P&T but scheduled for exam

P&T but scheduled for exam

Spentround
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Joined: 28 Sep 2017, 16:19

15 Nov 2017, 00:24 #1

I have a question that is puzzling me and my friend. He and I are both 100% P&T, however he just received notification for an upcoming scheduled exam. He is 100% for one medical condition and has additional percentages for other medical conditions. It is these other conditions that the VA wants him re-examed for. He does not draw SMC or anything else besides the regular 100% monthly pay. We are wondering why the VA would schedule him for an exam on these other conditions when he is not drawing SMC for any of them. The only thing I can figure is that the VA wants to close the door on some of these medical issues in case he passes as a result of them. Relieving the VA of having to pay DIC to his wife. Other then this I can't see why? Even if the C&P exam finds he no longer has these medical conditions, he is still 100% P&T with no future exams for his one static condition so the monthly payment would not change for him. Anyone have any idea what gives here?   
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nmfxstc
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Joined: 22 Jan 2003, 20:29

15 Nov 2017, 02:04 #2

Spentround wrote: I have a question that is puzzling me and my friend. He and I are both 100% P&T, however he just received notification for an upcoming scheduled exam. He is 100% for one medical condition and has additional percentages for other medical conditions. It is these other conditions that the VA wants him re-examed for. He does not draw SMC or anything else besides the regular 100% monthly pay. We are wondering why the VA would schedule him for an exam on these other conditions when he is not drawing SMC for any of them. The only thing I can figure is that the VA wants to close the door on some of these medical issues in case he passes as a result of them. Relieving the VA of having to pay DIC to his wife. Other then this I can't see why? Even if the C&P exam finds he no longer has these medical conditions, he is still 100% P&T with no future exams for his one static condition so the monthly payment would not change for him. Anyone have any idea what gives here?   
W/O knowing the particulars, I have no idea, but....I bet his VSO can find out most Ricky tic!!
Some mornings it just doesn't seem worth it to gnaw through the leather straps.
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SGT PAPA SMURF
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Joined: 07 Apr 2014, 21:25

15 Nov 2017, 04:28 #3

Based on you knowing his one condition is static, what are his other conditions status?

If they are not static that may explain the upcoming exam.
19D, SGT, E-5, ARMY100% IU P&T
SSDI--Appeal in the works


some days I believe it and see it...some days I can't find it through the levels of the pains physically and mentally




I am long-winded...but do try to put substance in it!!!
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rchap78101
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Joined: 31 Jul 2014, 18:32

15 Nov 2017, 05:30 #4

How would you know if there is a difference?  I am 100% P&T Schedular.  My award letter states "No examination will be scheduled in the future for your permanent and total disability/disabilities."  This was just above the Chapter 35 info on page 5, but page 6 shows 3 more disabilities.  Does that mean those 3 are subject to C&P?  Nothing noted in letter regarding static for any contentions.
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Spentround
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Joined: 28 Sep 2017, 16:19

15 Nov 2017, 10:12 #5

nmfxstc wrote:
Spentround wrote: I have a question that is puzzling me and my friend. He and I are both 100% P&T, however he just received notification for an upcoming scheduled exam. He is 100% for one medical condition and has additional percentages for other medical conditions. It is these other conditions that the VA wants him re-examed for. He does not draw SMC or anything else besides the regular 100% monthly pay. We are wondering why the VA would schedule him for an exam on these other conditions when he is not drawing SMC for any of them. The only thing I can figure is that the VA wants to close the door on some of these medical issues in case he passes as a result of them. Relieving the VA of having to pay DIC to his wife. Other then this I can't see why? Even if the C&P exam finds he no longer has these medical conditions, he is still 100% P&T with no future exams for his one static condition so the monthly payment would not change for him. Anyone have any idea what gives here?   
W/O knowing the particulars, I have no idea, but....I bet his VSO can find out most Ricky tic!!
NMFXSTC,

Neither he nor I have VSO's, we both managed to navigate our vessels through the VA canals on our own. I can say we both feel we faired well on our own. I know VSO's are highly recommended on this site, so perhaps it might be time to engage a VSO in case he or I for that matter have unforeseen obstacles in our future. 
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Spentround
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Joined: 28 Sep 2017, 16:19

15 Nov 2017, 10:28 #6

SGT PAPA SMURF wrote: Based on you knowing his one condition is static, what are his other conditions status?

