Greg88

Harley, after looking at things on Ebenefits, I realize that not all things are making it there, but after calling my 2 MDs, Primary and opthalmologist and finding out no records have been requested makes me think someone made error and then carried it all the way thru. According to the DAV SO, this proposal is calling for me to be reduced from 100-40%, not 60% where I was almost 17 years ago, now DAV has been wrong before, last July I was told my 100% was being reduced to 0%, never heard about that either. But how many Type 1 diabetics start getting better after 37 years with disease, I have been unemployed for the 16 years due to being a uncontrolled diabetic. I see DAV on Monday, I'm bringing the Dr.s note I brought to my C&P (it explains my condition, how long he has treated me, and in his opinion, that I'm permanently and totally disabled due to the diabetes) I will also bring the DBQ he filled out, if you can think of anything else please let me know. I see my Dr. on Aug 12th and will get new documents.

John, I have Type 1, the list of secondary conditions related to the disease are a mile long, with DMII, some may be related, but with Type 1 most medical professional's "say yes it's the diabetes" and after 37 years with disease, most of the Dr.s I visit with skin cancer, hypertension, say it was caused because your diabetic. According to Ebenefits, they never checked with the Bronx VA Hospital, that I had been going to for the 1st 22 years of the disease, if they would have checked, they would have learned that I'm a Brittle diabetic or as the term used these days uncontrolled, it's been this way for the last 37 years. I realize that the VA is overwhelmed now with claims, but a little due diligence on their part. The funny thing is I'm chained to an insulin bottle, the only thing that can cure me is an islet transplant and with my age and complications that was taken off the table 10 years ago.

I was just looking at Ebenefits (seeing what they used to make a determination) in the comp claim the only thing solicited was the C&P report, the unsolicited things were the letter from opthamologist I suppled at the C&P, the DBQ from Dr. given to the examiner at the C&P, the letter from my Dr. (a Nexus type letter-I know I'm SCed, but you hedge your bets anyway), and the Release of Info for my MD. According to Ebenefits they did not solicit any medical records (called my MD and opthalmolgist, no one asked for my records), so it looks their basing their proposal for reduction only what they saw in front of them. Did they think that the insulin that I need fell from the trees, this is a disease if you don't have insulin you die, now don't get me wrong, this make happy, produce the evidence and the proposed reduction should disappear, notice I said should.

Harley, thank you for the advice made appt.s today with DAV for Mon. and my private MD, to find out whats really going on, I will stop at DAV and the RO which is across the hall from them and get copies of my award letters so I can see what they are actually trying to reduce me on. In my mind and most of modern medicine, diabetes mellitus type 1 is as a disease that attacks across the whole body, most of the things that diabetes affects have disabled in my body ie: ED, PN, hypertension, but for me the worst thing has been the hypoglycemic unawareness, like I mentioned in an earlier post my BS was at 48 at the end of the C&P exam, most jobs will not touch you with what I have. I see my private MD on the 12th of August, I will have fill out 2 new DBQs for diabetes and PN, after 37 years of living with the disease I have been unemployed for the last 17 years, what do they want from me.

Harleyman, The C&P I had in Sept. 2012 was the 1st since Nov. 1997, I see my private MD 4-6 times a year, the thing is I have been a Brittle diabetic for 37 years now, I have passed out in the Bronx VA hospital 15-20 times, at Dr.s appt.s waiting to be seen, it now has come to the point that I have no warning when my sugar will drop, at the C&P exam the examiner noted that my blood sugar was 48, I'm pretty sure the raters in 1997 looked at this info when they made me 100%, the raters today proably not. The problem is at this point in my life I cannot my blood sugar get to high, who know how much my kidneys have left. The C&P examiner said to me when I asked her why the VA had never classified my Diabetes Mellitus as permanent "because they really don't understand the medical ramifications of the disease" I know I have a Pre hearing before they actually do anything, who do I get to fight with me at this hearing- a VSO, an attorney, Congressmen, at this point I don't know where to start.

