Military Disability

Military Disability

Disability Compensation A tax-free monetary benefit paid to Veterans with disabilities that are the result of a disease or injury incurred or aggravated during active military service. The benefit amount is graduated according to the degree of the Veteran's disability on a scale from 10 percent to 100 percent (in increments of 10 percent). Compensation may also be paid for disabilities that are considered related or secondary to disabilities occurring in service and for disabilities presumed to be related to circumstances of military service, even though they may arise after service. Generally, the degrees of disability specified are also designed to compensate for considerable loss of working time from exacerbations or illnesses.

Types of Compensation VA disability compensation provides monthly benefits to Veterans in recognition of the effects of disabilities, diseases, or injuries incurred or aggravated during active military service. The program also provides monthly payments to surviving spouses, dependent children, and dependent parents in recognition of the economic loss caused by a Veteran's death during military service or, after discharge from military service, as a result of a service-connected disability.

Combat-Related Special Compensation (CRSC) and Concurrent Retirement Disability Pay (CRDP) Comparing CRSC and CRDP Retirees cannot receive both Combat Related Special Compensation (CRSC) and Concurrent Retirement and Disability Pay (CRDP). If you qualify for both, in the initial year of your joint eligibility, DFAS will automatically apply the entitlement that is most beneficial to you based on your gross amount of each entitlement. This will remain in effect until the next CRDP/CRSC Open Season. You will receive an initial CRDP/CRSC Election form shortly following your joint eligibility. Complete and return the form within 45 days if you wish to change to the entitlement that we did not select for you. In subsequent years, you will need to make this determination yourself during Open Season. Open season usually takes place in January. The chart below highlights the differences between the two programs to help you decide which one is better Combat-Related Special Compensation (CRSC) and Concurrent Retirement Disability Pay (CRDP) Combat-Related Special Compensation (CRSC) and Concurrent Retirement Disability Pay (CRDP) are programs created by Congress to allow eligible military retirees to receive monthly entitlements in addition to retired pay. CRSC is a special compensation for combatrelated disabilities. It is non-taxable, and retirees must apply to their Branch of Service to receive it. CRDP is a restoration of retired pay for retirees with service-connected disabilities. It is taxed in the same manner as your retired pay, and it is normally considered taxable income. No application is required. Eligible retirees receive CRDP automatically. The purpose of these entitlements is to recover some or all of the retired pay that military retirees waive for VA disability compensation.

Combat-Related Special Compensation (CRSC) and Concurrent Retirement Disability Pay (CRDP) comparison

Disability Percentage Pay Charts 2017 FOOTNOTES: a. Rates for each school-aged child are shown separately. They are not included with any other compensation rates. All other entries on this chart reflecting a rate for children show the rate payable for children under 18 or helpless. To find the amount payable to a 70% disabled Veteran with a spouse and four children, one of whom is over 18 and attending school, take the 70% rate for a veteran with a spouse and 3 children, 1,680.48, and add the rate for one school child, 186.00. The total amount payable is 1,866.48. b. Where the veteran has a spouse who is determined to require A/A, add the figure shown as “additional for A/A spouse” to the amount shown for the proper dependency code. For example, veteran has A/A spouse and 2 minor children and is 70% disabled. Add 106.00, additional for A/A spouse, to the rate for a 70% veteran with dependency code 12, 1,623.48. The total amount payable is 1,729.48.

Percentage to Benefit Chart 2018

Presentation Intent Sooner or later you will submit your disability packet at ACAP. When you do, you will submit your medical records and DD214 then wait for notification on when to report to the medical doctors who will evaluate your medical claim. But are you ready? Did you do your homework for your claim? Do you know how to substantiate your claims in medical documents BEFORE the evaluators determine the outcome for percentage? Well, that's what I will attempt to do today educate you on how to validate your packet for the best possible outcome. It all starts with the timeline .

Before We do. Did you Know Did you know Convalescence Hospitalization Individual Unemployability VA may grant a temporary 100 percent disability compensation rating to recover from surgery or immobilization of a joint by a cast without surgery for a service-connected disability while awaiting final disability rating results. VA may grant a temporary 100% disability compensation rating to a Veteran who is hospitalized for more than 21 days for a service-connected disability while awaiting final disability rating results. Did you know VA may pay disability compensation at the 100% rate to certain Veterans who are unable to maintain substantially gainful employment as a result of service-connected disabilities, even though VA has not rated their serviceconnected disabilities at the total level.

Event Timeline 12 month mark The day you make the decision to retire Assess educate Print out and review the Disability Benefits Questionnaires (DBQs) based on your complains Assess your overall medical condition with primary care doctor Document and obtain Review File your BDD disability with ACAP VA Reps Always review the DBQs before you seek medical care especially a year out from separation Obtain all medical documentation / DVDs, and x-rays that support your conditions from any medical facility Tricare referred you to related to your conditions and get them in your records (keep copies of everything) When VA sends you to the evaluators make sure you read the DBQs to insure you know what they will ask pertaining to your condition (s)

g n i d n a t Unders the Process Medical Assessment

4 Pillars to VA Disability Claim Eligibility Pillar 1: Eligibility as a veteran I have shown that I am an eligible veteran. Explain the details of how you became eligible, and cite to the page in your VA C-file that has the evidence proving that you are eligible. Pillar 2: Service connection I have shown that I am entitled to service connection of my diabetes because I showed evidence of my high blood sugar in service, have provided a medical statement from the VA Medical Center showing that I have was diagnosed with diabetes after my discharge, and have an expert medical opinion explaining how my diabetes is at least as likely as not related to my military service. Again, be sure to cite to the page in your VA C-file that has the evidence proving that you are eligible. It doesn’t matter whether you think you have proven service connection. What does matter is that you provide evidence that you did prove each element. Pillar 3: Impairment rating I have attached a Disability Benefits Questionnaire from my VA medical center doctor that shows the current state of my diabetes, and in comparison with 38 CFR Table 4 (Diagnostic Code 7913) I believe I am entitled to a 40% rating for my diabetes. Pillar 4: Effective date It is my opinion that I am entitled to an effective date of [Choose the earliest date you think the law will support]. However, I will reserve my arguments about effective dates until after the VA ratings decision granting service connection and a 40% impairment rating is issued.

Pillar 1: Are you an eligible Veteran?VA Claim. There are 4 Pillars that support a sturdy VA Claim or appeal. Pillar 1 is all about VA Benefits eligibility. So what does it take to be an eligible Veteran – for the purpose of service-connected disability compensation? I could list the regulations, and you can read through the legalese and jibberish, but that’s not what the Veterans Law Blog is all about. I’m going to distill the eligibility criteria into a few easy questions – if you are still getting denied as ineligible after working through these questions, then I really think that you might have a bigger problem in your VA disability claim that an attorney will have to help you with. What would you like to know about VA Benefits eligibility that isn’t in this post? Feel free to comment, below. Question #1: Did you serve in the active duty military? Make sure that you include the right amount of 5-Star Evidence to show that you served in one the major branches (or a couple odd branches, like commissioned officers of the NOAA and the Public Health Service). This is usually accomplished by a copy of your DD-214, but sometimes you will need more proof. If you served in the National Guard, you are going to want to make sure that your call-up to active duty was a “federal” callup and not a state governor calling you up to active duty. The former will give you eligibility for service connected disability compensation through the VA. The latter will not. Question #2: Did your injury occur while on active duty? For service-connected disability eligibility purposes, it doesn’t matter WHERE you were injured. All the matters is the injury or incident which caused your medical condition have occurred between your date of entry to active service and your date of discharge. Question #3: These situations take away eligibility. Do you have any of these situations in your VA Claim? Its important to know that these remove your eligibility – if you can fix the situation (by getting a discharge upgrade, for example), you can become eligible again. Drug, Alcohol and Tobacco Use: The VA likes to deny any claim where drug use is even remotely at issue – on the grounds that they think the law removes a Veteran’s eligibility if they drank, smoked, or used illegal drugs. They are not always right to do that: there are plenty of situations where such situations can be service-connected. Do yourself a favor: get a lawyer that understands the Allen v. Principi case. Willful Misconduct: If your injury is the result of a service-members “willful misconduct”, then this may strip a Veteran of eligibility for service-connected disability benefits. How do you know if the VA is going to claim this? Simple: if the military service did a “Line of Duty” investigation and concluded that your injury is the result of “willful misconduct”, then you may be ineligible. The opposite is true, too – if the military branch concluded that your injury was NOT the result of willful misconduct, the VA is largely stuck with that conclusion. Bad Conduct Discharge: The only type of discharge that should disqualify you from service-connected disability benefits is the so-called “Bad-Conduct” or “Dishonorable” discharge. There are, however, ways to upgrade your discharge after military service – the Attig Law Firm does not handle these types of cases, but give us a holler and we can try to get you the names of some attorneys that do. For example, are you a LGBT soldier discharged dishonorably under “Don’t Ask, Don’t Tell”? You should be able to get a discharge upgrade in those situations, I would think. ***INSIDER TIP: Did you know that even if you got a “bad-conduct” or “dishonorable” discharge, if you are the victim of a Military Sexual Trauma, you are still entitled to free VA medical treatment for the injuries that resulted from that MST? Just go into your nearest VA Medical Center and get enrolled for VA Healthcare. If they give you any “flak” about eligibility, just have them take a look at VHA Health Administration Directive 2010-33 (July 2010).

