22:51 I had to ask her to tell me about her- my symptoms. Is this normal?" Unfortunately. Yeah. Um, what's not normal is you advocated for yourself. Right. 22:59 You understood why you were there, you understood what needed to be discussed, so, uh, you know, hats off to you. Um, uh, you know, you're dealing with people who don't understand the VA system. 23:09 They don't understand what, what entails a C&P exam, 'cause these are all private examiners. God knows if they've done one exam or a hundred. Or I could be a little paranoid- Well, Jesus, who's to guess?... 23:18 and you're dealing with somebody who wants to hurt your claim. So what I would do is I would file a forty-one thirty-eight, and I would explain, "During this examination, I was never asked about these things. 23:29 I wanted to tell her all of these things, these problems I have, but this examiner refused to listen and ask. All they wanted to ask about was what happened." Okay? I would make that very clear, and I would get that in. 23:41 And then if you're denied or not given the benefits, I would file a duty to assist saying, "This, this examiner did not do an examination like they should've." You've gotta, you've gotta get that on the record. 23:51 That's, that's, yeah. That's, I, I agree with that. I, I, I don't put- paranoia takes, uh, you know, conspiracy takes energy. 24:00 [laughs] Conspiracy takes energy and intelligence, so that's why I always default to incompetence. [laughs] 'Cause I don't think we're dealing with intelligent people or ambitious people. Ooh. 24:09 I think we're dealing with lazy, incompetent. Ooh, and I thought I was in trouble with the VA. I'm just saying. 24:14 [laughs] Khaled, "If I have arthritis in my hand and it connected for multiple joints, the wrist and each finger, could I receive ten percent for each joint for pain in multiple joints in the same hand, or is this pyramid?" 24:28 Yes, you could. Different joints. Yep.Tris Way 22, just received CUE from VA reducing my rating from 60 to 40 back to 14. MS 30, 24:43 I- UI 20, back strain 10, left leg weakness 10, GI secondary zero, shoulder direct 10, removing 30. What are my options? 24:53 Okay, remember, it is very hard for them to reduce anything that's been in effect more than five years. No, he's got 10. And you've got 10 or 11. And so I think you should go to the board. 25:05 I don't think the regional office is gonna help you. I think you should go to the board that says, this was an ille- illegal reduction. You know, this is what we see all the time from the VA. 25:13 The board understands that, and I would point out how many years you've been that. They probably only gave you one exam. Remember, they have to show that it has... 25:21 Uh, if you look up the five-year reduction rule, that's gonna give you all of the information about what the VA had to show, not you, the VA. Mm-hmm. Okay? And if you've got 10 years, that's even stronger. Yeah. 25:32 So look under reductions after 10 years, and that's gonna give you the things the VA should have done but didn't do. And go to the board, don't go to the regional office. 25:41 And I'm curious here, if you have MS, they give MS 30% just for the diagnosis, meaning you have no symptoms whatsoever of MS. 25:49 So I look at that, and yeah, there, there is asymptomatic MS, but unfortunately, a lot of times what we see is extremely symptomatic MS. Right. 25:57 So I'm, you know, d- I know you didn't ask this, but I'm just curious, what symptoms do you have? Are you being, are, are- Underrated. 26:05 Yeah, underrated there, because MS in and of itself, unfortunately, can l- l- lead to a very, very high SMC. 26:11 So let, um, focus on that as well, because I don't want them trying to, you know, divert your attention focusing on losing, what, it looks like 20% or something, when you [laughs] really should be paid, uh, aid and attendance or even higher. 26:26 So make sure you're, you're, you're compensated for MS. Oh, here's another thing I'll bring out about fraud, fraud at the VA. Do you ever seek CUE in the veteran's favor unless they have appeal for that? No. 26:38 You see, they argue CUE to reduce you all the time. First of all, their arguments are always wrong, and, you know, so they're going through to reduce you. 26:47 Are they looking for mistakes they made that would give you more benefits? No. I have yet to see that other un- unless we filed an appeal and pointed it out. 26:54 You know, the, what's interesting about that is I think we have seen an uptick in CUE for reduction in the la- I don't know, last year or two. This year. This year. This year. And so- And severance. 27:04 Yeah, which as Carol says, anybody who fights it, you know, gets standard. We all win. Yeah. So I, a- again, we're here- Oh, paranoia... not an option, but [laughs] Yeah. No, I'm serious. 27:14 You need to know there's a concerted effort by the VA this year. I've got more 27:19 s- uh, proposals for severance, more reductions than I've seen in years, and that's, they're attacking the veterans, and this is one way they're doing it. 27:27 They're trying to, even if they don't prevail on this, they kept you from filing for anything else. Right. Right. See? And again, that, that's what I'm saying about the MS. Like that- Yeah. 27:35 That, that is just for a diagnosis. So if you're asymptomatic, great. Tha- good, good for you, 'cause, uh, [laughs] you know, you don't wanna be symptomatic. But if you're not, if you're having symptoms- Yeah... 27:43 you need to apply for higher, um, benefits for that. Okay. Oh, free book here. Free book. Yeah, I've been meaning that, but, but I, I, I... Nate has a little shock collar and, and- [laughs]... 