bluewater
Registered: 03/02/09
Posts: 3 |
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03/03/09 |
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#1 |
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| I was granted I/U 3/16/08. My prior s/c is 10% tinnitus, 50% ptsd, 20% hep c. I went on a va clinical trial with alinia and soc treatment 8/08. After 24 weeks and a hospital stay due to sides from medication was taken off tx 1/20/09. My question to you is how would you suggest I tackle making my s/c permanent? Should I wait till the VA contacts me for a follow up, or send them a letter now? Still am not working, and am feeling worse now then when on tx. As all no this tx is brutal. I was putting up with the sides hoping fo svr, but no such luck. Stage 3. Thanks much Ron |
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NOD
 Manager
Registered: 11/22/08
Posts: 654 |
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03/03/09 |
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#2 |
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Dear Ron, Getting info out of some of you Vets is sometimes like prying teeth out of live crocodiles. You have done a marvelous job of condensing it down to the smallest space I’ve seen yet. Allow me to expand it a bit. Individual Unemployment was granted 3/08. I get fuzzy here. 50/20/10= 64% (net 60%), but you state it as a “prior rating”. Does this mean you have had a newer rating since that date and now? Ok- off TX and still not SVR. If you are feeling worse now, then your rating is not commensurate with your symptoms. Would that be a fair assessment? Are you familiar with Chapter 4 Diagnostic Codes (to wit DC 4.114 digestive system)? Check that and see where you fall in the 7354(hep c). Also see where you are on the PTSD. You will never get to 100% by assembling your rating % in bits and pieces of 50s, 40s, 20s and 10s. It takes another 90% rating on top of a 70%( say for PTSD) to get to 100%. Be realistic. You need a 100% schedular rating on one illness alone to really get there. You can attain this via the TDIU route, but it is arduous. Are you over 55? This is the real litmus test for beginning the P&T assault. You also need good medical records to get there- ones that clearly show your condition is static and no future improvement is contemplated. This, too, must be in your med recs. Look at 3.327 regarding reexaminations. It clearly goes over everything that concerns what you are asking. I see where they (VA) could conceivably give you the bum’s rush and reduce your PTSD to get you below the 60% you need to keep the TDIU. Don’t think for a moment that they wouldn’t resort to that one. I see a need to bump that Hep rating up to 40, or better yet 60%, to protect the IU. Or bump the PTSD up to 70%. That would be difficult and I don’t know what your GAF score is right now. The tinnitus is maxed so there’s no help there. It appears to boil down to the hep, sir. Without cooking the books, at stage 3, you must have some issues beginning to pile up that would easily put you into the 40 to 60 range. My binoculars are foggy so I can’ tell from here. Getting to the magic 100 permanently will, at a minimum, require a two year wait as you can see by the info in 3.327. It may even entail 5 years unless you hit S4 soon and have collateral assaults like PN, cirrhosis, dysthemia, DM2 and so on. Again, I ask- over 55? I’m 58. One shot of rat piss and everything went haywire, but the AIH was the straw that broke the camel’s back. Everything meaning my PCT got worse, fibro, cryo, brain bozos, fatigue- basically near constant debilitating symptoms. End result was a 100% rating to begin with. As things went south, I asked for P&T 6 months later. I filed for hardship as the house and my health were in a race to see who would go down first. They gave me the P&T 1/21 so my son can get DEA(he’s 20 now). That’s my guess on their generosity. My medrecs adequately support the P&T. S3G4, ALT usually around 250 with occasional spikes into the 600s. I’m on permanent prednisone/ Imuran now to keep the AIH from finishing what the Hep C hasn’t done already. I’m gonna have to say your best bet is a combo of over 55, rotten med recs,up the hep to 60, file for a lot of secondaries, and a Doc willing to state your shelf life is less than a Hostess Twinkie.Then, while you have them on the ropes, slip in the request for P&T. Just one Vet’s opinion here. My crystal ball is foggy without more input. I would never go for P&T just on the TDIU. Get there if possible via 100% schedular if you can. Our prayers are with you, Ron, so you’ve got that going for you. Take two of the attached and schedule an appointment with my receptionist in the morning. AmenAttached Images:
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bluewater
Registered: 03/02/09
Posts: 3 |
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03/04/09 |
