VA and Disabilities-What to prepare for before and after Retirement
I wrote this a few years ago as an AAR for my VA Ratings process. Some of the percentages and information may need to be updated the information is good to know.
DO NOT LIE on your VA claims. They will find out but understand what they are looking at and the process. Good luck Vets and stay safe.
VA Ratings and Preparations for Retirement
• First, you are doing the right thing by getting started now. I wish I had known what I am going to impart to you as I went about completing my military career. Even so, I have managed a compensation decision of 100% P&T-not bad for a first stab even though I did it through the IDES/MED process. 18 months of steady progress and preparations using the items below and learning 38 CFR book C were a huge part of my process. Use this process in an honorable way. This is not intended for you to cheat the system but don’t cheat yourself or your family.
• Get everything documented. Okay, ensure that every medical issue-past (if possible) and present (most certainly)-is reflected in your records. This includes headaches, twinges, sprains, aches, pains, muscle pulls, muscle strains, spasms, hemorrhoids-'-Everything! If you have had any kind of surgery-any numbness, limitation of motion, tenderness-anything at all resulting from your operation-get it documented. Too many Vets go into the VA Process saying they've been self-medicating-that it hurt, but they were too busy setting a good example for their troops to make an appointment at sick call or through TriCare. The VA does NOT accept any evidence unless it is in your medical records or from a doctor's written statement. In other words the Army may well appreciate your devotion to duty and your intense willingness to accomplish the mission, but the VA does NOT give a rat's ass!
For many VETS they have used TriCare for their doctor’s visits. If this is the case save every note, every prescription and then collect doctors notes and medical notes as much as you can. Even go back at a later date and get those civilian medical records again to verify you did not miss anything. You can take these to your Military facility such as LA Air Force base and have them uploaded into your military records. As you collect all of these documents organize them by date for future reference and filing. ·
• No matter how minor your ailment, especially if it is orthopedic, get it documented. For instance, if you twist an ankle or knee, strain your shoulder, or pull your back, get to the clinic and get it in your records no matter how minor you think it is. A simple ankle sprain or a back spasm can be worth 10% if you claim that ankle or your back as soon as you get out. Remember this, if it is in your records, you claim it, and you state it continues to bother you, they WILL award you for it. I have about a six separate issues for which I have been awarded 10%, most of those I only reported once or twice during my 26-year military career. Notice I underlined "continues to bother you”. This is because although you can make a claim for an issue that no longer hurts, you will not get a rating above zero for it. In addition if you get it recognized and awarded as service connection that issue will be taken care of by the VA after you get out.
• Ratings. Keep in mind, though, that if you exhibit even a small amount of pain or if, for example, you find it difficult to bend over or do a knee bend, then you should get a minimum of 10% for each disability. If it is your knees, you could get 10% starting for each knee, although it’s possible that the rating board could combine them into a single rating. (The VA rates in increments of 10% starting at 0%, anything over 5% is rounded up to the next 10). Also note that a 0% is still good, because that means the VA is granting service connection for that problem and if and when it ever flares up again you can make a claim for it. A good example of this is Hemorrhoids. If you had a single flare up for them in your records, but they are fine during the exam, it is common to get a 0% for them as a rating.
• No excuses! The VA doesn't care if you were too busy while you were active duty to get treatment for an illness or ailment. I've have seen and spoken with troops who had been injured in the field that had received treatment from field medics and never bothered to follow up and get the treatment entered in their medical records. Their only recourse is to go back and find that medic or corpsmen and get a statement from him. That can be very difficult if it happened years ago and the medic is no longer in the service. Lesson is get everything documented-the VA entertains no excuses.
• Tinnitus. If you have been exposed at any point in your career to loud noises, claim Tinnitus. It's easy to tell if you have it-go into a room with absolutely no noise, and if you hear a high pitched tone, or a ringing noise, you have it. If you ever qualified with a rifle or a pistol, you had enough exposure to have tinnitus. If you were around a flight line, that would do it as well. Most people have Tinnitus as they get older, and it only gets worse. Anyway, they can't tell if you don't have it-enough said. It' an easy 10 percenter If you are still on active duty, report it. Once you have it in your records its good forever.
