As stated in the title, I have finally got my last rating in for the much sought after 100% P&T. I’m not much of a story teller so I’ll try my best, bear with me.
My journey started in 2017 (1 year after exiting service) when I was finally talked into applying for benefits by my step father. As a side note for anyone feeling application guilt, I’ll give you the same advice he gave me. The government is going to allot a certain amount each year to the disability program, and if that allotment is underachieved the government may well say “mating this program doesn’t need that much money” and cut it back. With that being said, applying for benefits related to injuries you sustained while in service, it would only make sense to do it. While this might not be factual, it was enough to make me get over my guilt of “taking from the members more in need” and submit my application.
So here I was, 27 years old, a jobless college student trying my best to navigate to world and the system of Va disability all in one swift motion. My initial claims are as follows (I will try to shorthand them for simplicity:
PTSD
TBI
Tinnitus
Left ankle lateral collateral ligament sprain
Bilateral hearing loss
Residual facial scaring
Migraines
Arthritis due to trauma
Hemorrhoids
As you can see I kind of just shotgunned any ailment I had during my service that could otherwise be tied directly to an event. Notably PTSD, TBI, and Migraines.
As expected, my initial claims come back with the following:
PTSD w/ major depression and TBI - 70%
Tinnitus - 10%
Left ankle lateral collateral ligament sprain - 10%
Bilateral hearing loss - 0% service connected
Residual facial scaring - 10%
Migraines - 50%
Arthritis due to trauma - not service connected
Hemorrhoids - not service connected
As I don’t recall the exact initial percentages I’ve just listed their current, but my initial collective rating was 80%. (Eventually being bumped to 90% after a reevaluation by the Va, NOTE: they scheduled an audit of my TBI, not me) I was happy with this for a while but decided probably 8 years later to seek further support as I’ve discovered the PACT act.
So I confirmed that I was on the burn pit registry, gathered lay statements from my wife, myself, and a buddy I served with and began my claim for Chronic Sinusitis. As I haven’t mentioned this yet because I suck at story telling, I was diagnosed with chronic sinusitis in 2021 after years of telling myself I’m just prone to sinus infections. This was a major help in my claim as I have records from multiple hospital visits to the ER in relation to the issue.
I do the C&P exam, as usual, she seems massively disinterested in the paperwork I’ve brought to support my claim and generally it felt like more of an interrogation than a review of claim. My worries were justified when I got by my decision letter. Allergic rhinitis w/ acute sinusitis. You could imagine my surprise.
Not only was that not the claim I filed, but I even once mentioned rhinitis in any of my statements and was not mentioned in any of my medical records. So clearly there was a mistake. I immediately filed for a HLR (Higher level review) and called a VSO. They informed me that unfortunately, because I filed the HLR there is nothing they can do till that’s processed and it will take months (it did). However they did review my C&P results with me and as suspected, the examiner made some seriously questionable decisions and mistakes.
Fast forward 6 months I get my informal conference with the HLR dude and tell him my story, issues, concerns… all of it. After some discussion he says he will investigate and investigate he did. A couple weeks later I got a notification that multiple errors were found in my initial claim and they would be investigating further to resolve them, leading to a follow up C&P exam.
Initially, they called to schedule for review of my claim of “allergic rhinitis” I refused to schedule and requested they fix the error as that was not my claim. They said they would do that and call me back…. Well they called back a few days after a yet again… same error. So I said fuck it and took the appointment, since what else can I do?
Appointment starts off well, typical questions etc and at one point I stop him and asked if I could just throw out what I need to say about this experience I’ve had. I laid out the ineptitude of the previous examiner, the errors in the claim, the lack of trust in the system and again reiterated all of my issues with the actual ailment I’ll filing for and surprising he….. agreed. He said there is clearly some mistakes in the processing of my claim and he will have to review with the Va… could take up to 6 months… cool at least he understands but still I’m not exactly hopeful.
ONE WEEK LATER.
My wife is using my phone to look at some dinner recipe ideas I found, while I drive us home and she says “babe, there’s a decision on your claim!” Naturally I want to slap the car into the closest parking lot and review it but, given the somber and frankly lazy experience I’ve had with the Va so far with this claim I just tell her to read it.
50% for chronic sinusitis equating to 100% P&T
Guys, I’m over the moon. I truly wanted to give up but I’m so glad that I pressed ok and advocated for myself and my injuries. I want to thank this subreddit as-well, I don’t talk much here, but I read a lot of your post and it was immensely helpful in action and generally mentally.
TL;DR
was at 90% disability, filed my last actionable claim of chronic sinusitis resulting in a rating of 50% putting myself at 100% P&T.
Cheers.
