J Basser: 0:05

It's time for the ExposedVetHaddockcom Veteran Podcast. Exposedvet has teamed up with Haddockcom to bring you in-depth information about all issues affecting today's veteran. Now here's your host, john and Gerald. Welcome, ladies and gentlemen, to another exciting episode of the HATTAcom Exposed Vet Veterans Podcast. Today we've got Bethanie Spangenberg, I guess because she runs the organization Valor 4 Vet, we've actually got dual co-hosts. Today We've got Mr Alex Graham. Without further ado, gerald, how you doing? Well? I'm doing okay, son, feeling pretty good, still here. Well, lucky to be here, son, is that right? Yeah, lucky to be here.

J Basser: 1:01

I don't know about you. I'm from Sedona. Today, man, east of Mississippi, we've got a cold front and it's been the 30s all day today. Last week, just a few days ago, we was mowing grass. Now look at it. Wow, it's cold.

AskNod: 1:18

It almost hit 70 here in Seattle. Oh, wow.

J Basser: 1:24

Well, you've got a good diverse population mix today all over the country, but we were going to discuss earlier. We discussed with Bethany. We're going to work on a couple of issues Valor for Vet is an organization. They do medical stuff in the form of independent medical opinions, DBQs and stuff like that, and Bethany kind of coordinates everything. She runs the mix. She's actually an accredited VA appeals agent, but I don't really think she gets into that part. I think she uses that more or less to help process veterans' claims. Is that correct, Bethany?

Bethanie Spangenberg: 2:01

Yeah, I actually use it mainly to educate. You know our medical experts that we have on our team, and then I do a lot actually with working with attorneys and helping them kind of break things down from a medical perspective. So I use it a lot for educational purposes, rather than me representing somebody.

J Basser: 2:24

Well, I mean, it's your choice to use it the way you want to use it, and I think it's a good thing, because sometimes if you're doing examinations and you're an agent yourself, you know there could be a conflict of interest in some areas, but I think you're doing it correctly. So, from what I've seen and what I've heard from veterans across the country, you guys are doing a really good job.

Bethanie Spangenberg: 2:49

We certainly try to.

J Basser: 2:51

Tonight we were going to discuss maybe a case study of one of your cases and I wonder if you wanted to touch on that. I think there's some points you wanted to bring up, just something like that. We don't have to name names like that because we'll just, you know, we'll just keep everything generalized.

Bethanie Spangenberg: 3:11

Okay, well, yes, I did. I looked at this case. I broke it down for both a legal perspective and a medical perspective to really try to see you know what the missing pieces in this particular case. Now, you and I had previously discussed this individual and that was before I dove into the records and really took a look at what's going on. Unfortunately, this particular veteran isn't a prime example for most veterans because this veteran is a sick cookie. He's got three conditions that are laying at 100% and that's not typical for most of our veterans. When I went into the records as well, there wasn't a lot of legal documents provided to me, but from what I could see, in this particular case there is some room for increased benefit and it actually falls into something I think we're going to talk a little bit about tonight, which is the special monthly compensation.

Bethanie Spangenberg: 4:13

So really quickly, I just want to give a basic kind of rundown of what I took a look at and what I mean by this veteran and the sick cookie. So he's born in 1950. He was in the service in the early 1970s. He's currently 100% service connected for anxiety and depression. 100% service connected for his lung disease with pulmonary hypertension. He's 100% for ischemic heart disease. So having those three 100%, that's not typical for most of our veterans. So that should say a lot when you look at a case and you're like, oh boy, he's a sick cookie. So he's got one, two, three, four, five, six, seven, eight other service-connected conditions. That kind of pile on top of everything. He has 22 different medications that he is currently on. So this is a very complex case. The biggest thing you know I needed for this case to really break it down is those legal documents to see what he's currently service excuse me if he's currently getting that special monthly compensation.

J Basser: 5:26

So just based on the fact that he has two conditions lying at a hundred percent, he's going to qualify for a special monthly compensation yeah, that would be that probably the s when it because I mean I know you, because once you get to a certain level with S is to me SMCS means SMC stuck, you can be, 1,000% and have SMCS. You don't have aid to tenants, you don't have anything.

Bethanie Spangenberg: 5:55

Correct and this individual could qualify for some of those caregiver benefits. He's got some cases for SMCK if he's not getting that either. So really kind of wanted to do a comprehensive review on this case and I'm kind of stuck in some areas.

AskNod: 6:16

Hey Bethanie, let me ask her something here. John, notwithstanding what the M21 states, I got this from a gal out in Montana at Fort Harrison Regional Office. She's a DRO. I didn't bother to look it up, I just assumed they refused to grant one of my guys both bumps. He had 100% above and beyond what he was getting smcl for uh for aid and attendance. He had another hundred percent independently rateable and they gave him the f4 bump underneath uh. So it's a smc bump from l to m. But they I I said, wait a minute, what about he's 50 for his ptsd too? And they said well, you only get one bump. What's your take on that? I've tried. I've read a bunch of BVA decisions that go both ways, but in fact I've got one that's probably going to go up to the court. I don't mind taking it up there because I want to get a panel preference or precedence on it, but what's your take on it? Do you think that's double dipping?

