Posted on Sep 11, 2015
Are you a Reservist or Guardsman who was injured while on active duty or a deployment and want to file a claim with the VA?
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Here’s some tips on how to file a VA disability claim, especially if this is your first time. If you get injured, go to a military medical facility or TMC. Make sure they document the details of the injury and the treatment you received and ask for copies of the documentation. Notify your local commander and tell them you need a Line of Duty injury report (for Army, it’s a DA FORM 2173). They will likely tell you that you don’t need one because you’re on active duty and your medical records will suffice – do it anyway, you will thank me later. If there are witnesses to your injury, try to get them to write up a statement about your injuries. If you’re coming off a deployment, make sure you report all injuries to the medical out processing station and get further treatment as necessary – again, get copies of all reports, x-rays, therapy, etc. Depending on the seriousness of the injuries, they may ask you if want to stay and receive treatment or go home and get treatment. I know everyone wants to go home but seriously consider getting treatment at the installation you’re at. Again, the key is get documentation.
Once you get home, you should look into enrolling at your local VA hospital for medical treatment of service connected injuries. OEF/OIF/OND returning vets who enroll before February 12, 2016 can obtain treatment of service connected injuries without going through the VA disability application process and will be placed in priority group 6 or higher. You should receive a briefing on all this while out-processing.
You should begin your VA disability application process as soon as possible. If it’s your first time applying, collect all your medical records and get them organized. If you went to a doctor on the civilian side, get all those records too. There are two things I can’t stress enough: Review the VA’s WARMS website, 38 CFR Book C, Schedule for Rating Disabilities, http://www.benefits.va.gov/warms/bookc.asp and get an advocate! You want to review Book C, which describes all injuries and the rating for that injury, because you may find an injury you didn’t think to claim – I found three (of course, you’ll need to have documentation to support any claim). An advocate is a person or organization who is certified in assisting veterans with submitting disability claims. You want an advocate because you don’t want to take on the VA by yourself and an advocate knows how to cut through red tape and ensure your claim is submitted correctly (you don’t want your claim returned for errors). There are many advocates out there – I chose Disabled American Veterans (DAV) but many other organizations have advocates as well such as the American Legion and Veterans of Foreign Wars (VFW).
When submitting your claim, you will need to fill out required forms but I also submitted a Word document as there isn’t a lot of room to describe your injuries on those forms. I also referenced the verbiage used in Book C so my claim mirrored the VA’s language in describing my injuries (this was recommended to me by someone who used to process VA disability claims). You can also submit “buddy letters” that document an injury – if you got hurt and there is no medical documentation, buddy letters will suffice (you usually want to submit at least two per injury if possible). The “buddy” writing it needs to be detailed and they need to swear or affirm they are telling the truth – kind of like a sworn statement. Once you complete all the forms and get your statements and records together, photocopy the whole thing. You’ll need to compile a list of all doctors, hospitals, imaging facilities, therapists, etc., plus their addresses and phone numbers (you have to submit a release waiver for each non-military doctor and facility). Make sure you state if you’re an OEF/OIF/OND veteran on your claim (you’re supposed to receive priority once submitted). After all this is done, review everything with your advocate (if you need help with any of this process your advocate will help you).
Next comes submission of your claim. Give your claim to your advocate – they will submit it on your behalf. They also become your representative for the remainder of the process and are supposed to advise you on anything during the claim process. They will be cc’d on all correspondence between you and the VA. Also, don’t submit anything on your own to the VA, submit any additional paperwork through your advocate. It generally takes about a year to get a decision but it also depends on how complex your claim is. If you don’t agree with the decision you receive you have a year to appeal it but I suggest submitting any appeal as soon as possible. Additionally, you will need to submit evidence the VA hasn't already seen.
