Episode 5: How Veterans Actually Get to 100%

This episode breaks down how veterans actually get to 100% and why most are chasing it the wrong way.

We cover what really moves your rating forward:

• VA math and why your ratings don’t add up
• Secondary conditions that can increase your rating
• What evidence actually matters when the VA reviews your claim

We also explain why so many veterans stay stuck at 90% and what they’re missing when they try to figure this out on their own.

If your rating isn’t moving, this will show you why.

Transcript

SPEAKER_01 0:00

Denied, delayed, underrated. That's the story for too many veterans, including me. Hey veterans and the families listening in, welcome. My name is Robert Pinero. I'm a Marine Combat Veteran and the founder of Veterans Educating Veterans. I served two tours in Iraq, and like many veterans, I know how hard it is to get service connected and navigate the VA system. After service, I was frustrated, in pain, and told no more times than I can count. Even by VA attorney. So instead of giving up, I decided to learn the VA process myself. That's what Veterans Educating Veterans is built on. We educate and guide veterans through the VA compensation process, step by step, helping you understand how the system works so you can move forward with confidence, not confusion. I do this work alongside my wife Jillian and for our two daughters because our families live with the impact of service long after the uniform comes off. You deserve the benefits you've earned, not just for yourself, but for the family that stands beside you. Welcome to the War Room.

SPEAKER_04 1:17

The War Room by veterans educating veterans.

SPEAKER_01 1:36

Alright, welcome back to the war room. Um, thank you for listening in. And today we have Coach James with us. How's it going, guys? We have Coach Cody and we have Coach Jesse with us. What's up? How was your flight, guys?

SPEAKER_02 2:00

Mine was quick and easy. It was pretty good.

SPEAKER_00 2:03

Delayed, as always.

SPEAKER_03 2:04

Delayed as well, obviously, with everything going on.

SPEAKER_01 2:07

And how'd the weather feel when you got off the plane?

SPEAKER_03 2:11

Hot, of course. I was supposed to say nice, right? Yeah, nice. Hot.

SPEAKER_01 2:17

Alright, we got a hot topic today. No pun intended. No pun intended. Today we're talking about one of the biggest questions in the VA world. How veterans actually get to 100% and why most people are chasing it the wrong way. Alright. So most veterans think getting 100% is one big claim, right? So they're either going for that mental 100 or they're going for um thinking that they could get their back to 100%. Uh but in reality, it's a it's a mixture of a lot of things, right? Number one is VA math, number two is increases, number three is secondary conditions, and then how you prove those is with strong evidence, right? So a lot of veterans stay stuck because they don't know what they're looking at, right? They look at their claim and they start trying to guess and trying to listen to podcasts to try to pick up on what people are doing in order to get to 100. Um, but the reality is that everybody's claim is a fingerprint, right? It's different. So um today we're gonna break down really how you build that 100. And once again, like I said before, it is a fingerprint. So um your case may be different, but we're gonna go over some strategies, some evidence. Um, so let's start with the part that confuses almost everyone, which is VA math.

SPEAKER_00 3:56

Yeah, absolutely, Robert. VA math, I mean, the far the higher up you go, the scale, it it changes everything. Um, a lot of people see look at their rating, they're like, Well, I got 40 for my back, and then 10 for this and 10 for that. Well, I should be or in another 10, I should be at 70 percent, and they're only at 50, you know, because of the how the VA scale or 60, how the VA scale works. Um with that scale, it definitely changes everything. Um, especially the higher you go, the less impact it has on your rating. So you may have uh, especially once you get to 70, once you hit 70, um, to get up to the 100, it it's it's not, oh, I need 30. It's it's like 160 overall total to get you there. It's a significant amount, it can be for sure. Um with the you know, because of how the chart works. I mean, they they do it on purpose, you know, to because people can get so many different ratings and hold you know 15 service connections, but they're all at you know 10, 20 percent. It's you know, they have to limit, they have to limit it. They have to do it, you know, uh on a on a rating scale itself.

SPEAKER_01 5:13

Uh can you further elaborate on on the VA math?