Bethanie Spangenberg: 7:30

So when you use the internal SMC calculator, it only allows you to get one bump in that scenario. When. I was building this SMC calculator as well. That is my understanding of that one bump. I can probably email you specifically that section when it talks about that intermediate. I think it's actually P that talks about that intermediate jump, but that is my understanding.

AskNod: 8:03

Yeah, that's part of. Pete.

AskNod: 8:04

Well, you know, I studied it and studied and studied it, for I even bothered to ask for it, but I got ignored. At the regional. They just they just bucked it up, said you can't collect both. They didn't give me a chapter verse quote to it Other than says other than basically saying the regulation forbids it. But the clear reading of F3 or F4, it said, in addition to any rating between L and N, if you've got an additional 100% rating, okay, you get a bump from L to M or the next higher rate, and if you're at L and a half, it'd be the next bump up to the next intermediate at M and a half, but nothing. When you go to F3 or F4, nothing says and you only get this rating. You cannot, you know, can't take advantage of F3 as well as F4. Just that it's written exactly the same way, except, as you know, about the 100% versus 50 combined. But I found three decisions in BVA where judges granted it just in 2020. And then I've seen two decisions where the judge threw it out on Sambonis versus Brown and said no, no, no, no. That's illogical, it's not written.

AskNod: 9:26

You know my attitude about the. I go for the throat to try to get every rating I can for my clients. So I'm pushing this process. I don't know if you've heard of Jennifer Zajac from Paralyzed Vets of America. She does a lot of work with the paralyzed vets as their attorney on pro bono stuff for NBLSP and the Veterans Pro Bono Consortium and she in one of her briefs she shared with me she asked for it but they ended up giving the guy R1 instead, so that never, ever got before the court. I just wondered is it your attitude when you go to try to help these guys? Do you try to go for the double bump or do you even just stay with one?

Bethanie Spangenberg: 10:17

I do. I tell them to go for the double bump or any bump that they can get, only because it really depends on what, from what we've seen in the past, we can have the regulations and the judge will still grant outside of those regulations. So I think if you have a reasonable argument in how they should be either separate and distinct, how debilitating they are, you go for it. You go for that double bump.

AskNod: 10:49

Well, I sure can't go in there talking about the M21, because every BVA judge I've ever got in front of at the moment I even finished the second syllable of 21. They'll cut you off at the neck and say that's it, we're not going to talk about that. I don't believe in the m21 convert that into regulation that's hilarious to me.

J Basser: 11:12

That is so funny to me well, that's because the m21 itself is a working manual for the adjudicators and writersers. Do their job. It is not law.

Bethanie Spangenberg: 11:24

Well, it's not even wrong. The M-21, to me is like the VA's own internal process of creating their own laws. It's like this is how we make laws. We're going to circumvent that and we're going to make the M-21-1 because we can.

AskNod: 11:43

Well, unless you know, they're 100% correct until you prove them wrong. And according to them, they're 98% correct. But batting with me they're about 98% wrong. I would agree with that. I've lost two claims out of 1,000. I think that's 99.9%. I think that's 99.9%.

AskNod: 12:06

But I always try to push for the wildest and craziest combinations I can get in order to hang, get the golden R1, or at least that is a bare minimum for my clients who are like you're saying what they three 100 percenters and start developing because VA love to throw all of those in one basket and just call it SMCL for aid and attendance. They don't make a separate determination. As the guy permanently bedridden due to cardiopulmonary instead of leukemia, I make that kind of argument all the time, even to the point of going out and buying an IMO to make it say that, which is probably why I ought to be talking to you a little bit more frequently.

Bethanie Spangenberg: 12:57

Hey, we can talk about cases all day long. I get a lot of fuel from the VA, so there's never a moment that I don't get excited about their inefficiencies.

J Basser: 13:13

Well, beth, you have a distinct advantage over most people in your profession, either as an agent or as an examiner, because, basically, you've been on both sides of the fence and you see how it operates inside and you see how it operates on the outside and you know how it operates on the inside. 92, and it's not, you know. To me it's not very fair to the veteran, you know, but you know for what you do. Thank you for what you do.

Bethanie Spangenberg: 13:49

Well, thank you. You know, even talking about this SMC or this case, it reminds me of another case that I was working on with another attorney. I was working on with another attorney and it was about a guy who was they did pole vaulting in the military and he ended up having an injury and he broke his neck while he was in service from pole vaulting and he was able to function immediately after. But as time went on and that arthritis set in, he became paralyzed and it has been a tremendous fight for this attorney to get this veteran any benefits, let alone special monthly compensation, aid and attendance, and in fact he doesn't even have those yet.

Bethanie Spangenberg: 14:45

But the problem that we've ran into in this particular case is a problem within the VA system, and what it is is that we have this veteran whose neurologist is saying that they're paralyzed, they have loss of bowel and bladder, they require this full-time caregiver, and what happens is the VA then says okay, here's a contract examiner, I want you to do this piece and let's get this contract examiner to do another piece. And so you know, when you piecemeal it, you're not getting the big picture. So when I talked to this attorney, I'm like look, you can go for this benefit based off of what is already in the file, based on the VA examiners. Whenever we look at the neurology notes, it actually looks like that these VA examiners are not capturing the real picture of this veteran and the extent of his disease. So in order for you to get those additional benefits, you really need to find an examiner that knows what they're doing in order to translate that information to the VA.

