hypertension Nod +Tdiu?

[abbie1115]

Hello all,

I received a combined 90% rating on November 15th for my initial claims rated as follows:

Stress Incontinence post surgery for cystourethrocele - 60%

Sleep Apnea w CPAP - 50%

Depressive disorder, dythymic disorder - 30%

Fecal Incontinence - 10%

Painful Posterior fourchette to anal verge scar - 10%

Left carpal tunnel - 10%

Right carpal tunnel - 10%

Tinnitus - 10%

Posterior fourchette to the anal verge scar - 0%

Hypertension - 0%

TMJ - 0%

Allergic Rhinitis - 0%

Right ventral wrist scar - 0%

The decision portion states:

"An examination will be scheduled at a future date to evaluate the severity of your service connected Stress incontinence staus post operation for cystourethrocele and Depressive disorder, dysthemic disorder."

My questions:

I have been advised here to apply for TDIU, but I also want to file an NOD for the fecal incontinence and depressive disorder ratings. It even states in my award letter that I claimed my fecal incontinence as "complete loss of bowel control post rectal surgery, rectocele and encopresis". They assigned 10% evaluation for "impairment of sphincter control" based on "Constant slight leakage". It goes on to state that an award of 30% requires involves "occasional involuntary bowel movements, necessitating the wearing of a pad". - I wear a pad, and have worn a pad for daily involuntary bowel movements since my surgeries failed to correct the problems last year. I was told by my doctor that a colostomy is my last option. That is why I claimed "complete loss of bowel control" and forwarded with all of my records. The C&P they sent me to to evaluate my my fecal incontinence was an elderly one-stop-shop gentleman that seemed confused himself about how to rate my GYN issues. My case was a little more extreme than he was accustomed to I suppose, but he did a thorough job of poking around searching for his answers. When he saw the damages I had sustained, his tone changed and he spoke much softer to me. He advised me that if I am denied or lowballed by the VA for my incontinence issues that I should appeal, and now I will..

BUT..

Since an approval of an NOD for higher rating on my fecal incontinence rating would push me over to 100% on its own, and there is no reason for my bladder incontinence 60% or depression rating of 30% to be reduced in the near future as both of those conditions have significantly worsened this year, and filing for TDIU (as I understand it) opens the door to having everything reevaluated - should I just file an NOD for my fecal incontinence? By definition in the rating manual, I was expecting no less than a 60% rating there, and I supplied them 2 inches of documentation regarding it. The only thing I left out were the graphic 8 x 10 glossy photos of my damages, and I'm considering suppling those now with my NOD.

Should I file just an NOD for my fecal incontinence and depressive disorders which would take me to 100%, or should I file for those NODs + TDIU? If both, do I mail them together, or separate to my RO? Would photographs of the perineal scarring that is contributing to my incontinece be considered helpful or unnecessary?

I have tried fruitlessly to get a call back from my RO rep with these questions, none of my messages have been returned, so I hope someone can help me here. The one DAV rep I spoke to was kind, but seemed very uncertain on his responses. I tried other DAV reps, and was greeted with answering machines that told me to try again later. The experts here seem far more knowledgable than any "advisors" I've managed to speak to in person/over the phone. Thank you for any guidance you can provide.

Abbie

[broncovet]

Yes. If you think the rating is too low for fecal incontinence, then file a NOD and appeal it. In the interim if you are awarded TDIU, it may become "moot", but let THEM tell you that.

It may also "not" be moot. Why? Because, if you go "over" 100percent, then you can automatically qualify for SMC S. SMC S is if you have 100 plus 60, and, per Bradley vs Peak, the "100" can be TDIU.

[john999]

Like Bronco says I would file for TDIU yesterday. You want that TDIU date as early as possible. I filed when I was just 30%. You have many conditions that would make a person TDIU. Vets make a mistake by waiting. If you cannot work due to your conditions then file official form for TDIU.

John

[abbie1115]

Thank you both very much. I'll file TDIU on Monday and post updates as they come.

Abbie

[broncovet]

If you are at "less than the maximum" (and you are, at 90%), then you should appeal ALL the issues you dispute.

The pay does not "stop" at 100%. There is "special monthly compensation" over and above 100%.

There is an explanation of SMC, here:

http://www.vetsfirst.org/special-monthly-compensation-ratings-are-you-eligible/

You can/should also appeal the effective date of your award if you disagree with the date the VA came up with.