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Monday, August 10, 2009

An overview of my current battle. Some history.

I wrote the following some time ago but I feel it's the appropriate first post for my blog. It's a general overview of my current battle with the VA. In time I'll go into further detail. I am also enrolled in the Independent Living Plan of the Vocational Rehab Program and I want to chronicle how that is going as well. Bear with me, invisible reader. We will get through this together. I hope you will learn from my adventures.

I filed for my initial rating in 1994 when I first retired from the Army. First rating was returned at 20%. It took 14 months to come back. I was naive about the system back then or I would've filed a NOD because they totally screwed me on service connection for my left shoulder and right knee. I applied and was approved for Vocational Rehab. That took another 12 months to get approved. I used it to go to school. I earned a degree in psychology and used that degree as a management tool. I worked in the animal care field managing veterinary hospitals and animal boarding facilities until I could physically no longer work in that field due to my service connected disabilities in 2005.

As I got older, my service connected disabilities worsened. While I was living in Albuquerque I reopened my claim and requested an increase in my rating based on continuing treatment of my service connected disabilities. My left knee had gotten worse -- arthritis had settled in. My IBS was out of control -- I suffer from chronic diarrhea. I have impingement syndrome in my right shoulder and I have lost range of motion because it has gotten worse. I have broken several teeth and continue to wear a bite guard due to bruxism (I was diagnosed with it while on active duty). That came back and my disability rating was increased to 50%. That was approved in Jan of 2006. It took almost two years alone just to get the bruxism approved. No one seemed to know what bruxism was or who was supposed to handle a dental claim. When the bruxism was approved, they also approved TMJ as a secondary condition. I didn't even know that I had TMJ.

In November 2006 I had to go in for knee surgery. My left knee had gotten progressively worse. Months of physical therapy and the use of a brace hadn't helped it. There was so much damage to my left knee and so much scar tissue they had a difficult time getting into the actual capsule to look behind my knee cap. What they saw was not pretty. They cleaned out some of the scar tissue but that was all they could do at that point in time. I was diagnosed with Degenerative Joint Disease and Grade 4 Chrondomalacia. A complication of that surgery was a loss of range of motion and the beginning of chronic pain. My doctor advised me that in 6 months, after I healed from that surgery, I would have to go back in for a total knee replacement. However, because I moved to Florida in February 2007, I had to start the medical process all over again at the Tampa VA.

Because of the surgery in November 2006, I was unable to perform the duties of my job. I was a civilian Army recruiter. I couldn't drive a government vehicle because of the pain medications. I was on crutches and couldn't carry my recruiting "gorilla" bag. You cannot be an effective recruiter from behind a desk. I was unable to get to my schools, go to parent conferences, recruit on the streets, etc. I left that job and have not worked since. I moved to Florida in Feb 2007 and attempted to find work, but when you go on a job interview and you walk in using a cane and wearing a knee brace, no matter what your qualifications are, most employers aren't interested. To be honest, I wouldn't hire me. I knew that I was waiting to go into surgery for a knee replacement and I'd be out for a couple of months anyway. That didn't make me a good candidate anywhere. When I walked in for an interview I could see it in the eyes of the manager conducting the interview. I have enough of an HR background to know they can't ask about my physical abilities but they are legally entitled to ask if I can meet the physical qualifications required to perform the job I am being considered for. I was honest with potential employers. I let them know up front that I would be going in for knee replacement and would be out for a couple of months. All I received were letters of rejection stating they had hired a candidate more qualified to fill the position.

At that point, I reopened my claim again for another increase due to chronic pain, the diagnosis of DJD, grade 4 chrondomalacia, and knee instability. My claim was approved and my rating was increased to 80%. That was approved in June 2007, the same month that I went in for a total knee replacement but I didn't get the approval letter until October of 2007.