At some point in the process the VA will schedule you for physical exams - the last ones I had were performed by a contractor and not at the VA. This reminds me: Be careful what you say to the examiner, they are not there to be your friend. In fact, you will sign paperwork that explains they are strictly there to perform an exam and not treat you. I made an off the cuff comment about shooting a .357 with no hearing protection when I was a kid, trying to emphasize that I had learned the importance of using hearing protection. He wrote it down. That’s about it, other than this hint: If you have been exposed to loud noises such as gunfire, explosions, mortars, or artillery and you have hearing damage that causes your ears to ring or hiss, that’s called tinnitus. It’s an automatic 10% rating and can’t be disproved (at least for now). If you don’t have tinnitus, don’t claim it.
Lastly, please know I've been dealing with the VA and my own claims for about 10 years. My VA file is about a two feet thick. I've been compensated at 100% since 2007 - I had 80% plus 20% individual unemployability (meaning I couldn't work and they felt I was not capable of obtaining gainful employment). I recently was awarded a true 100% rating. I am also drawing social security disability. And yes, it is possible to be retained in the Army Reserve provided you meet at least the minimum retention requirements, which I do (I've been med boarded) and I am not paid (points only). But that's a whole other story.
Also, please read CPL David Salazar's post below, he makes some very good points and has additional advice!
Once you get home, you should look into enrolling at your local VA hospital for medical treatment of service connected injuries. OEF/OIF/OND returning vets who enroll before February 12, 2016 can obtain treatment of service connected injuries without going through the VA disability application process and will be placed in priority group 6 or higher. You should receive a briefing on all this while out-processing.
You should begin your VA disability application process as soon as possible. If it’s your first time applying, collect all your medical records and get them organized. If you went to a doctor on the civilian side, get all those records too. There are two things I can’t stress enough: Review the VA’s WARMS website, 38 CFR Book C, Schedule for Rating Disabilities, http://www.benefits.va.gov/warms/bookc.asp and get an advocate! You want to review Book C, which describes all injuries and the rating for that injury, because you may find an injury you didn’t think to claim – I found three (of course, you’ll need to have documentation to support any claim). An advocate is a person or organization who is certified in assisting veterans with submitting disability claims. You want an advocate because you don’t want to take on the VA by yourself and an advocate knows how to cut through red tape and ensure your claim is submitted correctly (you don’t want your claim returned for errors). There are many advocates out there – I chose Disabled American Veterans (DAV) but many other organizations have advocates as well such as the American Legion and Veterans of Foreign Wars (VFW).
When submitting your claim, you will need to fill out required forms but I also submitted a Word document as there isn’t a lot of room to describe your injuries on those forms. I also referenced the verbiage used in Book C so my claim mirrored the VA’s language in describing my injuries (this was recommended to me by someone who used to process VA disability claims). You can also submit “buddy letters” that document an injury – if you got hurt and there is no medical documentation, buddy letters will suffice (you usually want to submit at least two per injury if possible). The “buddy” writing it needs to be detailed and they need to swear or affirm they are telling the truth – kind of like a sworn statement. Once you complete all the forms and get your statements and records together, photocopy the whole thing. You’ll need to compile a list of all doctors, hospitals, imaging facilities, therapists, etc., plus their addresses and phone numbers (you have to submit a release waiver for each non-military doctor and facility). Make sure you state if you’re an OEF/OIF/OND veteran on your claim (you’re supposed to receive priority once submitted). After all this is done, review everything with your advocate (if you need help with any of this process your advocate will help you).
Next comes submission of your claim. Give your claim to your advocate – they will submit it on your behalf. They also become your representative for the remainder of the process and are supposed to advise you on anything during the claim process. They will be cc’d on all correspondence between you and the VA. Also, don’t submit anything on your own to the VA, submit any additional paperwork through your advocate. It generally takes about a year to get a decision but it also depends on how complex your claim is. If you don’t agree with the decision you receive you have a year to appeal it but I suggest submitting any appeal as soon as possible. Additionally, you will need to submit evidence the VA hasn't already seen.
