In early 2023, as the pandemic restrictions eased (and as healthcare workers tried to recover from burnout), I decided to catch up on three years of deferred maintenance: my medical bodywork.
Financial independence is great, and Tricare (plus military veterans’ benefits) make it even better.
The physical exams and blood tests came out fine. I even volunteered for a routine tetanus shot, because it was my first decade in 50 years without hearing an ER nurse admonish me “… and you’re gonna need a tetanus booster before the stitches come out.”
The PACT Act has helped speed up claims.
Yet later in 2023, other problems started to snowball. In mid-2024 I updated my VA disability claim to raise my 30% rating to 40%.
(And before anyone asks: No, I don’t want to pay the price to get to 50% for Concurrent Retirement and Disability Pay.)
This blog post closes the loop on over three decades of chronic health issues that have affected me (and hundreds of other vets) from the 1991 Mt Pinatubo volcano eruption. Reading about this process can help you (and many more vets, and their families) file their own claims. I’ve included links to the references.
We’ll explain why you need to file your VA disability claim (beyond simply helping your loved ones) and then why you need to get a copy of your claims file.
“Future You” will be greatly relieved that Today You has taken care of this.
(Side note: my apologies for the details of the organ recitals. I’m focusing this post on the VA disability claim process– and the admin, and the potential mistakes– but it still requires more context from the symptoms.)
“Normal For Your Age…?!?”
I’m in my mid-60s, and I’m coping with my body’s emerging issues “as well as can be expected for a man of your age.” I had to learn a few lessons the hard way, and I hope sharing my personal experiences will help some of you solve your own medical mysteries.
First, when Congress passed the 2022 PACT Act, it greatly simplified the disability claims process for hundreds of thousands of vets. This is a Very Good Thing. I wasn’t in a hurry to join the crowd, but in 2023 (after some politely firm nagging from my adult daughter) I went back to the VA clinic for my PACT Act screening.
During that screening we verified that my left knee has run out of cartilage in one meniscus, and my tibia’s the bone-on-bone contact with my femur explains why it’s hurting a bit more.
Everyone feels the pain of bone-on-bone differently, and I’m apparently tolerating it well. (The pain is typically 2-3 out of 10, and I’m strengthening my quads & hamstrings to compensate.) I’ll never hike the Appalachian Trail (let alone return to Haleakala Crater) and my taekwondo sparring days are over, so that knee might give me a couple more decades.
Unfortunately my pain management is slightly more challenging because my kidneys recently announced that they’ve reached their lifetime quota of ibuprofen. (Note for Crew Dog at One Sick Vet: thanks for reminding me all those years ago to keep an eye on this.) These days I’m treating the pain with acetaminophen while we’re putting my knees through all of the physical therapy. While I’m waiting for medical science to regrow human cartilage, perhaps someday I’ll try orthopedic (unloading) braces and injections of various cartilage substitutes.
My knees have kept their same VA bilateral disability rating (20% total) and… this is fine. I don’t want to experience the problems that qualify for a 30% rating.
Second, the pandemic clearly demonstrated how quickly my hearing has declined, because it’s really hard to lipread a facemask. In 2023-24 I went through a couple rounds of audiograms and even a contrast MRI to sort out the medical questions before fitting me for hearing aids. The VA audiologists did a great job, and (for my fellow Oahu vets) I highly recommend the Akaka clinic in Kapolei.
Seriously: a big help.
I’ve worn my hearing aids since July 2024, and boy did I need them. You don’t know what you’ve lost over the years until you get it all back in a few seconds.
I’m sporting Phonak Audéo L90-RLs with rechargeable Li-ion batteries– and Bluetooth connections to my iPhone and my PC. My left ear is once again carrying its share of the load, and my right ear needed some help too. Better yet, people have stopped sneaking up behind me.
I enjoy legitimately talking to myself in public when I’m on a call with hearing aids. Best of all, I can wear them when I’m guesting on podcasts or videos– no more headsets sliding around on my skull during recordings!