• Mental Health. What I am about to tell you next is sensitive information, but it can possibly be worth thousands of dollars to you. If you have any mood issues or disorders, fight with your spouse or kids, sleep problems, feel angry or sad/depressed; please consider seeing the mental health specialists. Most service folk won't consider doing it, because of the negative stigma or concerns for their careers. Thing is, if you have this kind of anxiety or depressive disorder documented in your records, it is almost an automatic 30% award or more. I started seeing a psychiatrist within weeks of a traumatic experience and I was well rewarded for it. Getting help does not mean you are broken. You joined the military to do good things, but even we need help at times. It is not seen as negative anymore. Get the help you need and deserve!
• Additional info: Watch out for military mental health specialists that try to saddle you with a Personality Disorder or Temporary Adjustment Disorder. I don't know if they are in collusion with the VA or what, but these conditions ARE NOT COMPENSABLE! Any of the depressive or anxiety disorders not considered temporary ARE ratable as service-connected, so heads up.
• Traumatic Events? On the same note as above, if you have ever been involved with a traumatic event such as witnessing the death of a co-worker, your own near death or trauma, or have just been around a lot of that kind of thing perhaps because of your job such as a medic, and it has affected you psychologically in some negative way, see your mental health specialist. The VA might well award you disability for it. You can do it after you are out, but it is immensely easier to get these kinds of conditions approved for service connection if you get them documented while you are STILL in the service.
Okay, enough said on that.
• Individual Unemployability. Keep this in mind. If your disabilities combine to 70% or more and you have at least one disability rated at 40%, OR if you have a single 60% that prevents gainful employment, then your next step will be to apply for "Individual Unemployability." That is equivalent to 100%. In that case, if you have a couple of dependents or so, your monthly disability check (combined with your retirement if you have at least 20 years active service) will come to almost $3400-tax-free.
• Check out what an E6, E7, or E8 gets after 20 or so years. They make a lot less than that, and Uncle Sam taxes what they do make.
• The beauty of VA disability is that it is the same for an E1 as it is for an 06-your rank after retirement means nothing when it comes to your disability award.
• A drawback regarding Unemployability is if you have a 4-year degree under your belt. The VA, as a matter of course, ALWAYS turns a veteran down for Unemployability if he has a college degree with the rationale that he should be able to do at least clerical work. There were a 77 year old WWII veteran that fought tooth-and-nail to get a rated 100% Unemployable because he had a degree. Mind you, this guy had a heart condition, was mostly blind, was a full blown diabetic, and constantly experienced mini-strokes where he would black out at any time even while he was walking! The VA finally relented and we got him his full 100% IU. What a bunch of weenies the VA can be at times!
• Percentage? Also, as I implied above, please understand that a disability "percentage" is not a percentage of your retirement pay as many folks suppose. Instead, it reflects the percentage of your body affected causing you to be unemployable, and that's where the monetary compensation comes in. By a simple formula, it works out to be a percentage of your body and your ability to use it to be employed. What it actually reflects is a number of dollars per month, or a symbolic number when it relates to a single award before totaling them up into an overall percentage. For instance, if the VA awards you 40% disability overall, that 40% is a dollar amount in a table listed under 40%. It increases depending on how many dependents you have, and it is not affected at all by what rank you were when you retired. Also, if you get awarded five awards each for 10%, another for your back for 40%, and then 30% more for a mood disorder, DO NOT try to simply add these up to get an overall award. There is a table called a Combined Ratings Table that the VA uses to total up the individual awards and it is NOT linear. Plus there is a very crucial formula aspect called the "bilateral factor," which must be figured out first before the rest of the individual disability ratings are totaled by using the Combined Ratings Table. To the untrained, it all seems complicated. It's why you need to find a Veterans Service Officer to help you.
