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SgtE5

Looking For Advise On Adding A Rebuttal To An Appeal

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First like to say that anyone that has access to myhealthvet should use the blue button to download your va medical records. I found out they are working on my nod or at least was in 2016.

I filed for compensation for tinnitus June 2015. Was denied in April 2016. Filed a NOD with a imo that stated "more than likely" related to service.

So today I downloaded my medical records from myhealthvet and saw an entry dated March 2016 by the same c&p examiner that said "less likely as not" she now has my str. She didn't at the c&p. She also had the imo I sent in wiith my nod. When I went to see the independent audiologist, I had my complete str with hearing examines during my service. She noted that "His
previous hearing tests were reviewed and revealed normal hearing bilaterally with minimal decline over the years."

But the c&p doctor says in the updated notes from 2016:

"Private Medical Records reviewed:
Audio: 2 Jul 15: Florida Meidcal Clinic:
Mild SNHL AD and normal hearing sensitivity AS with excellent word
recognition scores for AU: Dr. opined that Veteran's current HL and tinnitus
is a result of military noise exposure: (Examiner's note: Dr. did not
have access to Veteran's STRs so Dr. was unable to assess Veteran's
hearing status when Veteran was on active duty)"

The c&p doctor is fixated on without hearing loss, there is no tinnitus. She again states less likely as not in her updated 2016 notes.

My question is should I send in the copy of the updated c&p notes and the imo and highlight where the private doctor states "His
previous hearing tests were reviewed and revealed normal hearing bilaterally with minimal decline over the years."

And while I'm at it, I was giving a tinnitus question & answer pamplet from the va that says "The most common cause of tinnitus exposure to loud noise" Nothing in the pamplet says usually associated with HL. Should I send that in as well?

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What was your MOS and do you have a CAR Award listed on your DD214?                                                                                                                                                                                                                 How about posting a redacted copy of your Denial Letter, to include the page where the Rater discusses the Reason for the Denial and the Evidence Reviewed.                                                                                                                                                                                                                              If you haven't obtained a copy of the Audiology C & P DBQ from your MHV, do so, redact and post it.                                                                                                                                                                                                                                                                                                During your C & P Exam, what did you tell the Clinician regarding the development and progression of your current Tinnitus symptoms?                                                                                                                                  Semper Fi

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It would help if you posted a redacted copy of your denial (cover all personal information name claim # ect,,,ect,,)

 If your still in the limitations  with your NOD?

Request a DRO HEARING (ASAP) in your NOD or if you sent your NOD then send in a Request for the DRO Hearing..MAIN THING IS KEEP YOUR APPEAL GOING b/c its been over a Year Since you filed your NOD (Correct?)

You may need to file a Reconsideration. (not sure if your NOD time limit as run out?)

I would go get a private IMO using a specialist  and ask the specialist to read your pertinent medical records from the VA  about your hearing test & what the Audiologist mention.

Let the specialist know what you did in the military and just let him know what the VA Audiologist mention & the C&P Examiner

Ask the specialist to examine you and re test your hearing.

The private test must be done under the VA Guidelines  and use the Maryland CNC Word test. (found here on hadit) the Dr must be license in his state and certified, the specialist can call the your VAMC Audiologist Dept and request in CD the Maryland CNC Word test(about  7 or 8 bucks I think)  your VAMC should have all the test they have performed on you  and its in CD Format.  (and you can request a copy) have the specialist to compare his test with there's.   

 and also state what you stated your MOS was in the military &  as you mention that you do not hunt or been around loud noise since your military service,   then the specialist can give is Impression of his exam  that it is least likely as not your HL & TINNITUS was caused & related to your  military service  to be bilateral   Noise Induced HL and veterans states a rining/ buzz sounds in his head  as this sound is known as Tinnitus, Tinnitus is medically know to be caused from Noise induced hearing loss, and the Dr needs to give a medical reason behind his opinion and his credentials and years of experience.

The specialist can opine all this.

you need to ask the Dr to use these words as this is what the VA likes to use or read as their language

(IS LEAST LIKELY AS NOT) 

Now please realize this is just for service connection, the ## on the Hearing Test Scale will reveal how much hearing loss you actually have and the VA Raters go by a rating chart used especially for HL.

Hearing loss and Tinnitus are in no doubt (in my opinion) the hardest to win in a VA Claim.

Edited by Buck52

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Thanks Gastone for the reply.

My mos was 3531 motor vehicle operator. Has a listing in the Duty MOS Hearing Loss Probibility Chart-VA Fast Letter 10-35 as moderate probable exposure to noise. Yes I do have a CAR from Desert Storm. The c&p doctor never asked how long I've had tinnitus. Just what noises I was exposed to and about after military. Funny thing is that in her report, she states I was exposed to explosions.

 

VA Denial.docx

C&P1.pdf

IMO.docx

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Thanks for the reply Buck. The independent doctor I went to actually interned at the St. Petersburg VA hospital. She read my str hearing tests and va tests. Did her own tests and opined that "more than likely" my tinnitus is related to military. When I filed my NOD in 2016, I asked for a DRO hearing.

The c&p doctor just keeps copying the opinon from the Military Service Implications for Hearing loss and Tinnitus study that was done in 2005.

Rationale for Opinion Given: The induction and separation
audiograms indicate normal hearing bilaterally. There is insufficient evidence from
longitudinal studies in laboratory animals or humans to determine whether
permanent noise-induced hearing loss can develop much later in one's
lifetime, long after the cessation of that noise exposure. Although the
definitive studies to address this issue have not been performed, based on the
anatomical and physiological data available on the recovery process following
noise exposure, it is unlikely that such delayed effects occur".

Reference: 22 Sep
2005 Institute of Medicine's landmark study: Noise & Military
Service: Implications for Hearing loss and Tinnitus.
In the absence of an objectively verifiable noise injury, the
association between claimed tinnitus and noise exposure cannot be assumed to
exist. Tinnitus may occur following a single exposure to high-intensity
impulse noise, long-term exposure to repetitive impulses, long-term
exposure to continuous noise, or exposure to a combination of impulses and
continuous noise. However, you would have to accept the scientifically
unsubstantiated theory that tinnitus occurred as a result of some latent,
undiagnosed noise injury. IOM never stated that tinnitus could result from
undiagnosed noise injuries. In most cases, tinnitus is accompanied by measurable
hearing loss. We recognize that the audiogram is an imperfect measurement.
Nevertheless, it is accepted as the objective basis for determining noise
injuries.

 

Edited by SgtE5

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