After the knee replacement, I went on Temp 100% until August of 2008. Effective September 1, 2008, my rating was decreased to 70% because they said that my knee should be stable because it had been replaced. Not one ortho doctor ever examined my knee or asked me how I was doing. They never called me back for a Comp & Pension exam to reevaluate my knee like they were supposed to do. If they had, they would have seen that the surgery had failed miserably.

I take 90mg's of morphine, 600mgs of topomax and 7.5 mgs of mobic just to get through each day. My doctor wanted to put me on oxycodone for break through pain but that stuff makes me high and I don't want it. I'd rather deal with the pain. As it is, I struggle just to stay awake through the day with all the meds that I have to take.

I can no longer live alone. My shoulders are so screwed up from falling that I can't lift my left arm to wash my own hair. The VA has outsourced me to the Florida Orthopedic Institute (FOI) for surgery on my left shoulder. Haley VA is so backlogged they can't get me in for surgery until October or November. I am scheduled to see the FOI Surgeon on 21 August. It's been so long since I was able to move my left arm because of pain that my left arm has started to atrophy. My right shoulder isn't too far behind it. I've already had one injection of cortisone in my right shoulder. It's my understanding the max you can have in any joint is three. The falls are not from the medications that I take. The falls are due to the failed left knee replacement. My knee buckles without warning and when I fall, I always manage to land hard on one shoulder or the other. My primary care physician and my pain management doctor want me to use a walker for safety reasons but my shoulders are so painful that I can't support myself on a walker. I do the best that I can on a cane. My primary care physician put in a request for a motorized scooter for me but I don't meet the quals for one. She wrote a consult to send me to the "Falls Clinic" but they are so back logged that my appointment isn't until September.

My partner helps me to dress and undress. She has to help me in and out of the shower. She has to wash my hair for me. She does my laundry for me because I can't carry a laundry basket to the laundry room. I can't cook for myself because I forget that the stove is on and I am afraid of burning down the house. My doctor has forbidden me to drive and has written that in my medical records. When we go shopping, I have to ride in a motorized cart. I can't push a shopping cart anymore. If I sit for more than 30 minutes at a time my legs begin to swell and my ankles turn to cankles. I have been issued compression stockings but they don't help much. Sitting at the desktop computer is painful and uncomfortable but I broke my laptop recently. My knee gave out when I stood up and as I was falling I hit my computer stand on the way down and my laptop hit the floor and broke. If we are in a public place and the handicapped stall is not available and I can't wait to use the restroom, Terri has to help me down onto the toilet. When I am finished, she has to lift me off the toilet.

Last October 2008 I applied for 100% based on Individual Unemployability. As a show of good faith, I also applied for Vocational Rehabilitation. You can use Voc Rehab more than once if your circumstances have changed drastically since the last time you went through the program and mine have. I wanted to go back to school for my Master's in Social Work. I would love nothing more than to work with veterans like myself. Voc Rehab put me into an extended evaluation program for several months to monitor my health issues before making a decision on my case. Each month, my health has continued to deteriorate. My Voc Rehab counselor worked very closely with my primary care physician. My Voc Rehab counselor has access to all my VA Health care records so it's not like I can go in there every month and bullshit her. She sees the records in black and white. After four months of seeing no progress in my health, in fact, a steady decline in my physical and emotional health, I was turned down for the school portion of Voc Rehab. It makes good sense if you think about it. I can't drive to school. I can't concentrate. I am in way too much pain to sit, stand or do much of anything for more than a very short period of time. Why waste the money on sending me to school? My Voc Rehab Counselor issued what's called a Feasibility Letter and and sent it to the VA Regional Office for inclusion in my disability packet. What the letter says is that I am not a candidate to return to school or gainful employment. The next step is the Independent Living Track. My Voc Rehab Counselor drew up paperwork to have a contracted Social Worker come to the house to evaluate me at home to determine what I need at home to make it more handicapped friendly. I already have shower bars, a raised toilet and a shower chair but those are temporary fixes. This hasn't been a speedy process either. My Voc Rehab Counselor drew up the paperwork for the social worker evaluation three months ago. The Social Worker finally, two weeks ago, came to my house and did her evaluation. She made her recommendation to my Voc Rehab counselor that I be given a laptop computer so that I can elevate my legs when I am online. She recommended that a Rehab Engineer come to my house to evaluate my bathroom for renovations to make it easier for me to get in and out of the shower. She recommended that a new, raised toilet be permanently installed. The one that I have in my bathroom now is not stable, safe or sanitary. She recommended to my Voc Rehab Counselor that I be given a motorized scooter and a lift for my vehicle. She says that I am socially isolated and that if I have a motorized scooter, I can at least get to a bus stop so that I can get out of the house on my own. My Voc Rehab counselor agreed with all of these recommendations but due to training she has to attend, she will not be able to start working on any of this until the beginning of August. Because the VARO has not approved my claim for 100%, I am only eligible for a one time grant of $4200 for home renovations. Anything above and beyond that, because I am in the Independent Living Track of Voc Rehab, Voc Rehab will foot the bill.