Pillar 2: Service-Connection is more than you think #1: Do you have a currently diagnosed medical condition? Far too many Veterans fail to prove that they have been diagnosed with an actual condition. I have read through hundreds – if not thousands – of VA C-Files, and often see Veterans that fail to provide the VA with a copy of their medical diagnosis. One Veteran had been battling the VA for YEARS in his claim – when we told him that all the VA needed was proof that he was actually diagnosed with diabetes (and not pre-diabetic, as the VA thought), his battle for benefits was over in just a few weeks. #2: Can you prove an event occurred during your military service? Merely telling the VA that something happened is not enough. You have to prove it. By adding enough 5-Star Evidence into your C-File, you are going to have to establish that the in-service event occurred. It’s not enough to say – as so many Veterans do – that they hurt their back lifting artillery rounds. Or that they blew out a knee running 12 miles in jungle boots with an 80 pound ruck (Ever done that? It sucks, doesn’t it!). You will need enough 5-Star Evidence to prove the incident occurred. #3: Once you establish #1 and #2, you will need to show that there is a legal “nexus”. Nexus is not cause and effect. Many Vets think it is. The VA often thinks it is. Nexus simply means that there is a relationship between your in-service event and the currently diagnosed medical condition. A bridge, if you want to think of it that way. A bridge that connects 2 pieces of “terrain”: an incident in-service and a current disability, condition, illness, etc. Do you know all 5 Paths to building this bridge?

Pillar 3: Take the mystery out of Impairment Ratings. How does the VA calculate the amount of money you will be paid when your military injury is service connected? This is a question that not many Veterans know the answer to. In a nutshell, the VA examines the medical evidence in your C-File, compares it to the impairment rating table, and assigns a percentage. That percentage is what drives your VA disability compensation payment. Here’s how it works. What are the VA Impairment Rating Tables? The VA Impairment Rating Tables provide, in theory, a uniform way for the VA to fairly and consistently compensate Veterans who suffer from the same medical condition but who may not suffer from the same limitations in that condition. A very common disability for Veterans is service-connected diabetes. The VA Rates – or assigns a disability percentage – for diabetes based on whether there is medical evidence relevant to the following criteria* (found at 38 C.F.R. § 4.119, Diagnostic Code 7913): Diabetes managed by restricted diet: 10% Diabetes requiring insulin AND restricted diet: 20% * Diabetes requiring insulin AND restricted diet AND regulation of activities: 40% Diabetes requiring insulin, restricted diet, regulation of activities, and 1-2 hospitalizations per year: 60% After assigning a percentage, the VA rater than figures out the dollar amount of monthly compensation that correlates to that percentage, based on whether the Veteran is single, married, has children/dependents, etc. We all are familiar with the VA Compensation Rate Tables. *It’s important to know that this is just an overview of Diagnostic Code 7913, for illustration purposes only. There are many more factors that can yield a higher or lower rating that I do not discuss here. Where do you find the VA Impairment Rating? The VA publishes the Impairment Ratings at 38 CFR Table 4, which is known as the VA Schedule for Rating Disabilities. You can find it on the internet by doing a search for 38 CFR Table 4. You can buy the paper version of the Code of Federal Regulations, Title 38, Parts 18-end (Pensions, Bonuses & Veterans Relief) Department of Veterans Affairs: Revised 7/13 at Amazon.com. You can purchase a copy of the Code of Federal Regulations from the government (be prepared to shell out a few bucks and wait a few weeks) You can also buy the 2013 Edition of Federal Veterans Laws, Rules and Regulations (2013) around the internet be forewarned though, it carries a hefty 100 price tag. Here’s an option I like if you have a Kindle: Get Title 38, Code of Federal Regulations (Pensions, Bonuses and Veterans’ Relief), Volume 1 electronically and save some coin. You can also get the “Bible” in Kindle format: Federal Veterans Laws, Rules and Regulations, 2013 Edition ). Once you get to 38 CFR Table 4, you will notice that it is hundreds of pages long. The Table is broken down into 13 major body systems: a) Musculoskeletal System; b) Organs of Special Sense, c) Impairment of Auditory Acuity, d) Respiratory System, e) Cardiovascular System, f) Digestive System, g) Genitourinary System, h) Gynecological conditions and Disorders of the Breast, i) Hemic and Lymphatic Systems, j) Endocrine System, k) Neurological Conditions and Convulsive Disorders, l) Mental Disorders, m) Dental and Oral Conditions

Pillar 3: (continued). How do you figure out your VA Impairment Rating? This is over-simplified to illustrate how the VA Impairment Rating Tables work. But lets say that you are a Veteran of OIF (Iraq) or OEF (Afghanistan), and have a service-connected diagnosis of diabetes. Diabetes is a condition that (largely) affects the Endocrine system. So you go to 38 CFR Table 4, and find that conditions of the Endocrine System are found at 38 CFR § 4.119. You turn to 38 CFR § 4.119 and find that the rating criteria (what percentage relates to what medical evidence) for Diabetes Mellitus is listed under Diagnostic Code 7913. Then, you match up your medical evidence to the rating criteria under Diagnostic Code 7913 until you get the appropriate rating. Where does the VA get the medical evidence to determine your Impairment Rating? From your C-File: they are bound by the evidence in your C-File in determining this rating. Most times, the evidence used to assess the Impairment Rating is provided by the VA Doctor that performs the Compensation and Pension Exam(although the VA must look at all the medical evidence in your C-File) So, if you have a rating that is incorrect, or too low, then you can bet that it is because the right evidence was not in your C-File. This is one reason – among dozens – that I believe that the C-File is the most important document in your VA disability compensation claim. It is so important that I have published an eBook showing you how to get a copy of your C-File. Can a Veteran appeal the VA Impairment Rating decision? Yes. If you think that the rating is too low, you can and should file a Notice of Disagreement (NOD) with this decision. Most Veterans – believe it or not – do not know this. We are taught to challenge VA denials of service connection, but not denials of Impairment Rating. In fact, my experience analyzing hundreds – if not thousands – of VA C-Files is that one of the most common VA errorsthat Veterans don’t appeal is the assignment of a VA Impairment Rating that is too low. This is just a general overview of the VA Impairment Rating Tables – or as some folks call it, the VA’s Schedule for Rating Disabilities. I regularly read and reply to the comments to these posts. So, let me ask you: what else you would like to know about the VA Impairment Rating Tables?

Pillar 4: Did you get the earliest Effective Date? What is an Effective Date? The Effective Date is a really important part of a Veterans Disability Compensation Claim. I describe them as the 4th Pillar of a VA Claim. Effective Dates govern how much a Veteran – or a surviving spouse in an accrued benefits or DIC claim – might receive in past-due benefits. They can often be a determining element in other types of benefits the Veteran might want to apply for. For example, survivor benefits and pensions, state property tax exemptions,and more turn on the proper selection of an Effective Date in a Veterans disability benefits claim. In addition, many cities, counties, states and private companies have benefits for Veterans that may well turn on the selection of an Effective Date. A Veteran seeking an Earlier Effective date for entitlement to VA benefits that is earlier than the one decided by the VA Regional Office really has just 2 options to get an Earlier Effective Date. Which option you choose largely depends on the status of the decision that first assigned the effective date. If There’s Still Time to Appeal an Incorrect Effective Date, Try (Option #1). If the decision assigning the effective date has not become final, the Veteran – or Surviving Spouse – may file a direct appeal challenging the Effective Date. The Direct Appeal is done by filing a Notice of Disagreement. Decisions on Effective Dates become final when a deadline to respond passes without a response from the Veteran. For example, here are 3 of the biggest reasons that Effective Date Determinations become final (these are not the only ways, just the big ones): * 1 year after the Ratings Decision – and no NOD has been filed. * 60 days after the date of the Statement of the Case (SOC) – and the Veteran did not file a VA Form 9. * 120 days after the date of a BVA Decision, unless an appeal of that BVA Decision is filed with the Court of Appeals for Veteran’s Claims. If your appeal period has not ended, and your VA Ratings Decision is not final, then filing a CUE claim is a very bad idea. Why? The VA drags their feet on CUE claims, and in the end, almost always denies them. So by filing a Premature CUE Claim, you are giving up a way to properly appeal an adverse decision and, in all likelihood, giving up a right to your original effective date for a claim that the VA is not going to grant anyway. If Your Effective Date Decision is FINAL, Try (Option #2). If the decision assigning the effective date has become final, the only means by which a Veteran – or their surviving spouse – may be able to obtain an earlier Effective Date is by a collateral attack on the regional office or the decision of the Board of Veterans’ Appeals that assigned the effective date. That collateral attack is done through what is called a “CUE” claim, or a Motion to Revise an Effective Date based on Clear and Unmistakeable Error (CUE). Now, to be sure, this isn’t the only type of CUE Claim. I looked at a C-File a couple weeks ago, where the Air Force officially corrected a soldier’s medical records to say that a soldier had contracted a particular disease while on Active Duty in the Air Force. They wrote a fancy memo on Air Force letterhead, and an honest to goodness flight surgeon signed the letter. The VA ignored it, and denied the Veteran’s claim for service connection of that condition. The Veteran didn’t appeal, and he came to me about 3 years after the Ratings Decision denied the claim. My typical approach would be to first Reopen the Claim for Service Connection with some New and Material Evidence, get the Veteran service connected, and then appeal the denial of the original effective date. Once that appeal was exhausted – I might file a CUE claim to get the earlier effective date. However, in this case, we opted to go with an approach of filing a CUE claim first, since the error was so clear, and so unmistakeable, that I felt that while the VARO will certainly deny it, no BVA Judge could make a cogent argument that there was not CUE. Point is – the CUE claim in that example went to the element of nexus. But I much prefer, wherever I can, to use the traditional appeal process or the reopened claim to deal with the first 3 Pillars of a VA Claim, and save CUE claims to protect the Effective Date. Be smart about it, do your reading, and make your own decision. Just be careful with CUE.

