Benefits

Information on VA benefits, Social Security benefits, how to files claims, and how to appeal denials.

New agent orange presumptives

Question:

Hi Jim. Hope all is well with you. I received an email from the VA two days ago telling me that hypothyroidism has been added to the Agent Orange Presumptive list and that I could file a claim. I was boots on the ground in Nam 1968-1970 and started having thyroid problems in 1977. I have been on Synthroid since then and my TSH is within range but I still have issues with constipation, sensitivity to cold, etc. Synthroid dosage has been changed several times over the years due to side effects. Do you think that this will be like type 2 diabetes where a 10% rating is granted if continuous medication is required? Or do you think since medication keeps it pretty much under control it would be 0%?


My VA health records note that I do have hypothyroidism and for years, so have my civilian Dr. records. Trying to make a decision on whether or not to file, I am now at 60% for IHD and 10% for hearing loss which is, as you know, a total of 60% using VA math. Thanks much Jim.

 

Jim's Reply:

The VA put this into place much quicker than I'd ever thought possible. That's a good thing...kudos to the Secretary.
 

Yes, you should file the claim. Thyroid disease is very serious and as you age it can cause issues with diabetes, your heart and a host of other things. It's simpler to go ahead and get the claim done now rather than waiting until later. 
 

Yes...I think that like diabetes if the disease is controlled the rating won't amount to much. However, in the last year I've advocated for a veteran who had a health crisis when his service connected DM2 and his hypothyroidism conflicted and landed him in an ICU for 3 weeks. He's now rated at 100% plus SMC housebound and that may need to be reviewed for an increase soon.
 

Were I you, I'd get right to it and not let this pass you by. Good luck!

 

 

100% Rating?

Question:

My husband is a 74 yr old Vietnam Veteran. We recently got married and have been together 4 years. He is rated 80%. Some of his connected disability conditions are worsening, along with his short term memory loss now, it has been hard. Is there a way to request a 100% T&P rating? He never kept his papers in order and he just recently came to the realization that with his health conditions worsening he has to deal with what is happening. He finally let me help him work with the VA on his benefits. He can't help me very much. He can't remember a lot, and for a long time refused to deal with the VA at all because he didn't trust them. I believe he should be at 100% but don't know how to approach this. Thank you for any helpful advice.

 

Jim's Reply:

Thanks for your willingness to step up for your veteran. The things you tell me are so often the case with aging vets. They've often forgotten much of what happened all those years ago and their health is declining and if someone doesn't help, they'll be left behind. Trust in VA policies and procedures is often hard to come by too. 
 

To request an increase in an existing rating isn't difficult to do although it will take some time and a bit of effort on your part. He doesn't need any of his papers since he already has relatively high ratings. 
 

What needs to be done is to file a claim. Start here https://www.va.gov/disability/how-to-file-claim/?from=explore.va.gov  This can be intimidating but if you'll study it a bit you'll learn that most of what you see is boilerplate and the things that need doing aren't that difficult.
 

The claim form must be completed and then signed by the veteran. When you complete sections that ask what you're filing for, simply indicate a worsening of rated conditions. If you know what he's rated for (PTSD , Diabetes, Heart Disease, etc.) tell VA that it's worse. You don't have to elaborate more than that to get the process started. Keeping your part simple is always best.
 

As you'll learn on the VA site you can either file on line or complete the form and mail it in using certified mail. Be sure to keep good copies of it all because VA is known to lose paperwork. You may have to do it all twice or more to get this done. I'm a bit old school and I like completing the paper form and mailing it. 
 

The mailing address is here.
 

Once you've completed the claim form VA will acknowledge that with a letter telling your veteran that the claim is in process. He will be notified that he has to report for a Compensation & Pension (C & P) exam and that will cause some anxiety but it's all routine. After C & P exams are completed VA will process the claim and he'll be notified.
 

If you believe that you'll be more than 2 or 3 weeks filling out these forms you should file the "Intent To File A Claim" form here. This is really simple to fill out and will lock in the effective date of his claims if you file them in the next year.
 

Be aware that there is a significant backlog of claims in 2021 and it may take many months to get all this accomplished. Be patient. Keep great records of all you do. Stay aware and follow instructions from VA to the letter. 
 

Good luck.

 

C & P Exam?