SPEAKER_00 5:17

Yeah, absolutely, Robert. So VA math is definitely uh a huge talking point and confusion for most veterans. Um, they look at their rating, they see it, they got 50, 20, 20, and they're like, well, I should be at 90. And in reality, they're at 63 or 68 because of VA math. Um, and then the higher you go, the less impact that rating has um on your overall rating, especially once you get to the 70, 80, 90 percent. Um, these veterans look at it and they're like, I just I'm at 90. I just need to, you know, 10 more. I need a tonight is 10. In reality, they're the VA math equates it to 85%. So they're at their lowest 90% it could be. They add another 40% and it bumps them up to 92%. And they're like, Well, I got 40, but it didn't do anything, right?

SPEAKER_01 6:03

Because VA math because that's because 85 means that we round up because that's why you're at 90.

SPEAKER_00 6:11

You're not technically written at 90, but it rounds up when it's so 85 to 94, no matter anything in between, you're at 90 percent. Um, so that and then the higher you go, so if you're at 86 percent overall, you add 10, you're at 87, because that 10 is a one point once you hit that 90 rating. So it's a significant impact and and struggle to go from there.

SPEAKER_03 6:38

See, this is how you know a Marine came up with this, because in what world does 50 and 50 not equal 100, other than the Marines world in counting. So um in all seriousness, you really just need to be and who eats crayons. You just really need to be strategic in the way that you you you try to increase your claims. If you need to get over the hump to 100 and you're at 90, and you're looking at okay, I'm gonna add 30, and you're at, like you said, 85. Is it really gonna do anything for you? And it's not, it's not gonna change your rating. Um, so this is where secondaries come in big. Um, you know, adding the the ridiculopathy to your back is a big one because you also have bilateral factors, which is a huge one. Um, it's a multiplying factor. There's a lot of math that goes in it. And just because I was in the army, I went to public school, so I don't know a lot about that math, but there are a lot of calculators out there that do it. Um, but there's a a bilateral factor that gets multiplied in there with that. So just being strategic in how you go about it and and adding the right disabilities to get you over the hump is gonna be key to getting that increase.

SPEAKER_01 7:50

Um, you know, that's so besides the rating of the bilateral factors, which for example, we would always use ridiculothopy, which is a secondary condition to the back, which is 20 and 20, after that you get an additional 10% because of the bilateral factor.

SPEAKER_03 8:07

Absolutely. Yep, and those are like extremities, like your legs and your arms are are are bilateral factors. So that that's where those come into play. Um, and and just like you said, that adds that additional math to it, which like I said, public school, I gotta use a calculator.

SPEAKER_00 8:23

And that and just to jump in on that, Cody, that applies to all extremity portions. So left wrist, right wrist, left elbow, right elbow. Yes, left shoulder, right, right shoulder, ankles, right, exactly.

SPEAKER_02 8:34

Anything on the extremity portion. Exactly. Uh, and and that caused a lot of uh misunderstanding and uh confusion, frustration with the veterans. Like um a lot of them here, you know, that they're they're so close they think they're at 90%, and some of them come and think they only need 10%. Um, but in reality they need 50 or 60 and to get to their hundred percent. And um usually most of the time that confusion causes them to think that hey, if I just go for this, I I I'll I'll get it. If I go for this, and that's why you know they need that guidance to know like like what Cody said and and James about you know the secondary conditions, uh ridiculosopy and all that stuff that they don't even know that they might have. Um with uh some some veterans don't even know about the them getting a rating for their ridiculous people. Um they'd even and they do have that type that's that type of symptom.

SPEAKER_01 9:39

So it's not just about the math, it's what actually gets the veteran to 100.

SPEAKER_00 9:45

Yeah, first thing to definitely look at is you know, what are you currently rated for and is it underrated? Um has has that condition worsened since the original evaluation? You know, are your flare-ups worse? Are the range of motion worse? So all that is the first step. Um, second thing to take a look at is are there, um, like Cody was mentioning, are there um bilateral factors that can be applied? You know, so you are service connector for your back. You got you got stenosis in your lumbar spine, you got nerve impingement, which is affecting the femoral nerve or even the sciatic nerves, is the biggest one. They call it the colopathy. Um, so the numbness, tingling, burning sensation down those legs that's starting to bother you now because of the uh deterioration of that joint space or the disc space between your vertebrae. Um, and now you're having you know all these symptoms, they can be added on um without a nexus because it is it is you know it's just part of um the nervous system in the back itself.

