Jump to content
  • Searches Community Forums, Blog and more

  • Advertisemnt

  • 0
Sign in to follow this  
Porterhaus

Do I Have Grounds To Appeal Denial?

Question

Hello,

I am new to this site and must say that I am really glad to have found you as I find the tangled web we know as the VA to be one big pain in the neck.

I am currently rated at 30% for bi-lateral tinnitus and hearing loss. Over the past couple of years my tinnitus has gotten progressivly worse and the noise in my head makes it near impossible to sleep at night. The VA doctors have me on two different meds to help me sleep but the meds are not considered service connected so they are charging me for them. Because of this, I filed a claim for Service Connection for Insomnia as Secondary to the Service-Connected Disability of Tinnitus.

Here is the response I received back from the VA:

Service connection may be granted for a disease or injury which resulted from a service-connected disability or was agrravated thereby.

At our VA exam, you report insomnia and feel tired. Objective findings show that you take Ambien. You have memory problems and have problems with the retention of highly-learned materials. The rest of the exam is within normal limits. You are competent to manage your own funds. Your Global Assessment of Function is 70 which indicate mild symptoms. Our examiner diagnosed Axis - I insomnia. It is our examiner's opinion that your sleep disorder is less as likely as not secondary to your tinnitus due to your pattern of sleep difficulties in service. It is also our examiner's opinion that your sleep disorder is aggravated by your tinnitus, however the degree of aggravation cannot be determined without resorting to mere speculation. Service connection for insomnia is denied.

Do I have any grounds to appeal this decision? Their own examiner states that in their opinion, it is aggravated by my service connected tinnitus. Any recommendations on how to approach the appeal if I do have grounds to appeal?

Thanks for the advice,

Dale

Share this post


Link to post
Share on other sites

5 answers to this question

Recommended Posts

Hello,

I am new to this site and must say that I am really glad to have found you as I find the tangled web we know as the VA to be one big pain in the neck.

I am currently rated at 30% for bi-lateral tinnitus and hearing loss. Over the past couple of years my tinnitus has gotten progressivly worse and the noise in my head makes it near impossible to sleep at night. The VA doctors have me on two different meds to help me sleep but the meds are not considered service connected so they are charging me for them. Because of this, I filed a claim for Service Connection for Insomnia as Secondary to the Service-Connected Disability of Tinnitus.

Here is the response I received back from the VA:

Service connection may be granted for a disease or injury which resulted from a service-connected disability or was agrravated thereby.

At our VA exam, you report insomnia and feel tired. Objective findings show that you take Ambien. You have memory problems and have problems with the retention of highly-learned materials. The rest of the exam is within normal limits. You are competent to manage your own funds. Your Global Assessment of Function is 70 which indicate mild symptoms. Our examiner diagnosed Axis - I insomnia. It is our examiner's opinion that your sleep disorder is less as likely as not secondary to your tinnitus due to your pattern of sleep difficulties in service. It is also our examiner's opinion that your sleep disorder is aggravated by your tinnitus, however the degree of aggravation cannot be determined without resorting to mere speculation. Service connection for insomnia is denied.

Do I have any grounds to appeal this decision? Their own examiner states that in their opinion, it is aggravated by my service connected tinnitus. Any recommendations on how to approach the appeal if I do have grounds to appeal?

Thanks for the advice,

Dale

Dale,

You have a year from the date of the denial to file a NOD. What you should do with the year is gather independent supporting evidence. Go 1 or 2 outside audiologists work with them to provide an IMO supporting your belief that tennitus is causing your insomnia. Once you gather the info then file your NOD, and ask for a DRO hearing. I like hearings because unlike a DRO review you get to present your evidence in person and you can bring a spouce of significant other who can provide witness statements to support your condition. I've had good results from the hearing process VS the review process. This is just my openion of what I would do so take it as you will.

Good luck,

Bergie

Share this post


Link to post
Share on other sites

Ad


Hello,

I am new to this site and must say that I am really glad to have found you as I find the tangled web we know as the VA to be one big pain in the neck.

I am currently rated at 30% for bi-lateral tinnitus and hearing loss. Over the past couple of years my tinnitus has gotten progressivly worse and the noise in my head makes it near impossible to sleep at night. The VA doctors have me on two different meds to help me sleep but the meds are not considered service connected so they are charging me for them. Because of this, I filed a claim for Service Connection for Insomnia as Secondary to the Service-Connected Disability of Tinnitus.

Here is the response I received back from the VA:

Service connection may be granted for a disease or injury which resulted from a service-connected disability or was agrravated thereby.

At our VA exam, you report insomnia and feel tired. Objective findings show that you take Ambien. You have memory problems and have problems with the retention of highly-learned materials. The rest of the exam is within normal limits. You are competent to manage your own funds. Your Global Assessment of Function is 70 which indicate mild symptoms. Our examiner diagnosed Axis - I insomnia. It is our examiner's opinion that your sleep disorder is less as likely as not secondary to your tinnitus due to your pattern of sleep difficulties in service. It is also our examiner's opinion that your sleep disorder is aggravated by your tinnitus, however the degree of aggravation cannot be determined without resorting to mere speculation. Service connection for insomnia is denied.

