Explain VA Disability to me like I'm 5.

[Chicken]

I know there are a lot of topics that discuss VA disability here and there, but didn't se anything specific to it.. unless I completely missed it while searching on my phone at 3am.

As flyers, we document nothing.  I decided 3 years ago, prior to retirement, to start documenting everything.  This eventually led to me being DNIF and never flying again but also helped in getting 100% disability from the VA.  My 100% was from nothing big I claimed.. just a bunch of little aches and pains that added up to 97%.

When I got my notification letter, I noticed a number of items on there that are "deferred".  I called the VA and asked them what that meant, what was needed from me, what the way forward was and I got a vague answer of "they probably need more info".  That's it.  No path forward, no outline of what is going to happen, just a flat out guess.  Anyone have any idea what I am supposed to do with that?

I also didn't see anything specific to 100% P&T on there.  From what I read if you have a combined rating over 70% and one item at or more than 40% you should be P&T.  However it doesn't say anything in the letter.  Are they waiting for the deferred items to be finalized?  I also asked the VA about this and the answer was "well you're 100% so you should be P&T".  While I want to believe that's correct I don't think that's exactly how that works.  Any ideas?

I also have some things not mentioned in the letter at all like insomnia.  I've been diagnosed with severe & chronic insomnia and have had it heavily documented over the last 3 years to include sleep therapy, sleep restriction, meds, etc.  Yet it's not even mentioned in the letter... not denied, not awarded at least 0%, and not deferred.

 

On a side note, I was surprised at a number of things I got compensated for and the amount I got for them.  I was also surprised at some things they combined (IBS & GERD combined) and things I was denied for.  If anyone is starting to go through this feel free to hit me up with questions.  I started telling folks, particularly flyers, to start at least 2 years from retirement, preferably 3 years.  Additionally, things I went DNIF for are not even included in that rating FWIW. 

[brabus]

What is P&T?

[Chicken]

1 minute ago, brabus said:

What is P&T?

permanent and total.  My understanding is that I have 100% for life and no further evaluations required.  It's also a requirement for some benefits in some states for property tax exclusion.

[SocialD]

There is no explaining any of it other than PFM.  An admin master sergeant just retired from my base after a career of clerk work, where he only deployed once, to a desk at the deid.  Dude has 100% disability.  Meanwhile, an old fighter pilot who has deployed countless times and can't look behind him without turning his entire body around is sitting at 40%.  He who complains/documents the most, seems to end up with a high rating.  

[Chicken]

2 minutes ago, SocialD said:

There is no explaining any of it other than PFM.  An admin master sergeant just retired from my base after a career of clerk work, where he only deployed once, to a desk at the deid.  Dude has 100% disability.  Meanwhile, an old fighter pilot who has deployed countless times and can't look behind him without turning his entire body around is sitting at 40%.  He who complains/documents the most, seems to end up with a high rating.  

A lot of it is your C&P exam as well.  I didn't even know the range of motions test started until he pulled the protector out and started measuring.  I think I was expecting some sort of commencement ceremony.  Anytime I felt pain or even strain I said I can't move it anymore... and that's what they want.  When you feel pain or discomfort... not to power through it.  

I spent 2 years documenting and even built a spreadsheet to list all my ailments... I always ignored my plantar fasciitis but when it came down to it I got 30% for it.  It was the last year on skillbridge that I found out a bit more about it.  The guy I worked for was a recruiter and got 100%.  But he provided me with some insight on the final 6 months of the process and exams. 

Edited March 28 by Chicken

[uhhello]

I had a bunch of deferrements.  No follow on appts, they just forwarded my records to the proper specialist needed and they gave rating after that review.  It was a few months after my initial rating.  For flyers its def a catch 22, needs to be documented to show a history of it but if you do, you probably aren't flying anymore depending on the issue.  

[Chicken]

For me they deferred a few MH things which were the DNIFing ones.  No idea why as they've been documented for years.  They also deferred dry eye syndrome thought.. wtf?  They still gave me a rating with those being deferred... I assume because I already met the 100%.  But how does insomnia just completely drop off the claim?

[HeloDude]

19 minutes ago, uhhello said:

I had a bunch of deferrements.  No follow on appts, they just forwarded my records to the proper specialist needed and they gave rating after that review.  It was a few months after my initial rating.  For flyers it’s def a catch 22, needs to be documented to show a history of it but if you do, you probably aren't flying anymore depending on the issue.  

It kind of baffles me when I read on FB how many guys claim PTSD or something mental health related for VA claims and then all of a sudden are concerned about how it will affect their FAA medical.  I know plenty of guys who are 100% and have their class 1, they just just have a ton of little things to claim, the vast majority of which are muscular skeleton issues, but nothing mental health/sleep (other than maybe sleep apnea) related.  I do hear of some guys who have PTSD and have a special issuance (ie FAA waiver), but they can definitely be tricky/time consuming to get and depends on severity, symptoms, etc.  

