My finding and what I will be fighting

Ok first off percentages total 60* dod they will be marks by a *, VA 90%, contentions will be marked by a #

category 1, Unfitting and compensable and rateable
1. Total hip replacement code 5054 50% *
2. Left hip Osteo arthritis (FAI) 5003-5251 10% *

category 2 conditions
lumbago 20%
left peripheral nerve 20%
right peripheral nerve 20%
R shoulder strain 10%
L should strain 10%
Cervicalgia 10% ######
tinnitus 10%
L sciatica 10%
R sciatica 10%

zero's
right knee arthritis 0
bi lat hallux valgus/spurs 0
vericose vein removal 0
(now here is the funny thing they lumped the compartment syndrom/fasciotomy in with the veins/ the vein removal was in 2004 and on the interior of my leg, the fasciotomy was in 2012 and the anterior of my thigh)

sleep apnea 0% ( I have a sleep apnea index of 10, although the doctor did not write down hypersomonlence as a result of the apnea, he said the somolence was idopathic.)

hypertension 0%- even though I am on medication, my numbers are not high enough to warrant a rating, I thought this was a sure 10% because of the meds, but the findings state differently

status post hernia repair 0%
all scars 0%
toe nails 0%
pilionidal cyst removal 0%
headaches 0%

here is the conditions they say were not service connectable
ankle conditions (even though there was a bone scan showing uptake in both ankles done while I was stationed at lackland 6 years after my entrance)
Compartment syndrome right thigh- No evidence the problem ever existed (big miss on their part, Im guessing they lost/never had the surgical records showing the 2.8 litre blood clot removed from my thigh and the scar from hip to knee and even the C/P doctors notation that I had sever muscle damage as a result from it with internal scarring)
GERD- there was not enough evidence to support this, I never counted it
Voiding dysfunction-even though I have documented voiding problems, there is no absolute diagnosis, except for the C/P exam stating the problem and its result due to my elevated glucose levels, I counted this, but we shall see.

All in all, I am happy with the bulk of it, I think they clearly missed some items that i will have to fight for, the bad part is the neck should be 20% due to reverse lordosis as a result of spasm, the thigh should be 30/40% due to the muscle damage, the knee should be 10% because there is radiographic evidence of arthritis, but they said no evidence of painful motion, however that record was over a year ago now, so things do change. However I will have to go to a formal to have the neck/back/thigh etc. all listed as cat 1, then file my VARR.

Now for a question, say they deny my formal, how do I put in the records to appeal/NOD the totally missed thigh fasciotomy and resulting muscle damage?
 

gsfowler

Super Moderator
Staff Member
PEB Forum Veteran
I can help you to break down the ratings if you would like.

The first rating you gave a ###### was cervicalagia at 10%. This is a condition you can request a VARR for if you have medical evidence to support a higher rating.

Here is the standard on which the rating is derived from: http://www.gpo.gov/fdsys/pkg/CFR-2011-title38-vol1/pdf/CFR-2011-title38-vol1-sec4-71a.pdf you would need to look at pages 397-400

You can be rated on incapacitating episodes and/or range of motion. The rating the VA uses generally comes direct from the C&P evaluation. It is not likely they looked at any additional medical evidence than the C&P.

You can look at the range of motion that is listed under the C&P evaluation to see if a percentage was misapplied. If you warrant a higher rating based upon incapacitating episodes, you can provide that with the VARR.

I'll move onto some other areas in my next posts.
 

La Vaina

PEB Forum Regular Member
Registered Member
Ok first off percentages total 60* dod they will be marks by a *, VA 90%, contentions will be marked by a #

category 1, Unfitting and compensable and rateable
1. Total hip replacement code 5054 50% *
2. Left hip Osteo arthritis (FAI) 5003-5251 10% *

category 2 conditions
lumbago 20%
left peripheral nerve 20%
right peripheral nerve 20%
R shoulder strain 10%
L should strain 10%
Cervicalgia 10% ######
tinnitus 10%
L sciatica 10%
R sciatica 10%

zero's
right knee arthritis 0
bi lat hallux valgus/spurs 0
vericose vein removal 0
(now here is the funny thing they lumped the compartment syndrom/fasciotomy in with the veins/ the vein removal was in 2004 and on the interior of my leg, the fasciotomy was in 2012 and the anterior of my thigh)

sleep apnea 0% ( I have a sleep apnea index of 10, although the doctor did not write down hypersomonlence as a result of the apnea, he said the somolence was idopathic.)

