vlb-all-products

vlb-c-file-manual







Reddit

Sinus, Is This A Cue

35 posts in this topic

Hello, everyone,

Getting ready to send this information, to back up my cue.

i know this is long, but please help

I am currently evaluated at 10 percent Disabling under the provisions of 38 C.F.R. § 4.71a, Diagnostic Code 6513 (2010)

Whether a December 23, 1999, decision of Notice of Disagreement denying entitlement to a compensable rating for 10 percent under Diagnostic Code 6513(199) should be revised or reversed based on clear and unmistakable error

(CUE).

In the December 23, 1999, rating decision at issue, the RO granted service connection and assigned a noncompensable rating for sinus disability, effective December 11, 1997, the date after my discharge from the military. I did not appeal the assigned rating. Hence, unless one of the exceptions to finality applies, that decision is final based on the evidence then of record. See 38 U.S.C.A. § 7105 (West 2002); 38 C.F.R. §§ 3.104(a), 20.302, 20.1103 (2004). I seek an earlier effective date for the award of the 10 percent rating for sinus disability on the basis of error in the RO's award of an initial noncompensable rating for that disability. In this respect, I allege that the RO did not properly evaluate the medical evidence of record at the time and made a decision in improper applications of 38 U.S.C.A. §§ 1155, 5100, 5102, 5103, 5103A, 5107 West 2002 & Supp. 2009); 38 C.F.R. §§ 3.159, 4.97, Diagnostic Code 6513 (1997), of the December 23, 1999, rating decision. Thus, as a means of establishing CUE, I am contending that the December 23, 1999, rating decision was clearly and unmistakably erroneous. Under the provisions of 38 C.F.R. § 3.105(a), previous determinations that are final and binding will be accepted as correct in the absence of clear and unmistakable error. However, if the evidence establishes clear and unmistakable error, the prior decision will be reversed and amended. A finding of CUE has the same effect as if the corrected decision had been made on the date of the reversed decision. In determining whether a prior determination involves CUE, the United States Court of Appeals for Veterans Claims (the United States Court of Veterans Appeals prior to March 1, 1999) (Court) has established a three-prong test. The three prongs are: (1) either the correct facts, as they were known at the time, were not before the adjudicator (i.e., there must be more than a simple disagreement as to how the facts were weighed or evaluated) or the statutory or regulatory provisions extant at the time were incorrectly applied; (2) the error must be undebatable and of the sort which, had it not been made, would have manifestly changed the outcome at the time it was made; and (3) a determination that there was clear and unmistakable error must be based on the record and law that existed at the time of the prior adjudication in question. See Damrel v. Brown, 6 Vet. App. 242, 245 (1994); Russell v. Principi, 3 Vet. App. 310, 314 (1992). Clear and unmistakable error is a very specific and rare kind of "error." It is the kind of error, of fact or of law, that when called to the attention of later reviewers compels the conclusion, to which reasonable minds could not differ, that the result would have been manifestly different but for the error. Thus even where the premise of error is accepted, if it is not absolutely clear that a different result would have ensued, the error complained of cannot be, ipso facto, clear and unmistakable. Fugo v. Brown, 6 Vet. App. 40,43-44 (1993).

The RO's decision reflects its consideration of findings reported in the veteran's service medical records. Which was not complete at the time.

Sinusitis

Here is a list and copies of my service treatment records (note that I do not have them all). The RO should have had these and my service treatment records.

They are dated from June 1989 through February 1993.

`

In June 1989, I was diagnosed with sinusitis and it was detected by x-ray.

On February 11, 1991, I reported to Emergency Room Naval Hospital Pensacola, FL. with temperature 101.2, complaints sore throat, coughing, vomiting and body aches. Diagnose was Bronchitis and pharyngitts. Sick in quarters (incapacitated) 24 hours –Roger Mason, MDxxxxx8645

On February 12, 1991 I reported to military sick call for follow on Bronchitis. I stated was not feeling any better. The doctor findings were temperature 100.8, cough with greenish sputum, fever, chills, sore throat, body aches. Diagnose Bronchitis, Medication; erythromycin, Entex, Terpin Hydrate with codeine, Tylenol. Sick in quarters (SIQ)(incapacitated)24 hours

On July 9, 1991, I reported to military sick call with complaints of cold symptoms. I had a temperature was 99.2. I stated that the last sinus infection was about 6 month ago and sinuses colds about 1 -2 times per year. The doctor noted maxillary sinus tenderness, nasal edema: The diagnosis was sinusitis; medication was, Batrim D.S. BID x 14 days, Entex LA po BID sick in quarters (SIQ) (incapacitated) 72hrs. ----Allen M. Williams/LT/MC/USNR/xxxxx3606/ intern