Pillar 4: (continued) The CUE Claim for an Earlier Effective Date Can Be Dangerous! CUE Claims are some of the hardest claims that a Veteran can make. I’m NOT saying that you should not file a CUE Claim – they are another Arrow in the very small Quiver that Veterans are given. Just go into a CUE Claim with your “eyes wide open”, and spend a lot of time researching the law. Legal Search Tip: If you are searching Veterans Court and BVA Decisions on the issue of “Effective Date” determinations, the BVA and the Court sometimes refer to effective date appeals as one type of “Downstream Issue”. It’s an archaic term, and one that I try to use as little as possible – far too often, the BVA refuses to adjudicate Impairment Ratings and Effective Dates because they are “downstream issues”. Use of this term paints a “rosy picture” of the claims process, and in my opinion is one of the subtle ways that the BVA condones a 3-5 year (or more) wait for benefits owing to the Veteran. Here are 3 things I want you to think about as you prepare a CUE Claim: 1) A CUE claim requires a specific kind of error . The error must be so clear that reasonable minds could not differ in reaching a particular conclusion, and one where the result would have been manifestly different but for the error. A CUE claim is often not a claim involving interpretation of fact (although it can be); more commonly it is an administrative failure to apply the proper statutory and regulatory provisions to the correct and relevant facts. 2) CUE Claims have to meet special pleading requirements. CUE Claims can be raised at the Regional Office or at the Board of Veterans Appeals (BVA). Depending on where and when it is raised, there are certain things you need to include. This is one of the rare instances in a VA Disability Compensation Claim where the Veteran is best served by a claim that pleads with specificity. 3) CUE Claims can be Really Dangerous. Most Veterans are too quick to file a CUE Claim. Here’s an example. I looked at a Veteran’s C-File a couple weeks ago. The Veteran filed a Motion to Revise an Effective Date based on Clear and Unmistakeable Error (CUE). However, the Veteran’s appeal of the decision that got the Effective Date wrong was still at the BVA. When the BVA issued a decision on the Effective Date – of course denying it – the VA had a GREAT argument that the Veteran’s CUE Claim was “subsumed” by a Final BVA Decision on the same issue. (This rule about a BVA Decision “subsuming” a ‘CUE Claim’ is tricky business folks, and it’s easy to get yourself in a pinch. The result I described above is NOT always the outcome – but in far too many cases that I’ve reviewed, Veterans make their CUE claims harder – or impossible – by not waiting until all other avenues of TIMELY appeals have been exhausted). And then there’s this trick that the VA tried to play with us when we filed an Appeal to the Veterans Court alleging that the BVA erred in not adjudicating a so-called “CUE Claim”. I’ll write more about CUE Claims in the future – for now, it’s enough to know that they are REALLY tricky. If you intend to file – or have filed – a CUE Claim, there is no substitute for a discussion with an accredited VA Attorney about your case.

Types of Claims Fully Developed Claim VA established the Fully Developed Claim Program to expeditiously process claims certified by the claimant or his/her representative as meeting the Fully Developed Claim criteria. In order for you to participate in the Fully Developed Claim Program, you must obtain the relevant service treatment and personnel records and provide them to VA. If VA decides your claim before one year from the date it is received, you will still have the remainder of the oneyear period to submit additional information or evidence necessary to support your claim. For this program, VA will only obtain service treatment records and Federal treatment records when you identify them. Standard Claim As a standard claim, VA is responsible for getting relevant records from any Federal agency that you adequately identify and authorize VA to obtain. VA will make every reasonable effort to obtain relevant records not held by a Federal agency that you adequately identify and authorize VA to obtain. These may include privately held evidence and information you tell us about (such as records from a private doctor or hospital) and/or records from State or local governments or current or former employers. VA will provide a medical examination for you, or get a medical opinion, if determined it is necessary to make a claims decision.

Types of Claims Types of Claims Types Claims Thereofare numerous types of claims that apply to disability compensation. They can be based on disabilities that existed when entering There are numerous types of made claimsworse, that apply to disability compensation. canor bedisabilities based on disabilities entering military service, but were disabilities that occurred duringThey service, that arose that afterexisted you leftwhen military service. military service, there but were disabilities that occurred during service, or disabilities that arose after you left military service. Additionally, are made claimsworse, that are filed for special circumstances. Additionally, there are claims that are filed for special circumstances. Pre-Discharge Claims Pre-Discharge Claims Servicemembers that are within 180 days of separation or retirement from active duty or full time National Guard duty may file claims for Servicemembers that are within 180 days of separation or retirement from active duty or full time National Guard duty may file claims for disability compensation. disability compensation. Claims Based on Pre-Service Disabilities Claims Based Pre-Service Disabilities Individuals mayon enter military service with a known disability. Should this disability become worse due to military service, VA may be able to Individuals may enter military serviceaswith a known disability. this disability become worse duelevel to military service, VA be able pay compensation. This is known aggravation; however, Should compensation can only be paid for the of aggravation. Formay example, at to entry payinto compensation. This is known as aggravation; however, compensation can only be paid for the level of aggravation. For example, at entry military service, an individual has a disabling condition that could be considered 10% disabling. In order for this condition to be intoconsidered military service, an individual a disabling condition that be considered disabling. aggravated, it wouldhas have to have worsened due could to military service to10% at least 20%. In order for this condition to be considered aggravated, it would have to have worsened due to military service to at least 20%. Claims Based on In-Service Disabilities Claims onbased In-Service Disabilities TheseBased claims are on disabilities that are a result of an injury or disease that occurred in active service, and in the line of duty. Injuries or These claimsasare basedof onthe disabilities are a result of an injury or disease that occurred active service, and in the line of duty. Injuries or diseases a result Veteran'sthat own willful misconduct or abuse of alcohol or drugsin are excluded. diseases as a result of the Veteran's own willful misconduct or abuse of alcohol or drugs are excluded. Claims Based on Post-Service Disabilities Claims on Post-Service Disabilities ClaimsBased for post-service disabilities would include claims for disabilities that are a result of disabilities considered to be service-related, even Claims for post-service include for disabilities that are result of disabilities considered bebased service-related, though the disabilitydisabilities arose afterwould service. Thereclaims are various classifications of apresumptive disabilities which cantobe on locationeven or though the disability arose after service. Thereservice are various circumstances of service or just by military itself.classifications of presumptive disabilities which can be based on location or circumstances of service or just by military service itself. Claims Based on Special Circumstances Claims oncompensation Special Circumstances ClaimsBased regarding are not always based on an in-service event. In other words, after a disability has been determined to be Claims regarding compensation always on ana in-service In other words, been determined service connected, there mayare benot other typesbased of claims Veteran orevent. surviving spouse may after wish atodisability file. This has might include a claim to forbe a service connected, types claims a Veteran ordisability, survivingorspouse may compensation wish to file. This mightoninclude a claim a temporary 100%there ratingmay duebetoother surgery for of a service-connected additional based being in need for of regular aid temporary 100% rating due to surgery for a service-connected disability, or additional compensation based on being in need of regular aid and attendance. and attendance.

The s t fi e n e B y r e v i l De at e g r a h Disc (BDD) Medical (this is what you file at ACAP) Assessment

Benefits Delivery at Discharge (BDD) Benefits Delivery at Discharge (BDD) BDD allows a Servicemember to submit a claim for disability compensation 60 to 180 days prior to separation, retirement, or release from active duty or demobilization. BDD can help you receive VA disability benefits sooner, with a goal of within 60 days after release or discharge. Eligibility BDD requires a minimum of 60 days to allow sufficient time to complete the medical examination process (which may involve multiple specialty clinics) prior to separation from service. If you are closer than 60 days to separation from service, you can submit a Quick Start claim. BDD is available nationwide and open to all Servicemembers on full time active duty, including members of the National Guard and Reserve. Members of the Coast Guard may also participate. Requirements To Participate BDD Program Do I have a known separation date? Yes How far away is my known separation date? 60 - 180 days When must I submit my service treatment records to VA? At the time claim is submitted When and where must I complete all phases of my VA/DoD medical separation examination process? At your point of separation, prior to release from the military When may I apply? If you meet all of the BDD requirements above, you may apply for BDD 60-180 days prior to separation.

Step 1 (educate yourself) Identify which chronic illness or injury you intend to claim by Disability Benefits Questionnaires (DBQ), such as: 21-0960G-2s Gallbladder and Pancreas Conditions Enter the DBQ ( i.e 21-0960G-2s Gallbladder and Pancreas Conditions ), into google search or go to the central registry and click on the DBQ you seek (http://www.benefits.va.gov/compensation/dbq ListByDBQFormName.asp) Step 2 (Prepare Yourself) Print out the DBQ that relates to your issue and read the questionnaire to identify the “evidence” the VA evaluators are looking for Step 3 (Documentation) Whenever you seek medical care related to the injury or illness keep in mind what documentation VA will want to see pertaining to their questionnaires and get it documented in your medical records Documentation, consistency, and education are your keys to a fair disability rating

y t i l i b a s Di s Benefit s e r i a n n Questio ) (DBQs Medical Assessment

Sample DBQ ( the actual forms you are evaluated against by VA appointed specialists but that you don’t get to see )