My overall advice:  Like others have said, start 2-3 years before separating/retiring in getting all your aches and pains well documented, and hopefully some care if it can help.  If you have something mental health related in your records that you think shouldn’t be there/has improved, etc then spend time getting the appts and documentation done while you’re still AD and my guess is it will be a lot less cumbersome getting it approved with the FAA if you want to continue to fly.  But in the end, if you truly need help with mental health concerns (and you probably know if you do), then please get your help—you deserve it.  Your life and well being, and that of your family, is much more important and valuable than being in pain/completely miserable while flying post military.  

[Biff_T]

4 minutes ago, HeloDude said:

But in the end, if you truly need help with mental health concerns (and you probably know if you do), then please get your help—you deserve it.  Your life and well being, and that of your family, is much more important and valuable than being in pain/completely miserable while flying post military.  

This!

[Sua Sponte]

Here’s some good advice, keep your rating to yourself. There some veterans, usually former grunts from the Army and Marines, who assume one has to be a quadriplegic to have a high VA rating. This really goes for 100 P&T. 

[SocialD]

10 minutes ago, Sua Sponte said:

Here’s some good advice, keep your rating to yourself. There some veterans, usually former grunts from the Army and Marines, who assume one has to be a quadriplegic to have a high VA rating. This really goes for 100 P&T. 

 

I can't disagree with keeping it to yourself unless specifically discussing it within trusted agents.  However, it's not our problem that their assumptions are wrong.  It's not about what someone thinks is fair, it's what the law/gov says is fair.  

[Sua Sponte]

5 minutes ago, SocialD said:

 

I can't disagree with keeping it to yourself unless specifically discussing it within trusted agents.  However, it's not our problem that their assumptions are wrong.  It's not about what someone thinks is fair, it's what the law/gov says is fair.  

It becomes your problem when they maliciously file fraud complaints against you to the VA IG and they start investigating you. It’s more common than you think.  

[HeloDude]

34 minutes ago, Sua Sponte said:

It becomes your problem when they maliciously file fraud complaints against you to the VA IG and they start investigating you. It’s more common than you think.  

While that’s good advice (also not a bad idea to always keep your medical situation to yourself others than who need to know/those you can trust)…just because someone “looks fine” doesn’t mean they are, and the records and exams will speak for themselves.  But yes, if mean people are wanting to try and screw you, then it’s best to keep the information closer to yourself.

[uhhello]

I lucked out without really knowing it.  Over the course of my career I went to the doc many times complaining of macular/skeletal issues but never did anything to really fix it after talking with flight doc.  All that documentation really helped versus not having anything on record and trying to claim legitimate issues.  You can go to the flight doc and state xyz is hurting but getting MRI/X-rays and what not can be avoided.  In my experience. 

[Lawman]

Tip I got from my chiropractor (Former SEAL):

Document things that happen to you any time the military made you be there, that time you rolled down a hill at unit mandatory fun, that time you tweaked your groin jumping down off an aircraft… just everything that could have contributed to the condition you find yourself in as you are older.

In that documentation name possible witnesses, dates and times, and then digitally sign the document. Stow it away in your personal email.

If you find yourself in a fight with the VA to review your final total these documents effectively serve as evidence to force them to reevaluate your number, and you can hand them one at a time and force multiple reinvestigations of your condition.

This is what he had to do because all of his injuries are heavily redacted from his time as a SEAL, only his career ender made it into the normal medical records. All those times he rolled an ankle in a place he couldn’t go to sick call or “fell” off a roof/truck/etc… that stuff was never covered. He just successfully got his rating up to 100% so no more property tax in the state.


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[B52gator]

The VA...the benefits side anyway...wants you to go away/not put up a fight.  So they either: don't allow for service connection or they underrate your service connected disability.  They are counting on you not putting up a fight.  I've been out for 16 years now and I'm still claiming things/battling the VA.  If you get denied, appeal.  Get more evidence, submit applicable research studies and VA case law, get doctor(s) to submit medical opinion letters.  If your appeal gets denied, submit for a higher level review.  Again, the VA wants you to go away and is expecting you're not gonna put up a fight. 

Here is what has helped me:

-Document everything while you're in.  You don't necessarily need to go to the flight doc, but it does help to get documented and makes it easier.  When writing a personal statement for each claim, you absolutely should write a personal statement.  Because I never went to the flight doc for fear of DNIF, I wrote in each personal statement something to the effect of "because I didn't want to risk a career in flying, I did not go to the flight doc for this condition" in a couple I even wrote, "flight doc advised me not to discuss these symptoms because it would mean removal of flight status".  When writing your personal statement, I'm not saying to lie but embellishment can help. Also, research the rating schedule for the condition you're claiming.  Bumps from 10% rating to a 30% or 50% rating can be huge.  Make sure the verbiage in your letter and your symptoms match up with the different ratings.  If you're close to a higher rating, that's where the embellishment might come in.  Again, not saying to lie or commit fraud, but you have to fight for yourself and describe your symptoms when they have been at their absolute worse.  