At some point in the process the VA will schedule you for physical exams - the last ones I had were performed by a contractor and not at the VA. This reminds me: Be careful what you say to the examiner, they are not there to be your friend. In fact, you will sign paperwork that explains they are strictly there to perform an exam and not treat you. I made an off the cuff comment about shooting a .357 with no hearing protection when I was a kid, trying to emphasize that I had learned the importance of using hearing protection. He wrote it down. That’s about it, other than this hint: If you have been exposed to loud noises such as gunfire, explosions, mortars, or artillery and you have hearing damage that causes your ears to ring or hiss, that’s called tinnitus. It’s an automatic 10% rating and can’t be disproved (at least for now). If you don’t have tinnitus, don’t claim it.
Lastly, please know I've been dealing with the VA and my own claims for about 10 years. My VA file is about a two feet thick. I've been compensated at 100% since 2007 - I had 80% plus 20% individual unemployability (meaning I couldn't work and they felt I was not capable of obtaining gainful employment). I recently was awarded a true 100% rating. I am also drawing social security disability. And yes, it is possible to be retained in the Army Reserve provided you meet at least the minimum retention requirements, which I do (I've been med boarded) and I am not paid (points only). But that's a whole other story.
Also, please read CPL David Salazar's post below, he makes some very good points and has additional advice!
Department of Veterans Affairs (VA)
Disability
Reserves
Deployment
Injuries
Edited >1 y ago
Posted 10 y ago
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BLUF. in my opinion as a medical officer the entire line of duty system needs to be scrapped. It is immensely disrespectful and completely lacking any understanding to what it means to serve as a professional soldier. The whole idea that you only get covered for events that occur specifically while on duty demonstrates a complete lack of understanding for what it means to be and maintain your physical fitness. It is not is if you can turn on or turn off your fitness. How is it that an active-duty soldier can be injured training after hours in the evening or on the weekend and that is covered but if the guardsmen does the same thing in order to meet the same physical fitness standard it is not covered. They get 1/20th the paid time to train, have to meet the same standard but do not receive the same care when they are injured meeting that identical standard.
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Suspended Profile
So very true and I will post later regarding exactly this issue however I am currently working with a VSO and don't want to post things that could damage or influence my case , however Sir those are great words , hopefully they don't fall on deaf ears as they have in the past so much. hooaaa
SFC (Join to see)
Actually, if you are training in between Battle Assemblies you could be considered in a duty status if you are on a 1380 for points only. These are easy to complete and turn in and don't cost the Army a dime. The Points acrue toward your retirement and if you are injured they can substantiate being in a duty status IAW AR 600-8-4. The chalenge will be geting your commander to sign off. Most commanders have bought into the Lie that this is just stuf a good soldier should do on their own time along with writing evaluations, preparing training, checking in on their Joes and multiple other things.
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This info is a Veterans service reps' wet dream! A claim within a year from active duty discharge generally gets a general medical exam, full physical. If one was to submit all of this evidence from the beginning, claims would take much less time. Excellent advice! The VA considers any claim older than 125 days as a backlog claim. The minute somebody sees all the evidence you have provided, if it's what's listed above, an exam request will be sent out. Also, sending your own statements describing the injury in service and how it's bothered you ever since also helps. Don't underestimate the weight of your statement!!! Look for va form 21-4138 to submit any statements as they have the sworn statement language built in.
The only thing I will suggest against the advice of the original poster is if you don't agree with the decision, and have evidence that contradicts the decision but wasn't available or submites before, send in the new evidence and request for "reconsideration" asap. With new evidence, this goes directly to a rater to look over. If you still don't receive a decision you feel is fair, request for a decision review officer (dro) to look over your case. If then you still aren't satisfied, put in the formal appeal. Appeals right now is a black hole for claims. It could take years before anything of value happens, so I would suggest exhausting all alternative avenues before the appeal.
Don't wait! There are timeframes for everything!
Also, take note that the VA is now requiring all claims to be submitted on the appropriate form. This is why service organizations are vital! They should tell you what to submit to process your claim expeditiously.
Seriously though, feel free to send me a direct message with any questions you may have. Don't be intimidated by the labrynth of red tape; get informed!