27:55 I don't do things I'm supposed to, I get in trouble. But, uh, the book we wrote, the book I wrote on service-connected benefits, you know, everything I know, it's in there. Scan that thing. 28:05 We'll send you a physical copy. Um, you know, again, we're, we're looking to help as many people we can here, and, and that's been my playbook for the last- Free book... 15, 16 years. Give it to your friends. Yeah. 28:14 If they have questions, at least it, it's a great place to start. Yeah. And, you know, for you, those of you who are saying, "SMC, what's going on?" This is gonna give you all the basics- Right... 28:23 so you can get your claims filed, figure out, you know, ratings and things like that. It's free. That's, free is free. It's free. Yeah, we'll, we'll mail it to you. All right, is it about that time for- It is that time. 28:32 The Newark Carol's Corner. All right, here we go. All right, this time it's a little more complicated. 28:37 Um, so when we file, we file a supplemental claim or a new claim and get a decision, and then say we file a higher level review and argue there's a duty to assist, and then the VA says, "You're right, there's a duty to assist," and they make a new decision, okay? 28:55 Normally, because it's a new decision, your appeal would be a higher level review. But apparently, a- and I found this out because we keep having cases that don't go anywhere. 29:05 I'm filing a higher level review because this has been another decision, and nothing happens. They send me a say, "You filed the wrong form," or whatever. 29:14 I finally found out yesterday there is a problem with their system that doesn't understand, and they will only accept a supplemental claim or a BVA appeal. So- Even though the law says they should... 29:25 even though the law says. So these cases are sitting there one, two, and three years. I keep sending in, explaining. It's not getting me anywhere. 29:34 So from now on, I'm going to have to either file a supplemental claim or direct to the board, because otherwise, they are not moving these claims. So here's the scenario. 29:44 It's when there's been a supplemental decision and an HLR is filed, but instead of making a decision, they say there's a duty to assist, and then they make a new decision, which would normally entitle us to file another HLR. 29:57 You can't do that. You can do that, but you're not gonna get anywhere. So if you want your case to move, you either have to file a supplemental or board appeal, okay? 30:06 I found that out yesterday because I have so many cases. We keep writing and writing, and nothing happens. He said he's put in to get it changed. Nothing's happened. Wow. That's- So-... good info. Yeah. 30:17 That's where, you know, it's frustrating because the law says one thing, but the system says another, and, and at the end of the day, folks, the point is getting you these benefits you deserve- Right... 30:27 not making the VA get it right, so. I think ultimately, there are gonna be people who take this to the board. 30:33 Like, if I have a claim, I have a new file, and I see there's a claim there, I'm gonna file a claim, and then I'm gonna file an appeal to get the earlier effective dates. Mm. 30:41 And if I have to go to the board or the CAVC, but right now, like Matt says, you wanna move your claim. Move the claim, get service-connected, and then start filing and appealing the effective date. 30:51 Yeah.But that's, that's what I found out this week, folks. And that's Carol's Corner. Yep. No fingers. Yolanda Fergus Adams, good to see you. 1/5/827, filed in '23. 31:08 BVA grant service connection for bilateral MTSS. Osteoarthritis left knee and lumbar back, stated as back condition. 9/8 RO grants bilateral MTSS at zero with effective date of 2020. Lumbar 31:24 strained degenerative arthritis and- How generous... spinal stenosis at ten percent at nineteen. 31:30 Should it have been rated under DDD, granted twenty percent for sciatica each leg after BVA granted s- ten percent for back? First of all, it sh- it should be granted under- We're not done yet. We're not done yet. 31:41 Well, you're not gonna remember the question. Go ahead then. [laughs] Uh, RO sciatica rating did not address loss of use function, uh, secondary to back. 31:50 Which date would rule RO claims effective date when C&P exam's done? No. Bilateral sciatica should be sixty percent left, forty percent right. Also have claim for thoracic back. 32:04 Does BVA decision help that claim since decision stated as back claim? No. It's, it's- Ooh, that's frustrating... thoracic and back are pr- lumbar are pretty much gonna be together, unless you can show... 32:14 It's very hard to show that there's, they're separate issues. There's control effect, no. If you have more than one autoimmune disorder, do they rate them separately or do they combine them? 32:22 They affect different systems. Different symptoms, different ratings. Yeah, so it's, but it's gonna be on you to show what different systems, symptoms, uh, they have. 32:32 Okay, let's go back to the, um- I think it was second one you started yelling. [laughs] Effective date be- Well, okay. So you need to go back to when you filed the claim. 