INSIDE MEDICAL Condition Form Name Esophageal Conditions (including GERD Evaluation of conditions affecting the , Hiatal Hernia, and Other Esophageal esophagus such as stricture, spasm, or Disorders) other conditions with lump in throat or chest, pain on swallowing, or regurgitation. Evaluation of gallbladder disease, with inflammation, gallstones, pain after eating fatty food, or pancreatic conditions including pancreatitis that manifests as severe recurrent abdominal pain. Gastrointestinal Hepatitis, Cirrhosis and Other Liver Con ditions Peritoneal Adhesions Evaluation of peritoneal adhesions, which are scars of the visceral lining of the abdominal structures that produces episodes of partial or complete bowel obstruction. and Duodenum Conditions (n Evaluation of stomach and duodenum Stomach ot including GERD or Esophageal Disord conditions such as peptic ulcer disease, ers) recurrent pain relieved by antacids, bloody stools, nausea or vomiting, indigestion. Infectious Intestinal Disorders, includin g Bacterial and Parasitic Infections Evaluation of Amebiasis, dysentery, and various types of intestinal parasites with recurrent diarrhea, alteration in stool consistency or foul smell. Evaluation of removal of portions of the intestine and reconstruction and diversion of the intestinal tract: bowel diversion that requires use of external bags to collect stool. 21-0960G-1 Esophageal Conditions (Including GERD, Hia tal Hernia and Other Esophageal Disorders) 21-0960G-2 Gallbladder and Pancreas Conditions 21-0960G-3 Intestinal Conditions (other than Surgical or Infectious) Including Irritable Bowel Syndro me, Crohn’s Disease, Ulcerative Colitis and Diverticulitis 21-0960G-4 Intestinal Surgery (Bowel Resection, Colosto my, Illiostomy) 21-0960G-5 Hepatitis, Cirrhosis, and other Liver Conditi ons 21-0960G-6 Peritoneal Adhesions 21-0960G-7 Stomach and Duodenal Conditions (not incl uding GERD or Esophageal Disorders) 21-0960G-8 Infectious Intestinal Disorders (including Ba cterial and Parasitic Infections) Gallbladder and Pancreas Conditions Intestinal Conditions (other than surgic Evaluation of Irritable Bowel Syndrome al or infectious) including Irritable Bow el Syndrome, Crohn's Disease, Ulcerativ (IBS) (chronic recurrent diarrhea or constipation). Ulcerative colitis (chronic e Colitis, and Diverticulits inflammatory bowel condition leading to erosions and bleeding) and other conditions with Bloody stools, fistulas, and/or abscess. Evaluation of hepatitis (which refers to a variety of inflammatory and infectious conditions) and Cirrhosis (chronic liver disease resulting from liver injury leading to degeneration of the liver)and other conditions characterized by jaundice, ascitis, fluid retention. Disability Benefits Questionnaires (DBQs) Intestinal Surgery (Bowel Resection, Col ostomy, and Ileostomy) Gastrointestinal (GI) Symptoms and the Anxiety Disorder connection The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Gastrointestinal (GI) disturbances commonly include symptoms of stomach pain, heartburn, diarrhea, constipation, nausea and vomiting. When no medical cause for GI disturbances is und, they are often termed “functional GI symptoms.” Many studies have shown a coforrelation between anxiety, depression and functional GI symptoms. Generally, study results have demonstrated that people who have at least one GI symptom are more likely to have an anxiety disorder or depression than those without any GI symptoms. (So check it out and see mental health if you see a connection)

INSIDE MEDICAL Condition Evaluation of varicose veins, arterial diseases, producing swelling, claudication of legs, or pain on walking, skin/nail changes Evaluation of high blood pressure (BP): how to determine significance of BP readings or BP reading abnormalities. Conditions including: heart attack (MI), irregular rhythm, heart murmurs and heart surgery. Form Name Form # Artery and Vein Conditions (Vas cular Diseases including varicos e veins) Heart/Arterial Hypertension sustained elevation of systemic arterial blood pressure to a level likely to induce cardiovascular damage or other adverse consequences." The normal level for blood pressure is below 120/80, where 120 represents the systolic measurement (peak pressure in the arteries) and 80 represents the diastolic measurement (minimum pressure in the arteries). Blood pressure between 120/80 and 139/89 is called prehypertension (to denote increased risk of hypertension), and a blood pressure of 140/90 or above is considered hypertension. Hypertension may be classified as essential or secondary. Essential hypertension is the term for high blood pressure with unknown cause. It accounts for about 95% of cases. Secondary hypertension is the term for high blood pressure with a known direct cause, such as kidney disease, tumors, or birth control pills. 21-0960A-2 21-0960A-3 21-0960A-4 Heart Conditions (Including IHD, Non-IHD, Arrhythmias Valvular Disease and Cardiac Surgery) Hypertension means "High blood pressure; transitory or Disability Benefits Questionnaires (DBQs) The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Cardiovascular Artery and Vein Conditions (Vascular Disease s including Varicose Veins) Hypertension Heart Conditions (including IHD, Non-IHD, Ar rhythmias, Valvular Disease and Cardiac Surg ery)

Condition Evaluation for infectious and noninfectious diseases of the skin: how to evaluate rashes, spots, athlete's foot, sweating, and acne skin lesions. Form Name Skin Diseases Evaluation of palpable or disfiguring scars, producing distortion or asymmetry. Scars and Disfigurement Evaluation of all dental and oral conditions, except TMJ Conditions. Dental and Oral Conditions Evaluation of conditions affecting the TMJ joint with pain in the jaw when biting and clicks and sounds in the jaw. Temporomandibular Joint (TMJ) Conditions Evaluation of various conditions of the ear including: infections, dizziness, vertigo, acoustic tumors and other conditions with ringing in the ears (tinnitus). Ear Condition (including: Vestibula r and Infectious Conditions) Evaluation of Anosmia (inability to detect any odor), Hyposmia (reduced ability to detect odors), Ageusia (complete lack of taste), Hypogeusia (decrease in sense of taste) and other conditions affecting the sense of smell and taste. Evaluation of conditions affecting, the sinuses, nose, throat, larynx, and pharynx, including, but not limited to deviated nasal septum and organic aphonia, vocal chord problems. INSIDE MEDICAL Skin/scars Dental ENT Have constant headaches? Make sure you talk to your doctor about the possibility of Temporomandibular Joint (TMJ) Conditions If so make sure you claim both Form # Ear, Nose, Throat 21-0960N-1 Ear Conditions (including Vestibular and Infec tious Conditions) Loss of Sense of Smell and/or Taste 21-0960N-3 21-0960N-4 Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx Form # Dental / Oral 21-0960M-15 Temporomandibular Joint (TMJ) Conditions 21-0960D-1 Oral and Dental Conditions, including Mouth, Lips, and Tongue (other than Temporomandib ular Joint Conditions) Form # Scars/Skin 21-0960F-1 Scars/Disfigurement 21-0960F-2 Skin Diseases Dentistry Loss of Sense of Smell and/or Tast e Sinusitis, Rhinitis, and other Condi tions of the Nose, Throat, Larynx, and Pharynx Disability Benefits Questionnaires (DBQs) The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Dental benefits are provided by the Department of Veterans Affairs (VA) according to law. In some instances, VA is authorized to provide extensive dental care, while in other cases treatment may be limited.

Conditions - Symptoms Evaluation of DM Type I or II, with alteration of blood sugar regulation, abnormal Glucose Tolerance Test (GTT), requiring medication or hospitalization or complications. Evaluation of conditions affecting the hormone glands, including, but not limited to Cushing's syndrome, Acromegaly, and Addison's Disease. Evaluation of conditions affecting the functions regulated by the thyroid and parathyroid glands, including, but not limited to growth and metabolism. Evaluation of renal diseases including Nephritis, renal insufficiency, and other diseases of the kidney: kidney failure, abnormal kidney function tests, protein in the urine, edema, kidney stones. Evaluation of diseases of the urethra, penis, testes, and scrotum, producing pain on urination, swelling, blood in urine or incontinence. Form Name INSIDE MEDICAL Disability Benefits Questionnaires (DBQs) Diabetes Mellitus (DM) Endocrinological Genitourinary Endocrine Diseases (other than T hyroid and Parathyroid, or Diabet es Mellitus) Thyroid and Parathyroid Conditio ns Kidney Conditions (Nephrology) Male Reproductive Organ Conditio ns Evaluation of malignant lesions of the prostate gland with frequent diurnal or nocturnal urination. Prostate Cancer Evaluation of conditions affecting the bladder and urethra, including, but not limited to voiding dysfunctions and infections. Urinary Tract (Bladder and Urethra ) The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Form # Endocrinological 21-0960E-1 Diabetes Mellitus 21-0960E-2 21-0960E-3 Endocrine Diseases (other than Thyroid and P arathyroid, or Diabetes Mellitus) Thyroid and Parathyroid Conditions Form # Genitourinary 21-0960J-1 Kidney Conditions (Nephrology) 21-0960J-2 Male Reproductive Organ Conditions 21-0960J-3 Prostate Cancer 21-0960J-4 Urinary Tract (including Bladder and Urethra) Conditions (excluding Male Reproductive Sys tem)

Conditions - Symptoms Evaluation of conditions of red and white blood cells, producing anemias, leukemias on tumors such as lymphomas. Evaluation of various diseases of the eye, such as inflammation, infection, glaucoma, deformities, alteration of tear ducts, cataracts, retina disease, and other conditions. Evaluation of the respiratory system except Sleep Apnea and Tuberculosis. Evaluation of disorder characterized by cessation of breathing during sleep and provides information necessary to determine functional impact (sleep apnea, snoring) daytime complications. Evaluation of Chronic Fatigue Syndrome. Components including but not limited to tiredness, loss of memory or concentration and enlarged lymph nodes. INSIDE MEDICAL Form Name Disability Benefits Questionnaires (DBQs) Hematologic and Lymphatic Conditions Form # Eye Conditions Blood Eye Respiratory Rheumatological Respiratory Conditions (othe r than TB and Sleep Apnea) Sleep Apnea The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Chronic Fatigue Syndrome Note before you go further: when reviewing DBQs you may have to do your homework because some cross reference others such as in the case of: 21-0960N-2 (eye conditions), and 21-0960P-3 (Post Traumatic Stress Disorder). 21-0960M-8 (Hip and Thigh Conditions), and 21-0960M-9 (Knee and lower leg conditions). Keep that in mind when seeing the medical evaluators Hematologic and Lymphatic 21-0960B-1 Hairy Cell and Other B-Cell Leukemias 21-0960B-2 Hematologic and Lymphatic Conditions, inclu ding Leukemia Form # Ophthalmological 21-0960N-2 Eye Conditions Form # Respiratory 21-0960L-1 21-0960L-2 Respiratory Conditions (other than Tuberculo sis and Sleep Apnea) Sleep Apnea Form # Rheumatological 21-0960Q-1 Chronic Fatigue Syndrome

