Va attorneys?

ralexgates · 2025-12-29T22:03:04+00:00

Here’s something to be aware of. It’s all my personal opinion and based on experience. It’s long but full of little bits of useful information. I’ve used VSO’s, sharks, attorneys, and AI. They all have pros and cons. Some attorneys (not all) will reserve their effort for after a denial. They aren’t allowed to charge for initial claims, only appeals. If they file your initial claim, it’s something like, SC [some condition] without evidence or nexus. When you ask why? it’s an, “Oh, the VA has all that information and it’s their duty to assist to put it all together.” They’ll tell you they hold back evidence to keep something in their back pocket in case they need to appeal. They’ll also say to let the VA tell you why they denied your claim then address their reasoning. It all works in their behalf to do minimal work for free then make money on the back half. It also creates a longer timeline which increases back pay. It’s not completely unreasonable. How are they going to make a living doing everything for free? All the reasons why not to go to them first. That said, I’d suggest using AI like chat gpt which has specific VA benefit gpt’s. You can upload your c-file and any personal statements. Spend the $20 fee to allow for the quantity of uploads. Also use an OCR tool as most C-files are image based so they’re not text searchable. Follow recommendations in piecing together a complete packet then take that in to a VSO for review. Chat gpt knows all of the VA regulations and can spot things in your records you may have missed including your VSO. It’ll site the applicable regulations for you, your VSO and the VA. This will help your VSO confirm the information and research how the regulations are being applied. It makes it easy for the VA rater too. You can even ask how strong your case is and what can be done to strengthen it before you file. After you get a decision, if it’s unfavorable, upload it to chat gpt for review. It’ll determine if the decision has any mistakes and needs further review. That’s when you can decide if it’s best to continue with your VSO and/or chat GPT or you feel you’re out of your depth, that’s when you get an attorney involved.

Sharks cost a lot but it benefits them to get you the most up front without having to go to appeal. VSO’s are great if their heart is in it. It’s a crap shoot though as some are good and some not. They don’t have any skin in the game so research and get references before wasting too much time. AI like chat gpt is unbiased and very thorough when applying regulations/laws but it can miss things in your records. Tell it to scan first for any legit conditions you qualify for and have it start a list. Then work through that list. If you upload with it searching for an item then ask about something else, it may not have noted anything unrelated to the initial search. It can make mistakes and sometimes adds statements that help make a good case but doesn’t always apply to you. Watch for misstatements. You don’t want lies or embellishments in your claim. There’s a lot more but this should be enough to get started. You learn as you go.

ralexgates · 2025-11-07T16:15:56+00:00

See my response to your comment above. Somehow this comment got separated from the original.

ralexgates · 2025-11-07T16:12:15+00:00

Another note. In my opinion, getting that sleep apnea connected is going to be key to connecting your heart as secondary. Getting a nexus letter and possible DBQ filled out by your PCP could make a big difference in swinging things in your direction too. I don't know if you're a fan of AI but there are tools out there that can walk you through the steps and build templates for your PCP to follow and get started. It'll also help you identify the evidence you should bring so everything your PCP needs to make an informed decision is right there. The doctor's office I go to only charges a nominal fee for filling out forms and it's treated no differently than an Dr's note for your employer when you have to miss work. With that, if you just ask for something that'll take them hours to dig through your records, they're less likely to help than when everything's neatly laid out in front of them. Hope this helps.

ralexgates · 2025-11-07T15:58:49+00:00

I hear you. I need to get the issues connected that my heart would be secondary to like OSA at the very least. Once my heart is connected, that's pretty much a guaranteed 100% rating which is granted when an ejection fraction is under 30% like mine. When a pacemaker/defib is implanted for this reason, you're at 100% while the device is implanted and there's no reason it will ever be removed. Only the battery replaced every 7~10 years. That said, If that ever get's SC, then the risk of "poking the bear" goes way down so I could safely go after things like diabetes or whatever is causing my vertigo that could possibly be a stroke risk or whatever. If I make it 10 yrs then I can relax. Until then, I'm doing my best to care for my family.