hypertension 0%- even though I am on medication, my numbers are not high enough to warrant a rating, I thought this was a sure 10% because of the meds, but the findings state differently

status post hernia repair 0%
all scars 0%
toe nails 0%
pilionidal cyst removal 0%
headaches 0%

here is the conditions they say were not service connectable
ankle conditions (even though there was a bone scan showing uptake in both ankles done while I was stationed at lackland 6 years after my entrance)
Compartment syndrome right thigh- No evidence the problem ever existed (big miss on their part, Im guessing they lost/never had the surgical records showing the 2.8 litre blood clot removed from my thigh and the scar from hip to knee and even the C/P doctors notation that I had sever muscle damage as a result from it with internal scarring)
GERD- there was not enough evidence to support this, I never counted it
Voiding dysfunction-even though I have documented voiding problems, there is no absolute diagnosis, except for the C/P exam stating the problem and its result due to my elevated glucose levels, I counted this, but we shall see.

All in all, I am happy with the bulk of it, I think they clearly missed some items that i will have to fight for, the bad part is the neck should be 20% due to reverse lordosis as a result of spasm, the thigh should be 30/40% due to the muscle damage, the knee should be 10% because there is radiographic evidence of arthritis, but they said no evidence of painful motion, however that record was over a year ago now, so things do change. However I will have to go to a formal to have the neck/back/thigh etc. all listed as cat 1, then file my VARR.

Now for a question, say they deny my formal, how do I put in the records to appeal/NOD the totally missed thigh fasciotomy and resulting muscle damage?
hypertension 0%- even though I am on medication, my numbers are not high enough to warrant a rating,
Ok first off percentages total 60* dod they will be marks by a *, VA 90%, contentions will be marked by a #

category 1, Unfitting and compensable and rateable
1. Total hip replacement code 5054 50% *
2. Left hip Osteo arthritis (FAI) 5003-5251 10% *

category 2 conditions
lumbago 20%
left peripheral nerve 20%
right peripheral nerve 20%
R shoulder strain 10%
L should strain 10%
Cervicalgia 10% ######
tinnitus 10%
L sciatica 10%
R sciatica 10%

zero's
right knee arthritis 0
bi lat hallux valgus/spurs 0
vericose vein removal 0
(now here is the funny thing they lumped the compartment syndrom/fasciotomy in with the veins/ the vein removal was in 2004 and on the interior of my leg, the fasciotomy was in 2012 and the anterior of my thigh)

sleep apnea 0% ( I have a sleep apnea index of 10, although the doctor did not write down hypersomonlence as a result of the apnea, he said the somolence was idopathic.)

hypertension 0%- even though I am on medication, my numbers are not high enough to warrant a rating, I thought this was a sure 10% because of the meds, but the findings state differently

status post hernia repair 0%
all scars 0%
toe nails 0%
pilionidal cyst removal 0%
headaches 0%

here is the conditions they say were not service connectable
ankle conditions (even though there was a bone scan showing uptake in both ankles done while I was stationed at lackland 6 years after my entrance)
Compartment syndrome right thigh- No evidence the problem ever existed (big miss on their part, Im guessing they lost/never had the surgical records showing the 2.8 litre blood clot removed from my thigh and the scar from hip to knee and even the C/P doctors notation that I had sever muscle damage as a result from it with internal scarring)
GERD- there was not enough evidence to support this, I never counted it
Voiding dysfunction-even though I have documented voiding problems, there is no absolute diagnosis, except for the C/P exam stating the problem and its result due to my elevated glucose levels, I counted this, but we shall see.