32:43 Uh, if they're giving you two thousand nineteen, that's great, and the radiculopathy should be then as well, if it is present in the medical records. 32:50 You should be rated under whichever, uh, rating is more favorable to you, okay? Um, the next one, three, Nate. Right. If there's loss of use of function, then you definitely need to get a rating for that. 33:06 Um, the VA has taken the position, the regional office will often take the position that I can only give you a higher rating the date the examiner saw you, because before that, I didn't know. That's wrong. 33:17 Go to the board. The regional office probably won't listen to you. But the board knows you have a right to go back to when you filed that claim, okay? 33:24 So thirty-eight CFR four point one says they have to maximize your rating. Yes. 33:29 So if you're, you're applying for back, uh, or, or legs, whichever, the sciatica or the legs, and the rating should entail not only the percentage, the forty and sixty, I think you said, but it causes loss of use, that's all on the same rating. 33:41 That's- Yes... you know, that special monthly comp isn't like, they like to say it's its own claim, but that's just the rating you should be receiving. 33:48 So you, even though they didn't say, uh, denial, loss of use, you need to appeal that, okay? Yeah. Because that comes under their crazy rule about s-sub, uh- Um, yeah, yeah, yeah... you should have known. 34:01 Yeah, you should have known. You know what? You should have known. Implicit denial. Implicit denial. Four, let's see if there's still an outstanding question. I think we answered that. Answered that. Five. Yeah. 34:15 Yeah, we answered that one. Okay. Good luck, Yolanda. Richard, I'm currently rated a hundred percent permanent and total PTSD, fifty migraines, thirty chronic sinusitis, zero hypothyroidism. 34:27 When I asked questions before, it was mentioned to me about possibly qualifying for aid and intensity of PTSD. 34:35 My wife currently has intermittent FMLA for me and has to had internt-internet F-FMLA for my condition since twenty-three. My wife has this, should consider filing for aid and attendance, one or the other. 34:49 And she should file for caregiver. Yeah. Um, I don't consistently meet those requirements. I think all the time- It's not consistent, it's regularly. Yeah. 34:58 So you don't have to, it's, you know, it's activities of daily living, but you don't have to not meet those daily. It's regular. Right. You regularly need your wife. 35:07 I mean, forget about her being on FLA, um, you know, permanently, but, but the fact that she's on FMLA working from home, that to me says- Yeah... you need her there. 35:17 You might not need her that day, but you need her presence in case you need her. Right. Makes sense. 35:21 So there are two claims, aid and attendance, which gives you more money, and then caretaker, which will pay your wife directly. The caretaker you apply for at the VA health organization, not the benefits, okay? 35:34 They're run out of that, uh, office, where the benefits, the aid and attendance, is the regular VA that you're filing all the other claims under. And- [laughs] 35:44 If he, she, so Carol, what happens if he gets aid and attendance for the PTSD and he has fifty percent personal- Oh, then you go up the SMC ladder, my favorite ladder. Sure. 35:52 We're getting so many more benefits for our veterans using this SMC ladder. 35:57 And, you know, it's, the regional office doesn't understand it, but the board does, and the board likes that because it's a quick dec- you know, they're all, everything's numbers. 36:06 So with the board, each judge has to issue so many decisions. When they get a, you go, "I have a hundred percent for this in aid attendance. I have fifty percent for this, which should give me L and a half. 36:17 I have another fifty percent, which would give me M," that's a real quick decision for them, and they like that. So you are entitled to that. 36:23 If you get aid and attendance just for the PTSD, then you can use the other to go farther up the ladder. Happiness, good to see you. For SMCT, I want vets to understand central sleep apnea can be caused by TBIs. 36:39 Please research. It is different than obstructive, and you can have both. Central can be dominant. Thank you. There you have it. 36:49 Phil, I filed Q, first judge found error, remanded to the V- so the VA corrected the error and then denied claim. Appealed second judge, denied my claim. 36:57 What next?Uh, you might need, you might need to go to the Court of Appeals Veterans Claims. I know. 37:02 I- [sighs] the Court of Appeals for Veterans Claims, the problem with that, unless they almost never grant benefits, and the problem is it comes back to the judge and they don't wanna change their mind. 37:13 I've been filing more supplemental, um- You can do supplemental on Q. I know. So I think you're stuck with going to the board, to CAVC. There are a lot of lawyers out there who only do that. And, you know, 37:26 what he's arguing here is the law of the case. If you already had one judge find Q, the next judge can't overrule. That's, that's- Uh, yeah, I'd like to know more... 37:36 that's an old common law doctrine, and, uh, the court should understand that, so you wouldn't get reversal with benefits, but you should get a finding of law essentially by the court saying, "This was determined already by the first judge, Q. 37:49 The second judge can't overrule." Well, he didn't really say. He said, "I filed a Q in the first George W." Oh. "Era." Okay. So we don't know what that is, but I, I'm with Matt. 37:57 If it's Q, then you definitely have to go to the Court of Appeals. 