-- https://www.phpmyadmin.net/
--

START TRANSACTION;



--
-- Database: `u782394301_vaclaims`
--

-- --------------------------------------------------------

--
-- Table structure for table `abuse_patterns`
--

CREATE TABLE `abuse_patterns` (
  `id` int(11) NOT NULL,
  `user_id` int(11) DEFAULT NULL,
  `ip` varchar(45) DEFAULT NULL,
  `pattern_type` varchar(100) DEFAULT NULL,
  `severity` varchar(50) DEFAULT NULL,
  `details` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `admin_activity_log`
--

CREATE TABLE `admin_activity_log` (
  `id` bigint(20) NOT NULL,
  `admin_user_id` int(11) NOT NULL,
  `action_type` varchar(100) DEFAULT NULL,
  `target_user_id` int(11) DEFAULT NULL,
  `details` text DEFAULT NULL,
  `ip_address` varchar(45) DEFAULT NULL,
  `created_at` datetime DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `ai_history_reports`
--

CREATE TABLE `ai_history_reports` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `report_title` varchar(255) DEFAULT NULL,
  `report_data` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `audit_log`
--

CREATE TABLE `audit_log` (
  `id` bigint(20) NOT NULL,
  `user_id` int(11) DEFAULT NULL,
  `event_type` varchar(100) DEFAULT NULL,
  `event_description` text DEFAULT NULL,
  `ip_address` varchar(45) DEFAULT NULL,
  `created_at` datetime DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `audit_log`
--

INSERT INTO `audit_log` (`id`, `user_id`, `event_type`, `event_description`, `ip_address`, `created_at`) VALUES
(1, 5, 'TEST', 'V4 Audit System Operational', '2001:1960:6007:12b9:f7c5:e149:d149:d348', '2026-06-20 16:26:56');

-- --------------------------------------------------------

--
-- Table structure for table `audit_logs`
--

CREATE TABLE `audit_logs` (
  `id` int(11) NOT NULL,
  `user_id` int(11) DEFAULT NULL,
  `action_name` varchar(120) NOT NULL,
  `action_details` text DEFAULT NULL,
  `created_at` timestamp NOT NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `blocked_ips`
--

CREATE TABLE `blocked_ips` (
  `id` bigint(20) NOT NULL,
  `ip_address` varchar(45) DEFAULT NULL,
  `reason` text DEFAULT NULL,
  `blocked_at` datetime DEFAULT current_timestamp(),
  `active` tinyint(1) DEFAULT 1
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `body_systems`
--

CREATE TABLE `body_systems` (
  `id` int(11) NOT NULL,
  `system_name` varchar(100) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `body_systems`
--

INSERT INTO `body_systems` (`id`, `system_name`, `created_at`) VALUES
(1, 'Mental Health', '2026-06-18 19:05:15'),
(2, 'Respiratory', '2026-06-18 19:05:15'),
(3, 'Cardiovascular', '2026-06-18 19:05:15'),
(4, 'Neurological', '2026-06-18 19:05:15'),
(5, 'Musculoskeletal', '2026-06-18 19:05:15'),
(6, 'Hearing', '2026-06-18 19:05:15'),
(7, 'Vision', '2026-06-18 19:05:15'),
(8, 'Digestive', '2026-06-18 19:05:15'),
(9, 'Genitourinary', '2026-06-18 19:05:15'),
(10, 'Skin', '2026-06-18 19:05:15'),
(11, 'Endocrine', '2026-06-18 19:05:15'),
(12, 'Infectious Disease', '2026-06-18 19:05:15');

-- --------------------------------------------------------

--
-- Table structure for table `cases`
--

CREATE TABLE `cases` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `title` varchar(255) NOT NULL,
  `condition_text` text DEFAULT NULL,
  `exposure_text` text DEFAULT NULL,
  `impact_text` text DEFAULT NULL,
  `case_data` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp(),
  `updated_at` timestamp NULL DEFAULT current_timestamp() ON UPDATE current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `cases`
--

INSERT INTO `cases` (`id`, `user_id`, `title`, `condition_text`, `exposure_text`, `impact_text`, `case_data`, `created_at`, `updated_at`) VALUES
(1, 5, 'Primary Claim', 'heart desease, copd', 'blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5', 'high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd', '{\"condition\":\"heart desease, copd\",\"exposure\":\"blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5\",\"impact\":\"high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd\",\"statement\":\"STATEMENT IN SUPPORT OF CLAIM (VA FORM 21-4138)\\r\\n\\r\\nI am submitting this statement in support of my claim for:\\r\\nheart desease, copd\\r\\n\\r\\nDuring my military service, I experienced the following:\\r\\n\\r\\nblacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5\\r\\n\\r\\nSince that time, I have experienced ongoing symptoms including:\\r\\n\\r\\nhigh blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd\\r\\n\\r\\nThese symptoms continue to affect my daily life and ability to function.\\r\\nI request consideration under all applicable theories of service connection.\\r\\n\\r\\nI certify this statement is true and correct.\",\"type\":\"new\",\"strategy\":\"File Intent to File, build complete 21-526EZ claim, include diagnosis, service event or exposure, functional impact, personal statement, and supporting records.\",\"forms\":[\"21-0966\",\"21-526EZ\",\"21-4138\",\"21-10210\"]}', '2026-05-04 20:22:48', '2026-06-21 15:38:09'),
(2, 2, 'Primary Claim', 'Bi Lateral Ankle pain', 'basic training', '', '{\"condition\":\"Bi Lateral Ankle pain\",\"exposure\":\"basic training\",\"impact\":\"\",\"statement\":\"\",\"type\":\"new\",\"strategy\":\"File Intent to File, build complete 21-526EZ claim, include diagnosis, service event or exposure, functional impact, personal statement, and supporting records.\",\"forms\":[\"21-0966\",\"21-526EZ\",\"21-4138\",\"21-10210\"]}', '2026-05-04 23:07:32', '2026-06-05 02:53:07');

-- --------------------------------------------------------

--
-- Table structure for table `cfr_references`
--

CREATE TABLE `cfr_references` (
  `id` int(11) NOT NULL,
  `cfr_section` varchar(30) NOT NULL COMMENT 'e.g. 3.303',
  `title` varchar(255) NOT NULL,
  `description` text NOT NULL,
  `condition_name` varchar(255) DEFAULT NULL COMMENT 'related condition or NULL for general',
  `keywords` text DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `cfr_references`
--

INSERT INTO `cfr_references` (`id`, `cfr_section`, `title`, `description`, `condition_name`, `keywords`) VALUES
(1, '3.102', 'Reasonable Doubt', 'When there is an approximate balance of positive and negative evidence, the benefit of the doubt shall be given to the claimant. This is the foundational standard for all VA claims.', NULL, 'reasonable doubt,benefit of the doubt,equipoise'),
(2, '3.303', 'Direct Service Connection', 'Service connection requires: (1) a current disability, (2) in-service incurrence or aggravation, and (3) a nexus between the current disability and service. Evidence must show the condition was incurred in or aggravated by active military service.', NULL, 'direct service connection,nexus,in service,incurrence'),
(3, '3.303(b)', 'Continuity of Symptomatology', 'For chronic diseases listed in 3.309(a), service connection may be established by showing continuity of symptomatology since service. The claimant need not show a nexus opinion for these conditions — only continuous symptoms since discharge.', NULL, 'continuity,symptomatology,chronic disease,continuous symptoms'),
(4, '3.304(f)', 'PTSD Service Connection', 'Service connection for PTSD requires: (1) medical diagnosis of PTSD, (2) credible supporting evidence that the claimed in-service stressor occurred, and (3) a link between current symptoms and the in-service stressor. Special evidentiary rules apply for combat veterans, MST, and fear of hostile military activity.', NULL, 'ptsd,stressor,combat,mst,military sexual trauma,fear of hostile'),
(5, '3.307', 'Presumptive Service Connection — General', 'Certain chronic diseases are presumed service-connected if manifested to a compensable degree within the applicable presumptive period (generally 1 year after discharge, but varies by condition).', NULL, 'presumptive,chronic disease,presumptive period,one year'),
(6, '3.309(a)', 'Chronic Diseases — Presumptive List', 'Lists chronic diseases eligible for presumptive service connection if manifest within the presumptive period: arthritis, cardiovascular disease, diabetes mellitus, hypertension, psychoses, organic diseases of the nervous system (including sensorineural hearing loss and tinnitus), and many others.', NULL, 'chronic disease list,presumptive,arthritis,diabetes,hypertension,hearing loss,tinnitus'),
(7, '3.309(e)', 'Agent Orange / Herbicide Exposure', 'Veterans exposed to tactical herbicides (Agent Orange) are presumed service-connected for specific conditions including: type 2 diabetes, ischemic heart disease, Parkinson\'s disease, B-cell leukemia, bladder cancer, hypertension, and others — if they served in Vietnam, Thailand (certain bases), or other designated locations during specified periods.', NULL, 'agent orange,herbicide,vietnam,thailand,dioxin,presumptive'),
(8, '3.310', 'Secondary Service Connection', 'A disability that is proximately due to, or aggravated by, a service-connected disability may be service connected on a secondary basis. Requires: (1) a current disability, (2) an already service-connected disability, and (3) medical evidence showing the secondary disability was caused or worsened by the primary.', NULL, 'secondary,aggravation,proximately due to,secondary service connection'),
(9, '3.317', 'Gulf War Presumptives', 'Undiagnosed illnesses and medically unexplained chronic multi-symptom illnesses (including CFS, fibromyalgia, IBS) may be presumptively service connected for veterans who served in the Southwest Asia theater of operations. Symptoms must have manifested to a 10% degree.', NULL, 'gulf war,southwest asia,undiagnosed illness,medically unexplained,cfs,fibromyalgia,ibs'),
(10, '3.320', 'PACT Act — Toxic Exposure', 'The PACT Act of 2022 expanded presumptive conditions for veterans exposed to burn pits, Agent Orange, and other toxic substances. Concedes toxic exposure for veterans who served in specified locations during specified periods.', NULL, 'pact act,burn pit,toxic exposure,tera'),
(11, '3.340', 'Total Disability Ratings — General', 'Total disability will be considered to exist when the impairment is sufficient to prevent the average person from following a substantially gainful occupation. For total ratings, the schedule provides a 100% rating when the disability results in total impairment.', NULL, 'total disability,100 percent,total rating'),
(12, '3.341', 'Total Disability Ratings — Individual Unemployability (TDIU)', 'Total disability ratings may be assigned when the veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, even if the combined rating is less than 100%.', NULL, 'tdiu,individual unemployability,unemployability,iu'),
(13, '4.16', 'TDIU — Schedular and Extraschedular', 'Schedular TDIU: One disability rated 60%+ OR combined rating 70%+ with at least one disability rated 40%+. Extraschedular TDIU: When schedular criteria not met but veteran is still unemployable due to service-connected disabilities — referred to the Director of Compensation Service.', NULL, 'tdiu,schedular,extraschedular,4.16,unemployability'),
(14, '4.25', 'Combined Ratings Table', 'VA uses a combined ratings table, not simple addition. Each additional disability is calculated against the remaining efficiency (100 minus prior combined). Result is rounded to nearest 10%.', NULL, 'combined rating,bilateral,va math,combined ratings table'),
(15, '4.26', 'Bilateral Factor', 'When there are partial disabilities of two or more extremities from the same cause (e.g., both knees from running), the bilateral factor adds an additional amount. The combined value of the bilateral disabilities is multiplied by 10% and added to the combined degree.', NULL, 'bilateral,bilateral factor,paired extremities,both knees,both arms'),
(16, '3.350', 'Special Monthly Compensation (SMC)', 'SMC provides additional compensation above the combined rating for specific severe disabilities: loss or loss of use of a creative organ (SMC-K), need for aid and attendance (SMC-L), housebound (SMC-S), and higher levels for combinations of severe disabilities.', NULL, 'smc,special monthly compensation,aid and attendance,housebound,loss of use'),
(17, '3.352', 'Aid and Attendance Criteria', 'A veteran is considered in need of aid and attendance if: inability to dress/undress, inability to keep ordinarily clean, frequent need for adjustment of prosthetics, inability to feed self, incapacity (physical or mental) requiring care to protect from hazards of daily environment.', NULL, 'aid and attendance,a&a,adl,activities of daily living'),
(18, '3.156', 'Clear and Unmistakable Error (CUE)', 'A final decision may be revised if there was CUE. CUE exists when: (1) either the correct facts were not before the adjudicator or the law was incorrectly applied, (2) the error must be undebatable, and (3) the error must have manifestly changed the outcome. CUE cannot be based on a disagreement in how evidence was weighed.', NULL, 'cue,clear and unmistakable error,revision,final decision'),
(19, '3.400', 'Effective Dates', 'The effective date of an award of service connection is generally the date of receipt of the claim or the date entitlement arose, whichever is later. For claims filed within 1 year of discharge, the effective date is the day following discharge. Intent to File locks the effective date up to 1 year before the formal claim.', NULL, 'effective date,intent to file,itf,back pay,retroactive'),
(20, '4.3', 'Resolution of Reasonable Doubt', 'It is the defined and consistently applied policy of the VA to administer the law under a broad interpretation, resolving every reasonable doubt in favor of the claimant.', NULL, 'reasonable doubt,benefit of doubt'),
(21, '4.7', 'Higher of Two Evaluations', 'Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating.', NULL, 'higher evaluation,approximates,rating level');

-- --------------------------------------------------------

--
-- Table structure for table `claims`
--

CREATE TABLE `claims` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `claim_data` longtext DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT current_timestamp() ON UPDATE current_timestamp(),
  `diagnostic_code` varchar(50) DEFAULT NULL,
  `effective_date` date DEFAULT NULL,
  `claim_status` varchar(100) DEFAULT NULL,
  `historical_flag` tinyint(1) DEFAULT 0
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `claims`
--

INSERT INTO `claims` (`id`, `user_id`, `claim_data`, `updated_at`, `diagnostic_code`, `effective_date`, `claim_status`, `historical_flag`) VALUES
(1, 5, '{\"condition\":\"heart desease, copd\",\"exposure\":\"blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5\",\"impact\":\"high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd\",\"statement\":\"I am claiming service connection for: heart desease, copd.\\n\\nThe service event, duty, injury, exposure, or secondary cause I am relying on is: blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5.\\n\\nIf symptoms continued after service, they should be explained here, including what you experienced, how often it occurred, and how it changed over time.\\n\\nMy current symptoms include: [describe symptoms with frequency, severity, duration, flare-ups, treatment, and progression].\\n\\nThis condition affects my daily life by: high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd.\\n\\nI am submitting this statement to explain the connection between my military service, my symptoms, my current disability, and the evidence being submitted.\",\"type\":\"new\",\"strategy\":\"File Intent to File, build complete 21-526EZ claim, include diagnosis, service event or exposure, functional impact, personal statement, and supporting records.\",\"forms\":[\"21-0966\",\"21-526EZ\",\"21-4138\",\"21-10210\"]}', '2026-05-04 00:03:39', NULL, NULL, NULL, 0),
(2, 5, '{\"condition\":\"heart desease, copd\",\"exposure\":\"blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5\",\"impact\":\"high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd\",\"statement\":\"I am claiming service connection for: heart desease, copd.\\n\\nThe service event, duty, injury, exposure, or secondary cause I am relying on is: blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5.\\n\\nIf symptoms continued after service, they should be explained here, including what you experienced, how often it occurred, and how it changed over time.\\n\\nMy current symptoms include: [describe symptoms with frequency, severity, duration, flare-ups, treatment, and progression].\\n\\nThis condition affects my daily life by: high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd.\\n\\nI am submitting this statement to explain the connection between my military service, my symptoms, my current disability, and the evidence being submitted.\",\"type\":\"new\",\"strategy\":\"File Intent to File, build complete 21-526EZ claim, include diagnosis, service event or exposure, functional impact, personal statement, and supporting records.\",\"forms\":[\"21-0966\",\"21-526EZ\",\"21-4138\",\"21-10210\"]}', '2026-05-04 00:23:31', NULL, NULL, NULL, 0),
(3, 5, '{\"condition\":\"heart desease, copd\",\"exposure\":\"blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5\",\"impact\":\"high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd\",\"statement\":\"I am claiming service connection for: heart desease, copd.\\n\\nThe service event, duty, injury, exposure, or secondary cause I am relying on is: blacked out had syncope event on record in sickbay, my rate was abf, fuel handler flight deck crew tera exposure jp5.\\n\\nIf symptoms continued after service, they should be explained here, including what you experienced, how often it occurred, and how it changed over time.\\n\\nMy current symptoms include: [describe symptoms with frequency, severity, duration, flare-ups, treatment, and progression].\\n\\nThis condition affects my daily life by: high blood pressure, pace maker, copd, tinnitus, current bradicardia, stage 3 copd.\\n\\nI am submitting this statement to explain the connection between my military service, my symptoms, my current disability, and the evidence being submitted.\",\"type\":\"new\",\"strategy\":\"File Intent to File, build complete 21-526EZ claim, include diagnosis, service event or exposure, functional impact, personal statement, and supporting records.\",\"forms\":[\"21-0966\",\"21-526EZ\",\"21-4138\",\"21-10210\"]}', '2026-05-04 00:24:14', NULL, NULL, NULL, 0);

-- --------------------------------------------------------

--
-- Table structure for table `claim_build_items`
--

CREATE TABLE `claim_build_items` (
  `id` bigint(20) NOT NULL,
  `claim_build_id` bigint(20) NOT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `body_system` varchar(100) DEFAULT NULL,
  `path_type` varchar(100) DEFAULT NULL,
  `claim_theory` varchar(100) DEFAULT NULL,
  `selected_as_primary` tinyint(1) DEFAULT 0,
  `selected_as_secondary` tinyint(1) DEFAULT 0,
  `secondary_to_condition` varchar(255) DEFAULT NULL,
  `readiness_score` int(11) DEFAULT 0,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `claim_documents`
--

CREATE TABLE `claim_documents` (
  `id` int(11) NOT NULL,
  `event_id` int(11) DEFAULT NULL,
  `document_type` varchar(100) DEFAULT NULL,
  `claim_type` varchar(100) DEFAULT NULL,
  `decision_date` date DEFAULT NULL,
  `effective_date` date DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `claim_issues`
--

CREATE TABLE `claim_issues` (
  `id` int(11) NOT NULL,
  `document_id` int(11) NOT NULL,
  `issue_name` varchar(255) DEFAULT NULL,
  `claim_type` varchar(100) DEFAULT NULL,
  `outcome` varchar(50) DEFAULT NULL,
  `rating_percent` int(11) DEFAULT NULL,
  `effective_date` date DEFAULT NULL,
  `diagnosis_found` tinyint(1) DEFAULT NULL,
  `in_service_event_found` tinyint(1) DEFAULT NULL,
  `nexus_found` tinyint(1) DEFAULT NULL,
  `continuity_found` tinyint(1) DEFAULT NULL,
  `favorable_findings` text DEFAULT NULL,
  `missing_element` varchar(100) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `claim_paths`
--

CREATE TABLE `claim_paths` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `body_system` varchar(100) DEFAULT NULL,
  `path_type` varchar(100) DEFAULT NULL,
  `source_type` varchar(50) DEFAULT NULL,
  `readiness_score` int(11) DEFAULT 0,
  `evidence_found` int(11) DEFAULT 0,
  `status` varchar(100) DEFAULT 'active',
  `notes` text DEFAULT NULL,
  `records_needed` text DEFAULT NULL,
  `next_action` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp(),
  `selected_for_claim` tinyint(1) DEFAULT 0,
  `claim_theory` varchar(100) DEFAULT NULL,
  `recommended_rating` int(11) DEFAULT 0,
  `selected_as_primary` tinyint(1) DEFAULT 0,
  `selected_as_secondary` tinyint(1) DEFAULT 0,
  `secondary_to_condition` varchar(255) DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `claim_progress`
--

CREATE TABLE `claim_progress` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `stage_name` varchar(255) NOT NULL,
  `completed` tinyint(1) DEFAULT 0,
  `completed_at` datetime DEFAULT NULL,
  `notes` text DEFAULT NULL,
  `stage_order` int(11) DEFAULT 0
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `claim_progress`
--

INSERT INTO `claim_progress` (`id`, `user_id`, `stage_name`, `completed`, `completed_at`, `notes`, `stage_order`) VALUES
(1, 1, 'Intent To File', 1, '2026-05-31 19:32:35', NULL, 1),
(2, 1, 'Records Requested', 1, '2026-05-31 19:32:35', NULL, 2),
(3, 1, 'Records Received', 1, '2026-05-31 19:32:35', NULL, 3),
(4, 1, 'Evidence Uploaded', 1, '2026-05-31 19:32:35', 'Documents uploaded.', 4),
(5, 1, 'Conditions Identified', 0, NULL, NULL, 5),
(6, 1, 'Claim Strategy Built', 0, NULL, NULL, 6),
(7, 1, 'DBQ Obtained', 0, NULL, NULL, 7),
(8, 1, 'Nexus Evidence Obtained', 0, NULL, NULL, 8),
(9, 1, 'Evidence Review Complete', 1, '2026-06-01 04:49:53', 'Documents reviewed.', 9),
(10, 1, 'Forms Complete', 0, NULL, NULL, 10),
(11, 1, 'Claim Packet Complete', 0, NULL, NULL, 11),
(12, 1, 'Submission Ready', 0, NULL, NULL, 12);

-- --------------------------------------------------------

--
-- Table structure for table `conditions`
--

CREATE TABLE `conditions` (
  `id` int(11) NOT NULL,
  `body_system_id` int(11) DEFAULT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `keywords` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `conditions`
--

INSERT INTO `conditions` (`id`, `body_system_id`, `condition_name`, `keywords`, `created_at`) VALUES
(1, 2, 'COPD', 'copd,chronic obstructive pulmonary disease,breathing', '2026-06-18 19:06:22'),
(2, 2, 'Asthma', 'asthma,wheezing,shortness of breath', '2026-06-18 19:06:22'),
(3, 2, 'Chronic Bronchitis', 'bronchitis,chronic bronchitis', '2026-06-18 19:06:22'),
(4, 2, 'Sleep Apnea', 'sleep apnea,cpap,sleep issues', '2026-06-18 19:06:22'),
(5, 3, 'Coronary Artery Disease', 'cad,coronary artery disease,heart disease', '2026-06-18 19:06:22'),
(6, 3, 'Hypertension', 'high blood pressure,hypertension', '2026-06-18 19:06:22'),
(7, 3, 'Bradycardia', 'bradycardia,slow heart rate', '2026-06-18 19:06:22'),
(8, 3, 'Pacemaker', 'pacemaker,cardiac pacemaker', '2026-06-18 19:06:22'),
(9, 6, 'Tinnitus', 'tinnitus,ringing ears,ringing in ears', '2026-06-18 19:06:22'),
(10, 6, 'Hearing Loss', 'hearing loss,cannot hear', '2026-06-18 19:06:22'),
(11, 4, 'Migraines', 'migraine,migraines,headaches', '2026-06-18 19:06:22'),
(12, 5, 'Lumbar Strain', 'back pain,lumbar strain,low back', '2026-06-18 19:06:22'),
(13, 5, 'Cervical Strain', 'neck pain,cervical strain', '2026-06-18 19:06:22'),
(14, 5, 'Knee Condition', 'knee pain,left knee,right knee', '2026-06-18 19:06:22'),
(15, 5, 'Shoulder Condition', 'shoulder pain,left shoulder,right shoulder', '2026-06-18 19:06:22'),
(16, 1, 'PTSD', 'ptsd,post traumatic stress', '2026-06-18 19:06:22'),
(17, 1, 'Depression', 'depression,major depressive disorder', '2026-06-18 19:06:22'),
(18, 1, 'Anxiety', 'anxiety,panic attacks', '2026-06-18 19:06:22'),
(19, 1, 'Adjustment Disorder', 'adjustment disorder,life stress,stress reaction', '2026-06-18 19:29:33'),
(20, 1, 'Insomnia', 'insomnia,cannot sleep,sleep problems', '2026-06-18 19:29:33'),
(21, 1, 'Panic Disorder', 'panic disorder,panic attacks', '2026-06-18 19:29:33'),
(22, 1, 'Generalized Anxiety Disorder', 'gad,anxiety,worry,nervous', '2026-06-18 19:29:33'),
(23, 1, 'Major Depressive Disorder', 'major depression,depression,depressed', '2026-06-18 19:29:33'),
(24, 1, 'Persistent Depressive Disorder', 'persistent depression,dysthymia', '2026-06-18 19:29:33'),
(25, 1, 'Somatic Symptom Disorder', 'somatic symptoms,chronic symptoms', '2026-06-18 19:29:33'),
(26, 2, 'Emphysema', 'emphysema,breathing problems', '2026-06-18 19:29:33'),
(27, 2, 'Interstitial Lung Disease', 'lung disease,interstitial lung disease', '2026-06-18 19:29:33'),
(28, 2, 'Pulmonary Fibrosis', 'pulmonary fibrosis,lung scarring', '2026-06-18 19:29:33'),
(29, 2, 'Chronic Sinusitis', 'sinusitis,sinus problems', '2026-06-18 19:29:33'),
(30, 2, 'Rhinitis', 'rhinitis,nasal congestion', '2026-06-18 19:29:33'),
(31, 2, 'Sleep Apnea', 'sleep apnea,cpap,stop breathing', '2026-06-18 19:29:33'),
(32, 3, 'Atrial Fibrillation', 'afib,atrial fibrillation', '2026-06-18 19:29:33'),
(33, 3, 'Congestive Heart Failure', 'chf,heart failure', '2026-06-18 19:29:33'),
(34, 3, 'Heart Block', 'heart block,cardiac conduction', '2026-06-18 19:29:33'),
(35, 3, 'Peripheral Vascular Disease', 'pvd,vascular disease', '2026-06-18 19:29:33'),
(36, 3, 'Stroke Residuals', 'stroke,residual stroke', '2026-06-18 19:29:33'),
(37, 4, 'Seizure Disorder', 'seizure,epilepsy', '2026-06-18 19:29:33'),
(38, 4, 'Traumatic Brain Injury', 'tbi,brain injury,head injury', '2026-06-18 19:29:33'),
(39, 4, 'Vertigo', 'vertigo,dizziness', '2026-06-18 19:29:33'),
(40, 4, 'Essential Tremor', 'tremor,shaking', '2026-06-18 19:29:33'),
(41, 4, 'Peripheral Neuropathy', 'neuropathy,numbness,tingling', '2026-06-18 19:29:33'),
(42, 5, 'Degenerative Disc Disease', 'ddd,disc disease,back degeneration', '2026-06-18 19:29:33'),
(43, 5, 'Sciatica', 'sciatica,leg pain,nerve pain', '2026-06-18 19:29:33'),
(44, 5, 'Radiculopathy', 'radiculopathy,nerve involvement', '2026-06-18 19:29:33'),
(45, 5, 'Plantar Fasciitis', 'plantar fasciitis,foot pain', '2026-06-18 19:29:33'),
(46, 5, 'Flat Feet', 'pes planus,flat feet', '2026-06-18 19:29:33'),
(47, 5, 'Ankle Condition', 'ankle pain,ankle injury', '2026-06-18 19:29:33'),
(48, 5, 'Hip Condition', 'hip pain,hip injury', '2026-06-18 19:29:33'),
(49, 6, 'Meniere Disease', 'meniere,migraines,vertigo', '2026-06-18 19:29:33'),
(50, 7, 'Dry Eye Syndrome', 'dry eyes', '2026-06-18 19:29:33'),
(51, 7, 'Cataracts', 'cataracts', '2026-06-18 19:29:33'),
(52, 7, 'Glaucoma', 'glaucoma', '2026-06-18 19:29:33'),
(53, 8, 'GERD', 'gerd,reflux,acid reflux', '2026-06-18 19:29:33'),
(54, 8, 'IBS', 'ibs,irritable bowel', '2026-06-18 19:29:33'),
(55, 8, 'Ulcerative Colitis', 'ulcerative colitis', '2026-06-18 19:29:33'),
(56, 8, 'Crohns Disease', 'crohns,crohns disease', '2026-06-18 19:29:33'),
(57, 9, 'Erectile Dysfunction', 'ed,erectile dysfunction', '2026-06-18 19:29:33'),
(58, 9, 'Kidney Disease', 'kidney disease,renal', '2026-06-18 19:29:33'),
(59, 10, 'Psoriasis', 'psoriasis', '2026-06-18 19:29:33'),
(60, 10, 'Dermatitis', 'dermatitis,skin rash', '2026-06-18 19:29:33'),
(61, 11, 'Diabetes Mellitus', 'diabetes,blood sugar', '2026-06-18 19:29:33'),
(62, 11, 'Hypothyroidism', 'hypothyroidism,thyroid', '2026-06-18 19:29:33'),
(63, 11, 'Hyperthyroidism', 'hyperthyroidism,thyroid', '2026-06-18 19:29:33'),
(64, 12, 'Hepatitis C', 'hepatitis c', '2026-06-18 19:29:33'),
(65, 12, 'Tuberculosis', 'tuberculosis,tb', '2026-06-18 19:29:33'),
(66, 5, 'Cervical Strain', 'cervical strain,neck pain,neck injury', '2026-06-18 19:31:08'),
(67, 5, 'Cervical Degenerative Disc Disease', 'cervical ddd,neck degeneration', '2026-06-18 19:31:08'),
(68, 5, 'Thoracic Strain', 'thoracic pain,mid back pain', '2026-06-18 19:31:08'),
(69, 5, 'Thoracolumbar Strain', 'thoracolumbar strain,back strain', '2026-06-18 19:31:08'),
(70, 5, 'Lumbar Degenerative Disc Disease', 'lumbar ddd,lumbar degeneration', '2026-06-18 19:31:08'),
(71, 5, 'Lumbar Arthritis', 'lumbar arthritis,back arthritis', '2026-06-18 19:31:08'),
(72, 5, 'Cervical Arthritis', 'cervical arthritis,neck arthritis', '2026-06-18 19:31:08'),
(73, 5, 'Shoulder Impingement', 'shoulder impingement', '2026-06-18 19:31:08'),
(74, 5, 'Rotator Cuff Tear', 'rotator cuff,shoulder tear', '2026-06-18 19:31:08'),
(75, 5, 'Shoulder Arthritis', 'shoulder arthritis', '2026-06-18 19:31:08'),
(76, 5, 'Elbow Condition', 'elbow pain,elbow injury', '2026-06-18 19:31:08'),
(77, 5, 'Tennis Elbow', 'tennis elbow,lateral epicondylitis', '2026-06-18 19:31:08'),
(78, 5, 'Carpal Tunnel Syndrome', 'carpal tunnel,wrist numbness', '2026-06-18 19:31:08'),
(79, 5, 'Wrist Condition', 'wrist pain,wrist injury', '2026-06-18 19:31:08'),
(80, 5, 'Hand Condition', 'hand pain,hand injury', '2026-06-18 19:31:08'),
(81, 5, 'Trigger Finger', 'trigger finger', '2026-06-18 19:31:08'),
(82, 5, 'Thumb Condition', 'thumb pain', '2026-06-18 19:31:08'),
(83, 5, 'Knee Arthritis', 'knee arthritis', '2026-06-18 19:31:08'),
(84, 5, 'Knee Instability', 'knee instability', '2026-06-18 19:31:08'),
(85, 5, 'Meniscus Tear', 'meniscus tear', '2026-06-18 19:31:08'),
(86, 5, 'Patellofemoral Pain Syndrome', 'pfps,knee cap pain', '2026-06-18 19:31:08'),
(87, 5, 'Hip Arthritis', 'hip arthritis', '2026-06-18 19:31:08'),
(88, 5, 'Hip Strain', 'hip strain', '2026-06-18 19:31:08'),
(89, 5, 'Ankle Arthritis', 'ankle arthritis', '2026-06-18 19:31:08'),
(90, 5, 'Achilles Tendonitis', 'achilles tendonitis', '2026-06-18 19:31:08'),
(91, 5, 'Foot Condition', 'foot pain,foot injury', '2026-06-18 19:31:08'),
(92, 5, 'Hallux Valgus', 'bunions,hallux valgus', '2026-06-18 19:31:08'),
(93, 5, 'Hammer Toes', 'hammer toes', '2026-06-18 19:31:08'),
(94, 5, 'Pes Cavus', 'high arch foot', '2026-06-18 19:31:08'),
(95, 5, 'Fibromyalgia', 'fibromyalgia,widespread pain', '2026-06-18 19:31:08'),
(96, 2, 'Chronic Respiratory Failure', 'respiratory failure,oxygen dependent', '2026-06-18 19:32:26'),
(97, 2, 'Restrictive Lung Disease', 'restrictive lung disease', '2026-06-18 19:32:26'),
(98, 2, 'Pulmonary Hypertension', 'pulmonary hypertension', '2026-06-18 19:32:26'),
(99, 2, 'Lung Nodules', 'lung nodules', '2026-06-18 19:32:26'),
(100, 2, 'Chronic Cough Syndrome', 'chronic cough', '2026-06-18 19:32:26'),
(101, 2, 'Bronchiectasis', 'bronchiectasis', '2026-06-18 19:32:26'),
(102, 2, 'Sarcoidosis', 'sarcoidosis', '2026-06-18 19:32:26'),
(103, 3, 'Ischemic Heart Disease', 'ischemic heart disease,ihd', '2026-06-18 19:32:26'),
(104, 3, 'Myocardial Infarction', 'heart attack,myocardial infarction', '2026-06-18 19:32:26'),
(105, 3, 'Cardiomyopathy', 'cardiomyopathy', '2026-06-18 19:32:26'),
(106, 3, 'Valvular Heart Disease', 'heart valve disease', '2026-06-18 19:32:26'),
(107, 3, 'Aortic Aneurysm', 'aortic aneurysm', '2026-06-18 19:32:26'),
(108, 3, 'Peripheral Artery Disease', 'pad,peripheral artery disease', '2026-06-18 19:32:26'),
(109, 4, 'Parkinsonism', 'parkinsonism', '2026-06-18 19:32:26'),
(110, 4, 'Parkinson Disease', 'parkinsons,parkinson disease', '2026-06-18 19:32:26'),
(111, 4, 'Multiple Sclerosis', 'multiple sclerosis,ms', '2026-06-18 19:32:26'),
(112, 4, 'Cognitive Disorder', 'memory loss,cognitive issues', '2026-06-18 19:32:26'),
(113, 4, 'Chronic Headaches', 'chronic headaches', '2026-06-18 19:32:26'),
(114, 4, 'Balance Disorder', 'balance problems', '2026-06-18 19:32:26'),
(115, 4, 'Nerve Damage', 'nerve damage', '2026-06-18 19:32:26'),
(116, 6, 'Noise Induced Hearing Loss', 'hearing loss,noise exposure', '2026-06-18 19:34:04'),
(117, 6, 'Acoustic Trauma', 'acoustic trauma,loud noise', '2026-06-18 19:34:04'),
(118, 6, 'Hyperacusis', 'hyperacusis,sound sensitivity', '2026-06-18 19:34:04'),
(119, 6, 'Vestibular Disorder', 'vestibular disorder,balance issues', '2026-06-18 19:34:04'),
(120, 7, 'Macular Degeneration', 'macular degeneration', '2026-06-18 19:34:04'),
(121, 7, 'Retinopathy', 'retinopathy', '2026-06-18 19:34:04'),
(122, 7, 'Visual Field Loss', 'vision loss,visual field', '2026-06-18 19:34:04'),
(123, 7, 'Corneal Scarring', 'corneal scar', '2026-06-18 19:34:04'),
(124, 7, 'Diplopia', 'double vision,diplopia', '2026-06-18 19:34:04'),
(125, 8, 'Gastritis', 'gastritis,stomach inflammation', '2026-06-18 19:34:04'),
(126, 8, 'Hiatal Hernia', 'hiatal hernia', '2026-06-18 19:34:04'),
(127, 8, 'Diverticulitis', 'diverticulitis', '2026-06-18 19:34:04'),
(128, 8, 'Chronic Constipation', 'constipation', '2026-06-18 19:34:04'),
(129, 8, 'Chronic Diarrhea', 'diarrhea', '2026-06-18 19:34:04'),
(130, 8, 'Liver Disease', 'liver disease', '2026-06-18 19:34:04'),
(131, 8, 'Fatty Liver Disease', 'fatty liver', '2026-06-18 19:34:04'),
(132, 10, 'Eczema', 'eczema', '2026-06-18 19:34:04'),
(133, 10, 'Chronic Urticaria', 'urticaria,hives', '2026-06-18 19:34:04'),
(134, 10, 'Vitiligo', 'vitiligo', '2026-06-18 19:34:04'),
(135, 10, 'Skin Cancer', 'skin cancer', '2026-06-18 19:34:04'),
(136, 9, 'Urinary Frequency', 'urinary frequency,frequent urination', '2026-06-18 19:35:35'),
(137, 9, 'Urinary Incontinence', 'incontinence,loss of bladder control', '2026-06-18 19:35:35'),
(138, 9, 'Chronic Kidney Disease', 'ckd,chronic kidney disease', '2026-06-18 19:35:35'),
(139, 9, 'Kidney Stones', 'kidney stones', '2026-06-18 19:35:35'),
(140, 9, 'Prostate Condition', 'prostate condition,prostate enlargement', '2026-06-18 19:35:35'),
(141, 9, 'Benign Prostatic Hyperplasia', 'bph,enlarged prostate', '2026-06-18 19:35:35'),
(142, 9, 'Testicular Condition', 'testicular pain', '2026-06-18 19:35:35'),
(143, 9, 'Male Reproductive Organ Removal', 'testicle removal', '2026-06-18 19:35:35'),
(144, 11, 'Type 2 Diabetes Mellitus', 'type 2 diabetes', '2026-06-18 19:35:35'),
(145, 11, 'Type 1 Diabetes Mellitus', 'type 1 diabetes', '2026-06-18 19:35:35'),
(146, 11, 'Adrenal Disorder', 'adrenal disorder', '2026-06-18 19:35:35'),
(147, 11, 'Pituitary Disorder', 'pituitary disorder', '2026-06-18 19:35:35'),
(148, 11, 'Metabolic Syndrome', 'metabolic syndrome', '2026-06-18 19:35:35'),
(149, 11, 'Obesity Secondary', 'obesity secondary', '2026-06-18 19:35:35'),
(150, 11, 'Hypogonadism', 'low testosterone,hypogonadism', '2026-06-18 19:35:35');