If I get approved for 100% that opens up a whole new realm of benefits that will help take the burden of caring for me off of Terri. We struggle financially for one. I know, who isn't in this economy? Our house needs renovations because eventually I will be in a chair. They are renovations that neither of us have money for. The VA will pay for that and that's a huge relief for us. We have two boys in college right now and money is tight.

The reason I'm pissed is because the VA is lying about the processing time. The average processing time is NOT 179 days. Ask any veteran who has been waiting to get a claim through in the last 8 years and they will tell you. Veterans pay good money in lifetime dues to the VFW, the American Legion & the DAV. Those organizations prepare our claims for us and represent us in our claims yet they do nothing when the VA tells John Q Public that they are processing claims in 180 days. Someone is lining their pockets with a lot of money to keep quiet.

Yes, part of the backlog problem is the new veterans of Iraq & Afghanistan. They are getting preferential treatment when it comes to processing their claims and it's pissing off a lot of us older veterans. Their claims are being pushed to the front of the cue while ours keep getting pushed further and further back in the cue. Turn around time for the new veterans is about 4 months thanks to something called Tier Two. Tier Two is causing a huge division in Veterans. It's becoming an us against them young'uns issue. Older veterans are dying because of it. And as soon as a Veteran dies, the VA stops processing their claims. By law, the claim is to continue processing because the surviving spouse is due any back pay owed to the deceased veteran. Case in point, read the story of Irish Brennan, a female Vietnam Veteran who passed away recently. Google it. I'm also fairly certain I published her story on my Facebook page somewhere.

The St Pete, FL, VA Regional Office which is processing my claim has the largest backlog of claims over 180 days in the United States according to the Monday Morning Workload Report. It's no wonder I've been waiting since October 2008 for my claim to process.

One more issue I am dealing with and this is very recent. First, let me give you some background. Over the last few months, I have been in touch with a lot of veterans who are victims of Military Sexual Trauma. I am working with a group of them, trying to help them fight for benefits. MST is difficult to prove because the burden of proof is on the victim. Because most victims are diagnosed with PSTD, military shrinks refuse to acknowledge and assign a diagnosis of PTSD to women because their belief is that PTSD is only caused by combat service. And we all know, women aren't allowed to be in combat, right?

Seven weeks ago, I was sitting on my bed and out of the clear blue I had a flashback. It came out of nowhere and it hit me like a ton of bricks. I cried for two solid days. Now, seven weeks later, it's flinging around in my head like a boomerang and I still don't know what to do with it. My VA psychiatrist thinks the flashback was triggered by my close contact with all the women victims of MST I've been in touch with recently. I had locked this memory up nice and tight and safe and away in a place where it couldn't touch me. For whatever reason, it chose seven weeks ago to reach out and touch me.