Harleyman, I gave them a DBQ on diabetes and Peripheral neuropathy and a letter from MD, before the C&P, I don't have DMII, I have Type 1 which is much more debilitating to the body, though I think you did hit on part of the problem. I think the raters are so used to DMII, that they are stacking me up next to the DMII claims and the disease has a much more brutal record the longer you have it, which is 37 years. By the CFR rules though, they have to show a sustained improvement over the last 5 years and I can guarantee that has not happened.

Thanks Carlie, I'm thinking a lot of this could have been stopped if DAV took a more active role in it, I've spent the last hour and a half going over the C&P exam and my Dr.s note and DBQ, it should at least gone to IU in the least, actually it should have started there in 1997.

Calling my MDs offices they have had no inquiries from the VA at all, so they just used the C&P which was negative in ways that showed my condition has gotten worse. Is their anyway to nip this in the bud, before they can implement a reduction. It's hard to believe a rater can do something like this all by themselves.

So I went on Ebenefits and saw that they closeded my claim, I called my DAV office and was told they are proposing to reduce me from 100% to 40% based on improvement in my condition (what a joke), though they had a ton of evidence saying the other way around, this is what they do. What do I do next, get a lawyer, go back to DAV any help would be appreciated.

Phillip, The C&P in Sept. 2012 included an eye exam by an optometrist, I had brought a letter from an opthamalogist (one of the best on the East Coast) because the letter in Jan. 2012 said they were looking at Retinitis (nothing to do with diabetes so proabley a mistake) but with the VA I know you have to cover your bases. I was researching the CFR and looked at the Ratings for diabetes mellitus in section 4.119.1, 7913 lists the disabilities and the breakdown from 100-10% but an interesting little thing is at the end. Note (1): Evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100 percent evaluation. now this is what they used to give me a 100%, but the VSO who I saw on Friday told me that the rater said they were going to break it down individually by disability, and they have changed how they do it. Now the copy of the CFR I downloaded was the 2012 revision and nothing has changed on how they rate for diabetes, so they can't just change things in midstream can they ? The ED was on the record when I talked to the VSO friday, the examiner noted more things on the C&P and lttle things were even accounted for, she covered 36 pages in progress notes (she was a Nurse Prac.) After reading the many Forums talking about the VA these last 2 years, I do not trust them legally or medically.

I have been SC for the last 37 years with the VA, right out of the service at 40% with Diabetes Mellitus Type 1. I'm also have been Brittle (meaning my blood varies from low to high- in my case mainly low), for the last 37 years, I used the VA health care for 21 years, in 1996 I was bumped up to 60% because of Neuropathy in both feet, Proteinurea, and generally poor control due being unaware that sugar was going low (I passed out at work and lost my job in late 1996), I put in for 100% in 1997, Nov. 1997 I had my C&P. In Jan. 1998 I was granted 100%, my VA endocrinologist (who was my MD since the very beginning 21 years) retired from the VA, after 6 months of seeing Endo residents, I stopped using the VA system. I started the to see my private MD (I had been seeing him regularly for physicals and general medical for a year before my VA doctor retired. After being awarded the 100% the only time I heard from the VA was for COLA increase's, in 2012 I receive a letter from the VA saying they are setting me up for a physical because my Diabetes Mellitus in not considered Permanent. Sept. 2012 I see my private MD and have him fill out the DBQ for diabetes and peripheral neuropathy, he also includes letters from opthamologist showing I have Diabetic Retinopathy, he also writes a Nexus type letter (I know I'm SCed, but with the VA you have to hit the over the head) saying this disabilty and it's complications are permanent (My MD is not a general practioner, he is the head of internal medicine for a large prestigous hospital in NY), I have my C&P, I get a copy 3 weeks later, the C&P results are a carbon copy of my Dr.s DBQ and note. A brief overview, I take 7 shots a day, test my BS 12 times a day, my blood pressure is high (common in diabetics, 4 medications to control) the neuropathy is so bad I cannot stand or sit for more than 10 minutes, I sleep 3-4 hours a night and need 20 mgs of Ambien and a muscle relaxant to do that, my vision is poor, I urinate 40-50 times a day. My diet is strictly controlled, low protein due to protein urea, low fat due hyperchlosteroemia, and of course now I have Erectile Dysfucntion I called the 1-800 in Nov. and was told they reached a decision, actually nothing was decided, the farmed out part of my for an Admin Review, that was decided 3 weeks later. By 2013 no decisions, in March 2013 a new claim. a Rating Review, of course the compensation claim is still listed as Diabetes Mellitus (New). DAV who is my POA has been totally useless, when you do manage to get someone on the phone they give you the info, on March 15 I see my Comp claim go from Gathering to Preparation for Decision. To the present day on Friday July 19th, I decide to go down to DAV and ask whats going on (In Sept it will be 1 year since the C&P and the VA may declare it invalid), 9:00 in the A.M. DAV tells me to come back 2 hours later, I go to the RO across the hall (there in the same Building) and talk the VSO thats their, he's also a Diabetic and he's wondering why I'm not P&T, he calls up the Rater upstairs and she tells him that they are looking at each complication seperatley. So looking at Ebenefits and the unsolicited items I submitted ( under the things the VA solicited were just the C&P exam) the VA showed the Dr.s letters and DBQ and that was basically it. My question is if the VA looks at my Diabetes at the 60% rate and starts adding the peripheral neuropathy and others complications using VA math, it does not add up to 100% and I know that in 3.5 years I'm at my 20 year mark and theirs nothing they can do at that point, I just have a feeling they are going to try and lower it just to save money. Any input would be appreciated.