The only thing I will suggest against the advice of the original poster is if you don't agree with the decision, and have evidence that contradicts the decision but wasn't available or submites before, send in the new evidence and request for "reconsideration" asap. With new evidence, this goes directly to a rater to look over. If you still don't receive a decision you feel is fair, request for a decision review officer (dro) to look over your case. If then you still aren't satisfied, put in the formal appeal. Appeals right now is a black hole for claims. It could take years before anything of value happens, so I would suggest exhausting all alternative avenues before the appeal.
Don't wait! There are timeframes for everything!
Also, take note that the VA is now requiring all claims to be submitted on the appropriate form. This is why service organizations are vital! They should tell you what to submit to process your claim expeditiously.
Seriously though, feel free to send me a direct message with any questions you may have. Don't be intimidated by the labrynth of red tape; get informed!
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CW4 Russ Hamilton (Ret)
Thanks for offering to help! And regarding an appeal, by "new" evidence I meant something the VA hasn't seen yet, not calendar new. Glad you caught this. I'll fix this in the post.
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Back in 1990 I had been through Basic Training, AIT and back home at the National Guard, During our annual training, I was on Light duty because of a Knee injury that was aggravated, I was given an order to drag cable, Hawk System, while I was running through the field I tripped over a golfer hole and blew out the knee. I was sent to William Boamont Medical Hospital for an evaluation, they said my knee was no good, and kicked me out, I begged for a desk job being that it was not that big of an injury that I could not perform office duties, they gave me an honorable discharge I filed a claim, but was denied. It would never had happened if I was not given that order while on Light Duty. I was young then and loved my Country and State and was able to perform and work in the general public.. However the knee has never been the same and from time to time it causes pain..
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CW4 Russ Hamilton (Ret)
Same for you: Get an advocate (VSO) and submit a new claim. The VSO will guide you on how to do this. Don’t give up and don’t take on the VA by yourself.
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Amn Anne Hofferkamp
I have a similar story. In '92 I had a seizure while on AD while in tech school target intelligence. The problem was the NG linked seizure due to stress at 19 to a febrile seizure (fyi - there is no correlation). Like you I received an Honorable but underwent seizures for years until the VA finally paid for brain surgery. I applied for VA benefits upon discharge (& 3x thereafter) each time to be denied. I currently have a claim pending and the last letter from the government said they hadn't made a decision. It would have been nice to have discharged medically. My advice to you is to find a friend in the state government and try to see if your governor will make an exception. No way that's going to happen in my cash-strapped state.
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I have a complicated issue and would like some advice. I tore my ACL while on active duty in 1996. I separated in 1998. I was given an LOD approval with 0% disability through the VA. I re-entered the reserves in 2013 and reinjured my ACL in 2014. My unit was marginally helpful, in that they initiated a new LOD and I received care from the local MTF. I have a few complications requiring corrective surgeries from the original, and as the complications have become more severe I have discovered that the LOD from 2014 was not entered correctly and I am being refused care at the local MTF because my LOD is not complete. Now my unit is saying that I need to receive my care through the VA not the local MTF and that they are not required to do a new LOD. My Left ACL was reconstructed 4 times, with the latest surgery using a donor from the right side now I have issues with both knees. Do i require a second LOD for the reinjury of the ACL, do I require an LOD for the right knee as a complication of the surgery? I am going for a medboard soon and want my medical records to accurately reflect the issues at hand.
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In my situation, I was at Ft. Irwin on my Annual training and have injured my left ankle. I was checked by a medic at the field and was informed to check the doctor on base after field training.
I would of have not gotten to this injury if it wasn't for my chief, smoke, gunny. I told the medic of my injury while twisting it at a night ops while carrying Willy Pete rounds. Even though the medic given me a bandage to wrap my ankle my chief smoke and gunny got the best of me and I had to sacrifice my ankle. Which is why i had to get it treated before I go to work.