All in all, I am happy with the bulk of it, I think they clearly missed some items that i will have to fight for, the bad part is the neck should be 20% due to reverse lordosis as a result of spasm, the thigh should be 30/40% due to the muscle damage, the knee should be 10% because there is radiographic evidence of arthritis, but they said no evidence of painful motion, however that record was over a year ago now, so things do change. However I will have to go to a formal to have the neck/back/thigh etc. all listed as cat 1, then file my VARR.

Now for a question, say they deny my formal, how do I put in the records to appeal/NOD the totally missed thigh fasciotomy and resulting muscle damage?
hypertension 0%- even though I am on medication, my numbers are not high enough to warrant a rating,
Ok first off percentages total 60* dod they will be marks by a *, VA 90%, contentions will be marked by a #

category 1, Unfitting and compensable and rateable
1. Total hip replacement code 5054 50% *
2. Left hip Osteo arthritis (FAI) 5003-5251 10% *

category 2 conditions
lumbago 20%
left peripheral nerve 20%
right peripheral nerve 20%
R shoulder strain 10%
L should strain 10%
Cervicalgia 10% ######
tinnitus 10%
L sciatica 10%
R sciatica 10%

zero's
right knee arthritis 0
bi lat hallux valgus/spurs 0
vericose vein removal 0
(now here is the funny thing they lumped the compartment syndrom/fasciotomy in with the veins/ the vein removal was in 2004 and on the interior of my leg, the fasciotomy was in 2012 and the anterior of my thigh)

sleep apnea 0% ( I have a sleep apnea index of 10, although the doctor did not write down hypersomonlence as a result of the apnea, he said the somolence was idopathic.)

hypertension 0%- even though I am on medication, my numbers are not high enough to warrant a rating, I thought this was a sure 10% because of the meds, but the findings state differently

status post hernia repair 0%
all scars 0%
toe nails 0%
pilionidal cyst removal 0%
headaches 0%

here is the conditions they say were not service connectable
ankle conditions (even though there was a bone scan showing uptake in both ankles done while I was stationed at lackland 6 years after my entrance)
Compartment syndrome right thigh- No evidence the problem ever existed (big miss on their part, Im guessing they lost/never had the surgical records showing the 2.8 litre blood clot removed from my thigh and the scar from hip to knee and even the C/P doctors notation that I had sever muscle damage as a result from it with internal scarring)
GERD- there was not enough evidence to support this, I never counted it
Voiding dysfunction-even though I have documented voiding problems, there is no absolute diagnosis, except for the C/P exam stating the problem and its result due to my elevated glucose levels, I counted this, but we shall see.

All in all, I am happy with the bulk of it, I think they clearly missed some items that i will have to fight for, the bad part is the neck should be 20% due to reverse lordosis as a result of spasm, the thigh should be 30/40% due to the muscle damage, the knee should be 10% because there is radiographic evidence of arthritis, but they said no evidence of painful motion, however that record was over a year ago now, so things do change. However I will have to go to a formal to have the neck/back/thigh etc. all listed as cat 1, then file my VARR.

Now for a question, say they deny my formal, how do I put in the records to appeal/NOD the totally missed thigh fasciotomy and resulting muscle damage?
First of all I'll like to congratulate you. I have a question in regards to Hypertension. What do you mean that your numbers are not high enough to warrant a rating? Thank you!
 

gsfowler

Super Moderator
Staff Member
PEB Forum Veteran
Voiding dysfunction, I have this condition, it was diagnosed as Neurogenic Bladder, I have a LOD for it and it was listed on my claimed conditions.

My C&P evaluation never addressed the condition, it appears on my situation the VA MSC just never scheduled an eval. Nevertheless on your situation, make sure to do a Formal PEB request to get the condition rated. The formal board is going to jack you off and tell you they are only going to allow a Formal on missed conditions if the condition is unfitting. This is not legal as the MEB/PEB is required to look at and rate all conditions.