You may also use the Ratings calculator at https://goodcalculators.com/va-disability-calculator/ to get an idea. This is a very good tool to use.
• Former Spouse. A positive point on disability is the possibility that you have an ex-spouse out there waiting to take possession of half your retirement pay. By law, she cannot get your disability pay unless she goes to court and goes after you for child support-this is called apportionment. Even then, she can only get a percentage and it's a lot less than half. So, whatever of your retirement pay your disability pay offsets, that amount that is Disability Pay is safe from your Ex. The more the VA pays you, the less she can get her hands on. Of course, once you start receiving 50% or more, then she will also make out because in ten years she will have your full retirement check available, same as you do. Oh well, you will still get more than you would have. It's the difference between a full glass and a half a glass-but enough of this! Speak with the lawyers before you get out if this is a concern. Different States have different ways of figuring your monthly debt on this so do your homework by each State.
• Retirement Physical. When you retire, I wouldn't worry about whether or not the Army actually does your retirement physical, because it doesn't really matter. As far as your retirement physical goes, the Army won't really look for anything wrong with you anyway. The only reason the military services do so-called retirement physicals is to fill a square and it's mostly cursory. The examining doctor will have you fill out a form that has you describe your current medical issues that you plan to claim for from the VA. It will help you to have already gone over your records with a fine-toothed comb and pre-write EVERY item you intend to claim from the VA. Have this list with you when you go in for your physical. As I said, I would go to the VA without first getting a full-blown physical done by your service. Going through an IDES/MEB you will may have to go through a Military physical in the end. Stay in charge-stay proactive!
• Find a Service Officer to represent you. Before you make your initial claim at a VA Regional Office, contact a well-trained VA Benefits Service Officer also known as “VSO’s”. These people do NOT work for the VA-they work for YOU! The VFW, DAV, American Legion, etc., all those organizations provide Service Officers. Keep in mind these folks are not supposed to charge you for their help-most of them get paid from local city, county or state funds to assist Vets.
• I am convinced that the VFW does THE best job of representing veterans and helping them get their VA benefits. They are the best trained and the best informed.
• Call around, interview your potential Service Officer, and ask about success stories. If he acts like he doesn't have time for you, find someone else. Many folks try todo it on their own and they get beat down by the VA system, mostly out of ignorance. Or, they get an award and don't ever realize how underrated they actually are. How does it go, "You don't know what you don't know!"
• It's not supposed to be adversarial, but it IS! The VA Disability System is complicated, convoluted, and time-consuming. I know folks who have struggled through it, got what they sought after many years of fighting, and could have received the same award first time if they had used representation from the start.
• A good Service Officer will act exactly like your lawyer-a good lawyer of course (I know, that's contradiction in terms).
• A real crappy thing is that most veterans are NOT told of the existence of Service Officers during their TAP briefings. I am finishing up my Medical retirement and although we were briefed by what I thought at the time was a very informative VA Representative; HE did NOT mention once the need for a veteran to attain the services of a Service Officer in the veteran's quest for benefits. If he did and I missed it then it was brought up very briefly. Is this a conspiracy? NO I don’t think so but I feel more attention needs to be placed on this subject.
• Maximizing your disability rating is all about strategy! Get with your Service Officer Representative and map out what you want. Make two copies of every page of your active duty medical records BEFORE you get out. One copy you will submit to-the VA and you will keep the other copy. Get a highlighter and mark every medical issue, the date, the inclusive dates of treatment, the clinic and its address, and the doctor or clinician involved. You will need all this info when you make your claim. Then, using the format provided in the VA Form 21-526 (used for initial application of benefits) make a table just like the one shown in the form. The one in the 21-526 is not even a page long and the blocks are too small for the information they ask for. I suggest you do this on a computer using an application like Word or Excel that allows you to make tables. List each and every medical issue per line. Once you get them all loaded, group them together by issue still in chronological order. Do not worry about listing too much. When I filled out my form I turned in 12 pages of disabilities and I used a font of only 10! ·Overwhelm the bastards with your preparation! Most veterans do very little to prepare, so the VA workers that receive yours will be very impressed and in fact very appreciative. In reality they want to do what's right for the veteran and they love it when we make it easy for them to do exactly that. You being prepared means more valid ratings and more money to you. If you average out your VA disability over 30 years (I retired at 51 and expecting a life span through 80) you will find it comes out in the millions. Don’t short change your body or your family by not being prepared.