If they are not static that may explain the upcoming exam.
Sgt Papa Smurf,

I suppose more information will assist in the conversation so I can say this much. He is rated 100% P&T for PTSD. He is also rated 10% for tinnitus, 10% for left knee (arthritis), 0% for left knee scars from surgery, 10% migraines, 10% fatigue and 50% OSA. The VA wants to re-exam migraines and OSA. As we talked I come to find out that he does not use his CPAP machine because he claims it not comfortable. I use one myself and can attest to it but I still use mine or at least go to sleep wearing it and sometimes wake up with the mask on the floor as I somehow knock it off during the night. But anyways back to him, he keeps going back to the sleep clinic at the VA to meet with a sleep therapist and low and behold. Nowadays the machine is like E.T. in that is phones home and uploads data so the VAMC can look at the sleep patterns. Well his CPAP machine shows no action for over 5 months now so I believe this might be why he is being called before the carpet to explain. The migraines I am not too sure about.

But again, my original question is why does it matter if he does not receive SMC and is receiving 100% P&T for his PTSD? Going to do a C&P for these other two items I think is a moot point because if they find him "cured" of these two items, he is still at 100% for PTSD. Might this be a case of him poking the bear and now its awoken and he must face it dead on? 
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donnau1998
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Joined: 14 Aug 2017, 15:38

15 Nov 2017, 12:53 #7

Speaking as a wife of a veteran that uses a C-Pap....firstly and as far as I am concerned...most important..is that if he is not using his C-Pap he is risking severe physical and mental issues including and possibly death. That finally got my husband's attention when his doctor told him I would wake to find him dead one morning due to failed heart from not getting enough quality/quantity sleep and constantly stopping breathing during the night. Secondly, if your friend is deemed cured of his sleep apnea there would be no need for the VA to supply his machines and replacement parts. These things are extremely expensive as we used to have to purchase. 

So I would imagine that the VA sleep clinic is looking at cost reduction for unnecessary hardware if he no longer "needs" the C-pap and also at his well being in that they see he is listed as needing one and is not using it according to the ET abilities of these machines.  
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Spentround
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Joined: 28 Sep 2017, 16:19

15 Nov 2017, 16:00 #8

donnau1998 wrote: Speaking as a wife of a veteran that uses a C-Pap....firstly and as far as I am concerned...most important..is that if he is not using his C-Pap he is risking severe physical and mental issues including and possibly death. That finally got my husband's attention when his doctor told him I would wake to find him dead one morning due to failed heart from not getting enough quality/quantity sleep and constantly stopping breathing during the night. Secondly, if your friend is deemed cured of his sleep apnea there would be no need for the VA to supply his machines and replacement parts. These things are extremely expensive as we used to have to purchase. 

So I would imagine that the VA sleep clinic is looking at cost reduction for unnecessary hardware if he no longer "needs" the C-pap and also at his well being in that they see he is listed as needing one and is not using it according to the ET abilities of these machines.  
Donnau1998,

I agree with what your saying. I actually have a friend who had a family member (son-in-law) pass away during the night because of sleep apnea. He was only 24 and had been married less then a year so it was a bad situation for the bride to find her husband lying dead next to her. 