-- --------------------------------------------------------

--
-- Table structure for table `condition_exposures`
--

CREATE TABLE `condition_exposures` (
  `id` int(11) NOT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `exposure_type` varchar(100) DEFAULT NULL,
  `relationship_strength` int(11) DEFAULT 50
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `condition_exposures`
--

INSERT INTO `condition_exposures` (`id`, `condition_name`, `exposure_type`, `relationship_strength`) VALUES
(1, 'COPD', 'JP5', 85),
(2, 'Asthma', 'JP5', 80),
(3, 'Chronic Bronchitis', 'JP5', 80),
(4, 'COPD', 'BurnPit', 95),
(5, 'Asthma', 'BurnPit', 90),
(6, 'Coronary Artery Disease', 'TERA', 75),
(7, 'Hypertension', 'TERA', 70),
(8, 'Respiratory Condition', 'PACT', 95),
(9, 'COPD', 'JP5', 85),
(10, 'Emphysema', 'JP5', 85),
(11, 'Chronic Bronchitis', 'JP5', 85),
(12, 'COPD', 'BurnPit', 95),
(13, 'Asthma', 'BurnPit', 90),
(14, 'Pulmonary Fibrosis', 'BurnPit', 90),
(15, 'Chronic Sinusitis', 'BurnPit', 90),
(16, 'Rhinitis', 'BurnPit', 90),
(17, 'Diabetes Mellitus', 'AgentOrange', 95),
(18, 'Peripheral Neuropathy', 'AgentOrange', 95),
(19, 'Heart Disease', 'AgentOrange', 90),
(20, 'Kidney Disease', 'CampLejeune', 90),
(21, 'Bladder Cancer', 'CampLejeune', 95),
(22, 'Leukemia', 'Radiation', 95),
(23, 'Lung Cancer', 'Asbestos', 95),
(24, 'Mesothelioma', 'Asbestos', 100),
(25, 'COPD', 'PACT', 95),
(26, 'Asthma', 'PACT', 95),
(27, 'Chronic Bronchitis', 'PACT', 95),
(28, 'Chronic Sinusitis', 'PACT', 95),
(29, 'Rhinitis', 'PACT', 95),
(30, 'Pulmonary Fibrosis', 'PACT', 95),
(31, 'Restrictive Lung Disease', 'PACT', 90),
(32, 'Ischemic Heart Disease', 'AgentOrange', 100),
(33, 'Parkinson Disease', 'AgentOrange', 100),
(34, 'Peripheral Neuropathy', 'AgentOrange', 95),
(35, 'Bladder Cancer', 'AgentOrange', 95),
(36, 'Leukemia', 'Radiation', 100),
(37, 'Lung Cancer', 'BurnPit', 95),
(38, 'Respiratory Failure', 'BurnPit', 90),
(39, 'Pulmonary Hypertension', 'BurnPit', 85),
(40, 'Noise Induced Hearing Loss', 'NoiseExposure', 100),
(41, 'Tinnitus', 'NoiseExposure', 100),
(42, 'Skin Cancer', 'AgentOrange', 80),
(43, 'Skin Cancer', 'Radiation', 95),
(44, 'Liver Disease', 'CampLejeune', 80),
(45, 'Fatty Liver Disease', 'TERA', 70),
(46, 'Gastritis', 'TERA', 60),
(47, 'GERD', 'TERA', 60),
(48, 'Visual Field Loss', 'TBI', 85),
(49, 'Diplopia', 'TBI', 85),
(50, 'Chronic Kidney Disease', 'CampLejeune', 95),
(51, 'Kidney Cancer', 'CampLejeune', 100),
(52, 'Bladder Cancer', 'CampLejeune', 100),
(53, 'Type 2 Diabetes Mellitus', 'AgentOrange', 100),
(54, 'Peripheral Neuropathy', 'AgentOrange', 100),
(55, 'Hypertension', 'AgentOrange', 90),
(56, 'Hypogonadism', 'TERA', 70);

-- --------------------------------------------------------

--
-- Table structure for table `contradiction_flags`
--

CREATE TABLE `contradiction_flags` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `old_decision` longtext DEFAULT NULL,
  `new_decision` longtext DEFAULT NULL,
  `ai_analysis` longtext DEFAULT NULL,
  `severity` varchar(50) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `denial_letters`
--

CREATE TABLE `denial_letters` (
  `id` int(11) NOT NULL,
  `user_id` int(11) DEFAULT NULL,
  `filename` varchar(255) DEFAULT NULL,
  `content` longtext DEFAULT NULL,
  `parsed_json` longtext CHARACTER SET utf8mb4 COLLATE utf8mb4_bin DEFAULT NULL CHECK (json_valid(`parsed_json`)),
  `created_at` timestamp NULL DEFAULT current_timestamp(),
  `raw_text` longtext DEFAULT NULL,
  `ai_summary` longtext DEFAULT NULL,
  `extracted_json` longtext DEFAULT NULL,
  `confidence_score` float DEFAULT 0,
  `processed_at` timestamp NULL DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `dependents`
--

CREATE TABLE `dependents` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `dependent_type` varchar(50) DEFAULT NULL,
  `first_name` varchar(100) DEFAULT NULL,
  `last_name` varchar(100) DEFAULT NULL,
  `dob` date DEFAULT NULL,
  `relationship_type` varchar(100) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `diagnostic_codes`
--

CREATE TABLE `diagnostic_codes` (
  `id` int(11) NOT NULL,
  `dc_number` varchar(20) NOT NULL COMMENT 'e.g. 9411, 5237',
  `body_system` varchar(100) NOT NULL COMMENT 'e.g. Mental Disorders',
  `condition_name` varchar(255) NOT NULL,
  `rating_criteria` longtext CHARACTER SET utf8mb4 COLLATE utf8mb4_bin NOT NULL COMMENT '{"0":"...","10":"...","30":"...","50":"...","70":"...","100":"..."}' CHECK (json_valid(`rating_criteria`)),
  `max_rating` int(11) NOT NULL DEFAULT 100,
  `keywords` text DEFAULT NULL COMMENT 'search terms, comma-sep',
  `notes` text DEFAULT NULL,
  `bilateral` tinyint(1) NOT NULL DEFAULT 0 COMMENT '1 if bilateral factor applies'
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `diagnostic_codes`
--

INSERT INTO `diagnostic_codes` (`id`, `dc_number`, `body_system`, `condition_name`, `rating_criteria`, `max_rating`, `keywords`, `notes`, `bilateral`) VALUES
(1, '9411', 'Mental Disorders', 'Post-Traumatic Stress Disorder (PTSD)', '{\"0\":\"Formally diagnosed but symptoms not severe enough to interfere with occupational/social functioning or require continuous medication.\",\"10\":\"Occupational and social impairment due to mild or transient symptoms which decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.\",\"30\":\"Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal).\",\"50\":\"Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory; impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.\",\"70\":\"Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control; spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances; inability to establish and maintain effective relationships.\",\"100\":\"Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living; disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.\"}', 100, 'ptsd,post traumatic,combat stress,mst,military sexual trauma', NULL, 0),
(2, '9434', 'Mental Disorders', 'Major Depressive Disorder', '{\"0\":\"Formally diagnosed but symptoms not severe enough to interfere with occupational/social functioning or require continuous medication.\",\"10\":\"Mild or transient symptoms which decrease work efficiency only during periods of significant stress, or controlled by continuous medication.\",\"30\":\"Occasional decrease in work efficiency with intermittent inability to perform tasks, though generally functioning satisfactorily.\",\"50\":\"Reduced reliability and productivity due to flattened affect, panic attacks >1x/week, memory impairment, disturbances of motivation and mood, difficulty maintaining relationships.\",\"70\":\"Deficiencies in most areas: suicidal ideation, near-continuous depression affecting ability to function, impaired impulse control, inability to maintain relationships.\",\"100\":\"Total occupational and social impairment: gross impairment in thought processes, persistent danger to self/others, inability to perform ADLs.\"}', 100, 'depression,major depressive,mdd', NULL, 0),
(3, '9400', 'Mental Disorders', 'Generalized Anxiety Disorder', '{\"0\":\"Diagnosed but not impairing.\",\"10\":\"Mild or transient symptoms controlled by medication.\",\"30\":\"Occasional decrease in work efficiency.\",\"50\":\"Reduced reliability: panic attacks >1x/week, memory issues, motivation disturbances.\",\"70\":\"Deficiencies in most areas: near-continuous anxiety, impaired impulse control, inability to maintain relationships.\",\"100\":\"Total occupational and social impairment.\"}', 100, 'anxiety,gad,generalized anxiety', NULL, 0),
(4, '9440', 'Mental Disorders', 'Chronic Adjustment Disorder', '{\"0\":\"Diagnosed but not impairing.\",\"10\":\"Mild or transient symptoms.\",\"30\":\"Occasional decrease in work efficiency.\",\"50\":\"Reduced reliability and productivity.\",\"70\":\"Deficiencies in most areas.\",\"100\":\"Total occupational and social impairment.\"}', 100, 'adjustment disorder', NULL, 0),
(5, '9404', 'Mental Disorders', 'Obsessive-Compulsive Disorder (OCD)', '{\"0\":\"Diagnosed but not impairing.\",\"10\":\"Mild or transient symptoms.\",\"30\":\"Occasional decrease in work efficiency.\",\"50\":\"Reduced reliability due to obsessional rituals.\",\"70\":\"Obsessional rituals interfere with routine activities, deficiencies in most areas.\",\"100\":\"Total occupational and social impairment.\"}', 100, 'ocd,obsessive compulsive', NULL, 0),
(6, '9403', 'Mental Disorders', 'Specific Phobia / Social Anxiety', '{\"0\":\"Diagnosed but not impairing.\",\"10\":\"Mild or transient symptoms.\",\"30\":\"Occasional decrease in work efficiency.\",\"50\":\"Reduced reliability.\",\"70\":\"Deficiencies in most areas.\",\"100\":\"Total impairment.\"}', 100, 'phobia,social anxiety,agoraphobia', NULL, 0),
(7, '9432', 'Mental Disorders', 'Bipolar Disorder', '{\"0\":\"Diagnosed but not impairing.\",\"10\":\"Mild or transient symptoms.\",\"30\":\"Occasional decrease in work efficiency.\",\"50\":\"Reduced reliability.\",\"70\":\"Deficiencies in most areas.\",\"100\":\"Total impairment.\"}', 100, 'bipolar,manic', NULL, 0),
(8, '9435', 'Mental Disorders', 'Persistent Depressive Disorder (Dysthymia)', '{\"0\":\"Diagnosed but not impairing.\",\"10\":\"Mild or transient symptoms.\",\"30\":\"Occasional decrease in work efficiency.\",\"50\":\"Reduced reliability.\",\"70\":\"Deficiencies in most areas.\",\"100\":\"Total impairment.\"}', 100, 'dysthymia,persistent depressive', NULL, 0),
(9, '6260', 'Ear / Auditory', 'Tinnitus', '{\"10\":\"Recurrent tinnitus. Note: A single 10% rating is assigned regardless of whether tinnitus is unilateral or bilateral.\"}', 10, 'tinnitus,ringing ears,ringing in ears', NULL, 0),
(10, '6100', 'Ear / Auditory', 'Hearing Loss, Bilateral', '{\"0\":\"Hearing acuity Level I in both ears (per Table VI/VIa).\",\"10\":\"Specific puretone/speech combinations per Tables VI and VII.\",\"20\":\"Higher impairment per Tables VI and VII.\",\"30\":\"Higher impairment.\",\"40\":\"Higher impairment.\",\"50\":\"Higher impairment.\",\"60\":\"Higher impairment.\",\"70\":\"Higher impairment.\",\"80\":\"Higher impairment.\",\"90\":\"Higher impairment.\",\"100\":\"Profound bilateral hearing loss per Tables VI and VII.\"}', 100, 'hearing loss,bilateral hearing,sensorineural', NULL, 1),
(11, '5237', 'Musculoskeletal - Spine', 'Lumbosacral Strain', '{\"10\":\"Forward flexion >60° but ≤85°; OR combined ROM >120° but ≤235°; OR muscle spasm/guarding/localized tenderness not resulting in abnormal gait or spinal contour.\",\"20\":\"Forward flexion >30° but ≤60°; OR combined ROM ≤120°; OR muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour (scoliosis, reversed lordosis, or abnormal kyphosis).\",\"30\":\"Applies to cervical spine only (see 5242).\",\"40\":\"Forward flexion ≤30°; OR favorable ankylosis of the entire thoracolumbar spine.\",\"50\":\"Unfavorable ankylosis of the entire thoracolumbar spine.\",\"100\":\"Unfavorable ankylosis of the entire spine.\"}', 100, 'lumbar,lumbosacral,low back,back strain,back pain', NULL, 0),
(12, '5242', 'Musculoskeletal - Spine', 'Degenerative Arthritis of the Spine', '{\"10\":\"Forward flexion >60° but ≤85° (thoracolumbar) or >30° but ≤40° (cervical); OR combined ROM >120° but ≤235° (thoracolumbar) or >170° but ≤335° (cervical); OR muscle spasm not resulting in abnormal gait.\",\"20\":\"Forward flexion >30° but ≤60° (thoracolumbar) or >15° but ≤30° (cervical); OR combined ROM ≤120° (thoracolumbar) or ≤170° (cervical); OR muscle spasm severe enough to produce abnormal gait or spinal contour.\",\"30\":\"Forward flexion ≤15° (cervical); OR favorable ankylosis of the entire cervical spine.\",\"40\":\"Unfavorable ankylosis of entire cervical spine; OR forward flexion ≤30° (thoracolumbar); OR favorable ankylosis of entire thoracolumbar spine.\",\"50\":\"Unfavorable ankylosis of entire thoracolumbar spine.\",\"100\":\"Unfavorable ankylosis of entire spine.\"}', 100, 'degenerative disc,ddd,spondylosis,spinal arthritis,cervical,thoracic', NULL, 0),
(13, '5243', 'Musculoskeletal - Spine', 'Intervertebral Disc Syndrome (IVDS)', '{\"10\":\"Incapacitating episodes having a total duration of at least 1 week but less than 2 weeks during the past 12 months.\",\"20\":\"Incapacitating episodes of at least 2 weeks but less than 4 weeks during the past 12 months.\",\"40\":\"Incapacitating episodes of at least 4 weeks but less than 6 weeks during the past 12 months.\",\"60\":\"Incapacitating episodes of at least 6 weeks during the past 12 months. Note: An incapacitating episode is a period of acute signs/symptoms requiring bed rest prescribed by a physician.\"}', 60, 'ivds,intervertebral,herniated disc,bulging disc,sciatica', NULL, 0),
(14, '5260', 'Musculoskeletal - Knee', 'Limitation of Flexion, Knee', '{\"0\":\"Flexion limited to 60°.\",\"10\":\"Flexion limited to 45°.\",\"20\":\"Flexion limited to 30°.\",\"30\":\"Flexion limited to 15°.\"}', 30, 'knee flexion,knee bending,limited knee flexion', NULL, 1),
(15, '5261', 'Musculoskeletal - Knee', 'Limitation of Extension, Knee', '{\"0\":\"Extension limited to 5°.\",\"10\":\"Extension limited to 10°.\",\"20\":\"Extension limited to 15°.\",\"30\":\"Extension limited to 20°.\",\"40\":\"Extension limited to 30°.\",\"50\":\"Extension limited to 45°.\"}', 50, 'knee extension,knee straightening,limited knee extension', NULL, 1),
(16, '5257', 'Musculoskeletal - Knee', 'Recurrent Subluxation or Lateral Instability, Knee', '{\"10\":\"Slight recurrent subluxation or lateral instability.\",\"20\":\"Moderate recurrent subluxation or lateral instability.\",\"30\":\"Severe recurrent subluxation or lateral instability.\"}', 30, 'knee instability,knee subluxation,knee giving way,knee buckling', NULL, 1),
(17, '5258', 'Musculoskeletal - Knee', 'Dislocated Semilunar Cartilage (Meniscus)', '{\"20\":\"Dislocated semilunar cartilage with frequent episodes of locking, pain, and effusion into the joint.\"}', 20, 'meniscus,torn meniscus,cartilage,knee lock', NULL, 1),
(18, '5259', 'Musculoskeletal - Knee', 'Removal of Semilunar Cartilage (Meniscectomy)', '{\"10\":\"Symptomatic removal of semilunar cartilage.\"}', 10, 'meniscectomy,meniscus removal,knee surgery', NULL, 1),
(19, '5003', 'Musculoskeletal', 'Degenerative Arthritis (General)', '{\"10\":\"X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations.\",\"20\":\"X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations. Note: Rate on limitation of motion of affected joint if compensable; otherwise 10% per joint group with X-ray evidence.\"}', 20, 'arthritis,degenerative joint,osteoarthritis,djo', NULL, 1),
(20, '5201', 'Musculoskeletal - Shoulder', 'Limitation of Motion of the Arm', '{\"20\":\"Arm motion limited to shoulder level (90°).\",\"30\":\"Arm motion limited to midway between side and shoulder level (major) / 20% (minor).\",\"40\":\"Arm motion limited to 25° from side (major) / 30% (minor). Note: Dominant (major) arm ratings shown; minor arm is slightly lower.\"}', 40, 'shoulder,arm limitation,shoulder motion,rotator cuff', NULL, 1),
(21, '5200', 'Musculoskeletal - Shoulder', 'Ankylosis of Scapulohumeral Articulation', '{\"20\":\"Favorable ankylosis — abduction to 60°, can reach mouth and head.\",\"30\":\"Intermediate — between favorable and unfavorable.\",\"40\":\"Unfavorable — abduction limited to 25° from side (major).\",\"50\":\"Unfavorable ankylosis (major arm). Note: minor arm is slightly lower.\"}', 50, 'shoulder ankylosis,frozen shoulder', NULL, 1),
(22, '5252', 'Musculoskeletal - Hip', 'Limitation of Flexion, Thigh/Hip', '{\"10\":\"Flexion limited to 45°.\",\"20\":\"Flexion limited to 30°.\",\"30\":\"Flexion limited to 20°.\",\"40\":\"Flexion limited to 10°.\"}', 40, 'hip flexion,hip limitation,hip motion', NULL, 1),
(23, '5253', 'Musculoskeletal - Hip', 'Limitation of Abduction/Rotation, Thigh', '{\"10\":\"Limitation of rotation — cannot toe-out more than 15° (affected leg).\",\"20\":\"Limitation of abduction — motion lost beyond 10°.\"}', 20, 'hip abduction,hip rotation', NULL, 1),
(24, '5271', 'Musculoskeletal - Ankle', 'Limited Motion of the Ankle', '{\"10\":\"Moderate limitation of ankle motion.\",\"20\":\"Marked limitation of ankle motion.\"}', 20, 'ankle motion,ankle limitation,ankle range', NULL, 1),
(25, '5276', 'Musculoskeletal - Foot', 'Flatfoot, Acquired (Pes Planus)', '{\"0\":\"Mild — symptoms relieved by built-up shoe or arch support.\",\"10\":\"Moderate — weight-bearing line over or medial to great toe, inward bowing of tendo achillis, pain on manipulation and use. Bilateral.\",\"20\":\"Severe (unilateral) — objective evidence of marked deformity, pain on manipulation, swelling on use, characteristic callosities.\",\"30\":\"Severe (bilateral).\",\"50\":\"Pronounced (bilateral) — marked pronation, extreme tenderness of plantar surfaces, marked inward displacement, severe spasm of tendo achillis on manipulation, not improved by orthopedic shoes or appliances.\"}', 50, 'flatfoot,flat feet,pes planus,fallen arches', NULL, 1),
(26, '5284', 'Musculoskeletal - Foot', 'Foot Injuries, Other', '{\"10\":\"Moderate foot injury.\",\"20\":\"Moderately severe foot injury.\",\"30\":\"Severe foot injury.\"}', 30, 'foot injury,plantar fasciitis,metatarsalgia', NULL, 1),
(27, '8100', 'Neurological', 'Migraine Headaches', '{\"0\":\"Less frequent attacks.\",\"10\":\"Characteristic prostrating attacks averaging one in 2 months over the last several months.\",\"30\":\"Characteristic prostrating attacks occurring on average once a month over the last several months.\",\"50\":\"Very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability.\"}', 50, 'migraine,headache,migraines,headaches', NULL, 0),
(28, '8520', 'Neurological', 'Sciatic Nerve — Paralysis/Radiculopathy', '{\"10\":\"Mild incomplete paralysis.\",\"20\":\"Moderate incomplete paralysis.\",\"40\":\"Moderately severe incomplete paralysis.\",\"60\":\"Severe incomplete paralysis with marked muscular atrophy.\",\"80\":\"Complete paralysis: foot dangles and drops, no active movement possible below knee, flexion of knee weakened or lost.\"}', 80, 'sciatica,sciatic nerve,radiculopathy,lumbar radiculopathy', NULL, 1),
(29, '8515', 'Neurological', 'Median Nerve — Paralysis (Carpal Tunnel)', '{\"10\":\"Mild incomplete paralysis.\",\"30\":\"Moderate incomplete paralysis (major hand).\",\"50\":\"Severe incomplete paralysis (major hand).\",\"70\":\"Complete paralysis (major hand). Note: Minor hand ratings are slightly lower.\"}', 70, 'carpal tunnel,median nerve,cts,wrist numbness', NULL, 1),
(30, '8045', 'Neurological', 'Traumatic Brain Injury (TBI)', '{\"0\":\"Subjective symptoms that do not interfere with work or ADLs.\",\"10\":\"Facets of cognitive impairment and/or subjective symptoms that mildly interfere. Three or more subjective symptoms that mildly interfere with work or ADLs.\",\"40\":\"Facets that moderately interfere.\",\"70\":\"Facets showing marked interference. One or more neurobehavioral effects that frequently interfere.\",\"100\":\"Total occupational and social impairment. Note: TBI residuals are evaluated under 3 main areas: cognitive, emotional/behavioral, and physical — separately rated facets combined.\"}', 100, 'tbi,traumatic brain injury,concussion,head injury,brain injury', NULL, 0),
(31, '8510', 'Neurological', 'Upper Radicular Group (C5-C6)', '{\"20\":\"Mild incomplete paralysis.\",\"40\":\"Moderate incomplete paralysis (major).\",\"50\":\"Severe incomplete paralysis (major).\",\"70\":\"Complete paralysis (major). Note: Minor side is slightly lower.\"}', 70, 'upper radiculopathy,c5,c6,brachial plexus upper', NULL, 1),
(32, '8521', 'Neurological', 'External Popliteal (Peroneal) Nerve', '{\"0\":\"Mild incomplete paralysis.\",\"10\":\"Moderate incomplete paralysis.\",\"20\":\"Moderately severe incomplete paralysis.\",\"30\":\"Severe incomplete paralysis.\",\"40\":\"Complete paralysis: foot drop and slight droop of first phalanges of all toes.\"}', 40, 'peroneal nerve,foot drop,drop foot', NULL, 1),
(33, '6847', 'Respiratory', 'Sleep Apnea, Obstructive', '{\"0\":\"Asymptomatic but with documented sleep disorder breathing.\",\"30\":\"Persistent day-time hypersomnolence.\",\"50\":\"Requires use of a breathing assistance device such as CPAP machine.\",\"100\":\"Chronic respiratory failure with carbon dioxide retention or cor pulmonale; OR requires tracheostomy.\"}', 100, 'sleep apnea,osa,obstructive sleep apnea,cpap', NULL, 0),
(34, '6602', 'Respiratory', 'Asthma, Bronchial', '{\"10\":\"FEV-1 of 71-80% predicted, or FEV-1/FVC of 71-80%, or intermittent inhalational or oral bronchodilator therapy.\",\"30\":\"FEV-1 of 56-70% predicted, or FEV-1/FVC of 56-70%, or daily inhalational or oral bronchodilator therapy, or inhalational anti-inflammatory medication.\",\"60\":\"FEV-1 of 40-55% predicted, or FEV-1/FVC of 40-55%, or at least monthly visits to a physician for required care of exacerbations, or intermittent (at least 3x/year) courses of systemic corticosteroids.\",\"100\":\"FEV-1 <40% predicted, or FEV-1/FVC <40%, or more than one attack per week with episodes of respiratory failure, or requires daily use of systemic high dose corticosteroids or immunosuppressive medications.\"}', 100, 'asthma,bronchial asthma', NULL, 0),
(35, '6604', 'Respiratory', 'Chronic Obstructive Pulmonary Disease (COPD)', '{\"10\":\"FEV-1 of 71-80% predicted, or FEV-1/FVC of 71-80%, or DLCO (SB) 66-80% predicted.\",\"30\":\"FEV-1 of 56-70%, or FEV-1/FVC of 56-70%, or DLCO (SB) 56-65%.\",\"60\":\"FEV-1 of 40-55%, or FEV-1/FVC of 40-55%, or DLCO (SB) 40-55%, or maximum oxygen consumption of 15-20 ml/kg/min.\",\"100\":\"FEV-1 <40%, or FEV-1/FVC <40%, or DLCO (SB) <40%, or maximum exercise capacity <15 ml/kg/min O2 consumption with cardiorespiratory limitation, or cor pulmonale, or right ventricular hypertrophy, or pulmonary hypertension, or episodes of acute respiratory failure, or requires outpatient oxygen therapy.\"}', 100, 'copd,chronic obstructive,emphysema,chronic bronchitis', NULL, 0),
(36, '6510', 'Respiratory', 'Sinusitis, Chronic (Pansinusitis)', '{\"0\":\"Detected by X-ray only.\",\"10\":\"One or two incapacitating episodes per year requiring prolonged (4-6 weeks) antibiotic treatment, or three to six non-incapacitating episodes per year characterized by headaches, pain, and purulent discharge or crusting.\",\"30\":\"Three or more incapacitating episodes per year requiring prolonged antibiotic treatment, or more than six non-incapacitating episodes per year.\",\"50\":\"Following radical surgery with chronic osteomyelitis, or near constant sinusitis characterized by headaches, pain and tenderness, and purulent discharge or crusting after repeated surgeries.\"}', 50, 'sinusitis,sinus,chronic sinusitis,pansinusitis', NULL, 0),
(37, '6522', 'Respiratory', 'Allergic Rhinitis', '{\"10\":\"Without polyps, but with greater than 50% obstruction of nasal passage on both sides or complete obstruction on one side.\",\"30\":\"With polyps.\"}', 30, 'rhinitis,allergic rhinitis,nasal,stuffy nose', NULL, 0),
(38, '7101', 'Cardiovascular', 'Hypertension', '{\"10\":\"Diastolic predominantly 100 or more, or systolic predominantly 160 or more, or minimum evaluation for individual with history of diastolic 100+ requiring continuous medication.\",\"20\":\"Diastolic predominantly 110 or more, or systolic predominantly 200 or more.\",\"40\":\"Diastolic predominantly 120 or more.\",\"60\":\"Diastolic predominantly 130 or more.\"}', 60, 'hypertension,high blood pressure,htn', NULL, 0),
(39, '7005', 'Cardiovascular', 'Arteriosclerotic Heart Disease (CAD)', '{\"10\":\"Workload >7 METs but ≤10 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope; or continuous medication required.\",\"30\":\"Workload >5 METs but ≤7 METs; or evidence of cardiac hypertrophy/dilatation on EKG, echocardiogram, or X-ray.\",\"60\":\"More than one episode of acute CHF in the past year; or workload >3 METs but ≤5 METs; or left ventricular dysfunction with EF 30-50%.\",\"100\":\"Chronic CHF; or workload ≤3 METs; or left ventricular dysfunction with EF <30%.\"}', 100, 'cad,coronary artery,heart disease,arteriosclerotic,ischemic heart', NULL, 0),
(40, '7346', 'Digestive', 'Gastroesophageal Reflux Disease (GERD)', '{\"10\":\"Two or more of the symptoms for the 30% rating with less severity.\",\"30\":\"Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health.\",\"60\":\"Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health.\"}', 60, 'gerd,reflux,gastroesophageal,hiatal hernia,acid reflux', NULL, 0),
(41, '7319', 'Digestive', 'Irritable Bowel Syndrome (IBS)', '{\"0\":\"Mild — disturbances of bowel function with occasional episodes of abdominal distress.\",\"10\":\"Moderate — frequent episodes of bowel disturbance with abdominal distress.\",\"30\":\"Severe — diarrhea or alternating diarrhea/constipation with more or less constant abdominal distress.\"}', 30, 'ibs,irritable bowel,spastic colon', NULL, 0),
(42, '7338', 'Digestive', 'Inguinal Hernia', '{\"0\":\"Not operated, but remediable; or small, reducible, without true hernia protrusion.\",\"10\":\"Postoperative recurrent, readily reducible and well supported by truss or belt.\",\"30\":\"Small, postoperative recurrent, or unoperated irremediable, not well supported by truss, or not readily reducible.\",\"60\":\"Large, postoperative, recurrent, not well supported under ordinary conditions and not readily reducible.\"}', 60, 'inguinal hernia,hernia', NULL, 0),
(43, '7913', 'Endocrine', 'Diabetes Mellitus, Type II', '{\"10\":\"Manageable by restricted diet only.\",\"20\":\"Requiring insulin and restricted diet, or oral hypoglycemic agent and restricted diet.\",\"40\":\"Requiring insulin, restricted diet, and regulation of activities.\",\"60\":\"Requiring insulin, restricted diet, regulation of activities, with episodes of ketoacidosis or hypoglycemic reactions requiring 1-2 hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated.\",\"100\":\"Requiring more than one daily insulin injection, restricted diet, regulation of activities, with episodes of ketoacidosis or hypoglycemic reactions requiring at least 3 hospitalizations per year or weekly visits to a diabetic care provider, plus progressive loss of weight and strength attributable to diabetes.\"}', 100, 'diabetes,type 2,type ii,diabetic', NULL, 0),
(44, '7806', 'Skin', 'Dermatitis / Eczema', '{\"0\":\"Less than 5% of the entire body or exposed areas affected, and no more than topical therapy required during the past 12 months.\",\"10\":\"At least 5% but less than 20% of the entire body or exposed areas affected; or intermittent systemic therapy (corticosteroids/immunosuppressives) required for <6 weeks during the past 12 months.\",\"30\":\"20-40% of the entire body or exposed areas affected; or systemic therapy required for 6+ weeks during the past 12 months.\",\"60\":\"More than 40% of the entire body or exposed areas affected; or constant or near-constant systemic therapy required during the past 12 months.\"}', 60, 'eczema,dermatitis,skin rash,atopic dermatitis', NULL, 0),
(45, '7800', 'Skin', 'Burn Scars, Head/Face/Neck', '{\"10\":\"One characteristic of disfigurement.\",\"30\":\"Visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features, or two or three characteristics of disfigurement.\",\"50\":\"Visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features, or four or five characteristics of disfigurement.\",\"80\":\"Visible or palpable tissue loss and either gross distortion or asymmetry of three or more features or paired sets of features, or six or more characteristics of disfigurement.\"}', 80, 'scar,burn scar,facial scar,disfigurement', NULL, 0),
(46, '7804', 'Skin', 'Unstable or Painful Scars', '{\"10\":\"One or two scars that are unstable or painful.\",\"20\":\"Three or four scars that are unstable or painful.\",\"30\":\"Five or more scars that are unstable or painful.\"}', 30, 'painful scar,unstable scar,scar pain', NULL, 0),
(47, '7522', 'Genitourinary', 'Erectile Dysfunction / Loss of Erectile Power', '{\"0\":\"Loss of erectile power — rated 0% but entitled to SMC-K (special monthly compensation for loss of use of a creative organ). Note: The 0% rating is assigned for the condition itself; the real compensation comes through SMC-K.\"}', 0, 'erectile dysfunction,ed,impotence,sexual dysfunction', NULL, 0),
(48, '9905', 'Dental / Oral', 'Temporomandibular Joint (TMJ) Disorder', '{\"10\":\"Inter-incisal range limited to 31-40mm.\",\"20\":\"Inter-incisal range limited to 21-30mm.\",\"30\":\"Inter-incisal range limited to 11-20mm.\",\"40\":\"Inter-incisal range limited to 0-10mm.\"}', 40, 'tmj,jaw,temporomandibular,jaw pain', NULL, 1),
(49, '6066', 'Eye', 'Visual Acuity, Impairment', '{\"0\":\"20/40 in both eyes.\",\"10\":\"20/50 in one eye, 20/40 in other.\",\"20\":\"20/70 in one eye, 20/50 in other.\",\"30\":\"20/100 in one eye, 20/70 in other.\",\"40\":\"Higher visual acuity impairment per Table V.\",\"50\":\"Higher impairment.\",\"60\":\"Higher impairment.\",\"70\":\"Higher impairment.\",\"80\":\"Higher impairment.\",\"90\":\"Higher impairment.\",\"100\":\"5/200 bilateral or blindness.\"}', 100, 'vision loss,visual acuity,blindness,eye', NULL, 0),
(50, '6354', 'Infectious', 'Chronic Fatigue Syndrome', '{\"10\":\"Symptoms wax and wane but are generally controlled by continuous medication.\",\"20\":\"Nearly constant and restricts routine daily activities by less than 25% of pre-illness level; or periods of incapacitation of at least 2 but less than 4 weeks total duration per year.\",\"40\":\"Nearly constant and restricts routine daily activities to 50-75% of pre-illness level; or periods of incapacitation of at least 4 but less than 6 weeks per year.\",\"60\":\"Nearly constant and restricts routine daily activities to less than 50% of pre-illness level; or periods of incapacitation of at least 6 weeks per year.\",\"100\":\"Nearly constant and so severe as to restrict daily activities almost completely; or require rest therapy nearly continuously.\"}', 100, 'chronic fatigue,cfs,me/cfs', NULL, 0);

-- --------------------------------------------------------

--
-- Table structure for table `exposure_history`
--

CREATE TABLE `exposure_history` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `burn_pits` tinyint(1) DEFAULT 0,
  `jp5` tinyint(1) DEFAULT 0,
  `solvents` tinyint(1) DEFAULT 0,
  `asbestos` tinyint(1) DEFAULT 0,
  `lead_paint` tinyint(1) DEFAULT 0,
  `radiation` tinyint(1) DEFAULT 0,
  `agent_orange` tinyint(1) DEFAULT 0,
  `gulf_war` tinyint(1) DEFAULT 0,
  `tera` tinyint(1) DEFAULT 0,
  `pact` tinyint(1) DEFAULT 0,
  `notes` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `exposure_watchlist`
--

