Filing Claim for an Old AF-related Injury - Any Advice?

[Bailey Guns]

I injured myself in 92 during monthly ANG training. Went to the clinic on base and got checked out...still have a copy of the original medical paperwork. The injury has progressively worsened over the years to the point it makes it hard to function normally during the day now. I've seen a VA advisor or adovocate...whatever they're called, and we filed an intent to file a claim. He asked me for an "LoD". I had no idea what that was but apparently it's a "Line of Duty" report. I don't have that, wasn't given that, never told prior to this that I needed that. All I have is the original paperwork from the original trip to the clinic.

So, he tells me I need a diagnosis so this can be related to the original injury. I've started with my family practice doctor who ordered an MRI. MRI shows results of old injury. Have an appt with a specialist mid-Nov.

Any advice from you guys that may have been thru this before? Am I going about this the right way?

[fly boy]

in Cheyenne, the VA has on-site reps for VFW, DAV, AL, etc

I walked into the VFW and told them my story, and asked for help. I signed a power of attorney for them for medical stuff, and they filed all necessary paperwork and such. Now all my previous medical such is linked from military to VA and I can been seen for issues relating to those problems. Later in life if I want to claim disability, I can. The VFW reps are AMAZING! and helped with so much, I was blown away. Made it a very easy - Keep in mind they still can only work as fast as VA speed.

Hope that helps.

[BushMasterBoy]

Should be in the unit records. Looks like this. Short of this, affidavits from others that served with you. You can file a claim and include your entire personnel file. You need a National Service Officer to represent you. DAV ,VFW, etc.

http://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd0261.pdf (http://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd0261.pdf)

[Bailey Guns]

The service rep has me represented by the VFW. I never saw, nor completed, any report like that. I was just told to go to the clinic where I was given a basic exam...the "take two aspirin and call me in the morning" type thing. That's it. I guess that's why I'm going thru all the exams and such now...to try to prove the injury was related to that incident.

[Scanker19]

http://www.militarydisabilitymadeeasy.com/index.html

I’ve found this website to be a reasonable resource. I’ve been writing down all my symptoms just Incase I forget something later that could be important.

[Great-Kazoo]

While it's .mil related they can deny you based on no treatments since (25 years) separation AND tell you arthritis is the cause of said ongoing issues. Depends who you get for a rep and doctors that will review your claim. Based on the bad press the VA has been getting, they might rubber stamp your claim to the approved bin.

[BushMasterBoy]

Just don't give up pursuing the claim. Veterans Benefits is covered by US Code Title 38. I studied the law and won. In your case it might take a few years to adjudicate. Disability claims are based on the preponderance of the evidence. A denial can be appealed to the Court of Veterans Appeals.

www.va.gov

[Bailey Guns]

http://www.militarydisabilitymadeeasy.com/index.html

I’ve found this website to be a reasonable resource. I’ve been writing down all my symptoms just Incase I forget something later that could be important.

Wow...there's a lot of information on that site. Thanks.

Thanks for the other info, too. I'll keep after it...pretty much just starting the process now. We'll see.

[earplug]

Try and find a person in your old unit who witnessed the injury. That will help your claim. Have them write a statement etc.

[CS1983]

Check out the reddit subforum for Veterans (https://www.reddit.com/r/Veterans/). You'll need to post some info for folks to help navigate.

I've seen some great info on there.

I posted a question there once which was a bit convoluted and the info I got from posters lined up with the answer I finally got from the VA.

ETA: get ready for a potential ride. This poor chap took 5 years to get his claim approved:
https://www.reddit.com/r/Veterans/comments/78zogz/appealed_in_2012_received_decision_today/



(https://www.reddit.com/r/Veterans/)

[Bailey Guns]

Decided to update...

I got all my ducks in a row (records, current diagnosis, MRI results, original medical exam paperwork, etc) and we filed the claim on Jan 5. A few weeks ago I was notified to call the VA clinic in Walla Walla for an exam appt. I had that appt today.

I was very apprehensive about visiting a VA clinic. I've heard so many horror stories I expected to see skeletons of veterans in waiting rooms who had died waiting to get care. It was nothing like that.

I arrived a little early and the PA I had the appt with wasn't there yet. After a few minutes the receptionist came out and told me she had called the PA to tell her I was waiting. The PA apparently called in an order for xrays so I had that done prior to her getting there. Had to wait all of about 2 mins to get into the xray clinic. The radiology tech was very thorough, professional and friendly. I left there and walked back to the clinic. PA had arrived and called me right in. I knew it was going to go well when she apologized for all the pictures of her "kids" (dog photos) on the walls and she asked me if I liked dogs.

She asked a lot of historical questions and other questions related to my ability to function on a day-to-day basis, reviewed records, current xrays, old xrays, MRIs, etc, and then did the range of motion assessment. She said I was in the midst of a "spinal emergency". She flat out told me I'd get a rating, hopefully within 30 days, and she said my condition was slowly leading to paralysis. She gave me the name of a neurosurgeon and said we'd get an appt with him as soon as the rating letter was received.

After that she even walked me over to another building for an ID card. She told the guy to input all my info so I could get the card in Lewiston once I received the letter. Then she walked me to the travel desk to fill out the travel reimbursement voucher.

I don't know how she can be so sure I'm going to get a rating but she sure seemed to be. I'll believe that when it happens.

But...everyone I came in contact with was very friendly and helpful. It was nothing like I expected and I had worked myself up for nothing. At least for this visit. But everyone else seemed to be called in for various appts quickly as well. Overall it was a very positive experience.

So, now I just wait, again. It's moving much quicker than I thought it would.