Question:

Jim, I have been 70% TDIU on PTSD alone for 9 years 5 months. In March of 2021, I received letter stating I was totally and permanently disabled due to my service connected disabilities. My commissary letter states no future examinations. I also received a previous letter in March of 2020 stating Basic eligibility to Dependents educational assistance established from Jan 31 2020. Now that being said, I received a text scheduling me for a C&P examination on June 1, which is scheduled for June 10. My rep said she would pull it up and sure enough it was true. She also stated it was for evaluation on my TDIU. Could this be a mistake? Should I contact the RO office or go to the C&P without checking to see if the office made a mistake?

 

Jim's Reply:

Go to the exam. Don't try to buck the system, take the path of least resistance and go to the exam. It isn't a mistake, the exam is likely to confirm the permanent rating and then you're done with it all. It will be a sort of checkup to be sure your rating is correct.
 

I'll guess it's happening now because you've reached a 10 year mark of holding the rating. Once you're past that it becomes increasingly difficult for VA to modify your rating.
 

This is not far from the routine and although not everyone will be examined after a P & T decision but for whatever the reason you've been chosen so just do it. If you were to run into any problems get back to me and we'll introduce you to a veterans law attorney who can help you.
 

Good luck.

 

Nemer Decision Reviews

Question:

When I went to va.com and looked for the status of my claim it said my claims had been "reopened" and that Disabled American Veterans was my VA Claims representative.  


My question is that the DAV has never been of much help, so should I remove them from my case? I believe the VA has reopened these claims because of the Nemer Court decision. Although I am at 100% now and am 73 years old, I am concerned that reopening the case will cause my percent to decrease. 

 

Jim's Reply:

No, you don't need to do anything...in fact, you shouldn't attempt to interrupt what is happening. I'll assume you're Blue Water Navy or have similar circumstances regarding agent orange and VA is reviewing all those claims https://www.legion.org/veteransbenefits/252567/va-automatically-review-thousands-blue-water-navy-claims
 

The DAV isn't actually involved. They were notified at the time you were because they're your POA of record...that's SOP. The VA will conduct internal reviews of any findings and if they reach any conclusions that would affect you, you and the DAV will be notified so you can then decide what to do, if anything.
 

I would also suspect that this will not have any negative consequences for you. The review is actually looking for opportunities to award benefits that they may have missed in earlier reviews. Over time the rules are becoming more expansive...a good thing. You may come out ahead but there's little to no chance of losing anything.

 

 

 

TDIU?

Question:

Hi Jim, I am 70% and recieve IU. My physical conditions have led to depression, anxiety, and auditory hallucinations all of which have been documented through VA ER visits and all of my provider notes. I would like to try and get my mental health issues linked as secondary conditions (because they are) to try to get a regular 100% schedular rating. My problems is that I have a special needs son who needs ChampVA. My attitude is to not quit, ever. I have lied to my providers telling them that I don't have these mental health issues because it makes me look weak and feel embarrassed and that is not who I am. I want to go and try to earn more money because I live basic.


What type of advice would you give on this knowing that sometimes when people try to change their TDIU to schedular it sometimes reduces their rating? Secondly, is the poverty threshold only for one person or is it for the household size that you support. My idea to try and earn income is to try to generate multiple streams of revenue without working and I'm afraid if I do this my IU will be reduced. Thank you.

 

Jim's Reply:

CHAMPVA is available for dependents of TDIU veterans. If you don't have CHAMPVA it's because your rating is temporary rather than permanent. Mental health ratings are usually temporary ratings and changing to a schedular rating won't help that.
 

Trying to switch from a 100% TDIU rating to a schedular 100% rating makes no sense and may cost you the 100% and drop you to your base rate of 70%...it happens.
 

Income limits are for the veteran no matter the size of the household. If you have a special needs child I'm not sure why CHAMPVA is so important? CHAMPVA is health care insurance, not any other kind of assistance.
 

Good luck.

 

Current-Future ratings

Question:

Jim, thank you for your service. When I retired from Civil Service I was not disabled, my job was being eliminated. At the same time my VA disability rating was 60%. Since then, my VA disabilities have increased to 90% and in actuality the various disabilities numerically totaled 150. Regardless, I'm now sitting at VA 90%. I continue to work part time teaching. This year my disabilities have again worsened and those disabilities could be rated at more then 30%. Should I again file for an increase in disabilities which would bring my VA total to 100% with a numerical total of 180? How would my CSRS retirement be effected if I do this? I really would like my VA records to note these increases in disabilities over the years because they would depict the effects of Agent Orange on my health and physical conditions as I aged.

