Can someone help me fighting the results of my VA Claim?

2015-08-04T11:27:48-04:00

How is it that the VA can deny me for 100% P&T based off an illness that is not curable?

Background: I was in Iraq in 2009 and contracted Behcet's Disease.

Behcet’s Disease is a rare, chronic inflammatory disorder. It is a permanent, lifelong disorder and consist of episodic flares of oral ulcers, skin lesions, genital lesions, and diffused joint pain that come and go. Permanent remission of symptoms has not been reported.” (National Institute of Neurological Disorders)

The VA rules for P&T are simply "Permanent total disability shall be taken to exist when the impairment is reasonably certain to continue throughout the life of the disabled person.” (38 CFR 4.15)

All has been documented in my C-File and personal medical notes. Also Behcet's Disease is documented in the National Institute of Health. I also know personally a veteran who was given 100% P&T due to Behcet's in 2012.

So how is it that the VA will not give me 100% P&T? I am at a loss. I cannot work yet I cant even get the VA to give me IU or 100% P&T. Please I need help.

EDIT: I am service Connected for Behcet's Disease(60%) PTSD (70%)

Response by SCPO David Lockwood made Aug 4 at 2015 11:53 AM

2015-08-04T11:53:48-04:00

Go to a VFW or American Legion. They maybe able to help.

Response by SGM Private RallyPoint Member made Aug 4 at 2015 11:55 AM

2015-08-04T11:55:33-04:00

One would seek an appeal if one can connect the disease to a likely cause of military service. Not every illness can be connected to military service. Some illnesses have a presumption, some must have a proven cause. Read all the literature and find a doctor to make a diagnosis. Then a lawyer.

Response by CPL David Salazar made Aug 4 at 2015 12:01 PM

2015-08-04T12:01:08-04:00

What exactly did they service connect you for?

Response by SSG Warren Swan made Aug 4 at 2015 12:17 PM

2015-08-04T12:17:52-04:00

Can you share more info like what is your current rating? If you're already at 100%, P&T isn't going to get you any more money, it's more of an assistance for tax purposes depending on your state (it can also unlock additional state benefits). And usually you have to go through another evaluation of your conditions to ensure that the conditions will not improve over time. Have you been through a second or third eval yet by them?

Response by SSG Michael O'Malley made Aug 4 at 2015 12:25 PM

2015-08-04T12:25:59-04:00

this was the response I got from the WWP on my denial claim, "If a doctor renders an opinion that your conditions are static and will remain at the same severity level throughout your lifetime VA will consider a claim for permanency however, often VA doctors and private doctors opinions conflict."

This was after I already sent in all the information and a medical opinion stating my condition was not going to improve.

Response by LCDR Rabbah Rona Matlow made Aug 4 at 2015 12:54 PM

2015-08-04T12:54:12-04:00

SSG Michael O'Malley I'm sorry you are having such problems.

First off, let me remind everyone that disability ratings are determined by Congress. An example: I suffer from chronic debilitating headaches, that at times, lay me up 3-5 times a week, for hours at a time. There is no way to maintain employment based on this. So what's the VA rating for this? 50%. Even though it keeps me from working! In reality I'm already 100% statutory so it doesn't matter, but it's an example.

I don't know the details of your condition, so I can't comment. What rating did they give you for this specific condition? If it's greater than 40% and you have a cumulative of 70% you can apply for Individual Unemployability. IU pays at the 100% rate. The only thing is it's not P&T unless they rate it that way, based on CFR 38 regulations.

How debilitating is the pain you are experiencing right now? Does it keep you from working? If so, and you don't meet the statute requirements for IU, you can apply for extra-statutory IU based on your specific condition.

Since you are a Post 9/11 vet, Contact the Wounded Warrior Project for assistance. In my experience as a DAV service officer, while we were extremely successful, WWP was even better, so just go straight to them.

Also, auto-immune diseases are additive and very emotionally disabling. I hope you have a good mental health counselor that you are working with. If not, contact the Soldier's Project, http://www.soldiersproject.org - we provide free counseling service to Post 9/11 vets with emotional health issues.

I have tons of experience with chronic pain, and would be happy to take you on, if you need help. I see vets over Skype, phone, email, text, whatever. Just reach out...