CREATE TABLE `exposure_watchlist` (
  `id` int(11) NOT NULL,
  `exposure_name` varchar(255) DEFAULT NULL,
  `category` varchar(100) DEFAULT NULL,
  `classification` enum('confirmed','documented','probable','possible','emerging','research_watch') DEFAULT NULL,
  `description` text DEFAULT NULL,
  `source_reference` text DEFAULT NULL,
  `notes` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `favorable_findings`
--

CREATE TABLE `favorable_findings` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `denial_letter_id` int(11) NOT NULL,
  `finding_text` longtext DEFAULT NULL,
  `finding_type` varchar(100) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `granted_cases`
--

CREATE TABLE `granted_cases` (
  `id` int(11) NOT NULL,
  `claim_condition` varchar(255) DEFAULT NULL,
  `summary` text DEFAULT NULL,
  `key_factors` text DEFAULT NULL,
  `evidence_used` text DEFAULT NULL,
  `outcome` text DEFAULT NULL,
  `source` varchar(255) DEFAULT NULL,
  `tags` text DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `granted_cases`
--

INSERT INTO `granted_cases` (`id`, `claim_condition`, `summary`, `key_factors`, `evidence_used`, `outcome`, `source`, `tags`) VALUES
(2, 'PTSD - Combat', 'Veteran claimed PTSD based on combat stressor during deployment to Afghanistan. VA conceded combat stressor under relaxed evidentiary standard.', 'Combat MOS, deployment records confirmed, consistent PTSD diagnosis from VA psychiatrist, GAF 45', 'VA treatment records showing PTSD diagnosis and ongoing treatment, buddy statement from fellow service member, deployment orders', 'Service connected at 70%', 'BVA decisions database', 'ptsd,combat,stressor concession'),
(3, 'PTSD - MST', 'Veteran claimed PTSD secondary to military sexual trauma. No official report filed during service but behavioral markers supported the claim.', 'Behavioral markers: request for transfer after incident, decline in performance evaluations, documented STI treatment, mental health referral within 6 months of alleged event', 'Personal statement, behavioral markers in service records, nexus letter from treating psychologist citing markers, civilian treatment records', 'Service connected at 70%', 'BVA decisions database', 'ptsd,mst,behavioral markers'),
(4, 'Sleep Apnea secondary to PTSD', 'Veteran claimed sleep apnea as secondary to service-connected PTSD rated at 70%.', 'Strong nexus letter from sleep medicine specialist explaining how PTSD hyperarousal disrupts sleep architecture and contributes to upper airway obstruction, sleep study confirming OSA, CPAP prescribed', 'Sleep study (polysomnography), nexus letter from sleep specialist, VA treatment records showing sleep complaints contemporaneous with PTSD treatment', 'Service connected at 50% (CPAP use)', 'BVA decisions database', 'sleep apnea,secondary,ptsd,cpap'),
(5, 'Lumbar Spine - Direct', 'Veteran claimed lumbar spine condition based on parachute jumps and heavy lifting during service.', 'Parachute jump log, service treatment records showing back complaints, current MRI showing DDD, nexus opinion linking current condition to repetitive service activities', 'Service treatment records, jump log, current MRI, nexus letter from orthopedist', 'Service connected at 20%', 'BVA decisions database', 'lumbar,spine,direct,parachute'),
(6, 'Radiculopathy secondary to Lumbar Spine', 'Veteran claimed bilateral lower extremity radiculopathy secondary to service-connected lumbar DDD.', 'EMG/NCS confirming radiculopathy, MRI showing nerve root impingement, treating physician nexus stating radiculopathy is direct result of service-connected spinal condition', 'EMG/NCS results, lumbar MRI, treating physician opinion', 'Service connected at 20% each extremity', 'BVA decisions database', 'radiculopathy,secondary,lumbar,bilateral'),
(7, 'Bilateral Knee - Direct', 'Veteran with infantry MOS claimed bilateral knee condition from running, rucking, and jumping during 20 years of service.', 'Service records confirming infantry duties, multiple knee complaints in STRs, current X-rays showing bilateral osteoarthritis', 'STRs with knee complaints, current X-rays/MRI, in-service physical requirements documentation, buddy statements', 'Service connected at 10% each knee', 'BVA decisions database', 'knee,bilateral,infantry,direct'),
(8, 'GERD secondary to PTSD medications', 'Veteran claimed GERD as secondary to medications prescribed for service-connected PTSD.', 'Pharmacy records showing long-term SSRI use for PTSD, GI evaluation confirming GERD, medical literature linking SSRIs to increased acid reflux', 'Pharmacy records, GI consultation, nexus letter citing medication side effects', 'Service connected at 10%', 'BVA decisions database', 'gerd,secondary,ptsd,medication'),
(9, 'Migraine Headaches secondary to TBI', 'Veteran claimed migraines as secondary to service-connected TBI from IED blast.', 'TBI diagnosis in service, onset of migraines within months of TBI event, headache diary showing prostrating attacks, C&P examiner acknowledged likely connection', 'Service treatment records documenting TBI, headache diary, C&P examination, neurologist nexus letter', 'Service connected at 50%', 'BVA decisions database', 'migraine,secondary,tbi,ied'),
(10, 'Tinnitus - Direct', 'Veteran claimed tinnitus from noise exposure during MOS as an artillery crew member.', 'High noise MOS confirmed, veteran\'s lay testimony of onset during service found credible, no competing etiology', 'Military records confirming noise exposure MOS, veteran\'s lay statement about onset and continuity, audiological evaluation', 'Service connected at 10%', 'BVA decisions database', 'tinnitus,direct,noise exposure,artillery'),
(11, 'Hypertension secondary to PTSD', 'Veteran claimed hypertension as secondary to service-connected PTSD.', 'Recent NAS study (2018) supporting PTSD-hypertension link, treating cardiologist nexus opinion, blood pressure readings showing onset after PTSD diagnosis', 'Nexus letter citing NAS study, VA treatment records, blood pressure log', 'Service connected at 10%', 'BVA decisions database', 'hypertension,secondary,ptsd,nas study'),
(12, 'Erectile Dysfunction secondary to PTSD medications', 'Veteran claimed ED secondary to SSRI medications prescribed for service-connected PTSD.', 'Pharmacy records showing continuous SSRI use, urologist nexus letter citing SSRI sexual side effects, onset correlating with medication start date', 'Pharmacy records, urologist nexus letter, VA treatment records', 'Service connected at 0% with SMC-K', 'BVA decisions database', 'ed,erectile dysfunction,secondary,smc-k,ssri'),
(13, 'TDIU', 'Veteran unable to work due to combined effects of PTSD (70%), lumbar spine (40%), and bilateral knee (10% each). Combined rating 80%.', 'Vocational expert opinion that veteran cannot maintain substantially gainful employment, veteran\'s work history showing inability to sustain employment after discharge, SSA disability award for same conditions', 'VA Form 21-8940, employer statements, vocational expert opinion, SSA records', 'TDIU granted — paid at 100% rate', 'BVA decisions database', 'tdiu,unemployability,vocational'),
(14, 'Diabetes Type II - Agent Orange', 'Vietnam veteran claimed diabetes presumptively due to herbicide exposure.', 'Service records confirming Vietnam service during presumptive period, current diabetes diagnosis, no need for nexus — presumptive connection', 'Service records confirming Vietnam service dates, diabetes diagnosis', 'Service connected at 20% (presumptive)', 'BVA decisions database', 'diabetes,agent orange,presumptive,vietnam'),
(15, 'Peripheral Neuropathy secondary to Diabetes', 'Veteran claimed bilateral upper and lower extremity peripheral neuropathy secondary to service-connected diabetes.', 'EMG/NCS confirming polyneuropathy, endocrinologist nexus stating diabetic neuropathy, HbA1c records showing poor glycemic control', 'EMG/NCS, endocrinologist nexus, VA treatment records', 'Service connected at 10-40% per extremity depending on severity', 'BVA decisions database', 'neuropathy,secondary,diabetes,bilateral');

-- --------------------------------------------------------

--
-- Table structure for table `hr_documents`
--

CREATE TABLE `hr_documents` (
  `id` int(11) NOT NULL,
  `user_id` int(11) DEFAULT 1,
  `original_filename` varchar(255) DEFAULT NULL,
  `stored_filename` varchar(255) DEFAULT NULL,
  `document_type` varchar(120) DEFAULT 'Unknown',
  `claim_type` varchar(120) DEFAULT 'Unknown',
  `decision_date` date DEFAULT NULL,
  `decision_date_text` varchar(100) DEFAULT NULL,
  `effective_date` date DEFAULT NULL,
  `effective_date_text` varchar(100) DEFAULT NULL,
  `outcome_summary` varchar(120) DEFAULT 'Unclear',
  `raw_text` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `hr_findings`
--

CREATE TABLE `hr_findings` (
  `id` int(11) NOT NULL,
  `document_id` int(11) NOT NULL,
  `issue_id` int(11) DEFAULT NULL,
  `finding_type` varchar(120) DEFAULT NULL,
  `finding_text` text DEFAULT NULL,
  `is_favorable` tinyint(1) DEFAULT 0,
  `is_risk` tinyint(1) DEFAULT 0,
  `is_overlooked` tinyint(1) DEFAULT 0,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `hr_history_terms`
--

CREATE TABLE `hr_history_terms` (
  `id` int(11) NOT NULL,
  `term_label` varchar(255) DEFAULT NULL,
  `mention_count` int(11) DEFAULT 0,
  `document_count` int(11) DEFAULT 0,
  `first_seen` date DEFAULT NULL,
  `first_seen_text` varchar(100) DEFAULT NULL,
  `last_seen` date DEFAULT NULL,
  `last_seen_text` varchar(100) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp(),
  `updated_at` timestamp NULL DEFAULT current_timestamp() ON UPDATE current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `hr_issues`
--

CREATE TABLE `hr_issues` (
  `id` int(11) NOT NULL,
  `document_id` int(11) NOT NULL,
  `issue_name` varchar(255) DEFAULT NULL,
  `status_mentioned` tinyint(1) DEFAULT 1,
  `status_claimed` tinyint(1) DEFAULT 0,
  `status_adjudicated` tinyint(1) DEFAULT 0,
  `outcome` varchar(80) DEFAULT 'Mentioned',
  `rating_percent` int(11) DEFAULT NULL,
  `diagnostic_code` varchar(40) DEFAULT NULL,
  `effective_date` date DEFAULT NULL,
  `effective_date_text` varchar(100) DEFAULT NULL,
  `missing_element` varchar(120) DEFAULT NULL,
  `confidence` varchar(40) DEFAULT 'medium',
  `notes` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `import_conditions`
--

CREATE TABLE `import_conditions` (
  `id` int(11) NOT NULL,
  `body_system` varchar(100) DEFAULT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `keywords` text DEFAULT NULL,
  `exposure_type` varchar(100) DEFAULT NULL,
  `secondary_conditions` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `intent_to_file`
--

CREATE TABLE `intent_to_file` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `itf_date` date NOT NULL COMMENT 'Date ITF was submitted',
  `expiration_date` date NOT NULL COMMENT 'ITF + 1 year',
  `claim_type` varchar(100) DEFAULT NULL COMMENT 'Compensation, Pension, Survivors',
  `confirmation_number` varchar(100) DEFAULT NULL,
  `status` enum('active','expired','filed','cancelled') NOT NULL DEFAULT 'active',
  `notes` text DEFAULT NULL,
  `created_at` timestamp NOT NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `interview_responses`
--

CREATE TABLE `interview_responses` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `question_key` varchar(255) DEFAULT NULL,
  `response_value` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `interview_sessions`
--

CREATE TABLE `interview_sessions` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `selected_body_systems` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp(),
  `updated_at` timestamp NULL DEFAULT current_timestamp() ON UPDATE current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `login_attempts`
--

CREATE TABLE `login_attempts` (
  `id` bigint(20) NOT NULL,
  `email` varchar(255) DEFAULT NULL,
  `ip_address` varchar(45) DEFAULT NULL,
  `success` tinyint(1) DEFAULT NULL,
  `attempted_at` datetime DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `m21_references`
--

CREATE TABLE `m21_references` (
  `id` int(11) NOT NULL,
  `m21_section` varchar(50) NOT NULL COMMENT 'e.g. M21-1, Part III.iv.4.A',
  `title` varchar(255) NOT NULL,
  `description` text NOT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `keywords` text DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `m21_references`
--

INSERT INTO `m21_references` (`id`, `m21_section`, `title`, `description`, `condition_name`, `keywords`) VALUES
(1, 'III.iv.3.A', 'General Service Connection Development', 'Guidance on developing claims for direct service connection: obtaining service treatment records, arranging C&P examinations, obtaining medical opinions, and evaluating nexus evidence.', NULL, 'direct service connection,development,str,c&p exam,nexus'),
(2, 'III.iv.3.B', 'Secondary Service Connection Development', 'Procedures for developing secondary service-connection claims: documentation of the primary condition, medical evidence of causation or aggravation, and the standard for secondary claims under 38 CFR 3.310.', NULL, 'secondary,aggravation,causation,3.310'),
(3, 'III.iv.4.A', 'Rating Mental Disorders', 'Guidance on rating mental disorders under the General Rating Formula (38 CFR 4.130). Includes evaluation of GAF scores (now DSM-5 based), occupational impairment assessment, and social impairment assessment. Key: evaluate the level and frequency of symptoms, not just their presence.', NULL, 'mental health,ptsd,depression,anxiety,gaf,dsm-5,general rating formula'),
(4, 'III.iv.4.B', 'Rating Musculoskeletal Conditions', 'Guidance on range of motion testing, DeLuca factors (pain, fatigue, weakness, incoordination), repetitive use testing, and flare-up assessments. Key: rate based on functional limitation, not just ROM numbers. Consider painful motion under 38 CFR 4.59.', NULL, 'musculoskeletal,range of motion,deluca,flare,painful motion,4.59,rom'),
(5, 'III.iv.4.E', 'Rating Neurological Conditions', 'Guidance on evaluating peripheral nerve conditions: complete vs. incomplete paralysis, mild/moderate/moderately severe/severe gradations, and electrodiagnostic testing (EMG/NCS).', NULL, 'neurological,peripheral nerve,emg,ncs,paralysis,radiculopathy'),
(6, 'III.iv.4.F', 'Rating Respiratory Conditions', 'Guidance on PFT requirements, evaluation of sleep apnea (CPAP = 50%), and respiratory-condition-specific criteria. Key: use post-bronchodilator results unless pre-bronchodilator results are more favorable to the veteran.', NULL, 'respiratory,pft,pulmonary,sleep apnea,cpap,fev,fvc'),
(7, 'III.iv.4.G', 'Rating Cardiovascular Conditions', 'Guidance on METs testing, ejection fraction evaluation, and cardiac-condition-specific criteria.', NULL, 'cardiovascular,mets,ejection fraction,heart,cad'),
(8, 'III.iv.5.A', 'Special Monthly Compensation', 'Comprehensive guidance on all SMC levels (K through T), including loss of use determinations, aid and attendance criteria, and housebound evaluations. Includes combining rules and pyramiding prohibitions.', NULL, 'smc,special monthly compensation,k,l,s,o,r,t,aid and attendance,housebound'),
(9, 'III.iv.6.B', 'TDIU Evaluation', 'Guidance on evaluating TDIU claims: schedular criteria (one 60% or combined 70% with one 40%), employment history, education level, and the distinction between marginal and substantially gainful employment.', NULL, 'tdiu,unemployability,employment,marginal employment,sheltered workshop'),
(10, 'III.iv.6.C', 'Extraschedular Ratings', 'Guidance on when to refer cases for extraschedular consideration under 38 CFR 3.321(b)(1): when the disability picture is so exceptional that schedular criteria are inadequate.', NULL, 'extraschedular,3.321,exceptional,unusual disability picture'),
(11, 'IV.ii.1.A', 'Examining PTSD Claims', 'Specific guidance for PTSD claims: stressor verification procedures, relaxed evidentiary standards for combat veterans, MST development (markers), and fear-of-hostile-military-activity stressors.', NULL, 'ptsd,stressor,combat,mst,markers,fear of hostile'),
(12, 'IV.ii.1.D', 'Toxic Exposure and PACT Act', 'Guidance on processing claims under the PACT Act: conceding toxic exposure, presumptive conditions for burn pits and other exposures, and the TERA (Toxic Exposure Risk Activity) framework.', NULL, 'pact act,burn pit,toxic exposure,tera,presumptive'),
(13, 'IV.ii.2.C', 'Favorable Findings', 'Requirement to identify and communicate ALL favorable findings in rating decisions, even if the overall claim is denied. Favorable findings from one claim must be preserved and considered in future claims.', NULL, 'favorable findings,duty to assist,preserved,future claims'),
(14, 'IV.ii.2.E', 'Duty to Assist', 'VA\'s duty to assist includes: obtaining Federal records, making reasonable efforts for non-Federal records, providing medical examinations when evidence indicates a disability may be associated with service, and notifying the claimant of inability to obtain evidence.', NULL, 'duty to assist,federal records,c&p examination,notice');

-- --------------------------------------------------------

--
-- Table structure for table `managed_veterans`
--

CREATE TABLE `managed_veterans` (
  `id` bigint(20) NOT NULL,
  `manager_user_id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `relationship_type` varchar(100) DEFAULT NULL,
  `permission_confirmed` tinyint(1) DEFAULT 0,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `presumptive_conditions`
--

CREATE TABLE `presumptive_conditions` (
  `id` int(11) NOT NULL,
  `category` varchar(100) NOT NULL COMMENT 'Agent Orange, Gulf War, PACT Act, Radiation, Camp Lejeune, Chronic Disease',
  `condition_name` varchar(255) NOT NULL,
  `cfr_section` varchar(30) DEFAULT NULL,
  `presumptive_period` varchar(100) DEFAULT NULL COMMENT 'e.g. 1 year, no limit, during service',
  `service_requirement` text NOT NULL COMMENT 'where/when veteran must have served',
  `notes` text DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `presumptive_conditions`
--

INSERT INTO `presumptive_conditions` (`id`, `category`, `condition_name`, `cfr_section`, `presumptive_period`, `service_requirement`, `notes`) VALUES
(1, 'Agent Orange', 'AL Amyloidosis', '3.309(e)', NULL, 'Vietnam, Thailand (specific bases), or other designated locations during specified periods', NULL),
(2, 'Agent Orange', 'Bladder Cancer', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', 'Added 2022'),
(3, 'Agent Orange', 'Chronic B-cell Leukemias', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', NULL),
(4, 'Agent Orange', 'Chloracne', '3.309(e)', 'Within 1 year', 'Vietnam/Thailand/designated locations', NULL),
(5, 'Agent Orange', 'Diabetes Mellitus Type II', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', 'One of the most commonly granted AO claims'),
(6, 'Agent Orange', 'Hodgkin\'s Disease', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', NULL),
(7, 'Agent Orange', 'Hypertension', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', 'Added 2022 under PACT Act'),
(8, 'Agent Orange', 'Ischemic Heart Disease', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', 'Includes CAD, angina, MI'),
(9, 'Agent Orange', 'Multiple Myeloma', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', NULL),
(10, 'Agent Orange', 'Non-Hodgkin\'s Lymphoma', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', NULL),
(11, 'Agent Orange', 'Parkinson\'s Disease', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', NULL),
(12, 'Agent Orange', 'Parkinsonism', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', 'Added 2022'),
(13, 'Agent Orange', 'Peripheral Neuropathy, Early-Onset', '3.309(e)', 'Within 1 year', 'Vietnam/Thailand/designated locations', NULL),
(14, 'Agent Orange', 'Porphyria Cutanea Tarda', '3.309(e)', 'Within 1 year', 'Vietnam/Thailand/designated locations', NULL),
(15, 'Agent Orange', 'Prostate Cancer', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', 'Very commonly claimed'),
(16, 'Agent Orange', 'Respiratory Cancers', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', 'Lung, bronchus, larynx, trachea'),
(17, 'Agent Orange', 'Soft Tissue Sarcoma', '3.309(e)', NULL, 'Vietnam/Thailand/designated locations', NULL),
(18, 'Gulf War', 'Chronic Fatigue Syndrome', '3.317', NULL, 'Service in Southwest Asia theater during Gulf War era (Aug 1990 – present)', 'Medically unexplained chronic multi-symptom illness'),
(19, 'Gulf War', 'Fibromyalgia', '3.317', NULL, 'Southwest Asia theater', 'Medically unexplained chronic multi-symptom illness'),
(20, 'Gulf War', 'Irritable Bowel Syndrome', '3.317', NULL, 'Southwest Asia theater', 'Medically unexplained chronic multi-symptom illness'),
(21, 'Gulf War', 'Undiagnosed Illness', '3.317', NULL, 'Southwest Asia theater', 'Signs/symptoms that cannot be attributed to a known clinical diagnosis — rated by predominant disability'),
(22, 'PACT Act', 'Any cancer (covered toxic-exposed veteran)', '3.320', NULL, 'Served in toxic-exposure risk activity (TERA) location during specified period', 'PACT Act concedes toxic exposure for specified service'),
(23, 'PACT Act', 'Constrictive Bronchiolitis', '3.320', NULL, 'Burn pit / airborne hazard exposure', 'Specific respiratory condition linked to burn pit exposure'),
(24, 'PACT Act', 'Constrictive Pericarditis', '3.320', NULL, 'Burn pit / airborne hazard exposure', NULL),
(25, 'PACT Act', 'Respiratory conditions (various)', '3.320', NULL, 'Burn pit / airborne hazard exposure', 'Includes sinusitis, rhinitis, laryngitis, and other respiratory conditions'),
(26, 'Camp Lejeune', 'Bladder Cancer', '3.309(f)', NULL, 'Served at Camp Lejeune for 30+ days between Aug 1953 – Dec 1987', NULL),
(27, 'Camp Lejeune', 'Kidney Cancer', '3.309(f)', NULL, 'Camp Lejeune 30+ days, Aug 1953 – Dec 1987', NULL),
(28, 'Camp Lejeune', 'Leukemia', '3.309(f)', NULL, 'Camp Lejeune 30+ days, Aug 1953 – Dec 1987', NULL),
(29, 'Camp Lejeune', 'Liver Cancer', '3.309(f)', NULL, 'Camp Lejeune 30+ days, Aug 1953 – Dec 1987', NULL),
(30, 'Camp Lejeune', 'Multiple Myeloma', '3.309(f)', NULL, 'Camp Lejeune 30+ days, Aug 1953 – Dec 1987', NULL),
(31, 'Camp Lejeune', 'Non-Hodgkin\'s Lymphoma', '3.309(f)', NULL, 'Camp Lejeune 30+ days, Aug 1953 – Dec 1987', NULL),
(32, 'Camp Lejeune', 'Parkinson\'s Disease', '3.309(f)', NULL, 'Camp Lejeune 30+ days, Aug 1953 – Dec 1987', NULL),
(33, 'Camp Lejeune', 'Aplastic Anemia', '3.309(f)', NULL, 'Camp Lejeune 30+ days, Aug 1953 – Dec 1987', NULL),
(34, 'Chronic Disease', 'Arthritis', '3.309(a)', '1 year', 'Any active military service', 'Includes osteoarthritis and degenerative joint disease'),
(35, 'Chronic Disease', 'Cardiovascular-Renal Disease', '3.309(a)', '1 year', 'Any active military service', 'Includes hypertension'),
(36, 'Chronic Disease', 'Diabetes Mellitus', '3.309(a)', '1 year', 'Any active military service', NULL),
(37, 'Chronic Disease', 'Epilepsies', '3.309(a)', '1 year', 'Any active military service', NULL),
(38, 'Chronic Disease', 'Organic Diseases of the Nervous System', '3.309(a)', '1 year', 'Any active military service', 'Includes sensorineural hearing loss and tinnitus'),
(39, 'Chronic Disease', 'Psychoses', '3.309(a)', '1 year', 'Any active military service', 'Does not include PTSD, anxiety, or depression unless psychotic features'),
(40, 'Chronic Disease', 'Malignant Tumors', '3.309(a)', '1 year', 'Any active military service', 'Any malignant tumor');

-- --------------------------------------------------------

--
-- Table structure for table `rated_conditions`
--

CREATE TABLE `rated_conditions` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `condition_name` varchar(255) DEFAULT NULL,
  `rating_percent` int(11) DEFAULT NULL,
  `effective_date` date DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `rating_history`
--

CREATE TABLE `rating_history` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `combined_rating` int(11) DEFAULT 0,
  `effective_date` date DEFAULT NULL,
  `notes` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `role_types`
--

CREATE TABLE `role_types` (
  `id` int(11) NOT NULL,
  `role_name` varchar(100) NOT NULL,
  `description` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `role_types`
--

INSERT INTO `role_types` (`id`, `role_name`, `description`, `created_at`) VALUES
(1, 'Veteran', 'Veteran User', '2026-06-18 18:26:31'),
(2, 'Family', 'Family Member', '2026-06-18 18:26:31'),
(3, 'Caregiver', 'Caregiver', '2026-06-18 18:26:31'),
(4, 'VSO', 'Veteran Service Officer', '2026-06-18 18:26:31'),
(5, 'Attorney', 'Attorney', '2026-06-18 18:26:31'),
(6, 'Social Media', 'Social Media Provider', '2026-06-18 18:26:31'),
(7, 'Commercial', 'Commercial User', '2026-06-18 18:26:31'),
(8, 'Admin', 'Administrator', '2026-06-18 18:26:31');

-- --------------------------------------------------------

--
-- Table structure for table `secondary_condition_paths`
--

CREATE TABLE `secondary_condition_paths` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `primary_condition` varchar(255) DEFAULT NULL,
  `secondary_condition` varchar(255) DEFAULT NULL,
  `ai_reasoning` longtext DEFAULT NULL,
  `confidence_score` float DEFAULT 0,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `secondary_condition_paths`
--