I was stationed in Vilsek, Germany at Rose Barracks from December 1981 to Feb 1984. It was either early 82 or 83 that I went in for my annual pap smear and birth control refill. I was young, early 20's, and thought doctors were to be trusted. The doctor told me to get into the gown and get on the table so I did as I was told. I was an E4 and he was an O3, I believe, so there was also that whole military rank thing going on. There was no nurse or other chaperon in the room and I didn't think anything of it. During the internal portion of the exam, the doctor said to me, "I'm going to push down on your ovaries. You tell me if this hurts." He pushed down so hard that I screamed out in pain and started to cry. He said to me, "Remember that. That's what it feels like when you kick a man in the balls." I didn't stay to complete the exam. I got off the table, got dressed and left the TMC. When I got back to my duty section I was in hysterics. My husband asked me what was wrong and I told him everything. He wanted to go back to the TMC and kill the guy. Instead of doing that, we reported the doctor through the appropriate channels. I remember writing up a statement and having to turn it in. I don't know what happened to the doctor, but he was gone by the following week.

For twenty years I have been terrified of male doctors. I can't be in a room with one by myself and if I am, I can't get a single word out of my mouth. Until I had that flashback, I never knew why. I repressed that memory for 20 years. I won't sit here and tell you that I have PTSD. I don't have anger issues or any of the clinical signs of PTSD that I have seen in my friends that I know have PTSD. I will not put in a claim for PTSD. But I have suffered Military Sexual Trauma. Will I put in a claim for it? I don't know. I have contacted my ex-husband and he doesn't remember the incident. He was a very heavy drinker back in those days. I'm lucky he remembers being married to me. I have written to St Louis and requested a copy of my medical records because the incident was recorded in them when it happened. Hopefully it wasn't removed from them by someone trying to cover that officer's ass.

Now I can begin to wrap things up for you. I reopened my claim in October 2008. I requested 100% IU with Aid & Attendance. I requested an increase in my left knee. I requested service connection for my right knee as a secondary condition. I have a statement from a VA ortho surgeon stating that my right knee now needs to be replaced because they harvested parts from the right knee in an attempt to repair the left knee. The right knee is now arthritic and has grade four chrondomalacia. I also requested service connection for depression as a secondary condition. I have been under the care of a VA psychiatrist for over two years now with a diagnosis of major depressive disorder. It is caused by my service connected health issues.

In December 2008 I received a letter from the VA telling me they had received my claim and needed some additional forms from me along with some additional evidence. I sent all that in. In April 2009 they sent me another letter requesting further information. I sent that in as well. In early June 2009 they told me that I had amended my claim to ADD aid & attendance and that my claim was now back at the bottom of the cue because of that amendment. Fortunately I was able to show proof that Aid & Attendance was part of my original claim dated October 2008. If I had not been able to show proof it would have meant a potential loss of 7 months of back pay if I get approved for aid and attendance.

I did an inquiry via the VA website to get an update on the status of my claim and was told it had gone to the Rating Board on 26 May 09. I waited 30 days and checked again only to be told I had been "misinformed" and that my claim had not been sent to the Rating Board on 26 May. I copied and pasted the response I had received telling me it had been boarded on 26 May and asked for an explanation of the discrepancy. I was told it was a "clerical error."

As of today, all the documents that are needed to send my packet to the Rating Board have been received. They have enough medial evidence to make a decision and they have said I don't need to go in for a physical exam because I am in the doctor's office several times each month. For all intents and purposes, my packet is theoretically sitting on a desk at the VA Regional Office collecting dust while it waits to go before the Rating Board. There is nothing left to do to my packet according to the Regional Office and no one can answer why it isn't before the Rating Board.


On Friday, I received a letter from the VA dated 8/5/09 directing me to report to the VA Hospital Tuesday, Auguest 29th, for two C& P examinations. Finally I am seeing some progress in my claim. I have two appointments that day although my letter doesn't specify what the exams are. I suspect one is orthopedics and the other is either psychiatry or psychology. It's a step in the right direction.

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