As far as the rating goes, there are two ways to get a percentage, here is the standard: http://www.gpo.gov/fdsys/pkg/CFR-2011-title38-vol1/pdf/CFR-2011-title38-vol1-sec4-115a.pdf

Look at absorbent materials and post void residual. If you have not had a urodynamics study, just concentrate on the absorbant materials. You can keep a log of how frequently you must change pads. It is a good idea to save them and write the date/time on them. Do this for a week a photograph it. I was given this advice by my DAV rep prior to entering the MEB process.

20% is a realistic percentage to shoot for.
 

gsfowler

Super Moderator
Staff Member
PEB Forum Veteran
Sleep Apnea, kinda difficult to get a rating without a CPAP, once you get one prescribed if you use it then you qualify for 50%

If you are close to a VA, try to have the sleep study conducted there on Tricares dime. This way you will be in the system. I see at least 90 more days of you being on active duty for the FPEB and VARR if you pursue.

Even if you do not get rated prior to discharge, you can do a VA appeal the moment you are released from active duty. This will start the calendar for back pay if you do get approved.

I cannot stress enough how important it is to continue on and get the conditions missed rated. The difference between 90% and 95% is $1144 per month at a minimum

 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
Sleep Apnea, kinda difficult to get a rating without a CPAP, once you get one prescribed if you use it then you qualify for 50%

If you are close to a VA, try to have the sleep study conducted there on Tricares dime. This way you will be in the system. I see at least 90 more days of you being on active duty for the FPEB and VARR if you pursue.

Even if you do not get rated prior to discharge, you can do a VA appeal the moment you are released from active duty. This will start the calendar for back pay if you do get approved.

I cannot stress enough how important it is to continue on and get the conditions missed rated. The difference between 90% and 95% is $1144 per month at a minimum
well my conditions break down to 93%.

They completed missed the fasciotomy/compartment syndrome and said no evidence/diagnosis ever existed, so I guess my PCM never put the surgical notes in my records, that alone will put me at 100%.

Sleep apnea, I have sleep apnea, I have a sleep study showing it, the c/p doctor reviewed that sleep study and gave me an apnea index of 10, which if she had also wrote down the hypersomolence, it would of been rated at the 30% mark. I am not hoping for more as I am trying to control it via loosing weight and not taking so many meds before sleep, but until its better, I deserve that rating.

Voiding dysfunction, mine is based on nocturia/frequency more than dribble etc. Their are two medical opinions in my records that state the frequency of 3-4 times nightly and at least once every 2 hours, however they differ slightly in that 1 doctor says its due to the scars in my bladder from the multiple emergency catheters I required, and the other doc says its because of the heart medication, and of course the C/P doc says it because my elevated glucose. I think until I can get a firm diagnosis as to why, then a rating is gonna be difficult.

Neck issue- the rating is right based on ROM, however I had/have records showing that there is reverse lordosis due to severe spasm's (including x-ray's with reports) and an entire 1.5 years since the va got my records of doctors annotating the spasms (the c/p doc said no spasm present/ well no crap I had just had injections 2 days before but those don't last long)

and yes I agree with the timeline you suggest, I figure 30 days for FPEB, then 6-9 weeks current trend for VARR, then my outpocessing/ptdy/leave. I still plan to sell some leave, but since I have won my SSDI case now, I do not feel the need to sell it all for financial security as regular pay + the SCAADL being approved is worth more in the long run, but I am just ready to be done with this mess, however it is better to do your initial appeals/fights while in than out, so I will push through.
 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
First of all I'll like to congratulate you. I have a question in regards to Hypertension. What do you mean that your numbers are not high enough to warrant a rating? Thank you!

I guess the actual breakdown of the VASRD, even if your on lifetime medication, you still have to have a Diastolic pressure greater than 100 of a systolic greater than 160, to be ratable. I think thats funny, since with the medication I am at an average of 150 over 90, without I am at 160-170 over 110's. On one hand if thats the way it is then good, I slightly less disabled than I thought, on the other if its a mistake, then we can fix it lol.
 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
make sure to do a Formal PEB request to get the condition rated. The formal board is going to jack you off and tell you they are only going to allow a Formal on missed conditions if the condition is unfitting. This is not legal as the MEB/PEB is required to look at and rate all conditions.