Bethanie Spangenberg: 15:48

So the biggest fault within the VA examiner portion is that they're asked to piecemeal everything and it's not one big comprehensive picture. And when they piecemeal you take away from the true disability that that veteran is suffering.

J Basser: 16:09

Does that come in line as what we consider doctor shopping for a negative opinion. Yeah, that's happened a whole lot lately. That's's a whole lot lately, that's happened a whole lot lately.

AskNod: 16:30

Well, I see what Bethany's talking about on this. Bifurcating it, separating it that was the hallmark of the AMA. The new Appeals Management Act process is now. It's all piecemeal. You might put in three claims on a supplemental claim form or even a 526, and they end up in different degrees and timing of when they are adjudicated instead of one big pie and they become separated. So all of a sudden you're chasing three ants across your your table instead of one. And then the next thing you know, one of them's up at the BVA and you need an attorney or somebody that's well-versed in keeping track of what, where, where each item is and what stage it's in. And it gets more and more complicated. For the average veteran trying to do a pro se, it's almost criminal. I've got guys coming to me and say I don't know where it is. I say well, is it Legacy or AMA? What's Legacy? That's how bad it's getting now in the adjudication world. You've got to have a Sherpa.

AskNod: 17:47

Sherpa yeah, I definitely think at a certain point there's a point where you really need to find an advocate. That's vested in your case, because they get very, very crazy messy. Well, one thing I see when I'm trying to do SMC and that's my flatbread. That's mostly what I specialize in, because all my clients are dying or dead already. But when I'm looking at SMC I notice that if a guy does get initial aid and attendance under 350B, they'll take a dustpan and a broom and they'll sweep up every little thing you've got, including tinnitus, and say well, that's part and parcel of why you have aid and attendance.

AskNod: 18:35

Now, all of a sudden, let's just say you had muscle killer dystrophy and you had certain loss of use of each extremity.

AskNod: 18:45

It was impaired during due to neuropathy or something.

AskNod: 18:50

Uh, they sweep all that in there and then later on, if you get loss of use and I do mean total loss of use drop foot, peritoneal nerve, peritoneal nerve goes flat on you and you're dragging your foot around, causing you to fall down, they rate you for that, uh, smck, for that loss of use of that foot, but they they don't.

AskNod: 19:14

When they, when you actually lose both lower extremities, or a foot and a hand, or both hands, then they just fold that into the aid and attendance and start giving you the F3 and F4, 50 and 100% bump routine. They don't look at it as a separate condition, rather than what you've got the aid and attendance for. When you actually lose a hand and a foot or two feet, that's a completely different condition, even though it's the same disease process, which is the muscular dystrophy. That's where I find the biggest SMC screw-ups of why I end up with the business trying to get these people up to R1, because they've got loss of use in addition to the aid and attendance, rather than all of it being one disease process. Are you seeing a lot of those with your attorneys, bethany?

Bethanie Spangenberg: 20:11

You know, what I see mostly is again, I mainly do the medical side of it, but I'm seeing a lot of inadequacies of understanding what loss of use really is and understanding that portion from the medical side. Now, essentially, the loss of use is a quote-unquote legal determination, but there's a box in every DBQ that the medical examiner is supposed to say and it was literally like when I was in the VA. I'm like okay, if I would cut your leg off and I would give you a prosthetic, would you be better off?

AskNod: 20:46

No, Great, Okay, it's not better off, though it's equally well served Okay.

Bethanie Spangenberg: 20:53

Correct. So that's what I'm saying is the lack of comprehension of what that truly means in that box, on that DBQ. So I think that is a big downfall in getting any veteran a loss of use rating or understanding with the VA when it comes to actually adjudicating the legal side of it. I don't see that the VA does a fabulous job with SMC. So typically it's something that even the case I was talking about earlier he's going to the board, he has to go to the judge in order to get the appropriate decision.

AskNod: 21:34

Yeah, I don't see these loss of views and or R1, the higher SMCO and all that kind of stuff. I don't see these conditions being granted at the local level. I've had one SMCL for loss of use at a low extremity due to extreme neuropathy for one of my clients. They did it locally, right there at Waco, without my having to take it upstairs to the BVA. But every last one besides that is exactly that Knock down, drag out, fight. You're reading SMC calculator the wrong way? No, we're not. So you don't get any satisfaction down below. You have to look at it.

J Basser: 22:19

Okay, guys. Quick question what is the time limit now? Say you go to you file a claim, you get denied. You have your part of the review and get denied. What is the time frame from that to get to the BBA now?

AskNod: 22:35

For me, or would you want to throw in on that one, Bethany?

Bethanie Spangenberg: 22:41

Well, I think it's on who you know really, because at first with COVID. You know they were stagnant. The judges were twiddling their thumbs, and so I know an attorney that would pick up the phone and be like, hey, so-and-so, when can I get on? You know the roster for a hearing. Oh, next week. Okay, great, and they would get on next week. But I think from what I'm hearing now is that it's getting you know with everything picking back up, he doesn't have that perk of knowing who does the scheduling and getting in.

Bethanie Spangenberg: 23:18

So I don't really know from you know, we know legacy, what it used to be with the AMA, I don't know where, cause COVID throws it all off, so I don't know the actual timeframe.