SPEAKER_01 10:44

Sorry for the simplicity of of the folks listening because you went true medical terminology on us. Um so can you indicate like some symptoms of the ridiculothopy?

SPEAKER_00 10:57

Yeah, so you know, for uh to make things easy, you know, numbness, tingling, burning sensation, shooting pain down one or both of those legs, um, hot white pain, pins and needles, all those can be symptoms or if to this extreme drop foot or complete numbness of your toes and everything. Um from the impingement of the nerves, you know, to in your back that are affecting your legs, you know, mainly the sciatic nerves is a big, big one that a lot of people experience for sure. Um, people can also experience ephemeral nerves, which is the inside of the legs, same same concept. Um, it can also be applied to the neck and the upper extremities, same thing. Very true. Um, so you gotta, you know, those are key things that can be added on. Um a lot of people uh forget about those or are aren't aware that hey, I'm service connected for my back. These are also get applied to it because they are affecting and and our root cause from my service connected disability. So they gotta make sure they they take that into account for sure.

SPEAKER_03 12:07

And that's uh another great point um in trying to service connect these other issues. Is it's kind of like a chain reaction, right? So your your knees and and ankles are causing you to walk a certain way that's gonna cause issues in your hips, or your your chronic pain is causing you uh mental health issues. Um there's several other secondary conditions they're gonna that are gonna be uh a much bigger reason for you to get the increase and a much bigger increase in general to get you over the hump than trying to service connect something small, thinking that you only need 10% because you're at 90 and it's just not the case.

SPEAKER_02 12:45

Yeah, a lot of veterans they they tend to normalize their symptoms. Um and uh, you know, they do what they're what we were trained to do is suck it up, move you know, move forward, um, keep moving through life. Um, I've had veterans that had multiple injuries coming at zero percent. And they're just like, oh well, I didn't think I was I didn't have any type of like uh claim for this or or compensation, and I don't have a missing leg or I don't have a missing arm. It's like it doesn't matter. You know, you got you made this injury happen in service and now you're dealing with it now, you're making it normal for your life.

SPEAKER_01 13:25

So now that we explained uh VA math increases, secondaries, uh the next question is what actually proves it, right? So let's talk about the thing that separates guessing uh from strategy, which is evidence.

SPEAKER_00 13:41

Yeah, the biggest, biggest one for evidence um obviously is it is a DBQ because that's the evaluation itself, the severity of the symptoms. Um, for any kind of new thing, you must establish a nexus. So a nexus is a doctor's professional medical opinion stating that due to the injury you sustained while on active duty is the reason that's the root cause of why you're still experiencing these things to this day. Um, so i.e. you fell off a Humvee, you hurt your back, they took you to medical, they examined it, you're out light duty for two weeks from it. There's the injury, then Nexus says, boom, here we go. This is this is why your back is still messed up. Um, service streamer records for sure, showing that you sustained that injury in active duty. So it's not what we know, it's what we can prove with the VA. Um, we can, you know, if it's documented medically, there's proof right there. Um, the meta VA medical records has another great, great thing, um, showing continuation of symptoms. Hey, look, I injured my back when I fell off the Hum V, and you're still going to your doctor to this day, um, getting exam for it, complaining about you know, chronic pain from it or flare-ups, you know. I'm not saying you got to be there weekly in the ER, but you know, if you know, every six months or a year when you go to your doctor, you know, definitely let them know that's hey, it's not getting better because it's most of the time it's not going to, for sure. Um, or if you don't see the VA, if you see private health care just because you're not established, that's another great, great thing. And that doesn't have to be um a DO, MD. It could be a chiropractor, it could be uh uh um a masseuse. You get weekly massages to help loosen up the muscles because of the back, the tension in your back from it. Uh statements of supporter claims is another one because it gives the perspective an outside perspective. Like you, like as Cody said, you know, and and Jesse said, you know, a lot of these people live uh learn to deal with these issues and live with them, and you just suck them up and just move on. Um and the outside world can see you as your family, your coworkers, your kids, your wife, your husband can see the real struggles that you experience that you think you're hiding. Um, as simple as you can't pick up your kids because your back hurts too much, you can't get on the ground to play with your kids because your back hurts too much, it's flaring up, or you know, things like that. They can paint that outside picture that when you're not at the doctor and don't fully explain to them how this affects your day-to-day life for sure. Um, other thing I know Cody mentioned chronic pain can cause mental health issues. Um, uh, there's case studies out there um that prove that. Um, the doctors we have are very knowledgeable about it. They'll take a look at it and say, yeah, this, you know, this is definitely causing these problems, um, these sleep issues, these uh mood mood problems that affect your day-to-day life. And a lot of people don't realize that and think about it. Well, like, yeah, my back is so jacked up, I can't sleep, I can't work, I'm absolutely miserable, I can't enjoy my life. There's case studies that prove it and and and that are out there. Um, and the biggest thing is as Robert said it, this is a fingerprint for every case. Every person is different, everybody's story is different, injury's different. Um, just because you didn't, you know, lose a leg doesn't mean you weren't injured and not sustained and not compensatable for it. For sure.