• Get Every Test You Can!!! This bullet is very important, so read this one and its sub bullets carefully.
• What you want to do is to have every possible assessment, lab test, and procedure done to you while you are in or within a year after you are out.
• For example, if you have a bad back and an MRI to show any kind of disk abnormality, it may be worth 40% depending on the pain and limitation of motion. And remember, if any problem is discovered during the first year of your retirement, it IS SERVICE-CONNECTED, and it is money in the bank
• The bad thing is that it works the other way as well-if you find something wrong with you 366 days after you get out, it is NOT service connected.
• At the time I was getting my initial evidence together I was living in Southern California but had TriCare Prime Remote and I had access to unlimited TriCare. I merely had to suggest to my doctor that an MRI would be nice and I had an MRI within a week. My TriCare doctor took an x-ray and it really did not show much wrong with my spine. THEN, he had an MRI done and lo and behold it definitely showed multiple disk problems. Any kind of disk problem on film is huge when it comes to a rating. (Unfortunately TriCare has changed and has ceased to be so forthcoming. In fact it's become a nightmare, but I already used it to get rated so thank goodness for that!)
• Thing is, neither the VA nor TriCare in the good old USA will want to rush to getting an MRI accomplished. In the states, before a doctor will order an expensive procedure or test, he wants to be convinced that it must be done. This means you might have to complain about your back, or whatever, continuously until your doctor relents and consents to the cost of the test. What happens if a year passes before you can finally convince your doctor to tell TriCare that you need an MRI? The answer is you lose the possibility of getting service-connection and that sucks! Stay vigilant if the problem remains and causes pain.
• Of course every time you complain about a twinge, or a pain, or a pang, that is EVIDENCE, and it is no little thing. My advice to you is NOT to worry about being a "sick call ranger" because believe me, the Air Force, or the Army, or the Navy, is NOT going to be there for you once you get out. Take care of getting all your problems documented while you are in, and once your service washes it’s hands of YOU the Veterans Administration can start to take up the slack. Hey, you deserve it!
• Do NOT wait to file! Let me stress a point on the importance of not waiting years to file for your disability by describing what the VA requires to grant service connection for a disability.
• First, you must have had the problem while you were on active duty or by presumption, have it diagnosed within one year from the day you got out.
• Second, you must have the problem currently, even if it is simply a vestige of the original problem, such as a scar. I have a total of 9 large scars and it is all documented with the VA.
• And finally, you must show nexus, or that you were experiencing the problem over the time frame between the day you got out up to the present. Some veteran’s wait 4 or 5 years or more to file and they can show absolutely no evidence of treatment for the disability over those years. By the VA's rules, they can deny service-connection to the veteran. The rationale is that the problem the veteran is experiencing might not be the same problem that was shown in the veteran's medical records. Sure it sounds far-fetched, but the more time that goes by, the easier it is for the VA to say "No!" based on this way of thinking and they do it all the time.
• You CAN appeal. Keep in mind that if your initial VA decision is not to your liking that you can appeal it. You have the advantage because you can continue to acquire new medical evidence, and every .time you do, the VA is required to reassess your claim. Also, after you have been awarded, you can be reassessed after 2 years or whenever you feel that your condition has become more severe. Basically, it is a never-ending process until you get what you want-that is the beauty of the disability system. I have run into scores of vets who never pursue their claims past the original award, mostly because they didn't know they could or just figured it would be too hard. In my opinion, if they want to be wimps about it, then they get exactly what they deserved! With this though you need to remember that filing an appeal, additional issues or for a rating increase will allow the VA to reassess all of the claims. So if you come out of the gate with 100% you should leave it alone unless you have other major issues that you want recognized. In other words if you get 100% don’t go back and file for a hang nail issue. This may go the wrong way for you.