AskNod: 23:31

Well, I on on hearings. I've discovered I've got three. I got one from, I think, appealed. It's a Form 9, with hearing from 2019. I was supposed to get my hearing last May 4th and they shut down the Houston Regional Office, so I haven't even gotten that one rescheduled yet. But I've got one that I filed in January of 2020, and I've got the hearing scheduled for May 4th of this year, next month finally.

J Basser: 24:05

You know some of these veterans are sick. You know, and especially you see Vietnam veterans and other veterans that when you're talking high-level special medical compensation, that's a sick puppy and in order to get their claims out, well, if you have to wait another two years to get to the bda, man the clock's against them well, direct review is fast if if you file a 10182 right now, I I've got most of mine that are just coming through february of 2020 are being decided right now.

AskNod: 24:40

They're in the process or waiting for a signature from the judge or getting a final write-up. You can see that much in case flow. Case flow is starting to become a little bit more meaningful.

AskNod: 24:55

I don't think it hasn't reached the level of vacuoles yet, but it's getting there, but you can see that it's with the judge, back with the staff attorney and then back with the judge awaiting signature and you can see also in there it'll say granted, granted, denied, granted. So you can see that much in case flow. It does. It's getting better, but it it's. It's a solid year right now for direct. As far as the hearing goes. I've got 10 guys stacked up for a hearing, so a couple of them, like I said, in legacy, and they're, they're all silent at the switch. Now the gal that helped run, uh, nova, has given us a telephone number and a name, rank, airspeed and tail number of that guy in dc that's in charge of hearings and apparently, as bethany said, if you call him up and get on the stick with him, which I'm probably going to have to do all of a sudden it's like oh you, oh, you need a hearing aid. Yeah, no problem. What's the deal? Why didn't you call earlier?

AskNod: 25:59

Well excuse me, the telephone works both ways.

J Basser: 26:06

Yeah, but he has no intuition to call you Alex.

AskNod: 26:12

Well, it's getting a little bit irritating now. I had a good deal on that one in Houston. It was a win-win situation. I went to middle school with the regional director in Houston. His name is Major General Rob Worley. He was just a snot-nosed wet behind the kids like me in 1964. And I had Scharnberger, who's like the most senior judge there under Cheryl Mason. Well, actually he's senior to Cheryl, she's just a ladder climber, but Scharnberger, I mean, he doesn't do very much, so he must have been taking the golf clubs with him to Texas for that hearing last year.

J Basser: 26:56

Well, sometimes you get lucky.

AskNod: 27:00

Well, sometimes you get lucky. Well, yeah and you know when you're that senior. Yeah, you can take those Travel board hearings slots, Because they're all gone now with AMA. That's all video. They're getting rid of the actual face-to-face. That's the ones I love. I always have travel board hearings Whenever I can get them, and now we're lost on that.

AskNod: 27:17

We're in the Zoom world. Do you think that's just a COVID thing? Do you think that's here to stay? No, no, that's written right into the AMA. It said no more face-to-face hearings, it's all video from here on out. Well, that kind of takes.

J Basser: 27:37

I think the judge needs to be able to see the veteran in his current condition.

AskNod: 27:42

The one I'm doing on May 4th is for our gal. I'm not going to tell you her name, We'll call her Susie, but she's got MS. She came down with it in the service and she managed to crawl her way through three and three quarters of her four years in the Navy and finally they let her go and she's heavily rated at M and a half, but she should be at R1. And they did what I was describing to Bethany Instead of considering the loss of a hand and a foot as being a separate condition from the MS, they lumped it in and just called it an additional conditions associated with aid and attendance, which it's not. So I have to discuss Brenner-Sir versus Shinseki with the judge and explain the VA law to her.

AskNod: 28:34

I was hoping to get a guy, because when you have a girl vet or a gal, whatever, a lady, a male is a lot more forgiving than another woman as the judge in BVA land. I don't know why that is, but it just is. I don't mean anything by it, but vice versa. I've had Sherry Crawford and I want her in front of my male vets because she and I can talk turkey. We're like peas and carrots. I've done a bunch of hearings in front of her and she floats my boat.

AskNod: 29:08

She's got a nose stud and cornrows and I'm telling you we're just like two peas in a pod. She respects veterans, that's what I enjoy about this is I'm a veteran and I've walked in those boots and I can stand in front of that judge or sit in front of him and say, yeah, and this is my veteran.

Bethanie Spangenberg: 29:28

Oh yeah.

AskNod: 29:29

I'm a veteran too. I'd cheat, I'll lie, I'll steal, I'll do anything for my veteran, but it helps. No, I won't do that. I will not. I'll steal, I'll do anything for my veteran, but it helps. No, I won't do that. I will not support myself for the purpose. But yeah, I use every trick in the book that's legal to get a leg up on my vets.

J Basser: 29:51

Any type of neuromuscular disorders like ALS or MS. Over time they're going to have to have R2, especially ALS, because it's a life-ending disease, you know, and the other stuff. I guess that's lesions on different nerves and stuff. That's a little different disease but that's pretty sad. And somebody to be diagnosed and serviced and make it through their time almost to the end, that's pretty damn good.