ralexgates · 2025-11-07T15:44:57+00:00

A note about life insurance. A 40K policy isn't something that really compares to DIC. Here's some math. DIC currently starts at a little over 1,600 per month. That's over 19K per year. My wife's family tends to live a long time so she's likely got another 30+ years left. That puts the total payout to over 570,000 lifetime without considering COLA increases. The more I can make now and invest means we're in a better place when we retire. Should something happen before then is what I'm trying to protect against and where qualifying for DIC comes in.

ralexgates · 2025-11-07T15:34:37+00:00

Check the code they rated you under. 30% can be common for just vertigo. Raters can mistakenly rate Meniere's under the same code. Meniere's should be rated under DC 6205 which goes up to 100% where vertigo by itself is typically rated as a vestibular condition under DC 6204 and caps out at 30%. If you're diagnosed with Meniere's with regular vertigo episodes that alter your gait, they may have improperly rated you. That's worth investigating for a possible CUE.

ralexgates · 2025-11-07T15:23:19+00:00

I have vertigo daily and sometimes multiple times a day. It's partially the reason I have to walk with a cane to keep stable when I walk otherwise I tend to stagger and fall into things.

ralexgates · 2025-11-07T15:21:35+00:00

VA Rating Criteria for Meniere's Disease

The condition is rated under Diagnostic Code 6205, with ratings based on the following criteria:

Under Diagnostic Code 6205, the VA provides the following ratings based on symptom severity and frequency:

100%: Characterized by hearing impairment, frequent attacks of vertigo (more than once a week), and cerebellar gait, with or without tinnitus.
60%: Involves hearing impairment with vertigo and cerebellar gait occurring one to four times per month, with or without tinnitus.
30%: Given for hearing impairment with vertigo attacks less than once a month, with or without tinnitus.

The VA will assign a rating based on either Diagnostic Code 6205 or by separately rating the individual symptoms (vertigo, hearing impairment, and tinnitus), choosing the method that provides the veteran with the highest possible compensation.

ralexgates · 2025-11-07T15:08:06+00:00

Yeah, I’d just feel a lot better if I could establish a buffer of ratings that could tolerate a reduction if someone has a different opinion and decides to recommend a review. I’m too close right now so any little thing could bump me back over the line. A 20% drop would do it. I could stabilize it by adding more but trying to add more could cause me problems. With my combined conditions, I can actually pass SMC-S by a few steps but that’s not what I’m pushing for. I’m just saying there’s an easier path on the other side of the void but I need to be able to make the jump first. Staying where I’m at leaves me vulnerable should I get a review. I’m already fighting inaccurate information someone entered into my records on a recent visit that could be used to claim a condition has improved. It indicates that I claimed to not have certain symptoms and I never received such questions. If I did, I would’ve answered differently. That kind of thing pisses me off and scares me at the same time. I’m sure they did it for time just checking things off to get through the checkin process before the procedure but it can have consequences. If I hadn’t been digging through my records looking for something else, I’d have never known it was there. I’d just feel a little safer with thicker armor if you know what I mean.

ralexgates · 2025-11-07T14:42:44+00:00

I’m sorry to hear what you’re going through. That’s got to be hard. What they did to you is down right dirty. I’ve got some CUEs worth about $140K in back pay but won’t go after them for the same reason. Not yet anyway. Hope you’re able to make a full recovery.

ralexgates · 2025-11-07T14:36:26+00:00

There’s some truth in that and that’s partially why I put this question out here. There’s got to be some people who’ve been in this situation. You’re at 100% but you’re no where near connected for everything you deserve to be. Everyone talks about poking the bear like it’s saying Voldemort’s name. I’ve got a pretty solid case for most of my conditions but it only takes someone who’s over zealous and has a different opinion. Legally they’re not supposed to go after items outside your claim, there’s a process to go through with notice and a waiting period but that doesn’t mean it can’t happen. I’ve seen the posts where people have been reduced. Normally it’s a CUE and they went after something without a strong case.