Conditions - Symptoms Form Name Evaluation of conditions involving internal organs bulging through the muscle, except hiatal hernia. Hernias (including Abdominal , Inguinal, and Femoral Herni as) Evaluation of rectum and anus conditions causing alteration of sphincter control, stricture of prolapse, fistula, and other symptoms. Bowel incontinence or severe constipation blood in stools. Rectum and Anus Conditions ( including Hemorrhoids) General Surgery Psychological What’s other than PTSD? Evaluation for anorexia, bulimia, and other eating disorders. Eating Disorders Evaluation of symptoms, history, and impact related to mental disorders: depression, mood and affective disorders, psychosis, etc. Mental Disorders (other than P TSD) Review Evaluation of PTSD Evaluation of beginning and extent of symptoms (acute length of symptoms is usually less than 3 months, chronic symptoms usually last 3 months or more, with delayed onset - usually at least 6 months have passed between the traumatic experience and the beginning of symptoms). Symptoms may include: recurrent experiences of a traumatic event, avoiding an excitant or irritant associated with the trauma, deadening of general responsiveness, increased arousal, including insomnia, recurrent nightmares, and extreme caution; exhibiting an inflated frightened response; and experiencing changes in hostility. INSIDE MEDICAL Borderline Personality disorder Schizophrenia Anxiety disorder (to name a few) Look through PTSD medical documentation sometimes they will report more than just one diagnosis as in the case of anxiety disorder and PTSD. If so make sure you claim both The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Disability Benefits Questionnaires (DBQs) Form # General Surgery 21-0960H-1 Hernias (including Abdominal, Inguinal, and F emoral Hernias) Rectum and Anus Conditions (including Hemo rrhoids) 21-0960H-2 Form # Psychological 21-0960P-1 Eating Disorders 21-0960P-2 Mental Disorders (other than PTSD) 21-0960P-3 Review Post Traumatic Stress Disorder (PTSD) To receive VA compensation for PTSD there are two items of evidence that must exist. One without the other is worthless in establishing your claim to VA compensation for PTSD. Stressor: In a recent regulatory revision, the VA will accept as a stressor the fact that a veteran was in "fear of military or terrorist activity." Likewise any event that involves actual or threatened death or serious injury could also be considered as a stressor. That fear or event must be consistent with the places, types, and circumstances of the veteran's service. Moreover, a VA psychiatrist or psychologist, or those working under contract to the VA, must confirm that the claimed stressor is adequate to support a diagnosis of PTSD. Diagnosis: A diagnosis of Post-Traumatic Stress Disorder rendered by a psychiatrist. Counseling reports prepared by Vet Centers may be considered in determining the degree of your impairment; however, there must be a diagnosis of PTSD made by a physician specialized in psychiatry. Post Traumatic Stress Disorder: In addition to the evidence above, you must also submit: A completed VA Form 21-0781, "Statement in Support of Claim for Service Connection for PostTraumatic Stress Disorder (download form)," OR If claiming PTSD based on personal assault, VA Form 21-0781a, "Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder Secondary to Personal Assault ( download form).“

General Rating Formula for Mental Disorders: Total occupational and social impairment, due to such symptoms as: gross impairment in thought process or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name .100% Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships . 70% Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining Effective work and social relationships .50% Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events) . 30% Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication . 10% A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication . 0%

Conditions - Symptoms Form Name Evaluation of conditions associated with the Human Immunodeficiency Virus (HIV) and its treatment. HIV-Related Illnesses Evaluation of infectious diseases not specificallyassociated with either HIV or military service in a tropical area, the Persian Gulf, or Afghanistan. Infectious Diseases INSIDE MEDICAL Infectious Disease Evaluation of pulmonary and extrapulmonary tuberculosis symptoms. For use in evaluation of vitamin deficiencies (Beriberi, Pellagra, syndromes of dermatitis, diarrhea dementia in POW, post-GI surgery, bypass procedures, undernutrition and malabsorption.) Form # Infectious Diseases 21-0960I-1 Persian Gulf and Afghanistan Infectious Diseas es HIV-Related Illnesses 21-0960I-2 21-0960I-3 21-0960I-5 Infectious Diseases (other than HIV-Related Ill ness, Chronic Fatigue Syndrome, or Tuberculo sis) Systemic Lupus Erythematosus (SLE) and Othe r Autoimmune Diseases Nutritional Deficiencies 21-0960I-6 Tuberculosis 21-0960I-4 Persian Gulf and Afghanistan Infec Evaluation of infectious tious Diseases diseases associated with military service in tropical areas with exposure to salmonella, shigella, etc. producing symptoms such as chronic diarrhea. Evaluation of conditions in which the immune system begins attacking healthy body tissues, including, but not limited to, Goodpasture's syndrome and Guillain-Barre syndrome. Disability Benefits Questionnaires (DBQs) Systemic Lupus Erthematosus (SLE ) and Other Autoimmune Diseases Gulf War Illnesses Tuberculosis (TB) Nutritional Deficiencies The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Gulf War Veterans suffering from what is commonly referred to as "Gulf War Syndrome," which is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems may be eligible for disability compensation. In addition, Gulf War Veterans who served in Southwest Asia and have a disability resulting from certain infectious diseases may be eligible for disability compensation.

The Registries you should consider signing up with: Exposures to Hazardous Materials Depleted Uranium Registry Veterans may have been exposed to a range of chemical, physical, and environmental hazards during military service. Veterans may be entitled to disability compensation if exposure to these hazards resulted in a disease or injury. Examples include exposure to radiation, mustard gas, and asbestos. Depleted Uranium is natural uranium left over after most of the U-235 isotope has been removed, such as that used as fuel in nuclear power plants. DU possesses about 60% of the radioactivity of natural uranium; it is a radiation hazard primarily of internalized, such as in shrapnel, contaminated wounds, and inhalation, DU has some chemical toxicity related to being a heavy metal (similar to lead). http://www.publichealth.va.gov/exposures/burnpits/ registry.asp Gulf War Registry For veterans who served on Active Military duty in Southwest Asia during the Gulf War, which began in 1990 and continues to present, including OIF. The Gulf War examination registry was established after the first Gulf War to identify possible diseases resulting from US military personnel service in certain areas of Southwest Asia. These diseases were endemic to the area or may have been due to hazardous exposures, including heavy metals. Furthermore, air pollutants, i.e., carbon monoxide sulfur oxides, hydrocarbons, particulate matter, and nitrogen oxides, singly or in combination, could have caused chronic health problems. Veterans who are identified by the DOD or have concerns about possible DU exposure are eligible for a DU evaluation. VA maintains two registries for veterans possibly exposed to depleted uranium. The first is for veterans who served in the Gulf War including OIF. The second is for veterans who served elsewhere including Bosnia and Afghanistan. http://www.publichealth.va.gov/exposures/depleted uranium/index.asp http://www.publichealth.va.gov/exposures/gulfwar/benefits/registry-exam.asp

Conditions - Symptoms Form Name Evaluation of extremity, limb or digit Amputations (complete or partial amputation), and complications. Evaluation of stumps. Evaluation of ankle pain, persistent Ankle Conditions deformity (ankylosis), ankle injuries, reduction of movement, and use of assistive device. Evaluation for non-degenerative arthritic conditions such as Gout and Rheumatoid Arthritis: recurrent painful and swollen joints. Non-degenerative Arthritis (includin g Inflammatory, Autoimmune, Cryst alline, and Infectious Arthritis) and D ysbaric Osteonecrosis Evaluation of injuries, deformities, loss of elbow and forearm producing motion limitation. Elbow and Forearm Conditions Evaluation of reduction or loss of toe function and motion, and alteration in mobility. Evaluation of alteration in motion of the wrists or digits due to tendon or muscle injuries, and alteration in motion and function of the hand including ankylosis, trigger finger, loss of finger movement. INSIDE MEDICAL Musculoskeletal Disability Benefits Questionnaires (DBQs) Form # Form Name 21-0960M-1 Amputations 21-0960M-2 Ankle Conditions 21-0960M-3 21-0960M-4 Non-Degenerative Arthritis (including Inflammatory, Autoimmune, Crystalline and Infectious Arthritis) an d Dysbaric Elbow and Osteonecrosis Forearm Conditions 21-0960M-6 Foot Conditions, Including Flatfoot (Pes Planus) 21-0960M-7 Hand and Finger Conditions 21-0960M-8 Hip and Thigh Conditions 21-0960M-9 Knee and Lower Leg Conditions 21-0960M-10 Muscle Injuries 21-0960M-11 Osteomyelitis Foot conditions including flatfoot (p es planus) Hand and Finger Conditions Evaluation of alteration in extension Hip and Thigh Conditions and flexion, poor postural and body support, and alteration of rotation of the hip. Evaluation of ankylosis of the knee, Knee and Lower Leg Conditions subluxation of the knee, knee instability, meniscus lesions, and functional limitations knee cartilage problems, locked knee. Muscle Injuries Evaluation of traumatic and other injuries resulting in loss or alteration of function, location, type, tears, and weakness: torn scarred muscles. Osteomyelitis Evaluation of bone infections producing fever, local alteration of function, residuals from a bone infection with persistent drainage or bone alteration Automobile Allowance The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). VA may provide Veterans with a one-time allowance to purchase a new or used car to accommodate a service-connected disability. This benefit is available to Veterans with certain severe service-connected disabilities, such as loss of, or permanent loss of use of, a hand or foot. This benefit can also be used to purchase adaptive equipment. Clothing Allowance VA may provide an annual clothing allowance to Veterans who use a prosthetic or orthopedic device (including a wheelchair) because of a service-connected disability, or has a serviceconnected skin condition and uses a medication that causes irreparable damage to outer garments.

