VA disability question(s)

[Restitution]

A co-worker of mine is currently receiving VA disability payments from a back injury suffered while in service. Herniated, ruptured, and deteriorating discs. He has a bi-weekly appointment with a chiropractor, misses work due to flare ups, even has the ergo-chair at his desk to assist with the pain.

Currently, he is rated at 40% disability however, he has been questioning whether he should be re-evaluated for a higher rating. His only worry is that trying to do this, in the current economic climate, he will end up getting down graded and will lose benefits.

Has anyone gone through this? Attempted a re-evaluation?

 

[Misfit]

Has anyone gone through this? Attempted a re-evaluation?

I have, two years of battle and they kept me the same rating.

 

[Restitution]

I have, two years of battle and they kept me the same rating.

Another point he is weary of. Wasting his time for nothing to be accomplished.

Spoke with him yesterday about this. He told me that, from what he read, it is difficult to accomplish anything after the initial evaluation without getting lawyers involved. Pretty sad!

 

[Misfit]

Another point he is weary of. Wasting his time for nothing to be accomplished.

Spoke with him yesterday about this. He told me that, from what he read, it is difficult to accomplish anything after the initial evaluation without getting lawyers involved. Pretty sad!

If I did it again I'd go to a lawyer first.

I got PTSD from the VA.

 

[TWL]

A co-worker of mine is currently receiving VA disability payments from a back injury suffered while in service. Herniated, ruptured, and deteriorating discs. He has a bi-weekly appointment with a chiropractor, misses work due to flare ups, even has the ergo-chair at his desk to assist with the pain.

Currently, he is rated at 40% disability however, he has been questioning whether he should be re-evaluated for a higher rating. His only worry is that trying to do this, in the current economic climate, he will end up getting down graded and will lose benefits.

Has anyone gone through this? Attempted a re-evaluation?

If his condition has worsened, I would absolutely file for an increase. In order for the VA to reduce the rating, they have to prove the condition improved. They would have to use medical evidence such as x-rays, MRI's, etc. that show improvement. They can't use treatment that alleviates the pain, such as medication, going to a chiropractor, or using a ergo-chair as a basis for a decrease in rating. With DDD, it is highly unlikely the condition improved. Also, if he has sciatica symptoms that haven't been claimed and/or rated, claim that as secondary to DDD. If it affects both legs, make sure to claim both legs.

First thing to do is get a intent to file as soon as possible. You can either send an informal letter to the VA indicating your intent to file, or start a claim on eBenefits.va.gov and complete the claim within the 1 year deadline. This establishes the effective date for which the VA would start payment on the increase and/or new conditions. You have a year from the intent to file to complete the claim application. During the period before completing the claim, gather all the medical files, x-rays, MRIs, and get a statement from Dr's and the chiropractor stating the condition had worsened since the initial rating. Also get a statement from the employer indicating the use of the ergo-chair, if they provided it, and list all the time missed from work because of the flair ups. Send all this in with the claim application.

He can do this himself or have a representative (VSO, lawyer, etc.) do it for him. I, personally, would do it myself. Unless you find a good VSO, you may know more about your claim than they. You will most likely not be able to find a lawyer to take this case because there probably wouldn't be a significant enough of an increase in benefits to make worthwhile for them.

Yes, it is a PITA dealing with the VA. But, to me, it is worth the hassle.

 

[itsbob]

A co-worker of mine is currently receiving VA disability payments from a back injury suffered while in service. Herniated, ruptured, and deteriorating discs. He has a bi-weekly appointment with a chiropractor, misses work due to flare ups, even has the ergo-chair at his desk to assist with the pain.

Currently, he is rated at 40% disability however, he has been questioning whether he should be re-evaluated for a higher rating. His only worry is that trying to do this, in the current economic climate, he will end up getting down graded and will lose benefits.

Has anyone gone through this? Attempted a re-evaluation?

My only question is, if it's that bad why isn't he talking to a back/Neurosurgeon and not a chiropractor.

Went through something similar with Tracey, and wasted YEARS with Massage Therapists, Chiropractors, shots.. you name it.