AskNod: 30:28

Well, they try to treat this R1 and R2 as if you have to ask for it, like you have to file for it, and that's not the truth. Ackles versus.

J Basser: 30:37

Derminsky. No, that was the.

AskNod: 30:40

Yeah, it's exactly. You don't. If you're, if you're entitled SMC bethany's SMC calculator, supposed to discern it, decipher it and grant it, but it's not a self-starting computer. And then she says it doesn't work very well.

J Basser: 30:59

I agree but there's so much involved, alex I mean there's so many different factors involved it's very difficult to do well, I had one judge.

AskNod: 31:11

I had one judge. I was asking for r1 and I figured if I could get over the notch into r1 that I then I was going to file for R2. I had the judge after I got the, when he granted the R1, he says no, and in addition to this, because he's getting a nurse coming in every week and blah, blah, blah, I'm going to go one step further and grant him R2. And I went get the hell out of here. Really, when did you become so munificent, your Honor? When did you become so munificent, your honor?

J Basser: 31:42

do you remember those judges, man, because you know, once you get to know them, you can tell down the road basically what's going to happen. It gives you an idea of social security. The same way, you've got certain judges that are that award claims, and you've got certain judges that award claims, and you've got certain judges that won't award a claim even if you're dying.

AskNod: 32:06

There's some that are cold as a mackerel, like Judge Hendon was. I don't know if he's still there. I haven't seen any decisions by him, but he was a piece of work. I don't know how he does that. I want to put Bethany on the spot. Bethany, he was a piece of work. I don't know how he does that.

J Basser: 32:19

Okay, Now I want to put Bethany on the spot. Bethany, explain to us how you came up with, how you created this monstrosity of a special monthly compensation calculator.

Bethanie Spangenberg: 32:34

So it is still. We're still doing a lot of testing on it, but it's out there for people to use. My biggest thing with the special monthly compensation is it is very confusing and the questions that I get on it a lot. I have to do a lot of explaining. So my goal in creating the Special Monthly Compensation Calculator is for any veteran to go on there and say hey, what do I qualify for? And so it is based on so it's like color-coded, so like anything involving the head or the upper extremities. It's color-coded so that way you can kind of understand, you know visually each component of it.

Bethanie Spangenberg: 33:24

We do get a lot of requests for nexus letters on some of the special K. I guess that is a benefit because veterans get that special monthly compensation, category K, on top of their scheduler rating, so they could be 100% and still get that special monthly compensation K. So K is kind of different. So we get a lot of questions about that and so the calculator was built to kind of have the veteran put in hey, I have this, hey I have that, and then at the bottom it fits out what they're qualified for. It is different in the fact that the VA's compensation calculator is based off of dates, so they plug in a date so that way it calculates the compensation rate. This is just telling you what you should be asking for because, just as we have talked tonight, if you don't ask for the SMC you're not going to get it. It's going to be a fight. So you plug your information into the calculator and it will tell you what you should be asking the VA for.

J Basser: 34:37

Yeah, that's true. That's another auxiliary benefit that they don't want to give you either. That's pretty sad.

AskNod: 34:43

it should be available let me click on one of these and see how it's working. I finally got yours to load up. It took a while for it to boot on my computer.

Bethanie Spangenberg: 34:56

I don't know why the server, the company that we used, was slow because, while for it to boot on my computer, I don't know why the server, the company that we use, was slow, because somebody called me right after you and they're like hey, I can't even get the registration form to come up. They're on the same platform that is open to the veterans that are registered with us. They could jump into their portal. They click on the SMC calculator and it pops right up. Now I gave you to the shortcut link so you can look at it and see there is a lot of information there, but it's very specific. So each section it's very specific. So each section it's very specific, and so if that is something that the veteran has, they can click on it and it'll calculate everything.

AskNod: 35:47

So tell me, this is a burning question I have for you. I'll give you a really, really simple dumbed down scenario. Dumbed down scenario I get a vet who he came down with brain cancer and I had to. It metastasized from his nasal passages and I had to fight, get a long, two-year fight with a VA over it to get him service connected for cause of death and the cancer. And they finally came back and they said okay, he was permanently bedridden from December 17 until the time he passed in July of 2018.

AskNod: 36:26

And four days later they said, oh, and you also need aid and attendance because of your 100% for your IHD, your 50% for your PTSD and your 40% for your, your 50% for your PTSD and your 40 for your DM, diabetes and then peripheral neuropathy of 40% in every extremity, except for maybe it's 30 in every extremity and 40 on the right hand.

AskNod: 36:49

Anyway, long story short, they called it aid and attendance but all they did was give him the bump up 100% under F4 rather than a full aid and attendance kind of situation or loss of use. I've gotten one guy, only one two aid and attendances and got him to R1 that way. It was a real long haul. It took almost four years and a couple of BVA remands to do it, but it seems I'll never win one of these things at the local level. But I'm seeing raiders start saying, yeah, you're entitled to aid and attendance, but when you go to read the rating it says permanently bedridden. And you're going well, that's not aid and attendance, that's permanently bedridden. That's two different things. Is that the way the Adobe program just types out the rating decision to say aid and attendance instead of permanently bedridden?

Bethanie Spangenberg: 37:55

You know, I don't know. I'll have to look at that. I haven't ran into that situation. We did a lot of aid and attendance exams when I was at the VA and that was. It was always challenging as far as from a medical perspective.