On July 10, 1991, I reported to military sick call for follow-up on sinusitis x 3 days; My temperature was 99.8; I had no relief of prior systems of nasal congestion and also productive cough and pain between the shoulder blade in back. The doctor noted maxillary sinus tender/throat, continue medication, diagnosed sinusitis/ pharngitis; sick in quarters (SIQ) (incapacitated) 48hr-----M.M.Quigley/LT/MC/USNR/xxxxxx7615

On October 8, 1992, I reported to military sick call with complaints of sore throat and ear ache x 7 days. My diagnose was R/O Eustachian tube dysfunction and medication was Entex LA BID ---Susan Breedlove/FNP-C-CW,C/S/xxxxx5901

On October 9, 1992, I reported to military sick call, for follow-up on throat and ear pain. The doctor findings were no voice, and I was diagnosed with URI (upper respiratory infection) with bacterial infection. I was told to continue medication and given Erythymicin -----CDR Ang-Rabanes/MC/USN/xxxxx5305

On January 4, 1993, I reported to military sick call with complaints of having a sore throat, ear aches, cough productive of phlegm and headache (HA) some diarrhea. My temperature was: 99.2. The diagnosis was URI (upper respiratory infection) probable viral. I was given the medication Tylenol 325mg, Robitussion, and Sudafed 60 mg, Sick in Quarters (SIQ) (incapacitated) 24 hours.

On January 5, 1993, I reported to military sick call for follow-up on viral syndrome. The doctor diagnosed was no improvement and viral syndrome; still have cough productive of yellow sputum. Sick in Quarters (SIQ) (incapacitated) x 24 hours; Thompson, Gary/LT/MC/USNR/xxxxxx1076

On January 6, 1993, I reported to military sick call for follow-up on viral syndrome. I stated that I feels somewhat better, still cough up yellow phlegm; I was diagnosed this time with viral URI (upper respiratory Infection), sick in quarters (SIQ) (incapacitating) x 24, Thompson, Gary, LT/MC/USNR/xxxxxxx1076

On January 11, 1993, I reported to military sick call for follow-up on viral syndrome, findings: pt still cough at time, productive yellow phlegm, febrile, nausea/vomiting with cough; diagnosis; Sino bronchial Infection, Medication: Septra, Entex, Robutission; Robert Marchiano/D.O.Civ, C/Sxxxxx5952

On January 12, 1993, I returned to military sick call for follow-up on headache, stomach, nausea, vomiting; diagnose; URI(upper respiratory infection) with PND(SINBRONCHIAL)with N/V(nausea and vomiting)CBC:10.1 hemoglobin, 31.2 hemacrit, sick in quarters(SIQ)(incapacitated) x 48 hours, Robert E. Marchiano, D.O. civ C/S/xxxxx5952

On January 14, 1993, I reported to military sick call for follow-up on Upper Respiratory Infection; finding; Sinus X-ray (Muc, Maxillary sinus esp. L plus edema; diagnoses Slow resolving Sino bronchial Infection; Robert Machiano/D.O.Civ,C/S xxxxx5952

On February 17, 1993, I reported to military sick call with complaints of Migraine, findings: temp.101.6, body malaise, non-productive cough; Diagnose-Combination of Viral Infection and acute Migraine Ha, pulse Tilt; medication fionial, compaxine, sick in quarters(SIQ)(incapacitated) x 48 hours Jose Ang-Rabanes/CDR/MC/USN xxxx5305

On February 19, 1993, I returned military sick call for follow up on viral infection and migraine headache; diagnose; migraine resolved, viral infection improved, return to duty Ang-Rabanes/CDR/MC/USN xxxx5305

Here is a list of diagnose from my private doctor:

March 30, 1999—seen in Palmyra Hospital, PO Box 1908/2000, Palmyra Road, Albany, Ga. 31702 for fever (TEMP 103.9) cough body aches and chills

April 05, 1999----complaints-ill for 8 days, cold, chills and body aches; findings –respiratory distress, swollen nasal turbinates; diagnose; Bronchospasms, Post influenza bronchitis vs. pneumonia, Dr. Grady Thompson

April 05, 1999---I had to report to Palmyra Emergency Room via Dr. Thompson for difficulty breathing, history asthma, treatment; neb.tx. x 3times per v.o. Dr. Mankin/per Dr. Grady Thompson