From what I gather my process is the following,

1st, I have to request a formal to have the back, neck, fascitomy(compartment syndrome) added as unfitting
2nd I have to win those to do the VARR for them.
3rd If I do not win, my only option is to what, either appeal immediately upon receipt of dd214 or do I have to wait until they actually finalize the ratings? Can I submit the TDIU paperwork along with that appeal? Can I submit it with the VARR?

Since it is clear that they missed a huge section of records, for both the fasciotomy and neck, can I file a CUE? or would it be a NOD?

Thanks for your help. I do not often have questions, but when I do they are tricky lol.
 

gsfowler

Super Moderator
Staff Member
PEB Forum Veteran
I'm 100% confident that the DRAS does not look at a single military medical record and rates the file presented to them solely off of the C&P evaluation.

The PEBLO and MSC strokes you off and states all of the medical evidence is evaluated, but all to often this is what I see.

When you got your narrative summary at the MEB was the compartment syndrome and voiding disfunction present? Did the MEB send those conditions to the PEB for fit/unfit?
 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
Narsum, no, but C/P exam did include them, and in fact the C/P doctor even went into detail on the scar/internal condition of the compartment syndrome.

BUT the va linked the fasciotomy to my vericose vein removal from 2004.
 

Warrior644

Super Moderator
Staff Member
PEB Forum Veteran
Lifetime Supporter
Registered Member
From what I gather my process is the following,

1st, I have to request a formal to have the back, neck, fascitomy(compartment syndrome) added as unfitting
2nd I have to win those to do the VARR for them.
3rd If I do not win, my only option is to what, either appeal immediately upon receipt of dd214 or do I have to wait until they actually finalize the ratings? Can I submit the TDIU paperwork along with that appeal? Can I submit it with the VARR?

Since it is clear that they missed a huge section of records, for both the fasciotomy and neck, can I file a CUE? or would it be a NOD?

Thanks for your help. I do not often have questions, but when I do they are tricky lol.

Indeed, as such I offer the following responses to your inquiries:

Q1. 1st, I have to request a formal to have the back, neck, fascitomy(compartment syndrome) added as unfitting.
A1a. Yes, albeit did you indicate a rebuttal for your neck condition during the MEB? If not, the PEB could potentially use that as evidence in support of a non-favorable decision if rendered.
A1b. Was your back condition and fascitomy condition listed as "medically acceptable" or similar verbiage by the MEB which shows that applicable DoVA C&P Examinations were completed with results?

Q2. 2nd I have to win those to do the VARR for them.
A2a. For your neck condition since a DoVA rating has been assigned by the D-RAS, you will need to show that either a significant error was made during the rating process or need to provide new additional medical evidence showing the condition is worst to justify a rating reconsideration if found unfit for duty.
A2b. For your back condition which I shall assume is lumbago rated at 20%, you will need the "unfit for duty" determination in order to potentially request a VARR.
A2c. For your fascitomy condition, it seems by the 38 CFR 4.14 avoidance pyramiding rule, you have a default rating of 0% in my opinion. Therefore, if an "unfit for duty" determination is rendered then you will need to show that either a significant error was made during the rating process or need to provide new additional medical evidence showing the condition is worst to justify a rating reconsideration. Otherwise, the DoVA D-RAS rating of 0% may result in my opinion.