38:03 Timothy, part one, "Filed BVA direct review appeal February 25 for varied half-steps increase, also waived the 365 waiting period," you're making Carol's day, "to file my appeal in different lanes. 38:17 Submitted VA Form 4138 twice to ensure they received it. Last podcast, someone mentioned that they want to forward my claim to VLJ after the time has expired on my last BVA decision, which was December 24, 2020." 38:34 Only if you haven't waived the year to appeal, but you've done that. And it sounds like you followed up- Right... with them as well, which is frustrating 'cause sometimes they don't read those things- I know... 38:42 until a year has gone by. Um- If they get it in a ba- in a pile, they don't look at it. Yeah. So. 38:48 I mean, honestly, you're a month away, so, uh- So remember what, what we've started doing is we either put that we've waived it right in the appeal, or we file the waiver a day or two after we file the appeal. 39:03 'Cause remember, we also found out if you file the two together, they may not get the appeal right away, but if they get the waiver, they don't have a file to connect it with, so they throw it in the trash, 39:15 and they don't let you know they threw it in the trash, so just another thing we've learned. Because they're overly arching vet friendly and trying to give you- [laughs]... 39:26 all these benefits that you shouldn't be getting. You know? It's just, thank God we have newspapers to tell us what's true. [laughs] B. 39:34 Thomas, "Is a medical opinion from VA rater of chronic sleep impairment as a symptom of PTSD enough to secondarily service connect sleep apnea to PTSD?" Should be. [scoffs] They're saying- Chronic sleep impairment. 39:48 I mean, sleep impairment is part of the rating code for mental health conditions, so that's like a 30% rating. 39:54 So if they're just saying it's nightmares, uh, uh, flashbacks- We're thinking sleep impairment, you just can't sleep. You wake up all night for whatever reason, and that could definitely... 40:04 I think there's many articles to connect the two. I... Right. I think you're right, but I don't think the regional office grants that. Uh, sometimes they do. Okay. Well, I disagree. 40:14 [laughs] Carrie, "100%," I mean, 1,000%. "100% for P- P&T, filed for SMC for ED. I'm not sure if I can file for aid and attendance also. I need to get he- help getting socks on. Would that qualify?" Yes. 40:29 That is a basic function, your ability to dress yourself every day. Um, be interested to see what the 100% for P&T is. Is it one issue? Is it multiple issues? Um- 40:41 And I suggest that- And the ED SMC is separate, so- Yeah... you gotta keep that filing going. That would be SMC-K, which is, like, what, 130 bucks a month or something. 40:47 So I would suggest that you and your spouse keep a list of all the things that you need help with over the next week or so, and I'll bet you find it's a lot more than putting your socks on. I know. 40:56 I bet you she has a lot more input than, than you might realize, all the stuff she's doing for you. Yeah. 41:01 Um, so yes, this does qualify, and honestly, if you're having trouble putting your socks on, I, I'm, I'm not stopping at an A&A. 41:08 I'm trying to see is there loss, bilateral loss of use of feet, uh, can I get A&A for, you know, one issue and get- Right... SMC-L for another. So yeah, that, that's, you got a lot going on there. 41:22 The Veteran's Aid, good to see you. "In reference to a decided legacy system claim, if there was VA med- medical center records added that would've substantiated the claim within one-year period, which is now closed, 41:39 would those records apply?" And that was our favorite regulation. Yep. "38 CFR 3.156b. If so, what's the proper way to get the VA to reopen?" It's open. 41:47 "A Q, supplemental claim, or can this be pointed out as a missed issue?" You don't wanna say Q. Yeah. It's an open claim. It's an open claim, but, but your point is how do you get them to recognize it? You file an O995. 41:57 Yeah. A supplemental claim. Supplemental claim, and again, what, the, the order we seek in-house is first we wanna get our vet service connected, then we wanna get the proper rating, and then we get the effective date. 42:09 And the thought being there is we want the vets to get the maximum benefits they have going forward, because we might wait years on the effective date. Yeah. 42:16 So I don't want, I don't want your rating attached to the effective date if I can get you a higher rating and we're just waiting for Sometimes you have to, though, Matt. 42:23 No, I, I, I, I agree, but I'm just saying, so, so you're, you're filing a claim. If you file a claim just for effective date, they're gonna say there's no such thing. 42:30 So I'd just file a claim to reopen, and then once you get the rating you want, or once you get the first decision, disagree with the effective date and the rating if it's too low. Right. 