Okay, so for some reason I can't remember my own administrative password to my scanner and I can't scan and upload my decision rating letter(narrative) that I had to Go get from the TVC because they didn't mail it with with the reply letter!!
They totally screwed me and now I have to go through the Appeals process which could take years!
I'm just going to summarize:
Reasons for Decision
The decision to grant compensation from December 1, 1994 for sinusitis is not considered to have been clearly and unmistakably erroneous because the alleged error involved an exercise of judgment which cannot be characterized as undebatably erroneous.
(And this is where they get really thrown off because they use the current rating criteria for 6512(sinusitis)
A noncompensable evaluation is granted unless there is evidence of one or two incapacitating episodes per year of sinusitis requiring prolonged(lasting four to six weeks) antibiotic treatment, or three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain and purulent discharge or crusting.
(And then for some odd reason...they throw in this statement..)
Since there is a likelihood of improvement, the assigned evaluation is not considered permanent and is subject to a future review examination.
(So here is some of the evidence that was already in my records, plus what I believe the bullet they provided for their own gun was in their May 1995 Rating Decision)
March 1994 Evaluated for complaint of sinus congestion
April 1994 Presents with 1 day history of respiratory symptoms ear pain, sore throat, nose congested, otitis media
July 22 1994 Noted some maxillary sinus tenderness with complaints of left ear pain and drainage, and temporal headaches.
July 29 1994 Evaluated for complaint of headache frontal X 1week Tension headache SIQ 24hrs
August 1994 Noted complaints of headaches and slight ear pain. Examination noted right maxillary sinus tenderness
Separation Examination noted history of frequent tension headaches and frequent sinus infections
February 1995 C & P Exam Diagnoses : 1. Frontal Sinusitis, Mild 2. History of Urinary Tract Infection 3. Sinus Headache
May 1995 Rating Decision:
In determining evaluations for sinusitis, consideration is given to the frequency and severity of recurrences, and the severity of symptomatology such as headaches, sinus discharge, and crusting or scabbing of the mucous membranes.
The evidence shows mild or occasional symptoms with X-ray evidence of sinusitis which warrants a noncompensable evaluation.
2. Whether the claim for headaches is well grounded.
The condition of sinus headache is considered a symptom of sinusitis. Service medical records show treatment for a tension headache however, this was shown to be a temporary condition which resolved with treatment, and no permanent residual disability was shown at the time of separation.
(Sinusitis was granted at a noncompensable rate and headache claim was not well grounded)
Criteria for sinusitis before October 7, 1996
With X-ray manifestations only with mild or occasional symptoms warrant a noncompensable rating
For moderate symptomatology with discharge or crusting or scabbing, with infrequent headaches a 10% rating is warranted.
For severe impairment manifested by frequently incapacitating recurrences, severe and frequent headaches, purulent discharge or crusting reflecting purulence a 30% rating is warranted.
50% evaluation is warranted for postoperative, following a radical operation with chronic osteomyelitis, repeated curettage, or severe symptoms after repeated operation.
(I feel like they should have given me the 10% rating because of the sinus headaches)