The organization is in the crapper, in Jan 2012 I received a letter that I may be set up for my 1st C&P after 15 years at 100%, I called DAV and got a SO, he told me "many vets received those letters, it was a computer generated letter and it was sent out by mistake, don't worry about it" 2 months go by, it's now March I call again (at least they were answering the phone) I'm told that the VSO checked and it was a mistake. I call again in late May of 2012, just double checking, "once again the VSO says nothing to worry about you will not get a C&P" On June 3rd I take off to my sisters house for 2.5 weeks- on June 6th a letter from the VA saying that I was being set up for a C&P, the VA Medical Center would set me up, on the 9th the letter came for an appt. on the 19th. I got home on the 21st, almost had a heart attack, called the VA hospital and DAV (they were away at a conference) finally get in touch with them on the 27th or 28th, told to write a letter explaining what happened. For the next 2 months I'm told their will be no C&P, they will decide next week. September comes and I have a C&P on the 13th, C&P shows that things have gotten worse in the last 15 years (35 years with Diabetes Type 1) it's to be expected, now the phone calls to DAV remain unanswered, when someone does pick up the phone it's the receptionist, no VSO response finally I'm told that everything will be decided in Nov., nothing happens except part of the claim is shipped to Lincoln, NE and then it is shipped back 21 days later closed. The compensation claim still rolls on, DAV still does not call, I go down there in Feb. 2013 and the DAV SO tells me they won't even look at my claim till late March. So from March until July the only way I get any news is from the 1-800 #, finally frustrated as hell I go down to the DAV office (it's located in the RO in Manhattan) the place is empty just me and another vet, and we are told we now need an appt. I'm pissed so I go over to the RO office across the hall and learn that by showing up and asking I get moved from Prep to Pending and was told the rating will be in next week (it might have helped that my Congressmen called last month also) DAV took my lifetime money in 1986 and delivered good results in the 90's, but it seems to be a totally different place now.

I went to the DAV at the Manhattan NY RO, 9:00 A.M. Friday morning, another vet was already there. The receptionist asked us both if we had an appointment, since I have been calling for the last 2 months and had not talked to anyone, because no one answers the phone, I said no and the other vet said no also, we have no appts., we are both told to come back in 2-3 hours. The funny thing is that NY is going thru a massive heatwave and I got their early so I could be home before I was roasted. I walked across to the RO and asked about my claim and was told I should have a rating by next week, being pessimistic, I checked Ebennies and lo and behold my claim moved from Prep for Decision to Pending Decision approval. In the 90's the DAV provided me with a lot of help, but the organization has really deterioated.

