Ask Your VA Claims Questions | Read Current Posts
Read Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules
Greg88
-
Posts
111 -
Joined
-
Last visited
Content Type
Profiles
Forums
Events
VA Disability and Benefits Information
VA Benefits News
Store
Posts posted by Greg88
-
-
It's strange I brought a DBQ that the C&P examiner basically copied, but I did not put the ICD codes for all my problems, the funny thing is the DBQ for diabetes does not cover some complications of Diabetes. It covers Erectile dysfunction, the problem is ED is under the Diabetic Autonomic Neuropathy (DAN) umbrella, if you have Type 1 or 2 diabetes for a long period of time you more than likely have symptoms of DAN, but I see nothing covering it anywhere. I contacted my DAV office, but no one has called back as of yet, I hope I'm not walking into this hearing by myself with no support (even moral support would be better than none).
-
Hi everyone,
I have my Proposal to Reduce hearing in 3 weeks, I have a strong Dr.s and letter and a new DBQ which I feel is even stronger because it list's all my actual disabilities. I had my C&P last year and thought I covered all my bases, but the VA still said they want to reduce after 16 years at 100%. Since I have not seen or read much about a hearing, what do they say carry's the most weight, the letter or DBQ.
-
I love the way the VA is very timely with us having to put things and deny because things are late or whatever. It seems that disabled means that we are on a different and strict clock, but they miss things, leave evidence out (or just don't read it) and they get a free pass. I think somebody in Congress should look into these continued clusterfu*ks and start to address them. Does anybody have any idea what the error rate on claims is at this point ?
-
Berta, the funny thing was I was pemanently retired by the Marines for diabetes mellitus type 1, the VA became my sole medical support for 23 years for Type 1, the Type 1 issue should be a moot point, it's 37 years after so the Type 1 is protected. The C&P found the peripheral neuropathy, ED, and the examiner commented on the issue that had made me unemployed in 1997, the hypoglycemic unawareness (which is another secondary related to diabetics who have the disease a long time) the VA does not have anything mentioning diabetic autonomic neuropathy (DAN) in it's DBQs, though it's easy to be found in medical journals and books. I'm seeing an endocrinologist for an IMO a week before the hearing, just for this issue. As Harley said there not looking at the total medical history and I did not realize how important to the VA computer the ICD codes were, now I do. My Dr.s new DBQ will outline what my condition is now and his new letter will say nothing has improved in the last 16 years.
-
So today I received a New Proposal to Reduce that superseded the old one. The new reduction is from 100% to 70%, but there still seeing me as a Type 2 diabetic, the funny thing is the very last line of the original proposal said there reducing to 70%. I think their trying to get me to roll over and accept this. They say the reviewed medical records, well I don't think they were mine, cause when your taking 7 shots a day for the last 7 years, and before that 4 shots a day for 20 years and 2 shots from the begining your not Type 2 your Type 1, but that shows how hard the records are being reviewed.
-
I checked out Ebenefits and your right that is a new letter format, but when I printed out mine, nothing about P&T or the reasons why I'm disabled, it also does not mention anything about the proposed reduction notice I received in July. Did they send a Proposed Reduction letter to you, that should be done before any reductions are implemented, so you have a chance to fight their "plan"
-
Harley, I was wondering if you by chance what the DBQ was for Autonomic Neuropathy, I'm having a tough time even finding an ICD code for it. With diabetes it's now called Diabetic Autonomic Neuropathy (DAN) and it covers ED, Hypoglycemic Unawareness and a list of complications I really don't want to think about (thank god i don't have those is all I say) I see my MD this week and would like to fill out the DBQs for what I have, he filled out the diabetes, and the C&P examiner covered the peripheral neuropathy one. I don't think I've seen anything that covers these problems.