-VA docs will diagnose you with whatever you might have going on, but they will not write an "in my opinion" (IMO) or nexus (memo connecting your condition to the service) letter.  Go to a private doc for that or there are services you can pay to have that done.  

-Speaking of letters...get friends, co-workers, fellow flyers, family, to write "buddy statements" for you.  There is even an offical VA form for this.  Have them state that they witnessed you have symptoms related to the condition you're claiming.  

-Secondary conditions are where you can really do well.  For example everyone should claim and get service connected tinnitus.  Let's say you get migraine headaches, but didn't necessarily get migraines while you were in.  You can claim migraines secondary to service connected tinnitus.  There are many many examples of secondary conditions connected to service connected disabilities.  

-r/veteransbenefits on Reddit is an excellent source of info.  I've used it primarily for my research and help filing my own claims.  Have never used a VSO or paid service.  There are also a lot of good YT channels.  DO NOT pay for a service like VA Claims Insider.  I'm not a smart guy by any means and I was able to do all of my claims myself through dedicated research.  

-You have to look at researching and building good claims as a second job, it can be a lot of work, but the benefits are worth it.  You have to know your condition and related symptoms inside/out, you have to know the VA rating schedule for that condition, you have to know how to write a personal statement, you have to know how to prep for your C&P exam, ultimately you have to be your own advocate.  

[B52gator]

I forgot:

PACT ACT is huge.  Because of the PACT ACT a lot of conditions/disability claims are presumptive, basically meaning the VA assumes you already have this due to service.  Basically if you flew anywhere or were stationed other than CONUS (more specifically OIF/OEF/Syria related) over the past 25 years, you are eligible.  Doesn't matter if you landed in country, even flying over those countries (I'm looking at you BUFF guys flying out of DG) you are eligible.  So do you research PACT ACT stuff, related conditions, etc.  Tying disabilities/conditions your claiming to the PACT ACT is gonna be a huge win for a lot of folks.

ALSO:  You have one year after separation to make claims and get them service connected w/little to no trouble.  By that I mean after you're out and you get diagnosed w/something the VA considers that "in service" making it much easier to get a claim done.  After that one year, it is much harder to get service connection for conditions that are diagnosed post service.  

Edited March 29 by B52gator

[nsplayr]

On 3/29/2024 at 8:54 AM, B52gator said:

For example everyone should claim and get service connected tinnitus.

Eh…you’re flying too close to the sun here man.

I have thus far not claimed this condition because I do not, in fact, have ringing in my ears.

Without appropriate symptoms, a service member should not claim to suffer from a condition that would warrant a disability rating, full stop.

[herkbum]

Eh…you’re flying too close to the sun here man.
I have thus far not claimed this condition because I do not, in fact, have ringing in my ears.
Without appropriate symptoms, a service member should not claim to suffer from a condition that would warrant a disability rating, full stop.

And you likely never will in the GCS. All of my damage was done in the Herk.


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[Sua Sponte]

A pulmonary tech at the last VA I went to was a retired Army artillery soldier. He was denied tinnitus by the VA because they didn’t find it service connected.

Edited March 31 by Sua Sponte

[HeloDude]

1 hour ago, nsplayr said:

I have thus far not claimed this condition because I do not, in fact, have ringing in my ears.

Consider yourself fortunate man.

[hindsight2020]

Has there been any discussion on legislation to make sub 50%ers offset-exempt for active retirees? That's about the only way I'd even bother with it tbh, given my generally favorable *knock on wood* state of health and unwillingness to malign range of motion potato. 

Edited March 31 by hindsight2020

[B52gator]

3 hours ago, nsplayr said:

Eh…you’re flying too close to the sun here man.

I have thus far not claimed this condition because I do not, in fact, have ringing in my ears.

Without appropriate symptoms, a service member should not claim to suffer from a condition that would warrant a disability rating, full stop.

Wasn't advocating for fraud...I guess I just figured we all had it. Happy that you don't, it fucking sucks.  

[slc]

16 hours ago, herkbum said:

 

And you likely never will in the GCS. All of my damage was done in the Herk.


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Add to that neck pain and visual acuity loss from hours of NVG time......

[nsplayr]

17 hours ago, herkbum said:

And you likely never will in the GCS. All of my damage was done in the Herk.

 

I mean sure…I did fly 2K hours manned previously, I guess I’m just lucky to not suffer from that particular ailment. One fan of freedom on Draco is much quieter than the four on the Herc 😄

BLUF: claim all the stuff you have that’s legit, don’t claim things that aren’t even if they just so happen to be common and very hard to disprove. I felt like there was an implied *wink wink nod nod* there that perhaps wasn’t intended.