AskNod: 38:10

So well, I, yeah, I noticed. No, I've had. Uh, yeah, I had gone out and gotten IMOs for loss of use of lower extremities due to, like for example, parkinson's. This guy kept falling down and had a lot of problems towards the end of his deal there and I filed him for loss of use of lower extremities extremities. I spent a year doing that and finally they cued themselves after I started screaming, doing what you're doing, calling to the Office of Administrative Review or the AMC back in DC and saying, hey, you can't do this.

AskNod: 38:50

I'm being told I'm sorry, you can't make a diagnosis of loss of use of any extremities. Only a VA examiner can make that conclusion. Medically, I know they won't let you in the front door. They said if only we can make that decision. But I've seen it on DBQs where it'll be right down there at the bottom. Last question they'll say in your estimation, would this man be equally? Has he lost the use of his lower extremities with the prosthesis hacksaw language? And why would they even ask a doctor that if they won't allow, they won't accept what the doctor says anyway, that's a medical decision. Doesn't that conflict with Colvin?

Bethanie Spangenberg: 39:45

I could go round and round, but the whole thing is nonsensical. It's nonsensical, it's a fight and it shouldn't be, but it really is. But the way that I explained it with the if I cut your arm off, would you be better off? That's literally what I would say to the veteran, because that is how it is understood to us. But it's in the hands of the VA. If they decide, oh well, this is loss of use. This isn't loss of use, it's a legal determination. It's like it is a difficult situation.

Bethanie Spangenberg: 40:26

That's what the regulations say. Is that it's a legal determination? Well, that's what the regulations say. Is that it's a legal determination? Well, that's what the M21-1 says. Is that it's a legal determination, and it's not. You know something that the medical examiner is to say. But if you look through those DBQs, there is not a single one. And I've reviewed thousands and I've done hundreds of these exams, and I've reviewed thousands and I've done hundreds of these exams.

Bethanie Spangenberg: 40:48

The way that our mindset is inside the VA is that? No, because we don't look at the function of that extremity. We look at the burden that it causes. Well, okay, if we cut his leg off, he's more burdened with having to put the prosthesis on, and then he has sores, and then he has all this other stuff having to put the prosthesis on, and then he has sores, and then he has all this other stuff. And so for somebody to have an amputation or a prosthetic is a significant decision on a medical perspective. And so when you try to wrap your head around what that legal definition is, it just doesn't connect. And so that's why, when I stepped away from the VA and I realized the legal side or I understood the legal side that it's like there's such a disconnect for that medical examiner and what they're being asked to do, and that's why Valid for Vet came around.

J Basser: 41:47

That's very similar to the way had Itcom came around, or Asnodorg.

AskNod: 41:58

When I won in 2008,. I wanted a crow from the rooftops 28 years, but now, I know how to do it so it doesn't take 28 years. But now I know how to do it, so it doesn't take 28 years.

AskNod: 42:12

I'm so old, at 70, that I can tell you about my first BVA appearance. It was three judges and one of them was a doctor as well as a judge. That was back in the infamous. There were 20 boards with three veteran, three judges in each board until it was 1994 and then I all the single judge decision started, but you talked about hard ass.

AskNod: 42:37

You couldn't you couldn't win hearing loss if you came out of the service deaf. They just say well, you know, you got it. You've been out more than a year, son. You could have gotten have gotten deaf in a year since you've been out.

J Basser: 42:50

You couldn't win, that's because you weren't well-rounded, buddy Well.

AskNod: 42:57

Bethany's got a good point. I'm telling you, it took me even and I'm dense, you know, I'm a man, you know you get the SMC box out of the file cabinet and you start staring in there and I'm looking at this thing about prosthesis and would you be equally well served? And finally, I had to read a good decision. I think it was Tucker versus West and they explained it a little bit more succinctly but in layman's terms yeah, would you be equally well served if, if, if, if push came to shove and we had to have an amputation in order to get you mobile again, could you do it with a prosthesis? And the answer might be yes and it might be no. But by the same token, would you be well served to have the amputation?

AskNod: 43:48

In the first instance? It shouldn't be a legal determination. It should be a medical determination by a medical doctor, whereupon a legal decision, a conclusion of law, would manifest from it. Rather than for somebody who is a rater to, rather than for somebody who is a rater to look at it and try to figure out a medical decision and decide whether you're going to grant it. Granted, you've got to make sure it's independently ratable and this and that there are a bunch of legal conclusions you have to reach, but you shouldn't abrogate the medical conclusion and start reaching your own conclusions about it. Remember we're non-adversarial and the benefit goes to the vet. Yada, yada, yada. I don't see that, and I'm sure Bethany was hard-pressed to find it when she was working there.

Bethanie Spangenberg: 44:44

I didn't.

AskNod: 44:48

I didn't. Well, I've had a couple of VA raters who are active, who use burner ID emails to dump things on me, including the purple book. So you know there's a deep throat in every organization. They pass me on all kinds of weird ass things and I guess they they know that I would never, ever turn their names in, like the veterans law judge that gave me a purple book, swore me to secrecy up one wall and down the other when he was still a veterans law judge, but we talked all the time. I asked him for information once he started talking to me, but I had to go through a separate non-VAgov address, that's for sure.