-
Thanks Harley, I was wondering what DBQ would be used for Autonomic neuropathy, I checked Neurology and Endocrine, but did not see it. I have to say I'm a little apprehensive about the hearing. I was'nt till I talked to the DAV SO, and basically he told me he could not support me, I figured at least he would know the in and outs of the CFR, but he says he does not know and all I need is my testimony, which to me sounds like going to a gunfight with a knife. Once again Thank You Harley, Broncovet and Phillip for you excellent input and patience. Please have a nice weekend.
Gregory
-
Harley, yes but according to the CFR before they reduce they have to be able to look at a baseline ie: the exam in 1997 and all the medical history that preceded it. It's not smart to say well I see you as being somewhat improved, you need to compare especially in medicine. As broncovet said it's not a matter of arguing what has already been decided 15.7 years ago, there not showing any material improvement, truth be told how they see improvement is something I find amazing. They say they see improvement, but they don't say where.
In the proposal they freely admit to the neuropathy, retinopathy and ED, the C&P examiner stated she saw signs of the Autonomic neuropathy, but there's no box for it so they act like it does not exist. Actually Harley if they would have read the letter and DBQ that my Dr. prepared, then I would not where I'am. I also like how they completley omit any mention of IU, which they should be looking at, according to the CFR 3.343. I really think this is all because of in 4 years, I'm at 20 years.
Going back through the documentation, it really pisses me off that they say "the evaluation for diabetes mellitus was not considered permanent", for 23 years they provided me with insulin and they don't think it's permanent.
-
Broncovet, I had read Katrina Eagles essay on it and it had slipped my mind about arguing conditions (nobody else mentions these things even though the CFR states it). This is the funny thing here, I thought they had to look at the C&P exam from 1997 and compare it to the 2012, they keep using the rating schedule as there reason (even though they say you must have all the problems listed, they forgot to include the "or", they say you must have A, B, C, D the ratings say A or B, C or D.
Like I metioned earlier I have not worked for 16 years due to the diabetes, so the CFR say's you must show "material improvement", all they say in their proposal "we noted some improvement" but compared to what. Compared to the C&P in 1998 I'm operating at 15-20% of that level now. They see improvement compared to what and they do not go into any detail on exactly where they see improvement.
-
Hi guys, my hearing is set up for the beginning of Oct, I see my private MD next week and are getting a new IMO letter from him and having him fill out a new DBQ. The new DBQ will cover the things he treats me for, the VA has already proven the retinopathy, peripheral neuropathy, and ED. The ignored the autonomic neuropathy (which causes most of the life threatining problems) because it's not on the DBQ, though ED is a sign of Autonomic neuropathy and the NP who did my C&P exam saw it, my blood sugar when I left the exam was 48.
I talked to my DAV rep today and it looks like he like most people have no real knowledge of diabetes mellitus type 1 and he admits to it. So I have to go to the hearing without a real knowledgable backup. I can talk about the medical aspects of my condition, I'm just worried I may be tripped up by some hidden CFR rule. To be truthful it's like George Carlin said: "the game is rigged"
-
Infantry, IRIS is the email system used to communicate with the VA via Ebenefits, log on to Ebenefits and search it's there, I've never used it. I checked Ebenefits at 2:20 a.m. and noticed I too had an Administrative review going on, they closed my case July 22nd and made a boatload of errors saying there going to reduce me from 100% to 40% after 15.6 years at 100%, I'm hoping they realize they made a mistake, but it's the VA you never know.
-
Actually I do not have Type 2 I have TYPE 1, I was at 40% from 1976 till 1996 when I went to 60% and up to a 100% in Jan.1998. I had my C&P in Nov. 1997 and was at 100% 6 weeks later because I had Type 1 diabetes, if you look at the rating s for 100%, note 1 at the bottom clearly states :
Note (1): Evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100 percent evaluation. Noncompensable complications are considered part of the diabetic process under diagnostic code 7913
I take 7 shots a day, I'm on a restricted diet that is brutal to most people, I test my BS 12 times a day, I'm restricted from work and most other things because of the peripheral and autonomic neuropathy, my way of dealing with my hypoglycemia requires hospitalaztions 2-3 times a year, and the strength and loss of weight were covered in the C&P. The proposal to reduce only looked at the C&P exam, the evidence I presented, and that was it, this is from the evidence shown on the proposal, no looking at the all the years of medical evidence from 1976 to 1997 actually 2002 that the VA had accumulated as they were my only medical providers then.