INSERT INTO `secondary_condition_paths` (`id`, `user_id`, `primary_condition`, `secondary_condition`, `ai_reasoning`, `confidence_score`, `created_at`) VALUES
(1, 0, 'PTSD', 'Sleep Apnea', 'PTSD-related hyperarousal, nightmares, and sleep fragmentation have been shown to contribute to or aggravate obstructive sleep apnea. Multiple BVA decisions have granted this connection.', 0.8, '2026-06-04 14:56:17'),
(2, 0, 'PTSD', 'Major Depressive Disorder', 'Depression is a common comorbid condition with PTSD. The shared neurobiological pathways and emotional dysregulation of PTSD frequently cause or aggravate depressive episodes.', 0.9, '2026-06-04 14:56:17'),
(3, 0, 'PTSD', 'Generalized Anxiety Disorder', 'PTSD and generalized anxiety share symptom overlap (hypervigilance, worry, startle response). GAD is frequently secondary to PTSD.', 0.85, '2026-06-04 14:56:17'),
(4, 0, 'PTSD', 'Substance Use Disorder', 'Veterans with PTSD frequently self-medicate with alcohol or drugs. Substance use disorders are well-established as secondary to PTSD.', 0.8, '2026-06-04 14:56:17'),
(5, 0, 'PTSD', 'GERD', 'PTSD medications (SSRIs, SNRIs) and the chronic stress response associated with PTSD can cause or aggravate gastroesophageal reflux disease.', 0.75, '2026-06-04 14:56:17'),
(6, 0, 'PTSD', 'Irritable Bowel Syndrome (IBS)', 'The gut-brain axis connects PTSD-related stress to gastrointestinal dysfunction. IBS is recognized as secondary to PTSD, especially for Gulf War veterans.', 0.8, '2026-06-04 14:56:17'),
(7, 0, 'PTSD', 'Migraine Headaches', 'Chronic stress, hyperarousal, sleep disruption, and muscle tension from PTSD contribute to migraine development and exacerbation.', 0.75, '2026-06-04 14:56:17'),
(8, 0, 'PTSD', 'Hypertension', 'Chronic stress from PTSD causes sustained sympathetic nervous system activation, elevating blood pressure. Studies show PTSD independently increases hypertension risk.', 0.7, '2026-06-04 14:56:17'),
(9, 0, 'PTSD', 'Bruxism / TMJ', 'PTSD-related tension, clenching during nightmares, and stress-induced jaw clenching can cause or aggravate temporomandibular joint dysfunction.', 0.7, '2026-06-04 14:56:17'),
(10, 0, 'PTSD', 'Erectile Dysfunction', 'PTSD medications (SSRIs) commonly cause sexual dysfunction. Additionally, the psychological impact of PTSD (avoidance, emotional numbing) contributes to ED.', 0.75, '2026-06-04 14:56:17'),
(11, 0, 'PTSD', 'Chronic Fatigue Syndrome', 'PTSD-related sleep disturbance, hyperarousal, and physiological stress contribute to chronic fatigue. Often comorbid.', 0.65, '2026-06-04 14:56:17'),
(12, 0, 'PTSD', 'Obesity', 'PTSD-related physical inactivity, emotional eating, sleep disruption, and medication side effects contribute to weight gain and obesity.', 0.6, '2026-06-04 14:56:17'),
(13, 0, 'Major Depressive Disorder', 'Sleep Apnea', 'Depression-related weight gain, physical inactivity, and sleep disturbance contribute to OSA development.', 0.65, '2026-06-04 14:56:17'),
(14, 0, 'Major Depressive Disorder', 'Chronic Fatigue Syndrome', 'Depression and chronic fatigue share significant symptom overlap and neurobiological mechanisms.', 0.7, '2026-06-04 14:56:17'),
(15, 0, 'Sleep Apnea', 'Hypertension', 'Untreated OSA causes repeated nocturnal hypoxia and sympathetic activation, directly increasing blood pressure. Strong medical consensus.', 0.9, '2026-06-04 14:56:17'),
(16, 0, 'Sleep Apnea', 'Heart Disease (CAD)', 'OSA is an independent risk factor for coronary artery disease via repeated oxygen desaturation, oxidative stress, and systemic inflammation.', 0.8, '2026-06-04 14:56:17'),
(17, 0, 'Sleep Apnea', 'Stroke', 'OSA increases stroke risk through the same cardiovascular mechanisms as heart disease.', 0.75, '2026-06-04 14:56:17'),
(18, 0, 'Sleep Apnea', 'GERD', 'Negative intrathoracic pressure during apneic events promotes reflux. OSA and GERD are frequently comorbid.', 0.7, '2026-06-04 14:56:17'),
(19, 0, 'Sleep Apnea', 'Erectile Dysfunction', 'OSA-related hypoxia and cardiovascular effects contribute to erectile dysfunction.', 0.7, '2026-06-04 14:56:17'),
(20, 0, 'Sleep Apnea', 'Depression', 'OSA-related sleep fragmentation and hypoxia contribute to depressive symptoms.', 0.75, '2026-06-04 14:56:17'),
(21, 0, 'Lumbar Spine Condition', 'Radiculopathy (Lower Extremities)', 'Disc herniation, spinal stenosis, or degenerative changes in the lumbar spine compress nerve roots, causing radiating pain, numbness, and weakness in the legs.', 0.95, '2026-06-04 14:56:17'),
(22, 0, 'Lumbar Spine Condition', 'Sciatica', 'Direct nerve root compression from lumbar spine pathology causes sciatic nerve symptoms.', 0.95, '2026-06-04 14:56:17'),
(23, 0, 'Lumbar Spine Condition', 'Bilateral Knee Condition', 'Altered gait mechanics from lumbar spine disability place abnormal stress on the knees. Veterans compensate for back pain by changing how they walk.', 0.7, '2026-06-04 14:56:17'),
(24, 0, 'Lumbar Spine Condition', 'Bilateral Hip Condition', 'Similar to knees — altered biomechanics from spinal disability affect hip joints.', 0.7, '2026-06-04 14:56:17'),
(25, 0, 'Lumbar Spine Condition', 'Erectile Dysfunction', 'Lumbar nerve damage can impair sexual function through pudendal nerve involvement.', 0.6, '2026-06-04 14:56:17'),
(26, 0, 'Cervical Spine Condition', 'Radiculopathy (Upper Extremities)', 'Cervical disc herniation or stenosis compresses nerve roots causing pain, numbness, and weakness in the arms and hands.', 0.95, '2026-06-04 14:56:17'),
(27, 0, 'Cervical Spine Condition', 'Migraine Headaches', 'Cervical spine pathology, particularly at C1-C3, can cause cervicogenic headaches that may trigger or aggravate migraines.', 0.7, '2026-06-04 14:56:17'),
(28, 0, 'Knee Condition', 'Lumbar Spine Condition', 'Chronic knee disability causes altered gait that places abnormal stress on the lumbar spine.', 0.7, '2026-06-04 14:56:17'),
(29, 0, 'Knee Condition', 'Contralateral Knee Condition', 'Compensatory overuse of the uninjured knee due to favoring the service-connected knee.', 0.75, '2026-06-04 14:56:17'),
(30, 0, 'Knee Condition', 'Hip Condition (Ipsilateral)', 'Altered biomechanics from knee disability affect the hip on the same side.', 0.7, '2026-06-04 14:56:17'),
(31, 0, 'Knee Condition', 'Ankle Condition (Ipsilateral)', 'Altered gait from knee disability places abnormal stress on the ankle.', 0.65, '2026-06-04 14:56:17'),
(32, 0, 'Shoulder Condition', 'Cervical Spine Condition', 'Shoulder limitation causes compensatory cervical spine strain from altered upper body mechanics.', 0.6, '2026-06-04 14:56:17'),
(33, 0, 'Ankle Condition', 'Knee Condition (Ipsilateral)', 'Altered gait from ankle disability places abnormal stress on the knee.', 0.65, '2026-06-04 14:56:17'),
(34, 0, 'Ankle Condition', 'Plantar Fasciitis', 'Ankle instability or limited motion changes foot mechanics, contributing to plantar fascia inflammation.', 0.7, '2026-06-04 14:56:17'),
(35, 0, 'Flatfoot (Pes Planus)', 'Plantar Fasciitis', 'Flat feet alter the biomechanics of the plantar fascia, causing chronic inflammation.', 0.85, '2026-06-04 14:56:17'),
(36, 0, 'Flatfoot (Pes Planus)', 'Knee Condition', 'Overpronation from flat feet causes medial knee stress and accelerates joint degeneration.', 0.7, '2026-06-04 14:56:17'),
(37, 0, 'Flatfoot (Pes Planus)', 'Shin Splints', 'Flat feet alter lower leg mechanics and contribute to medial tibial stress syndrome.', 0.75, '2026-06-04 14:56:17'),
(38, 0, 'Diabetes Mellitus Type II', 'Peripheral Neuropathy', 'Diabetic neuropathy is one of the most common complications of diabetes, caused by sustained hyperglycemia damaging peripheral nerves.', 0.95, '2026-06-04 14:56:17'),
(39, 0, 'Diabetes Mellitus Type II', 'Erectile Dysfunction', 'Diabetes causes both vascular and neuropathic damage that impairs erectile function.', 0.9, '2026-06-04 14:56:17'),
(40, 0, 'Diabetes Mellitus Type II', 'Hypertension', 'Insulin resistance and diabetic kidney changes contribute to elevated blood pressure.', 0.8, '2026-06-04 14:56:17'),
(41, 0, 'Diabetes Mellitus Type II', 'Heart Disease (CAD)', 'Diabetes is a major independent risk factor for coronary artery disease via vascular damage.', 0.85, '2026-06-04 14:56:17'),
(42, 0, 'Diabetes Mellitus Type II', 'Chronic Kidney Disease', 'Diabetic nephropathy from sustained hyperglycemia.', 0.9, '2026-06-04 14:56:17'),
(43, 0, 'Diabetes Mellitus Type II', 'Vision Loss / Diabetic Retinopathy', 'Diabetes damages retinal blood vessels causing progressive vision loss.', 0.9, '2026-06-04 14:56:17'),
(44, 0, 'Diabetes Mellitus Type II', 'Skin Conditions', 'Diabetic dermopathy, increased infection risk, and poor wound healing.', 0.65, '2026-06-04 14:56:17'),
(45, 0, 'Hypertension', 'Heart Disease (CAD)', 'Chronic hypertension is a direct cause of coronary artery disease through vascular damage and left ventricular hypertrophy.', 0.85, '2026-06-04 14:56:17'),
(46, 0, 'Hypertension', 'Stroke', 'Hypertension is the leading modifiable risk factor for stroke.', 0.85, '2026-06-04 14:56:17'),
(47, 0, 'Hypertension', 'Chronic Kidney Disease', 'Sustained high blood pressure damages renal vasculature leading to nephropathy.', 0.8, '2026-06-04 14:56:17'),
(48, 0, 'Hypertension', 'Vision Loss', 'Hypertensive retinopathy damages retinal blood vessels.', 0.65, '2026-06-04 14:56:17'),
(49, 0, 'Tinnitus', 'Migraine Headaches', 'Tinnitus-related auditory distress and sleep disruption contribute to migraine development.', 0.55, '2026-06-04 14:56:17'),
(50, 0, 'Tinnitus', 'Sleep Disturbance / Insomnia', 'Persistent tinnitus interferes with sleep onset and maintenance.', 0.7, '2026-06-04 14:56:17'),
(51, 0, 'Tinnitus', 'Depression / Anxiety', 'Chronic tinnitus causes significant psychological distress and is associated with increased rates of depression and anxiety.', 0.7, '2026-06-04 14:56:17'),
(52, 0, 'Hearing Loss', 'Tinnitus', 'Sensorineural hearing loss and tinnitus share the same etiology (noise exposure) and frequently co-occur.', 0.9, '2026-06-04 14:56:17'),
(53, 0, 'Hearing Loss', 'Depression', 'Hearing loss causes social isolation and communication difficulties that contribute to depression.', 0.65, '2026-06-04 14:56:17'),
(54, 0, 'Traumatic Brain Injury (TBI)', 'Migraine Headaches', 'Post-traumatic headaches are the most common sequela of TBI.', 0.9, '2026-06-04 14:56:17'),
(55, 0, 'Traumatic Brain Injury (TBI)', 'PTSD', 'TBI and PTSD frequently co-occur from the same traumatic event.', 0.8, '2026-06-04 14:56:17'),
(56, 0, 'Traumatic Brain Injury (TBI)', 'Depression', 'TBI causes neurobiological changes that increase depression risk.', 0.8, '2026-06-04 14:56:17'),
(57, 0, 'Traumatic Brain Injury (TBI)', 'Sleep Apnea', 'TBI-related changes in upper airway muscle control and weight gain contribute to OSA.', 0.65, '2026-06-04 14:56:17'),
(58, 0, 'Traumatic Brain Injury (TBI)', 'Tinnitus', 'Blast exposure or head trauma damages the auditory system.', 0.8, '2026-06-04 14:56:17'),
(59, 0, 'Traumatic Brain Injury (TBI)', 'Vision Problems', 'TBI can cause convergence insufficiency, photophobia, and other visual disturbances.', 0.75, '2026-06-04 14:56:17'),
(60, 0, 'Traumatic Brain Injury (TBI)', 'Seizure Disorder', 'Post-traumatic epilepsy from brain injury.', 0.6, '2026-06-04 14:56:17'),
(61, 0, 'Any condition requiring NSAIDs', 'GERD', 'Chronic NSAID use for service-connected pain conditions damages the gastric mucosa, causing or aggravating GERD.', 0.8, '2026-06-04 14:56:17'),
(62, 0, 'Any condition requiring opioids', 'Constipation / IBS', 'Opioid medications prescribed for service-connected pain frequently cause gastrointestinal dysfunction.', 0.75, '2026-06-04 14:56:17'),
(63, 0, 'Any condition requiring SSRIs/SNRIs', 'Erectile Dysfunction', 'SSRI/SNRI medications prescribed for service-connected mental health conditions commonly cause sexual dysfunction.', 0.8, '2026-06-04 14:56:17'),
(64, 0, 'Any condition requiring SSRIs/SNRIs', 'Weight Gain / Obesity', 'Psychiatric medications frequently cause metabolic changes leading to weight gain.', 0.7, '2026-06-04 14:56:17'),
(65, 0, 'Any condition requiring corticosteroids', 'Diabetes Mellitus Type II', 'Long-term corticosteroid use can cause steroid-induced diabetes.', 0.65, '2026-06-04 14:56:17'),
(66, 0, 'Any condition requiring corticosteroids', 'Osteoporosis', 'Corticosteroids accelerate bone density loss.', 0.7, '2026-06-04 14:56:17'),
(67, 1, 'PTSD', 'Sleep Apnea', 'Common secondary pathway between PTSD and sleep apnea.', 85, '2026-06-18 19:08:30'),
(68, 1, 'PTSD', 'Migraines', 'Frequently associated due to chronic stress and neurological effects.', 80, '2026-06-18 19:08:30'),
(69, 1, 'PTSD', 'Depression', 'Mental health conditions commonly coexist.', 95, '2026-06-18 19:08:30'),
(70, 1, 'Lumbar Strain', 'Radiculopathy', 'Lumbar spine conditions often produce nerve involvement.', 90, '2026-06-18 19:08:30'),
(71, 1, 'Knee Condition', 'Hip Condition', 'Altered gait may impact hip mechanics.', 75, '2026-06-18 19:08:30'),
(72, 1, 'Knee Condition', 'Back Condition', 'Altered gait may contribute to back problems.', 75, '2026-06-18 19:08:30'),
(73, 1, 'COPD', 'Depression', 'Chronic respiratory disease may contribute to depression.', 70, '2026-06-18 19:08:30'),
(74, 1, 'Heart Disease', 'Depression', 'Chronic cardiovascular disease may contribute to depression.', 70, '2026-06-18 19:08:30'),
(75, 1, 'Diabetes Mellitus', 'Peripheral Neuropathy', 'Common diabetic complication.', 95, '2026-06-18 19:08:30'),
(76, 1, 'Diabetes Mellitus', 'Peripheral Neuropathy', 'Common diabetic complication.', 95, '2026-06-18 19:30:25'),
(77, 1, 'Diabetes Mellitus', 'Kidney Disease', 'Common diabetic complication.', 90, '2026-06-18 19:30:25'),
(78, 1, 'Diabetes Mellitus', 'Erectile Dysfunction', 'Frequently secondary to diabetes.', 85, '2026-06-18 19:30:25'),
(79, 1, 'Sleep Apnea', 'Hypertension', 'Common secondary pathway.', 80, '2026-06-18 19:30:25'),
(80, 1, 'Sleep Apnea', 'Heart Disease', 'Frequently associated.', 80, '2026-06-18 19:30:25'),
(81, 1, 'Lumbar Strain', 'Sciatica', 'Common spinal nerve involvement.', 90, '2026-06-18 19:30:25'),
(82, 1, 'Lumbar Strain', 'Radiculopathy', 'Common spinal nerve involvement.', 90, '2026-06-18 19:30:25'),
(83, 1, 'Radiculopathy', 'Depression', 'Chronic pain pathway.', 70, '2026-06-18 19:30:25'),
(84, 1, 'Tinnitus', 'Depression', 'Quality of life impact.', 70, '2026-06-18 19:30:25'),
(85, 1, 'Hearing Loss', 'Depression', 'Quality of life impact.', 70, '2026-06-18 19:30:25'),
(86, 1, 'Heart Disease', 'Sleep Apnea', 'Frequently linked.', 75, '2026-06-18 19:30:25'),
(87, 1, 'COPD', 'Sleep Apnea', 'Frequently linked respiratory conditions.', 75, '2026-06-18 19:30:25'),
(88, 1, 'COPD', 'Anxiety', 'Breathing limitations may contribute.', 70, '2026-06-18 19:30:25'),
(89, 1, 'COPD', 'Depression', 'Chronic disease pathway.', 75, '2026-06-18 19:30:25'),
(90, 1, 'Lumbar Degenerative Disc Disease', 'Radiculopathy', 'Nerve root involvement common.', 95, '2026-06-18 19:31:38'),
(91, 1, 'Lumbar Degenerative Disc Disease', 'Sciatica', 'Common lumbar complication.', 95, '2026-06-18 19:31:38'),
(92, 1, 'Lumbar Arthritis', 'Radiculopathy', 'Nerve compression possible.', 85, '2026-06-18 19:31:38'),
(93, 1, 'Cervical Degenerative Disc Disease', 'Radiculopathy', 'Cervical nerve involvement.', 90, '2026-06-18 19:31:38'),
(94, 1, 'Knee Arthritis', 'Hip Arthritis', 'Altered gait relationship.', 75, '2026-06-18 19:31:38'),
(95, 1, 'Knee Arthritis', 'Lumbar Arthritis', 'Altered gait relationship.', 75, '2026-06-18 19:31:38'),
(96, 1, 'Hip Arthritis', 'Lumbar Arthritis', 'Biomechanical relationship.', 80, '2026-06-18 19:31:38'),
(97, 1, 'Fibromyalgia', 'Depression', 'Frequently associated.', 80, '2026-06-18 19:31:38'),
(98, 1, 'Fibromyalgia', 'Anxiety', 'Frequently associated.', 80, '2026-06-18 19:31:38'),
(99, 1, 'Chronic Pain', 'Depression', 'Chronic pain pathway.', 85, '2026-06-18 19:31:38'),
(100, 1, 'Chronic Pain', 'Anxiety', 'Chronic pain pathway.', 85, '2026-06-18 19:31:38'),
(101, 1, 'Ischemic Heart Disease', 'Depression', 'Common chronic disease pathway.', 75, '2026-06-18 19:33:17'),
(102, 1, 'Heart Disease', 'Anxiety', 'Frequently associated.', 75, '2026-06-18 19:33:17'),
(103, 1, 'Parkinson Disease', 'Depression', 'Common neurological pathway.', 80, '2026-06-18 19:33:17'),
(104, 1, 'Parkinson Disease', 'Sleep Disorder', 'Frequently associated.', 85, '2026-06-18 19:33:17'),
(105, 1, 'Multiple Sclerosis', 'Depression', 'Frequently associated.', 80, '2026-06-18 19:33:17'),
(106, 1, 'Migraines', 'Depression', 'Chronic pain relationship.', 70, '2026-06-18 19:33:17'),
(107, 1, 'Migraines', 'Anxiety', 'Chronic condition relationship.', 70, '2026-06-18 19:33:17'),
(108, 1, 'Sleep Apnea', 'Migraines', 'Frequently associated.', 75, '2026-06-18 19:33:17'),
(109, 1, 'Sleep Apnea', 'Depression', 'Frequently associated.', 75, '2026-06-18 19:33:17'),
(110, 1, 'Sleep Apnea', 'Anxiety', 'Frequently associated.', 75, '2026-06-18 19:33:17'),
(111, 1, 'Tinnitus', 'Sleep Disorder', 'Sleep disruption commonly reported.', 75, '2026-06-18 19:34:46'),
(112, 1, 'Tinnitus', 'Anxiety', 'Frequently associated.', 75, '2026-06-18 19:34:46'),
(113, 1, 'Hearing Loss', 'Tinnitus', 'Commonly linked.', 95, '2026-06-18 19:34:46'),
(114, 1, 'GERD', 'Sleep Apnea', 'Frequently discussed association.', 65, '2026-06-18 19:34:46'),
(115, 1, 'Diabetes Mellitus', 'Retinopathy', 'Common diabetic complication.', 95, '2026-06-18 19:34:46'),
(116, 1, 'Diabetes Mellitus', 'Cataracts', 'Common diabetic complication.', 85, '2026-06-18 19:34:46'),
(117, 1, 'TBI', 'Migraines', 'Frequently associated.', 90, '2026-06-18 19:34:46'),
(118, 1, 'TBI', 'Cognitive Disorder', 'Frequently associated.', 95, '2026-06-18 19:34:46'),
(119, 1, 'TBI', 'Depression', 'Frequently associated.', 80, '2026-06-18 19:34:46'),
(120, 1, 'TBI', 'Anxiety', 'Frequently associated.', 80, '2026-06-18 19:34:46'),
(121, 1, 'Type 2 Diabetes Mellitus', 'Peripheral Neuropathy', 'Well established diabetic complication.', 100, '2026-06-18 19:36:30'),
(122, 1, 'Type 2 Diabetes Mellitus', 'Retinopathy', 'Common diabetic complication.', 95, '2026-06-18 19:36:30'),
(123, 1, 'Type 2 Diabetes Mellitus', 'Chronic Kidney Disease', 'Common diabetic complication.', 95, '2026-06-18 19:36:30'),
(124, 1, 'Type 2 Diabetes Mellitus', 'Erectile Dysfunction', 'Common diabetic complication.', 90, '2026-06-18 19:36:30'),
(125, 1, 'Chronic Kidney Disease', 'Depression', 'Chronic disease pathway.', 70, '2026-06-18 19:36:30'),
(126, 1, 'Prostate Cancer', 'Urinary Incontinence', 'Common residual condition.', 95, '2026-06-18 19:36:30'),
(127, 1, 'Prostate Cancer', 'Erectile Dysfunction', 'Common residual condition.', 100, '2026-06-18 19:36:30');

-- --------------------------------------------------------

--
-- Table structure for table `security_events`
--

CREATE TABLE `security_events` (
  `id` bigint(20) NOT NULL,
  `user_id` int(11) DEFAULT NULL,
  `severity` varchar(20) DEFAULT NULL,
  `event_type` varchar(100) DEFAULT NULL,
  `details` text DEFAULT NULL,
  `ip_address` varchar(45) DEFAULT NULL,
  `created_at` datetime DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `service_history`
--

CREATE TABLE `service_history` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `branch` varchar(100) DEFAULT NULL,
  `component` varchar(100) DEFAULT NULL,
  `service_number` varchar(100) DEFAULT NULL,
  `entry_date` date DEFAULT NULL,
  `separation_date` date DEFAULT NULL,
  `discharge_type` varchar(100) DEFAULT NULL,
  `combat_service` tinyint(1) DEFAULT 0,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `service_positions`
--

CREATE TABLE `service_positions` (
  `id` bigint(20) NOT NULL,
  `veteran_profile_id` bigint(20) NOT NULL,
  `branch` varchar(100) DEFAULT NULL,
  `mos_rate` varchar(150) DEFAULT NULL,
  `unit_name` varchar(255) DEFAULT NULL,
  `duty_station` varchar(255) DEFAULT NULL,
  `start_date` date DEFAULT NULL,
  `end_date` date DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `uploads`
--

CREATE TABLE `uploads` (
  `id` int(11) NOT NULL,
  `user_id` int(11) NOT NULL,
  `case_id` int(11) DEFAULT NULL,
  `original_name` varchar(255) NOT NULL,
  `stored_name` varchar(255) NOT NULL,
  `file_type` varchar(100) DEFAULT NULL,
  `file_size` int(11) DEFAULT NULL,
  `uploaded_at` timestamp NULL DEFAULT current_timestamp(),
  `evidence_type` varchar(100) DEFAULT NULL,
  `evidence_tags` text DEFAULT NULL,
  `extracted_text` longtext DEFAULT NULL,
  `ai_conditions` text DEFAULT NULL,
  `ai_evidence_summary` text DEFAULT NULL,
  `file_category` varchar(100) DEFAULT 'general',
  `parsed` tinyint(1) DEFAULT 0,
  `ai_processed` tinyint(1) DEFAULT 0,
  `decision_date` date DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `user_files`
--

CREATE TABLE `user_files` (
  `id` int(11) NOT NULL,
  `user_id` int(11) DEFAULT NULL,
  `filename` varchar(255) DEFAULT NULL,
  `filepath` varchar(255) DEFAULT NULL,
  `filetype` varchar(50) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `v3_cfr_references`
--

CREATE TABLE `v3_cfr_references` (
  `id` int(11) NOT NULL,
  `document_id` int(11) NOT NULL,
  `cfr_reference` varchar(100) DEFAULT NULL,
  `citation_text` longtext DEFAULT NULL,
  `confidence` varchar(20) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `v3_cfr_references`
--

INSERT INTO `v3_cfr_references` (`id`, `document_id`, `cfr_reference`, `citation_text`, `confidence`, `created_at`) VALUES
(9, 1, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-04 16:18:34'),
(10, 1, '38 CFR 3.655', 'CFR reference found in uploaded document text.', 'High', '2026-06-04 16:18:34'),
(11, 1, '38 CFR 3.352', 'CFR reference found in uploaded document text.', 'High', '2026-06-04 16:18:34'),
(12, 1, '38 CFR 3.104', 'Favorable findings review area.', 'Medium', '2026-06-04 16:18:34'),
(13, 2, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-04 16:18:34'),
(14, 2, '38 CFR 3.655', 'CFR reference found in uploaded document text.', 'High', '2026-06-04 16:18:34'),
(15, 2, '38 CFR 3.352', 'CFR reference found in uploaded document text.', 'High', '2026-06-04 16:18:34'),
(16, 2, '38 CFR 3.104', 'Favorable findings review area.', 'Medium', '2026-06-04 16:18:34'),
(84, 3, '38 CFR 3.385', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(85, 3, '38 CFR 14.636', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(86, 3, '38 CFR 3.352', 'Aid and Attendance criteria review area.', 'Medium', '2026-06-12 04:34:51'),
(87, 3, '38 CFR 3.303', 'Direct service connection review area.', 'Medium', '2026-06-12 04:34:51'),
(88, 4, '38 CFR 4.31', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(89, 4, '38 CFR 14.636', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(90, 4, '38 CFR 3.352', 'Aid and Attendance criteria review area.', 'Medium', '2026-06-12 04:34:51'),
(91, 4, '38 CFR 3.303', 'Direct service connection review area.', 'Medium', '2026-06-12 04:34:51'),
(92, 5, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(93, 5, '38 CFR 3.352', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(94, 5, '38 CFR 3.104', 'Favorable findings review area.', 'Medium', '2026-06-12 04:34:51'),
(95, 6, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(96, 6, '38 CFR 3.655', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(97, 6, '38 CFR 3.352', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(98, 6, '38 CFR 3.104', 'Favorable findings review area.', 'Medium', '2026-06-12 04:34:51'),
(99, 7, '38 CFR 3.2501', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(100, 7, '38 CFR 3.303', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(101, 7, '38 CFR 3.304', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(102, 7, '38 CFR 3.306', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(103, 7, '38 CFR 3.352', 'Aid and Attendance criteria review area.', 'Medium', '2026-06-12 04:34:51'),
(104, 7, '38 CFR 3.104', 'Favorable findings review area.', 'Medium', '2026-06-12 04:34:51'),
(105, 8, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(106, 8, '38 CFR 3.352', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(107, 8, '38 CFR 3.104', 'Favorable findings review area.', 'Medium', '2026-06-12 04:34:51'),
(108, 9, '38 CFR 3.2500', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(109, 9, '38 CFR 3.2501', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(110, 9, '38 CFR 3.400', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(111, 9, '38 CFR 3.303', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(112, 9, '38 CFR 3.304', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(113, 9, '38 CFR 3.155', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(114, 9, '38 CFR 4.96', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(115, 9, '38 CFR 4.97', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(116, 9, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(117, 9, '38 CFR 3.352', 'Aid and Attendance criteria review area.', 'Medium', '2026-06-12 04:34:51'),
(118, 10, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(119, 10, '38 CFR 3.155', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(120, 10, '38 CFR 3.400', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(121, 10, '38 CFR 3.2500', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(122, 10, '38 CFR 3.2501', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(123, 10, '38 CFR 3.352', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(124, 10, '38 CFR 3.351', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(125, 10, '38 CFR 3.1', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(126, 10, '38 CFR 3.6', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(127, 10, '38 CFR 3.102', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(128, 10, '38 CFR 3.103', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(129, 10, '38 CFR 3.104', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(130, 10, '38 CFR 3.156', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(131, 10, '38 CFR 3.159', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(132, 10, '38 CFR 3.303', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(133, 10, '38 CFR 3.304', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(134, 10, '38 CFR 3.320', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(135, 10, '38 CFR 4.1', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(136, 10, '38 CFR 4.2', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(137, 10, '38 CFR 4.3', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(138, 10, '38 CFR 4.6', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(139, 11, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(140, 11, '38 CFR 3.400', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(141, 11, '38 CFR 3.352', 'Aid and Attendance criteria review area.', 'Medium', '2026-06-12 04:34:51'),
(142, 12, '38 CFR 3.352', 'Aid and Attendance criteria review area.', 'Medium', '2026-06-12 04:34:51'),
(143, 12, '38 CFR 3.350', 'Special Monthly Compensation review area.', 'Medium', '2026-06-12 04:34:51'),
(144, 13, '38 CFR 3.2500', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(145, 13, '38 CFR 3.2501', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(146, 13, '38 CFR 3.400', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(147, 13, '38 CFR 3.350', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(148, 13, '38 CFR 3.401', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(149, 13, '38 CFR 3.352', 'Aid and Attendance criteria review area.', 'Medium', '2026-06-12 04:34:51'),
(150, 13, '38 CFR 3.310', 'Secondary service connection review area.', 'Medium', '2026-06-12 04:34:51'),
(151, 14, '38 CFR 3.351', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(152, 14, '38 CFR 3.352', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(153, 14, '38 CFR 3.350', 'Special Monthly Compensation review area.', 'Medium', '2026-06-12 04:34:51'),
(154, 14, '38 CFR 3.310', 'Secondary service connection review area.', 'Medium', '2026-06-12 04:34:51'),
(155, 14, '38 CFR 3.303', 'Direct service connection review area.', 'Medium', '2026-06-12 04:34:51'),
(156, 16, '38 CFR 3.310', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(157, 16, '38 CFR 3.102', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(158, 16, '38 CFR 3.303', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(159, 16, '38 CFR 3.304', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51'),
(160, 17, '38 CFR 3.310', 'Secondary service connection review area.', 'Medium', '2026-06-12 04:34:51'),
(161, 20, '38 CFR 3.159', 'CFR reference found in uploaded document text.', 'High', '2026-06-12 04:34:51');

-- --------------------------------------------------------

--
-- Table structure for table `v3_claims`
--

CREATE TABLE `v3_claims` (
  `id` int(11) NOT NULL,
  `user_id` int(11) DEFAULT 1,
  `claim_title` varchar(255) DEFAULT NULL,
  `claim_type` varchar(100) DEFAULT NULL,
  `primary_condition` varchar(255) DEFAULT NULL,
  `secondary_to` varchar(255) DEFAULT NULL,
  `theory` text DEFAULT NULL,
  `evidence_summary` text DEFAULT NULL,
  `nexus_summary` text DEFAULT NULL,
  `readiness_score` int(11) DEFAULT 0,
  `forms_json` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp()
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

-- --------------------------------------------------------

--
-- Table structure for table `v3_documents`
--

CREATE TABLE `v3_documents` (
  `id` int(11) NOT NULL,
  `user_id` int(11) DEFAULT 1,
  `original_filename` varchar(255) DEFAULT NULL,
  `stored_filename` varchar(255) DEFAULT NULL,
  `document_type` varchar(120) DEFAULT 'Unknown',
  `claim_type` varchar(120) DEFAULT 'Unknown',
  `decision_date` date DEFAULT NULL,
  `decision_date_text` varchar(100) DEFAULT NULL,
  `effective_date` date DEFAULT NULL,
  `effective_date_text` varchar(100) DEFAULT NULL,
  `outcome_summary` varchar(180) DEFAULT 'Unclear',
  `raw_text` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT current_timestamp(),
  `document_classification` varchar(150) DEFAULT NULL,
  `classification_confidence` varchar(20) DEFAULT NULL
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `v3_documents`
--

