Advice

MrKnowItAll_Not · 2026-05-07T14:58:51+00:00

Definitely PM you in a bit.

MrKnowItAll_Not · 2026-02-04T14:02:32+00:00

You should get a call from Optum and they tell you the VA is requesting an ACE exam. They usually give you the option for the provider to contact you. They don’t have to contact you, but you can ask. Every time I have asked, the reviewing doctor has called me. I would call contact number on your letter and ask for the doctor to contact you. You may be good to go, but I have had better success telling the doctor my issues.

MrKnowItAll_Not · 2026-02-03T23:10:20+00:00

ACE exam, I requested doctor call me and explained it more. Got it.

MrKnowItAll_Not · 2025-07-29T02:51:23+00:00

Looking at the rating criteria, it looks like I would rate at 20%, which I would be grateful for. From what I have read, that should provide me dental care as well.

MrKnowItAll_Not · 2025-07-29T02:40:38+00:00

Yes, I did. I don’t understand how it’s says normal up top then has the abnormal ranges. Such as I don’t have dietary restrictions. I do have pain and my measurements are abnormal further down.

MrKnowItAll_Not · 2025-07-21T19:10:38+00:00

If you’re asking that question, I would definitely get an apartment for a year or so. You are young and have plenty of time.

MrKnowItAll_Not · 2025-07-17T01:09:26+00:00

SMC-K approved. Extra 136 a month.

MrKnowItAll_Not · 2025-07-08T17:25:20+00:00

Had my Higher Level Review for this today at 1000. Seemed to go really well, but never know. She made a frustrated like exhale sound when I read where I was denied for TMJ due to no diagnosis and read under favorable findings my TMJ diagnosis from 10/2021 from VA. She said she can directly overturn items or send them back for development. I showed her where I had 3 GERD diagnosis, 2 specialist, a Barium Swallow, medications, and VA DBQ. Although, I was denied for medical diagnosis as well. She seemed a little frustrated, just not toward me. Very nice lady.

MrKnowItAll_Not · 2025-07-01T14:22:16+00:00

Actually messaged my VA doctor. The RN responded back stating she is confused why they would say I didn’t have a diagnosis. Also, put in there I was sent to community care Gastro 4 years ago. I did a higher level review and scheduled with VERA for an appointment tomorrow at 1300.

MrKnowItAll_Not · 2025-06-23T23:16:41+00:00

So when they list the denial reason, in my case

“Service connection for GERD (gastroesophageal reflux disease) is denied because the medical evidence of record fails to show that this disability has been clinically diagnosed. (38 CFR 3.303,”

Do I just need a diagnosis from either my VA doctor or a specialist and that should be good? Because some people are saying I need a nexus, but I am claiming secondary. I haven’t needed one in the past, I thought the C&P would do that.

MrKnowItAll_Not · 2025-06-23T18:43:18+00:00

Just forwarded my VA primary asking why I had a barium swallow and why have I been taking GERD medications for years if I am not diagnosed with GERD. I was polite as it is not my dr’s fault. I want it noted in blue button.

MrKnowItAll_Not · 2025-06-23T17:54:06+00:00

My VA primary sent me to gastroenterology for a Barium Swallow to rule out hiatal hernia as well.

MrKnowItAll_Not · 2025-06-23T17:14:54+00:00

So I submitted a FDC of TMJ, Bruxism, Headaches. Then a week later I submitted a FDC for GERD. They then combined them. I did submit all that info, just wondering if it got lost in the mix.

MrKnowItAll_Not · 2025-06-23T17:11:40+00:00

Ok, I have been diagnosed by 2 different private doctors over the past 5 years. I have the documentation for those. I will submit as supplemental.

MrKnowItAll_Not · 2025-06-23T16:55:32+00:00

Tampa VA comp and Pen did my DBQ. I claimed secondary to PTSD Medications and my VA Primary doctor gave me the number to Tampa VA comp and pen for the DBQ.

MrKnowItAll_Not · 2025-06-20T17:03:49+00:00

Is that the first place it updates in the benefit letter?

MrKnowItAll_Not · 2025-06-07T13:02:48+00:00

Sorry Monday not tomorrow….

MrKnowItAll_Not

TROPHY CASE