After the field training, I was sent to the hospital treat my injury. I was given a profile of my injury. But the issue is that I was given the wrong information from the medic to check in the hospital but should of went first to see the PHA. Lt. Found out from my chief and informed me that i will be billed directly from my Annual training pay because I'm a LOD. The LT. Has given me DDFORM 689, 2173, 2870, 2823, and DISABILITY COUNSELING FORM
In my situation what should I do. It's my first time in this situation. If higher ups make me work more than my limitations (which they have). What are my options?
I would of have not gotten to this injury if it wasn't for my chief, smoke, gunny. I told the medic of my injury while twisting it at a night ops while carrying Willy Pete rounds. Even though the medic given me a bandage to wrap my ankle my chief smoke and gunny got the best of me and I had to sacrifice my ankle. Which is why i had to get it treated before I go to work.
After the field training, I was sent to the hospital treat my injury. I was given a profile of my injury. But the issue is that I was given the wrong information from the medic to check in the hospital but should of went first to see the PHA. Lt. Found out from my chief and informed me that i will be billed directly from my Annual training pay because I'm a LOD. The LT. Has given me DDFORM 689, 2173, 2870, 2823, and DISABILITY COUNSELING FORM
In my situation what should I do. It's my first time in this situation. If higher ups make me work more than my limitations (which they have). What are my options?
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CW4 Russ Hamilton (Ret)
I'm having some trouble understanding what happened. Sounds like you were in the field, hurt your ankle, and saw a medic who wrapped it up. Someone (who?) told you to go to the base hospital after AT and you received a profile. I don't get the rest. Why and how could you be billed for going to a military hospital while on AT? Even if it was a civilian hospital Tricare will cover it. You got a sick slip, a LOD statement, a disclosure of medical information waiver, a sworn statement and a disability counseling form. Who gave you these forms? Did you go to the hospital without permission? Did you go to the hospital while on orders?
Sounds like you received the profile after being injured - the medic should have at least told your supervisors of any limitations when you were initially injured but he didn't. I don't see anything stating they are going to bill you and don't know how they could do that. This is a question for someone either higher up in your chain of command (1SG/CSM?) or the IG if they won't assist. Bottom line: you were hurt in the line of duty and you received medical treatment. As long as you were still on orders when you went to the hospital you are good.
Sounds like you received the profile after being injured - the medic should have at least told your supervisors of any limitations when you were initially injured but he didn't. I don't see anything stating they are going to bill you and don't know how they could do that. This is a question for someone either higher up in your chain of command (1SG/CSM?) or the IG if they won't assist. Bottom line: you were hurt in the line of duty and you received medical treatment. As long as you were still on orders when you went to the hospital you are good.
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SPC (Join to see)
Hello Chief,
What initially happened, I was at Fort Irwin for Annual Training. I sprained my ankle at a night operations, got my ankle stuck in a pot hole while running to give ammunition. After the ops, I was seen by the medic the next day. The medic has given me the treatment and have recommended me to see the doctor once training was done.
I asked the medic for a sick call slip, I gave the slip to my BC to be signed. The slipped was signed and the medic has given me instructions to go. I was taken to weed hospital (Fort Irwin) to see my left ankle. I gave the slip to the receptionist and was admitted. The doctor ran tests and have concluded thst I have a sprain ankle (based on swelling and limited movement). Doctor has given me my profile. Arriving back to the reception hall, my battalion Medic was looking for me. He told me because I didn't see the PHA first I will be billed because I have disobeyed orders to go see the PHA first and not the doctor.
The LT has given me forms and have informed me that i will be billed from my Annual training pay
I hope I was brief enough chief, I hope to hear from you soon chief
What initially happened, I was at Fort Irwin for Annual Training. I sprained my ankle at a night operations, got my ankle stuck in a pot hole while running to give ammunition. After the ops, I was seen by the medic the next day. The medic has given me the treatment and have recommended me to see the doctor once training was done.