Finally went to the Neuro and Pain center in Annapolis.. when she woke up from surgery she knew she was better.

I have seen cases of people declining sugery (not suggesting this is the case) as if they got better they'd lose their disability.

 

[Restitution]

My only question is, if it's that bad why isn't he talking to a back/Neurosurgeon and not a chiropractor.

Asked him about that this morning.

He told me that he knows a few people that have had the surgery and did the rehab but they are MORE miserable than before. Basically they are still doing the same treatments as they were doing before the surgery.

Right now, he tolerates the pain but it is the missing work, the inconvenience of routine adjustments and treatments, etc. that bother him. Along with the fact that rising costs are not commensurate with the disability payments he is receiving.

 

[black dog]

I'm trying to understand why he's not getting free chiropractor services from the VA, does the local VA not offer chiropractor services there?
Does he go to a doctor that accepts the VA payment?
I shuttle a few guys back and forth to the Marion VA hospital and other doctors through the VA and I've never seen them have to pay a bill after seeing the doctor.
I'm just trying to understand here...

 

[b23hqb]

Like any other kind of disability claims, there is a lot of fraud out there, no doubt. Dude just has to keep his ducks in a row, keep on pursuing it, and don't do ANYTHING outside his limitations to avoid prosecution for falsifying information. That's big. The VA, along with many other governmental agencies, both local, state, and Federal, do seriously pursue fraud when they think someone is faking it, and they will send people out to observe.

Keep working at it. Usually, all first claims are rejected, usually along with the second request. Most approvals for a rating or rating increase happen on the third and "final" ruling.

I have a 10% disability rating for tinnitus. My hearing worsened. Went to the VA, they acknowledged my worsened condition, and gave me hearing aids, which do help some in certain circumstances. I applied again, went for further testing, and received a new rating of hearing loss, a big fat Zero. That means they acknowledge a worsening of my condition, but not enough to receive a higher rating, but at least I have a rating. Just keep trying next year.

Good luck.

 

[Restitution]

I'm trying to understand why he's not getting free chiropractor services from the VA, does the local VA not offer chiropractor services there?
Does he go to a doctor that accepts the VA payment?
I shuttle a few guys back and forth to the Marion VA hospital and other doctors through the VA and I've never seen them have to pay a bill after seeing the doctor.
I'm just trying to understand here...

I believe that the service is not offered locally (I am not 100% sure on this but will have to ask)

He uses his disability payments to offset costs to a local chiropractor and treatments.

 

[Restitution]

Like any other kind of disability claims, there is a lot of fraud out there, no doubt. Dude just has to keep his ducks in a row, keep on pursuing it, and don't do ANYTHING outside his limitations to avoid prosecution for falsifying information. That's big. The VA, along with many other governmental agencies, both local, state, and Federal, do seriously pursue fraud when they think someone is faking it, and they will send people out to observe.

Keep working at it. Usually, all first claims are rejected, usually along with the second request. Most approvals for a rating or rating increase happen on the third and "final" ruling.

I have a 10% disability rating for tinnitus. My hearing worsened. Went to the VA, they acknowledged my worsened condition, and gave me hearing aids, which do help some in certain circumstances. I applied again, went for further testing, and received a new rating of hearing loss, a big fat Zero. That means they acknowledge a worsening of my condition, but not enough to receive a higher rating, but at least I have a rating. Just keep trying next year.

Good luck.

He is always saying that he finds it funny that he is diagnosed with "degenerative discs" which, by definition, means that it will not get better and only will get worse over time BUT, the same people (VA doc) will probably not grant him a disability increase.

 

[black dog]

I believe that the service is not offered locally (I am not 100% sure on this but will have to ask)

He uses his disability payments to offset costs to a local chiropractor and treatments.

Ok, and my understanding with going to the VA is if you need to go out of service they will on a case by case basis send you to a doctor that should accept what the VA pays.
This is what I don't understand here.. unless he is going and the va doesn't know perhaps?
I don't know, it just seems like something missing here.
Good Luck to him.