Do I have any grounds to appeal this decision? Their own examiner states that in their opinion, it is aggravated by my service connected tinnitus. Any recommendations on how to approach the appeal if I do have grounds to appeal?

Thanks for the advice,

Dale

s

Yes, you should file for a DRO review of this decision. In doing so, it would help if you had an outside doctor's statement that it is "at least as likely as not" that your sleep disorder is aggravated by your service-connected tinnitus and then point out the fact that your VA examiner's opinion also states the same and that the rating decision to NOT grant the sought-after benefit is ALSO resorting to "mere spectulation" whereas they should have resorted to the recognized "benefit of the doubt" AND the findings of the VA examiner instead of the mere speculation as shown by the rater in this case.

just sayin..................

(BTW, I suffer from exactly the same hearing/sleep/tinnitus on-going hell as you.)

Edited by LarryJ

Share this post


Link to post
Share on other sites

Hi All,

Just wanted to thank everyone that provided advice on how to handle my claim. I just received a letter from the VA stating that my claim was granted and that they have awarded me a 20% increase in my rating. I didn't think I had a chance when they initially denied my claim. I wasn't going to file the appeal. Thank God I found this site. :smile:

Thanks again for all of the advice,

Dale

Share this post


Link to post
Share on other sites

Hi All,

Just wanted to thank everyone that provided advice on how to handle my claim. I just received a letter from the VA stating that my claim was granted and that they have awarded me a 20% increase in my rating. I didn't think I had a chance when they initially denied my claim. I wasn't going to file the appeal. Thank God I found this site. :smile:

Thanks again for all of the advice,

Dale

Porter,

Congrats, so what new evidence did you submit for the appeal?

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
Sign in to follow this  

  • Ads


  • Advertisemnt


  • Latest News
  • Our picks

    • Survivors- a Must read
      If you are new to hadit and have DIC questions it would help us tremendously if you can answer the following questions right away in your first post.

      What was the Primary Cause of Death (# 1) as listed on your spouse’s death certificate?

      What,if anything, was listed as a contributing cause under # 2?

      Was an autopsy done and if so do you have a complete copy of it?

       It can be obtained through the Medical Examiner’s office in your locale.

      What was the deceased veteran service connected for in his/her lifetime?

      Did they have a claim pending at death and if so what for?

      If they died from anything on the Agent Orange Presumptive list ( available here under a search) when did they serve and where? If outside of Vietnam, what was their MOS and also if they served onboard a ship in the South Pacific what ship were they on and when? Also did they have any major  physical  contact with C 123s during the Vietnam War?

      And how soon after their death was the DIC form filed…if filed within one year of death, the date of death will be the EED for DIC and also satisfy the accrued regulation criteria.
        • Like
      • 17 replies
    • If you are a Veteran, represented by MOPH, you need to know that MOPH is closing down its offices.  This can have a drastic effect on your claim, and it wont be good for you.  You likely need to get a new representative.  

      This station confirms MOPH is closing its doors:

      http://www.kwtx.com/content/news/Waco--Purple-Heart-veterans-service-center-to-close-its-doors-480422933.html

       
      • 0 replies
    • Retroactive Back Pay.
      Retroactive Back Pay - #1Viewed Post Week of March 19. 2018

      My claim is scheduled to close tomorrow for my backpay.
      Does anyone know if it does close how long till the backpay hits the bank?
      Also does information only get updated on our claims whenever the site is down?
      • 44 replies
    • Examining your service medical records...
      * First thing I do after receiving a service medical record is number each page when I get to the end I go back and add 1 of 100 and so on.

      * Second I then make a copy of my service medical records on a different color paper, yellow or buff something easy to read, but it will distinguish it from the original.

      * I then put my original away and work off the copy.

      * Now if you know the specific date it's fairly easy to find. 

      * If on the other hand you don't know specifically or you had symptoms leading up to it. Well this may take some detective work and so Watson the game is afoot.

      * Let's say it's Irritable Syndrome 

      * I would start page by page from page 1, if the first thing I run across an entry that supports my claim for IBS, I number it #1, I Bracket it in Red, and then on a separate piece of paper I start to compile my medical evidence log. So I would write Page 10 #1 and a brief summary of the evidence, do this has you go through all the your medical records and when you are finished you will have an index and easy way to find your evidence. 

      Study your diagnosis symptoms look them up. Check common medications for your IBS and look for the symptoms noted in your evidence that seem to point to IBS, if your doctor prescribes meds for IBS, but doesn't call it that make those a reference also.
      • 9 replies
    • How to get your questions answered on the forum
      Do not post your question in someone else's thread. If you are reading a topic that sounds similar to your question, start a new topic and post your question. When you add your question to a topic someone else started both your questions get lost in the thread. So best to start your own thread so you can follow your question and the other member can follow theirs.

      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.



      Leading to:

      Post clear questions and then give background info on them.



      Examples:

      A. I was previously denied for apnea – Should I refile a claim?



      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?




      B. I may have PTSD- how can I be sure?


      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?





      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 2 replies
  • latest-posts-activity.pngstart-new-topic.pngsearch.png

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

×

Important Information

{terms] and Guidelines