I was not aware he did not use his CPAP until this weekend when we discussed his upcoming C&P exam. This is why I mentioned that perhaps the VA is looking to tidy up loose ends so they are off the hook for a DIC claim relations to OSA. I for one also struggled using the full face make so I keep going back and after trying a few other options, the best for me was the smaller cup that just covers the noise. But since I tend to open my mouth while sleeping, the air flow was leaving out my mouth before it made it past the throat. The sleep clinic issues me a strap that keeps my mouth closed and everything works fine now. Except for those few nights when I somehow manage to wake up with the equipment tossed on the floor. But this is rare nowadays. So yes I agree everyone with OSA should use their equipment and not risk having your spouse find your deceased body lying next to them.
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SGT PAPA SMURF
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Joined: 07 Apr 2014, 21:25

15 Nov 2017, 20:25 #9

Spentround wrote:
SGT PAPA SMURF wrote: Based on you knowing his one condition is static, what are his other conditions status?

If they are not static that may explain the upcoming exam.
Sgt Papa Smurf,

I suppose more information will assist in the conversation so I can say this much. He is rated 100% P&T for PTSD. He is also rated 10% for tinnitus, 10% for left knee (arthritis), 0% for left knee scars from surgery, 10% migraines, 10% fatigue and 50% OSA. The VA wants to re-exam migraines and OSA. As we talked I come to find out that he does not use his CPAP machine because he claims it not comfortable. I use one myself and can attest to it but I still use mine or at least go to sleep wearing it and sometimes wake up with the mask on the floor as I somehow knock it off during the night. But anyways back to him, he keeps going back to the sleep clinic at the VA to meet with a sleep therapist and low and behold. Nowadays the machine is like E.T. in that is phones home and uploads data so the VAMC can look at the sleep patterns. Well his CPAP machine shows no action for over 5 months now so I believe this might be why he is being called before the carpet to explain. The migraines I am not too sure about.

But again, my original question is why does it matter if he does not receive SMC and is receiving 100% P&T for his PTSD? Going to do a C&P for these other two items I think is a moot point because if they find him "cured" of these two items, he is still at 100% for PTSD. Might this be a case of him poking the bear and now its awoken and he must face it dead on? 
First I want to say I share you issues with the CPAP/APAP machine and love your ET analogy.

I should have be clearer, with you knowing that one condition is static; I was thinking you could see on the code sheet if the other issues in question of the re-examination are listed as non-static?  Then,  if this is a "normal" scheduled follow up exam (more than 2 years from but less than 5 years) from the date rated on the migraines and OSA or if there was records of improvement coinciding with these "non-static" disabilities for the scheduled re-examinations.

Now, if you say all the veterans disabilities are listed as static; then I am hoping one of the elder's chime in for a better explanation as to what may have prompted the re-examination of a static disability(ies).  Was there another claim put in after those percentages of disabilities you have listed above for the veteran?  

Where this would matter from what I know is if these are non-static disabilities (migraines and OSA); then it may be that their scheduled re-examination has come due.  While the veteran is still 100% for PTSD; if the other disabilities are non-static they may produce the current situation/re-examinations.  In the case these are non-static and they have worsened, this may open the door for SMC.  

When you find out the reasons, please update because if it is because of non use of the equipment through the ET phoning home; this information would let other veterans know about it as well.
19D, SGT, E-5, ARMY100% IU P&T
SSDI--Appeal in the works


some days I believe it and see it...some days I can't find it through the levels of the pains physically and mentally




I am long-winded...but do try to put substance in it!!!
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levelheaded4ever
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Joined: 06 Apr 2014, 02:45

15 Nov 2017, 20:30 #10

With the disabilities listed 100 plus 50+10+10+10+10 he is should be getting SMC-S Statutory Housebound (Single, SC disability evaluated as totally disabling (100%) with additional SC disability(ies) rated at 60%)
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Spunky
h3
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Joined: 23 Sep 2013, 05:41

16 Nov 2017, 04:27 #11

Issues do not receive future exams to "tidy up" issues that may result in DIC. DIC has zero bearing on how the alive veteran's claims are handled.