Condition Form Name Evaluation of arm limitation of function, dislocation, alteration in joint function, incomplete movements, deformity, dislocation, nonunion, and fracture complications : frozen shoulder. Evaluation of arthritis and neck deformities. Evaluation of unfavorable or incomplete wrist motion due to ankylosis (limitation in range), painful or other alteration in function, resulting from traumatic or other injury complications, joint replacement. Evaluation of chronic low back pain, arthritis and back injuries, spinal conditions or disc disease: low back pain with sciatica. INSIDE MEDICAL Shoulder and Arm Conditions Neck (Cervical Spine) Condition s Musculoskeletal (cont) Wrist Conditions Back (Thoracolumbar Spine) Co nditions The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Title 38 U.S.C. 1151 Claims VA may provide compensation for injuries incurred or aggravated while receiving care from VA, such as medical treatment or vocational rehabilitation. Disability Benefits Questionnaires (DBQs) Form # Form Name 21-0960M-12 Shoulder and Arm Conditions 21-0960M-13 Neck (Cervical Spine) Conditions 21-0960M-14 Back (Thoracolumbar Spine) Conditions 21-0960M-16 Wrist Conditions

Conditions - Symptoms Form Name Amyotrophic Lateral Sclerosis (Lo Evaluation of progressive u Gehrig's Disease) degenerative disease of the brain and spinal cord with progressive muscle weakness and wasting, speech, swallowing and breathing problems. Diabetic Sensory-Motor Peripher Evaluation of alteration of the al Neuropathy function of the nerves (motor and sensory), related to Diabetes Mellitus: weakness, numbness, tingling of legs and arms related to diabetes. Evaluation of numerous other neurologic conditions such as: meningitis, HIV, brain abscess, Lyme Disease, encephalitis, stroke, brain tumor, and spinal cord injury. INSIDE MEDICAL Disability Benefits Questionnaires (DBQs) Form # Form Name 21-0960C-2 Amyotrophic Lateral Sclerosis (Lou Gehrig’s Dis ease) Diabetic Sensory-Motor Peripheral Neuropathy Neurological 21-0960C-4 (Part #1) 21-0960C-5 Central Nervous System and Neu romuscular Diseases (except TBI, ALS, Parkinson's Disease, MS, He adaches, TMJ, Epilepsy, Narcolep sy, Peripheral Nerves, Sleep Apne a, Cranial Nerves, Fibromyalgia, a nd Chronic Fatigue Syndrome) 21-0960C-7 Central Nervous System and Neuromuscular Di seases (except TBI, ALS, PD, MS, Headaches, T MJ, Epilepsy, Narcolepsy, Peripheral Nerves, Sle Cranial Nerve Conditions ep Apnea, Cranial Nerves, Fibromyalgia, and CF S) Fibromyalgia 21-0960C-8 Headaches (Including Migraine Headaches) 21-0960C-11 Seizure Disorders 21-0960C-3 Cranial Nerve Conditions Evaluation of conditions affecting the following nerves in the Cranium: V (trigeminal, VII (facial), IX (glossopharyngeal), X (vagus), XI (spinal accessory), and XII (hypoglossal). (Conditions affecting cranial nerves I (olfactory), II (optic), III (oculomotor), IV (trochlear), VI(abducens), and VIII (vestibulocochlear (auditory)) are addressed in other DBQs.) Prestabilization (including Migraine H Evaluation of recurrent episodes Headaches eadaches) of head pain producing work limitation or incapacitation: with other symptoms such as nausea, vomiting, tearing etc. Evaluation of fibromyalgia components, including, but not limited to sleep problems, muscle and joint pain, and altered affect. Fibromyalgia Evaluation of seizure conditions Seizure Disorders including epilepsy. The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). VA may grant a temporary 12month 50 or 100 percent initial rating to a Veteran who recently separated from service and has an unstable disability and is in need and cannot be self-sufficient. Examples: Lou Gehrig's Disease, MS, Parkinson's Disease

Conditions - Symptoms Evaluation of disorders of the myelin sheath of the central nervous systems producing recurrent alterations of neurological function: such as weakness, numbness, urine incontinence, visual symptoms. Form Name INSIDE MEDICAL Multiple Sclerosis (MS) Neurological (Part #2) Parkinson's Disease Evaluation of symptoms that may include tremors, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions. Evaluation of narcolepsy components, including, but not limited to, sleep attacks, sleepiness, paralysis, and cataplexy. Evaluation of alteration of the function of Nerves associated with metabolic disorders, exposure to toxins, infections, immunological disorders, or inflammation and other conditions. Disability Benefits Questionnaires (DBQs) Form # Form Name 21-0960C-1 Parkinson’s Disease 21-0960C-9 Multiple Sclerosis (MS) 21-0960C-6 Narcolepsy 21-0960C-10 Peripheral Nerve Conditions (Not Including Dia betic Sensory-Motor Peripheral Neuropathy) Special Monthly Compensation (SMC) Narcolepsy Peripheral Nerve Conditions ( not including Diabetes Sensor y-Motor peripheral Neuropat hy) The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). SMC is an additional tax-free benefit that can be paid to Veterans, their spouses, surviving spouses and parents. For Veterans, Special Monthly Compensation is a higher rate of compensation paid due to special circumstances such as the need of aid and attendance by another person or by specific disability, such as loss of use of one hand or leg. For spouses and surviving spouses, this benefit is commonly referred to as aid and attendance and is paid based on the need of aid and attendance by another person.

FEMALE (SPECIFIC) MEDICAL Conditions - Symptoms Form Name Evaluation of inflammatory neoplastic and cystic lesions of the breast: Breast mass or lumps. Breast Conditions and Disorders Evaluation of diseases of the female genital tract including: uterus, vagina, cervix, ovaries, endometriosis, complications of pregnancy, and other conditions. Gynecological Conditions Gynecological Assault Trauma Form Name 21-0960K-1 Breast Conditions and Disorders 21-0960K-2 Gynecological Conditions 21-0960P-3 Review Post Traumatic Stress Disorder (PTSD) Specialty Care Management and screening of chronic conditions includes heart disease, diabetes, cancer, glandular disorders, osteoporosis, and fibromyalgia as well as sexually transmitted diseases such as HIV/AIDS and hepatitis. Review Evaluation of PTSD Evaluation of beginning and extent of symptoms (acute - length of symptoms is usually less than 3 months, chronic - symptoms usually last 3 months or more, with delayed onset - usually at least 6 months have passed between the traumatic experience and the beginning of symptoms). Symptoms may include: recurrent experiences of a traumatic event, avoiding an excitant or irritant associated with the trauma, deadening of general responsiveness, increased arousal, including insomnia, recurrent nightmares, and extreme caution; exhibiting an inflated frightened response; and experiencing changes in hostility. Form # Reproductive health care includes maternity care, infertility evaluation and limited treatment; sexual problems, tubal ligation, urinary incontinence, and others. VA is prohibited by legislative authority from providing either in-vitro fertilization or abortion services. PTSD Can also be claimed for personal assault and Trauma Birth Defects/Spina Bifida VA may provide a tax-free monetary allowance to children with Spina Bifida or certain birth defects born to women who served in the Republic of Vietnam or served in or near the demilitarization zone in Korea during certain time periods. Rehabilitation, homebound, and long-term care. VA referrals are given to those in need of rehabilitation therapies such as physical therapy, occupational therapy, speech-language therapy, exercise therapy, recreational therapy, and vocational therapy. Homebound and long-term care services are available as well, limited to those meeting specific requirements. The chart matches the Disability Benefits Questionnaires (DBQs) to medical conditions or symptoms to the corresponding Disability Benefits Questionnaire (DBQs). Woman Veterans who are interested in receiving care at VA should contact the nearest VA Medical Center and ask for the Women Veterans Program Manager. Post Traumatic Stress Disorder: In addition to the evidence above, you must also submit: A completed VA Form 21-0781, "Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (download form)," OR If claiming PTSD based on personal assault, VA Form 210781a, "Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder Secondary to Personal Assault

If your Doctor will not review and sign your DBQ based on the documentation and eval DBQ, then find another doctor. Why? Because chances are he/she is receiving guidance from VA and is working for them (not for you) when it comes to your DBQ claim Many Doctors are given guidance by the VA TRICARE VA facilities Army Hospitals and are discouraged from ranking you high on the DBQs claims so Get Second Opinions !! The Key to your rating is to find a Doctor that will support your DBQs Read and make sure you have support documentation in your record that supports your DBQs

Part of documentation success depends on how well you think outside the box to substantiate your claim item. Look at your related DBQs and dissect its elements i.e. it helps to substantiate migraines and also assists in determining claim % Headaches also relate to TBI: did you list this as complimentary DBQs forms for separate claim items? i.e. it substantiates claim % The location of the headache determines the type of headache i.e. it substantiates claim % If you have headaches know what you are talking about (to include symptoms) and make sure you have documented history WITH Medications Are you taking prescribed opioids or over counter medication when the pain gets hard to manage The location of headache determines the type of headache Did you cross reference the headaches on both the Headache and PTSD DBQs? Note: So you don’t have PTSD but you have headaches. Go get checked at the dentist for TMJ; which also substantiates your headaches, and it relates to stress. If approved that means you will get free dentistry at the VA hospital (think outside the box)

Lets make other “outside the box” connections DBQ ITEM RELATES TO DBQ 21Review P 21-0960N-2 0960P-3 ost Traum atic Stress Disorder ( PTSD) ITEM RELATE S TO DBQ 21-0960CEye Condi 8 tions ITEM RELATES TO DBQ ITEM COMMENTS Submit four separate claim items and make sure the documentation is consistent on all DBQ forms Headaches (In cluding Migrai ne Headaches ) * GET A DENTAL EXAMINATION FOR STRESS RELATED TMJ 210960M14 Back (Tho 21-0960M-8 racolumba r Spine) C onditions 21-0960M21-0960MHip and T Knee and Low 11 high Condi 9 er Leg Conditi tions ons Osteomyelitis As we know all bones are connected so if you have a back issue it might be worth looking at the other DBQs * CANT GET A NEXUS LETTER OR DBQ FILLED OUT BY YOUR PM? GO GET ONE FILLED OUT FROM A CHIROPRACTOR W/X-RAYS Review P 21ost Traum 21-0960I-3 0960P-3 atic Stress Disorder ( PTSD) sexual assault 21-0960KInfectious Diseases ( 2 other than HIV-Relat ed Gynecological Conditions VA provides free care to veterans who experienced sexual assault or harassment while in uniform. Seeing a counselor @ VA can help your claim * SEXUAL ASSAULT IN UNIFORM? IT MIGHT HAVE A DIRECT COOROLATION TO YOUR TOTAL HYSTERECTOMY

After Service Care So now you have your rating. Now what do you do about post military health care TRICARE? VA Facility? The following slides are some talking points

VA Medical Care NOW FOR THE BAD NEWS: Just because you are now approved for compensation doesn’t mean you can be seen at a VA medical Hospital even if you receive 100% Care at a VA facility is income based and if you’re retired you probably don’t qualify UNLESS the care you intend on receiving is SERVICE CONNECTED and relates to WAR TIME SERVICE.