• Use the Internet. Here's a new suggestion that I am freshly adding to this list Go on line to the 38 CFR (US Code of Federal Regulation Book C) https://www.benefits.va.gov/WARMS/bookc.asp and become familiar with it. It is what the VA uses in adjudicating ratings for veterans. It includes all the possible disabilities, the codes assigned to those ratings, the various levels of severity, and a whole host of other valuable information. Use this info to first figure out what level you should be awarded for each disability, and then when you get your initial ratings you can compare what they give you to what they should have given you.
• If you file a "disagreement" it is very useful to quote passages from the 38 CFR to show them you know what you are talking about.
• Also, you can print out the ratings descriptions and show them to your doctor to see if he thinks you meet the next higher level of ratings severity. It is useful to know that the VA almost always underrates the veteran on his initial application and they actually seem to expect the veteran to challenge them for the higher level. Usually, if the veteran provides the pertinent evidence, the next ratings board WILL rate in favor of the veteran.
· • The VA loves to use only their doctors for evidence, but you can use your own sources of evidence to refute or rebut the VA doctors.
• Personally, I don't trust the VA doctors because they work for the "enemy!"(/ say
that tongue-in-cheek, but there is some truth to my cynicism).
• As I said above, an entirely different set of raters will evaluate your disabilities when you go through to the next level of the appeal process and they will definitely take your doctor's evidence to heart and usually give you, the veteran the benefit of the doubt.
• Here's what I've learned over the last year, "Perseverance Always Works in Favor of the Veteran." The VA seems to respect a man that won't take "No" for an answer and doesn't quit.
• Again, make two copies of your medical records now! It's not too early to start. Go through it with a highlighter. Annotate on a separate sheet all your issues, the dates, doctors, clinic, address, etc. Get a copy of a VA form 21-526 so you will know what info they will want. Start filling it out. Then every time a doctor, PA, or Lab Tech sees you, go and obtain all the documents generated. It sounds tedious, but it will be worth thousands of bucks to you in the not too distant future.
• Get it right! If you are sent to a civilian specialist, ensure the civilian doctor writes a complete summative and that it makes it into your records. Read it yourself and make sure it is correct and complete. If you have to, you can go back to the doctor and ask that the statement be amended or have a follow up done to more easily support your future VA claim. I did this with all my civilian specialists, and even with the service doctors. Most of them are well aware that what they write has far-reaching consequences for you (especially if you tell them!), and they will want to do whatever they can to help you.
• Make copies, make copies, and make copies. Once you have a complete set of your medical records and they are ready to turn in with your case to the VA, make yourself your own copy. This goes for every single piece of evidence or VA Form you fill out and turn in. The VA is notorious for losing paperwork. They are for the most part very well trained, responsible, and responsive BUT they have a lot on their collective plate. Make it easy for them to say, "Yes," by knowing what it is they need to help you. And, if they happen to misplace a piece of your evidence, you can help them by being able to replace it.
• Vocational Rehab (VRE). This is a big deal and worth some money. If you get a combined rating of 20% and sometimes as little as 10% depending on the problem, you can qualify for Vocational Rehabilitation. This is a great deal for you younger guys who didn't pay into the new Post 911 GI Bill or are too young for the old GI Bill like I am now using.
• First you apply for it after you get your disability rating of at least 20%. You will speak with a VA Voc Rehab counselor who will work with you on what vocation you want to pursue.
• The rules have become a bit more stringent lately because they actually try to see if you actually ARE gainfully employable even with your current disabilities. You need to stay one step ahead of them and be able to explain why you are not, or show that you are not by applying for jobs and being "brutally" honest with the employer that you don't really want to hire you. Sounds like you are playing a game and you are.
• However, if your disabilities are severe enough, such as a bad back and knees, so that you cannot work anymore in your original profession that you did in service, then you are home free. I was a HAZMAT and Homeland Security soldier and that is no longer possible. My career had to change.