Period.
___________________
USAF (ret) 1991-2012
VBA Counselor 2014-2016
VBA RVSR 2016-current
90% SMC-K
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Retired TopKick
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Joined: 20 Aug 2012, 04:13

16 Nov 2017, 04:57 #12

Moved To P&T Forum
Retired TopKick
100% P&T + SMC-K
States Army (1974-2002)

"Never Make Anyone A Priority Within Your Life Whom Makes You An Option In Theirs!"
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bigcountry
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Joined: 10 Jan 2014, 03:11

16 Nov 2017, 05:22 #13

I wouldn't worry about the cpap check too much.  Even if he doesn't wear it, it doesn't mean he doesn't have sleep apnea anymore. Just go to the exam and see what they say.

bc
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Spentround
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Joined: 28 Sep 2017, 16:19

16 Nov 2017, 19:39 #14

SGT PAPA SMURF wrote:
Spentround wrote:
SGT PAPA SMURF wrote: Based on you knowing his one condition is static, what are his other conditions status?

If they are not static that may explain the upcoming exam.
Sgt Papa Smurf,

I suppose more information will assist in the conversation so I can say this much. He is rated 100% P&T for PTSD. He is also rated 10% for tinnitus, 10% for left knee (arthritis), 0% for left knee scars from surgery, 10% migraines, 10% fatigue and 50% OSA. The VA wants to re-exam migraines and OSA. As we talked I come to find out that he does not use his CPAP machine because he claims it not comfortable. I use one myself and can attest to it but I still use mine or at least go to sleep wearing it and sometimes wake up with the mask on the floor as I somehow knock it off during the night. But anyways back to him, he keeps going back to the sleep clinic at the VA to meet with a sleep therapist and low and behold. Nowadays the machine is like E.T. in that is phones home and uploads data so the VAMC can look at the sleep patterns. Well his CPAP machine shows no action for over 5 months now so I believe this might be why he is being called before the carpet to explain. The migraines I am not too sure about.

But again, my original question is why does it matter if he does not receive SMC and is receiving 100% P&T for his PTSD? Going to do a C&P for these other two items I think is a moot point because if they find him "cured" of these two items, he is still at 100% for PTSD. Might this be a case of him poking the bear and now its awoken and he must face it dead on? 
First I want to say I share you issues with the CPAP/APAP machine and love your ET analogy.

I should have be clearer, with you knowing that one condition is static; I was thinking you could see on the code sheet if the other issues in question of the re-examination are listed as non-static?  Then,  if this is a "normal" scheduled follow up exam (more than 2 years from but less than 5 years) from the date rated on the migraines and OSA or if there was records of improvement coinciding with these "non-static" disabilities for the scheduled re-examinations.

Now, if you say all the veterans disabilities are listed as static; then I am hoping one of the elder's chime in for a better explanation as to what may have prompted the re-examination of a static disability(ies).  Was there another claim put in after those percentages of disabilities you have listed above for the veteran?  

Where this would matter from what I know is if these are non-static disabilities (migraines and OSA); then it may be that their scheduled re-examination has come due.  While the veteran is still 100% for PTSD; if the other disabilities are non-static they may produce the current situation/re-examinations.  In the case these are non-static and they have worsened, this may open the door for SMC.  

When you find out the reasons, please update because if it is because of non use of the equipment through the ET phoning home; this information would let other veterans know about it as well.
Sgt Papa Smurf,

