diabetes Need advice

[treysnonna]

Ok my husband has Ann appeal in since11/12 for chronic renal failure secondary to diabetes.  There is a new claim in ebenifits, which we did not do.  It is saying for cornary heart disease RFE.  I'm assuming that means renal failur evaluation.  So I'm assuming again they are going to try and approve it asso with the heart disease.  We put in  for the heart disease 7/14.  He was diagnosed with diabetic nephropathy by his private nephrologist.  What are they trying to do?  The appeal is still up.  We have not gotten anything from them.  No docket no etc.  but he would loose a lot of back pay is what I'm thinking.  Any thoughts ?  From anyone. 

 

[Berta]

Can you scan and attach here the decision for the claim you filed the NOD on as to their Reasons and Bases part and the evidence they listed?

(Cover C file #, name, address prior to scanning it)

If he is SC now for the DMII they should award something for the diabetic  nephropathy ,if that was claimed and if they have the private doctor's evidence on that.

...I am confused here..

"Yes filed a nod, filed19 within the 60 days. Vso thru American legion filed all.  We have copies did an iris, about 10 days ago.  No ans yet."

I assume then that you are waiting on a Statement of the Case.....????

 

." I have got all his lab work from the time he was diagnosis with renal failure.  His Vso  to wait till we rec docket number, otherwise it might get lost without it. However, we ar still waiting on that. Of course it is like everyone else, by the time they get around to rating it, you are  et etc etc "

That does not make sense to me.

If this claim was actually denied we need more info.

 

In my opinion, if a claim is Still at a VARO and you have more probative evidence, send it to them with proof of mailing. 

 

Is this the claim he filed in 2012?

 

Is the VSO supposed to prepare a 646 and is that holding up a BVA transfer?

I am lost here and probably I am not making any sense at all......because we dont know what they denied ,why they denied and when they denied.

 

However, once you get to the BVA (they (BVA) will send you a letter with your docket # on it, and you can send any additional evidence directly to the BVA and then check with them to make sure they have it.

 

Has any C & P doctor given any opinion on the renal disease yet? Was renal failure due to DMII part of the 2012 claim?

 

[treysnonna]

I hope so,. But I hav to wonder what or if the va is trying to wave a bone here.  Maybe they are not wanting to pay from 1/2012.  So they are looking to tie it into heart disease and pay from 07/14.  But he has had the kidney disease for about 5 yrs.    and you know what is on the even site on the claim they put on,  over to the side,  it has a section that ask if he want them to make a decision now.   I have never seen that before.  Any one else ever had this to happen?

 

[Gastone]

Your Appeal is at the BVA, just no Docket # yet, right. You do have a copy of your husbands C-File? We need to see a redacted copy of the initial Denial and the "Statement of Case." What exactly is your "Evidence of Record?"

Many vet's that get caught up in the VA Appeals process, get a negative attitude, right away. They believe that there is a VA conspiracy to Deny and/or limit their Comp Benefits.

VA Raters base their Award/Denial Decisions on "Evidence of Record," if the provided Evidence doesn't substantiate the claim, you get a Denial. That's not to say Rater's don't make errors, but a conspiracy (takes more than 1 person) to Deny is hard to believe, these are mid-level VA Employees.

What does your VSO say about your Evidence regarding the linkage to CAD or Kidney Disease? Which condition is most likely the causative SC for the Secondary issue?

Could you post redacted Dr's Clinician Notes, or other Medical Evidence supporting your claim? 

Semper Fi

[treysnonna]

Yes appeal is at intake center at bva.  But have not received a docket number yet.here is a copy of c-file denial.  We have not talked to Vso yet.  And the reason is the new claim says a development letter has been sent but of course again it has not arrived yet.  The claim originated June 30 and is in gathering evidence.  We don't have any new evidence relating to kidney disease connected to his heart disease.  He has had diabetes since 1999.  He was diagnosised with kidney disease in 2011.  And ihd in 2013, when they  had to replace his arotic valve.  Now I have no idea what is going on.  On the new claim on ebennies in a little box.  It ask if we want them to go ahead and decide the claim to check the box.  My other question he did not put in for p and t,. But if you notice on one of the dbq our doc said in his opinion he is not able to work.  And these are diseases that are going to get worse and contribute to his death.  So will they grant p and t.  Even if he did not file for it.  I think they want to say it is related to his heart,. But afraid they will say related to valve problem and deny it again.  So if we say yes decide it. Then that kills the appeal.  I'm I right on that?  Any ideas are appreciated.

[treysnonna]

Gastone and Berta,. I finally posted the info to help figure out what is gong on.  Thanks ahead of time.

[Berta]

I cant read the attachments.

What specific disability(ies) is the claim on appeal for?

Exactly why did the VA deny it?