Filing a VA Compensation Claim for Aggravation of a Medical Condition

By / April 21, 2017 / Veterans Disability / 6 Comments

Learn the difference between a service-connected aggravation and a natural progression of a non-service-connected medical condition.

Dear Disability Advisor,

USMC 1977, three weeks into training I broke my wrist doing jump down push ups sent home my position because of scare tactics of operation and recovery time by usmc. Filed they said it was an old break had arthritis in it said it was a overfight at recruitment physical (not true) denied claim filed again years later they said I should file for made worse by training . VA no help. I Don’t trust any of this where do I go for help. Jim

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Dear Jim,

A viable compensation claim can be made as a result of a service-connected condition or due to an increase in severity of a non-service-connected disability. The increase in severity has to be attributable to aggravation by a service-connected medical even, which you appeared to suffer. That aggravation must not be caused by the natural progression of the non-service-connected medical problem.

First, you must establish a baseline of the non-service connected disability from before you entered the servcie. If this is not possible, then you must find the earliest medical records that show the onset of the current aggravation and the then-current level of severity of the non-service-related disability. If you cannot do so, then it is doubtful that you will ever be granted VA benefits.

Accordingly, you need to seek the advice of a VA accredited attorney or the services of a non-profit veterans’ organization such as Disabled American Veterans or the American Legion. These providers of VA services can decode your claim and situation to determine if you have a viable VA compensation claim.

Sincerely,
Craig L. Ames

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Filing a VA Compensation Claim for Aggravation of a Medical Condition
3 (60%) 1 vote

  • Dear Edward,

    Your question was forwarded to a VA attorney, who said he did not have enough information to understand your question. Could you clarify what you mean by “we are stuck” and what specifically you are asking? Then I will forward your question to the attorney again.

    Sincerely,
    Kay

  • Dear Edward,

    Proving a VA compensation claim is no place for a novice or layperson unless the merits of the claim are unquestionable. In your situation, you need to prove the existence of an in-service injury. If medical records, which should have recorded, do not exist or cannot be located, you must have another way to prove the fact of the medical event. In most cases like yours, you will need to consider hiring professional legal services to do so.

    Also, you need to understand the purpose of a “C & P” examination. That exam has nothing to do with past events. The “C & P” exam is only used as a tool to evaluate your current medical condition. The mere passage of time has much to do with the current state of one’s health. Experience dictates that some of the consequences of prior injuries disappear over time; a disabled person can fully recover from a traumatic event. Other injuries can lessened in the degree of disability over time. Other cases involve an increase in the nature of the disability over time. The physician is only assessing the current degree of disability, if any. The VA is not having the doctor render a medical opinion as to how, when or where a prior injury may have been incurred.

    Sincerely,
    Craig L. Ames
    Accredited VA Attorney

  • Dear Love,

    Veterans who develop type 2 diabetes mellitus and were exposed to Agent Orange or other herbicides during military service do not have to prove a connection between their diabetes and service to be eligible to receive VA health care and disability compensation. This type of medical disorder is referred to as a presumptive disability pursuant to VA regulations.

    The veteran would have to have evidence that the diabetes is disabling. Diabetes is a chronic disease that affects the body’s ability to use blood sugar for energy. In type 2 diabetes mellitus, the body does not produce enough insulin or the body’s cells ignore the insulin. Signs of untreated diabetes type 2 are: blurry vision, excessive thirst, fatigue, hunger, frequent urination, and weight loss. Risk factors for diabetes type 2 include: age over 45 years, family history and genetics, sedentary lifestyle, unhealthy eating habits, obesity, and gestational diabetes.

    A claimant can file a claim directly with the VA Regional Office in the state where the veteran lives.

    Sincerely,
    Craig L. Ames
    Accredited VA Attorney

  • Dear Rich,

    Posted questions are not visible until they are answered. Here is the answer that was posted a few minutes ago to your first question under the other article.

    Your rights to file an appeal have been abandoned due to the expiration of the one-year appeal rule. There are limited exceptions to this rule, none of which apply in your situation. You would need to file a new claim.

    Sincerely,
    Craig L. Ames
    Accredited VA Attorney

  • Dear Eric,

    Each claim involves four elements that must be proven. In this situation you need to find independent medical records that your father had, in fact, an in-service medical condition. If you can obtain such evidence, then you need a current expert opinion from a licensed physician that the in-service medical condition links directly to a current medical diagnosis that your father now has.

    Sincerely,
    Craig L. Ames
    Accredited VA Attorney

  • Dear Eric,

    In the background information you provide leading up to your inquiry, you state that your father’s condition is due to a genetic condition. Hence your father’s claim will be subject to scrutiny as to the issue of whether or not he had an in-service medical condition which is eligible for benefits.

    There are some conditions that do not qualify for VA disability. This could be because they are not considered service-connected, they existed prior to service (EPTS), or they do not significantly limit the overall functioning of the service member or make them unfit for duty, Instead they are caused by natural causes or by a person’s own bad decisions.

    These conditions and any symptoms they cause do not qualify for military disability benefits and so cannot be given military disability ratings. These conditions cannot be rated in any way, in any circumstances, unless there is a specific exception which applies. This is the case even if the condition is caused by another condition that is ratable.

    Congenital conditions are conditions that occur at birth or within the first month after birth. Hereditary and genetic conditions are natural physical developments based on genetics that would occur no matter the circumstances of a person’s life.

    Some examples include:

    – Developmental defects

    – Physical birth defects (missing, deformed, or extra body parts/organs)

    – Being too tall or short ( gigantism, dwarfism)

    – Vision defects that occur before joining the military, like refractive error

    – Genetic or inherited diseases

    These conditions are not ratable because they cannot be caused by military service. They can, however, be worsened by military service. If a hereditary or genetic condition is worsened by military service (meaning the condition was service-aggravated), it can be rated.

    Some genetic conditions will not develop until later in life. If a genetic condition develops while a service member is in the military, it is automatically assumed service-aggravated, and thus ratable, unless it can be definitely proven that it would have developed at the exact same time and to the exact same degree outside of the military.

    If the service member is on active duty for eight years or more, all congenital, hereditary, genetic and EPTS conditions are service-connected and thus ratable.

    Sincerely,
    Craig L. Ames
    Accredited VA Attorney

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