I have been SCed vet for the last 37 years all due to Diabetes Type 1, I was 40% in 1977, 60% in 1995 and 100% in 1997, I had a C&P after 15 years at 100% in Sept. 2012. My private MD (who I have been seeing for the 16 years) gave me a DBQ and a Nexus type letter saying that my diabetes and it's complications were permanent and he saw little chance of my improvement. The C&P examiner agreed with all my Dr.s findings and added a few more on her examination. On 10/02/2012 my claim was farmed out to Lincoln, NE and closed on 10/26/2012, the 1-800# told me the VA hade made a decision and I should hear something in the mail, DAV who is my POA did not call me back or answer an e-mail. November went by and nothing called DAV, emailed DAV, nothing, the 1-800# tells me one day they made a decision, 2 weeks later no decision has been made, on Ebenefits my claim went from Prep for Decision to Gathering of Dust on 11/20/2012. Called DAV nothing back, December nothing new, January nothing new, Febuary nothing new, numerous calls and e-mails to DAV and zero response back. March, Spring is in the air and I call DAV, the reciptionest tells me I'll get a call back-I'm thinking where have heard that before. I get a call at 2:45 P.M. and the DAV rep tells me well since your insulin has been increased, you should not expect an increase in your disability-WTF, my insulin requirements have nothing to do with disability rate at this point, I told the rep "I'm not looking for an increase, I'm at 100% already" he stammered and then tells me well you've been at 100% since 2007, I told him no it been 100% since 1996. "oh they have not updated the record". Basically I think I got the office newbie, who knows little or nothing about claims, instead of clarifying things, DAV just muddys up the water a little more.

Hi Everyone, So far I have not received a bit of documentation from the VA or DAV, calling the 1-800 gets me a different story each time, I called 2 days and was told it could up to a year before any decision is made. DAV who is my POA has not returned a call or email in 4 months, so I think I'm going to make a visit to my Congressmen and let him deal with it. Looking at my case it's pretty cut and dry, Diabetes for 36 years (all insulin dependent) 40-60-100% progression all well documented by the VA, a new DBQ and letter from my private MD of 16 years stating this is P&T and is getting worse, then a C&P in Sept. showing the same things my private MD stated in his DBQ and letter. I figured with all the overwhelming evidence, they would be finished and done. But this is the VA where even the simple becomes complicated. Greg

No I was at 100% for the DM Type 1, the VA had not contacted me at all for 15 years (except COLA increase letters) then in January of this year, I got a letter stating they wanted Reevaluate my case, C&P in Sept. which confirmed the original 100% (except now things have increased in severity and a few more complications have popped up all were noted on the C&P DBQ) I know from all the reading if the VA is not bothering you, just leave them alone and don't rock the boat. On Ebenefits it has me listed a Diabetes mellitus (New), 36 years of being SC and they still consider it a new problem.

So I called the 1-800 number and was told that the Regional office wants to see the Medical Records I submitted during my C&P exam, I asked what about the decision that was already made the response was "no decision was ever made" Ebenefits now has me listed as Gathering Evidence. I called DAV, did not get an SO, the receptionist is checking the computer and trying to make sense of things. I guess the only way to get a straight answer at this point is to go down to the Regional Office and ask questions.

So I checked Ebeneifits and see that the the original claim went from Pending decision approval to Gathering of Evidence, if though the 1-800 number told me the decision has already been made, it also says that a development letter has been sent, but nothing as of yet. It seems that Ebenefits is really out of the loop as far as whats really going on.