VA Priority Groups per care Priority Groups The number of Veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up Priority Groups to make sure that certain groups of Veterans are able to be enrolled before others. Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a Priority Group. The Priority Groups range from 1-8 with 1 being the highest priority for enrollment. Based on eligibility and income, some Veterans may have to agree to pay copay to be placed in certain Priority Groups and some Veterans may not be eligible for enrollment. You may be eligible for more than one Enrollment Priority Group. In that case, VA will always place you in the highest Priority Group that you are eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled Veterans.VA determines your eligibility for VA’s comprehensive medical benefits package through our patient enrollment system, which is based on Priority Groups from 1 through 8. Priority Group 1 Veterans with VA-rated service-connected disabilities 50% or more disabling Veterans determined by VA to be unemployable due to service-connected conditions Priority Group 2 Veterans with VA-rated service-connected disabilities 30% or 40% disabling Priority Group 3 Veterans who are Former Prisoners of War (POWs) Veterans awarded a Purple Heart medal Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty Veterans with VA-rated service-connected disabilities 10% or 20% disabling Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation” Veterans awarded the Medal Of Honor (MOH) Priority Group 4 Veterans who are receiving aid and attendance or housebound benefits from VA Veterans who have been determined by VA to be catastrophically disabled Priority Group 5 Nonservice-connected Veterans and noncompensable service-connected Veterans rated 0% disabled by VA with annual income below the VA’s and geographically (based on your resident zip code) adjusted income limits. Veterans receiving VA pension benefits Veterans eligible for Medicaid programs

Priority Groups (Continued) Priority Group 6 Compensable 0% service-connected Veterans Veterans exposed to Ionizing Radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki Project 112/SHAD participants Veterans who served in the Republic of Vietnam between January 9,1962 and May 7,1975 Veterans of the Persian Gulf War who served between August 2, 1990 and November 11, 1998 *Veterans who served on active duty at Camp Lejeune for not fewer than 30 days beginning August 1, 1953 and ending December 31, 1987 Veterans who served in a theater of combat operations after November 11, 1998 as follows: – – Currently enrolled Veterans and new enrollees who were discharged from active duty on or after January 28, 2003, are eligible for the enhanced benefits for 5 years post discharge. Combat Veterans who were discharged between January 2009 and January 2011, and did not enroll in the VA health care during their 5 year period of eligibility have an additional one year to enroll and receive care. The additional one-year eligibility period began February 12, 2015 with the signing of the Clay Hunt Suicide Prevention for America Veterans Act. Note: At the end of this enhanced enrollment priority group placement time period Veterans will be assigned to the highest Priority Group their unique eligibility status at that time qualifies for. *Note: While eligible for Priority Group (PG) 6; until system changes are implemented you would be assigned to PG 7 or 8 depending on your income. Priority Group 7 Veterans with gross household income below the geographically-adjusted income limits (GMT) for their resident location and who agree to pay copays Priority Group 8 Veterans with gross household income above the VA and the geographically-adjusted income limits for their resident location and who agrees to pay copays Veterans eligible for enrollment: Noncompensable 0% service-connected: Sub priority a: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub priority due to changed eligibility status Sub priority b: Enrolled on or after June 15, 2009 whose income exceeds the current VA or geographic income limits by 10% or less Nonservice-connected and: Sub priority c: Enrolled as of January 16, 2003, and who have remained enrolled since that date and/or placed in this sub priority due to changed eligibility status Sub priority d: Enrolled on or after June 15, 2009 whose income exceeds the current VA or geographic income limits by 10% or less Veterans not eligible for enrollment: Veterans not meeting the criteria above: Sub priority e: Noncompensable 0% service-connected (eligible for care of their SC condition only) Sub priority g: Nonservice-connected

Once you receive your VA compensation letter (spelling out percentages), take it along with your DD214 and Retirement *Green Card* to your nearest VA Medical Center and apply for your VA Card 2011 Should you qualify for VA care, attend the facility orientation and you will be assigned to a clinic for primary care 1 Apply on line for the Registries GETTING IN THE SYSTEM 2 (whether you qualify for VA Facility care or not) Determine if you will keep TRICARE for yourself vs VA 3 4 At your first appointment take all the prescription medication with you to primary care

Medical follow-up When people finally receive their VA determination they tend to mitigate their conditions and rationalize their decision to stop taking required medication overtime. Its important to note that VA might decide to reevaluate you years down the road if you don’t see the need to follow up with care, don’t expect the VA to continually compensate you. (Keep your medications current and follow your care regiment per your doctor). Refilling Medications There are several ways you can refill your prescriptions. Online You can use the "My HealtheVet" Website to refill your VA prescriptions and view your VA prescription history online. To access Prescription Refill, you must be a registered user of My HealtheVet. If you are not a registered user, to register and learn how to use Prescription Refill, visit the My Healthe Vet Web site. Mail Order Medication refills can be requested by mailing the refill notice provided to you at the time of your original fill. Your order will be processed through our Pharmacy mail-out program. Routine refills cannot be processed at the Pharmacy windows (unless there are special circumstances). Telephone Some VA Pharmacies have toll-free automated telephone refill systems. See the phone number listing for your local VA Facility. In Person at the VA pharmacy

Syringe treatment Make sure you retrieve your medical shot record and keep it current through your primary care doctor. Consider the shingles shot if you have ever had Chicken Pox as well as seasonal flu shots.

Additional Information What about an appeal? And Do you have a family member who has never filed but was injured or taken ill while on active duty (never reached retirement and was never medically chaptered?) If I die can my spouse continue to receive my disability pay? The following slides review the process

Use the VA provided portals to manage your VA appts and medication My Healthevet eBenefits My Access Center

Filing an appeal or for Family member with prior service Use DBQs for Faster Service VA’s Disability Benefits Questionnaires (DBQs) speed the Fully Developed Claims process. These forms provide medical information that is directly relevant to determining a disability rating and ensure that VA’s ratings specialists have the precise information to assess claims. Private and VA medical providers are qualified to complete these forms. If you’re filing by mail, ask a VA or private provider to fill out all applicable DBQs (find them by form name or symptom name) and fax or mail them to the regional office. If you’re filing electronically, gather completed DBQs from your medical providers and upload them through the eBenefits system. FDC Checklist for Disability Compensation Make sure your Fully Developed Claim is right the first time by following this checklist, depending on the type of claim you are filing. Step 1: Log on to eBenefits.va.gov. Click "Apply for Benefits". Click "Apply for Disability Compensation". Start by answering questions about your claim. Hit "Save & Continue" to preserve the date from which VA may be able to pay you if your claim is approved. You have a year from the start date to gather evidence and submit the claim. VA will not process your claim until you hit "Submit". Step 2: Tell us about your Federal/State records: Tell us if you receive Social Security benefits for a condition you are claiming. Tell us where your military medical records and/or military personnel records (OMPF) are located (If you have copies, submit them). Identify all (if any) relevant medical records held by a Federal agency, such as the Social Security Administration, so that VA may obtain these records for you. Include the date ranges of your medical treatment records for your claimed conditions. You may also submit copies of these records if you have them in your possession. For members of the National Guard or Reserve components, include copies of all relevant treatment and personnel records in the custody of your unit(s). Step 3: Gather non-Federal records (as applicable): Request and submit copies of relevant private medical treatment records from your private medical provider. If you are claiming a disability as a result of an incident that you believe is not recorded in your military records, then submit statements supporting your claim from you, family, friends, clergy members, law enforcement, or other persons who you may have spoken with or who have knowledge of your claimed medical condition(s) and how/when it occurred.

(cont) Step 4: Choose Your Type of Claim: Original Disability Claim An original claim is the first claim you file for disability compensation from VA and can be submitted at any time after your discharge from the military. However, you are encouraged to submit your claim as soon as you are able to ensure all available documents are on hand. Evidence required: Medical evidence of a current physical or mental disability; AND Evidence of an event, injury or disease in service; AND Evidence of a link between your current disability and the event, injury, or disease in military service. Medical records or medical opinions are usually required to establish this relationship. New Disability Claim A new claim is a claim for service connection for a disability that has not been filed before. Evidence Required: Medical evidence of a current physical or mental disability; AND Evidence of an event, injury or disease in service; AND Evidence of a link between your current disability and the event, injury, or disease in military service. Medical records or medical opinions are usually required to establish this relationship. Reopened Disability Claim This is a claim already filed that VA could not grant and the decision is over one year old. Evidence required: To reopen these claims, VA must receive new evidence that has never been considered, which pertains to the issue claimed. Claim For Increased Disability This is a claim for an increased evaluation of a disability that VA has already determined to be service-connected. Evidence Required: Current medical evidence that shows your disability has gotten worse. Secondary Disability Claim This is a claim for a disability that developed as a result of or was worsened by a disability which VA has already determined to be service-connected. Evidence Required: Medical evidence that shows you have a disability that was caused or aggravated by an already established service-connected disability.