INSERT INTO `v3_documents` (`id`, `user_id`, `original_filename`, `stored_filename`, `document_type`, `claim_type`, `decision_date`, `decision_date_text`, `effective_date`, `effective_date_text`, `outcome_summary`, `raw_text`, `created_at`, `document_classification`, `classification_confidence`) VALUES
(3, 1, 'ClaimLetter-2018-12-14.pdf', '20260605_161417_a3855e222a6e5d56_ClaimLetter-2018-12-14.pdf', 'PDF', 'Uploaded Evidence', '2018-07-02', 'July 2, 2018', NULL, NULL, 'Deferred: 6 | Denied: 2 | Granted: 2', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Rating Decision 4. Where to Send Written Correspondence 5. VA Form 4107 6. VA Form 21-0958 Contact information: Web: www.vets.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://iris.custhelp.com/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed DISABLED AMERICAN VETERANS as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line at 1-800-273-8255 and press 1. December 14, 2018 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski, This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l A decision on entitlement to compensation for heart conditions is deferred. l Service connection for hearing loss, left ear is denied. l Service connection for hearing loss, right ear is granted with an evaluation of 0 percent effective July 2, 2018. l A decision on entitlement to compensation for chronic obstructive pulmonary disease (COPD) is deferred. l Service connection for tinnitus is granted with an evaluation of 10 percent effective July 2, 2018. Your combined rating evaluation is 10%. How VA Combines Percentages If you have more than one condition, VA will combine percentages to determine your overall disability rating. The percentages assigned for each of your conditions may not always add up to your combined rating evaluation. The following website has additional information about how VA combines percentages: http://www.benefits.va.gov/compensation/rates-index.asp#howcalc. Your monthly entitlement amount is shown below:\n\nMonthly Entitlement Amount Payment Start Date Reason $136.24 Aug 1, 2018 Original Award $140.05 Dec 1, 2018 Cost of Living Adjustment If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. Please Take Action: Accept, Appeal, and/or Ask for Help about Other Choices If you disagree with our decision: This decision notice explains why we made this decision about your benefits. If you disagree with the decision and would like to appeal it, you must complete and return a Notice of Disagreement, VA Form 21-0958, by December 14, 2019, one year from the date of this notice. The enclosed VA Form 4107 explains your right to appeal our decision. Your accredited representative can help you decide your next step. Your appointed accredited representative, DISABLED AMERICAN VETERANS, can help you with any questions you have about your claim. You can visit https://www.vets.gov/disability-benefits/claims-appeal/ to learn more about how the appeals process works. If you agree with our decision: File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 2\n\nThere is no need to do anything other than ensure that if your banking and contact information changes, that you promptly notify us so there is no disruption to your benefit. Thank you for your service, Regional Office Director cc: DISABLED AMERICAN VETERANS File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 3\n\nExplanation of Payment Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Student Loans: l Job training and employment : For more information, please call 1-800-827-1000 or visit File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 5\n\nwww.vba.va.gov/bln/vre/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . l Change in Compensation Benefits : For more information, please call 1-877-222-VETS or visit www.va.gov/healtheligibility . l Clothing Allowance : For more information, please call 1-800-827-1000 or visit www.vets.gov/disability-benefits/conditions/special-claims/clothing/ . l VA Medical Care : Present a copy of this notification letter to the Patient Registration/Eligibility Section at your nearest VA Medical Center www.vets.gov/facility- locator/ . l Dental Benefits : For more information, please contact your nearest VA Medical Center or outpatient clinic www.vets.gov/facility-locator/ . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Government life insurance premiums : For more information, please call 1-800-669-8477 or visit www.benefits.va.gov/insurance . Payment for Travel: l Payment for Travel : You may be eligible for reimbursement for beneficial travel mileage for previous VA medical appointments because of your newly granted service-connected conditions. You must make a request for such reimbursement within 30 days of this letter by contacting the Enrollment office at your Medical Center and providing a copy of this letter. State Benefits: l State Benefits: For more information, please visit www.va.gov/statedva.htm . File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 6\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: DISABLED AMERICAN VETERANS Rating Decision 12/12/2018 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974, to August 26, 1976. You filed an original disability claim that was received on July 2, 2018. Based on a review of the evidence listed below, we have made the following decision on your claim. DECISION 1. Service connection for tinnitus is granted with an evaluation of 10 percent effective July 2, 2018. 2. Service connection for hearing loss, right ear is granted with an evaluation of 0 percent effective July 2, 2018. 3. Service connection for hearing loss, left ear is denied. 4. A decision on entitlement to compensation for chronic obstructive pulmonary disease (COPD) is deferred.\n\n5. A decision on entitlement to compensation for heart conditions is deferred. EVIDENCE l VAMC (Veterans Affairs Medical Center) treatment records, Huntington VAMC, from May 10, 2018 through December 11, 2018 l VA Form 21-526 EZ: Application for Disability Compensation and Related Compensation Benefits, July 2, 2018 l Private Treatment Records-St. Jude Medical - Cardiac Rhythm Management Division, received on July 02, 2018, from July 2, 2005 through September 20, 2006 l Pre-Hearing Memorandum-Office of Disability Adjudication and Review, July 2, 2018 l VA Form 21-22, Appointment of Veterans Service Organization as Claimant\'s Representative, Disabled American Veterans, received July 2, 2018 l Section (§) 5103 Notice Response, received July 16, 2018 l Statement-Philadelphia County Board of Assistance, no record of Mr. Wldikowski being in receipt of any disability benefits at the above agency, October 11, 2018 l DD Form 214, Certificate of Release or Discharge from Active Duty, received on Ocotber 11, 2018, from October 9, 1974 through August 26, 1976 l Service Personnel Records, received on October 11, 2018, from October 9, 1974 through August 26, 1976 l Service Treatment Records, received on October 11, 2018, from October 9, 1974 through August 26, 1976 l Disability Benefit Questionnaire-Hearing Loss and Tinnitus, conducted by a private contractor (VES), November 29, 2018 REASONS FOR DECISION 1. Service connection for tinnitus. Service connection for tinnitus has been established as directly related to military service. The effective date of this grant is July 2, 2018. Service connection has been established from the day VA received your claim. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA received the claim. An evaluation of 10 percent is assigned from July 2, 2018. We have assigned a 10 percent evaluation for your tinnitus based on: • Recurrent tinnitus A single evaluation for recurrent tinnitus is assigned whether the sound is perceived in one ear, both ears, or in the head. LAWRENCE WIDIKOWSKI 200 46 9795 2 of 4\n\nThis is the highest schedular evaluation allowed under the law for tinnitus. 2. Service connection for hearing loss, right ear. We have granted your claim for hearing loss, right ear. The effective date of this grant is July 2, 2018. Service connection has been established from the day VA received your claim. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA received the claim. Service connection is warranted because your military occupational specialty (MOS) of Aviation Machinists Mate is consistent with acoustic trauma and your right hearing loss has been linked to that acoustic trauma. Your VA examiner opined that it is at least as likely as not that your right ear hearing loss is due to military noise exposure. VA examination findings show the right ear with 84 percent discrimination. Decibel (dB) loss at the puretone threshold of 500 Hertz (Hz) is 20, at 1000 Hz is 35, at 2000 Hz is 20, at 3000 Hz is 30, and at 4000 Hz is 35. The average decibel loss is 30 in the right ear. An evaluation of 0 percent is assigned because your right ear has a speech discrimination of 84 with an average decibel loss of 30. The evaluation for hearing loss is based on objective testing. Higher evaluations are assigned for more severe hearing impairment. An evaluation of 0 percent is assigned from July 2, 2018. 3. Service connection for hearing loss, left ear. Service connection for hearing loss, left ear is denied because your left ear hearing is normal. Service connection may not be established for disability due to impaired hearing unless the auditory threshold in any of the frequencies 500, 1000, 2000, 3000 or 4000 Hertz is 40 decibels or greater; or the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000 or 4000 Hertz are 26 decibels or greater; or speech recognition scores using the Maryland CNC Test are less than 94 percent. (38 CFR 3.385). There are no audiometric findings in your service treatment records that meet the above requirements for your left ear. You have in-service acoustic trauma, but service connection for your left ear based on military noise exposure alone cannot be granted. For service connection to be considered there must first be a showing of actual hearing loss in your left ear for VA purposes. LAWRENCE WIDIKOWSKI 200 46 9795 3 of 4\n\nVA examination findings show the left ear with 96 percent discrimination. Decibel (dB) loss at the puretone threshold of 500 Hertz (Hz) is 15, at 1000 Hz is 15, at 2000 Hz is 35, at 3000 Hz is 25, and at 4000 Hz is 25. The average decibel loss is 25 in the left ear. Your examiner provided an opinion that linked your left ear hearing loss to in-service acoustic trauma, but service connection cannot be granted as your left ear hearing does not meet the above definition of hearing loss for VA purposes. Your VA examination does not show left ear hearing loss for VA purposes. In this case, the evidence of record does not show current audiometric findings which meet the criteria for a grant of service connection for hearing loss. As you do not currently meet the criteria for hearing loss in your left ear for VA purposes, service connection may not be granted. In addition, there is no evidence that disabling sensorineural hearing loss manifested itself to a compensable degree within a year of service. 4. Compensation for chronic obstructive pulmonary disease (COPD). The issue of compensation for chronic obstructive pulmonary disease (COPD) is deferred for the following information: VA exam. 5. Compensation for heart conditions. The issue of compensation for heart conditions is deferred for the following information: VA exam. REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 4 of 4\n\nWhere to Send Your Written Correspondence In order to properly determine where to send your written correspondence, please first identify your benefit type (Compensation, Veterans Pension, or Survivor Benefits); then, locate the corresponding address based on your location of residence. For correspondence relating to all Compensation claims: Location of Residence Address All United States and Foreign Locations * Note : For foreign Veterans Pension and Survivor Benefits please refer to the below addresses. Department Of Veterans Affairs Evidence Intake Center P.O. Box 4444 Janesville, WI, 53547-4444 Or fax your information to: Toll Free: 844-531-7818 Local: 248-524-4260 For correspondence relating to all Veterans Pension and Survivor Benefit claims : Location of Residence Address Alabama Arkansas Illinois Indiana Kentucky Louisiana Michigan Mississippi Missouri Ohio Tennessee Wisconsin Department Of Veterans Affairs Claims Intake Center Attention: Milwaukee Pension Center P.O. Box 5192 Janesville, WI 53547-5192 Or fax your information to: Toll Free: (844) 655-1604 Alaska Arizona California Colorado Hawaii Idaho Iowa Kansas Minnesota Montana Nebraska Nevada New Mexico North Dakota Oklahoma Oregon South Dakota Texas Utah Washington Wyoming Mexico Central America South America Caribbean Department Of Veterans Affairs Claims Intake Center Attention: St. Paul Pension Center P.O. Box 5365 Janesville, WI 53547-5365 Or fax your information to: Toll Free: (844) 655-1604 Connecticut Delaware Florida Georgia Maine Maryland Massachusetts New Hampshire New Jersey New York North Carolina Pennsylvania Rhode Island South Carolina Vermont Virginia West Virginia District of Columbia Puerto Rico Canada Department Of Veterans Affairs Claims Intake Center Attention: Philadelphia Pension Center P.O. Box 5206 Janesville, WI 53547-5206 Or fax your information to: Toll Free: (844) 655-1604 Countries outside of North, Central or South America\n\nYOUR RIGHTS TO APPEAL OUR DECISION After careful and compassionate consideration, a decision has been reached on your claim. If we were not able to grant some or all of the VA benefits you asked for, this form will explain what you can do if you disagree with our decision. If you do not agree with our decision, you may: Start an appeal by submitting a Notice of Disagreement. Give us evidence we do not already have that may lead us to change our decision. This form will tell you how to appeal and how to send us more evidence. You can do either one or both of these things. H OW C AN I A PPEAL THE D ECISION? How do I start my appeal? To begin your appeal, you must submit VA Form 21-0958, \"Notice of Disagreement,\" if that form was provided to you in connection with our decision. If we denied more than one claim for a benefit (for example, if you claimed compensation for three disabilities and we denied two of them), please tell us in Part IV of VA Form 21-0958 each of the claims you are appealing. A filed VA Form 21-0958 is considered your Notice of Disagreement. If you did not receive VA Form 21-0958 in connection with our decision, then write us a letter telling us you disagree with our decision or enter your disagreement on VA Form 21-0958 in questions 11 or 12A. If you did not receive VA Form 21-0958 in connection with our decision, then either your statement or VA Form 21-0958 is considered your Notice of Disagreement. Send your Notice of Disagreement to the address included on our decision notice letter. How long do I have to start my appeal? You have one year to start an appeal of our decision. Your Notice of Disagreement must be postmarked (or received by us) within one year from the date of our letter denying you the benefit. In most cases, you cannot appeal a decision after this one-year period has ended. What happens if I do not start my appeal on time? If you do not start your appeal on time, our decision will become final. Once our decision is final, you cannot get the VA benefit we denied unless you either: Show that we were clearly wrong to deny the benefit or Send us new evidence that relates to the reason we denied your claim. What happens after VA receives my Notice of Disagreement? We will either grant your claim or send you a Statement of the Case. A Statement of the Case describes the facts, laws, regulations, and reasons that we used to make our decision. We will also send you a VA Form 9, \"Appeal to Board of Veterans\' Appeals,\" with the Statement of the Case. If you want to continue your appeal to the Board of Veterans\' Appeals (Board) after receiving a Statement of the Case, you must complete and return the VA Form 9 within one year from the date of our letter denying you the benefit or within 60 days from the date that we mailed the Statement of the Case to you, whichever is later . If you decide to complete an appeal by filing a VA Form 9, you have the option to request a Board hearing. Hearings often increase wait time for a Board decision. It is not necessary for you to have a hearing for the Board to decide your appeal. It is your choice. Where can I find out more about the VA appeals process? You can find a \"plain language\" pamphlet called \"How Do I Appeal,\" on the Internet at: http://www.bva.va.gov/How_Do_I_Appeal.asp . You can find the formal rules for the VA appeals process in title 38, Code of Federal Regulations, Part 20. You can find the complete Code of Federal Regulations on the Internet at: http://www.ecfr.gov . A printed copy of the Code of Federal Regulations may be available at your local law library. VA FORM JUN 2016 4107 (Please continue reading on page 2) Can I get someone to help me with my appeal? Yes. You can have a Veterans Service Organization representative, an attorney-at-law, or an \"agent\" help you with your appeal. You are not required to have someone represent you. It is your choice. Y OUR R IGHT TO R EPRESENTATION Representatives who work for accredited Veterans Service Organizations know how to prepare and present claims and will represent you. You can find a listing of these organizations on the Internet at: http://www.va.gov/vso .\n\nA private attorney or an \"agent\" can also represent you. VA only recognizes attorneys who are licensed to practice in the United States or in one of its territories or possessions. Your local bar association may be able to refer you to an attorney with experience in veterans\' law. An agent is a person who is not a lawyer, but who VA recognizes as being knowledgeable about veterans\' law. Contact us if you would like to know if there is a VA accredited agent in your area. Do I have to pay someone to help me with my appeal? It depends on who helps you. The following explains the differences. Veterans Service Organizations will represent you for free. Attorneys or agents can charge you for helping you under some circumstances. Paying their fees for helping you with your appeal is your responsibility. If you do hire an attorney or agent to represent you, a copy of any fee agreement must be sent to VA. The fee agreement must clearly specify if VA is to pay the attorney or agent directly out of past-due benefits. See 38 C.F.R. § 14.636(g)(2). If the fee agreement provides for the direct payment of fees out of past-due benefits, a copy of the direct- pay fee agreement must be filed with us at the address included on our decision notice letter within 30 days of its execution. A copy of any fee agreement that is not a direct-pay fee agreement must be filed with the Office of the General Counsel within 30 days of its execution by mailing the copy to the following address: Office of the General Counsel (022D), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420. See 38 C.F.R. § 14.636(g)(3). G IVING VA A DDITIONAL EVIDENCE You can send us more evidence to support a claim whether or not you choose to appeal . NOTE: Please direct all new evidence to the address included on our decision notice letter. You should not send evidence directly to the Board at this time. You should only send evidence to the Board if you decide to complete an appeal and, then, you should only send evidence to the Board after you receive written notice from the Board that they received your appeal. If you have more evidence to support a claim, it is in your best interest to give us that evidence as soon as you can. We will consider your evidence and let you know whether it changes our decision. Please keep in mind that we can only consider new evidence that: (1) we have not already seen and (2) relates to your claim. You may give us this evidence either in writing or at a personal hearing with your local VA office. In writing. To support your claim, you may send documents and written statements to us at the address included on our decision notice letter. Tell us in a letter how these documents and statements should change our earlier decision. At a personal hearing. You may request a hearing with an employee at your local VA office at any time, whether or not you choose to appeal. We do not require you to have a local hearing. It is your choice. At this hearing, you may speak, bring witnesses to speak on your behalf, and hand us written evidence. If you want a local hearing, send us a letter asking for a local hearing. Use the address included on our decision notice letter. We will then: Arrange a time and place for the hearing Provide a room for the hearing Assign someone to hear your evidence Make a written record of the hearing WHAT H APPENS A FTER I G IVE VA E VIDENCE? We will review any new evidence, including the record of the local hearing, if you choose to have one, together with the evidence we already have. We will then decide if we can grant your claim. If we cannot grant your claim and you complete an appeal, we will send the new evidence and the record of any local hearing to the Board. BACK OF VA FORM 4107, JUN 2016 SUPERSEDES VA FORM 4107, JUN 2015, WHICH WILL NOT BE USED.\n\nVA FORM SEP 2015 21-0958 INFORMATION AND INSTRUCTIONS FOR COMPLETING NOTICE OF DISAGREEMENT (NOD) IMPORTANT: Please read the information below carefully to help you complete this form quickly and accurately. Some parts of the form also contain notes or specific instructions for completing that part. The use of this form is mandatory to initiate an appeal from the decision on disability compensation claims you received . This form has several key components, which, when filled out completely and accurately, will decrease the amount of time it takes to process your NOD. FREQUENTLY ASKED QUESTIONS How do I use this standard Notice of Disagreement (NOD) form? You must use this form if you wish to indicate that you disagree with a decision you received regarding your claim for disability compensation. Examples of these decisions may include entitlement to service connection, percentage of evaluation assigned, and effective date among other things. This form is the only way that you can initiate an appeal from a decision on your claim for disability compensation. Should I fill out this form? You must fill out this form if you disagree with a decision issued by the VA regional office (RO) about your disability compensation claim. This includes an initial decision, a decision for an increased rating, or any other decision with which you disagree. Only those issues that you list on this NOD will be considered on appeal. For those issues you do not list on this NOD, you will still have one year from the date of the decision notification letter to file an appeal for those issues. Where can I get help? You can ask the Department of Veterans Affairs (VA) to help you fill out the form by contacting us at 1-800-827-1000. Before you contact us, please make sure you gather the necessary information and materials, and complete as much of the form as you can. You can also contact your representative, if applicable, for assistance with completing this form. If you do not already have a representative, you can find a list of approved Veterans Service Organizations at www.va.gov/vso . You can be represented by a Veterans Service Organization representative, an attorney-at-law, or \"agent\". Contact your local RO for assistance with appointing a representative or visit www.ebenefits.va.gov . What should I do when I have finished my NOD? You should provide your signature in Item 13A and the date signed in Item 13B. Be sure to sign every form you fill out before you send it to us. If you don\'t sign the form, VA will return it for you to sign, and it will take longer to process. Attach any materials that support and explain your NOD. Mail your NOD to the address included on the VA decision notice letter or take your NOD to your local RO. Do I need to keep a copy of this NOD form? It is important that you keep a copy of all completed forms and materials you give to VA. What constitutes a complete NOD form? Generally, VA will consider your NOD \"complete\" if the following information is provided on the form: (1) Part I - Information to identify the claimant such as name, Social Security Number, or VA claim number . Please note that it would assist VA if you provide all the personal information in Part I. However, if you provide certain information specific to the claimant such as the claimant\'s last name and Social Security Number or VA file number, VA will be able to identify the claimant in our system and would not necessarily consider this NOD incomplete if other information in Part I, such as the claimant\'s address and telephone number, is excluded. (2) Part IV - Information to identify the specific nature of the disagreement. Please list the issues or conditions for which you seek appellate review in Item 11 of Part IV. At a minimum, please indicate the specific issue of disagreement in Item 11A such as \"right knee disability\" or \"Post Traumatic Stress Disorder (PTSD)\" and indicate the area of disagreement in Item 11B by checking the appropriate box. If you disagree with an evaluation of a disability, you may tell us what percentage evaluation you seek in Item 11C; however, you are not required to indicate the percentage of evaluation sought in Item 11C in order to complete this form. (3) Part V - Claimant\'s signature. Please be sure to sign the NOD, certifying that the statements on the form are true and correct to the best of the claimant\'s knowledge and belief. IMPORTANT : If you do not provide the above information on this NOD, VA will consider your form incomplete and will request clarification from you. You must respond to this request for clarification either 60 days from the date of VA\'s request for clarification or one year from the date of mailing of the notice of decision of the RO, whichever is later. If you do not provide VA with a completed form within that time frame, the decision will become final, and you will have to file a new claim. Page 1\n\nVA FORM 21-0958, SEP 2015 SPECIFIC INSTRUCTIONS FOR THE NOD Part I - Personal Information Please provide all personal contact information. Part II - Telephone Contact Why is VA asking to contact me by telephone? The purpose of the optional telephone contact is to help process your NOD faster by requesting clarification of any ambiguous information on the form. If you indicate you wish to be contacted by telephone, VA may make up to two attempts to call you at the telephone number provided during the time slot you select. It is important to make sure you select a time period you will be available to speak with a RO representative by telephone. Part III - Election of Decision Review Officer (DRO) Review or Traditional Appellate Review How does the DRO Review Process work? A DRO is a senior technical expert who did not participate in the decision being reviewed who is responsible for holding post-decisional hearings, if requested, and processing appeals. The DRO will conduct a new and complete review of your claim, without deference to the original decision. The DRO will determine if there is additional evidence necessary to resolve the appeal, may ask you to participate in an informal conference, and/or may pursue additional evidence. The DRO may issue a new decision that changes the original decision by the RO. How does the Traditional Appellate Review Process work? A VA staff member will examine your file and any new evidence that you submit with or after your NOD. The reviewer may change the original decision based on new evidence or upon a finding of clear and unmistakable error in that decision. How do I complete this section? If you wish to elect the DRO Review Process, please check the \"Decision Review Officer (DRO) Review Process\" box in Item 9 . If you wish to continue in the Traditional Appellate Review Process, please check the \"Traditional Appellate Review Process\" box in Item 9. Please note that failure to complete this section will not render the form incomplete. Part IV - Specific Issues of Disagreement What date do I enter in the Notification/Decision Letter Date? You should enter the date stamped on the notification or decision letter you received that you disagree with in Item 10. Please do not enter today\'s date in this field. If you need help identifying the date of the notification or decision you disagree with, contact us at 1-800-827-1000. How do I complete this section? The purpose of this section is for you to individually identify each area of disagreement that you have with the VA decision notification letter. Please list only the issues or disabilities with which you disagree. Only those issues that you list on this NOD will be considered on appeal. For those issues you do not list on this NOD, you will still have one year from the date of the decision notification letter to file an appeal for those issues. In the Specific Issue of Disagreement column in Item 11A, please individually identify in separate boxes each of the issues with which you disagree. For example, \"left knee condition,\" \"hearing loss,\" etc. In the \"Area of Disagreement\" column, Item 11B, please check the area with which you disagree. For example, if you disagree with the effective date that VA assigned for a particular benefit, check the \"Effective Date of Award\" option. If VA granted a benefit, but you disagree with the evaluation that we assigned, check the \"Evaluation of Disability\" option. If you were claiming service connection for an injury or disability that you believe to be the result of your military service, and VA denied that claim, please check the \"Service Connection\" option. If you are disagreeing with our decision for reasons other than listed in the \"Area of Disagreement\" column, please check \"Other\" and specify your reason. If you disagree with a disability evaluation that we have assigned and believe that the evidence justifies a specific evaluation, please list the percentage that you believe the evidence to warrant in the \"Percentage of Evaluation Sought If Known\" column, Item 11C, within Part IV of the form. To assist, please refer to our decision notification letter where we indicate what the evidence must show for the evaluation we assigned as well as the next higher evaluation. Please note that this information is not required and that, even if you limit your appeal by indicating a specific percentage evaluation sought in Item 11C, evaluation levels above the percentage evaluation sought will be considered in cases where the evidence supports a higher evaluation. There is extra space provided for you in Item 12A, to explain why you feel VA incorrectly decided your claim, and to list any disagreements not covered by the form. Please utilize this space to briefly and clearly explain why you disagree with our decision. Part V - Certification and Signature Sign and date the NOD, certifying that the statements on the form are true to the best of your knowledge and belief. Privacy Act Notice: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (i.e., civil or criminal law enforcement, congressional communications, epidemiological or research studies, the collection of money owed to the United States, litigation in which the United States is a party or has an interest, the administration of VA programs and delivery of VA benefits, verification of identity and status, and personnel administration) as identified in the VA system of records, 58/VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA, published in the Federal Register. Your obligation to respond is required to obtain or retain benefits. VA uses your SSN to identify your claim file. Providing your SSN will help ensure that your records are properly associated with your claim file. Giving us your SSN account information is voluntary. Refusal to provide your SSN by itself will not result in the denial of benefits. VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of law in effect prior to January 1, 1975, and still in effect. The requested information is considered relevant and necessary to determine maximum benefits under the law. The responses you submit are considered confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching programs with other agencies. Respondent Burden: We need this information to determine entitlement to benefits (38 U.S.C. 501). Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 30 minutes to review the instructions, find the information, and complete the form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain . If desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form. Page 2\n\n6. PREFERRED TELEPHONE NUMBER (Include Area Code) OMB Approved No. 2900-0791 Respondent Burden: 30 minutes Expiration Date: 09/30/2018 CLAIMANT\'S PERSONAL INFORMATION PART II - TELEPHONE CONTACT PART I - PERSONAL INFORMATION NOTICE OF DISAGREEMENT A CLAIMANT OR HIS OR HER DULY APPOINTED REPRESENTATIVE MAY FILE NOTICE EXPRESSING THEIR DISSATISFACTION OR DISAGREEMENT WITH AN ADJUDICATIVE DETERMINATION BY THE VA REGIONAL OFFICE. A DESIRE TO CONTEST THE RESULT WILL CONSTITUTE A NOTICE OF DISAGREEMENT (NOD.) WHILE SPECIAL WORDING IS NOT REQUIRED, THE NOD MUST BE IN TERMS WHICH CAN BE REASONABLY CONSTRUED AS DISAGREEMENT WITH THAT DETERMINATION AND A DESIRE FOR APPELLATE REVIEW. (AUTHORITY: 38 U.S.C. 7105) TO FILE A VALID NOD, THERE IS A TIME LIMIT OF ONE YEAR FROM THE DATE VA MAILED THE NOTIFICATION OF THE DECISION TO THE CLAIMANT. FOR CONTESTED CLAIMS INCLUDING CLAIMS OF APPORTIONMENT, THIS TIME LIMIT IS 60 DAYS FROM THE DATE VA MAILED THE NOTIFICATION OF THE DECISION TO THE CLAIMANT. (DO NOT WRITE IN THIS SPACE) (VA DATE STAMP) C/CSS - 8. WOULD YOU LIKE TO RECEIVE A TELEPHONE CALL OR E-MAIL FROM A REPRESENTATIVE AT YOUR LOCAL REGIONAL OFFICE REGARDING YOUR NOD? (If you answered \"Yes,\" VA will make up to two attempts to call you between 8:00 a.m. and 4:30 p.m. local time at the telephone number and time period you select below. Please select up to two time periods you are available to receive a phone call.) 8:00 a.m. - 10:00 a.m. 10:00 a.m. - 12:30 p.m. 12:30 p.m. - 2:00 p.m. 2:00 p.m. - 4:30 p.m. Phone number I can be reached at the above checked time: PART III - APPEAL PROCESS ELECTION 21-0958 VA FORM SEP 2015 1. VETERAN\'S NAME (First, middle initial, last) 3. VA FILE NUMBER 2. VETERAN\'S SOCIAL SECURITY NUMBER 4. CLAIMANT\'S NAME (First, middle initial, last) 5. CURRENT MAILING ADDRESS (Number and street or rural route, P.O. Box, City, State, ZIP Code and Country) 7. PREFERRED E-MAIL ADDRESS Page 3 9. SELECT ONE OF THE APPEALS PROCESSING METHODS BELOW (See Specific Instructions , Page 2 , Part III for additional information) Traditional Appellate Review Process Decision Review Officer (DRO) Review Process NOTE : You can either complete the form online or by hand. Please print information using blue or black ink, neatly, and legibly to help process the form. No. & Street Apt./Unit Number State/Province Country ZIP Code/Postal Code City YES NO SUPERSEDES VA FORM 21-0958, JAN 2015, WHICH WILL NOT BE USED.\n\nService Connection PART IV - SPECIFIC ISSUES OF DISAGREEMENT PENALTY: THE LAW PROVIDES SEVERE PENALTIES WHICH INCLUDE A FINE, IMPRISONMENT, OR BOTH, FOR THE WILLFUL SUBMISSION OF ANY STATEMENT OR EVIDENCE OF A MATERIAL FACT, KNOWING IT TO BE FALSE. 12A. IN THE SPACE BELOW, OR ON A SEPARATE PAGE, PLEASE EXPLAIN WHY YOU FEEL WE INCORRECTLY DECIDED YOUR CLAIM, AND LIST ANY DISAGREEMENT(S) NOT COVERED ABOVE: 12B. DID YOU ATTACH ADDITIONAL PAGES TO THIS NOD? (If so, how many?) PART V - CERTIFICATION AND SIGNATURE I CERTIFY THAT THE STATEMENTS ON THIS FORM ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. 13A. SIGNATURE 13B. DATE SIGNED VA FORM 21-0958, SEP 2015 Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ 11. PLEASE LIST EACH SPECIFIC ISSUE OF DISAGREEMENT AND NOTE THE AREA OF DISAGREEMENT. IF YOU DISAGREE ON THE EVALUATION OF A DISABILITY, SPECIFY PERCENTAGE EVALUATION SOUGHT, IF KNOWN. PLEASE LIST ONLY ONE DISABILITY IN EACH BOX. YOU MAY ATTACH ADDITIONAL SHEETS IF NECESSARY. A. Specific Issue of Disagreement B. Area of Disagreement C. Percentage (%) Evaluation Sought (If known) 10. NOTIFICATION/DECISION LETTER DATE Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Page 4 VETERAN\'S SSN YES NO', '2026-06-05 16:14:17', 'VA Decision Letter', 'High');
INSERT INTO `v3_documents` (`id`, `user_id`, `original_filename`, `stored_filename`, `document_type`, `claim_type`, `decision_date`, `decision_date_text`, `effective_date`, `effective_date_text`, `outcome_summary`, `raw_text`, `created_at`, `document_classification`, `classification_confidence`) VALUES
(4, 1, 'ClaimLetter-2019-2-4.pdf', '20260605_161418_772de0b71d593583_ClaimLetter-2019-2-4.pdf', 'PDF', 'Uploaded Evidence', '2018-07-02', 'July 2, 2018', NULL, NULL, 'Denied: 2 | Granted: 2', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Rating Decision 4. Where to Send Written Correspondence 5. VA Form 4107 6. VA Form 21-0958 Contact information: Web: www.vets.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://iris.custhelp.com/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line at 1-800-273-8255 and press 1. February 4, 2019 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski, This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l Basic eligibility to Dependents\' Educational Assistance is established from July 2, 2018. l Service connection for chronic obstructive pulmonary disease (COPD) is denied. l Service connection for hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions) is granted with an evaluation of 100 percent effective July 2, 2018. l Service connection for scar anterior left upper chest is granted with an evaluation of 0 percent effective July 2, 2018. Your combined rating evaluation is 100%. How VA Combines Percentages If you have more than one condition, VA will combine percentages to determine your overall disability rating. The percentages assigned for each of your conditions may not always add up to your combined rating evaluation. The following website has additional information about how VA combines percentages: http://www.benefits.va.gov/compensation/rates-index.asp#howcalc. See Rating Decision to find out why we made this decision. Your dependents may be eligible for Dependents’ Educational Assistance (Chapter 35). For more information on this program, please visit the following web site: https://www.vets.gov/education/gi-\n\nbill/survivors-dependent-assistance/ or call 1-888-GIBILL-1 (1-888-442-4551). Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $2,973.86 Aug 1, 2018 Original Award $3,057.13 Dec 1, 2018 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. Evidence Considered In making our decision, in addition to the evidence listed in the Rating Decision, we considered the following evidence: l Please see enclosed rating decision narrative for evidence considered. Please Take Action: Accept, Appeal, and/or Ask for Help about Other Choices If you disagree with our decision: This decision notice explains why we made this decision about your benefits. If you disagree with the decision and would like to appeal it, you must complete and return a Notice of Disagreement, VA Form 21-0958, by February 4, 2020, one year from the date of this notice. File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 2\n\nThe enclosed VA Form 4107 explains your right to appeal our decision. Your accredited representative can help you decide your next step. Your appointed accredited representative, AMERICAN LEGION, can help you with any questions you have about your claim. You can visit https://www.vets.gov/disability-benefits/claims-appeal/ to learn more about how the appeals process works. If you agree with our decision: There is no need to do anything other than ensure that if your banking and contact information changes, that you promptly notify us so there is no disruption to your benefit. Thank you for your service, Regional Office Director cc: AMERICAN LEGION File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 3\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Your combined evaluation is 30 percent or more disabling; therefore, you may be eligible for additional benefits based on dependency. We may be able to pay you retroactive benefits for your dependents if you submit your dependency claim within a year from the date of this letter. If you wish to notify us of your dependents, please do so through eBenefits, an electronic resource in a self-service environment. Use of these resources often helps us serve you faster! Just visit www.eBenefits.va.gov to enroll and submit your dependency information. Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 5\n\nEvidence received shows a change is warranted. other agencies. Additional Benefits Education, Training, and Student Loans: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or visit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . l Job training and employment : For more information, please call 1-800-827-1000 or visit www.vba.va.gov/bln/vre/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . l Change in Compensation Benefits : For more information, please call 1-877-222-VETS or visit www.va.gov/healtheligibility . l Clothing Allowance : For more information, please call 1-800-827-1000 or visit www.vets.gov/disability-benefits/conditions/special-claims/clothing/ . l VA Medical Care : Present a copy of this notification letter to the Patient Registration/Eligibility Section at your nearest VA Medical Center www.vets.gov/facility- locator/ . l Dental Benefits : For more information, please contact your nearest VA Medical Center or outpatient clinic www.vets.gov/facility-locator/ . l Spouse or child health care : For more information, please call 1-800-733-8387 or visit www.va.gov/purchasedcare/programs/dependents/champva/ . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Home upgrade due to disability : For more information, please visit File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 6\n\nwww.benefits.va.gov/homeloans/adaptedhousing.asp . l Car upgrade due to disability : For more information, please call 1-800-827-1000 or visit www.vets.gov/disability-benefits/conditions/special-claims/automobile/ . l Government life insurance premiums : For more information, please call 1-800-669-8477 or visit www.benefits.va.gov/insurance . Armed Forces Commissary and Exchange: l Armed Forces Commissary and Exchange : For more information, please visit www.ebenefits.va.gov to locate your Regional Benefit Office, please visit www.vets.gov/facility-locator/ . Payment for Travel: l Payment for Travel : You may be eligible for reimbursement for beneficial travel mileage for previous VA medical appointments because of your newly granted service-connected conditions. You must make a request for such reimbursement within 30 days of this letter by contacting the Enrollment office at your Medical Center and providing a copy of this letter. State Benefits: l State Benefits: For more information, please visit www.va.gov/statedva.htm . Social Security Administration (SSA) Benefits: l Social Security Administration (SSA) Benefits : For more information about Social Security benefits, please call SSA at 1-800-772-1213 (Hearing Impaired TTY line 1-800-325-0778) or visit www.ssa.gov . File Number: 200469795 WIDIKOWSKI, LAWRENCE PAUL Page 7\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 02/01/2019 INTRODUCTION The records reflect that you are a veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974, to August 26, 1976. You filed an original disability claim that was received on July 2, 2018. Based on a review of the evidence listed below, we have made the following decision(s) on your claim. DECISION 1. Service connection for hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions) is granted with an evaluation of 100 percent effective July 2, 2018. 2. Service connection for scar anterior left upper chest is granted with an evaluation of 0 percent effective July 2, 2018. 3. Basic eligibility to Dependents\' Educational Assistance is established from July 2, 2018. 4. Service connection for chronic obstructive pulmonary disease (COPD) is denied.\n\nEVIDENCE l Correspondence received December 14, 2018 l Private Treatment Records received, December 14, 2018 l Disability Benefit Questionnaire Medical Opinions dated, January 16, 2019 l Disability Benefit Questionnaires dated, January 16, 2019 REASONS FOR DECISION 1. Service connection for hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions). Service connection for hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions) has been established as directly related to military service. The effective date of this grant is July 2, 2018. Service connection has been established from the day VA received your claim. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA received the claim. An evaluation of 100 percent is assigned from July 2, 2018. We have assigned a 100 percent evaluation for your heart conditions based on: • Workload of three METs or less results in dyspnea, fatigue, angina, dizziness, or syncope Additional symptom(s) include: • Evidence of cardiac hypertrophy on echocardiogram • Left ventricular dysfunction with an ejection fraction of more than 50 percent This is the highest schedular evaluation allowed under the law for hypertensive heart disease. One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. 2. Service connection for scar anterior left upper chest. Service connection for scar anterior left upper chest has been established as directly related to military service. A noncompensable evaluation is assigned from July 2, 2018, the date your claim was received. We have assigned a 0 percent evaluation for your scar anterior left upper chest based on: • Other areas of disfigurement not considered under another appropriate diagnostic code LAWRENCE WIDIKOWSKI 200 46 9795 2 of 4\n\nAdditional symptom(s) include: • Scar 1 Location: Anterior trunk • Scar 1 type: scar • cm Note: In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. {38 CFR §4.31} Your first scar/area has a length of 3 cm and a width of 0.5 cm for a total area of 1.5 sq. cm. An additional, separate compensable evaluation under Diagnostic Code 7804 is not warranted unless there is at least one scar that is painful or unstable. This is the highest schedular evaluation allowed under the law for scars, other (including linear scars) and other effects of scars evaluated under diagnostic codes 7800, 7801, 7802, and 7804. 3. Eligibility to Dependents\' Educational Assistance under 38 U.S.C. Chapter 35. Eligibility to Dependents\' Educational Assistance is derived from a veteran who was discharged under other than dishonorable conditions; and, has a permanent and total service-connected disability; or a permanent and total disability was in existence at the time of death; or the veteran died as a result of a service-connected disability. Also, eligibility exists for a serviceperson who died in service. Finally, eligibility can be derived from a service member who, as a member of the armed forces on active duty, has been listed for more than 90 days as: missing in action; captured in line of duty by a hostile force; or forcibly detained or interned in line of duty by a foreign government or power. Basic eligibility to Dependents\' Education Assistance is granted as the evidence shows you have a total service-connected disability, permanent in nature. Basic eligibility to Dependents\' Educational Assistance is established from July 2, 2018, the date your claim was received. 4. Service connection for chronic obstructive pulmonary disease (COPD). Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. VA examiner reported chronic obstructive pulmonary disease (COPD) was less likely than not (less than 50% probability) incurred in or caused by the claimed in-service injury, event or illness. Rationale: COPD/Emphysema are normally conditions that develop over time. It is not likely your respirations/oxygen level would be severe enough to cause your symptoms of fatigue, dizziness, unconsciousness and syncope while you were on active duty without being detected. It is less likely than not that your COPD is related to your active duty symptoms of dizziness, unconsciousness and syncope. Service connection for chronic obstructive pulmonary disease (COPD) is denied. LAWRENCE WIDIKOWSKI 200 46 9795 3 of 4\n\nREFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 4 of 4\n\nWhere to Send Your Written Correspondence In order to properly determine where to send your written correspondence, please first identify your benefit type (Compensation, Veterans Pension, or Survivor Benefits); then, locate the corresponding address based on your location of residence. For correspondence relating to all Compensation claims: Location of Residence Address All United States and Foreign Locations * Note : For foreign Veterans Pension and Survivor Benefits please refer to the below addresses. Department Of Veterans Affairs Evidence Intake Center P.O. Box 4444 Janesville, WI, 53547-4444 Or fax your information to: Toll Free: 844-531-7818 Local: 248-524-4260 For correspondence relating to all Veterans Pension and Survivor Benefit claims : Location of Residence Address Alabama Arkansas Illinois Indiana Kentucky Louisiana Michigan Mississippi Missouri Ohio Tennessee Wisconsin Department Of Veterans Affairs Claims Intake Center Attention: Milwaukee Pension Center P.O. Box 5192 Janesville, WI 53547-5192 Or fax your information to: Toll Free: (844) 655-1604 Alaska Arizona California Colorado Hawaii Idaho Iowa Kansas Minnesota Montana Nebraska Nevada New Mexico North Dakota Oklahoma Oregon South Dakota Texas Utah Washington Wyoming Mexico Central America South America Caribbean Department Of Veterans Affairs Claims Intake Center Attention: St. Paul Pension Center P.O. Box 5365 Janesville, WI 53547-5365 Or fax your information to: Toll Free: (844) 655-1604 Connecticut Delaware Florida Georgia Maine Maryland Massachusetts New Hampshire New Jersey New York North Carolina Pennsylvania Rhode Island South Carolina Vermont Virginia West Virginia District of Columbia Puerto Rico Canada Department Of Veterans Affairs Claims Intake Center Attention: Philadelphia Pension Center P.O. Box 5206 Janesville, WI 53547-5206 Or fax your information to: Toll Free: (844) 655-1604 Countries outside of North, Central or South America\n\nYOUR RIGHTS TO APPEAL OUR DECISION After careful and compassionate consideration, a decision has been reached on your claim. If we were not able to grant some or all of the VA benefits you asked for, this form will explain what you can do if you disagree with our decision. If you do not agree with our decision, you may: Start an appeal by submitting a Notice of Disagreement. Give us evidence we do not already have that may lead us to change our decision. This form will tell you how to appeal and how to send us more evidence. You can do either one or both of these things. H OW C AN I A PPEAL THE D ECISION? How do I start my appeal? To begin your appeal, you must submit VA Form 21-0958, \"Notice of Disagreement,\" if that form was provided to you in connection with our decision. If we denied more than one claim for a benefit (for example, if you claimed compensation for three disabilities and we denied two of them), please tell us in Part IV of VA Form 21-0958 each of the claims you are appealing. A filed VA Form 21-0958 is considered your Notice of Disagreement. If you did not receive VA Form 21-0958 in connection with our decision, then write us a letter telling us you disagree with our decision or enter your disagreement on VA Form 21-0958 in questions 11 or 12A. If you did not receive VA Form 21-0958 in connection with our decision, then either your statement or VA Form 21-0958 is considered your Notice of Disagreement. Send your Notice of Disagreement to the address included on our decision notice letter. How long do I have to start my appeal? You have one year to start an appeal of our decision. Your Notice of Disagreement must be postmarked (or received by us) within one year from the date of our letter denying you the benefit. In most cases, you cannot appeal a decision after this one-year period has ended. What happens if I do not start my appeal on time? If you do not start your appeal on time, our decision will become final. Once our decision is final, you cannot get the VA benefit we denied unless you either: Show that we were clearly wrong to deny the benefit or Send us new evidence that relates to the reason we denied your claim. What happens after VA receives my Notice of Disagreement? We will either grant your claim or send you a Statement of the Case. A Statement of the Case describes the facts, laws, regulations, and reasons that we used to make our decision. We will also send you a VA Form 9, \"Appeal to Board of Veterans\' Appeals,\" with the Statement of the Case. If you want to continue your appeal to the Board of Veterans\' Appeals (Board) after receiving a Statement of the Case, you must complete and return the VA Form 9 within one year from the date of our letter denying you the benefit or within 60 days from the date that we mailed the Statement of the Case to you, whichever is later . If you decide to complete an appeal by filing a VA Form 9, you have the option to request a Board hearing. Hearings often increase wait time for a Board decision. It is not necessary for you to have a hearing for the Board to decide your appeal. It is your choice. Where can I find out more about the VA appeals process? You can find a \"plain language\" pamphlet called \"How Do I Appeal,\" on the Internet at: http://www.bva.va.gov/How_Do_I_Appeal.asp . You can find the formal rules for the VA appeals process in title 38, Code of Federal Regulations, Part 20. You can find the complete Code of Federal Regulations on the Internet at: http://www.ecfr.gov . A printed copy of the Code of Federal Regulations may be available at your local law library. VA FORM JUN 2016 4107 (Please continue reading on page 2) Can I get someone to help me with my appeal? Yes. You can have a Veterans Service Organization representative, an attorney-at-law, or an \"agent\" help you with your appeal. You are not required to have someone represent you. It is your choice. Y OUR R IGHT TO R EPRESENTATION Representatives who work for accredited Veterans Service Organizations know how to prepare and present claims and will represent you. You can find a listing of these organizations on the Internet at: http://www.va.gov/vso .\n\nA private attorney or an \"agent\" can also represent you. VA only recognizes attorneys who are licensed to practice in the United States or in one of its territories or possessions. Your local bar association may be able to refer you to an attorney with experience in veterans\' law. An agent is a person who is not a lawyer, but who VA recognizes as being knowledgeable about veterans\' law. Contact us if you would like to know if there is a VA accredited agent in your area. Do I have to pay someone to help me with my appeal? It depends on who helps you. The following explains the differences. Veterans Service Organizations will represent you for free. Attorneys or agents can charge you for helping you under some circumstances. Paying their fees for helping you with your appeal is your responsibility. If you do hire an attorney or agent to represent you, a copy of any fee agreement must be sent to VA. The fee agreement must clearly specify if VA is to pay the attorney or agent directly out of past-due benefits. See 38 C.F.R. § 14.636(g)(2). If the fee agreement provides for the direct payment of fees out of past-due benefits, a copy of the direct- pay fee agreement must be filed with us at the address included on our decision notice letter within 30 days of its execution. A copy of any fee agreement that is not a direct-pay fee agreement must be filed with the Office of the General Counsel within 30 days of its execution by mailing the copy to the following address: Office of the General Counsel (022D), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420. See 38 C.F.R. § 14.636(g)(3). G IVING VA A DDITIONAL EVIDENCE You can send us more evidence to support a claim whether or not you choose to appeal . NOTE: Please direct all new evidence to the address included on our decision notice letter. You should not send evidence directly to the Board at this time. You should only send evidence to the Board if you decide to complete an appeal and, then, you should only send evidence to the Board after you receive written notice from the Board that they received your appeal. If you have more evidence to support a claim, it is in your best interest to give us that evidence as soon as you can. We will consider your evidence and let you know whether it changes our decision. Please keep in mind that we can only consider new evidence that: (1) we have not already seen and (2) relates to your claim. You may give us this evidence either in writing or at a personal hearing with your local VA office. In writing. To support your claim, you may send documents and written statements to us at the address included on our decision notice letter. Tell us in a letter how these documents and statements should change our earlier decision. At a personal hearing. You may request a hearing with an employee at your local VA office at any time, whether or not you choose to appeal. We do not require you to have a local hearing. It is your choice. At this hearing, you may speak, bring witnesses to speak on your behalf, and hand us written evidence. If you want a local hearing, send us a letter asking for a local hearing. Use the address included on our decision notice letter. We will then: Arrange a time and place for the hearing Provide a room for the hearing Assign someone to hear your evidence Make a written record of the hearing WHAT H APPENS A FTER I G IVE VA E VIDENCE? We will review any new evidence, including the record of the local hearing, if you choose to have one, together with the evidence we already have. We will then decide if we can grant your claim. If we cannot grant your claim and you complete an appeal, we will send the new evidence and the record of any local hearing to the Board. BACK OF VA FORM 4107, JUN 2016 SUPERSEDES VA FORM 4107, JUN 2015, WHICH WILL NOT BE USED.\n\nVA FORM SEP 2015 21-0958 INFORMATION AND INSTRUCTIONS FOR COMPLETING NOTICE OF DISAGREEMENT (NOD) IMPORTANT: Please read the information below carefully to help you complete this form quickly and accurately. Some parts of the form also contain notes or specific instructions for completing that part. The use of this form is mandatory to initiate an appeal from the decision on disability compensation claims you received . This form has several key components, which, when filled out completely and accurately, will decrease the amount of time it takes to process your NOD. FREQUENTLY ASKED QUESTIONS How do I use this standard Notice of Disagreement (NOD) form? You must use this form if you wish to indicate that you disagree with a decision you received regarding your claim for disability compensation. Examples of these decisions may include entitlement to service connection, percentage of evaluation assigned, and effective date among other things. This form is the only way that you can initiate an appeal from a decision on your claim for disability compensation. Should I fill out this form? You must fill out this form if you disagree with a decision issued by the VA regional office (RO) about your disability compensation claim. This includes an initial decision, a decision for an increased rating, or any other decision with which you disagree. Only those issues that you list on this NOD will be considered on appeal. For those issues you do not list on this NOD, you will still have one year from the date of the decision notification letter to file an appeal for those issues. Where can I get help? You can ask the Department of Veterans Affairs (VA) to help you fill out the form by contacting us at 1-800-827-1000. Before you contact us, please make sure you gather the necessary information and materials, and complete as much of the form as you can. You can also contact your representative, if applicable, for assistance with completing this form. If you do not already have a representative, you can find a list of approved Veterans Service Organizations at www.va.gov/vso . You can be represented by a Veterans Service Organization representative, an attorney-at-law, or \"agent\". Contact your local RO for assistance with appointing a representative or visit www.ebenefits.va.gov . What should I do when I have finished my NOD? You should provide your signature in Item 13A and the date signed in Item 13B. Be sure to sign every form you fill out before you send it to us. If you don\'t sign the form, VA will return it for you to sign, and it will take longer to process. Attach any materials that support and explain your NOD. Mail your NOD to the address included on the VA decision notice letter or take your NOD to your local RO. Do I need to keep a copy of this NOD form? It is important that you keep a copy of all completed forms and materials you give to VA. What constitutes a complete NOD form? Generally, VA will consider your NOD \"complete\" if the following information is provided on the form: (1) Part I - Information to identify the claimant such as name, Social Security Number, or VA claim number . Please note that it would assist VA if you provide all the personal information in Part I. However, if you provide certain information specific to the claimant such as the claimant\'s last name and Social Security Number or VA file number, VA will be able to identify the claimant in our system and would not necessarily consider this NOD incomplete if other information in Part I, such as the claimant\'s address and telephone number, is excluded. (2) Part IV - Information to identify the specific nature of the disagreement. Please list the issues or conditions for which you seek appellate review in Item 11 of Part IV. At a minimum, please indicate the specific issue of disagreement in Item 11A such as \"right knee disability\" or \"Post Traumatic Stress Disorder (PTSD)\" and indicate the area of disagreement in Item 11B by checking the appropriate box. If you disagree with an evaluation of a disability, you may tell us what percentage evaluation you seek in Item 11C; however, you are not required to indicate the percentage of evaluation sought in Item 11C in order to complete this form. (3) Part V - Claimant\'s signature. Please be sure to sign the NOD, certifying that the statements on the form are true and correct to the best of the claimant\'s knowledge and belief. IMPORTANT : If you do not provide the above information on this NOD, VA will consider your form incomplete and will request clarification from you. You must respond to this request for clarification either 60 days from the date of VA\'s request for clarification or one year from the date of mailing of the notice of decision of the RO, whichever is later. If you do not provide VA with a completed form within that time frame, the decision will become final, and you will have to file a new claim. Page 1\n\nVA FORM 21-0958, SEP 2015 SPECIFIC INSTRUCTIONS FOR THE NOD Part I - Personal Information Please provide all personal contact information. Part II - Telephone Contact Why is VA asking to contact me by telephone? The purpose of the optional telephone contact is to help process your NOD faster by requesting clarification of any ambiguous information on the form. If you indicate you wish to be contacted by telephone, VA may make up to two attempts to call you at the telephone number provided during the time slot you select. It is important to make sure you select a time period you will be available to speak with a RO representative by telephone. Part III - Election of Decision Review Officer (DRO) Review or Traditional Appellate Review How does the DRO Review Process work? A DRO is a senior technical expert who did not participate in the decision being reviewed who is responsible for holding post-decisional hearings, if requested, and processing appeals. The DRO will conduct a new and complete review of your claim, without deference to the original decision. The DRO will determine if there is additional evidence necessary to resolve the appeal, may ask you to participate in an informal conference, and/or may pursue additional evidence. The DRO may issue a new decision that changes the original decision by the RO. How does the Traditional Appellate Review Process work? A VA staff member will examine your file and any new evidence that you submit with or after your NOD. The reviewer may change the original decision based on new evidence or upon a finding of clear and unmistakable error in that decision. How do I complete this section? If you wish to elect the DRO Review Process, please check the \"Decision Review Officer (DRO) Review Process\" box in Item 9 . If you wish to continue in the Traditional Appellate Review Process, please check the \"Traditional Appellate Review Process\" box in Item 9. Please note that failure to complete this section will not render the form incomplete. Part IV - Specific Issues of Disagreement What date do I enter in the Notification/Decision Letter Date? You should enter the date stamped on the notification or decision letter you received that you disagree with in Item 10. Please do not enter today\'s date in this field. If you need help identifying the date of the notification or decision you disagree with, contact us at 1-800-827-1000. How do I complete this section? The purpose of this section is for you to individually identify each area of disagreement that you have with the VA decision notification letter. Please list only the issues or disabilities with which you disagree. Only those issues that you list on this NOD will be considered on appeal. For those issues you do not list on this NOD, you will still have one year from the date of the decision notification letter to file an appeal for those issues. In the Specific Issue of Disagreement column in Item 11A, please individually identify in separate boxes each of the issues with which you disagree. For example, \"left knee condition,\" \"hearing loss,\" etc. In the \"Area of Disagreement\" column, Item 11B, please check the area with which you disagree. For example, if you disagree with the effective date that VA assigned for a particular benefit, check the \"Effective Date of Award\" option. If VA granted a benefit, but you disagree with the evaluation that we assigned, check the \"Evaluation of Disability\" option. If you were claiming service connection for an injury or disability that you believe to be the result of your military service, and VA denied that claim, please check the \"Service Connection\" option. If you are disagreeing with our decision for reasons other than listed in the \"Area of Disagreement\" column, please check \"Other\" and specify your reason. If you disagree with a disability evaluation that we have assigned and believe that the evidence justifies a specific evaluation, please list the percentage that you believe the evidence to warrant in the \"Percentage of Evaluation Sought If Known\" column, Item 11C, within Part IV of the form. To assist, please refer to our decision notification letter where we indicate what the evidence must show for the evaluation we assigned as well as the next higher evaluation. Please note that this information is not required and that, even if you limit your appeal by indicating a specific percentage evaluation sought in Item 11C, evaluation levels above the percentage evaluation sought will be considered in cases where the evidence supports a higher evaluation. There is extra space provided for you in Item 12A, to explain why you feel VA incorrectly decided your claim, and to list any disagreements not covered by the form. Please utilize this space to briefly and clearly explain why you disagree with our decision. Part V - Certification and Signature Sign and date the NOD, certifying that the statements on the form are true to the best of your knowledge and belief. Privacy Act Notice: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (i.e., civil or criminal law enforcement, congressional communications, epidemiological or research studies, the collection of money owed to the United States, litigation in which the United States is a party or has an interest, the administration of VA programs and delivery of VA benefits, verification of identity and status, and personnel administration) as identified in the VA system of records, 58/VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA, published in the Federal Register. Your obligation to respond is required to obtain or retain benefits. VA uses your SSN to identify your claim file. Providing your SSN will help ensure that your records are properly associated with your claim file. Giving us your SSN account information is voluntary. Refusal to provide your SSN by itself will not result in the denial of benefits. VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of law in effect prior to January 1, 1975, and still in effect. The requested information is considered relevant and necessary to determine maximum benefits under the law. The responses you submit are considered confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching programs with other agencies. Respondent Burden: We need this information to determine entitlement to benefits (38 U.S.C. 501). Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 30 minutes to review the instructions, find the information, and complete the form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain . If desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form. Page 2\n\n6. PREFERRED TELEPHONE NUMBER (Include Area Code) OMB Approved No. 2900-0791 Respondent Burden: 30 minutes Expiration Date: 09/30/2018 CLAIMANT\'S PERSONAL INFORMATION PART II - TELEPHONE CONTACT PART I - PERSONAL INFORMATION NOTICE OF DISAGREEMENT A CLAIMANT OR HIS OR HER DULY APPOINTED REPRESENTATIVE MAY FILE NOTICE EXPRESSING THEIR DISSATISFACTION OR DISAGREEMENT WITH AN ADJUDICATIVE DETERMINATION BY THE VA REGIONAL OFFICE. A DESIRE TO CONTEST THE RESULT WILL CONSTITUTE A NOTICE OF DISAGREEMENT (NOD.) WHILE SPECIAL WORDING IS NOT REQUIRED, THE NOD MUST BE IN TERMS WHICH CAN BE REASONABLY CONSTRUED AS DISAGREEMENT WITH THAT DETERMINATION AND A DESIRE FOR APPELLATE REVIEW. (AUTHORITY: 38 U.S.C. 7105) TO FILE A VALID NOD, THERE IS A TIME LIMIT OF ONE YEAR FROM THE DATE VA MAILED THE NOTIFICATION OF THE DECISION TO THE CLAIMANT. FOR CONTESTED CLAIMS INCLUDING CLAIMS OF APPORTIONMENT, THIS TIME LIMIT IS 60 DAYS FROM THE DATE VA MAILED THE NOTIFICATION OF THE DECISION TO THE CLAIMANT. (DO NOT WRITE IN THIS SPACE) (VA DATE STAMP) C/CSS - 8. WOULD YOU LIKE TO RECEIVE A TELEPHONE CALL OR E-MAIL FROM A REPRESENTATIVE AT YOUR LOCAL REGIONAL OFFICE REGARDING YOUR NOD? (If you answered \"Yes,\" VA will make up to two attempts to call you between 8:00 a.m. and 4:30 p.m. local time at the telephone number and time period you select below. Please select up to two time periods you are available to receive a phone call.) 8:00 a.m. - 10:00 a.m. 10:00 a.m. - 12:30 p.m. 12:30 p.m. - 2:00 p.m. 2:00 p.m. - 4:30 p.m. Phone number I can be reached at the above checked time: PART III - APPEAL PROCESS ELECTION 21-0958 VA FORM SEP 2015 1. VETERAN\'S NAME (First, middle initial, last) 3. VA FILE NUMBER 2. VETERAN\'S SOCIAL SECURITY NUMBER 4. CLAIMANT\'S NAME (First, middle initial, last) 5. CURRENT MAILING ADDRESS (Number and street or rural route, P.O. Box, City, State, ZIP Code and Country) 7. PREFERRED E-MAIL ADDRESS Page 3 9. SELECT ONE OF THE APPEALS PROCESSING METHODS BELOW (See Specific Instructions , Page 2 , Part III for additional information) Traditional Appellate Review Process Decision Review Officer (DRO) Review Process NOTE : You can either complete the form online or by hand. Please print information using blue or black ink, neatly, and legibly to help process the form. No. & Street Apt./Unit Number State/Province Country ZIP Code/Postal Code City YES NO SUPERSEDES VA FORM 21-0958, JAN 2015, WHICH WILL NOT BE USED.\n\nService Connection PART IV - SPECIFIC ISSUES OF DISAGREEMENT PENALTY: THE LAW PROVIDES SEVERE PENALTIES WHICH INCLUDE A FINE, IMPRISONMENT, OR BOTH, FOR THE WILLFUL SUBMISSION OF ANY STATEMENT OR EVIDENCE OF A MATERIAL FACT, KNOWING IT TO BE FALSE. 12A. IN THE SPACE BELOW, OR ON A SEPARATE PAGE, PLEASE EXPLAIN WHY YOU FEEL WE INCORRECTLY DECIDED YOUR CLAIM, AND LIST ANY DISAGREEMENT(S) NOT COVERED ABOVE: 12B. DID YOU ATTACH ADDITIONAL PAGES TO THIS NOD? (If so, how many?) PART V - CERTIFICATION AND SIGNATURE I CERTIFY THAT THE STATEMENTS ON THIS FORM ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. 13A. SIGNATURE 13B. DATE SIGNED VA FORM 21-0958, SEP 2015 Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ 11. PLEASE LIST EACH SPECIFIC ISSUE OF DISAGREEMENT AND NOTE THE AREA OF DISAGREEMENT. IF YOU DISAGREE ON THE EVALUATION OF A DISABILITY, SPECIFY PERCENTAGE EVALUATION SOUGHT, IF KNOWN. PLEASE LIST ONLY ONE DISABILITY IN EACH BOX. YOU MAY ATTACH ADDITIONAL SHEETS IF NECESSARY. A. Specific Issue of Disagreement B. Area of Disagreement C. Percentage (%) Evaluation Sought (If known) 10. NOTIFICATION/DECISION LETTER DATE Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Service Connection Effective Date of Award Evaluation of Disability Other (Please specify below) ____________________________ Page 4 VETERAN\'S SSN YES NO', '2026-06-05 16:14:18', 'VA Decision Letter', 'High');
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(5, 1, 'ClaimLetter-2024-7-18.pdf', '20260605_161418_f2a5eaa128cc740d_ClaimLetter-2024-7-18.pdf', 'PDF', 'Uploaded Evidence', '2018-08-01', 'Aug 1, 2018', NULL, NULL, 'Denied: 3', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.vets.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://iris.custhelp.com/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1. July 18, 2024 LAWRENCE WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l Entitlement to special monthly compensation based on aid and attendance/housebound is denied. See Rating Decision to find out why we made this decision. As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, https://www.va.gov/life-insurance/options-eligibility/valife/ , for further information. Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $2,973.86 Aug 1, 2018 Original Award $3,057.13 Dec 1, 2018 Cost of Living Adjustment $3,106.04 Dec 1, 2019 Cost of Living Adjustment $3,146.42 Dec 1, 2020 Cost of Living Adjustment Page 1\n\nMonthly Entitlement Amount Payment Start Date Reason $3,332.06 Dec 1, 2021 Cost of Living Adjustment $3,621.95 Dec 1, 2022 Cost of Living Adjustment $3,737.85 Dec 1, 2023 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option in order to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request: Supplemental Claim Higher-Level Review VA Form 20-0996, Decision Review Request: Higher-Level Review Appeal to the Board of Veterans’ Appeals VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) Please note: You may not request a higher-level review of a higher-level review decision issued File Number: 200469795 WIDIKOWSKI, LAWRENCE Page 2\n\nby VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision , explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process works. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision . If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request: Supplemental Claim . If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov . Thank you for your service, Regional Office Director cc: AMERICAN LEGION File Number: 200469795 WIDIKOWSKI, LAWRENCE Page 3\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or File Number: 200469795 WIDIKOWSKI, LAWRENCE Page 5\n\nvisit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Funding Fee Refund : If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin the refund process. l Government life insurance : As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.gov/life-insurance/options-eligibility/valife/ . Armed Forces Commissary and Exchange: l You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va.gov/resources/commissary-and-exchange-privileges-for-veterans . File Number: 200469795 WIDIKOWSKI, LAWRENCE Page 6\n\nIf you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Department of Veterans Affairs Compensation Intake Center P.O. Box 4444 Janesville, WI 5354 7 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 531 - 7818 Pension & Survivors Benefit s Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 655 - 1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Department of Veterans Affairs Board of Veterans’ Appeals Fiduciary Intake Center P.O. Box 27063 P.O. Box 5211 Washington, DC 20038 Toll Free Fax: ( 844 ) 678 - 8979 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (888) 581 - 6826 These addresses serve all United States and foreign locations . WTSYC v8 ( 04 /2 4 ) Where to Send Your Correspondence Documents may be submitted by mail, in person at a VA regional office or electronically. However, VA recommends submitting correspondence electronically as this is the fastest method of receipt. VA provides several tools to assist in electronic submission. To learn more about how to submit documents and claims electronically, visit www.va.gov/disability/upload-supporting-evidence. You can also go directly to access.va.gov to digitally upload any correspondence using QuickSubmit. By visiting www.va.gov you can also check your claim status and learn about other VA benefits. If you need assistance, you can find a local, accredited representative at https://www.benefits.va.gov/vso/ You can also send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net Veterans Crisis Line: Dial 988 then Press 1\n\nYOUR RIGHT TO SEEK REVIEW OF OUR DECISION This document outlines your right to seek review of our decision on any issue with which you disagree. You may generally select one of three different review options for each issue decided by VA. However, you may not request review of the same issue using more than one option at the same time. Below is information on the three different review options. For most VA benefits, you have 1 year from the date on your decision notice to request a decision review to ensure the earliest possible effective date. Consult your decision notice for specific limitations. Supplemental Claim A reviewer will determine whether new and relevant evidence changes the prior decision. Higher-Level Review Board Appeal VA FORM SEP 2022 20-0998 SUPERSEDES VA FORM 20-0998, FEB 2021 Page 1 What Is This? An experienced claims adjudicator will review your decision using the same evidence VA considered in the prior decision. A Veterans Law Judge at the Board of Veterans\' Appeals (Board) will review your decision. You are adding or identifying new and relevant evidence to support your claim that we did not previously consider. VA will assist you in gathering new and relevant evidence that you identify to support your claim. You have no additional evidence to submit to support your claim, but you believe there was an error in the prior decision. You can request an optional, one-time, informal conference with a Higher-Level Reviewer to identify specific errors in the case, although requesting this conference may delay the review. You must choose a docket: Direct Review - You do not want to submit evidence or have a hearing. Evidence Submission - You choose to submit additional evidence without a hearing. Hearing - You choose to have a hearing with a Veterans Law Judge. 125 days on average 125 days on average 365 days on average for Direct Review (longer for the other options) You may request another Supplemental Claim, a Higher-Level Review, or a Board Appeal. You may request a Supplemental Claim or a Board Appeal. You may request a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims. * All forms listed are available at www.va.gov/find-forms/ or use your mobile device camera to scan the QR code to take you directly to the form you select. By Selecting This Option Goal To Complete Further Options After This Decision Review VA Form 20-0995, Decision Review Request: Supplemental Claim VA Form 20-0996, Decision Review Request: Higher-Level Review VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) Form To File* Scan QR Code to Access Form\n\nWhile most decision review options are available to you, there are limitations based on the type of decision you received. • If you are a party to a contested claim - such as claims for apportionment, attorney fee disagreement, or multiple parties filing for survivor\'s benefits - your only option for disagreeing with your decision is to file a Board Appeal within 60 days of the date on your decision notice. • A Supplemental Claim. If you file a Supplemental Claim after the 1-year time limit, the effective date for any resulting award of benefits generally will be tied to the date VA receives the Supplemental Claim. • A request to revise the decision based on a clear and unmistakable error, or If you do not submit a decision review request within the required time, you may only seek review through the following: • If you are seeking review of an insurance decision you have an additional option to challenge VA\'s decision by filing a complaint with a United States district court in the jurisdiction in which you reside within 6 years from when the right of action first accrues. Consult your decision notice for details on what options are available and where to send the request. VA FORM 20-0998, SEP 2022 Page 2 Get Help with Your Review Request: For more information on all the available review options, contact us at 1-800-827-1000 or visit www.va.gov/decision- reviews/ . If you need help filing a decision review, you may want to work with an accredited attorney, claims agent, or a Veterans Service Organization (VSO) representative. Additional information about working with an accredited attorney, claims agent, or VSO representative is available at www.va.gov/decision-reviews/get-help-with-review-request/ . You can find a searchable database of VA-recognized representatives at www.va.gov/ogc/apps/accreditation . Scan the QR Code to Open the Appropriate Decision Review Website Page Supplemental Claim Higher-Level Review Board Appeal\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 07/17/2024 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974 to August 26, 1976. You filed a claim for increased evaluation that was received on February 26, 2024. Based on a review of the evidence listed below, we have made the following decisions on your claim. DECISION Entitlement to special monthly compensation based on aid and attendance/housebound is denied. EVIDENCE l VAMC (Veterans Affairs Medical Center) treatment records, Huntington VAMC, received July 15, 2024, conducted July 15, 2024, for the period February 12, 2024 to July 9, 2024 l Section (§) 5103 Notice, conducted June 25, 2024 l VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance, received February 26, 2024\n\nREASONS FOR DECISION Entitlement to special monthly compensation based on aid and attendance/housebound. Entitlement to an additional payment of compensation is established when service-connected impairment imposes a special level of disability. Entitlement to special monthly compensation is not warranted in this case because the criteria regarding aid and attendance/housebound have not been met. (38 CFR 3.350) Aid and attendance is payable for being so helpless (due to service-connected disabilities) as to be permanently bedridden or in need of regular aid and attendance. Aid and attendance is defined as: inability to dress or undress, or to keep ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid; inability to feed oneself through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or physical or mental incapacity which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to the daily environment. \"Bedridden\" means that condition which actually requires that the claimant remain in bed. Voluntarily taking to bed or the fact that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is only necessary that the evidence shows that the claimant is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations as to the need for regular aid and attendance will not be based solely upon an opinion that their condition is such as would require them to be in bed. They must be based on the actual requirement of personal assistance from others. Housebound benefits are payable when the claimant is substantially confined, due to service- connected disability(ies), to their dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that this is permanent. Housebound benefits are also payable for a single service-connected disability rated as totally disabling with additional service-connected disability(ies) independently ratable at 60 percent, separate and distinct from the totally disabling service-connected disability. (38 CFR 3.350, 38 CFR 3.352) Favorable Findings identified in this decision: Your service-connected disabilities are considered permanent. Your are 100 percent service connected for hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions). You require aid and attendance. Your recent exam shows you require assistance opening bottles and jars, help with putting on shoes and socks as well as help when using the bathroom. REFERENCES: LAWRENCE WIDIKOWSKI 200 46 9795 2 of 3\n\nTitle 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all Veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 3 of 3\n\nFraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised. • You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000. • You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000. • VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA. • VA does not threaten claimants with jail or lawsuits. • Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place. • When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.). • Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised. • Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api.id.me/en/registration/new • Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly. • To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp , or go to VA.gov and search “Office of Inspector General”. • For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams • Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/ • Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau.com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High'),
(6, 1, 'ClaimLetter-2024-12-19.pdf', '20260605_161418_09e1d0084e16af6f_ClaimLetter-2024-12-19.pdf', 'PDF', 'Uploaded Evidence', '2018-08-01', 'Aug 1, 2018', NULL, NULL, 'Denied: 3', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.vets.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://iris.custhelp.com/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1. December 19, 2024 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l Entitlement to special monthly compensation based on aid and attendance/housebound is denied. See Rating Decision to find out why we made this decision. As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, https://www.va.gov/life-insurance/options-eligibility/valife/ , for further information. Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $2,973.86 Aug 1, 2018 Original Award $3,057.13 Dec 1, 2018 Cost of Living Adjustment $3,106.04 Dec 1, 2019 Cost of Living Adjustment $3,146.42 Dec 1, 2020 Cost of Living Adjustment ICN: 1024355407V649270 Page 1\n\nMonthly Entitlement Amount Payment Start Date Reason $3,332.06 Dec 1, 2021 Cost of Living Adjustment $3,621.95 Dec 1, 2022 Cost of Living Adjustment $3,737.85 Dec 1, 2023 Cost of Living Adjustment $3,831.30 Dec 1, 2024 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option in order to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request: Supplemental Claim Higher-Level Review VA Form 20-0996, Decision Review Request: Higher-Level Review Appeal to the Board of Veterans’ Appeals VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 2\n\nPlease note: You may not request a higher-level review of a higher-level review decision issued by VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision , explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process works. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision . If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request: Supplemental Claim . If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov . Thank you for your service, Regional Office Director cc: AMERICAN LEGION File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 3\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 5\n\nvisit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Funding Fee Refund : If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin the refund process. l Government life insurance : As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.gov/life-insurance/options-eligibility/valife/ . Armed Forces Commissary and Exchange: l You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va.gov/resources/commissary-and-exchange-privileges-for-veterans . Veterans Signals (VSignals), a VA Customer Experience Survey VA is conducting short surveys to gather feedback regarding the new decision review process. VA will randomly select survey participants from individuals who filed a request for a decision review. The survey will be sent via email and should take less than three minutes to complete. If selected, you will receive a survey within 10 days of the date on your notification letter. To be considered for VA surveys, please review your va.gov profile and ensure we have your current email address. The survey may not route to your inbox, so please check your junk folder. File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 6\n\nIf you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Department of Veterans Affairs Compensation Intake Center P.O. Box 4444 Janesville, WI 5354 7 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 531 - 7818 Pension & Survivors Benefit s Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 655 - 1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Department of Veterans Affairs Board of Veterans’ Appeals Fiduciary Intake Center P.O. Box 27063 P.O. Box 5211 Washington, DC 20038 Toll Free Fax: ( 844 ) 678 - 8979 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (888) 581 - 6826 These addresses serve all United States and foreign locations . WTSYC v8 ( 04 /2 4 ) Where to Send Your Correspondence Documents may be submitted by mail, in person at a VA regional office or electronically. However, VA recommends submitting correspondence electronically as this is the fastest method of receipt. VA provides several tools to assist in electronic submission. To learn more about how to submit documents and claims electronically, visit www.va.gov/disability/upload-supporting-evidence. You can also go directly to access.va.gov to digitally upload any correspondence using QuickSubmit. By visiting www.va.gov you can also check your claim status and learn about other VA benefits. If you need assistance, you can find a local, accredited representative at https://www.benefits.va.gov/vso/ You can also send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net Veterans Crisis Line: Dial 988 then Press 1\n\nYOUR RIGHT TO SEEK REVIEW OF OUR DECISION This document outlines your right to seek review of our decision on any issue with which you disagree. You may generally select one of three different review options for each issue decided by VA. However, you may not request review of the same issue using more than one option at the same time. Below is information on the three different review options. For most VA benefits, you have 1 year from the date on your decision notice to request a decision review to ensure the earliest possible effective date. Consult your decision notice for specific limitations. Supplemental Claim A reviewer will determine whether new and relevant evidence changes the prior decision. Higher-Level Review Board Appeal VA FORM APR 2024 20-0998 SUPERSEDES VA FORM 20-0998, SEP 2022. Page 1 What Is This? An experienced claims adjudicator will review your decision using the same evidence VA considered in the prior decision. A Veterans Law Judge at the Board of Veterans\' Appeals (Board) will review your decision. You are adding or identifying new and relevant evidence to support your claim that we did not previously consider. VA will assist you in gathering new and relevant evidence that you identify to support your claim. You are entitled to a hearing at any time in the supplemental claim process. You have no additional evidence to submit to support your claim, but you believe there was an error in the prior decision. You can request an optional, one-time, informal conference with a Higher-Level Reviewer to identify specific errors in the case, although requesting this conference may delay the review. You must choose a docket: Direct Review - You do not want to submit evidence or have a hearing. Evidence Submission - You choose to submit additional evidence without a hearing. Hearing - You choose to have a hearing with a Veterans Law Judge. 125 days on average 125 days on average 365 days on average for Direct Review (longer for the other options) You may request another Supplemental Claim, a Higher-Level Review, or a Board Appeal. You may request a Supplemental Claim or a Board Appeal. You may request a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims. * All forms listed are available at www.va.gov/find-forms/ or use your mobile device camera to scan the QR code to take you directly to the form you select. By Selecting This Option Goal To Complete Further Options After This Decision Review VA Form 20-0995 Decision Review Request: Supplemental Claim VA Form 20-0996 Decision Review Request: Higher-Level Review VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) Form To File* Scan QR Code to Access Form\n\n• A Supplemental Claim. If you file a Supplemental Claim after the 1-year time limit, the effective date for any resulting award of benefits generally will be tied to the date VA receives the Supplemental Claim. • A request to revise the decision based on a clear and unmistakable error, or If you do not submit a decision review request within the required time, you may only seek review through the following: • If you are a party to a contested claim - such as claims for apportionment, attorney fee disagreement, or multiple parties filing for survivor\'s benefits or claims for life insurance - your only option for disagreeing with your decision is to file a Board Appeal within 60 days of the date on your decision notice. While most decision review options are available to you, there are limitations based on the type of decision you received. o If you wish to have a hearing during the supplemental claim process, you can contact us online through Ask VA: https://ask.va.gov/ or call us toll-free at 1-800-827-1000 (TTY:711). VA FORM 20-0998, APR 2024 Page 2 Get Help with Your Review Request: For more information on all the available review options, contact us at 1-800-827-1000 or visit www.va.gov/decision- reviews/ . If you need help filing a decision review, you may want to work with an accredited attorney, claims agent, or a Veterans Service Organization (VSO) representative. Additional information about working with an accredited attorney, claims agent, or VSO representative is available at www.va.gov/decision-reviews/get-help-with-review-request/ . You can find a searchable database of VA-recognized representatives at www.va.gov/ogc/apps/accreditation . Scan the QR Code to Open the Appropriate Decision Review Website Page Supplemental Claim Higher-Level Review Board Appeal • If you are seeking review of an insurance decision you have an additional option to challenge VA\'s decision by filing a complaint with a United States district court in the jurisdiction in which you reside within 6 years from when the right of action first accrues. Consult your decision notice for details on what options are available and where to send the request.\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 12/16/2024 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974 to August 26, 1976. We received your supplemental claim on July 21, 2024. Based on a review of the evidence listed below, we have made the following decision(s) on your claim. DECISION Entitlement to special monthly compensation based on aid and attendance/housebound is denied. EVIDENCE l Correspondence, received on October 29, 2024 l TERA Memorandum, received on September 20, 2024 l VA Form 27-0820, Report of General Information, received on August 05, 2024 l Subsequent Development Letter, received on August 01, 2024 l VA Form 27-0820, Report of General Information, received on July 31, 2024 l Correspondence, received on July 31, 2024\n\nl Correspondence, received on July 28, 2024 l VA Form 21-10210, Lay Witness Statement, received July 26, 2024 l VA Form 20-0995, Supplemental Claim Application, received on July 21, 2024 l VA Form 21-4138, Statement In Support of Claim, received July 21, 2024 l VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance, received February 26, 2024 l Correspondence, received on August 17, 2024 l Rating Decision - Narrative, received on July 17, 2024 l CAPRI, VA Medical Center, Huntington, WV, for the period August 13, 2024 to September 19, 2024 l CAPRI, VA Medical Center, Huntington, WV, for the period November 25, 2022 to July 31, 2024 REASONS FOR DECISION Entitlement to special monthly compensation based on aid and attendance/housebound. Entitlement to an additional payment of compensation is established when service-connected impairment imposes a special level of disability. Entitlement to special monthly compensation is not warranted in this case because the criteria regarding aid and attendance/housebound have not been met. (38 CFR 3.350) A review of the available evidence does not warrant a change of our previous decision to deny Special Monthly Compensation.. A VA examination was scheduled to determine the current level of disability; however, evidence expected from the examination, which might have been material to the outcome of this claim, could not be considered as you failed to report. The evidence showed no good cause for the failure to report. Therefore, this evaluation is based on the evidence of record, to include your service treatment records and VA treatment records. (38 CFR 3.655) Aid and attendance is payable for being so helpless (due to service-connected disabilities) as to be permanently bedridden or in need of regular aid and attendance. Aid and attendance is defined as: inability to dress or undress, or to keep ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid; inability to feed oneself through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or physical or mental incapacity which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to the daily environment. \"Bedridden\" means that condition which actually requires that the claimant remain in bed. Voluntarily taking to bed or the fact that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is only necessary that the evidence shows that the claimant is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations as to the need for regular aid and attendance will not be based solely upon an opinion that their condition is such as would require them to be in bed. They must be based on the actual requirement of personal assistance from others. LAWRENCE WIDIKOWSKI 200 46 9795 2 of 3\n\nHousebound benefits are payable when the claimant is substantially confined, due to service- connected disability(ies), to their dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that this is permanent. Housebound benefits are also payable for a single service-connected disability rated as totally disabling with additional service-connected disability(ies) independently ratable at 60 percent, separate and distinct from the totally disabling service-connected disability. (38 CFR 3.350, 38 CFR 3.352) Favorable Findings identified in this decision: Your service-connected disabilities are considered permanent. Your are 100 percent service connected for hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions). You require aid and attendance. Your recent exam shows you require assistance opening bottles and jars, help with putting on shoes and socks as well as help when using the bathroom REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all Veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 3 of 3\n\nFraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised. • You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000. • You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000. • VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA. • VA does not threaten claimants with jail or lawsuits. • Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place. • When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.). • Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised. • Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api.id.me/en/registration/new • Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly. • To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp , or go to VA.gov and search “Office of Inspector General”. • For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams • Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/ • Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau.com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High');
INSERT INTO `v3_documents` (`id`, `user_id`, `original_filename`, `stored_filename`, `document_type`, `claim_type`, `decision_date`, `decision_date_text`, `effective_date`, `effective_date_text`, `outcome_summary`, `raw_text`, `created_at`, `document_classification`, `classification_confidence`) VALUES
