Benefits

Question:

I am 100% P&T with PTSD with a nexus related to my first enlistment with an honorable discharge. I also receive SSDI with PTSD as the disabling condition I received a BCD due to a Special Court Martial near the end of my second enlistment BCNR has denied my request for upgrade in part due to a lack of "Nexus" between my disability and my conduct which is in direct contradiction of the VA findings and post service medical notes. What is my next step?

Jim's Reply:

It sounds as if you've been going it alone in your attempt to have a discharge upgraded. The success rate for a DIY attempt is low, you need professional representation.
 

Click https://www.vetsprobono.org/ and talk with the folks there. Good luck sir.

Question:

I filed a compensation claim in Dec 2020 for prostate cancer AO. I submitted my DD214 as proof of service in Vietnam along with the Biopsy Report with a second opinion by Johns Hopkins. My Urologist has placed me on "Watch and Wait" and because of my age (84), he does not want to operate or use radiation. What can I do to get a decision from the VA? From what I have read, they should have given me a 100% temp. rating upon receipt of my claim.

Jim's Reply:

Your story makes me wonder if you actually filed the claim? It happens all too often that we think we filed it but for whatever the reason, it didn't happen. You're correct that your simple claim should have been managed long ago. But I have concerns since you don't mention a C & P exam and so on.
 

So...did you DIY or use a "rep"? Either way, do you have confirmation of receipt of paperwork in Janesville? In other words, how do you know your claim was properly received by VA? Do you have the Certified Mail receipt in your hand? Can your rep show you proof of filing? If faxed, do you have the fax receipt? 
 

Have you checked eBenefits? Does that show your claim was received and is in processing? Did you receive a letter from VA via USPS saying, "We're working on your claim?" If you can't show any evidence your claim has been properly filed, that may be the problem. You can try and check the status of your claim here.
 

If you discover your claim didn't get filed properly, do it again. If your claim is properly filed and you can prove it, then what's happening is that the system is just that backed up.
 

This has been ongoing since long before the COVID pandemic and like many other business functions, the VA is now even further behind in processing claims and appeals. If you have proof positive that your claim is in process, try calling or emailing the boss.
 

Phone: (855) 948 - 2311

Email: Denis.McDonough@va.gov
 

That goes to a 'hotline' and often enough they can move your claim along. You're welcome to email me again if none of this provides you a solution. I have other tricks up my sleeve that may help.
 

Good luck sir.

Question:

I was diagnosed with prostate cancer July 2020, in September 2020 my prostate was robotically removed. I was about to apply for disability benefits but realized since the prostate is no longer with me neither is the cancer. I have been left with incontinence and ED, am I a dog barking up the wrong tree?

Jim's Reply:

When an eligible (usually Vietnam) veteran learns he has prostate cancer he should apply for the disability benefit immediately. The diagnosis of prostate cancer (usually a biopsy) is all it takes to trigger the temporary 100% benefit you're awarded for having a service connected cancer when you file the claim.
 

Many men decline treatment these days in favor of 'watchful waiting' or no treatment at all. The veteran who chooses watchful waiting will retain the 100% temporary rating until he dies or seeks treatment for the cancer.
 

Once you have the cancer treated it's apparent you're no longer eligible for a 100% cancer rating. Veterans are seen a few months after treatment for a C & P exam to determine what, if any, residual disabling effects are left from the treatments. In the prostate cancer patient the most common residual effects are uncontrolled or barely controlled leakage of urine, increased frequency and urgency of urination, particularly at night, and erectile dysfunction.
 

Those factors will be used to determine the after-treatment permanent rating. The rating is usually 20%, 40% or 60% depending on how many absorbent pads you require each day.
 

You should proceed to file a claim for service connected prostate cancer as soon as possible. You're just over the one year mark for retroactive benefits. In other words, if you can explain the delay in filing your claim (COVID delays, etc.) you may (or may not) be eligible for significant back pay. In any case if you get the claim in now you'll be scheduled for a C & P and VA will take it from there.
 

If the result isn't what you wanted to hear, you can appeal with the help of an accredited veterans law attorney.  Good luck sir.

Question:

If a veteran is rated 100% P&T and they win an appeal can they still receive retroactive pay?

Jim's Reply:

Yes, under some circumstances that may happen. Let's say your appeal results in your rating becoming one with 'housebound' status...an SMC-s rating that would bump your monthly compensation up a bit.
 

In that case you'd be owed the back pay or the difference between the SMC-s and your usual 100% pay back to the effective date of the appeal.
 

That's actually just a bit unusual though and most appeals that add 10% or even 50% to your established 100% schedular rating don't add anything because of what I like to call VA Math.
 

The Combined Ratings Table  (CRT) is the exercise that VA uses to ensure that 10 minor (or ten 10% ratings) don't add up to a 100% disabled individual. 

You can probably determine whether or not you'll see an increase by predicting what rating you may get and then using that plus your current individual ratings and then doing the math yourself. There are various calculators available on the Internet that promise o do the hard part for you but I don't trust any of them. If you'll read the instructions carefully you'll get the hang of it in no time.
 

Yes, it's tedious and boring but that's the VA way. Good luck.

