Should I Expect A Denial Letter At Some Point?

[disasta]

Happy Almost 4th Everyone. I have read the boards for a while during my process of my claim and appeals.

Let me explain my situation.

During my time in basic training(2002) we received a pnemonia vacine and since then I have had multiple bouts of pnemonia and bronchitis. I have a small restriction in my lungs from the scaring which I have a rating of 30% for asthma. In December of 2005 I had a particularly bad occurance of pnemonia in which I basically put a hole in my lung. The lung healed and since then I have had serious reflux which the VA is planning surgery(nissen fundoplication) to fix the damage the reflux has done to my esophagus and some additional damage to the lungs. A medium sized hiatal hernia appeared after the incident with the lung. I can only guess the hiatal hernia came from the severe coughing when I had pnemonia which is how the lung got the hole. It took the VA quite a while to figure out why I could not breath and had really bad reflux(by really bad I mean I am maxed out on the medication and I still get an upset stomach and throw up and again will be having surgery in the next few months). My claim was put in when I was discharged in Feb of 06 and denied Feb 07, the appeal was put in and i was granted the 30% in May of 07 for asthma. In June of 07 the GI doctor figured out that the reflux was part of the major problem. The Dr's theory being lungs got tore up during pnemonia/bronchitis but worse with the hole which healed itself. After the award for the asthma my VSO from DAV said I needed to file a new claim for the reflux. I dont know how it was put in but when I got my denial letter it was listed as being filed secondary to the asthma with the argument that asthma does not cause acid reflux. I obviously understand that as being true but do not know how it should go. June of 08 is when I received the denial for the reflux and immediately put in a NOD. I didnt hear anything so in January of 09 and May of 09 I contacted the DAV to see what was going on. They gave me a bunch of evasive answers and was basically told to wait. I sent an IRIS message at the end of June and I received this message:

This is in response to your inquiry dated June 26, 2009, regarding the status of your appeal seeking service connection for hiatal hernia.

Our records indicate that we received your Form 9 on May 4, 2009. You will be receiving information regarding if you want a Board of Veterans Appeals (BVA) hearing or have the appeal go to the Appeals Management Center.

Now I did not send any forms but from googling and pulling up the Form 9 and it saying "appeal to BVA" should I expect that I will be receiving a denial letter for the claim? I cant get ahold of my DAV rep until atleast monday so I am just curious. Any advise of help would be appreciated. Thanks.

[Pete53]

Welcome to Hadit. You need a good Doctors opinion to link your current problems to the shot you received while you served.

Good Luck

[disasta]

Ok for my first claim with the asthma I got the doctors opinion that the asthma occurred during service. Do I still need a seperate one even if I have it all over my VA medical record and active duty medical records?

[Pete53]

Sorry you have already been rated Medical evidence from VAMC should be enough. If not you will need an IMO or Independent Medical Opinion that will match you up for a higher rating

Good Luck

[sharon]

Ok for my first claim with the asthma I got the doctors opinion that the asthma occurred during service. Do I still need a seperate one even if I have it all over my VA medical record and active duty medical records?

You will need for your doctor to opin that the hernia/reflux problem that you now have is secondary to your lung condition. He/she has to make a medical connection between the two. I would also put in for an increase in my service connected asthma as it seem that you condition has gotten worse.

[disasta]

You will need for your doctor to opin that the hernia/reflux problem that you now have is secondary to your lung condition. He/she has to make a medical connection between the two. I would also put in for an increase in my service connected asthma as it seem that you condition has gotten worse.

How can I connect the asthma to the acid reflux. The reflux has caused the asthma to be worse. I cant seem to get them to understand the argument that because of the asthma and pnemonia that caused the hole in the lung which caused the hiatal hernia and current reflux problems. Should I have the doctor add that part into the IMO?

[Berta]

Yes-the IMO doctor needs to make that point and take them step by medically as to the relationship of the 2 disabilities.

Most IMO docs will make direct references to the established clinical record and then explain how the secondaries are due to the service connected condition, and also they should provide citations from medical texts of any known medical associations.

It doesn't hurt to research yourself and provide along with the records to an IMO doctor, any recent good medical abstracts or text info that supports a claim.

There is a topic here under the search feature called Getting an Independent Medical Opinion.

The VA will ignore or reject any IMO that does not conform to this criteria.