Bethanie Spangenberg: 45:37

You know, what's interesting is, when I was in the VA and I was a CMP examiner, I knew that I wanted to do more when I was there.

Bethanie Spangenberg: 45:48

So I would literally pull attorney contracts out of the C-file photocopy them redacted. So then that way because if you copy it you put a highlighter through it or the permanent marker and then you copy it again, it completely blocks out that redacted or those names and the social security numbers and things like that but I was looking at those attorney contracts. I mean I was trying to learn the legal side in-house while I was in-house, so it was something that I had a drive for. So even when I left the VA, I tried to stay in contact with some of the people that I used to work with. And so it's funny how the VA works, because it's very bureaucratic and when I, to this day, I still talk to the C&P manager that's there, but the nurse practitioner that became over that department it was like I am sworn to secrecy, I am not saying anything, and it's like I don't understand. It's just very strange how things function in there. So I'm glad that you found somebody that was like hey, non-va email.

AskNod: 47:08

Well, it's kind of funny. I've been contacted by a bunch of staff attorneys that have their own little private Facebook page I guess it's not a Facebook, I don't know how it's inward facing certainly and one of them gave me access to the group because I guess they think I'm a kindred soul from the way I write on my site. But you should have seen the long list of bitches about these guys. They have to take all their homework home for all the BVA judges and end up working all weekend long. Just it drives them bonkers to have to work 80 hours a week and they're not making. You know they're making like starvation wages.

AskNod: 47:48

I was born in washington dc. I know how much it costs to live there. It's insane. And these poor guys are knocking off about 88 000 a year and they're they're probably paying 2 000 a month minimum for a, a coat closet of an apartment and it's you. You know they're not making any money at it and I keep admonishing them to go private. You got to JD, use it. This is, I hate to say it, but it's a target. Rich environment is what we used to say in Laos. And there's more veterans. I get like six calls a week at a bare minimum. I get like six calls a week at a bare minimum and I just hand them off to any NOVA attorney that will sit still long enough for me to send them over to praying that they'll take them, because I can't. I'm a one-man band, bethany, I know you're not, but then again you're not doing the representation facet of it for the most part.

Bethanie Spangenberg: 48:50

But we get that question all the time. They, they people ask me to represent them. People ask who do I go to? And we, we do, we, we send them. So of course we have attorneys that we're close with and that we work with. The biggest thing we want to do is find somebody in their territory and of course they are always NOVA, because I enjoy and appreciate the work and knowledge that NOVA has brought to me. But we get that question all the time and I honestly think that this AMA has made it worse, has made it worse. I think the veterans are needing more representation since AMA came about.

AskNod: 49:37

The AMA, all they did was add three more miles to the end of the tunnel and it's an instant panacea. It's like buying a scratch-and-sniff lottery ticket. You go down there, you buy your ticket, you walk outside and you grab your quarter and you scratch it off. Did I win? You know? Next, 10 years from now, they'll have drive-through windows. You come to the first window, you place your claim order, pull around to the side window. It's just denied. Here's your 101.82 or your 996. Oh Lord.

J Basser: 50:13

Go ahead, john. It kind of reminds me years ago when they came out with the first disabled social security claims and the process they had to go through back in the day. The process they had to go through back in the day. And now, unless you have a life-threatening illness that meets their listing level impairments on the Social Security website or their law book, nobody's going to win Social Security payments unless you go in front of a judge. That's what it's morphed into today, and in the future, I believe the VA will morph into the same type of system.

Bethanie Spangenberg: 50:54

You know, I think you really lose a lot whenever you don't have your eyes on the veteran. The case becomes black and white and you lose the testimony and the the visual portion of the veterans case, and I think that's so important.

J Basser: 51:16

Well, the human factor is a big issue, you know, because you look at the VA. I mean we all go to VA. Alice goes, gerald goes and I go I'm sure people listening calling in go to VA when you go. When you go to the VA, what's the first thing they ask you? What's your last four? Hello, mr 2525. How you doing today.

AskNod: 51:41

Don't put me in that box, John. I don't go to the VA. They almost killed me.

J Basser: 51:49

I don't think you can get across the hill to the VA Al.

AskNod: 51:52

Well they know who I am. I had quite a wonderful conversation with Mr McDonald one time back in 15 or 16. He was very cordial for being a fake ranger. He didn't have any combat Vs though, so I don't respect him.

J Basser: 52:10

Who McDonald had a. I remember Mr Robert McDonald.

AskNod: 52:19

I think he was the most transparent and the most accessible of all of the guys. Personally, I had really poor luck with Wilkie, but then again, you know, when you've got a client that's dying and you've got a letter from his doctor saying, yeah, we're just giving him palliative care until next month, when we have to call up hospice and start that up, well, you get people who jump through the hoops for you. I got a 30-day decision from March 4th to March 29th for a grant. It was PTSD or not PTSD. What do you call that?

AskNod: 52:58

I guess a major depressive disorder associated with IHD he filed in 2002. He wasn't approved for Agent Orange stuff. Then he was Blue Water. When he finally got the NEMER classification they re-rated him. When I re-filed him, but they didn't grant him that major depressive disorder. I called up the judge and filed a 101.82 with the judge and sent an AOD. Please, please. He's over 75 and he's dying. March 4th to March 29th he granted debt all the way back to 2002. So now he gets his concurrent receipt of both his retirement and a VA comp. So it's a big win.