My entire family agrees that it was time for hearing aids, although my audiogram is still good enough that I’m not (yet) rated for hearing loss. I’m still rated by the VA at 10% for tinnitus, and it’s tolerable. I’m hoping (against hope?) that the hearing aids will slow my hearing loss and maybe even reduce the tinnitus a bit. More importantly, I’d much rather get used to wearing these in my 60s than trying to learn the gear in my 70s.
Finally, in late 2023 near the end of our slow travel in Japan, thirty years of sinus infections caught up with me. I made it back to the U.S. (with lots of headaches & heavy decongestants) and it took three separate courses of antibiotics over five weeks to kill the bacteria. I’m now doing daily sinus flushes (preferably while I’m surfing!) and using Flonase to keep the mucous moving. I’m sorry to report that this has become a new lifetime routine like flossing & brushing my teeth.
Ironically the PACT Act screening questionnaire is all about burn pits, chemical exposure, and even Gulf War Syndrome— yet none of those questions had made me think about chronic sinusitis. I wasn’t trying to be a tough guy… I’ve just never had such a nasty infection before.
During the sinus treatment with the ear, nose, & throat doctor, I went back over my medical records. My VA disability claim file (my C-file) from my 2016 claim is nearly a thousand pages, and this time I had a new perspective on the old evidence.
My dawning awareness began in 2013 when I profiled my genome (with 23andMe) and learned that I’m a carrier for cystic fibrosis. While I was recovering from my 2023 sinusitis, a random comment on a medical website mentioned that CF carriers often have minor CF symptoms like thick, heavy mucous. The ENT doctor raised his eyebrows at my question and said that ENT docs know about it… but in the days before consumer genome analysis, very few humans even knew whether they were CF carriers.
I never knew.
Reviewing only the existing evidence in my C file (no new info!) it became clear that my respiratory system (with its heavy mucous) was fine when I started my Navy career. That abruptly changed in June 1991 when our submarine crew inhaled volcanic ash from the Mt. Pinatubo eruption.
Over the next three decades I had over three dozen different incidents of respiratory infections, allergic rhinitis, sinusitis, ear infections, bronchitis, and even pneumonia. That included my final decade of active duty as well as 20 years of retirement. Each doctor’s summary listed symptoms of sinus pain while my heavy mucous was getting particularly stuck in my left sinus. Over those decades, the repeated cycle of infections caused scarring of the spongy bone in my left ethmoid sinus. Today that scarring impedes the flow out of the sinus.
When you’re on active duty, it’s all too easy to believe that your respiratory infections are caused by chronic fatigue. You’re also worried about being beached or grounded (or even separated), and you don’t want the medical professionals digging too deeply into your symptoms.
In retirement, I thought that I was simply vulnerable to respiratory infections. (Especially in the parenting years when your kids are bringing home viruses from school, and later in the empty-nester decades when you’re traveling the globe.) Eventually you decide that you’re getting older and your immune system must be getting weaker.
None of it seems like a big problem… until the day when your scarred sinus barely drains your thick mucous, and then it gets infected. While you’re visiting Japan.
The ENT doctor observed all of this with a nasal endoscope (on a 4K HD large-screen monitor, yay?) and later a radiologist confirmed it with a CT scan. I’m fine as long as I keep up with daily sinus flushes and Flonase, but if this chronic condition ever gets worse then the next-level treatment is a sinusotomy.
Don’t search on that keyword while you’re eating. Maybe not even while you’re drinking.
Updating Your VA Disability Claim
After I recognized the sinus story in my medical records, I summarized the documents for an updated VA disability claim. Once again I returned to a Veteran Service Officer (at Oahu’s Disabled American Veterans office in Tripler Army Medical Center) and asked for their professional help at updating my claim. They sent in the letter requesting a review of my rhinitis & sinusitis ratings. In retrospect I could have done that myself, but I wasn’t sure what had changed in the process since my 2016 claim.
My 2024 summary (based on my C file from 2016) listed the Mt. Pinatubo eruption as an example of the PACT Act’s service-connected exposure to toxic substances and fine particulates (breathing volcanic ash). I included a copy of a fitness report documenting my submarine’s presence in Subic Bay plus two pages with the dates of all the infections.
