Is The Va Getting Ahead Of Themseves

[Hughie]

Hi all,

Did some searching of the forum first to see if there was already an aswer to my quetion but no luck. I am currently rated at 10% for cluster Headaches under 8100 and have been since getting out in 97. Over the years my Headaches have gotten worse and in April of 09 while in California I put in for a re-evaluation via local County VS. I have since moved to North Carolina and finally gotten everything moved to Winston-Salem.

After getting everything moved myself. The DAV suggested doing it myself as they were afraid if they tryed taking over prolong the proccess but have offered to handle any chalenge. I had to do a lot of the paperwork over again to get medical records requested and send in my statements again which is fine but I got a compensation exam scheduled for next week with QTC and after that was scheduled I just got a letter from the VA saying they just sent requests for medical records out.

My question is "Don't they normally get or attempt to get all medical records before scheduling a compensation exam?"

I am also affraid they don't have all my statements since these were sent in with my forms to request medical records.

[Hughie]

I will scan it in a bit. We are flabbergasted right now.

I think I found part of their reasoning. The Conditions they were rating me for has changed. They no longer say "due to medications taken for cluster headaches" at the end.

That is the other thing. I would think that they would at the least, since they agree, decide they are not monetarily ratable and give me a zero percent. I got nada, period.

[Hughie]

Here is the document. Thanks Berta!

vasecondary2.pdf

[Hughie]

Went in and talked to the DAV. The service rep had not heard of being able to get secondary based on medication prescribed by VA causing issues so he contacted the County VA Services to work with them. They just called me back as they were doing research the past few days.

Together they have figured out that yes the VA will give a secondary caused by medications for a primary. They believe the reason for the denial is it was filed incorrectly and should have been done so under a Sec 1151 code. They suggest we refile the claims under that referencing the original improperly filled claims in hopes that the VA would use the original claim date.

I have a few concerns about this.

1. Sec 1151 Claims appear (from my limited research) be for medical malpractice on the VA's part. The problems I have from the medication are know side effects. I can choose not to take the medication and not have the side effects and have worse headaches as well.

2. I would be loosing my original Claim date. Although does it really matter at this point.

3. Which would really be faster? Appealing or Sec 1151 claim. I heard an 1151 can take just as long or longer and are rarely awarded.

[Berta]

Sorry I missed your Dec 11th post.

They are saying this condition (the numbness) isnt chronic and it has not been diagnosed as some sort of neuropathy etc.

"Together they have figured out that yes the VA will give a secondary caused by medications for a primary." Gee I thought all VSOs knew that!

" They believe the reason for the denial is it was filed incorrectly and should have been done so under a Sec 1151 code."

I suggest when a vet has a secondary condition solely due to a primary SC or any SC meds they take they should file under secondary and also 1151 too.

"I can choose not to take the medication and not have the side effects and have worse headaches as well." That would be mitigating any damage from the med that causes the secondary problem but I don't see how the VA will compensate you if this is not a chronic condition and if it disappears if you don't take the specific med that causes it.

Is the vertigo and dizziness also claimed as due to this med?

[Berta]

I see they did cover the vertigo etc-----

they are saying these are known side affects of the specific med -however these do not leave you with a chronic and ratable condition.

What has the VSO said as to that point?

[LarryJ]

Berta is correct. If the medications that you are taking cause problems and the NOT taking of those medications cause a reversal of these bad symptoms, then these symptoms are, arguably, NOT a result of your service-connected disability.

Albeit, when you do take your problem-causing medication then your original, service-connected, disability is improved, then you could, quite literally, file for an increase in your original, service-connected disability, due to it's worsening, due to your IN-ability to take the drugs that are causing you problems and un-toward reactions.

Just file for an increase in your service-connected disabilty, get a c&p of this condition while NOT taking the drugs, or, at least, get a medical opinion, either thru a c&p or via a private physician, stating your condition were you NOT taking these drugs.

You CAN play their game, you just need to know HOW.

........sheeeesh, the "games" we adults must play...........never ceases to amaze me. I swear, sometimes I think that I am dealing with a room full of unruly 10 year olds, instead of a branch of our government.