April 19, 1999---Palmyra Medical Center (emergency room) complaints sore throat, cough and body ache Temp. 100.1 diagnosis; Acute Sinusitis, medication z-pak and endal HD; Dr. James Thomas

The rating decision on December 23, 1999, for maxillary sinus stated that,

Service medical records show that the veteran was treated for sinus and nasal congestion beginning in June 1989. X-Rays in 1989 and 1991 reveal thickening of the maxillary sinuses and maxillary sinusitis was diagnosed. At the May 1998 VA examination the veteran reported a history of allergic rhinitis with episodes of stuffy nose. Examination of the nose and sinuses was within normal limits.

“The RO wrote that service medical records for the period of May 1988 to September 1993 were use. Service medical records for the period September 1993 to December 1997 could not be obtained for review. The RO also, wrote that if these records are located at a later date, this decision will be reconsidered. If a different decision results, that decision will be effective as of the date of the original claim”.

This favorable decision is considered to have resolved the issues of service connection for sinusitis and allergic rhinitis under appeal.

.

An improper applications of 38 U.S.C.A. §§ 1155, 5100, 5102, 5103, 5103A, 5107

(West 2002 & Supp. 2009); 38 C.F.R. §§ 3.159, 4.97, Diagnostic

Code 6513 (1997)

38 C.F.R. §§ 3.104(a), 20.302, 20.1103 (2004).

Based on the medical evidence of record at the time of question regarding the maxillary sinusitis and the general rating formula for sinusitis

Chronic Sinusitis

My sinus disability has been rated 10 percent disabling under DC 6513. Diagnostic Code 6513 pertains to chronic maxillary sinusitis. 38 C.F.R. § 4.71a, DC 6513.

Diagnostic Codes 6510 through 6514 pertain to various types of sinusitis, each of which is rated pursuant to a general formula for sinusitis set forth in the rating schedule following DC 6514. This general rating formula for sinusitis applies in all circumstances in which VA is to evaluate the severity of sinusitis, no matter the particular diagnosis.

Under the General Rating Formula for Sinusitis, chronic maxillary sinusitis detected by x-ray only warrants a noncompensable disability evaluation; 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 warrants a 10 percent disability evaluation; three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting warrants a 30 percent disability evaluation; following radical surgery with chronic osteomyelitis, or; near constant sinusitis, characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries warrants a 50 percent disability evaluation. An Incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician. 38 C.F.R. § 4.97, Diagnostic Code 6513 (2003).

Under the schedule ratings for Sinusitis and allergic Rhinitis:

Diagnostic code 6513 Sinusitis, maxillary chronic;

It stated that chronic maxillary sinusitis detected by x-ray only warrants a noncompensable: which was detected in 1989, 1991, 1993 and a disability evaluation 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 warrants a 10 percent disability evaluation;

My service treatment record stated that, I was diagnosed with sinus in June 1989, July 1991, January 12, 1993, April 19, 1999(Acute Sinusitis).

On July 9, 1991, I reported to military sick call and complained of runny nose, post nasal drip, congested, sinuses and non productive cough. I stated that the last time that I had a sinus infection was about 6 months ago. I said that I have sinus colds about 1-2 times per year (see SF 600 dated July 9, 1991, LT Allen M. Williams, MC. USNR).The doctor noted that I had maxillary sinus tenderness, bilateral nasal edema and bilateral TM’s dull with air bubbles. I was diagnosed was Sinusitis, and given the medication Bactrim D.S. x14 days and Entex LA. Again on July 10, 1991, I reported to military sick call for follow-up on sinusitis x 3 days; my temperature was 99.8; I had no relief of prior systems of nasal congestion and also productive cough and pain between the shoulder blade in back. The doctor noted maxillary sinus tender/throat, continue medication, diagnosed sinusitis/ pharngitis; sick in quarters (SIQ) (incapacitated) 48hr-----M.M.Quigley/LT/MC/USNR/xxxxxx7615

Then on January 11, 1993 for follow-up on viral syndrome and then my diagnose change to Sino Bronchial (sinus and Bronchitis together) (see SF 600 dated January 11, 1993 I was place on the medication septra D.S, Entex, and Robitusson, and then the next day on January 12, 1993, I reported to military sick call with a follow-up on headache, stomach pain, and nausea and vomiting. I was diagnosed with URI with PND (SINO BRONCHIAL) with n/v (nausea and vomiting) see SF 600 dated 12 January 1993), placed sick in quarters for 48 hours, by Dr. Robert Marciano. On January 14, 1993, I reported to military sick call for follow-up on Upper Respiratory Infection; finding; Sinus X-ray (Muc, Maxillary sinus esp. L plus edema; diagnoses Slow resolving Sino bronchial Infection; Robert Machiano/D.O.Civ,C/S xxxxx5952.