 

Jim's Reply:

The first problem I see is that although you believe you could/should be rated at 100% if you file for it, I have doubts. The distance between 90% and 100% is the greatest reach of all. In other words, don't rely on that.
 

Your VA records would by default note increases in ratings. I can't speak to your CSRS as each individual's status is unique and dependent on your ratings and only DFAS will have those answers. Good luck.

 

TDIU

Question:

DAV said even though I am IU I can still obtain a job, but I can only make a certain amount. Is this true? I couldn’t understand why I had 90%, they took away 10% but gave me 20% which of course gives me 100%.

 

Jim's Reply:

The TDIU veteran isn't allowed to earn an income greater that the federal poverty level for his region. https://aspe.hhs.gov/2021-poverty-guidelines 
 

You don't have to do anything to tell VA you're working. They track your work history by following your SSA and IRS accounts. If you earn more than the guideline in a year VA will contact you and ask "What's up?" Go for it!

 

Agent Orange Presumptives

Question:

Hello Jim, I am a Vietnam Vet, Blue Water Navy, within the required 12 nautical miles. I had lung cancer in 2007. Had part of my lung removed and luckily it was successful. I claimed benefits for Lung Cancer/presumptive illness. They had me go to a C&P exam and they confirmed via Pulmonary Function Test that I have severe obstructive lung disease. I knew that from prior tests I had before my AAA surgery for an aortic aneurysm in 2018. I also suffered a Stroke in 2016 and have Aphasia. Will the VA rate me on my severe COPD even with my lung cancer in remission as a residual illness? The examiner also measured my lung cancer scar. Not sure if my stroke will qualify for VA rating as being related or connected. Thank you.

 

Jim's Reply:

When a Vietnam veteran has a presumptive disease like lung cancer, he is evaluated at 100% disabled until he has treatment. Once treatment has completed the veteran no longer has cancer and will be rated on the residuals of having had the disease and treatments. After lung cancer it's fairly predictable that you'll have a reduced lung capacity. If I understand your question correctly, you'll be rated on what your pulmonary function tests show today with no particular regard as to the root cause or other history. Rating a large scar after surgery is a pretty routine part of the evaluation of residual effects of treatment.
 

Typically strokes and aneurysms are not service connected because of agent orange. However, if you have a diabetes condition that is service connected (as many Vietnam vets do) you may want to consider filing any vascular diseases as secondary to the service connected diabetes.
 

If you are short of breath, as is typical for a post-lung surgery patient, ask your doctor for a prescription to get home oxygen and have VA set you up. The home oxygen therapy will make you feel better and it will keep your rating at 100%.
 

Good luck.

 

 

C & P Exams?

Question:

Is there any point (age) at which the VA no longer calls you in for D&B exams? I turn 60 this year. I have 90% disability

 

Jim's Reply:

I'm going to guess you're asking about "future exams" or the Compensation & Pension (C & P) exams that are required of veterans who have temporary ratings. A temporary rating is usually awarded for a mental health condition or any other condition that VA believes will improve over time and with treatment.
 

Most often the temporary rating is 100% and since I don't know what you're rated for I'm not going to be able to tell you much more that that. Your condition must be static over time for you to be awarded a permanent rating and the best place to get that documented is at the next C & P exam. The examiner can suggest to the record that your condition has stabilized and won't change and that usually prompts a change to a permanent rating. Good luck.

 

Conscription

Question:

I joined the army in 1973 and was honorably discharged. My question is: Is there a difference between one who volunteers and one who is drafted?

 

Jim's Reply:

The draft, or conscription, is a law that ensures in time of need that America has enough troops to fight a war. If there aren't enough people volunteering to serve, the draft can kick in and under any of a number of methods of picking and choosing, folks will be ordered to serve in the military.
 

The big difference that applies in the military service experience would first be the length of time and then who drafts? The draft is only for the Army, the other services don't draft troops. When the draft was last in effect, a draftee served 2 years and a "Regular Army" soldier served 3. I was Regular Army and served 1967-1970. Otherwise, if memory serves me well, there really aren't any differences other than the time one will serve. Of course today the draft isn't in effect and with luck we won't need that any time soon.
 

Otherwise, I can't think of any other differences. If I'm missing something, y'all please let me know.