• Once accepted to the program, the VA will pay you a stipend to live on, and all your school expenses. It's not quite as good as the GI Bill, especially if you are going to school in a place where matriculation fees are low but it is pretty substantial and well worth the hassle of pursuing.
• What can work against you however is if you obtained a 4 year college degree while you are in service, especially if this degree should make you employable in the eyes of the VA
• What it comes down to is that simply being at 20% does NOT guarantee a veteran will be accepted into Voc Rehab-you must strategize.
• And last but NOT least: Here are the last bits of advice on what to do during your VA Compensation & Pension (C&P) physical at a VA clinic or hospital.
· Don't take any pain meds for as long as you can stand it before you get there.
· You want the doctor to see you in your most "tender" state. If there is any time to "act like a big baby" then this is it! The doctor will probably ask if you have been taking them and it is up to you if you are going to "fib" or not. I can't and won’t tell you what to say, but use your "bad boy" common sense and "error" on the side of what is going to benefit you.
§ Look, here's the situation: the VA doctor will look at you for ONLY a few seconds and if during that brief time you don't happen to be displaying any of your symptoms or they are not so bad as usual, then as far as the VA is concerned your problem does NOT exist or is as trivial as you showed at that specific time! It's not right and THAT is why, understanding this, it is too your benefit if your body displays to the highest severity as possible ALL of the symptoms of the disabilities you are claiming. If you can control this at all, then do so.
§ When any VA staff member asks you how you are, be careful NOT to respond with an unthinking "Fine." Say anything, but not "Fine" or "Alright." They are evil; they will ask you how you are, and if you say you are "Fine" that is exactly what they will write in their worksheets. You are not fine at all. You are hurting and they need to know that. Put your pride aside and be honest about your conditions.
§ When the doctor checks your joints for limitation of motion, DO NOT try to show how tough you are. On the contrary, their own regulations have them observe you for any sign of pain at all, such as a wince or an utterance reflecting soreness or stiffness. There is no test for pain; they have to go completely on your reactions and what you say. I cannot state too much how critical this is. If you don't let them know it hurts, they won't know! This pain issue is VERY IMPORTANT! I recommend that as soon as you get to a point where it starts to hurt, tell the doctor immediately that it's starting to hurt! I cannot over emphasize this!!!!
· When talking to a psychiatrist, let it all hang out. If you feel emotion, let the shrink see it. Then again, if you experienced an event that should be emotional and you feel nothing, THAT also shows psychological issues. Don't fake it, but don't hold back either! They will ask if you have considered suicide. Be honest. Although I couldn't get myself to fully say "yes," I told him that I had honestly considered the thoughts and I said this with a straight face.
· If you have any orthopedic devices, wear them to your exam. This includes braces, supports, corsets, wraps, etc.
· Bring ALL your medications with you, including creams, analgesics, ointments,
pain pills, etc. This has more impact than simply describing what you take or have had prescribed, besides, you might forget.
· Some the items above were taken from a VSO who is also on social media sites on Facebook. These can be very helpful but be careful to verify what they are stating by doing your homework. Study up, get prepared and always stay vigilant to what your body is telling you throughout your time in the service. When you retire you need to make sure you and your family are taken care of and it is not the time to hope for the best. It is time to buckle down and get the job done one last time. Be honest and be forthright but don’t be dismissive. I live by the Army values and I used that during all of my visits and my claims process. This entire paper is for those that want to do the right thing. As with any advice it can be taken and used in a dishonest way. With that said claim true issues that happened to you while in the service and get what you have earned. You are not taking away from other Vets and you are not being a hero by not claiming issues that have or are hurting you. They will only get worse as we get older and you and your family are worth every penny.
· After 26 years of service with 22 being active my time has come. I want to thank each and every one of your for what you have done during your time. Find peace in the fact that you did make a difference and you did a lot of good while in. We are all one team and one person not matter the job makes a difference. Enjoy your years after service. Peace be with you all and God Bless.