My private medical treatment records shows that I was treated on March 30, 1999, at Palmyra Medical Hospital, PO Box 1908/2000 Palmyra Road, Albany, Ga. 31702 for fever (TEMP 103.9) cough body aches and chills. I was also seen on April 05, 1999 for complaints of illness for 8 days, cold, chills and body aches; The diagnosed was respiratory distress, swollen nasal turbinates; diagnose; Bronchospasms, Post influenza bronchitis vs. pneumonia, Dr. Grady Thompson, then I reported to Palmyra Emergency Room via Dr. Thompson for difficulty breathing, history asthma, treatment; neb.tx. X 3 times per v.o. Dr. Mankin/per Dr. Grady Thompson. Then place on bed rest.

I was seen later that month on April 19, 1999, at Palmyra Medical Center (emergency room) complaints sore throat, cough and body ache Temp. 100.1 diagnosis; Acute Sinusitis, medication z-pak and endal HD, place on bed rest; Dr. James Thomas.

I was diagnosed with sinus and given antibiotics in 1989, 1991, and 1993. I was place sick in quarters (incapacitated) several times. After I was discharge in 1997, I was diagnosed again in 1999 with acute sinusitis and given antibiotics while my claim was in appeal status. I met the criteria for a 10 percent evaluation for maxillary sinusitis from December 11, 1997. Which is for disability evaluation 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 warrants a 10 percent disability evaluation;

38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, Part 4, Diagnostic Code 6513.

In December `16, 2008, Huntington, WV,(Atlanta, GA), RO confirmed and continued a noncompensable disability rating.

November 01, 2001, chief complain- ill since last night with cough, , chills, n/v(nausea and vomiting) H?A (headache) chills; finding(pink and swollen nasal turbinate, throat red, medication—endal hd, tamiflu, bed rest until 11/05/01 diagnose flu, recheck on 11-05-01

November 05, 2001- patient feels better, return to work in a.m.(11/06/2001)

December 25, 2001—pt. seen at Phoebe East for cold symptoms,

January 07. 2002—chief complaint—cold symptoms, headaches, cough prod. Of white and yellow sputum. Medication—endal hd, diagnosis; Asthma Bronchitis and Influenza, return to work after 8 hr. appt. 1/23/02 Dr. Grady Thompson

January 21, 2004—complaints cough, body aches, productive cough white/yellow phlen diagnosis; flu, medication z-pack, endal hd and tamiflu, bed rest, return to work 1/28/04

January 28, 2004—palmrya Medical Center—chief complaint, flu symptoms, vomiting

May 04, 2005—chief complaint- cold temp. 101.2, diagnose URI(upper respiratory infection, bronchitis. Medication-Maxifed, attusans

May 02,2008—chief complaints—headache, nausea and vomiting; diagnoses-sinusitis, headaches, nausea and vomiting(N/V)

In December 16, 2008, Huntington, WV,(Atlanta, GA), RO confirmed and continued a noncompensable disability rating.

This is what the reason for the decision stated for December 2008:

The evaluation of maxillary sinuses is confirmed and continued as 0 percent disabling. Review of outpatient treatment reports revealed treatment for sinusitis, May 2008; treatment consisted of antibody therapy, flonase nasal spray and Allegra-D.

During Va examination, your history of recurrent sinusitis, confirmed by x-ray, was noted. You stated that the last episode for which you received treatment began in April 2008. Sinusitis episodes occur about 2 to 3 times yearly, with symptoms to include post nasal drip, nasal congestion, rhinorrhea, headaches, you reported no significant occupational effects from sinusitis. Physical evaluation reveals no signs of obstruction, nasal polyps, or hypertrophy of turbinate, and sinus e-ray showed no significant abnormalities: diagnosis was chronic maxillary sinusitis

The non compesable evaluation of 0 percent was assigned for maxillary sinusitis, from December 11,1997, BECAUSE EVIDENCE AT THAT TIME SHOW 0NE OR TWO INCAPACIATING EPISODES PER YEAR OF SINUSITIS requiring prolonge(lasting four to six weeks) antibotic treatment or three to six non-incapaciting episodes per year of sinusitis characterized by headaches, pain and purulent discharge or crusting. Because evidence does not demonstrate a schedular increase in maxillary sinusitis, the current evaluation of 0 percent is continued.

