ptsd Dh's 21-4138 For Smc-K Claim - Wording Help, Please!

[hedgey]

DH has a claim in for SMC-K, for his erectile dysfunction. While he could very likely win a claim that his ED is secondary to his PTSD, it will be much easier and simpler if he claims based on his PTSD and his pain medication.

For SC rated conditions he is taking:

Lorazepam

Venlafaxine

Meloxicam

Gabapentin

Based on our research on Web-MD, all of these meds have sexual dysfunction as common/possible side effects.

While he's mentioned his ED to his VA providers, both mental health and primary care, he hasn't sought treatment for it (this goes back to his PTSD), so there doesn't seem to be much in his VA records about it.

What would be the best wording to express the connection between these medications and his persistent ED? Does he need to include copies or links to web pages?

Thanks!

Hedgey

[hedgey]

I should clarify: DH submitted his claims a few months ago. The VA has sent the letter requesting evidence supporting DH's claim for SMC-K. I'm trying to help him but getting stuck in the wording.

I know the meds that I listed are linked to ED. I don't know how I tell the VA what they should already know. I'm sure there's better ways than others. DH asked his VSO for help, and the guy just said to send a list of his medications, no comments necessary. That doesn't seem like it would be holding their hands enough.

My brain isn't working so well these days, and I just need some help with how to phrase things. DH will submit a 4138 and any printouts necessary.

Thanks again for any help.

[Philip Rogers]

Better than enclosing links or printouts from WebMD, would be to enclose the printouts that come w/each prescription renewal, that he receives from the VA. jmo

pr

[hedgey]

PR, thanks, that's a great idea! Makes perfect sense - how can they argue with their own information? (Yeah, we know they will, right?)

Thank you!!

[hedgey]

DH submitted this a couple of weeks ago to the VA, but I thought I would post it here. I think the wording is pretty good and that a VA claims rep will find it understandable... I hope!!

Thank you very much for assisting me with my claim for SMC-K (Erectile Dysfunction).

I have filed for SMC-K based on my chronic Erectile Dysfunction, secondary to my severe PTSD and also caused by the medications I must take for service-connected issues. The medications that my VA physicians have prescribed that commonly cause Sexual Dysfunction are Lorazepam and Venlafaxine; (both treat my service-connected PTSD). I have been told that combining these medications intensifies the impact of the side effects, and that I will be taking these medications for the rest of my life.

I have attached a copy of my VA prescription list and copies of pages from the prescription inserts that accompany the VA medications. These inserts state that Sexual Dysfunction is a side-effect of the medication.

I will be visiting my private Urologist at the end of this month and will ask him to complete a DBQ. I have indicated on the VCAA letter that I will be submitting additional documentation.

I filed for SMC-S, because I believe that I qualify based on my 100% rating for PTSD plus my other service-connected ratings (which combine to 80%).

Again, thank you so very much for helping me with this claim. I appreciate your assistance greatly.




Encl: VCAA Letter dated 08/26/2013
My VA medications list
VA Prescription Medication Information Inserts for:
Lorazepam
Venlafaxine

Meloxicam

Gabapentin

None of the correspondence DH has received from the VA about his SMC claim have mentioned SMC-S. Instead it seems like they are only working on the claim for SMC-K. He's asked me to call Peggy and inquire about the status of his SMC-S claim, but I'm leaning more toward having him send in an IRIS request.

Any thoughts?

Thanks so much!

[FormerMember]

You do have a diagnosis of ED from a urologist linking the aforementioned drugs to the ED, right? Without it, this will be a short trip to the circular file. I can almost read the denial. "While the claimant states he has ED, there is no evidence of it in the record provided and the VA examiner states it is not at least as likely as not that it is related to the listed drugs. The Veteran has no medical knowledge or training to support his allegations. A mere subjective statement unsupported by medical rational is speculative and worthless for ratings purposes." As for SMC-S, you need a rating giving you 100% TDIU for the 70% BB rating alone. Then the combination of 10% ratings you mention (you'll need eight) will have to add up to 60% in their own right. Just FYI. Of course, if your disabilities are less than 160% but keep you substantially housebound in fact, you'll have to prove that facet as well, medically.

cp

Edited October 15, 2013 by asknod