42:40 But if you've passed the time to disagree, if y- if you just found those records, then, uh, the, one of the problems we find when we file an open claim is they don't process it. Right. Even though they have an O995. 42:53 So I'd file the claim, and then I'd mark three months to follow up what's going on, and then I'd mark every two months what's going on. Okay? Because those tend to sit. Yeah. 43:03 They don't know what to do with them, so they just-If you don't have a claim for higher rating, uh, why I was trying to couple those higher rating claim is that once you get it in the system, then it's easier to attack the effective date once there's already a decision. 43:15 Right. 43:15 But if you're saying this supplemental claim for correct effective date, they say, "Oh, there's no such thing as a freestanding claim for effective date," and they just don't even acknowledge it, what Carol's saying. 43:23 So, uh, it just gets a little harder to get traction. B. Thomas, "Can you claim multiple theories of service connection for the same diagnosis?" Yes. Yes. 43:34 For example, sleep apnea and secondary PTSD, secondary asthma, et cetera. Yes. Pick one theory, list... Nope. Um, you just put it all in there, and the VA has to figure it out. Right. You are not a medical doctor. 43:45 They keep telling you that, so use it to your advantage. Yeah. "Claimant has military profile from Armed Reserves listing OSA in problem diagnosis section. Does this suffice for direct OSA?" 43:56 No, uh, because you're a reservist- Right... and not active duty. Deborah, "Injured right knee while on active duty. Cannot locate medical records. Claim from a 1024 denied due to lack of diagnosis." 44:11 Okay, so we got two things going on here. Right. You got to get service-connected benefits, something has to happen in service. You got to show proof of that. 44:16 You have to have a current diagnosis and then a nexus, basically a link putting the two together. So, um, 44:22 uh, as far as what happened in service, how we can cure that is if you have anybody you served with, you know, anybody who knew you beforehand and saw that you had a knee problem. 44:32 If the person saw you hurt your knee, that's even better. File that in there, but the diagnosis you need to get with a doctor and, you know, a painful knee, restrictive knee, those aren't diagnoses. 44:42 You got to have some kind of arthritis or, um, you know, s-something that actually gives you a diagnosis for that. Right. Menis- meniscal problem, something. Yeah. 44:55 Navy U, "Have a record review only request from VA to contractor following a denial supplemental. Is this a sign in the right direction?" It's not a sign in any direction, unfortunately. No. 45:05 They're sending it back to probably the same examiner to review records, not to see you. Basically, the records are, you know, should have been considered probably in the first go-around when they saw you. 45:14 So it's, uh, you know, moving the ball forward, but whether it's good or bad- Yeah, you don't know. No. 45:22 [clears throat] Joseph, "When the BVA remand my appeal back to the regional office, it's denied, but the decision doesn't go back to the BVA. Is it final?" Yes. 45:30 This is the, this is one of the new insidious, frankly, I think this is the most insidious thing that they did and when they remade the appeal process through the AMA. 45:38 It used to be in the legacy system that if you appealed to the board and the board remanded, the, um, the underlying regional office had to issue a decision, and if they denied, they issued what's called a supplemental state of the claim, and it went, automatically went right back to the board. 45:52 Right. Now, if the board remands and they make a decision at the RO, you have to appeal that to get back to the board. And frankly, even when you appeal it, it goes to the back of the line instead of where it was. 46:02 So this is, this is awful. Um, this is something we see all the time where a claim dies. You know, we, we, we think this is ridiculous how they do that. But yes, you, you have to appeal within a year. 46:17 Maribel, "My father is an Army veteran living in Colombia. He's already service-connected 10% for tinnitus and zero for hearing loss. He wants to claim additional conditions. 46:25 How is the best way to claim with Alzheimer's?" Um- He's gonna need someone to help him, someone appointed that, you know, you'd be his POA, someone that can deal with the VA. Um, you're gonna have to do that. 46:40 Otherwise, they won't talk to you. They'll insist on talking to your father, and they won't get anywhere. So you can file an intent to file a claim to get it started, and then you can file a 526, which is the new claim. 46:53 You have to show why Alzheimer's would be service-connected. Brian L., "VA awarded me 70% for T- TBI, depression, anxiety, all in one rating. Is that correct?" It just depends on what your TBI symptoms are. 47:10 Do you have any distinct and, um, you know, completely different from mental health ratings? If you do, then I think you should be rated for both. 47:18 You should be rated, you know, one rating for depression, another rating for TBI. 47:22 But if, if, if the worst symptom for the TBI is depression and you happen to also have depression, that's pyramiding, and that would be all you'd be rated for. 47:31 Usually, the TBI that you get additional ratings for not connected with PTSD are the physical ones, headaches, Meniere's, dizziness, maybe, uh, the TBI gave you some kind of paralysis. Mm-hmm. 47:43 Then, and then, you know, I think one of the things that definitely should be separate that I see is a lot of times, um, veterans can't find their way home. I don't think that's PTSD. I, I agree. 