I asked the medic for a sick call slip, I gave the slip to my BC to be signed. The slipped was signed and the medic has given me instructions to go. I was taken to weed hospital (Fort Irwin) to see my left ankle. I gave the slip to the receptionist and was admitted. The doctor ran tests and have concluded thst I have a sprain ankle (based on swelling and limited movement). Doctor has given me my profile. Arriving back to the reception hall, my battalion Medic was looking for me. He told me because I didn't see the PHA first I will be billed because I have disobeyed orders to go see the PHA first and not the doctor.
The LT has given me forms and have informed me that i will be billed from my Annual training pay
I hope I was brief enough chief, I hope to hear from you soon chief
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SPC (Join to see)
But in reality I didn't disobeyed. The medic told me to see the clinic that is infront of the airfield.
The PHA was at the reserve barracks no where near the airfield. Which is Why i went to the clinic that is infront of the airfiled
The PHA was at the reserve barracks no where near the airfield. Which is Why i went to the clinic that is infront of the airfiled
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CW4 Russ Hamilton (Ret)
This is really strange - I really don't get what the problem is regarding the PHA and going to the hospital. You need to run this up your chain of command starting with your squad leader and uo the NCO chain. Notify your PLT LDR and CO CDR. Go up to the BN CDR - if there's still an issue you can file an IG complaint through your local JAG. I don't see how you can be billed for the hospital visit when you're on orders and injured. It sounds like there is more to this situation.
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If you are hurt on AD-Training or IDT make sure to get the LOD. There is a cut off for Gulf War claims:If your disability or illness did not appear during active duty in the Southwest Asia theater of military operations, then it must have appeared prior to December 31, 2016, to a degree that is at least 10-percent disabling (for VA rating purposes). If you served in the Gulf you should have a gulf war exam, with the Burn pit and particulate matter memo's checked. Afghanistan just Burn pit.
The advocate is a Veteran Service Officer, from Veteran Service Organizations, IE American Legion, VFW, Purple Heart..most have an office in every VA Regional Office. There are also lawyer's and other civilian advocates.
When you have your exam do a Freedom of Information Act request to the VA facility where your exams were done.
The advocate is a Veteran Service Officer, from Veteran Service Organizations, IE American Legion, VFW, Purple Heart..most have an office in every VA Regional Office. There are also lawyer's and other civilian advocates.
When you have your exam do a Freedom of Information Act request to the VA facility where your exams were done.
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CW4 Russ Hamilton (Ret)
Excellent advice LTC Sands. LOD's are worth their weight in gold when it comes to VA claims - always request one. I have found most military and civilian medical facilities don't want to do this - make them do it. There are questions on the form civilian doctors don't want to answer or fill out as they are not familiar with this form. If possible, bring one with your commander's info on it and fill out everything possible on the form (other than what the doctor fills out) - this way it looks more important and required. Most military medical facilities will state it's not necessary and that it's documented in your records - make them do it anyway.
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Good article, with sound advice! We need more people to learn about the tinnitus situation. I made a post on a video someone posted on Youtube, and have helped about 50 people get there 10%. I have been trying to help some co workers with their claims as well. I have been doing mine all on my own. Im at 80% now, and should be at 100% by summers end. I did similar things, like you have also stated. I would look up what the VA calls certain ailments, see how they are rated, and then when I file my claim, I use the same wording they use. So instead of claiming "back pain", I would claim " degenerative disc disease". I wish I could start my own advocacy service!
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I was on AD for six month orders. Got injured (ACL tear). I was sent home before healed. Got home and could not do my civi job (paramedic). The Reserves is working with WTU. But it has been six months since I was released. Does anyone know if they put me on WTU orders, is there anyway I can get help for the last six months of no pay? Could I get Incap pay even if I am now on WTU orders?
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Actually threw out my back in Basic Training. Stayed on going to chiropractor 2x a week. They blamed it on my wieght loss. Chiro visits stopped when i got to AIT still dealing with the pain and using the army wonder drug to get through i completed. When i got home i was on my own. It became harder and harder to work out and ended up with an under honorable conditions seperation after 6 years of perfect attendance because i failed my last wiegh in 1 week before my time was up. So i say i got screwed all the way around.
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