[Gman]

Thanks for the update. Sounds like they care and that's a great sign.

My 2nd fusion attempt is going much better than my first. If you do end up requiring a lumbar fusion, I'd highly recommend having it done by an orthopedic surgeon. They know a lot more about structure than the neuro folks.

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[Irving]

I don't know how I missed this thread earlier, but my neighbor runs a non-profit that is specifically for helping vets just like you. I realize you moved away, but I can share info if you need. Sounds like you have things straightened out for now though.

[Bailey Guns]

Thanks, Irving. I've got what I need but I appreciate the offer.

[Bailey Guns]

UPDATE:

Last month I went back for another appointment related to my claim. Had another very positive experience at the Walla Walla VA hospital. Prompt, efficient and professional.

Yesterday I checked on the status and found it to be "Closed - Decision Letter Sent". The word "closed" sounded pretty ominous so I dug around the website a bit. Turns out the claim was approved at a rating higher than I expected...60%. And it was made effective back to May 2017 since that's the date I filed the "Intent to File Claim" paperwork.

So, needless to say I'm pretty happy about that. Even though I have insurance the co-pay on spinal surgery I need is going to be well over $20k and I can't swing that just yet. Now I'm hopeful that I won't have to come up with that amount and I can finally get this fixed.

For me, the process was pretty smooth and had a better than expected outcome. I actually filed the claim on Jan 5, 2018 and it was closed on June 28, 2018. I did do a lot of preparation in the time since I filed the intent in the form of rounding up records, getting physician statements, a current MRI and diagnosis by a neuro surgeon, etc... I think that really helped and it was a pretty solid claim with the evidence to back it up. So if anyone is looking for help or advice on filing a VA claim, that would be my best advice. Get everything together beforehand that supports your claim even if that means a note from your mother. You can't have too much supporting evidence.

In my situation, the VA actually ADDED conditions (nerve damage related to the stenosis) that I didn't apply for that amounted to an extra 20% rating. The extra money will be nice but the thought of the possibility of living pain free, or at least being in a lot less pain, is even more appealing.

ETA: And if you're thinking of filing a claim, FILE YOUR INTENT LETTER ASAP! Then get your claim filed within a year of filing the intent. When your claim is approved it will be effective back to the date the intent letter was filed. In my case that's going to add up to an additional 8 months of back pay. Obviously, this is a simplified example but for generic service-related injury claims like mine, that's how it works.

[CS1983]

Nice. Were you rated before and they bumped previous percentage or did you go from 0 to 60%?

[Gman]

I wish you the best with getting your back fixed. I was much happier the second time around using an ortho rather than a neuro surgeon. The ortho guys seem to have a better understanding of spinal structure.

$20k? Ouch. My not so great insurance through work at least has 100% coverage once you hit $12k out of pocket. At least the hospitals will let you set up payment plans without interest charges (at least the ones I've dealt with).

My insurance company has negotiated rates that seem to knock costs down by roughly two-thirds. Maybe you can negotiate the $20k down further?

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[Bailey Guns]

0 to 60 in 5.8 months.

[Bailey Guns]

I wish you the best with getting your back fixed. I was much happier the second time around using an ortho rather than a neuro surgeon. The ortho guys seem to have a better understanding of spinal structure.

$20k? Ouch. My not so great insurance through work at least has 100% coverage once you hit $12k out of pocket. At least the hospitals will let you set up payment plans without interest charges (at least the ones I've dealt with).

My insurance company has negotiated rates that seem to knock costs down by roughly two-thirds. Maybe you can negotiate the $20k down further?

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Fortunately now the VA will take care of it and I don't have to worry about the out-of-pocket costs. The big question now is when.

[Gman]

That's great to hear! Sorry for my misunderstanding.

Hopefully your employer will be flexible with treatment and recovery.

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[theGinsue]

Excellent news Carl.

While my rating is high, I'd give up every penny I receive to be pain free. Some of the money goes towards my monthly out of pocket costs for some of my treatment but most of my pain is related to things I'll need surgery for in a few years.

Having a VA declaration of "service connected" is very important for care both today and in years to come.

[BushMasterBoy]

Get registered with the VA online service. It is called my "healthevet". Get upgraded to the "Premium" status. You have to do that in person at the VA clinic or hospital. Then you can use the internet to refill prescriptions, send messages to doctor and nurses and a myriad of other things. Link below

https://www.myhealth.va.gov/mhv-portal-web/home


https://www.myhealth.va.gov/mhv-portal-web/web/myhealthevet/upgrading-your-my-healthevet-account-through-in-person-or-online-authentication

[Gman]

I echo TheGinsue, I would give up my rating in a second to be perfectly healthy again.
I wasn't perfectly healthy since birth, so I'm not sure what that means. ;-)

[Bailey Guns]

I'd rather be healthy, too. Not gonna get rich over a VA disability rating.

I've already signed up for the healthevet stuff and upgraded my account. Already got my wife added. VA SAYS she's worth an additional $99 month. I told her the govt typically overpays. :)

[CS1983]

anyone got a rating yet based on the burn pit registry and their respiratory issues?



I echo TheGinsue, I would give up my rating in a second to be perfectly healthy again.

I haven't looked into it really. I seem to remember registering, but I honestly hate dealing with the VA. Even having free care for life, I have never gone except when they tell me I have to.

However, I should look into it. When I got back after 2005, my breathing was awful and never really recovered -- I went from a poor runner compared to a lot of guys to just awful. I often wonder if the burn pit had an effect.

[Scanker19]

anyone got a rating yet based on the burn pit registry and their respiratory issues.

I’ll answer that in 40 years when they finally admit it’s a problem.