(7, 1, 'ClaimLetter-2025-1-6.pdf', '20260605_161418_adc0cce5a790c441_ClaimLetter-2025-1-6.pdf', 'PDF', 'Uploaded Evidence', '2018-08-01', 'Aug 1, 2018', NULL, NULL, 'Pending review', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.vets.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://iris.custhelp.com/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1. January 6, 2025 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l The previous denial of service connection for chronic obstructive pulmonary disease (COPD) is confirmed and continued. As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, https://www.va.gov/life-insurance/options-eligibility/valife/ , for further information. Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $2,973.86 Aug 1, 2018 Original Award $3,057.13 Dec 1, 2018 Cost of Living Adjustment $3,106.04 Dec 1, 2019 Cost of Living Adjustment $3,146.42 Dec 1, 2020 Cost of Living Adjustment $3,332.06 Dec 1, 2021 Cost of Living Adjustment ICN: 1024355407V649270 Page 1\n\nMonthly Entitlement Amount Payment Start Date Reason $3,621.95 Dec 1, 2022 Cost of Living Adjustment $3,737.85 Dec 1, 2023 Cost of Living Adjustment $3,831.30 Dec 1, 2024 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option in order to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request: Supplemental Claim Higher-Level Review VA Form 20-0996, Decision Review Request: Higher-Level Review Appeal to the Board of Veterans’ Appeals VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) Please note: You may not request a higher-level review of a higher-level review decision issued File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 2\n\nby VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision , explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process works. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision . If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request: Supplemental Claim . If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov . Thank you for your service, Regional Office Director cc: AMERICAN LEGION File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 3\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 5\n\nvisit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Funding Fee Refund : If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin the refund process. l Government life insurance : As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.gov/life-insurance/options-eligibility/valife/ . Armed Forces Commissary and Exchange: l You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va.gov/resources/commissary-and-exchange-privileges-for-veterans . Veterans Signals (VSignals), a VA Customer Experience Survey VA is conducting short surveys to gather feedback regarding the new decision review process. VA will randomly select survey participants from individuals who filed a request for a decision review. The survey will be sent via email and should take less than three minutes to complete. If selected, you will receive a survey within 10 days of the date on your notification letter. To be considered for VA surveys, please review your va.gov profile and ensure we have your current email address. The survey may not route to your inbox, so please check your junk folder. File Number: 200469795 WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 6\n\nIf you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Department of Veterans Affairs Compensation Intake Center P.O. Box 4444 Janesville, WI 5354 7 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 531 - 7818 Pension & Survivors Benefit s Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 655 - 1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Department of Veterans Affairs Board of Veterans’ Appeals Fiduciary Intake Center P.O. Box 27063 P.O. Box 5211 Washington, DC 20038 Toll Free Fax: ( 844 ) 678 - 8979 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (888) 581 - 6826 These addresses serve all United States and foreign locations . WTSYC v8 ( 04 /2 4 ) Where to Send Your Correspondence Documents may be submitted by mail, in person at a VA regional office or electronically. However, VA recommends submitting correspondence electronically as this is the fastest method of receipt. VA provides several tools to assist in electronic submission. To learn more about how to submit documents and claims electronically, visit www.va.gov/disability/upload-supporting-evidence. You can also go directly to access.va.gov to digitally upload any correspondence using QuickSubmit. By visiting www.va.gov you can also check your claim status and learn about other VA benefits. If you need assistance, you can find a local, accredited representative at https://www.benefits.va.gov/vso/ You can also send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net Veterans Crisis Line: Dial 988 then Press 1\n\nYOUR RIGHT TO SEEK REVIEW OF OUR DECISION This document outlines your right to seek review of our decision on any issue with which you disagree. You may generally select one of three different review options for each issue decided by VA. However, you may not request review of the same issue using more than one option at the same time. Below is information on the three different review options. For most VA benefits, you have 1 year from the date on your decision notice to request a decision review to ensure the earliest possible effective date. Consult your decision notice for specific limitations. Supplemental Claim A reviewer will determine whether new and relevant evidence changes the prior decision. Higher-Level Review Board Appeal VA FORM APR 2024 20-0998 SUPERSEDES VA FORM 20-0998, SEP 2022. Page 1 What Is This? An experienced claims adjudicator will review your decision using the same evidence VA considered in the prior decision. A Veterans Law Judge at the Board of Veterans\' Appeals (Board) will review your decision. You are adding or identifying new and relevant evidence to support your claim that we did not previously consider. VA will assist you in gathering new and relevant evidence that you identify to support your claim. You are entitled to a hearing at any time in the supplemental claim process. You have no additional evidence to submit to support your claim, but you believe there was an error in the prior decision. You can request an optional, one-time, informal conference with a Higher-Level Reviewer to identify specific errors in the case, although requesting this conference may delay the review. You must choose a docket: Direct Review - You do not want to submit evidence or have a hearing. Evidence Submission - You choose to submit additional evidence without a hearing. Hearing - You choose to have a hearing with a Veterans Law Judge. 125 days on average 125 days on average 365 days on average for Direct Review (longer for the other options) You may request another Supplemental Claim, a Higher-Level Review, or a Board Appeal. You may request a Supplemental Claim or a Board Appeal. You may request a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims. * All forms listed are available at www.va.gov/find-forms/ or use your mobile device camera to scan the QR code to take you directly to the form you select. By Selecting This Option Goal To Complete Further Options After This Decision Review VA Form 20-0995 Decision Review Request: Supplemental Claim VA Form 20-0996 Decision Review Request: Higher-Level Review VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) Form To File* Scan QR Code to Access Form\n\n• A Supplemental Claim. If you file a Supplemental Claim after the 1-year time limit, the effective date for any resulting award of benefits generally will be tied to the date VA receives the Supplemental Claim. • A request to revise the decision based on a clear and unmistakable error, or If you do not submit a decision review request within the required time, you may only seek review through the following: • If you are a party to a contested claim - such as claims for apportionment, attorney fee disagreement, or multiple parties filing for survivor\'s benefits or claims for life insurance - your only option for disagreeing with your decision is to file a Board Appeal within 60 days of the date on your decision notice. While most decision review options are available to you, there are limitations based on the type of decision you received. o If you wish to have a hearing during the supplemental claim process, you can contact us online through Ask VA: https://ask.va.gov/ or call us toll-free at 1-800-827-1000 (TTY:711). VA FORM 20-0998, APR 2024 Page 2 Get Help with Your Review Request: For more information on all the available review options, contact us at 1-800-827-1000 or visit www.va.gov/decision- reviews/ . If you need help filing a decision review, you may want to work with an accredited attorney, claims agent, or a Veterans Service Organization (VSO) representative. Additional information about working with an accredited attorney, claims agent, or VSO representative is available at www.va.gov/decision-reviews/get-help-with-review-request/ . You can find a searchable database of VA-recognized representatives at www.va.gov/ogc/apps/accreditation . Scan the QR Code to Open the Appropriate Decision Review Website Page Supplemental Claim Higher-Level Review Board Appeal • If you are seeking review of an insurance decision you have an additional option to challenge VA\'s decision by filing a complaint with a United States district court in the jurisdiction in which you reside within 6 years from when the right of action first accrues. Consult your decision notice for details on what options are available and where to send the request.\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 01/03/2025 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974 to August 26, 1976. We received your supplemental claim on July 10, 2024. Based on a review of the evidence listed below, we have made the following decision(s) on your claim. DECISION The previous denial of service connection for chronic obstructive pulmonary disease (COPD) is confirmed and continued. EVIDENCE l VA Form 20-0995, Supplemental Claim Application, received on July 10, 2024 l Correspondence, received on July 11, 2024 l VA Form 27-0820, Report of General Information, received on July 17, 2024 l Intent to File Letter, received on July 22, 2024 l VA Form 21-10210, Lay Witness Statement, received July 26, 2024\n\nl Correspondence, received on July 28, 2024 l Correspondence, received on July 28, 2024 l VA Form 27-0820, Report of General Information, received on July 31, 2024 l Correspondence, received on July 31, 2024 l Subsequent Development Letter, received on August 01, 2024 l Correspondence, received on August 05, 2024 l VA Form 27-0820, Report of General Information, received on August 05, 2024 l Medical Treatment Record - Government Facility MY HEALTHEVET PERSONAL INFORMATION REPORT, 08/13/2024; CPOD (Pgs. 13-15,17), records received August 13, 2024 l Correspondence, received on August 17, 2024 l Correspondence, received on August 17, 2024 l ILER IES Record Unavailable Response, received on September 20, 2024 l TERA Memorandum, received on September 20, 2024 l Correspondence, received on October 24, 2024 l Medical Treatment Record - Government Facility TAB BB: Outpatient Encounters, Documents and Images (JLV), 10/23/24; COPD Pgs.5,22,24,55,82, records received October 23, 2024 l C&P Exam, Veterans Evaluation Service, DBQ Medical Opinion, conducted November 01, 2024 l C&P Exam, Veterans Evaluation Service, DBQ RESP Respiratory Conditions (Other than Tuberculosis and sleep apnea), conducted November 01, 2024 l CAPRI, VA Medical Center, Huntington, WV, for the period May 10, 2018 to October 23, 2024 REASONS FOR DECISION Service connection for chronic obstructive pulmonary disease. A claimant may file a supplemental claim by submitting or identifying new and relevant evidence. New evidence is evidence not previously part of the actual record before agency adjudicators. Relevant evidence means evidence that tends to prove or disprove a matter at issue in a claim. (38 CFR 3.2501) In support of your claim, new and relevant evidence has been received and your claim is now reconsidered. Service connection for this condition remains denied as the evidence continues to show this condition was not incurred in or aggravated by military service. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.306) A direct grant of service connection requires: 1) medical evidence of a current disability, 2) evidence of the incurrence or aggravation of a disease or injury in active military service, and 3) medical evidence of a nexus (link) between the current disability and the in-service disease or injury. (38 CFR 3.303, 38 CFR 3.304) Your service treatment records do not contain complaints, treatment, or diagnosis for this LAWRENCE WIDIKOWSKI 200 46 9795 2 of 4\n\ncondition. The VA medical opinion found no link between your diagnosed medical condition and military service. The VA examiner opinioned \" COPD is a serious lung disease that can be caused by various factors. The most significant risk factor for this condition is cigarette smoking, especially a long history of heavy smoking. For instance, a 40-50 year smoking history of 0.5-1 pack per day like this veteran had significantly increased the risk of developing COPD. That said, occupational and environmental exposures, including jet fuels, and exhaust fumes, as outlined, can also contribute to the development of this condition. However, cigarette smoking is generally considered to have a greater risk potential compared to these other factors. The claimed condition diagnosed as Chronic Obstructive Pulmonary Disease (COPD) was less likely than not (likelihood is less than approximately balanced or nearly equal) caused by the indicated toxic exposure risk activity(ies), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. \" Service connection may be granted for a condition diagnosed after military discharge provided evidence establishes that the condition was caused by service. Service connection may be granted on this basis for a disability related to toxic exposure risk activity (TERA) during military service if evidence demonstrates that the Veteran was actually exposed in service and that a disease associated with such exposure resulted. (38 CFR 3.303, 38 CFR 3.304) We considered whether your condition resulted from a toxic exposure risk activity (TERA) in service. (38 U.S.C. 1168, 38 U.S.C. 1710(e)(4)) The evidence of record shows participation in a TERA. There is no basis in the available evidence of record to establish service connection for chronic obstructive pulmonary disease (COPD). This condition did not happen in military service, nor was it aggravated or caused by service. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.306) Favorable Findings identified in this decision: Participation in a toxic exposure risk activity is conceded. The evidence shows that you may have been exposed to JP-4 and JP-7 fuels( jet fuels) during your military service. You have been diagnosed with a disability. Your VA examination dated November 11, 2024 documents a diagnosis of chronic obstructive pulmonary disease (COPD). REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all Veteran LAWRENCE WIDIKOWSKI 200 46 9795 3 of 4\n\nbenefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 4 of 4\n\nFraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised. • You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000. • You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000. • VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA. • VA does not threaten claimants with jail or lawsuits. • Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place. • When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.). • Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised. • Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api.id.me/en/registration/new • Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly. • To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp , or go to VA.gov and search “Office of Inspector General”. • For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams • Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/ • Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau.com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High');
INSERT INTO `v3_documents` (`id`, `user_id`, `original_filename`, `stored_filename`, `document_type`, `claim_type`, `decision_date`, `decision_date_text`, `effective_date`, `effective_date_text`, `outcome_summary`, `raw_text`, `created_at`, `document_classification`, `classification_confidence`) VALUES
(8, 1, 'ClaimLetter-2025-7-17.pdf', '20260605_161418_0e149c99191aa7c8_ClaimLetter-2025-7-17.pdf', 'PDF', 'Uploaded Evidence', '2018-08-01', 'Aug 1, 2018', NULL, NULL, 'Denied: 4', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.va.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://ask.va.gov/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1. July 17, 2025 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l Entitlement to special monthly compensation based on aid and attendance/housebound is denied. See Rating Decision to find out why we made this decision. As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, https://www.va.gov/life-insurance/options-eligibility/valife/ , for further information. Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $2,973.86 Aug 1, 2018 Original Award $3,057.13 Dec 1, 2018 Cost of Living Adjustment $3,106.04 Dec 1, 2019 Cost of Living Adjustment $3,146.42 Dec 1, 2020 Cost of Living Adjustment ICN: 1024355407V649270 Page 1\n\nMonthly Entitlement Amount Payment Start Date Reason $3,332.06 Dec 1, 2021 Cost of Living Adjustment $3,621.95 Dec 1, 2022 Cost of Living Adjustment $3,737.85 Dec 1, 2023 Cost of Living Adjustment $3,831.30 Dec 1, 2024 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request: Supplemental Claim Higher-Level Review VA Form 20-0996, Decision Review Request: Higher-Level Review Appeal to the Board of Veterans’ Appeals VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 2\n\nPlease note: You may not request a higher-level review of a higher-level review decision issued by VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision , explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process works. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision . If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request: Supplemental Claim . If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov . You may also use the following link to access your Public Contact representative at your local VA Regional Office for assistance at https://va.my.site.com/VAVERA/s/ . Thank you for your service, Regional Office Director cc: AMERICAN LEGION WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 3\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 5\n\nvisit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Funding Fee Refund : If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin the refund process. l Government life insurance : As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.gov/life-insurance/options-eligibility/valife/ . Armed Forces Commissary and Exchange: l You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va.gov/resources/commissary-and-exchange-privileges-for-veterans . Veterans Signals (VSignals), a VA Customer Experience Survey VA is conducting short surveys to gather feedback regarding the new decision review process. VA will randomly select survey participants from individuals who filed a request for a decision review. The survey will be sent via email and should take less than three minutes to complete. If selected, you will receive a survey within 10 days of the date on your notification letter. To be considered for VA surveys, please review your va.gov profile and ensure we have your current email address. The survey may not route to your inbox, so please check your junk folder. WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 6\n\nIf you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Department of Veterans Affairs Compensation Intake Center P.O. Box 4444 Janesville, WI 5354 7 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 531 - 7818 Pension & Survivors Benefit s Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 655 - 1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Department of Veterans Affairs Board of Veterans’ Appeals Fiduciary Intake Center P.O. Box 27063 P.O. Box 5211 Washington, DC 20038 Toll Free Fax: ( 844 ) 678 - 8979 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (888) 581 - 6826 These addresses serve all United States and foreign locations . WTSYC v8 ( 04 /2 4 ) Where to Send Your Correspondence Documents may be submitted by mail, in person at a VA regional office or electronically. However, VA recommends submitting correspondence electronically as this is the fastest method of receipt. VA provides several tools to assist in electronic submission. To learn more about how to submit documents and claims electronically, visit www.va.gov/disability/upload-supporting-evidence. You can also go directly to access.va.gov to digitally upload any correspondence using QuickSubmit. By visiting www.va.gov you can also check your claim status and learn about other VA benefits. If you need assistance, you can find a local, accredited representative at https://www.benefits.va.gov/vso/ You can also send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net Veterans Crisis Line: Dial 988 then Press 1\n\nYOUR RIGHT TO SEEK REVIEW OF OUR DECISION This document outlines your right to seek review of our decision on any issue with which you disagree. You may generally select one of three different review options for each issue decided by VA. However, you may not request review of the same issue using more than one option at the same time. Below is information on the three different review options. For most VA benefits, you have 1 year from the date on your decision notice to request a decision review to ensure the earliest possible effective date. Consult your decision notice for specific limitations. Supplemental Claim A reviewer will determine whether new and relevant evidence changes the prior decision. Higher-Level Review Board Appeal VA FORM APR 2024 20-0998 SUPERSEDES VA FORM 20-0998, SEP 2022. Page 1 What Is This? An experienced claims adjudicator will review your decision using the same evidence VA considered in the prior decision. A Veterans Law Judge at the Board of Veterans\' Appeals (Board) will review your decision. You are adding or identifying new and relevant evidence to support your claim that we did not previously consider. VA will assist you in gathering new and relevant evidence that you identify to support your claim. You are entitled to a hearing at any time in the supplemental claim process. You have no additional evidence to submit to support your claim, but you believe there was an error in the prior decision. You can request an optional, one-time, informal conference with a Higher-Level Reviewer to identify specific errors in the case, although requesting this conference may delay the review. You must choose a docket: Direct Review - You do not want to submit evidence or have a hearing. Evidence Submission - You choose to submit additional evidence without a hearing. Hearing - You choose to have a hearing with a Veterans Law Judge. 125 days on average 125 days on average 365 days on average for Direct Review (longer for the other options) You may request another Supplemental Claim, a Higher-Level Review, or a Board Appeal. You may request a Supplemental Claim or a Board Appeal. You may request a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims. * All forms listed are available at www.va.gov/find-forms/ or use your mobile device camera to scan the QR code to take you directly to the form you select. By Selecting This Option Goal To Complete Further Options After This Decision Review VA Form 20-0995 Decision Review Request: Supplemental Claim VA Form 20-0996 Decision Review Request: Higher-Level Review VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) Form To File* Scan QR Code to Access Form\n\n• A Supplemental Claim. If you file a Supplemental Claim after the 1-year time limit, the effective date for any resulting award of benefits generally will be tied to the date VA receives the Supplemental Claim. • A request to revise the decision based on a clear and unmistakable error, or If you do not submit a decision review request within the required time, you may only seek review through the following: • If you are a party to a contested claim - such as claims for apportionment, attorney fee disagreement, or multiple parties filing for survivor\'s benefits or claims for life insurance - your only option for disagreeing with your decision is to file a Board Appeal within 60 days of the date on your decision notice. While most decision review options are available to you, there are limitations based on the type of decision you received. o If you wish to have a hearing during the supplemental claim process, you can contact us online through Ask VA: https://ask.va.gov/ or call us toll-free at 1-800-827-1000 (TTY:711). VA FORM 20-0998, APR 2024 Page 2 Get Help with Your Review Request: For more information on all the available review options, contact us at 1-800-827-1000 or visit www.va.gov/decision- reviews/ . If you need help filing a decision review, you may want to work with an accredited attorney, claims agent, or a Veterans Service Organization (VSO) representative. Additional information about working with an accredited attorney, claims agent, or VSO representative is available at www.va.gov/decision-reviews/get-help-with-review-request/ . You can find a searchable database of VA-recognized representatives at www.va.gov/ogc/apps/accreditation . Scan the QR Code to Open the Appropriate Decision Review Website Page Supplemental Claim Higher-Level Review Board Appeal • If you are seeking review of an insurance decision you have an additional option to challenge VA\'s decision by filing a complaint with a United States district court in the jurisdiction in which you reside within 6 years from when the right of action first accrues. Consult your decision notice for details on what options are available and where to send the request.\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 07/15/2025 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974 to August 26, 1976. We received your supplemental claim on January 9, 2025. Based on a review of the evidence listed below, we have made the following decision(s) on your claim. DECISION Entitlement to special monthly compensation based on aid and attendance/housebound is denied. EVIDENCE l VA Form 20-0995, Decision Review Request - Supplemental Claims, received January 9, 2025 l VA Form 21-4138, Statement in Support of Claim, received January 9, 2025 l VA Form 27-0820, Report of General Information, dated April 29, 2025 l VA Examination Report of No Show, by VES, received May 1, 2025 l VA Examination for heart conditions, Huntington VAMC, conducted January 16, 2019\n\nl VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance, received February 26, 2024 l Rating Decision, dated July 17, 2024 l VA letter, dated December 19, 2024 l VA Examination Report of Unavailability, by VES, conducted November 26, 2024 l Rating Decision, dated July 17, 2024 l VA letter, dated July 18, 2024 l VAMC (Veterans Affairs Medical Center) treatment records, Huntington VAMC network, for the period May 3, 2018 to July 9, 2025 REASONS FOR DECISION Entitlement to special monthly compensation based on aid and attendance/housebound. Entitlement to an additional payment of compensation is established when service-connected impairment imposes a special level of disability. Entitlement to special monthly compensation is not warranted in this case because the criteria regarding aid and attendance/housebound have not been met. (38 CFR 3.350) Aid and attendance is payable for being so helpless (due to service-connected disabilities) as to be permanently bedridden or in need of regular aid and attendance. Aid and attendance is defined as: inability to dress or undress, or to keep ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid; inability to feed oneself through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or physical or mental incapacity which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to the daily environment. \"Bedridden\" means that condition which actually requires that the claimant remain in bed. Voluntarily taking to bed or the fact that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is only necessary that the evidence shows that the claimant is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations as to the need for regular aid and attendance will not be based solely upon an opinion that their condition is such as would require them to be in bed. They must be based on the actual requirement of personal assistance from others. Housebound benefits are payable when the claimant is substantially confined, due to service- connected disability(ies), to their dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that this is permanent. Housebound benefits are also payable for a single service-connected disability rated as totally disabling with additional service-connected disability(ies) independently ratable at 60 percent, separate and distinct from the totally disabling service-connected disability. (38 CFR 3.350, 38 CFR 3.352) The medical evidence indicates that you are confined to your immediate premises and that that you do need regular assistance to perform activities of daily life. However, the evidence also shows that your non-service connected disabilites of chronic obstructive pulmonary disease, age- LAWRENCE WIDIKOWSKI 200 46 9795 2 of 3\n\nrelated macular degeneration and chronic low back pain contribute significantly to that impairment. Therefore, entitlement to special monthly compensation is denied as it is not your service connected disability that is causing the need for assistance. Your phone call on April 29, 2025 is documented and your willingness to attend an exam is noted. In this case, however, an examination is not warranted as medical evidence supports that your non-service connected disabilities substantially impact your ability to perform tasks independently. Favorable Findings identified in this decision: You are housebound. VA Form 21-2680 received February 26, 2024 indicates that you are confined to your immediate premises. You require aid and attendance. VA Form 21-2680 received February 26, 2024 indicates that you are in need of regular assistance. REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all Veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 3 of 3\n\nFraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised. • You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000. • You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000. • VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA. • VA does not threaten claimants with jail or lawsuits. • Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place. • When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.). • Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised. • Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api.id.me/en/registration/new • Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly. • To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp , or go to VA.gov and search “Office of Inspector General”. • For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams • Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/ • Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau.com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High');
INSERT INTO `v3_documents` (`id`, `user_id`, `original_filename`, `stored_filename`, `document_type`, `claim_type`, `decision_date`, `decision_date_text`, `effective_date`, `effective_date_text`, `outcome_summary`, `raw_text`, `created_at`, `document_classification`, `classification_confidence`) VALUES
(9, 1, 'ClaimLetter-2025-9-17.pdf', '20260605_161418_1b93df64e7aceb0a_ClaimLetter-2025-9-17.pdf', 'PDF', 'Uploaded Evidence', '2024-07-10', 'July 10, 2024', NULL, NULL, 'Granted: 2', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.va.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://ask.va.gov/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1. September 17, 2025 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l Service connection for chronic obstructive pulmonary disease (COPD) with emphysema and severe restrictive lung disease (claimed as chronic obstructive pulmonary disease) is granted with an evaluation of 60 percent effective July 10, 2024. l Entitlement to special monthly compensation based on housebound criteria being met is granted from July 10, 2024. Your combined rating evaluation is: Combined Rating Evaluation Effective Date 100% Jul 2, 2018 100% Jul 10, 2024 How VA Combines Percentages If you have more than one condition, VA will combine percentages to determine your overall disability rating. The percentages assigned for each of your conditions may not always add up to your combined rating evaluation. The following website has additional information about how VA combines percentages: http://www.benefits.va.gov/compensation/rates-index.asp#howcalc. See Rating Decision to find out why we made this decision. ICN: 1024355407V649270 Page 1\n\nAs a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, https://www.va.gov/life-insurance/options- eligibility/valife/ , for further information. Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $4,183.85 Aug 1, 2024 Special Monthly Compensation Adjustment $4,288.45 Dec 1, 2024 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request: Supplemental WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 2\n\nReview Option Required Application Form Claim Higher-Level Review VA Form 20-0996, Decision Review Request: Higher-Level Review Appeal to the Board of Veterans’ Appeals VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) Please note: You may not request a higher-level review of a higher-level review decision issued by VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision , explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process works. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision . If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request: Supplemental Claim . If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov . You may also use the following link to access your Public Contact representative at your local VA Regional Office for assistance at https://va.my.site.com/VAVERA/s/ . Thank you for your service, Regional Office Director WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 3\n\ncc: AMERICAN LEGION WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 4\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Your combined evaluation is 30 percent or more disabling; therefore, you may be eligible for additional benefits based on dependency. We may be able to pay you retroactive benefits for your dependents if you submit your dependency claim within a year from the date of this letter. If you wish to notify us of your dependents, please do so through eBenefits, an electronic resource in a self-service environment. Use of these resources often helps us serve you faster! Just visit www.eBenefits.va.gov to enroll and submit your dependency information. If you would prefer to submit your request to add your dependents to your award in paper, please complete, sign, and return VA Form 21-686c, Application Request to Add and/or Remove Dependents . You can locate the appropriate form(s), please the visit the following website: www.va.gov/vaforms . Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 5\n\nEvidence received shows a change is warranted. imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or visit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . l Education, training, and employment : For more information, please call 1-800-827-1000 or visit www.va.gov/vre . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . l Change in Compensation Benefits : For more information, please call 1-877-222-VETS or visit www.va.gov/healtheligibility . l Clothing Allowance : For more information, please call 1-800-827-1000 or visit https://www.va.gov/disability/eligibility/special-claims/clothing-allowance/ . l VA Medical Care : Present a copy of this notification letter to the Patient Registration/Eligibility Section at your nearest VA Medical Center https://www.va.gov/find-locations . l Dental Benefits : For more information, please contact your nearest VA Medical Center or outpatient clinic https://www.va.gov/find-locations . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Funding Fee Refund : If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 6\n\nthe refund process. l Government life insurance : As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.gov/life-insurance/options-eligibility/valife/ . Armed Forces Commissary and Exchange: l You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va.gov/resources/commissary-and-exchange-privileges-for-veterans . Payment for Travel: l Payment for Travel : You may be eligible for reimbursement for beneficial travel mileage for previous VA medical appointments because of your newly granted service-connected conditions. You must make a request for such reimbursement within 30 days of this letter by contacting the Enrollment office at your Medical Center and providing a copy of this letter. State Benefits: l State Benefits: For more information, please visit www.va.gov/statedva.htm . Veterans Signals (VSignals), a VA Customer Experience Survey VA is conducting short surveys to gather feedback regarding the new decision review process. VA will randomly select survey participants from individuals who filed a request for a decision review. The survey will be sent via email and should take less than three minutes to complete. If selected, you will receive a survey within 10 days of the date on your notification letter. To be considered for VA surveys, please review your va.gov profile and ensure we have your current email address. The survey may not route to your inbox, so please check your junk folder. WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 7\n\nIf you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Department of Veterans Affairs Compensation Intake Center P.O. Box 4444 Janesville, WI 5354 7 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 531 - 7818 Pension & Survivors Benefit s Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 655 - 1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Department of Veterans Affairs Board of Veterans’ Appeals Fiduciary Intake Center P.O. Box 27063 P.O. Box 5211 Washington, DC 20038 Toll Free Fax: ( 844 ) 678 - 8979 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (888) 581 - 6826 These addresses serve all United States and foreign locations . WTSYC v8 ( 04 /2 4 ) Where to Send Your Correspondence Documents may be submitted by mail, in person at a VA regional office or electronically. However, VA recommends submitting correspondence electronically as this is the fastest method of receipt. VA provides several tools to assist in electronic submission. To learn more about how to submit documents and claims electronically, visit www.va.gov/disability/upload-supporting-evidence. You can also go directly to access.va.gov to digitally upload any correspondence using QuickSubmit. By visiting www.va.gov you can also check your claim status and learn about other VA benefits. If you need assistance, you can find a local, accredited representative at https://www.benefits.va.gov/vso/ You can also send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net Veterans Crisis Line: Dial 988 then Press 1\n\nYOUR RIGHT TO SEEK REVIEW OF OUR DECISION This document outlines your right to seek review of our decision on any issue with which you disagree. You may generally select one of three different review options for each issue decided by VA. However, you may not request review of the same issue using more than one option at the same time. Below is information on the three different review options. For most VA benefits, you have 1 year from the date on your decision notice to request a decision review to ensure the earliest possible effective date. Consult your decision notice for specific limitations. Supplemental Claim A reviewer will determine whether new and relevant evidence changes the prior decision. Higher-Level Review Board Appeal VA FORM APR 2024 20-0998 SUPERSEDES VA FORM 20-0998, SEP 2022. Page 1 What Is This? An experienced claims adjudicator will review your decision using the same evidence VA considered in the prior decision. A Veterans Law Judge at the Board of Veterans\' Appeals (Board) will review your decision. You are adding or identifying new and relevant evidence to support your claim that we did not previously consider. VA will assist you in gathering new and relevant evidence that you identify to support your claim. You are entitled to a hearing at any time in the supplemental claim process. You have no additional evidence to submit to support your claim, but you believe there was an error in the prior decision. You can request an optional, one-time, informal conference with a Higher-Level Reviewer to identify specific errors in the case, although requesting this conference may delay the review. You must choose a docket: Direct Review - You do not want to submit evidence or have a hearing. Evidence Submission - You choose to submit additional evidence without a hearing. Hearing - You choose to have a hearing with a Veterans Law Judge. 125 days on average 125 days on average 365 days on average for Direct Review (longer for the other options) You may request another Supplemental Claim, a Higher-Level Review, or a Board Appeal. You may request a Supplemental Claim or a Board Appeal. You may request a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims. * All forms listed are available at www.va.gov/find-forms/ or use your mobile device camera to scan the QR code to take you directly to the form you select. By Selecting This Option Goal To Complete Further Options After This Decision Review VA Form 20-0995 Decision Review Request: Supplemental Claim VA Form 20-0996 Decision Review Request: Higher-Level Review VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) Form To File* Scan QR Code to Access Form\n\n• A Supplemental Claim. If you file a Supplemental Claim after the 1-year time limit, the effective date for any resulting award of benefits generally will be tied to the date VA receives the Supplemental Claim. • A request to revise the decision based on a clear and unmistakable error, or If you do not submit a decision review request within the required time, you may only seek review through the following: • If you are a party to a contested claim - such as claims for apportionment, attorney fee disagreement, or multiple parties filing for survivor\'s benefits or claims for life insurance - your only option for disagreeing with your decision is to file a Board Appeal within 60 days of the date on your decision notice. While most decision review options are available to you, there are limitations based on the type of decision you received. o If you wish to have a hearing during the supplemental claim process, you can contact us online through Ask VA: https://ask.va.gov/ or call us toll-free at 1-800-827-1000 (TTY:711). VA FORM 20-0998, APR 2024 Page 2 Get Help with Your Review Request: For more information on all the available review options, contact us at 1-800-827-1000 or visit www.va.gov/decision- reviews/ . If you need help filing a decision review, you may want to work with an accredited attorney, claims agent, or a Veterans Service Organization (VSO) representative. Additional information about working with an accredited attorney, claims agent, or VSO representative is available at www.va.gov/decision-reviews/get-help-with-review-request/ . You can find a searchable database of VA-recognized representatives at www.va.gov/ogc/apps/accreditation . Scan the QR Code to Open the Appropriate Decision Review Website Page Supplemental Claim Higher-Level Review Board Appeal • If you are seeking review of an insurance decision you have an additional option to challenge VA\'s decision by filing a complaint with a United States district court in the jurisdiction in which you reside within 6 years from when the right of action first accrues. Consult your decision notice for details on what options are available and where to send the request.\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefit Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 09/15/2025 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974 to August 26, 1976. We received your supplemental claim on June 12, 2025. Based on a review of the evidence listed below, we have made the following decision(s) on your claim. DECISION 1. Service connection for chronic obstructive pulmonary disease (COPD) with emphysema and severe restrictive lung disease (claimed as chronic obstructive pulmonary disease) is granted with an evaluation of 60 percent effective July 10, 2024. 2. Entitlement to special monthly compensation based on housebound criteria being met is granted from July 10, 2024. EVIDENCE\n\nl VA Form 20-0995, Decision Review Request - Supplemental Claims, received June 12, 2025 l VA Form 21-0966, Intent To File A Claim For Compensation and/or Pension, or Survivors Pension and/or DIC, received June 12, 2025 l VA Form 20-0995, Decision Review Request - Supplemental Claims, received July 10, 2024 l VA Form 21-0966, Intent To File A Claim For Compensation and/or Pension, or Survivors Pension and/or DIC, received July 10, 2024 l VA Form 21-526 EZ: Application for Disability Compensation and Related Compensation Benefits, received July 2, 2018 l Disability Benefit Questionnaire, LHI Exam, Respiratory Conditions (Other than Tuberculosis and Sleep Apnea), Family Nurse Practitioner, Kelly Browning, received July 31, 2025, conducted July 3, 2025 l Disability Benefit Questionnaire, LHI Exam, Respiratory Conditions (Other than Tuberculosis and Sleep Apnea), Dr. Sirish Kondabolu, received December 17, 2024, conducted November 1, 2024 l Disability Benefit Questionnaire, LHI Exam, Medical Addendum, Respiratory Conditions (Other than Tuberculosis and Sleep Apnea), Family Nurse Practitioner, Nancy Ortiz, received September 10, 2025, conducted September 10, 2025 l Disability Benefit Questionnaire, LHI Exam, TERA Medical Opinion, Respiratory Conditions (Other than Tuberculosis and Sleep Apnea), Family Nurse Practitioner, Kelly Browning, received July 31, 2025, conducted July 3, 2025 l Huntington VAMC (Veterans Affairs Medical Center) treatment records, received July 10, 2025 l TERA Memorandum, received September 20, 2024 l ILER IES Record - Unavailable Response, received September 20, 2024 l Rating Decision, received July 15, 2025 l Rating Decision, received January 3, 2025 l Rating Decision, received February 1, 2019 REASONS FOR DECISION 1. Service connection for chronic obstructive pulmonary disease (COPD) with emphysema and severe restrictive lung disease (claimed as chronic obstructive pulmonary disease). A claimant may continuously pursue a claim by timely and properly filing a supplemental claim. \"Timely\" means the supplemental claim is submitted within one year of the VA decision. \"Properly\" means VA form 20-0995, Decision Review Request: Supplemental Claim, is completed and submitted along with new and relevant evidence. (38 CFR 3.2500, 38 CFR 3.2501) If the claim is continuously pursued and benefits are granted, the effective date will be the date of receipt of the initial claim or the date entitlement arose, whichever is later. (except as otherwise provided by other regulations including 38 CFR 3.400) Service connection for chronic obstructive pulmonary disease (COPD) with emphysema and severe restrictive lung disease (claimed as chronic obstructive pulmonary disease) has been established as directly related to military service. (38 CFR 3.303, 38 CFR 3.304) LAWRENCE WIDIKOWSKI 200 46 9795 2 of 4\n\nService connection may be granted for a condition diagnosed after military discharge provided evidence establishes that the condition was caused by service. Service connection may be granted on this basis for a disability related to toxic exposure risk activity (TERA) during military service if evidence demonstrates that the Veteran was actually exposed in service and that a disease associated with such exposure resulted. (38 CFR 3.303, 38 CFR 3.304) We considered whether your condition resulted from a toxic exposure risk activity (TERA) in service. (38 U.S.C. 1168, 38 U.S.C. 1710(e)(4)) The evidence of record shows participation in a TERA. The effective date of this grant is July 10, 2024. Service connection has been established from the day VA received your intent to file (ITF) a claim for compensation. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA receives the intent to file when a prescribed form is received within a year of the ITF. (38 CFR 3.155, 38 CFR 3.400) An evaluation of 60 percent is assigned from July 10, 2024. We have assigned a 60 percent evaluation for your chronic obstructive pulmonary disease (COPD) with emphysema and severe restrictive lung disease based on: • Ratio of Forced Expiratory Volume in One Second (FEV-1) to Forced Vital Capacity (FEV- 1/FVC) of 40 to 55 percent of predicted value ( 45 %) When there is a disparity between the results of different Pulmonary Function Tests (PFTs), so that the level of evaluation would differ depending on which test result is used, the test result that the examiner states most accurately reflects the level of disability shall be used. In your case, the examiner has indicated that your FEV-1/FVC ratio most accurately reflects your level of disability. (38 CFR 4.96) A higher evaluation of 100 percent is not warranted for chronic obstructive pulmonary disease unless the evidence shows: • Cor pulmonale (right heart failure); or, • Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted; or, • Episode(s) of acute respiratory failure; or, • Forced Expiratory Volume in One Second (FEV-1) less than 40 percent predicted; or, • Maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation); or, • Outpatient oxygen therapy required; or, • Pulmonary hypertension (shown by Echo or cardiac catheterization); or, • Right ventricular hypertrophy; or, • The ratio of FEV-1 to Forced Vital Capacity (FVC) (FEV-1/FVC) less than 40 percent. (38 CFR 4.96, 38 CFR 4.97) 2. Entitlement to special monthly compensation based on housebound. LAWRENCE WIDIKOWSKI 200 46 9795 3 of 4\n\nEntitlement to special monthly compensation is warranted in this case because criteria regarding housebound have been met. (38 CFR 3.350) Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions) rated 100 percent and additional service-connected disabilities of chronic obstructive pulmonary disease (COPD) with emphysema and restrictive lung disease, tinnitus, independently ratable at 60 percent or more from July 10, 2024. Entitlement to this benefit has been established from the date we received your intent to file a claim for benefits. (38 CFR 3.155, (38 CFR 3.400) REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all Veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 4 of 4\n\nFraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised. • You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000. • You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000. • VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA. • VA does not threaten claimants with jail or lawsuits. • Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place. • When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.). • Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised. • Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api.id.me/en/registration/new • Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly. • To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp , or go to VA.gov and search “Office of Inspector General”. • For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams • Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/ • Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau.com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High');