SPEAKER_03 17:06

Yeah, absolutely. Uh speaking in evidence, the one of the biggest pieces clearly is the DBQ, the disability benefit questionnaire. Um, like you said, explaining the severity and the symptoms that you're having is going to be one of the most important pieces that you're having. Um the the studies that go along with it, like uh I think you mentioned the chronic uh pain leading to mental health issues. There's a lot of studies that link the two. Um, there's a lot of studies that link tinnitus to mental health issues issues as well. Um, there's several studies out there that link secondary conditions to main conditions. Um and the the job that one of the jobs that we do is is research that for you and and go out there and find that for you.

SPEAKER_01 17:50

Um if you're there's even MOS type studies. Yeah. So, you know, people who were paratroopers, you know, there's studies out there about how their knees, you know, were affected, and they studied a hundred people who jumped out of planes, and and how that's a common injury um in service. So yeah.

SPEAKER_03 18:11

And I think a lot of people don't know that, and and that's that's one of the key things that's going to get you service connection or going to get an increase from what you have, or service connected in general. Um, so the evidence that you have isn't just gonna be all of this paperwork, it's gonna be paperwork that makes sense. You have to make all of this line up in order and make it make sense to the VA. That that's sometimes a hard job to do because making stuff make sense to them isn't as easy as as one, two, three, because for some reason the VA likes to do VA things. So the goal is to be able to build a believable and supported case with all the evidence at hand. So that's just kind of what we do here.

SPEAKER_02 18:53

I mean, even like a simple uh statement of like how explaining how their life is and you know, connecting the dots on on the what's going on with the when his doctor visits and all that, and getting someone to like write a statement for you that has known you for a long time, um, a wife, a friend, um, even somebody that knew you before the military, or um seen the change within with the time that you got out. Um, that's been that's what the statements to me are are very important. Uh and yeah.

SPEAKER_01 19:30

So SCRs can show you what happened in service, right? Um it indicates either a the event or injury, which is one of our pillars that we need to prove for service connection, or um it could also show the continuous of symptoms, right? So VA and private medical records can show the continued the continuity or um how severe your condition is, or it can also highlight a new condition um that may be a secondary condition um in those records um that can actually put a full light on your on your on your whole case as well. So a full review can also reveal things that veterans overlook, um, meaning that uh you would send us a STR, um, and we would do a full uh service treatment record review and a and a full review of all your records, actually. Um so looking at the MOS can sometimes identify common injuries, um, which I had stated before that there were studies that actually um can coincide, especially the infantry side of any branch that has the infantry. Um, there's a lot of studies on that, and and and especially with back and infantry. Um, so this is where experience matters, right? It's it's it's about going to somebody who knows what they're doing, what they're looking for. Um, it's not about you looking at your records and then trying to piece things together. Um, it's about going to somebody who's done it before, right? So giving us a call, uh booking an appointment with a fuss uh would would have a greater um increase of success. Um so the question is why do veterans stay stuck? Right? Number one, their your lack of knowledge, number two, your lack of experience, um, not knowing what to look for, guessing instead of reviewing strategically, um, and then filling um following without a real plan, right? You're so you're throwing stuff against the wall, seeing what happens, and then of course those denial letters come in like like it's raining. Um and a lot of veterans are stuck, not because they have no path, but they're stuck because nobody helped them um see the path, right?