I added copies of my ENT doctor’s exams, and I described the sinusitis treatment with the terms used in the VA Schedule for Rating Disabilities, requiring “four to six weeks of antibiotics.”
Finally, I filled out a draft copy of the VA’s Disability Benefits Questionnaire for my sinusitis symptoms.
DBQs are completed by the doctor during the Compensation & Pension exam, using their medical keywords and ICD-10 codes. I give them my draft if they feel it would help them write up their reports.
When I showed up at the C&P exam, it turned out that the VA’s doctor could already access my Tricare Select electronic health record with the ENT doctor’s diagnosis & treatment. (This is a big improvement over the last decade.) He was happy with everything in my memo and the records. He even canceled his CT scan because he could see the other radiology results.
The C&P doctor sent in his recommendations for a sinusitis rating.
How a claim denial really feels.
A few weeks later the VA mostly denied the claim:
“Service connection for sinusitis is granted with an evaluation of zero percent.”
I have to admit that I was a little sad & frustrated, because everything in the claim appeared to meet the rating criteria for 10%. Yet for the long term, I was happy that I’d documented the problems today so that my family wouldn’t have to do it for me years later.
That week I was also busy with physical therapy, audiology, grandparenting, and everything else in my life. I set aside the VA’s letter until I could make the time to start the appeals process.
Surprisingly, the system eventually worked— I didn’t have to file an appeal after all. A month later I got a new letter from the VA:
“A clear and unmistakable error is found in the evaluation of sinusitis and a retroactive increased evaluation to 10 percent disabling is established.”
I can’t tell whether a senior rater checked another rater’s work, or whether the DAV VSO flagged the error and told the VA to do better.
The additional 10% disability rating for sinusitis pushed me up to a 40% rating. Instead of waiving $586.31/month of my $4581/month (taxable) pension for tax-free disability compensation, I’m now waiving $838.28.
Call to action
Over the last 20 years I’ve heard from a few Pinatubo veterans. If you’re one of the vets who’s contacted me in the past, check your e-mail or please reach out. I’ve already sent an update to those who’ve contacted me. Hopefully they’ll be able to pursue treatment (and VA disability compensation) for the damage caused by the ash.
If you’re a veteran, go get your PACT Act screening. It’d be great if you could backdate your claim, but it’s more important to do the screening now so that (someday) your loved ones won’t have to do it for you.
If you’ve already finished a VA disability claim (whether it’s been approved or denied), then follow up by requesting your C file.
That claims file is the VA’s legal archive of your service and your symptoms. If it’s not correct (or if it’s missing some details) then update it before your memories get any older. Nobody else can do it as well as you can, and your loved ones will appreciate that you’re easing their potential caregiver stress.
Finally, if you’ve never had your genome analyzed, I think it’s worth the price. This is controversial with some cultures and religions (and families) but it could be the important first step in taking care of your health. I’m not particularly happy with the zingers in my DNA, but my awareness is the first step in doing the best I can with what I have. Genetics may have loaded the gun on my longevity, but a healthy lifestyle can help me keep the safety on.
Check the related links at the bottom of this post for far more background info.
When’s the last time you checked your VA disability claim?
There are no affiliate links or paid ads in this post. Try your military base library or local public library before you pay money for these books– in any format.
Military Financial Independence on Amazon:
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Raising Your Money-Savvy Family on Amazon:
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Related articles:
Will Your Retirement Plan Handle Long-Term Care Needs? How Your Genome Impacts Disability, Caregiving, And Estate Planning
I’m going to retire. Now what? (part 2 of 2)
The VA’s Public Disability Benefits Questionnaires (DBQs)
The VA Schedule for Rating Disabilities (Title 38 of federal law)
A four-part series:
Why You File Your Veterans Disability Claim (Not Just How)
(It’s for your spouse, family, & caregivers.)
What Happens When (Not Just How) You File Your VA Disability Claim
(This will be done in parallel with your retirement physical)
What The VA Really Does With Your Disability Claim
What Happens After Your VA Disability Claim Has Been Approved
Military Financial Independence 