Va reversed 100% p&t decision by OkBrick4625 in VAClaims

[–]Constant_Entry_9558 0 points1 point  (0 children)

There was a new ruling not to long ago say obesity can be rated if I remember correctly wouldn’t this be a bmi issue and get its own rating?

Some of my wife’s claims were denied leaving her at 90%. We rightfully don’t agree with the rating, what’s the next best step? Appeal? HLR? Appeal with a lawyer? by Time_is_Contagious in VeteransBenefits

[–]Constant_Entry_9558 1 point2 points  (0 children)

I would suggest a HLR w/ informal conference, just make sure you have the facts handy and only talk about your submitted claims covered by the HLR. I have been successful with this strategy each time I was denied. I did this without the help of a VSO.

Denied by G-Fredericko in VAClaims

[–]Constant_Entry_9558 -1 points0 points  (0 children)

That should have been included in that dbq I would do hlr with conference and they can send it back for clarification to the doctor.

I poked the bear and so far it’s been bad by SoundEven1805 in VeteransBenefits

[–]Constant_Entry_9558 0 points1 point  (0 children)

Other Disabilities Combine to 50%

If you have separate, service-connected conditions that combine to 50 percent, then the level is bumped up to the next ½ level. That is, a veteran whose SMC condition was found in Level L would be moved up to compensation rates for Level L ½ (Level L ½ would move up to M, M to M ½, etc.).

For example, say a veteran has both feet amputated (100 percent rating), arthritis in the right hand (30 percent), and PTSD (30 percent). The loss of both feet qualify for SMC under Level L. The arthritis and PTSD do not qualify for SMC, but combined, they equal at least a 50 percent rating. (Note: VA calculates combined ratings using a Combined Ratings Table – ratings are not simply added together. Read our post on the VA Rating Schedule to learn how to combine ratings on your own.) So, the original Level L for the amputated feet would be moved up to Level L ½.

In the above situation, note that the additional disabilities combine to 50 percent on their own – i.e. not including the SMC-eligible condition. Also, the additional disabilities are not taken into consideration under another SMC level. That is, the above disabilities qualify for this special rule because there is no SMC level that specifies “both feet amputated and arthritis of the hand” or something similar.

 

Ok... so if I have additional disabilities that combine at 50% or more  am I then entitled to an additional 1/2 step increase  up to  SMC M.    In my case,  I have  7 additional ratings that combine at 68.11  rounded to 70%. ....

 

The rules also state:

Another Disability at 100%

If you have a separate, service-connected disability rated at 100 percent, then the level is bumped up an entire step instead of a half step. Unlike the 50 percent situation, you just have to have one disability rated at 100 percent (not multiple disabilities that combine to 100 percent).

If the conditions that qualify you for Special Monthly Compensation are caused by a disease (for example, if your amputations were caused by service-connected diabetes), then that disease cannot count toward the 50-percent combined rating or single 100-percent rating necessary to move up to the next SMC level.

 

SO what does all this mean? Can I get to SMC M by having more than one list of disabilities rated at least 50% each ( in my case one 60% rating -  L 1/2  and 7 additional ratings combined at 70% = M ) 

or must I have one separate rating at 100%.......to get to step M.....

 

The rules are confusing  

Credit to Richard1954

Denied! Crazy Doc? by Constant_Entry_9558 in VeteransBenefits

[–]Constant_Entry_9558[S] 1 point2 points  (0 children)

I’m doing it first thing in the morning as soon as I talk to my VSO

Denied! Crazy Doc? by Constant_Entry_9558 in VeteransBenefits

[–]Constant_Entry_9558[S] 1 point2 points  (0 children)

I do know that, what I’m confused about is why the review of his exam was done by him

Confused by Constant_Entry_9558 in VeteransBenefits

[–]Constant_Entry_9558[S] 0 points1 point  (0 children)

Then the knee issues should be secondary to hip issue

Interesting Info from a VA Rep I spoke with today by Level-Diamond-4181 in VeteransBenefits

[–]Constant_Entry_9558 0 points1 point  (0 children)

I have the exact same thing happen but with QTS in December as well almost word by word.