INSERT INTO `v3_documents` (`id`, `user_id`, `original_filename`, `stored_filename`, `document_type`, `claim_type`, `decision_date`, `decision_date_text`, `effective_date`, `effective_date_text`, `outcome_summary`, `raw_text`, `created_at`, `document_classification`, `classification_confidence`) VALUES
(10, 1, 'ClaimLetter-2025-10-29.pdf', '20260605_161418_a512c459c90f9d4c_ClaimLetter-2025-10-29.pdf', 'PDF', 'Uploaded Evidence', '2018-08-01', 'Aug 1, 2018', NULL, NULL, 'Denied: 4 | Continued: 1', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.va.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://ask.va.gov/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1. October 29, 2025 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l Entitlement to special monthly compensation based on aid and attendance is denied. See Rating Decision to find out why we made this decision. As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, https://www.va.gov/life-insurance/options-eligibility/valife/ , for further information. Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $2,973.86 Aug 1, 2018 Original Award $3,057.13 Dec 1, 2018 Cost of Living Adjustment $3,106.04 Dec 1, 2019 Cost of Living Adjustment $3,146.42 Dec 1, 2020 Cost of Living Adjustment ICN: 1024355407V649270 Page 1\n\nMonthly Entitlement Amount Payment Start Date Reason $3,332.06 Dec 1, 2021 Cost of Living Adjustment $3,621.95 Dec 1, 2022 Cost of Living Adjustment $3,737.85 Dec 1, 2023 Cost of Living Adjustment $4,183.85 Aug 1, 2024 Special Monthly Compensation Adjustment $4,288.45 Dec 1, 2024 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request: Supplemental Claim Higher-Level Review VA Form 20-0996, Decision Review Request: Higher-Level Review Appeal to the Board of VA Form 10182, Decision Review Request: Board Appeal WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 2\n\nReview Option Required Application Form Veterans’ Appeals (Notice of Disagreement) Please note: You may not request a higher-level review of a higher-level review decision issued by VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision , explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process works. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision . If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request: Supplemental Claim . If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov . You may also use the following link to access your Public Contact representative at your local VA Regional Office for assistance at https://va.my.site.com/VAVERA/s/ . Thank you for your service, Regional Office Director cc: AMERICAN LEGION WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 3\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 5\n\nvisit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Funding Fee Refund : If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin the refund process. l Government life insurance : As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.gov/life-insurance/options-eligibility/valife/ . Armed Forces Commissary and Exchange: l You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va.gov/resources/commissary-and-exchange-privileges-for-veterans . Veterans Signals (VSignals), a VA Customer Experience Survey VA is conducting short surveys to gather feedback regarding the new decision review process. VA will randomly select survey participants from individuals who filed a request for a decision review. The survey will be sent via email and should take less than three minutes to complete. If selected, you will receive a survey within 10 days of the date on your notification letter. To be considered for VA surveys, please review your va.gov profile and ensure we have your current email address. The survey may not route to your inbox, so please check your junk folder. WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 6\n\nIf you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Department of Veterans Affairs Compensation Intake Center P.O. Box 4444 Janesville, WI 5354 7 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 531 - 7818 Pension & Survivors Benefit s Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (844) 655 - 1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Department of Veterans Affairs Board of Veterans’ Appeals Fiduciary Intake Center P.O. Box 27063 P.O. Box 5211 Washington, DC 20038 Toll Free Fax: ( 844 ) 678 - 8979 Janesville, WI 53547 Toll Free Phone: 1 - 800 - 827 - 1000 Toll Free Fax: (888) 581 - 6826 These addresses serve all United States and foreign locations . WTSYC v8 ( 04 /2 4 ) Where to Send Your Correspondence Documents may be submitted by mail, in person at a VA regional office or electronically. However, VA recommends submitting correspondence electronically as this is the fastest method of receipt. VA provides several tools to assist in electronic submission. To learn more about how to submit documents and claims electronically, visit www.va.gov/disability/upload-supporting-evidence. You can also go directly to access.va.gov to digitally upload any correspondence using QuickSubmit. By visiting www.va.gov you can also check your claim status and learn about other VA benefits. If you need assistance, you can find a local, accredited representative at https://www.benefits.va.gov/vso/ You can also send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net Veterans Crisis Line: Dial 988 then Press 1\n\nYOUR RIGHT TO SEEK REVIEW OF OUR DECISION This document outlines your right to seek review of our decision on any issue with which you disagree. You may generally select one of three different review options for each issue decided by VA. However, you may not request review of the same issue using more than one option at the same time. Below is information on the three different review options. For most VA benefits, you have 1 year from the date on your decision notice to request a decision review to ensure the earliest possible effective date. Consult your decision notice for specific limitations. Supplemental Claim A reviewer will determine whether new and relevant evidence changes the prior decision. Higher-Level Review Board Appeal VA FORM APR 2024 20-0998 SUPERSEDES VA FORM 20-0998, SEP 2022. Page 1 What Is This? An experienced claims adjudicator will review your decision using the same evidence VA considered in the prior decision. A Veterans Law Judge at the Board of Veterans\' Appeals (Board) will review your decision. You are adding or identifying new and relevant evidence to support your claim that we did not previously consider. VA will assist you in gathering new and relevant evidence that you identify to support your claim. You are entitled to a hearing at any time in the supplemental claim process. You have no additional evidence to submit to support your claim, but you believe there was an error in the prior decision. You can request an optional, one-time, informal conference with a Higher-Level Reviewer to identify specific errors in the case, although requesting this conference may delay the review. You must choose a docket: Direct Review - You do not want to submit evidence or have a hearing. Evidence Submission - You choose to submit additional evidence without a hearing. Hearing - You choose to have a hearing with a Veterans Law Judge. 125 days on average 125 days on average 365 days on average for Direct Review (longer for the other options) You may request another Supplemental Claim, a Higher-Level Review, or a Board Appeal. You may request a Supplemental Claim or a Board Appeal. You may request a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims. * All forms listed are available at www.va.gov/find-forms/ or use your mobile device camera to scan the QR code to take you directly to the form you select. By Selecting This Option Goal To Complete Further Options After This Decision Review VA Form 20-0995 Decision Review Request: Supplemental Claim VA Form 20-0996 Decision Review Request: Higher-Level Review VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) Form To File* Scan QR Code to Access Form\n\n• A Supplemental Claim. If you file a Supplemental Claim after the 1-year time limit, the effective date for any resulting award of benefits generally will be tied to the date VA receives the Supplemental Claim. • A request to revise the decision based on a clear and unmistakable error, or If you do not submit a decision review request within the required time, you may only seek review through the following: • If you are a party to a contested claim - such as claims for apportionment, attorney fee disagreement, or multiple parties filing for survivor\'s benefits or claims for life insurance - your only option for disagreeing with your decision is to file a Board Appeal within 60 days of the date on your decision notice. While most decision review options are available to you, there are limitations based on the type of decision you received. o If you wish to have a hearing during the supplemental claim process, you can contact us online through Ask VA: https://ask.va.gov/ or call us toll-free at 1-800-827-1000 (TTY:711). VA FORM 20-0998, APR 2024 Page 2 Get Help with Your Review Request: For more information on all the available review options, contact us at 1-800-827-1000 or visit www.va.gov/decision- reviews/ . If you need help filing a decision review, you may want to work with an accredited attorney, claims agent, or a Veterans Service Organization (VSO) representative. Additional information about working with an accredited attorney, claims agent, or VSO representative is available at www.va.gov/decision-reviews/get-help-with-review-request/ . You can find a searchable database of VA-recognized representatives at www.va.gov/ogc/apps/accreditation . Scan the QR Code to Open the Appropriate Decision Review Website Page Supplemental Claim Higher-Level Review Board Appeal • If you are seeking review of an insurance decision you have an additional option to challenge VA\'s decision by filing a complaint with a United States district court in the jurisdiction in which you reside within 6 years from when the right of action first accrues. Consult your decision notice for details on what options are available and where to send the request.\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 10/28/2025 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974 to August 26, 1976. We received your supplemental claim on September 25, 2025. Based on a review of the evidence listed below, we have made the following decision(s) on your claim. DECISION 1. Entitlement to special monthly compensation based on housebound criteria being met is continued. 2. Entitlement to special monthly compensation based on aid and attendance is denied. EVIDENCE l DD Form 214, Certificate of Release or Discharge from Active Duty, received October 11, 2018, for the period October 9, 1974 to August 26, 1976\n\nl Service Treatment Records, received July 2, 2018, August 13, 2024, and October 23, 2024, for the period October 9, 1974 to August 26, 1976 l Service Personnel Records, received July 16, 2018, October 11, 2018, and October 24, 2018, and for the period October 9, 1974 to August 26, 1976 l VA Form 20-0995, Decision Review Request - Supplemental Claims, received September 25, 2025 l VA Form 21-0966, Intent To File A Claim For Compensation and/or Pension, or Survivors Pension and/or DIC, received September 25, 2025 l Rating Decision, (to include all evidence) received December 16, 2024 l Rating Decision, (to include all evidence) received July 17, 2024 l Veterans Health Administration medical record, received September 27, 2025, for the period May 3, 2018 to September 18, 2025 l Veterans Health Administration scanned images, received September 27, 2025, for the period May 10, 2018 to September 15, 2023 l Veterans Health Administration scanned images, received September 27, 2025, for the period September 15, 2023 to June 20, 2025 l VA Form 21-4138, Statement In Support of Claim, received September 26, 2025 l Request for Application, received on September 26, 2025 l C&P Exam, LHI, DBQ A&A Worksheet - VA Form 21-2680, conducted October 27, 2025 l Rating Decision, to include all evidence)vreceived September 15, 2025 REASONS FOR DECISION 1. Entitlement to special monthly compensation based on housebound. Entitlement to special monthly compensation is warranted in this case because criteria regarding housebound have been met. (38 CFR 3.350) Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions) rated 100 percent and additional service-connected disabilities of chronic obstructive pulmonary disease (COPD) with emphysema and restrictive lung disease, tinnitus, independently ratable at 60 percent or more from July 10, 2024. Entitlement to this benefit has been established from the date we received your intent to file a claim for benefits. (38 CFR 3.155, (38 CFR 3.400) 2. Entitlement to special monthly compensation based on aid and attendance. A claimant may continuously pursue a claim by timely and properly filing a supplemental claim. \"Timely\" means the supplemental claim is submitted within one year of the VA decision. \"Properly\" means VA form 20-0995, Decision Review Request: Supplemental Claim, is completed and submitted along with new and relevant evidence. (38 CFR 3.2500, 38 CFR 3.2501) LAWRENCE WIDIKOWSKI 200 46 9795 2 of 5\n\nIf the claim is not continuously pursued and benefits are granted, the effective date will be the date entitlement arose, but will not be earlier than the date of receipt of the supplemental claim currently under review. (except as otherwise provided by other regulations including 38 CFR 3.400) Entitlement to an additional payment of compensation is established when service-connected impairment imposes a special level of disability. Entitlement to special monthly compensation is not warranted in this case because the criteria regarding aid and attendance have not been met. (38 CFR 3.350) This benefit is payable for being so helpless (due to service-connected disabilities) as to be permanently bedridden or in need of regular aid and attendance. The following will be considered in determining the need for regular aid and attendance: inability to dress or undress, or to keep ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability to feed oneself through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or physical or mental incapacity which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to the daily environment. Bedridden will be a proper basis for the determination. \"Bedridden\" means that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that a claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions be found to exist before a favorable rating may be made. The particular personal functions which the claimant is unable to perform should be considered in connection with their condition as a whole. It is only necessary that the evidence shows that the claimant is so helpless as to need regular aid and attendance, not that there be a constant need. Determinations as to the need for regular aid and attendance will not be based solely upon an opinion that their condition is such as would require them to be in bed. They must be based on the actual requirement of personal assistance from others. (38 CFR 3.350, 38 CFR 3.352) Entitlement to special monthly pension aid and attendance may be awarded when the claimant is blind in both eyes having visual acuity of 5/200 or less, or has contraction of the visual field to 5 degrees or less; is a patient in a nursing home because of mental or physical incapacity; or, when the evidence shows aid and attendance is required to perform routine activities of daily living. The routine activities of daily living are basic self-care tasks which include such things as the ability to dress or undress one\'s self, to keep one\'s self ordinarily clean and presentable, ability to feed one\'s self, the ability to attend to the needs of nature, or the ability to protect one\'s self from the hazards or dangers incident to his or her daily environment. Housebound benefits are payable if the Veteran has a single disability ratable at 100 percent and additional disabilities independently ratable at 60 percent or more; or if the Veteran is substantially confined to his or her dwelling and immediate premises due to disability. (38 CFR 3.351,38 CFR 3.352) For nonservice-connected pension, per Public Law 107-103, a rating decision is not required as the Veteran is over the age of 65. LAWRENCE WIDIKOWSKI 200 46 9795 3 of 5\n\nThe medical evidence submitted shows that you need assistance with needs physical assistance or supervision for transfers on/off the toilet due to shortness of breath, poor balance, and limited endurance. . However, the evidence also shows that you are neither blind nor in a nursing home. You are able to protect yourself from the hazards and dangers of your immediate environment, and are able to perform routine activities of daily living without the assistance of another person. Therefore, entitlement to special monthly pension based on the need for aid and attendance is denied. Favorable Findings identified in this decision: Your service-connected disabilities are considered permanent. Your are 100 percent service connected for hypertensive heart disease with sick sinus syndrome (also claimed as heart conditions). You require aid and attendance. Your recent exam shows you require assistance with bathing, dressing, toileting, personal hygiene, and transfers due to limited endurance, poor balance, and fall risk. Laws and regulations applicable to this issue: 38 U.S.C 1110 & 1131 Basic entitlement. 38 U.S.C. 1168 Medical nexus examinations for toxic exposure risk activities. 38 U.S.C. 5103 Duty to assist claimants 38 U.S.C. 5107 Claimant responsibility; benefit of the doubt. 38 U.S.C. 5110 Effective dates of awards. 38 C.F.R. §3.1 Definitions. 38 C.F.R. §3.6 Duty periods. 38 C.F.R. §3.102 Reasonable doubt. 38 C.F.R. §3.103 Procedural due process and appellate rights. 38 C.F.R. §3.104 Finality of decisions. 38 C.F.R. §3.156 New and material evidence. 38 C.F.R. §3.159 Department of Veterans Affairs assistance in developing claims. 38 C.F.R. §3.2500 Review of Decisions. 38 C.F.R. §3.303 Principles relating to service connection. 38 C.F.R. §3.304 Direct service connection; wartime and peacetime. 38 C.F.R. §3.320 Claims based on exposure to particulate matter. 38 C.F.R. §4.1 Essentials of evaluative ratings. 38 C.F.R. §4.2 Interpretation of examination reports. 38 C.F.R. §4.3 Resolution of reasonable doubt. 38 C.F.R. §4.6 Evaluation of evidence. REFERENCES: LAWRENCE WIDIKOWSKI 200 46 9795 4 of 5\n\nTitle 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all Veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 5 of 5\n\nFraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised. • You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000. • You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000. • VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA. • VA does not threaten claimants with jail or lawsuits. • Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place. • When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.). • Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised. • Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api.id.me/en/registration/new • Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly. • To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp , or go to VA.gov and search “Office of Inspector General”. • For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams • Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/ • Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau.com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High');
INSERT INTO `v3_documents` (`id`, `user_id`, `original_filename`, `stored_filename`, `document_type`, `claim_type`, `decision_date`, `decision_date_text`, `effective_date`, `effective_date_text`, `outcome_summary`, `raw_text`, `created_at`, `document_classification`, `classification_confidence`) VALUES
(11, 1, 'ClaimLetter-2026-1-15.pdf', '20260605_161418_faefeef9b7763bf8_ClaimLetter-2026-1-15.pdf', 'PDF', 'Uploaded Evidence', '2025-10-27', 'October 27, 2025', NULL, NULL, 'Granted: 2', 'We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.va.gov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit https://ask.va.gov/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1. January 15, 2026 LAWRENCE PAUL WIDIKOWSKI 11 COOPER ST DANVILLE WV 25053 We made a decision on your VA benefits. Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information: l Entitlement to special monthly compensation based on aid and attendance criteria being met is granted from October 27, 2025. See Rating Decision to find out why we made this decision. As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, https://www.va.gov/life-insurance/options-eligibility/valife/ , for further information. Your monthly entitlement amount is shown below: Monthly Entitlement Amount Payment Start Date Reason $4,767.34 Nov 1, 2025 Special Monthly Compensation Adjustment $4,900.83 Dec 1, 2025 Cost of Living Adjustment ICN: 1024355407V649270 Page 1\n\nWe are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request: Supplemental Claim Higher-Level Review VA Form 20-0996, Decision Review Request: Higher-Level Review Appeal to the Board of Veterans’ Appeals VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) Please note: You may not request a higher-level review of a higher-level review decision issued by VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision , explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 2\n\nworks. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision . If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request: Supplemental Claim . If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov . You may also use the following link to access your Public Contact representative at your local VA Regional Office for assistance at https://va.my.site.com/VAVERA/s/ . Thank you for your service, Regional Office Director cc: AMERICAN LEGION WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 3\n\nExplanation of Payment We are currently paying you as a single Veteran with no dependents. Your combined evaluation is 30 percent or more disabling; therefore, you may be eligible for additional benefits based on dependency. We may be able to pay you retroactive benefits for your dependents if you submit your dependency claim within a year from the date of this letter. If you wish to notify us of your dependents, please do so through eBenefits, an electronic resource in a self-service environment. Use of these resources often helps us serve you faster! Just visit www.eBenefits.va.gov to enroll and submit your dependency information. If you would prefer to submit your request to add your dependents to your award in paper, please complete, sign, and return VA Form 21-686c, Application Request to Add and/or Remove Dependents . You can locate the appropriate form(s), please the visit the following website: www.va.gov/vaforms . Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker\'s Compensation: Your payments may be affected by the following, which you must bring to our attention: l Reentrance into active military or naval service. l Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation. l Receipt of benefits from the Office of Federal Employees Compensation. l Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you: l fail to submit evidence we requested, l fail to attend a VA examination when requested, or l Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 5\n\nEvidence received shows a change is warranted. imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment: l Education loans : For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or visit www.vets.gov/education . l Veterans with student loans : For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/ . Medical Care and Treatment: l Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web/ . l Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab/ . l Change in Compensation Benefits : For more information, please call 1-877-222-VETS or visit www.va.gov/healtheligibility . l Clothing Allowance : For more information, please call 1-800-827-1000 or visit https://www.va.gov/disability/eligibility/special-claims/clothing-allowance/ . l VA Medical Care : Present a copy of this notification letter to the Patient Registration/Eligibility Section at your nearest VA Medical Center https://www.va.gov/find-locations . l Dental Benefits : For more information, please contact your nearest VA Medical Center or outpatient clinic https://www.va.gov/find-locations . Home Adaptations/Loans, Automobile Benefits, and Life Insurance: l Loans: For more information, please visit www.benefits.va.gov/homeloans/ . l Funding Fee Refund : If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin the refund process. l Government life insurance : As a Veteran with a service-connected disability, you may be WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 6\n\neligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.gov/life-insurance/options-eligibility/valife/ . Armed Forces Commissary and Exchange: l You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va.gov/resources/commissary-and-exchange-privileges-for-veterans . Payment for Travel: l Payment for Travel : You may be eligible for reimbursement for beneficial travel mileage for previous VA medical appointments because of your newly granted service-connected conditions. You must make a request for such reimbursement within 30 days of this letter by contacting the Enrollment office at your Medical Center and providing a copy of this letter. State Benefits: l State Benefits: For more information, please visit www.va.gov/statedva.htm . Veterans Signals (VSignals), a VA Customer Experience Survey VA is conducting short surveys to gather feedback regarding the new decision review process. VA will randomly select survey participants from individuals who filed a request for a decision review. The survey will be sent via email and should take less than three minutes to complete. If selected, you will receive a survey within 10 days of the date on your notification letter. To be considered for VA surveys, please review your va.gov profile and ensure we have your current email address. The survey may not route to your inbox, so please check your junk folder. WIDIKOWSKI, LAWRENCE P ICN: 1024355407V649270 Page 7\n\nWhere to Send Your Correspondence Documents may be submitted by mail, in person at a VA regional office or electronically. However, VA recommends submitting correspondence electronically as this is the fastest method of receipt. VA provides several tools to assist in electronic submission. To learn more about how to submit documents and claims electronically, visit www.va.gov/disability/upload-supporting-evidence . You can also go directly to AccessVA ( https://eauth.va.gov/accessva/?cspselectfor=quicksubmit ) to digitally upload any correspondence using QuickSubmit. By visiting www.va.gov you can also check your claim status and learn about other VA benefits. If you need assistance, you can find a local, accredited representative at https://www.benefits.va.gov/vso/ . If you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Pension & Survivors Benefits Department of Veterans Affairs Compensation Intake Center P.O. Box 4444 Janesville, WI 53547 Toll Free Phone: 1-800-827-1000 Toll Free Fax: (844) 531-7818 Department of Veterans Affairs Pension Intake Center P.O. Box 5365 Janesville, WI 53547 Toll Free Phone: 1-800-827-1000 Toll Free Fax: (844) 655-1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Board of Veterans’ Appeals P.O. Box 27063 Washington, DC 20038 Toll Free Fax. (844) 678-8979 Department of Veterans Affairs Fiduciary Intake Center P.O. Box 5211 Janesville, WI 53547 Toll Free Phone: 1-800-827-1000 Toll Free Fax: (888) 581-6826 These addresses serve all United States and foreign locations . Veteran Crisis Line Dial 988 then Press 1 You can also send a text message to 838255 to receive confidential support 24 hours a day, 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net WTSYC (November 2022)\n\nYOUR RIGHT TO SEEK REVIEW OF OUR DECISION This document outlines your right to seek review of our decision on any issue with which you disagree. You may generally select one of three different review options for each issue decided by VA. However, you may not request review of the same issue using more than one option at the same time. Below is information on the three different review options. For most VA benefits, you have 1 year from the date on your decision notice to request a decision review to ensure the earliest possible effective date. Consult your decision notice for specific limitations. Supplemental Claim A reviewer will determine whether new and relevant evidence changes the prior decision. Higher-Level Review Board Appeal VA FORM APR 2024 20-0998 SUPERSEDES VA FORM 20-0998, SEP 2022. Page 1 What Is This? An experienced claims adjudicator will review your decision using the same evidence VA considered in the prior decision. A Veterans Law Judge at the Board of Veterans\' Appeals (Board) will review your decision. You are adding or identifying new and relevant evidence to support your claim that we did not previously consider. VA will assist you in gathering new and relevant evidence that you identify to support your claim. You are entitled to a hearing at any time in the supplemental claim process. You have no additional evidence to submit to support your claim, but you believe there was an error in the prior decision. You can request an optional, one-time, informal conference with a Higher-Level Reviewer to identify specific errors in the case, although requesting this conference may delay the review. You must choose a docket: Direct Review - You do not want to submit evidence or have a hearing. Evidence Submission - You choose to submit additional evidence without a hearing. Hearing - You choose to have a hearing with a Veterans Law Judge. 125 days on average 125 days on average 365 days on average for Direct Review (longer for the other options) You may request another Supplemental Claim, a Higher-Level Review, or a Board Appeal. You may request a Supplemental Claim or a Board Appeal. You may request a Supplemental Claim or appeal to the U.S. Court of Appeals for Veterans Claims. * All forms listed are available at www.va.gov/find-forms/ or use your mobile device camera to scan the QR code to take you directly to the form you select. By Selecting This Option Goal To Complete Further Options After This Decision Review VA Form 20-0995 Decision Review Request: Supplemental Claim VA Form 20-0996 Decision Review Request: Higher-Level Review VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) Form To File* Scan QR Code to Access Form\n\n• A Supplemental Claim. If you file a Supplemental Claim after the 1-year time limit, the effective date for any resulting award of benefits generally will be tied to the date VA receives the Supplemental Claim. • A request to revise the decision based on a clear and unmistakable error, or If you do not submit a decision review request within the required time, you may only seek review through the following: • If you are a party to a contested claim - such as claims for apportionment, attorney fee disagreement, or multiple parties filing for survivor\'s benefits or claims for life insurance - your only option for disagreeing with your decision is to file a Board Appeal within 60 days of the date on your decision notice. While most decision review options are available to you, there are limitations based on the type of decision you received. o If you wish to have a hearing during the supplemental claim process, you can contact us online through Ask VA: https://ask.va.gov/ or call us toll-free at 1-800-827-1000 (TTY:711). VA FORM 20-0998, APR 2024 Page 2 Get Help with Your Review Request: For more information on all the available review options, contact us at 1-800-827-1000 or visit www.va.gov/decision- reviews/ . If you need help filing a decision review, you may want to work with an accredited attorney, claims agent, or a Veterans Service Organization (VSO) representative. Additional information about working with an accredited attorney, claims agent, or VSO representative is available at www.va.gov/decision-reviews/get-help-with-review-request/ . You can find a searchable database of VA-recognized representatives at www.va.gov/ogc/apps/accreditation . Scan the QR Code to Open the Appropriate Decision Review Website Page Supplemental Claim Higher-Level Review Board Appeal • If you are seeking review of an insurance decision you have an additional option to challenge VA\'s decision by filing a complaint with a United States district court in the jurisdiction in which you reside within 6 years from when the right of action first accrues. Consult your decision notice for details on what options are available and where to send the request.\n\nDEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office LAWRENCE WIDIKOWSKI VA File Number 200 46 9795 Represented By: AMERICAN LEGION Rating Decision 01/13/2026 INTRODUCTION The records reflect that you are a Veteran of the Peacetime and Vietnam Era. You served in the Navy from October 9, 1974 to August 26, 1976. We received your supplemental claim on November 29, 2025. Based on a review of the evidence listed below, we have made the following decision on your claim. DECISION Entitlement to special monthly compensation based on aid and attendance criteria being met is granted from October 27, 2025. EVIDENCE l VA Form 20-0995, Supplemental Claim Application, received on November 29, 2025 l VA Form 21-4138, Statement In Support of Claim, received December 20, 2025 l VA Form 21-4138, Statement In Support of Claim, received December 20, 2025 l Notification Letter (e.g. VA 20-8993, VA 21-0290, PCGL), received on October 29, 2025 l Rating Decision - Narrative, received on October 28, 2025\n\nl Physician\'s Statement in Support of Aid and Attendance, received November 29, 2025 l VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance, LHI, received October 27, 2025, conducted October 27, 2025 l Notification Letter (e.g. VA 20-8993, VA 21-0290, PCGL), received on July 18, 2024 l Rating Decision - Narrative, received on July 17, 2024 REASONS FOR DECISION Entitlement to special monthly compensation based on aid and attendance. Entitlement to special monthly compensation is warranted in this case because criteria regarding aid and attendance have been met. (38 CFR 3.350) Entitlement to special monthly compensation (l) based on the need for aid and attendance is granted effective October 27, 2025. The effective date of this grant is October 27, 2025. Entitlement to special monthly compensation has been established from the date the evidence shows the criteria have been met. (38 CFR 3.350, 38 CFR 3.400) REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans\' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all Veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov . LAWRENCE WIDIKOWSKI 200 46 9795 2 of 2\n\nFraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised. • You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000. • You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000. • VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA. • VA does not threaten claimants with jail or lawsuits. • Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place. • When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.). • Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised. • Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api.id.me/en/registration/new • Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly. • To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp , or go to VA.gov and search “Office of Inspector General”. • For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams • Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/ • Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau.com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High'),
(12, 1, 'ClaimLetter-2026-1-16.pdf', '20260605_161418_fe03340dbb6feaa1_ClaimLetter-2026-1-16.pdf', 'PDF', 'Uploaded Evidence', '2018-08-01', 'Aug 1, 2018', NULL, NULL, 'Denied: 2', '01/16/2026 02:11:42 -VA Compensation Intake Center BEST COPY Source: QuickSubmit July 18, 2024 LAWRENCE WIDIKOWSKI 11 COOPER ST DAN VILLE WV 25053 We made a decision on your VA benefits Dear Lawrence Widikowski: This letter will guide you through the information you should know and steps you may take now that VA has made a decision about your benefits. Your Benefit Information:  Entitlement to special monthly compensation based on aid and attendance/housebound is denied. See Rating Decision to find out why we made this decision. As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. Visit the VALife Insurance website, httl2s://www.va.gov/life-insurance/o]2tions-eligibilily/valife , for further information. Your monthly entitlement amount is shown below: Monthly Payment Start Entitlement Date Reason Amount $2,973.86 Aug 1, 2018 Original Award $3,057.13 Dec 1, 2018 Cost of Living Adjustment $3,106.04 Dec 1, 2019 Cost of Living Adjustment $3,146.42 Dec 1, 2020 Cost of Living Adjustment We have included with this letter: 1. Explanation of Payment 2. Additional Benefits 3. Where to Send Your Correspondence 4. VA Form 20-0998 5. Rating Decision 6. Fraud Prevention Attachment Contact information: Web: www.vets.ov Phone: 1-800-827-1000 TDD: 711 To send questions online: visit htts:I/iris.custhel.com/ Social Media: Twitter: @VAVetBenefits Facebook: www.facebook.com/ VeteransBenefits Your representative: You appointed AMERICAN LEGION as your accredited representative. They have also received a copy of this letter. They can help you with any questions you have about your claim. If you or someone you know is in crisis, call the Veterans Crisis Line by dialing 988 and then pressing 1.\n\n01/16/2026 02:11:42 -VA Compensation Intake Center BEST COPY Source: QuickSubmit File Number: 200469795 WIDIKOWSKI, LAWRENCE Monthly Entitlement Amount Payment Start Date Reason $3,332.06 Dec 1, 2021 Cost of Living Adjustment $3,621.95 Dec 1, 2022 Cost of Living Adjustment $3,737.85 Dec 1, 2023 Cost of Living Adjustment We are currently paying you as a single Veteran with no dependents. If payments are due, you should receive your first payment, if not already in receipt of payments, within 7-10 days of this notice. See Explanation of Payment for more details about your payment. Your payment will be directed to the financial institution and account number that you specified. To confirm when your payment was deposited, please contact your financial institution. If this account is no longer open, please notify us immediately. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you have one year from the date of this letter to select a review option in order to protect your initial filing date for effective date purposes. You must file your request on the required application form for the review option desired. The table below represents the review options and their respective required application form. Review Option Required Application Form Supplemental Claim VA Form 20-0995, Decision Review Request. Supplemental Claim Higher-Level Review VA Form 20-0996, Decision Review Request. Higher-Level Review Appeal to the Board of VA Form 10182, Decision Review Request. Board Appeal Veterans’ Appeals (Notice of Disagreement) Please note: You may not request a higher-level review of a higher-level review decision issued Page 2 Rol 5 10 IiIII\n\n01/16/2026 02:11:42 -VA Compensation Intake Center BEST COPY Source: QuickSubmit File Number: 200469795 WIDIKOWSKI, LAWRENCE by VA. The enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision, explains your options in greater detail and provides instructions on how to request further review. You may download a copy of any of the required application forms noted above by visiting www.va.gov/vaforms/ or you may contact us by telephone at 1-800-827-1000 and we will mail you any form you need. You can visit www.va.gov/decision-reviews to learn more about how the disagreement process works. Important: If you have a service-connected condition which you feel has worsened and is no longer accurately reflected by the level of disability assigned, please use VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits to request an increased evaluation. However, if you disagree with a decision made within the last year, please refer to the enclosed VA Form 20-0998, Your Right To Seek Review Of Our Decision. If you would like us to review a claim that was denied more than one year ago, and you have new and relevant evidence for us to consider, please use VA Form 20-0995, Decision Review Request. Supplemental Claim. If you would like to obtain or access evidence used in making this decision, please contact us by telephone, email, or letter as noted below letting us know what you would like to obtain. Some evidence may be obtained online by visiting www.va.gov. Thank you for your service, Regional Office Director cc: AMERICAN LEGION Page 3 IiIII\n\n01/16/2026 02:11:42 -VA Compensation Intake Center BEST COPY Source: QuickSubmit File Number: 200469795 WIDIKOWSKI, LAWRENCE Explanation of Payment We are currently paying you as a single Veteran with no dependents. Please Take Action: What Things Affect Your Right to Payment? Please notify VA immediately if there is a change in any condition affecting your right to continued payments. If you don’t notify us of these changes immediately, you may have to return any overpayments. Those changes include: Evidence received shows a change is warranted. Military Pay or Worker’s Compensation: Your payments may be affected by the following, which you must bring to our attention:  Reentrance into active military or naval service.  Receipt of armed forces service retirement pay, unless your retirement pay has already been reduced because of award of disability compensation.  Receipt of benefits from the Office of Federal Employees Compensation.  Receipt of active duty or drill pay as a reservist or member of the National Guard. Dependents: If you have a disability rating of 30 percent or more, you must advise VA of any change with your spouse or children. Hospitalization: If your award includes Aid and Attendance benefits, we may reduce this additional allowance if you are admitted to a hospital, nursing home, or domiciliary care at VA expense. Incarceration: Benefits will be reduced if you are incarcerated in a federal, state, or local penal institution for more than 60 days for conviction of a felony. Lack of Cooperation: We may stop monthly payments if you:  fail to submit evidence we requested,  fail to attend a VA examination when requested, or  Submit false or fraudulent evidence to VA, or cause false or fraudulent evidence to be submitted to VA. Fraud/Lying to Government: The law provides severe penalties, which include fines, imprisonment, or both, for the fraudulent acceptance of any payment to which you are not entitled. We may verify information you submit through computer-matching programs with other agencies. Additional Benefits Education, Training, and Employment:  Education loans: For more information, please call 1-888-GIBILL-1 (1-888-442-4551) or Page 5WF !1L!1 IiI\n\n01/16/2026 02:11:42 -VA Compensation Intake Center BEST COPY Source: QuickSubmit File Number: 200469795 WIDIKOWSKI, LAWRENCE visit www.vets.aov/education.  Veterans with student loans: For more information, please call 1-888-303-7818 or visit www.disabilitydischarge.com/. Medical Care and Treatment:  Mental Health Counseling: For more information, please visit www.myhealth.va.gov/mhv- portal-web!.  Blind Rehabilitation: For more information, please visit www.va.gov/blindrehab!. Home Adaptations/Loans, Automobile Benefits, and Life Insurance:  Loans: For more information, please visit www.benefits.va.gov!homeloans/.  Funding Fee Refund: If you paid a funding fee at the closing of a VA guaranteed home loan and your VA compensation award provides an effective rating date that was prior to your loan closing date, then you may be eligible for a funding fee refund. Please contact either your current mortgage servicer or a VA Regional Loan Center at (877) 827-3702 to begin the refund process.  Government life insurance: As a Veteran with a service-connected disability, you may be eligible for up to $40,000 in VA life insurance benefits. Veterans Affairs Life Insurance (VALife) is guaranteed acceptance whole life insurance available to all service-connected, disabled veterans with no time limit to apply as long as you are age 80 or under. Veterans age 81 and over are still eligible in certain circumstances. For more information on VALife, please visit https://www.va.aov/life-insurance/options-elifzibility/valife/. Armed Forces Commissary and Exchange:  You may be entitled to Armed Forces Commissary and Exchange privileges. Honorably discharged Veterans with a service-connected disability; Former Prisoners of War; Purple Heart or Medal of Honor recipients; military retirees; members of the reserves; and their dependents may qualify for entitlement to this additional benefit. For more information, please visit va. gov!resources!commissary-and-exchange-privileges-for-veterans. Page 6 !1L!1 WF IiI\n\n01/16/2026 02:11:42 -VA Compensation Intake Center BEST COPY Source: QuickSubmit Where to Send Your Correspondence ocuments may be submitted by mail, in person at a VA regional office or electronically. [owever, VA recommends submitting correspondence electronically as this is the fastest method f receipt. A provides several tools to assist in electronic submission. To learn more about how to submit )cuments and claims electronically, visit www.va.gov/disability/upload-sul2porting-evidence. ou can also go directly to access.va.gov to digitally upload any correspondence using uickSubmit. visiting www.va.gov you can also check your claim status and learn about other VA benefits. you need assistance, you can find a local, accredited representative at If you prefer to mail your correspondence, please use the related mailing address below: Compensation Benefits Pension & Survivors Benefits Department of Veterans Affairs Department of Veterans Affairs Compensation Intake Center Pension Intake Center P.O. Box 4444 P.O. Box 5365 Janesville, WI 53547 Janesville, WI 53547 Toll Free Phone: 1-800-827-1000 Toll Free Phone: 1-800-827-1000 Toll Free Fax: (844) 531-7818 Toll Free Fax: (844) 655-1604 Board of Veterans’ Appeals Fiduciary Department of Veterans Affairs Department of Veterans Affairs Board of Veterans’ Appeals Fiduciary Intake Center P.O. Box 27063 P.O. Box 5211 Washington, DC 20038 Janesville, WI 53547 Toll Free Fax: (844) 678-8979 Toll Free Phone: 1-800-827-1000 Toll Free Fax: (888) 581-6826 These addresses serve all United States and foreign locations. You can also send a text message to / s Crisis Line: 838255 to receive confidential support 24 hours a day, Dial 988 then Press 1 7 days a week, 365 days a year. For more information, visit www.veteranscrisisline.net WTSYC v8 (04/24)\n\n01/16/2026 02:11:42 -VA Compensation Intake Center BEST COPY Source: QuickSubmit Fraud Prevention: Protect Your Benefits Please contact the VA immediately at 1-800-827-1000 if you suspect your information is compromised.  You receive correspondence from VA concerning a claim, and you don’t remember filing a claim contact the VA at 1-800-827-1000.  You receive correspondence requesting a processing fee prior to releasing benefit payments contact the VA at 1-800-827-1000.  VA may check in with you by phone, email, or text message. The VA will never ask for personal information via email. This includes verification of your SSN, address, and/or bank information. If you are unsure about any call, email, or text, confirm details directly with the VA.  VA does not threaten claimants with jail or lawsuits.  Be cautions of telephone numbers on caller ID. Scammers may change the telephone number (spoofing) to make a call appear to come from a different person or place.  When in doubt, hang up and call VA directly at 1-800-827-1000, or call your Power of Attorney representative (DAV, VFW, etc.).  Do not ignore emails or letters from the VA notifying you of an update to direct deposit or eBenefits account information. If you don’t remember making changes, it could be the first sign your information was compromised.  Use secure, unique passwords, and two factor identification where available. To establish a more secure logon for Vets.gov and ebenefits.va.gov with two factor identification create an account via ID.me at https://api . id .me/en/registration/new  Monitor your accounts regularly, respond to fraud alerts and report unauthorized transactions promptly.  To learn more about protecting yourself from fraud, and how to report it visit https://www.va.gov/oig/hotline/default.asp, or go to VA.gov and search \"Office of Inspector General\".  For more details on how to avoid scams go to https://www.fcc.gov/veterans- targeted-benefits-scams  Download free financial scam awareness resources at https://www.consumerfinance.gov/about-us/blog/helping-prevent-scams- targeted-veterans/  Get up-to-date information on fraud and scams from the Federal Trade Commission https://public.tableau .com/profile/federal.trade.commission', '2026-06-05 16:14:18', 'VA Decision Letter', 'High');