Q3. 3rd If I do not win, my only option is to what, either appeal immediately upon receipt of dd214 or do I have to wait until they actually finalize the ratings? Can I submit the TDIU paperwork along with that appeal? Can I submit it with the VARR?
A3a. If FPEB hearing and/or VARR request are not successful, then you will need to start the appeals process as a military veteran. It's your decision whether you want to submit additional medical evidence prior to the completion of DoVA final ratings, or await until the completion of DoVA final ratings and receipt of the DoVA final award decision letter to submit any appeal option (e.g., a rating review/reconsideration or an official NOD).
A3b. In my opinion, submittal of a TDIU application as a military veteran could occur at anytime as long as the applicable criteria is met.
A3c. In my opinion, submit all medical evidence supportive of TDIU during your VARR request so that it's officially on record albeit it probably will not be evaluated until the obtainment of military veteran status. In retrospect, I submitted my SSA SSDI Notice of Award and SSA Disability Determination and Transmittal (Form SSA-831-C3) with my VARR request "an IDES case file review for increased DoVA compensation for service-connected total disability benefits" as based on my unemployability and validated by the aforementioned SSA records. To that extent, the DRO Reconsideration had a statement by the VSR of "initate development for IU. See attached deferral. If development is not complete by the time the SM is discharged establish EP 020 and forward to ROJ" and subsequent statement by the RVSR of "do not defer IU per VBA Ltr 20-13-07." As such, I was successful with the submittal of my request for DoVA total disability benefits as an active duty military soldier to include having it adjudicated during the forthcoming DoVA final ratings process upon my status change as a military disabled veteran.

Q4. Since it is clear that they missed a huge section of records, for both the fasciotomy and neck, can I file a CUE? or would it be a NOD?
A4a. A Clear and Unmistakable Error (C&UE) occurs when the DoVA D-RAS make a decision on a claim that is incorrect because a law was applied wrong or a material fact was relied upon that directly resulted in an erroneous decision. This is a relatively a short process which should take a couple of weeks to receive an adjudicated response.
A4b. A Notice of Disagreement (NOD) is a written communication from a claimant or his/her representative expressing dissatisfaction or disagreement with a decision, and a desire to contest the result. As such, for a non-contested or apportionment claim, a NOD must be filed within one year from the date the DoVA mailed the notification of the decision to the claimant. This is relatively a very long process which could take multiple years to receive a final decision.
A4c. In my opinion, both the C&UE and NOD are potentially applicable for your situation. Therefore, I would submit the C&UE initially and wait for the adjudicated response. It the DoVA C&UE response isn't received prior to the NOD filing deadline, then it's definitely time to officially file the NOD to ensure submission compliance.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
Last edited:

dallasfan405

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Hope everything works out for you Twitch and you get what you deserve. If I may ask do you know when the PEB determined your unfit status and when your package was sent to the VA for ratings. I'm asking cuz I'm trying to get a timeline on when I should expect mine back. Thanks God Bless
 

moneyblind

PEB Forum Regular Member
PEB Forum Veteran
Twitch, congratulations brother! Another step down, and now you know the rest of the path! Best of luck to you on the formal (if you do it, I would) and the hearing!
 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
Hope everything works out for you Twitch and you get what you deserve. If I may ask do you know when the PEB determined your unfit status and when your package was sent to the VA for ratings. I'm asking cuz I'm trying to get a timeline on when I should expect mine back. Thanks God Bless
Time line is in my sig, unfit on 18 sep 2013, sent to va same day (providence).
 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
Indeed, as such I offer the following responses to your inquiries:


A1a. Yes, albeit did you indicate a rebuttal for your neck condition during the MEB? If not, the PEB could potentially use that as evidence in support of a non-favorable decision if rendered.


Q2. 2nd I have to win those to do the VARR for them.
A2a. For your neck condition since a DoVA rating has been assigned by the D-RAS, you will need to show that either a significant error was made during the rating process or need to provide new additional medical evidence showing the condition is worst to justify a rating reconsideration if found unfit for duty.

A2c. For your fascitomy condition, it seems by the 38 CFR 4.14 avoidance pyramiding rule, you have a default rating of 0% in my opinion. Therefore, if an "unfit for duty" determination is rendered then you will need to show that either a significant error was made during the rating process or need to provide new additional medical evidence showing the condition is worst to justify a rating reconsideration. Otherwise, the DoVA D-RAS rating of 0% may result in my opinion.

Out of curiousity, why do you believe the Fasciotimy/compartment syndrome would be pyramiding? I have asked this question before and gotten several different answers, but the general consesus has been it would not be, since the rating for the THR is based on the joint intself and the limitation of motion of the joint, The fasciotomy on the other hand ( W/ compartment syndrome REMEMBER NOT EXERCISE COMPARTMENT SYNDROME but acute due to an arterial bleed after surgery) would be rated as the muscle damage of muscle group 14.