Question:

How do I obtain a roster of my fellow Marines who served with me in Vietnam?

Jim's Reply:

You'll have to use the Internet to search for the info you're seeking. Go to Google search and enter the name of your unit. Once the results are returned, it's then time to refine your search. You can enter any names you may remember and so on.
 

There are a ton of commercial sites that promise you they'll do all this for you for a membership fee. Don't bite, all they do is set you up with spam emails.
 

The info you're seeking may or may not be out there. Records weren't computerized back then and paper records tend to disappear over time.
 

Good luck.

UPDATE:

Thanks to a reader of Jim's Mailbag, another resource has come to light that may help you find a roster of those you served with in Vietnam.

Go to this searchable database created by Texas Tech University to search for your unit, its unit diaries, and more. Specifically, the unit diaries should include personnel joining and leaving the unit, along with any casualties. The information is not limited to the Marines, though of course they are included.

Hope this helps!

Question:

I am TDIU P&T for 11 years now. If I die, what does my spouse (wife) have to do to claim her compensation?

Jim's Reply:

She will notify VA of your passing...often enough the funeral director will do that for her. Details are here https://www.vawatchdog.org/dic---survivor-benefits.html  

PS From StatesideLegal:

You can also find out who qualifies and how to apply at StatesideLegal's DIC webpage.

Question:

Jim—I am a Vietnam era Navy Veteran—served from 1965–1968. I have hearing loss and tinnitus. I applied for VA Disability in 2010 and was denied because the VA says there is nothing in my medical records to prove it is service related. I served as an Electronics Tech for 2 years and my work location was right next to a 5inch gun mount, which was fired constantly and we were never given ear protection. How can I pursue this? 

Jim's Reply:

This is typical of how VA handles hearing loss and tinnitus cases. You get denied, you appeal, you win the appeal. Unfortunately, if you were denied in 2010 you're years too late for an appeal. If I were you I'd apply again and this time submit evidence stating clearly the circumstances of your hearing loss. Good luck.

Question:

First time reader. Hello Jim. I am also a VN vet. I just read you comments concerning cancer and disability. You say in that short column: "Once the cancer is no longer diagnosed as active, VA will reexamine you and rate you on the residuals of treatment" Can they reduce my rating to zero based on a PSA test result, or do they have to have a biopsy completed first?
 

I have/had prostate cancer. I tried to get the VA to provide dental coverage, while still rated 100%. The lady I talked to hesitated and said I was just reevaluated. I pointed out I had not been and she said, "well, they are behind schedule and this and I was due for it and likely will not get dental." I said my upper plate had caused a painful sore. She said well, Ill pass it my request along. My thought was that I am currently rated 100% and should thus be eligible for dental coverage. Other than cancer, I have been rated 50% for my left should from a gun shot wound in RN, and % for hearing loss. I realize you must be very busy, and will understand if you do not have the time to respond. Thank you for your consideration.

Jim's Reply:

A 100% temporary benefit is awarded for service connected prostate cancer until treatment is completed. Once treatment is completed and your cancer is 'cured' or otherwise in remission, you can't be rated for cancer any longer...according to the gold standard of the PSA test, if your PSA falls to normal levels, you are cancer free.
 

The 100% rating will fall to reflect any lasting disabling conditions like leakage of urine or ED. The permanent rating is usually 20%, 40% or 60% depending on how many absorbent pads you wear each day for leakage. There is no requirement for invasive testing like a biopsy...you really don't want that done routinely?
 

Eligibility for dental care, CHAMPVA and DEA for your dependents requires a 100% permanent rating. The dental care people never know how to explain it but that's the reason you won't get dental care...that and the fact that VA has very little dental care available to vets...staffing those clinics is a challenge. 
 

If you choose watchful waiting and no treatment, your 100% rating will stay with you for life as a temporary rating. If you die of service connected prostate cancer your survivors will be eligible for DIC and a wide array of benefits that can't be tapped until you're dead.
 

Welcome to VA. Good luck sir.

Question:

I have a 10% VA rating for high blood pressure. I had a pacemaker installed on in 2016. Should I file for a VA rating? Thanks in advance.

Jim's Reply:

Yes, maybe. The need for the pacemaker must first be proven to be secondary to your high blood pressure (HBP). If you can prove that your HBP has caused or contributed to the need for a pacer to control the timing of your heartbeats, you may have a well grounded claim that the pacer is service connected (SC) secondary to the HBP. If you're having a touch of heart failure that will be enough to require a pacer and heart failure is often secondary to very high/treatment resistant hypertension.
 

If you do have a diagnosis of heart failure, you should file that as secondary to the SC HBP also.
 

As I so often do, I predict that to prevail you're going to have to have an Independent Medical Opinion that spells out exactly, precisely how and why your SC HBP caused the need for the device. Unless you have the IMO, the VA isn't going to see the secondary connection. More about that is here https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html  Good luck.

Question:

I take oral chemo to keep my mantel cell lymphoma in remission. If I go off them it will most likely come back will this be something I should make the C & P examiner aware of or does it matter in the ratings reduction?

Jim's Reply:

Oral chemo is treatment and your cancer is not cured. Your 100% temporary rating should remain in place while you are being treated. Good luck!