I feel that I cue was also made in December 2008. I feel that I met the criteria for a 10 percent rating for sinuis under Diagnostic Code 6513

The criteria for a 10 percent rating for sinusitis have

been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. Part 4, Diagnostic Code 6513 (1997). I was seen on November 01, 2001, for been ill since last night with cough, chills, n/v (nausea and vomiting) H/A (headache) chill. The doctor finding was (pink and swollen nasal turbinate, throat red. The medication I was given was endal hd, Tami flu, bed rest until November 5,2001 I was diagnose with the flu, recheck on November 5,2001.I was seen again on November 05, 2001. I stated that I felt better. I return to work in a.m. (11/06/2001).

I was seen again on December 25, 2001 at Phoebe East for cold symptoms and on January 07, 2002, I was seen for cold symptoms, headaches, cough productive of white and yellow sputum. I was given the medication endal hd, diagnosis; Asthma Bronchitis and Influenza, return to work after 8 hr. appt. 1/23/02 Dr. Grady Thompson

Then on January 21, 2004, I complaint of cough, body aches, productive cough white/yellow phlegm. I was diagnosis with the flu. I was given the medication z-pack, endal hd and tamiflu. I placed on bed rest and to return to work on 1/28/04. I was seen by Dr. Grady Thompson.

On January 28, 2004, I was seen at Palmyra Medical Center for flu symptoms and vomiting. I was place on bed rest.

On May 04, 2005, I was seen for cold symptoms. I had a temperature of 101.2. I had sinus pain/pressure nasal drainage, ear and eye pain, sore throat, a nonproductive cough, wheezing, fever, dizziness and headache. The diagnosed me with URI (upper respiratory infection) and bronchitis. I was placed on the medication-Maxifed, attusans. I was seen by Dr. Michael Raines of Medical Associates of Albany, Georgia.

I was seen again on May 02, 2008, at Palmyra Medical Center, Albany, Ga.31702, for headache, dizziness, nausea and vomiting; I was diagnosed with sinusitis, headaches, nausea and vomiting (N/V). I was already on bed rest.

During Va examination, my sinusitis was, confirmed by x-ray, and review of my outpatient treatment reports revealed treatment for sinusitis, May 2008; treatment consisted of antibody therapy, flonase nasal spray and Allegra-D. I was diagnosed with chronic maxillary sinusitis, but I still received a non compensable evaulation of 0 percent.

Once again I met the criteria for a 10 percent rating for sinusitis. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. Part 4, Diagnostic Code 6513 (1997).

I did not received the 10 percent rating instead it was continue at 0 percent.

This is what the reason for the decision stated for December 2008:

The evaluation of maxillary sinuses is confirmed and continued as 0 percent disabling. Review of outpatient treatment reports revealed treatment for sinusitis in May 2008; treatment consisted of antibody therapy, flonase nasal spray and Allegra-D.

During Va examination, my history of recurrent sinusitis, confirmed by x-ray, was noted. I stated that the last episode for which I received treatment began in April 2008. Sinusitis episodes occur about 2 to 3 times yearly, with symptoms to include post nasal drip, nasal congestion, rhinorrhea, headaches, you reported no significant occupational effects from sinusitis. Physical evaluation reveals no signs of obstruction, nasal polyps, or hypertrophy of turbinate, and sinus e-ray showed no significant abnormalities: diagnosis was chronic maxillary sinusitis

The non compesable evaluation of 0 percent was assigned for maxillary sinusitis, from December 11,1997, BECAUSE EVIDENCE AT THAT TIME SHOW 0NE OR TWO INCAPACIATING EPISODES PER YEAR OF SINUSITIS requiring prolonge(lasting four to six weeks) antibotic treatment or three to six non-incapaciting episodes per year of sinusitis characterized by headaches, pain and purulent discharge or crusting. Because evidence does not demonstrate a schedular increase in maxillary sinusitis, the current evaluation of 0 percent is continued.

I file a claim for an increased for maxillary sinus on February 22, 2010.

On August 31, 2010 Cleveland Regional VA Office (Atlanta, GA) evaluation of maxillary sinus, which was currently at 0 percent disabling, increased to 10 percent effective February 22, 2010.