Now as to the neck/back, I did request an IMR for my neck/back/left hip to be added to the NARSUM, the IMR doctor added the left hip and the back, but not the neck. I should have requested the thigh at the same time, but in my LOE, I stated on going hip and thigh issues, but did not specifically state the thigh condition.

So from what I can gather by the "decision" paperwork.
1. The MEB and/or the va did not review the evidence for my neck that shows the reverse lordosis and spasm, and the c/p stated no spasms on that day. I have the x-ray report showing the reverse lordosis and at least 15 separate office visits in the last 18 months (all "new" records since my pcm obviously did not include any of them as I brought them in) showing moderate to severe spasms, The same paperwork also lists the spasms/injections for the low back although I am not contesting that rating yet, just for it to be found unfit.

2. The VA must not of gotten a large chunk of records I am nearly certain got turned into the peblo, but it was after the initial case was built. I know this because they say I was never diagnosed with compartment syndrome, yet I have 3 different doctors verifieng it, and the surgical reports that stopped the bleeding, removed a 2.5-3 liter blood clot from my IT band, that the entirety of the fascia was left open etc. etc. etc., this is the biggie, it should according to other similar instances in the VA's history been rated at 30-40% as muscle damage to xyz group. However the Va seems to of lumped it in to my varicose veins condition which is entirerly separate and a separate part of the leg.

The army spells out compartment syndrome requiring fasciotomy as a pottentially unfitting item, but the AF does not, so I may not have a case to get that added as unfit based on records alone, but I will try.
 

Kim76

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
TSgt Twitch,

I'm glad you have finally gotten your ratings but I'm sorry that your fight is not yet over.

Please do not forget that if you are unsuccessful at the FPEB, you still have the SECAF appeal. My apologies if you already stated this but I didn't notice it in these posts.

Good luck!
 

Weapons loader

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Were you profiled for any of your cat 2 conditions? I'm assuming not since you aren't trying to get any of those moved to unfitting. If you are unsuccessful with getting your VA percentage raised it might be worth your time to get your DOD total raised. In my case 100% VA rating is the only thing that would trump a 50% retirement rating, and a 75% DOD rating would trump a 100% VA rating. That is when it comes to straight pay, not taking into account what the tax breaks are.
 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
Were you profiled for any of your cat 2 conditions? I'm assuming not since you aren't trying to get any of those moved to unfitting. If you are unsuccessful with getting your VA percentage raised it might be worth your time to get your DOD total raised. In my case 100% VA rating is the only thing that would trump a 50% retirement rating, and a 75% DOD rating would trump a 100% VA rating. That is when it comes to straight pay, not taking into account what the tax breaks are.

I was never profiled for the cat 2's because the cat 1 (hip replacement) was always the over riding factor. I am/will be trying to get the neck, back,thigh as unfitting, I originally did the IMR for the neck and back left hip and the IMR doc added the left hip and low back but not the neck.

I do not know any other way to get the VARR done for the cat ii's without having them moved to cat 1, otherwise I would be content with the 60% DoD rating, but I am not content with the 90, knowing for almost certainty that they either did not get or ignored certain evidence, and the wording in their decision supports my belief.

I am currently at 93% total VA, if I win the thigh i am 100, If I get the neck increased appropriately and the blood pressure icreased with some new evidence I found, I am 100%, if I get the sleep apnea correctly rated I am 100% etc.

Sleep apnea=should be 30%
Thigh=should be 30-40%
Blood pressure=should be 10%
headaches=should be 30% (but I would settle for 10 because I did not complain everytime I had a headache)
Voiding dysfunction= should be 20%-but even though they acknowledge condition exists, no diagnosis was made so 0%


In regards to DoD percentage, 75% DoD is less money for me than 100% va (only 17 year e-6), but if I win my FPEB, the DoD % will go up to 70% and 75% with just the neck being being corrected.