So I had my C&Ps in Sept. (I'm Diabetic Type 1 for 36 years) this was the 1st C&P in 15 years for Diabetes and it's complications, I've been 100% for 15 years. C&P generally agreed with everything my private MD had put down on the Diabetes DBQ that I had fill out. My claim was sent from NY to Nebraska for a "Review" on Oct 2, and was closed on the 26th, it was sent back to NY and now is in a new claim 'Rating Review", I called the 800 number and was told the decision was made and I should see something in the mail. I know Ebenefits is sketchy at best and I'm wondering if the 800 number just basically tells you whatever will get you off the phone. I'm just curious about how long after they make the decision, that they mail you something.

So after they closed my case in Lincoln, Nebraska on Friday, last week (it was farmed out there on10/02/12) a new claim shows up as a Rating Review under claim type, the original case is still at Pending Decision Approval. Since I've been at 100% for the last 15 years for Diabetes Type 1, I'm wondering if this just the VAs way of crossing it's Ts and dotting it's Is, or maybe there is something more involved. My AB8 still shows 100%, the RO in Manhattan is more than likely under water from Sandy so I'll be looking at more time. Just curious what a Rating Review Claim is.

So my case (I've SC for 36 years, the last 15 years at 100% for Diabetes Type 1 with complications) was sent to Lincoln, NE for Regulatory or Procedural Review in 10/2/2012, the original case was listed as Diabetes which showed my original RO as the office that was handling everything now show's Lincoln, NE as sharing the case, the Regulatory or Procedural Review showed up as something seperate on 10/2/12. Tonight I checked Ebenefits the Regulatory or Procedural Review was listed as closed with Appeal possible, the original case was at Pending Decision Approval. Since I've been at 100% for the last 15 years and my AB8 still shows 100% and the same amount of money as last month, should I expect any big changes (the C&P exam that the VA examiner did echoed all the things my private MD listed in the DBQ he did) Greg

So I'm wondering how is Lincoln,NE RO compared to other RO's in settling claims, my DAV SO told me the soonest the VA would look at my case was Oct. 19th, he told me this on the Sept 31st, then the switch to the NE RO in Oct., my DAV SO tells me it's a pretty simple claim compared to other's in the system. The VA was my primary provider fro 1976-1997, then I went private and gave them my MDs letter and filled out DBQ, C&P exam in Sept. affirmed my Dr.s DBQ, in my eyes it's pretty cut and dry. It's funny with the condition I have I need an MD's care, it's not like I can disappear for 4 or 5 years and not seek medical care, a week without insulin and a needle and I'm knocking on the deaths door. For the last 36 years the VA has been saying my condition is not permanent, I wonder what it takes to convince them. Greg

So they transferred my claim from the NY RO to the Lincoln, NE RO, it shows that they received pieces of the evidence I submitted (Letter from private MD and permission to contact my MD), but not the DBQ my private MD filled out or medical records that were submitted. With the transfer they changed my claim from "Preparing for Descision" to Regulatory or procedural Review, does the process start over or do they just look at the what they have ie: C&P done on 9/11/12 (exactley the same as the one my private MD filled out, though the C&P examiner noted my peripheral neuropathy is worse than my MD stated) or do they keep going thru things. I've been at 100% for the last 15 years, 2 years at 60% and 20 at 40% all for Diabetes Type 1 and it's complications. With the VA I know one should expect surprises, even though the evidence all leans in my favor, but reading in many posts that they have decided to cut someone back makes me wonder. Greg

I was just checking Ebenefits and looked at Claim Status and a new claim box was added, with todays date, no mention of whats being reviewed. The address thats listed is in Lincoln, Nebraska, my old claim with Diabetes as the problem is still there with Prep for decision under Status, I'm wondering if their looking at the new complications that have popped up in the last 15 years and were listed in the C&P I had on the 11th, any idea's anyone. I've been SC for 36 years with Diabetes type 1, 40% for 21 years, 60% for 2 years and 100% for the last 15 years, all related to diabetes and it's complications, but why send it to Nebraska.

Hi, like others on the board my AB8 letter disappeared and reappeared, with the cryptic message about evidence past due and letter sent. Is this just VA boilerplate, or does it mean there's some movement on the claim or is Ebenefits just blowing smoke as usual. Greg