47:54 That's what I was gonna say, the, the mental issues, the cognitive issue. Yeah. So if there's cognitive problems for, you know, forgetting how to get home or getting lost walking outside- Yes... 48:04 um, those, those should be rated separately, I think. Yeah. 'Cause that, that's specific TBI versus depression. [clears throat] Sherry, good to see you. "Thank you for all your help. 48:15 Uh, thank, thanks to y'all-" [laughs] I love that. "90% climbing the steps." Good God. [laughs] I love it. Carol's gonna be walking around with all these crazy T-shirts. 48:23 [laughs] People are gonna be like, "What is this woman doing?" [laughs] Good luck, Sherry. J.D. Minfour, good to see you. "Heard from BVA, landed a hundo this week." Ooh. "Thank you for your advice, helped so much. 48:35 Of note, two VA opinions were deemed to be of no probative value." [laughs] "Which I understand is rare." That's great to see. It's good when they admit- Yeah, the truth. Yeah. You know what? 48:45 I think, just to tell you, lately I've been getting some really favorable BVA decisions. I think they're really ticked off about what... 48:53 I don't know if you know, this happened, but the VA-The head of the VA, Doug Collins- Secretary... 49:00 the secretary of the VA, went to the Board of Appeals and said, "We want you to stop issuing decisions while the government is closed." 49:07 And they said, "No, these veterans need their benefits, and we're not gonna do that." Hooray for the BVA. Yeah. And- We, we don't sing their praises. Well, I guess we do sing their praises sometimes. We do. 49:17 But that, that was just- That was huge... ballsy and great decision. I mean, he, in person, went over. You see the picture of him there with the head judge, and they said, "No, we're not doing that." 49:26 So I'm shouting out to you, BVA. Great job. B. Thomas, claimant is 73%, receives IU since 2011. 49:37 Should she pursue 100% scheduler if she can get 50, 40, 30, 50 for OSA, 30 for flat feet, for, 40 for fibromyalgia, 30 for tinnitus, 10 tinnitus, or leave it at IU? Okay, are we gonna fight over this? 49:50 I, I mean, look- I'm not worried about getting 100% c-, uh, combined. I'm worried about you getting additional benefits once you get aid and attendance. If she has... 49:59 She's not working, he or she is not working, and they have all of these problems, it seems like they might be entitled to aid and attendance, and then you can use all of these to go up the SMC ladder. 50:10 So I, I am assuming the 73% is, 70% is usually PTSD, right? Mental. I don't know of any- Yeah. So I, so I mean, to me, the low-hanging fruit on the SMC here is you should be IU just for- Right... 50:26 the PTSD, and then since you have, uh, over 60 combined, that's SMCS. So that's the easy one. See, one, two. So you can go up one. Okay, so you got 250, so you go up one. 50:38 If you get aid and attendance, you'll have 250, so you can go up to M, then you have 40 and 30 and 30, M and a half. You're almost... Oh, at 40. Look at that. N, you're at least N, N and a half. Yeah. 50:50 We don't know that you would be aid and attendance. With all those problems, look at that. Sleep apnea, flat feet, fibromyalgia, tinnitus. Don't leave it at that. 51:01 Go file for those or file for aid and attendance if you need it and then use those to get up to the SMC ladder. Love that ladder. Ladder. 51:10 Um, I definitely think you should be SMCS, which is the first one, where if you show 100% IU for one condition, you have combined 60% for the others. That's not m- big money. We're talking big money. 51:20 [laughs] My veterans are gonna get big money. She gets- They are entitled to it... she gets her Vets big money. And you know what, Washington Post? It's all legal. And long overdue. I like that Darwin needs to be... 51:33 I did [laughs] I love that. That's, it's, it's just incompetence. It's, or just it's, it's like unprofessional journalism that they don't, they don't show both sides of the issue. 51:41 You know, Jeff Bezos owns The Washington Post now. Bezos. And I, I'm, you know, there are a lot of millionaires out there, and are they fighting for the people who don't have millions? No, I don't think so. 51:53 For some reason, it offends them that people like veterans are getting their benefits. I mean, give me a break. Eduardo, uh, "VA assisted me by requesting medical records via FOIA in April 25. I decided to check online. 52:09 In messages, they show previous request and was shut down. I can't refile." Well, you shouldn't have to- No... refile. I, well, I don't know that this is a claim. This is a FOIA request for records, so, um, 52:22 uh, you know, they, they have closed down certain parts of the VA. Um, it could be for FOIA. You can refile. They will get to it when they open up. Yeah. So it- At least file an intent to file... 52:32 just because they've closed down doesn't mean things stop. You need to keep filing everything that you think you're entitled to, okay? But yes, it means a lot of people aren't doing anything because they're not there. 