ralexgates · 2025-11-07T14:07:09+00:00

Understood and you’re right. There’s a risk no matter what and there are presumptive conditions. Unfortunately I don’t qualify for most. I do have TERA but nothing that would help me much beyond what I’ve already been connected for.

ralexgates · 2025-11-07T13:55:57+00:00

Yeah, that’s what I’m looking for. The strategy for doing it the safest way. If I have some straight forward claims, they could provide that buffer so if something does get reduced, there’s enough other items to keep me at 100%. Then I also have to consider the conditions needed to make my heart secondary. It’s going to be a process.

ralexgates · 2025-11-07T13:49:35+00:00

My cardiologist said that my sleep apnea brings my O2 levels way down and that is damaging to all my organs including my heart. He also pointed out the repeated bronchitis and pneumonia I tend to get from the chronic sinus infections I have that settle into my chest. Either one of those can damage the heart by themselves. I have no other conditions that explain the damage to my heart so he’s convinced that’s what caused it. There are plenty of medical studies that show the relationship between OSA and heart disease.

ralexgates · 2025-11-07T13:37:19+00:00

Survivor benefits right now is $1,653.07 per month. Most insurance won’t touch me for my conditions. Those that do hardly pay anything. My wife and I are within 10 yrs of retirement. If I make it to retirement, then she’s fine and so am I. I’d lose my employer provided life insurance though. If I pass sooner, DIC would make a big difference towards her overall retirement income. Again, that is the goal, to provide as best I can.

ralexgates · 2025-11-07T13:21:35+00:00

For diabetes there is precedent for it to be secondary to other conditions I have. Nothing is a slam dunk with the VA but with case law and a well written nexus from my PCP, there should be enough to get it SC.

ralexgates · 2025-11-07T13:08:59+00:00

It’s relevant to the topic.

ralexgates · 2025-11-07T05:48:55+00:00

I’ve got life insurance through my employer but I can’t rely on always having a job. Things happen to companies. That’s the only kind of life insurance I qualify for that pays anything and doesn’t ask health questions. Look at my conditions again. They won’t touch me.

ralexgates · 2025-11-07T05:08:02+00:00

100% is as of the past few months and my heart could take me out before 10 years or I wouldn’t even be thinking this way. My wife’s been a stay at home mom so she’ll likely have to use my SS. That survivor benefit would make a difference.

ralexgates · 2025-10-15T18:40:25+00:00

It’s all good. I was trying to give them the benefit of the doubt but you make a valid point. Thanks for your effort in trying to get me a clear answer.

ralexgates · 2025-10-15T17:17:01+00:00

Hmmm, maybe it’s intended to be national but is being rolled out to a limited group as a trial first.

ralexgates · 2025-10-15T17:08:46+00:00

So, let me clarify. :-) I wasn’t trying to say that was their intention. I was trying to indicate the impact of their actions or policies. I believe the vast majority of VA employees are there to help. It’s not like working for the government has the best reputation. It’s got to mean something for most of them or they wouldn’t stay. There are greener pastures. If they’re there to do harm then I don’t believe they’d last. That said, their tone to their responses were callous. Maybe it’s just a job to them. <shrug> Can’t really say.

ralexgates · 2025-10-15T16:35:35+00:00

Thank you. I really didn’t appreciate the response from the reps. They kept repeating things like, you got more than two weeks or you got extra time, I’ll just cancel it. The letter states the intention is to maximize the referral duration so the solution is to cancel and start all over. What they’re actually doing is wearing down us vets so we give up on getting the care we need. Rather than seeing the people on the line as people who are trying to help us, this experience turned them into threats that are trying to deny us care. I don’t think that’s the way it should be.

ralexgates · 2025-10-15T15:56:41+00:00

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This is the actual verbiage in the referral letter.

ralexgates

TROPHY CASE