Veterans Claims Help

Over the years I have had occasion to listen to Vets expound on the theory of all things VA. From VSOs to veteran Veterans, I often hear one common thread. “You’d better watch out. You’d better not pout. You’d better not over-file or your claim’ll sink to the bottom of the pile”.

If this were true, I’d still be waiting for my computer. When I filed this last time out, my Purple Heart Rep finally explained how it works. First of all, I would never get SC for the Hep. Tattoos were willful misconduct. Ding dong. Who’s there? No tattoos. As for the PCT? Sorry. Nobody wins Agent Orange claims forty years later. The smart money was to take the Tinnitus for 10% and go home.

The DAV rep in 1992 was similarly enthusiastic. Getting 0% for hearing (left ear only) and tinnitus was phenomenal luck. The smart money said to lie low and come back for an increase to 10% for the ear ring in ten years. We (he) didn’t want to be seen as greedy.

Where did this idiocy begin? It flows from VSOs. For some inane reason they are loathe to go after VA for any serious money once they strike gold. I can’t tell you how many Vets I’ve talked to down at the VAMC in waiting rooms who voice this same sentiment  “My VSO says we’re gonna go for the final push (TDIU) in 2014. He thinks he can swing it ’cause he knows the rater pretty good”. When filing a claim or filing for an increase in your rating, the operable concept is degree of disability, not whether VA will view it favorably. VSOs can’t seem to get this through their heads. VA’s propensity to deny, lowball and ignore you is legend. Waiting several years until they are having a good hair day is not going to improve your odds.

In my book, I get rather obnoxious on the tactical pursuit of claims. No territory in a military venture was ever taken by a static, defensive posture. Going on the attack is what they (VA) do. Emulating their methods puts them at a strategic disadvantage. An Army general (and I’m not sure who) summed it up when he surmised that a soldier shooting over his shoulder at you while running away wasn’t nearly as accurate as the advancing one shooting at his broad, exposed back.

Pursuing a claim at the VA should not be done with a Caspar Milquetoast mentality. By the same token, you can’t throw hand grenades and question whether the VA examiner was raised by pygmy wolves Down Under. Striking a balance while being aggressive is a  fine line to hew to. When errors are discovered, they should be pointed out buttressed by the appropriate regulation(s) and statutes. When it appears the Examiner or rater is simply being narrow-minded in their interpretation of, say DM2, and demanding an exact set of criteria for an increase to 40%, it’s better to revert to the precepts of §4.7 and §4.21 rather than write him/her and tell them things you know will cause hard feelings.

From what I read in the VAOIG November 2012 report, yelling at them can bring unwanted attention.

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I apologize. Apparently I pushed Publish instead of Save Draft.

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Now, where was I? VA, as an agency of government, has way too much on the table and too little in the computer. It’s an example of what the insurance business becomes when the government gets involved and then fails to modernize. Being able to collate it all and assemble a coherent, accurate picture is where VA will always fall short. They’ll eventually reach that proficiency but the learning curve is pretty steep at the moment and denial has five phases. Amtrak and the US Post Office are similar examples.

Trying to be nice right now will get you nothing but a lump of “Your claim is expected to be accomplished by April 5th, 2014”.   Similarly, being naughty, obnoxious and overbearing is not going to hurt you unless you exceed the above-mentioned bounds of propriety. VA may at one time have buffaloed a lot of VSOs and Vets into toeing the line and being submissive. Much like the dial telephone, those days are gone. The internet and Veterans Help sites have illuminated the process and exposed all the fallacies. The modern day VA Santa has metamorphozioded into more of a scrooge-if he ever was a Santa.

Member Randy and I have been trying to unravel VA’s latest largesse where they awarded him TDIU and then start chipping away his old back/leg injuries claims down from 40% to 20% and 20% to 10% respectively. The Merry Christmas/Happy holidays cheerful news, as they pointed out of course, was that this would not result in a loss of benefits $. Being’s as he’s now TDIU at 100%, the other ratings reductions will have no monetary effect on his monthly compensation amount.  That’s exactly what they said. What they fail to mention, like a used car salesman, is that this will also detract from his ability to reach the next pinnacle of Special Monthly Compensation (SMC) Table “S”. There are other tables that apply as well-most especially when you begin to lose the use of your lower extremities.

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(4) Additional independent 100 percent ratings. In addition to the statutory rates payable under 38 U.S.C. 1114 (l) through (n) and the intermediate or next higher rate provisions outlined above additional single permanent disability independently ratable at 100 percent apart from any consideration of individual unemployability will afford entitlement to the next higher statutory rate under 38 U.S.C. 1114 or if already entitled to an intermediate rate to the next higher intermediate rate, but in no event higher than the rate for (o). In the application of this subparagraph the single permanent disability independently ratable at 100 percent must be separate and distinct and involve different anatomical segments or bodily systems from the conditions establishing entitlement under 38 U.S.C. 1114 (l) through (n) or the intermediate rate provisions outlined above.

I think Randy has observed the Take No Prisoners approach to claims filing after a few years. TDIU with hepatitis should be a stepping stone to 100% schedular. Once again, VA has neglected its Santa role and assumed the Santa Clause role. Read the SMC’s and you will see that if you have two (2) deux 100% ratings you move up on the pay scale to SMC (L). That’s $3,601.00/month- up from the $2,924.00  that VA insists is the TDIU ceiling.

Without Children, SMC-L through SMC-N

This isn’t double dipping. I don’t encourage cheating  as all here know. I point out what is legal and legitimate. Many of you gave to your Country and this same Santa that purports to be your Guarantor of Benefits gets to pick and choose what they will divulge willingly and what they won’t concerning what you  are entitled to. Lord knows, they beat you to death with their lips when they deny you and now they suddenly become mum when the payout begins- or worse- start rescinding what they’ve already given you? I have a medical news flash for VA. 60 year old guys with bad backs don’t suddenly start getting better as they get older with full-blown HCV. Only in VAville.

Veterans should not have to bow and be submissive to get these benefits. They should not expect to be kept in the dark, or worse, led to believe this will not have monetary implications. I have said repeatedly that these fellows are semantically gifted. Who else could come up with a tortured phrase like ” The VA examiner opined that it is not at least as likely as not that the injury Billybob  Halfrack currently suffers from is service-connected.” Yo ho ho, dude.

Now, here’s a winner. In order to make the good Senator realize that VA is Santa personified, here’s how they approached the explanation for the denial of my greenhouse. I point to the “Mr. NOD is currently receiving monthly compensation benefits of (OMG) Two Thousand Nine Hundred and Twenty Four tax-free dollars” and has been since March April of 2007 (remember that when you die, they still owe you that first month they never paid you for). I’m not asking for a second greenhouse. The one I have doesn’t even belong to me.

The concept of a munificent VASanta is much like God. I’m sure he exists but I’ve just never seen or met him.