52:44 Yeah. [clears throat] B. Thomas, "Does an ITF grandfather claims under old law, or should the claim be pending a time of law change for grandfather clause? Strategy for your upcoming OSA mental health intents changes." 52:57 Uh, no. Uh, and I have that report. Um, so this is different. Go back to the first one. Go back to the first one? See if there's anything else to add, Carol. Yeah. 53:09 You file an intent to file a claim, and yes, I think you're entitled to the law as of that time. So that has not decided, but I would think. 53:16 Yeah, when they give you the exam, they're gonna say, "Currently, you are this, and so we rate you under the current system." That's what I understand. 53:22 Yeah, but you, don't you have a right to whatever law is more favorable? I think you do. I, I think you do too, but I also think that's, uh, open for debate. That's not settled law. 53:31 The court has not settled that under the new law, but I, I think you have a good argument for it. I don't think these changes are... 53:38 The, I think sleep apnea change will probably happen, but mental health I don't see happening. Um, you know, it's been, it's been on the books for four years now to change it. 53:45 I don't think this administration's gonna follow what the prior administration did. Um, sleep apnea is one they've complained about forever. 53:52 Obviously, you read The Washington Post, and they think it's, you know, ridiculous, but whatever. That, that's one that I see momentum behind. I do not see the momentum behind, uh, sleep, or sorry, mental health. 54:00 No, because that was supposed to be favorable to the veterans. Yeah. And then the second part, um, I mean, you would have to, y- basically what you're trying to do is trigger this, okay? 54:12 So you're trying to trigger them getting a Terra memo by saying, "I was at this base exposed to that chemical." And if you show that, then they have to go out and get a Terra memo. Right. 54:22 If it, if you were, um, exposed to anything, then that's where the IVL report comes in. They say, "Okay, these persons with this MOS at this base were exposed to TCE in this quantity." So that's where that would come in. 54:35 But y- you know, you can't go get that yourself, or you can't ask them to manufacture it. 54:41 You, you can only trigger it by saying the magic words, which were, "I was, I was on this base, and I was exposed to this and this and this." "And it caused this." Yeah, yeah. Remember, it's not exposure. 54:50 It's exposure that's caused a problem, okay? Mad Cow Como, "I helped my brother file for tinnitus claim. From filing to award was two months and a few days. 55:03 Have you seen faster service?"You know, when they get it right, um, and frankly, when they get it wrong on the initial decision, we're seeing fast initial decisions. 55:11 We're seeing- Initial decisions are usually pretty fast... yeah, two, two months, three months. That- that- Yeah... you see quick turnarounds. Unless it-- that's not a complicated one. 55:18 Yeah, that's pretty straightforward. Okay. If you have, like, three or four different dia- diagnoses and they need a lun- a lot of exams, then that's gonna take later, but that's typical. 55:26 It's really on the appeal side that we start seeing things slow down quite, quite dramatically. Right. Thomas C., "Filed a claim for PLMD secondary to asthma. VA changed it to PLMD secondary to PTSD- [laughs]... 55:39 and denied. We have a filed supplemental explaining I didn't file secondary to PTSD." I'd file a higher-level review here. And a duty to assist because they failed to- Yeah... 55:48 you know, file, w- examine what you asked for. Martin, "My community care mental health provider wrote a Nexus letter for a secondary claim. 55:58 Do I need to ask for DBQ as well, or is the Nexus letter all I need to file my claim? Thank you." Remember, you want service connection, and then you want rating. 56:06 So he gave you a Nexus letter, which gives you service connection, but that doesn't give you a rating. The DBQ talks to things that give you a rating. So you wanna have a chance to get the highest rating you can. 56:16 I'd get him to do a DBQ. Right? Yeah, I, I mean, if he will, I, I-- that'd be great. If he won't, then, you know, go with the Nexus letter and, and take that forward. It's great that you got one- Yeah... as it is. 56:32 Alex, "J- January '24, hospitalized for ventricular tachycardia. Happened again in July '25. Heart damage rated at 100% effective '25. 56:44 Using 38 CFR Section 3.40002, can I request back pay to 2024?" Did you file a claim? Yeah. Yeah. S-s-s-tr- or did it get worse within the year? Or did it get worse within the year? Yeah. So- January to 57:01 July of '25. So, yeah, when did you file the claim? Yeah. Um, the- And how bad was it in January '24? Did it get significantly worse? Yeah, so it has-- you have, basically would've had to have filed January '25. 57:14 It's the-- that law is the craziest thing. Basically, it says if you can show that a service-connected condition got worse within a year prior to filing, then you can get that back date. 57:24 But if it got worse eighteen months before, you get nothing. It's just the date you, you applied. So it's a, it's a wacky law. Go figure. 