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#3 |
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| Wow nod I was not expecting such a detailed, knowledgeable, and fast responce. As you can see I am new here. Thank You. I have to digest everything you said, and look up all the things you told me to check. I am 60 years old. The I/U brought me to a 100% money wise, but I know it is not permanent. I am not sure when they review my case time wise. That is why I was asking you should I prepare and submit paper work now for permanent s/c or wait till they contact me. Can you get permanent on I/U and 60% other ratings?? I will due the homework you gave me. Thanks again!! Ron |
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NOD
Manager
Registered: 11/22/08
Posts: 654 |
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03/08/09 |
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#4 |
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| 3.327 is the arbiter of the P&T. You can get there via IU, but it requires medrecs to prove it- good ones. Most P&Ts are done on the 100% schedular ratings path- not all- but a lot. I see a lot w/ the 70% on one rating like PTSD, and maybe a 60% on the hep. All the little 10s and 20s are window dressing and don’t really do much unless they are secondarys to the primary ratings. So Tinnitus and hemmeroids are not gonna help one bit. Does any of that help? |
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bluewater
Registered: 03/02/09
Posts: 3 |
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03/09/09 |
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#5 |
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| OK, yes that all helps, but you still have not answered my question. Should I wait till the VA contacts me for the evaluation, and continue to build my records or write them a letter, and submit all forms to try and accomplish it now. Began I/U 4/1/08. I should be in the 60% hep c rating after reading the regs. Glad the site is up and running again. Thks Ron |
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NOD
Manager
Registered: 11/22/08
Posts: 654 |
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03/09/09 |
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#6 |
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| Brain fart, Ron. Hyperspazzed out and didn’t finish the project. I would get the 60% on the hep, assuming you’ve got the medrecs. to prove it. Big item is the time loss factor. Unmentioned, but important is weight loss of 10% of what your highest was in the last 12 months. Start packing your pockets with rolls of pennies, Ron. Anemia isn’t mentioned either, but it is a determinative tool. The acid test is all the words in combo. Lots of vets go in and say: “Hey, Doc. Yeah I’m doin’ okay. Not hitting on all eight, but what the hey. Could be worse. How about them Cardinals, Huh? Who woulda thunk it.” Start saying things like RUQPain, fatigue. Sleeping all day. Get big on the “bed rest”. Mention them words!!! Get it in your med. recs-written down, Ron. Get the 60% on the Hep(if there’s no hope on inflating the GAF- and don’t lie about it.)If you ever screw up and lie about anything and they catch you, they will make life miserable for you forever. You should never lie about anything unless it involves a pending visit from your mother in law. Anything is legal then. Lying is a indicator of improper upbringing, gentle reader. You are clearly not of that ilk so we will not discuss that any further. Look up 38 CFR part 4. 4.114 and look at the DC 7354. It discusses all the details of what = % rating. It is what they will use to rate you and its based on what you report to them.After you attain that higher rating, we will have another attitude talk and we will teach you how to use the “Force”. Work on you slice, too. It’s really ugly. |
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NOD
Manager
Registered: 11/22/08
Posts: 654 |
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04/17/10 |
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#7 |
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| Well, Ron. It’s been a year and some change.I hope you are not any worse for the wear and have upped your ratings % on the HCV. With all the injured vets coming home from Iraq and Af-stan, it’s causing a large backlog everywhere. I hope you claim is now far along in the process. I filed an NOD for a higher % on my PCT right after I got the original rating in 10/2008. I just received my new rating(I won!). 16 months. I assume, if you filed for a higher rating after we talked last year, that you are still in limbo. Hang in there. With the government involved in 2 wars simultaneously, you can only assume its going to be slow. Perhaps our illustrious VASEC Shinseki will hire more Loompah-Loompahs or train the ones he has to be more efficient. Best of Luck. |
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