Here is the downsides,
I am on 4 hour days, continuing to go in every day causes me great pain, its a long drive and a long walk to my desk, where I spend my short day, before doing it again, and whereas my chain is supportive, ultimately I dislike my situation to put it mildly.
I have been approved for SSDI, but no clue if they are gonna start off paying me right with all my dependents or not, or what date they are gonna use for back pay reasons. (if they go by my claim date, and pay me for my dependants from the start, I am looking at a healthy back payment).

I have been approved for SCAADL, but have not broached the va caregiver portion yet, so concern there.
I have no clue what I will need to do about tricare/medicare etc. or SBP, or DIC, or whatever.

Bottom line is, I dislike what I am currently going through at work, have been in this process for a very long time, and am mentally DONE, but I am still unsure about my financial future, 90% VA is not enough to live on, and without knowing my SSDI payments stuff yet, I am still financially "insecure", So it would be dumb of me to not "fight for the proper rating" while at the same time extending my pay and benefits until a time that I am more secure. but for my health and happiness, sometimes the smartest move is not the best.
 

TSgt Twitch

PEB Forum Regular Member
PEB Forum Veteran
OK, still reading and digesting stuff,

In rating the vericose veins/fasciotomy together, they did state that the weakness/dysthesia was all ready covered under the Sciatica. I can buy that, but what about the Open fascia/deep channel trough in my leg/large fluid filled sac mid thigh, recurrent bursitis etc. which would be covered appropriately as the C/P doctor stated by the muscle group damage. I still think they missed the surgeical reports etc. as they are not listed as evidence.

On the sleep Apnea, it says the higher pecentage (30 from 0) is not warranted unless a diagnosis of excessive sleepiness is made, So I think I just need the sleep doctor to do a nexus style letter saying that the mild sleep apnea likely contributes to my "idiopathic insomnia", and that should be good.

Blood pressure, This one intrigues me, Should be an easy fix, I have plenty of documentation over periods of months with blood pressure numbers above the stated (160/100), the funny thing is if you go to the base clinic and have over 160/100 they make you wait and sit until it drops below, because if its over 160 they have to admit you or something/the system wont take it. So hopefully with multiple readings on multiple days over multiple months, that should be good.

Neck- I have an x-ray report that states plainly "reverse lordosis possibly evidence of muscle spasms", I also have plenty of visits verifying the muscle spasms are present, same with my low back, which should also help my case of having both of those added as unfit.

Low back- rating is good at 20% I agree with it for now (I do not believe I bent that far, but any other ROM measurment I have that is less rom, is not a complete work up, so I would be spinning my wheels until I can get that done), however I need to fight for it to be unfit, So I am hopeing my continued pain management records need for continued management/injections/medication/spasms etc. will help win that fight. Basically stuff the board did not have initially.

Right knee- It hurts, but I always put down the pain was due to the large muslce damage just above it, and I told the C/P doctor that, probally my mistake, if they refuse to acknowledge the muscle damage, then I will have to have another exam just to tell the doctor it hurts.

bilateral feet- the notes state pain or surgical residuals would raise the rating, yet I told the doctor my feet hurt all the time, but that it was more than likely due to the bad gate/swelling in my legs etc. not super concerned about this, its a small fight, I would rather just get the bone spurs and bunions removed, so since they are service connected, its gonna be on the short list.

Scars- I am guessing I will just have to photograph every time I get a rise/skin shed/redness/irritation etc. hard to complain about painful scars, when the nerves underneath them are all dead because your thigh exploded.

blarg, I really do not wanna drag my wife and kids down to San Antonio and put on my service dress for these folks. I am now thinking it might be best to request the VARR for the right hip and lump all the bursitis/er visits etc. into that and pray for the 70% and then fight for the other stuff on the outside. Why do they gotta make a member do all the work that their medical staff should have done months and years ago to get a proper outcome, yet the staff will never be held accountable, the peblo's do not know whats going on with a person, MSC's are so beat up every day by folks waiting, their attitudes are shot. not gonna give up, not gonna give up, not gonna give up, not gonna give up, not gonna give up, not gonna give up, not gonna give up.
 
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