AskNod: 53:46

But they can move like light speed when you want them to. What I don't understand let me ask John one question. Ask Bethany real quick. Why is it the VA says 75 years old or terminal illness or something, or 85, but the BVA says 75? Do you have a read on that one? No, I don't even think that's appropriate but the BVA says 75.

Bethanie Spangenberg: 54:09

Do you have a read on that one? No, I don't even think that's appropriate.

J Basser: 54:17

Well, to tell you the truth, I saw a claim I was actually involved with. This has been four or five years ago. This guy was service-connected for tuberculosis TB. He contracted it in 1940 in World War II Was discharged at 100% 1958, they come up and said by God, man, you're cured. Of course we all know there is no cure for tuberculosis, right? Well, they cut him down to 30% and his lung function was terrible. I mean, he couldn't hold a regular job. He had to do sit-down jobs and all kind of crazy stuff. When we revisited his claim, he filed claims through the DAV and other folks and he kept getting denied. Got hold of his claim and saw what they were doing to him back in 2012-11. And so I turned it over to another agent and got it filed. He went from a denial letter to a BVA hearing to a grant All three within 21 days. Wow, all three within 21 days Wow, that's impressive.

J Basser: 55:32

Two days after he won his claim he died.

AskNod: 55:38

I had one like that last year, John. I finally got him busted through on an 1151 claim. I won it. They raided him April 9thth and he died April 10th. It was disgusting.

Bethanie Spangenberg: 55:55

You know, what I think they should do is again let the medical professional in these cases designate the veteran's overall health condition At the bottom of the DBQ. The very last question it should be what is the overall current status of this veteran's health? Stable, severe, you know? Because I think that would allow the medical component to kind of give that urgency factor and not just he's 75 or he's over 85. Because the veterans in general they're sick cookies. When I was in the civilian side of medicine, I could tell when a veteran walks in, based off of their medication list and what they look like, because they're the sickest of the sickest, and so I wish that they would kind of depend on their own contractors to say, hey, what's the overall status of this veteran's health?

AskNod: 56:59

Well, somebody is supposed to look at 4.2 and 4.6 in Part 4 of Art 38 CFR and started looking at it as the whole claim, the whole body, the whole status of that whole. Excuse me, longitudinal, I don't. That never happens. As Bethany says, it's all in isolation here. You take care of the left front tire, you take care of the right rear tire, you check the rear view mirror and the oil and you, you know, check the right rear tire, you check the rear view mirror and the oil and you check the trunk and make sure everything's in there. It gets so broken up, just like an assembly line in Detroit on a vehicle where no one person ever sees the final product. They're too busy looking straight ahead of them, screwing nuts, bolts and fenders and car antennas onto the product, without seeing the whole car. And that's where I hit my problems.

J Basser: 58:04

You know that's true. They've got to look at the whole vet. They should look at the whole vet. Why did they not be on me? And you're also right, the doctors that do the exams, that see the veteran, should be able to put their opinion out there and they should abide by their opinion. Last I heard the regular office doesn't have a license to practice medicine.

AskNod: 58:31

Well, I've seen the directive that went out to the VA doctors and all the VAMCs and they told them to keep their mitts off of the VBA's business and noticed that the initials at their joint says BHA rather than VBA, and so they run the risk of losing their jobs. Some of them don't want to even have the jobs because of the turnover. You can see that. But they're given an ultimatum. You do not hand out IMOs, you do not give a veteran information. They would need to win his claim.

AskNod: 59:07

They're really tight-lipped. It's more a rule-out game than actual medicine, the way we think of it. You know there's supposed to be.

J Basser: 59:17

We've got about 40 seconds left. Bethany, why don't you give everybody your website information, and Alex will do the same thing. Go on too.

Bethanie Spangenberg: 59:28

Valorforvetcom V, as in Victor A-L-O-R, the number four vet V-E-Tcom.

AskNod: 59:38

AskNod at gmailcom or asknodorg. That's my website. I'm pretty easy to find. I'm in the Bethany's probably in there too. We're both in the NOVA directory of accredited agents or attorneys and stuff.

J Basser: 59:56

We want to thank you both for coming on, guys. We appreciate it. We need to do this again soon because there's so much information out there your wealth information and this ain't been a lot enough all afternoon. We'll do this again very soon. Co-host. Mr Cook, I hope you're still awake, gerald. Yeah, I'm awake Boy, I got an education today Well that's our goal. That's our goal is to bring.

J Basser: 1:00:24

You know we need to bring people on. That, you know, can make a difference and I've got an idea of how to do that and we've got to meet the agencies. We've got a new agent coming next week, so we've got a guy overseas coming up on the show. So everybody, thanks for listening. I do want to appreciate and want to thank Bethany and Alex both for coming on and we'll see you next Thursday. Guys on the Haddoncom Expose that podcast and we'll be signing off. For now You've been listening to another episode of the Expose that Veterans Podcast. The Expose that podcast is brought to you by Expose that Tune in next week for another edition of the Expose that podcast. And thanks for listening.