Sometimes when you review a 60-s-70’s-vintage claims file, you run in to all manner of errors immortalized now in VBMS. Not only that, they are in living color. That old C&P exam on the vintage VA Form 10-2545 is still in glorious living color (yellow). All the VAF 21-6796b ratings sheets are still in that lovely, light blue color. The combat code was always correct and you could almost guarantee the rating did not exceed 10% unless you were missing body parts.
Meet my neighbor right down the road Ms. MEC. Back in 1976, she was stationed down at McChord AFB. One day, she needed some kind of workup and they sent her over to the superiorly-equipped American Lake VAMC. They overmedicated her for the treatment and let her walk out the door. And drive back to McChord. She didn’t make the right turn from Veterans Drive onto Gravely Lake Drive and rolled over a few times. It was obviously LOD. The VA doctors had turned her loose and said she was good to go. Nobody argued that. I felt this motor vehicle accident (MVA) would be akin to a TBI. Nowhere in the records does it show she got a psychiatric/neurological workup either after the accident or at her first VA claim when she separated six months later.
In 2008, she finally got around to it and filed for headaches. VA said she’d only mentioned having headaches once during service. I looked it up. They were right-sort of. She mentioned about a year after the accident that she’d been having headaches… for about a year. She complained they were getting worse. Chronic? Well, not at VA, baby.
I think, or should say I thought, it was a legitimate CUE claim. I still do. Unfortunately, I did not know, nor was I told, that the client had had additional automobile accidents and a head trauma in the intercurrent period following service. That’s really immaterial for my purposes. There’s a method to my madness. The claim was legitimate in every respect. The motive was purely ulterior.
Ms. MEC had filed several times in the last decade for TDIU but been mysteriously denied each and every time. She was easily TDIU material at 80% combined. She had a solid 70% for MDD and a 20% and 10% for back and right wrist injuries from the MVA and we all knew her and her employment travails very well.
I finally met her in person several years ago but she never evinced an interest in fighting VA for the final assault on Mount TDIU. The final catalyst was the gal that cuts Cupcake’s hair. Men don’t call them stylists or beauticians. She’s my barber (barbrist?). Traci for short.
Traci laid into me in no uncertain terms. She figured if anyone could cut the Gordian Knot, it was probably me. I’m drowning in claims but agreed to do it. I’m glad I did. It was very rewarding. It took six months of throwing more and more claims at them and turning up the heat. I began by filing for increases on all three of the SC conditions. Next, I served up a VAF 20-0995 for headaches secondary to TBI in the MVA and the icing on the cake was a 526EZ CUE on the headaches back to 2008.
Well, that got everyone’s attention. Ms. MEC had a passel of records archived at the American Lake VAMC going back to 1976 as they could clearly see. It took them almost this long just to hunt them all up out of a warehouse somewhere. The result? TDIU.
Without so much as increasing a single rating, without granting a single new claim or granting CUE, they finally sent up the white flag. This is the reason I do this. MEC, of all the folks I’ve ever done this for, was the most obvious candidate for IU. She hasn’t worked since 1998. I even had her go down to the SSA and get a printout of her earnings history to submit. The businesses we sent the VAF 21-4192s to had gone out of business years ago. There was no proof to find in the way of employment. Yet all these years someone had been dogging it. If I didn’t even have an iota of psychiatric acumen, I would still have opined she was a candidate. Check it out.
This will mark a first. VA sent us a rating that essentially says “Absolutely nothing has changed, Ms. MEC, but we now think you qualify for unemployability. We really have no explanation why we stiffed you for the last 15 years but we’re gonna make it up to you now.” I usually go through a carefully orchestrated dance- a reduction, a fight to get it restored, an increase on something else and finally a TDIU after 2.5 years, so this is actually a welcome relief.
The teaching moment here is to do what I sometimes warn others not to. If you are filing for a big, brand new rating, it’s a bad idea to turn it into an 18- wheeler pulling a double trailer of secondary contentions. On the other hand, in this case, when you’ve been hitting a brick wall and can’t get any traction for years, the best advice is to get an agent or attorney to come in and start firing both barrels of the shotgun and let them know you’re going to make adjudication life absolute hell for them until they make it right. You don’t have to say so in as many words but your actions will speak for you.
The neat thing about this one is Ms. MEC gets everything behind Door #3. Because VA has granted her claim for TDIU, there is no appeal or Notice of Disagreement. She owes me nothing and I’m happy with that. Remember, the object of this game is the Veteran. It’s not about being paid for the work. It’s the joy I find in screwing VA over again. If they had simply admitted I had served in Vietnam in 1994, I wouldn’t be the thorn in their side now. But they ignored my evidence… and here we are.
As you can see, today’s show is brought to you by the letters T,D, I and U. And that’s all I’m going to say about that.
call me as soon as you can 6232298322 louie cell ph. willing pay for help.
Revenge is the best revenge. The VA so richly deserves to pay up for decades of misdeeds. There is satisfaction in knowing another vet is finally getting justice of a sort. If you lose an arm or a leg or a mind how can you ever use money to replace what is lost? It is better than nothing however.
Shoot the wounded, well done
The trendy expression “marginalized” is bandied about a lot these days but it does fit veterans like this who had basically given up trying to get justice. That the VA’s decision in this case is a rarity, is a pity. But thanks to her friends, and your willingness to help, the quality of her life should get better now.
It should disturb everyone that when you apply for TDIU, the VA retaliates by reducing ratings that you then have to fight to have restored. That is absolutely horrible. I wonder if this strategy is written in some secret manual, if this is a system-wide policy, and if VA keeps track of how many times rating reductions are used to punish the SC ill.
Well, take out my assumption of punishment as a motivation and just consider what an enlightening social study topic this would be. The anthropology of each VISN would probably be somewhat different–perhaps very different.