My buddy and I decided to take a trip on down to the VARO in San Diego yesterday to look into this matter a lot closer. When we got to the SD VARO we ran into a rep from DAV. We explained to him the situation and he asked us to follow him back to his office. When he got to his office, he made a call to someone within the building and we have our answer within minutes. It turns out the reason for a new C&P is not that the equipment called back to the VAMC and snitched on him. The reason was that 14 months ago my friend had Roux-en-Y surgery and he has lost 113 lbs since diagnosed with OSA. He told his PCP at his physical 2 months back that he stopped using the CPAP machine 5 months ago because he had lost so much weight and his wife said he no longer snored or could see him going through apnea episodes. So he is now going to be reevaluated to see is the OSA is gone. I don't recall who but someone on this forum keeps asking about weight when someone asks about OSA so there you have it, that poster is on to something, sorry I can't recall the name. As for the migraines, since it was not static, he is due for a recheck. This might sound like a bad thing to some but he and I agree if he no longer has OSA that is a big win for him. On a side note, he was entitled to SMC so the DAV rep filed paper work so he can get back pay going back to when he was entitled to receive it. This is a win all around for him, and he believes the migraine rating will remain the same since it has neither gotten better or worse, per his words.
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SGT PAPA SMURF
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Joined: 07 Apr 2014, 21:25

16 Nov 2017, 20:33 #15

That is good news for him regarding the signs of not having OSA.  I would ask for another sleep test to verify as I wouldn't think being asked some questions in a C&P alone would be as conclusive as the actual sleep test.  This would help identify the times his wife would not be able to monitor him consistently throughout the night as thorough as the machine all hooked up to him.  Again, it would be good news.

Cavmedic is the big advocate on the weight loss/OSA.  I believe the weight factor is a big part of it but not the total answer.  I am sure cavmedic has done way more research and understanding of it than me as I believe he also has a medical background of sorts.

Glad you were able to get with the DAV rep and got some answers quick!!!

Like you said, I would be happy to not be labeled with the OSA give up the money(don't get it now anyways as I have not claimed it) and the machine to have one less health problem.

Definitely a win win win for him!!!
19D, SGT, E-5, ARMY100% IU P&T
SSDI--Appeal in the works


some days I believe it and see it...some days I can't find it through the levels of the pains physically and mentally




I am long-winded...but do try to put substance in it!!!
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Spentround
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Joined: 28 Sep 2017, 16:19

16 Nov 2017, 20:42 #16

SGT PAPA SMURF wrote: That is good news for him regarding the signs of not having OSA.  I would ask for another sleep test to verify as I wouldn't think being asked some questions in a C&P alone would be as conclusive as the actual sleep test.  This would help identify the times his wife would not be able to monitor him consistently throughout the night as thorough as the machine all hooked up to him.  Again, it would be good news.

Cavmedic is the big advocate on the weight loss/OSA.  I believe the weight factor is a big part of it but not the total answer.  I am sure cavmedic has done way more research and understanding of it than me as I believe he also has a medical background of sorts.

Glad you were able to get with the DAV rep and got some answers quick!!!

Like you said, I would be happy to not be labeled with the OSA give up the money(don't get it now anyways as I have not claimed it) and the machine to have one less health problem.

Definitely a win win win for him!!!
Sgt Papa Smurf,

He has already had the sleep test done. I am amazed that he did not have to go to the VA or a contractor to have the test. Instead he said it was done by himself at home and the results uploaded to VAMC. When I had my test I had to go to a contractor and has all sorts of cables and probes hook up to just about everywhere but the family jewels. Glad to see technology is making things a lot easier to assess. And yes I am hopeful and praying that he is done with OSA, in his case as well he was not receiving compensation and as I have stated before, I will give every dollar back with interest in exchange for a clean bill of health.
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SGT PAPA SMURF
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Joined: 07 Apr 2014, 21:25

16 Nov 2017, 21:00 #17

I am curious about the results of the at home test if you can get that with consent and post without personal info.  He might have the info in his VA medical records if you all know how to view them through EBENEFITS or MYHEALTHEVET.  I too had the 20 cable hook up and took the test in a recliner at the VA hospital that really didn't recline much.

I appreciate the follow up from the VARO/DAV visit, that always helps when updating the results for the inquiring minds.
19D, SGT, E-5, ARMY100% IU P&T
SSDI--Appeal in the works


some days I believe it and see it...some days I can't find it through the levels of the pains physically and mentally




I am long-winded...but do try to put substance in it!!!
Reply