The evaluation of maxillary sinusitis is increased to 10% percent disabling effective 2/22/2010. That date the claim was received. An evaluation of 10 percent is assigned from 2/22/2010.An evaluation of 10 percent is assigned whenever there is evidence of 0ne or two incapacitating episodes per year of sinus requiring prolonged(lasting four to six weeks) antibiotic treatment, or three to six non -incapacitating episodes per year.

At the VA examination, you reported continued sinus problems over the years, progressively worse. Your treatment is Levaquin 500 mg daily for 7 days at a time, Maxifed as needed, Aleve Sinus and Headache as needed and Mucinex. (I had this with me at the C&P exam). You had just finished treatment of Levaquin. You reported incapacitating episodes requiring 4-6 weeks of antibiotic treatment. You reported non-incapacitating episodes with headache, fever, purulent drainage and sinus pain, more than six per year lasting 7 to 14 days. You reported nasal congestion, excess nasal mucous, itchy nose, watery eyes, sneezing, purulent discharge, headaches, and sinus pain and sinus tenderness.

On examination, there was no evidence of active disease or speech impairment. There was no sign of nasal obstruction, nasal polyps, septal deviation, and permanent hypertrophy of turbinates or granulomatous infection. The diagnosis was possible hypopneumatization of the sinuses and that the frontal, sphenoidal and ethmoidal sinuses appeared clear. Medical evidence in support of your claim has not been received showing evidence of three or more incapacitating episodes per year of sinusitis or requiring prolonged antibiotic treatment, or more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain and purulent discharge or crusting and higher evaluation is not warranted.<BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

<BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

Here is the medical evidence that I need to support my claim for a higher rating of 30 percent. Medical evidence in support of my claim is listed below .This evidence shows three or more incapacitating episodes per year of sinusitis or requiring prolonged antibiotic treatment, or more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain and purulent discharge or crusting and higher evaluation is not warranted.<BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

These are the diagnoses that I have had this year along.

On March 22, 2010, I was seen for cold and respiratory symptoms. I complain of productive cough, chest congestion, head congestion, sore throat and fever. Diagnosis -Acute Bronchitis medication- Levaquin 500 mg, maxifed dm Motrin/Tylenol for pain

October 4, 2010, I was seen for sinus congestion, pressure and pain, mild cough, chest congestion, sore throat. Finding; nose-red and stuffy, diagnoses—acute sinusitis, medication; maxified, lauquan---David Fischer, MD, of Medial Associates of Albany, Georgia.

October 21, 2010, I was seen for sinus congestion and sinus pressure. I was diagnosed with allergic rhinitis by Dr. Deville Young, MD, of Medial Associates of Albany, Georgia. I was given antibiotics that he administered in his office.

Share this post


Link to post
Share on other sites



Your cue is very simple. The VA failed to apply the regs to the newly discovered service department records.

Good preperation. I like your style.

JBasser

Share this post


Link to post
Share on other sites

So, do you think I will win this cue?

Share this post


Link to post
Share on other sites

Maybe? When I did my C&P exam they wanted to know how many times I had been treated with a course of antibiotics (4-6 weeks) for my Chronic Sinusitis.

Your records show a lot of fever and common cold symptoms, not trying to be a downer, but most people get colds a few times a year. I'm betting the rater just based it on the X-ray evidence and assumed the rest were colds/UGI's.

Eustachian tube pain,UGI, common cold with fever and headache are not necessarily sinusitis. The only thing I can see in those treatment records that indicates chronic sinusitis is 1989 diagnosis and xray showing thickening of maxillary sinus

Share this post


Link to post
Share on other sites

Reddit,

Your claim of cue is not clear to me.

Can you post the shortened version.

I am claiming a cue was made on rating decision dated XX/XX/XXXX.

This rating decision granted - denied - lowballed the disability of XXXXXXX.

By doing/not doing XXXXX the VARO broke the 38 CFR reg of XXXXX.

Share this post


Link to post
Share on other sites

Your claim of cue is not clear to me.

Can you post the shortened version.

I am claiming a cue was made on rating decision dated 12/23/1999

This rating decision granted - denied - maxillary sinuis.

By not following the regulation for 38 C.F.R. § 4.71a, Diagnostic Code 6513 (1997)

An improper applications of 38 U.S.C.A. §§ 1155, 5100, 5102, 5103, 5103A, 5107

(West 2002 & Supp. 2009); 38 C.F.R. §§ 3.159, 4.97, Diagnostic

Code 6513 (1997)

38 C.F.R. §§ 3.104(a), 20.302, 20.1103 .

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now