SPEAKER_00 21:56

Yeah, and we can absolutely help you um see that path. For sure. Um veterans have hope and a dream and it just filing randomly randomly. It just doesn't work. Um because the evidence isn't there and there's nothing to support it. Um we take a look at it, we build a complete review um of your file and everything that you are entitled to, the severity of your symptoms is secondary, what your MOS, what you experience, and what you know, what realistically, hey, this is what is known to the VA that you can qualify for um based on what the evidence you have and and everything that you are experiencing. Um so with that is the clear evidence showing that you that you are entitled to this, and then to make sure that you know stop with the guessing game and say, hey, this is exactly what you qualify based on everything evidence that you have a record and everything that you're telling me and what you're experiencing.

SPEAKER_03 22:53

Yeah, absolutely. I think the one of the biggest things to finding six finding success is going to be knowing where to look and where you can increase. Um talking about knowing what you're currently service connected for and what you can increase. Some stuff is maxed out. I get calls quite often like, hey, my tinnitus is getting worse. If you're at 10%, you're at 10%. That's what it is. But if it's getting worse, the fact that you're losing sleep at night, uh, you're irritable throughout the day, you're losing friendships, you don't want to go out, that's a mental health issue. Like that that can cause that issue. So that that's just one thing that you need to know is knowing where to look to increase your claim. Uh, those secondaries, uh, knowing what's in your records, knowing to keep your records current and reporting your claims. Um, that that's just gonna be key in in getting success and not just filing randomly, getting denied, and then fighting a battle on two fronts, one the denial letter. Even if you have a path forward, you have to fight that denial letter and what was said in that, and still find your path forward with the evidence that you currently have. So that's just uh knowing the path forward is the biggest thing by far.

SPEAKER_02 24:01

Right, right. There's some veterans don't know how how close they actually are. Um, some trying to go a different path, telling us, you know, they'll come and seek for help, and but they're actually I'll hear them out. And they, you know, like they say they want to go for sleep app, or or um I had a vet say he wants to go for obesity. And you know, and then I asked them the questions on what um what um can connect him to obesity. And he, if he don't have none of those connections to be a secondary conditioner, if it didn't start while you were in service, you know, it's not it's not going to be a good you're just hoping for to get it. You know, instead of um building a good claim and thinking and talking to somebody and uh listening to that person, you might just have something just to increase, just to get you there. Um something small, a secondary, or um, like we said before, ridiculous, or um any of those small things um can get you there. But um, yeah, ask for so ask for some help, get some advice, and um buy a professional, by guys that do it, and you can and we can get you there. You're closer to what you think you are.

SPEAKER_01 25:14

All right. So a hundred percent is usually not random, it's built through strategy review and understanding the full picture. Um, but I just want to make it clear that we're not here to make up claims or make up disabilities for you that we're gonna find something to to make up something just to get you to 100%. Because that's that's not what we're we're here to do. You know, we're gonna look at your claim, we're gonna look at records, we're gonna ask you questions about symptoms. Um, there's a lot of strategies that we use because um, like Cody said throughout the episode, your body is all connected. So, you know, what's affecting me in my right knee is not gonna be affecting me on my left knee because I'm I'm putting more pressure on it. And, you know, and that's those are the questions that we ask. We're not we're not here to just get you to 100%. Um, we do things ethically, um, and that's what we try to strategize with you. So, veterans, stop guessing and start looking at the claim as a whole. Okay. Um, call one of us, give us a call, book an appointment, talk with a coach, and we'll see you on the next one.

SPEAKER_04 26:30

The war room by veterans educating veterans.