Increase

ngkm5

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PEB Forum Veteran
Registered Member
I have a bunch of questions pertaining to submission for higher ratings.

I’m 70% DoD/80% VA/70% CRSC. I was TDRL as of 2017 and PDRL as of 2019.

Question1:

If I request an increase of rating for knee (example) is it possible to get a decrease in another injury (like my PTSD)?
Why do I ask ?:I haven’t seen a medical provider in almost a year. I hated the VA and decided to go private. And since then, I’ve slowly tapered of my drugs and if I had to show my progress to the VA (if they asked) I’m afraid it would appear I’m doing better.



Question 2:
(A few of my current VA ratings)
-Hearing loss - 0% (service connected)
-Tinnitus- 10% (service connected)
-Migraines - 0% (service connected)
-Sleep apnea - 0% (service connected)

These are what I currently seek for increase. I was issued hearing aids a year before my exit of active duty AND given a CPAP by the VA (I have since started using a mouth piece instead). If I want an increase, do I need to start making medical appointments to further document my concerns or do I initially submit a request on eBenifits and go from there?

If I do decided to go ahead and just request exams for an increase, should I see a medical provider through my primary care (Tricare) first, and get a Nexus letter to link all of these conditions together, THEN request and bring the Nexus to the VA for my exam(s)? I just learned about this Nexus letter; how hard is it to get a private physician to write this up???

I have more - but these are my primary concerns. Thanks for any input/advice.
 
There are three versions of the post above. One is partially answered at VA increase concerns <---LINK

Ron
 
If you are PDRL, your rate can only increase, if at the time of the PDRL you can prove your rating was inaccurate. This would take a BCMR.

If by increase you are asking about the VA, that is possible. You have to submit a claim. That can be done online via E-Benefits. In the case of Sleep Apnea;use of an oral appliance or CPAP should be rated at 50%.
 
I apologize for the multiple postings (moderators).
Yes; only speaking on behalf of VA increase. My concern is VA lowering my PTSD rating when asking for increase for other service connected disabilities. And I’m not sure if I need a Nexus letter or not.
 
You MH percentage would not be examines on the basis of applying for a higher rating for sleep apnea. The examiner that would see you for sleep apnea would not normally be qualified by the VA to comment on your MH rating.
 
Right, which makes total sense.
I’ve never requested an increase before, so I’m unaware of how the process takes place.
But after reading your post and thinking about it, I guess it’s safe to say that if I request an increase in sleep apnea/back pain/migraines/hearing - there’s zero reason for VA to dive into my MH (and not worry about any decrease).
Thank you.
 
Question 2:
(A few of my current VA ratings)
-Hearing loss - 0% (service connected)
-Tinnitus- 10% (service connected)
-Migraines - 0% (service connected)
-Sleep apnea - 0% (service connected)

Usually a nexus is used to help secure service connection. Your Tinnitus is maxed at 10%.
 
If awarded 50% for the sleep apnea machine/ oral device alone should put you at 90%.
 
If you ask for any increase the VSR can request exams on any of your other conditions as well this is always a risk when when you file new claims. Once your claims file is open its subject for additional re-evals. You do not need a Nexus you are already service connected for all those conditions you just need medical documentation to back up the increases.

1. Go to your Tricare providers and request a copy of all your medical records.
2. Find a free VSO to give them to and tell them what claims you are wanting to file for an increase.

Just requesting exams sometimes works but most of the time doesn't especially if you haven't been seeing providers.
 
You MH percentage would not be examines on the basis of applying for a higher rating for sleep apnea. The examiner that would see you for sleep apnea would not normally be qualified by the VA to comment on your MH rating.
Which is strange because sleep disorder are all in DSM-V. (The bible of mental disorders)
 
See...
This was my real internal concern; that many disabilities can be interpreted being related and creating paths I do not want to venture with the VA.
I’m super lucky and tremendously thankful on how things have worked out for me since being placed on TDRL and then only having one reexamination, within 1.5 years, and being moved to permanent. Then being fortunate enough for CRSC. Literally, everything has worked in my favor. However, I have loss of hearing and wear hearing aids (zero rating), I have migraines (zero rating) and my back has gotten worse (10%).
I don’t want to rock the boat, but feel that I’m also possibly not getting getting what’s on the table - which is why I started this thread for any insight.
Thanks for all the comments.
 
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Which is strange because sleep disorder are all in DSM-V. (The bible of mental disorders)

Just for SA and clarification. Sleep Apnea and Obstructive Sleep Apnea, are classified as respiratory issues not MH. It's secondary to physical oral and neck anatomy, not cognitive processing of past trauma or stress like insomnia or hypersomnia's. There is brain related sleep apnea (Central Sleep Apnea) but this is where the auto-regulatory center int he brain stem does not properly regulate your respiratory rate. It to is an organic/mechanical issue, not a cognitive.
 
T
Attach files


Just for SA and clarification. Sleep Apnea and Obstructive Sleep Apnea, are classified as respiratory issues not MH. It's secondary to physical oral and neck anatomy, not cognitive processing of past trauma or stress like insomnia or hypersomnia's. There is brain related sleep apnea (Central Sleep Apnea) but this is where the auto-regulatory center int he brain stem does not properly regulate your respiratory rate. It to is an organic/mechanical issue, not a cognitive.
The VA does list Obstructive, Central and Mixed Apnea as respiratory disorders. What I find odd is the DSM list them as mental disorders in DSM-V.
 
Approximately 9 weeks after requesting an increase for sleep apnea (0%), lumbar (10%) and migraines (0%), I had a visit at a local LHI. The entire visit, wait time including was less than an hour.

Last night I logged in just to check (the appointment was 5 days ago) and I was awarded:
Sleep apnea - 50%
Migraines - 30%
Lumbar - 20%

All of these have already been rated service connected in 2017 during my initial VA claim visit; post active duty service.
My concern is if these ratings should be retroactive from the initial VA claim visit in 2017? I was diagnosed with sleep apnea well before my exit of active duty? (Back pay?)
 
No back pay if you weren't happy with the rating in 2017 you had one year to file an appeal to keep your effective date. Any new claim or increase you file the effective date is the date you filed the claim.
 
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