(cont) There are other special issues where additional forms and evidence may be needed: Individual Unemployability as determined by VA: In addition to the evidence above, you must also submit: A completed VA Form 21-8940, "Veteran's Application for Increased Compensation Based on Unemployability" (download form), A completed VA Form 21-4192, "Request for Employment Information in Connection with Claim for Disability Benefits" (download form,) completed by your last employer, AND Medical evidence that a service-connected disability prevents you from obtaining or maintaining substantially gainful employment. Post Traumatic Stress Disorder: In addition to the evidence above, you must also submit: A completed VA Form 21-0781, "Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (download form)," OR If claiming PTSD based on personal assault, VA Form 21-0781a, "Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder Secondary to Personal Assault (download form).“ Step 5: Upload the documents: Scan all of the documents. Note that depending on how many documents you have you may need to split them into smaller batches and then upload. Under the "Upload Documents" tab, select "Manage Files". Upload the documents. If you have an appointed Veterans Service Officer, your representative will be able to check your claim and make sure you have all the required documents. Once all records are uploaded and your Veterans Service Officer has reviewed the claim, verify that you have "No More Evidence" and click "Submit".

Dependency and Indemnity Compensation (DIC) DIC is a tax-free monetary benefit generally payable to a surviving spouse, child, or parent of Servicemembers who died while on active duty, active duty for training, or inactive duty training, or to survivors of Veterans who died from their service-connected disabilities. Parents DIC is an income-based benefit for parents who were financially dependent on of a Servicemember or Veteran who died from a service-related cause.

VA Travel Reimbursement Reimbursement for mileage or public transportation may be paid to the following: Veterans with service-connected disabilities rated at 30% or more; Veterans traveling for treatment of a service-connected condition; Veterans receiving a VA pension; Veterans traveling for scheduled compensation or pension examinations; Veterans whose income does not exceed the maximum VA pension rate; Mileage Reimbursement is at the rate of 41.5 cents per mile. These mileage subject to a deductible of 3 for a one way trip, 6 for a round trip, with a maximum of 18 per or the amount after six one-way trips (whichever occurs first) per calendar month. However, these deductibles can be waived if they cause a financial hardship to the veteran. The deductible is also waived for veterans traveling for scheduled compensation or pension examinations.

Social Security Disability How does the process work? How does it affect my medical insurance? Social Security disability, conversely, does not compensate disability claimants based on a partial loss of employability. You are either totally disabled or not disabled under this program

Pressing Questions on your mind QUESTION #1 NO (CLICK YES OR NO) INCORRECT Is it Legal? YES CORRECT! QUESTION #2 YES CORRECT Do I qualify even if I'm receiving VA disability? NO This is a state program INCORRECT! separate from the fed QUESTION #3 YES Can I still work if I collect SSD? NO QUESTION #4 NO INCORRECT taxable YES CORRECT! IS IT TAXABLE? You have to be 100% total and INCORRECT can not work if you receive this CORRECT! Unlike VA disability, SSD IS

Should I file? That’s up to you Social security Disability is your own income withheld as part of your tax withholdings each month. If you are considered disabled you are paid from the SSD fund account until you reach SS retirement age when the account changes to your regular Social Security account (its just a matter of different pots of money for payment purposes). It's not uncommon for veterans to have both Social Security and Veterans Disability claims going on at the same time. Alternatively, some veterans receive veterans disability benefits before applying for Social Security disability. VA disability benefits, also known as service-connected disability, is not based on income, so you can receive VA disability compensation and Social Security disability insurance (SSDI) at the same time. There is also VA pension, which is a needs-based program similar to Supplemental Security Income (SSI). VA pension is paid to veterans who have very little or no income and are disabled based on non-service disabilities. It is possible to receive SSI and VA pension at the same time.

Does Getting Benefits in one Program Help Getting Benefits in the Other Program? Overall, the answer is yes, but it does depend on your circumstances. VA approval can help get Social Security disability. If you are the recipient of a very high VA rating (70% or higher), then your chances for success on your Social Security disability claim are quite high. This is because another federal agency has already found that you are either incapable of work or you are at a level where full-time work would be very difficult. One advantage many veterans with high disability ratings is that, while VA only considers service-connected disabilities, the SSA will consider all impairments, whether they are service-related or not. Because of the similarity between a VA finding of unemployability and what it means to be disabled under the Social Security disability program, it is the rule in many federal circuit courts that VA disability ratings are entitled to “great weight.” (See McCartey v. Massanari, 298 F.3d 1072 (9th Cir. 2002); Chambliss v. Massanari, 269 F.3d 520, 522 (5th Cir. 2001); Brady v. Heckler, 724 F.2d 914, 921 (11th Cir. 1984); and De Loatche v. Heckler, 715 F.2d 148, 150 n.1 (4th Cir. 1983).) And one circuit court said that VA disability ratings were entitled to “substantial weight.” (Kane v. Heckler, 776 F.2d 1130, 1135 (3d Cir. 1985).) In addition, Social Security Ruling 06-3p says that the decision and the evidence used to make the VA decision “may provide insight into the individual’s mental and physical impairment(s) and show the degree of disability determined by these agencies based on their rules." All of this comes down to the fact that Social Security should strongly consider that you were approved for disability benefits in making its decision on benefits.

When do I apply? Note: If your considered totally disabled you should apply for SSD after you have received your 70% (or higher) disability rating from VA. VA disability results are viewed by the Social Security Disability evaluators but if you plan on applying for both you should wait a few months between the VA determination and filing for SSD so the system can update at social security. Why? Because the reverse is not true . So file VA first then SSD Social Security approval does not necessarily help get VA benefits. Unfortunately, if you are disabled under SSA rules, the VA may not give Social Security's decision as much weight, since it's not usually clear whether the disability is based on service-connected or non-service disabilities. Many veterans have a wide array of both types of disabilities, and the VA can be quick to attribute total disability to a host of non-service disabilities. The VA must be able to make a specific finding on what disabilities prevent employability. To convince the WA that the disability was caused by service-connected impairments, a veteran may need to hire a Vocational Expert to specifically attribute the unemployability to service-related disabilities.

Things you should know. Pitfall #1 Pitfall #2 Pitfall #3 Taxes Social Security Disability pay is TAXABLE income when filing your tax returns so if you are lucky enough to receive SSD have the Social Security Administration hold some back for taxes. Bulk Payment Health Insurance Just like with VA Disability you will receive a bulk payment upfront which is also TAXABLE Income so hold back at least 10% or more to avoid an April sticker shock. As with pay, health care benefits are tied together. This means that you will have to sign up for Medicare part A and B if you want to keep TRICARE. If you don’t, TRICARE will be notified by SS and TRICARE will cancel itself which could result in a 6 month delay to get signed up for Medicare A / B

Differences Between Social Security and Veterans Disability Total disability vs percentage of disability. One major difference between Social Security disability and veterans disability is that you don’t need to be totally disabled in order to be eligible for VA compensation. In fact, most veterans who receive VA compensation do not receive a total disability rating. Veterans can receive a compensable rating as low as 10% (and can have a rating as low as 0%). (In many cases, it makes sense to get a 0% rating even though its not compensable. The reason for this is that it means the veteran will at least have proven a service-connected disability -- which may deteriorate into a more serious problem and turn into a compensable disability. See Filing for Social Security Disability as a Veteran.)

Apply for SSD after receiving your VA determination if you receive 100% 2011 When you start receiving SSD call the social security office and have them hold back a monthly amount against taxes 1 When you receive the initial bulk pay hold back at least 10% for taxes The process for SSD 2 3 Or don’t sign up for Medicare part B if you intend on using just your local VA Hospital for care (just remember your TRICARE will cancel) Make sure you sign up for Medicare part A & B if you want to keep TRICARE for yourself (does not affect TRICARE pertaining to your family just you) UPDATE: TRICARE will no longer do referrals or keep a record of VA medications for refill. You now have to find your own doctor and use MEDICARE B as the primary with TRICARE as secondary for payment. 4 https://www.youtube.com/watch?v OvQFbwq4dNA&list PLGSYaZN04xzFCoEqDlY3n7xgWLh55vvDh

Decisions / Options to Healthcare Coverage Just use VA facilities (Cost: 0) 100% ers 100% ers 100% (VA) 100% (VA) Service Connect Service Connect VA facilities and TRICARE (Single: 282.60 per year) VA, TRICARE & Medicare Part B TRICARE 282.60 per year MEDICARE B: 121.80 Per Month (or higher depending on your income) Adding Up the Costs Everything is interconnected: If you want to keep TRICARE then you have to sign up for MEDICARE Part B. TRICARE premiums are taken out of your retirement check and MEDICARE B is taken out of your SSD check “see costs above”.

FINAL NOTES As a recent change, Tricare will no longer refer you to a specialist nor does it have visibility of VA prescribed medicine if you have Medicare parts A/B. Under new guidelines, you can directly contact a specialist and make appointments based on any medical recommendations of your primary care doctor.

Source References Burn Pit Registry http://www.publichealth.va.gov/exposures/burnpits/registry.asp Social Security Disability http://www.disabilitysecrets.com/resources/disability/disability-social-security/ overview-social-security-va-veterans-disability VA Disability Compensation http://www.benefits.va.gov/COMPENSATION/claims-special-index.asp The Benefits Delivery at Discharge (BDD) printable forms http://www.benefits.va.gov/compensation/dbq ListByDBQFormName.asp