My proposal is loaded with errors, the proposal itself is illegal according to the CFR rules, if they went to a civilian court with this they would be laughed out, it really is deplorable how they treat the veterans. When I was down at the VA to visit my VSO at DAV, there were 5 or 6 men there in their 60s, with proposals to reduce, everyone had shown up because the proposal had reduced their payments (it's to late then, you have 30 days to request a hearing and 60 days to present evidence, strange how their so tight with time when their making most of the mistakes and so free with ours when deciding our claims)
I guess that people realize that I'm a little bitter about this, maybe it's because if one talks to a licensed medical professional about diabetes Type 1 and Type 2, there is no confusion about mixing them up, they are both bad, but it's two different ends of the diabetes spectrum, bad and much much worse. The problem is as I stated earlier Type 1s have been lost in the crowd, there were no where near the amount of type 2s around like they are today when I was diagnosed. Just look how many times I've written I'm Type 1 in the the previous posts and people still say I have Type 2.
-
I have looked at it, it covers a lot of diabetes problems, but it's tilted towards Type 2, it does not show all the complications that affect us Type 1s (granted the ratio of type 2s to type 1s must be 200-1) they have ED under neuropathys, but nothing saying that it's Autonomic neuropathy which also causes my hypoglycemic unawareness and urinary leakage. Like I said the C&P examiner took everything from the DBQ that I handed in with my Dr.s note and put it in her C&P. Harley in the last 15 years Type 1 has been totally eclipsed by Type 2, people in general think their the same, but it's a different situation entirley. I have to say your post on July 27th finally made me realize what there seeing, those ICD codes are very important, I barely paid attention to them, everything that goes in will be detailed, every ICD code will listed in order of importance.
-
Harley, I'm guessing that the VA is using ICD codes so that the computer can "help" with the ratings. The problem with ICD codes is that Type 1 and Type 2 are are interspersed together and input of the last number means a lot. According to the CFR "rules" diabetes rated at 100% should not need all the secondaries claims opened at this point, here are the ratings for Diabetes mellitus :
7913 Diabetes mellitus
Requiring more than one daily injection of insulin, restricted diet,
and regulation of activities (avoidance of strenuous occupational
and recreational activities) with episodes of ketoacidosis or
hypoglycemic reactions requiring at least three hospitalizations per
year or weekly visits to a diabetic care provider, plus either
progressive loss of weight and strength or complications that
would be compensable if separately evaluated ........................................... 100
Requiring insulin, restricted diet, and regulation of activities with
episodes of ketoacidosis or hypoglycemic reactions requiring one
or two hospitalizations per year or twice a month visits to a diabetic
care provider, plus complications that would not be compensable
if separately evaluated ................................................................................... 60
Requiring insulin, restricted diet, and regulation of activities ........................... 40
Requiring insulin and restricted diet, or; oral hypoglycemic agent
and restricted diet .......................................................................................... 20
Manageable by restricted diet only ..................................................................... 10
Note (1): Evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100 percent evaluation. Noncompensable complications are considered part of the diabetic process under diagnostic code 7913.
Note 1 being the most important and relevent to my claim.
The DBQ my Dr. submitted last year should have had all the ICD codes layed out, neither my Dr. or I realized the how important they are in the determinations.
-
Berta and Carlie, the C&P report was 36 pages long, there was no medical opinion, which after reading other peoples posts I thought was strange. But one interesting thing the that the NP had said yes that the DM does affect my ability to work under the Functioning questions. Carlie what should I put up as far as the C&P it's 36 pages, I scanned the Proposal in and it was 6 pages long and 15 megabytes.