Response by LTC John Shaw made Aug 4 at 2015 3:34 PM

2015-08-04T15:34:00-04:00

SSG Michael O'Malley You need to engage your Senator and House of Rep office, they want to hear about your situation and can be a help.
https://www.opencongress.org/people/zipcodelookup

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Response by MSgt Manuel Diaz made Aug 4 at 2015 3:39 PM

2015-08-04T15:39:52-04:00

Omaley call [login to see] VFW Post 5290 Conyers Georgia, ask for Bill Mitiu. He may be able to assist

Response by MAJ Ken Landgren made Aug 4 at 2015 4:12 PM

2015-08-04T16:12:06-04:00

I used a DAV rep and he was able to help me.

Response by CPL(P) Bret Farritor made Aug 4 at 2015 4:54 PM

2015-08-04T16:54:45-04:00

SSG Michael O'Malley -

First, thank you for your service and whatever solace this may or may not hold I am wholly cognizant of your level of anxiety of frustration as I, like you, have gone through the process on both the DoD and VBA side and it is NOT an enjoyable one.

I am not comfortable going into 'nuts and bolts' about your Rating Decision and the specifics of your Service Medical Record(s) as this should be discussed in confidence with your accredited Veterans Service Officer. It is also worth mentioning I am always one to warn of 'data dumping' protected or privileged information such as that protected under HIPAA in a public format.

I will say that Title 38 / CFR 38 is often read and quoted without 'interrelation' or how one line of the Code does not necessarily stand alone and act as the sole arbiter of any given 'outcome' or determination. If you have been represented by a VSO and you are unsatisfied with the (rarely do folks go all the way to the penultimate outcome of the appellate process which is the United States Court of Appeals for Veterans Claims) decision timely file a Notice of Disagreement to protect your rights and consult with either:

1. Another accredited VSO or two or three
2. A pro bono Legal Clinic such as one we have here in Syracuse, staffed and targeted by and for Veterans. These are few and far between so don't be surprised if you are unable to find one.
3. Last, an attorney that specializes in VBA Rating Decisions. I say 'last' as there are so many accredited VSOs throughout the country (The American Legion, Veterans of Foreign Wars, Disabled American Veterans, AMVETS, MOPH, County Agencies, State Agencies and that is not an exhaustive listing) that provide this service at no charge. The VSOs listed even have levels of representation to match the level of the appellate process. If however, you feel that your Claim has not been decided IAW the applicable guidelines then I would not rule this last 'nuclear option' out.

I wish you the best and should you have any other questions please feel free to connect and message me privately.

Response by MSG Floyd Williams made Aug 6 at 2015 12:20 PM

2015-08-06T12:20:54-04:00

You need representation from one of the Veterans Organization, I had to learn the hard way fighting for my claim all over again, I wish you well keep fighting.

Response by MSgt Stephen Council made Aug 6 at 2015 3:23 PM

2015-08-06T15:23:01-04:00

THere are organizations out there that are very good at this type of assistance. I am a life member of the Disabled American Veterans because of the results that they get helping veterans. There are phrases and characterizations that you shouyld use when filling out your paperwork. DO NOT USE THE VA and try to file your own claim! THe VA has NO VESTED INTEREST in getting your maximum benefit awarded. I sent you my e-mail address in a connect request. Please contact me and lets discuss how we can get you your fuull benefit!

Response by 1stSgt Private RallyPoint Member made Aug 6 at 2015 7:13 PM

2015-08-06T19:13:00-04:00

Contact the DAV and ask for an advocate. Never accept "no" for an answer, unless you are asking for the impossible and stay positive. It is a process that takes time. Also ask your local VFW/AMLeg if they can help and contact your elected national people. But most of all, stay positive.

Response by SGT Private RallyPoint Member made Aug 6 at 2015 10:17 PM

2015-08-06T22:17:41-04:00

SSG Michael O'Malley, I'm P&T, 100% PTSD. I'm stone deaf in my left ear, 60% in my right ear. Do I get any compensation for loss of hearing due to my job in Vietnam? No! I get 10% for tinnitus. One other thing I learned is to never ask for an appeal for a claim. Ask for a reconsideration. I used DAV as my service officers. They got my disability in 6 months. I'm not sure what paperwork you have sent in, but, if you can get some witness statements about your conditions leading up to and after your illness, that helped me more than anything.

Response by CPT Pedro Meza made Aug 7 at 2015 2:21 PM

2015-08-07T14:21:50-04:00

SSG Michael O'Malley Please follow the advice of LCDR Rabbi Jaron Matlow, MSgt Manuel Diaz, LTC John G Shaw MBA, JD, In that order.