57:33 [laughs] Jay, "Are the VA's thirty-eight CFR codes available to veterans with the shutdown still going on?" Yeah. Yeah. Um, just, just, uh, go into Google, you can find them. 57:44 Cornell University actually publishes all of them anyway, so for some reason the, the, the E-codes are down, um, then you can go there. So they're, yeah, they're published. 57:58 Hocus, "I'm a US veteran currently living overseas. My VA primary care provider is refusing to provide telehealth appointments because I'm outside the USA. 58:08 I requested a podiatry consultant through my health vet, but my provider declined, stating they can't conduct virtual visits internationally. Can they legally deny this service? 58:20 I need a podiatry consultant to help service-connect my plantar fasciitis." Can you ask them to refer you to someone outside the country? 58:28 I know a lot of countries have actual places where you can get treatment there rather than having the long-distance Zoom. Um, have you looked into that? I know Spain, lots of countries have places for you to go. 58:43 Yeah, so it's... Yeah, I, I don't know if you're asking me- I don't know it... or, or who would that be? It'd be, like, a patient advocate you'd ask? Yeah. Hmm. 58:52 Let the Galaxy Burn, "How does the VA rate skin conditions?" Uh- God, that's complicated... dermatitis, uh, could- It can-- is it a burn? Is it... 59:01 I mean, it really is a little more complicated than- Yeah, um- Is it disfiguring? How long is it? How thick is it? How many do you have? Where are they? I mean, it's, it's not just a simple answer. No. 59:13 The great thing about artificial intelligence now is you can go to Google or Gemini, any of those, and ask them to pull up the ratings for. Yeah. 59:21 And then try to say it several different ways, because sometimes you don't get the right answer 'cause you don't ask the question right. Mm-hmm. That's still a big problem with them. 59:28 But I ask them to pull it up a lot of times just to check, and usually they're right. All right. Let's do two more here. Michael, 59:39 "Do I go forth with a claim for CAR HLR or just stick with 100% and don't push more buttons?" Need more info, Michael. Can't. 59:47 If you have legitimate additional problems, I would file for them, unless you think you have a chance of losing what you have. 59:54 I mean, if you have 100% and you file- If you are the guy that The Washington Post wrote about- [laughs]... where they're just giving you benefits 'cause they like you, and it's not real, then don't bother. 1:00:03 Yeah, who likes somebody? I mean, really. No, remember, once you have 100%, if you're filing for things that are totally unrelated, they shouldn't touch your 100% or look at that. 1:00:13 And what I-- before, I would, once you got 100%, if there was nothing else there, I'd stop. 1:00:19 But now that I know that ultimately, with many of these conditions, Parkinson's, peripheral neuropathy, MS, you're going to need aid and attendance, I file for all of the conditions so that when you need it, then I can get you moved up the ladder. 1:00:33 She just mentioned some very significant diseases, disease processes that we know get worse and worse. If you don't have that, I wouldn't apply. 1:00:42 If you're talking about tinnitus, if you're talking about a scar, I would, I would walk away from it. Right. All right. Last question for the day is from Chet, "Don't understand one thing. 1:00:54 I was Air Force af- Air, Air Force air traffic specialist, strictly radar. If we were less than 150 feet from the runway but was denied hearing loss. 1:01:06 I had 10% for my left knee, was given another 10% for my right ankle, but my pay is 175. Why?" That I don't know.So it should be 20%, which is it's over 200, right? Yeah. I, I- Unless, okay, remember- Offset... 1:01:22 I think separation, they take away all the money. Remember, if you had separation pay, they're gonna re- they're gonna recoup that before they pay you anything. So why there's a reduction, I don't know. 1:01:33 Well, what is 10% right now? 10%, it was like 123 or 130, and I think it's 235 for 20. Hold on. We're looking at this, 'cause this is 175. 1:01:48 So you're being paid for one disability, which would lead me to believe that you were discharged for one of those, either the left knee or the right ankle. What do you mean discharged? 1:01:57 That they were discharged and given that separation pay for it, right? 1:02:01 So if they're medically discharged due to a left knee, they give them, you know, whatever, couple thousand bucks, and so once they go to apply for VA benefits, they have to get more than 10% to get paid for it, 1:02:13 'cause 175 is for one disability, so one of those two is probably why you got discharged. All right, folks. That's what we got for today. 1:02:22 Thanks again for all your great questions, and I gotta say, you know, again, the knowledge you guys bring, the, the penetrating questions I think are so great, shows us that you're really putting the work you need to into your case, because knowledge is power here, and, you know, if you don't know what's going on with your case, you just can't count the VA to know on. 1:02:39 Right. Regardless- Please click like... regardless of what you hear- Make, me happy... in the newspapers about them knowing and being, well, whatever. 1:02:49 [laughs] More BS stories probably coming out of the Washington Post sometimes. Yeah. All right, guys. Have a great week. Keep yourself safe, and we look forward to seeing you next week. 1:02:59 [outro music]