-
Berta, yes the body hates stasis, which PN causes, I have noticed now that I'm 57 it's harder to get up when the pain starts in my feet, it was a lot easier when I was 40. I find it amazing how VA examiners nitpick about things that Dr.s in the real world see things much differently than the VA. but doesn't the VA do ultrasounds for diagnosing DVT, oh wait it's the VA.
-
Harley, yes DVT is not uncommon among Type 2 diabetics especially with PN, with the loss of one extremity, ambulation becomes more difficult leading to poor circulation, the PN further inhibits things by not signaling that their is problems. Diabetes main culprit is the attack on the vascular system- that's why so many secondary's to things like IHD.
-
Hi Berta,
I conform to 100% rating except for the hospital visits part, my wife gives me a shot of Glucagon when I'm unresponsive 2-3 times a month, thats the funny on the ratings, there the exact same as 1970, in diabetes we have progressed a little. what used to hospitalize you does not anymore I have a copy of the C&P, I can scan it but don't know how to edit. My POA are DAV, but I've gotten a lot erroneous information the past 2 years, so I take everything with a grain of salt.
-
Harleyman, a DRO made the decision, not a simple rater.
-
Harley, yes I signed the 21-4142 for my MD, but they never requested anything from his office, I thought before they reduced they had to look at the entire picture and see a 5 year sustained improvment. I'm bringing them all medical rcords and a new DBQ, plus another letter, what else do they need, I can't find much more than that.
-
Harley, thanks for the response, my Dr.s letter stated everything that was related to the diabetes and his last line was the diabetes was a personal and totally disabling to me. The problem I suffer from which is the most damaging to me is the Brittle diabetes, this has been well documented by the VA, but they did not use my VA medical records (and if they did, it was not in the list of evidence) I see my private MD on Aug. 12th, I will obtain the documents you asked for and bring them in. I thought the VA before reducing has to show a sustained recorded improvement, I've gotten continually worse year after year. I'm 57 years old and have a disease that is known as one the diblitating there is, what is the medical knowledge of the people rating these days. Sorry Harleyman, it's very frustrating
-
Harley, received the letter today, it's dated the 22nd, filling out my hearing request this weekend and bringing it down to the RO Monday, I was right they are basing it on Type 2 instead of Type 1, they went no further then what I provided at the C&P. Never checked the 22 years of VA medical records before I started using a private MD and only checked the records I brought to the C&P. The kicker is the things they were looking at Retinitis, neuropathy of the hands and proteinurea, when I had my C&P in the 90's, those were not what I was complaining about, it makes me wonder if they even looked at that C&P.
-
So the VA sent the Proposal to Reduce my Diabetes Type 2 from 100% to 40%, theirs only 1 problem, I don't have Type 2 I have Type 1. I have been at 100% for the last 15.5 years and 60% before that. I used the VA healthcare for 22 years for my diabetes and then switched to my present private Dr. 17 years ago, I continued to use the VA till 2002 or 2003 for my eye checks. When I went to the C&P exam in Sept. 2012, I brought a DBQ for diabetes filled out by my Dr., a letter from my Dr. explaining my condition and present complications, and that in his opinion it was permanent and total (he is the head of Internal medicine for a big NY hospital) the only evidence that was reviewed was the Medical records going back to 2004 that I brought and the DBQ that I brought. I'm writing up the letter for the hearing, I'll bring it down Monday. I guess that battle begins now for real.
Which Has More Weight A Strong Dr.s Letter Or Dbq
in VA Disability Claims Research
Posted
Harley, at this point I'd like to know a little about the hearing, what I'll be facing and who I'll be dealing with. The evidence and obvious mistakes in the proposal, the lack of due diligence by the VA in not looking at all records like is required by the CFR, but then again the proposal says they see some improvement, my Dr. has noted that my condition has not improved, it has been in a steady state of decline since 1997. The problem at this point is I have 2 or 3 valid points that should stop the reduction, I have to decide which to start and end with. My Dr. brought up an interesting point, all my lab tests show readings that correlate to a Type 2 (A1Cs all under 6.5), I keep my blood sugar extremely tight, does the computer also pick up on that ?