Brandy

Ricky, This is the GM exam that the VA uses: General Medical Examination Narrative: This is a comprehensive base-line or screening examination for all body systems, not just specific conditions claimed by the veteran. It is often the initial post-discharge examination of a veteran requested by the Compensation and Pension Service for disability compensation purposes. As a screening examination, it is not meant to elicit the detailed information about specific conditions that is necessary for rating purposes. Therefore, all claimed conditions, and any found or suspected conditions that were not claimed, should be addressed by referring to and following all appropriate worksheets, in addition to this one, to assure that the examination for each condition provides information adequate for rating purposes. This does not require that a medical specialist conduct examinations based on other worksheets, except in the case of vision and hearing problems, mental disorders, or especially complex or unusual problems. Vision, hearing, and mental disorder examinations must be conducted by a specialist. The examiner may request any additional studies or examinations needed for proper diagnosis and evaluation (see other worksheets for guidance). All important negatives should be reported. The regional office may also request a general medical examination as evidence for nonservice-connected disability pension claims or for claimed entitlement to individual unemployability benefits in service-connected disability compensation claims. Barring unusual problems, examinations for pension should generally be adequate if only this general worksheet is followed. A. Review of Medical Records: Indicate whether the C-file was reviewed. B. Medical History (Subjective Complaints): Discuss: Whether an injury or disease that is found occurred during active service, before active service, or after active service. To the extent possible, describe the circumstances, dates, specific injury or disease that occurred, treatment, follow-up, and residuals. If the injury or disease occurred before active service, describe any worsening of residuals due to being in military service. Describe current symptoms and treatment. Occupational history (for pension and individual unemployability claims): Obtain the name and address of employers (list most current first), type of occupation, employment dates, and wages for last 12 months. If any time was lost from work in the past 12-month period, please describe the reason and extent of time lost. Describe details of current treatment, conditions being treated, and side effects of treatment. Describe all surgery and hospitalizations in and after service with approximate dates. If a malignant neoplasm is or was present, provide: Date of confirmed diagnosis. Date of the last surgical, X-ray, antineoplastic chemotherapy, radiation, or other therapeutic procedure. State expected date treatment regimen is to be completed. If treatment is already completed, provide date of last treatment. If treatment is already completed, fully describe residuals. C. Physical Examination (Objective Findings): Address each of the following and fully describe current findings: The examiner should incorporate results of all ancillary studies into the final diagnoses. VS: Heart rate, blood pressure (see #13 below), respirations, height, weight, maximum weight in past year, weight change in past year, body build, and state of nutrition. Dominant hand: Indicate the dominant hand and how this was determined, e.g., writes, eats, combs hair with that hand. Posture and gait: Describe abnormality and reason for it. Describe any ambulatory aids. Skin, including appendages: If abnormal, describe appearance, location, extent of lesions. If there are laceration or burn scars, describe the location, exact measurements (cm. x cm.), shape, depression, type of tissue loss, adherence, and tenderness. For each burn scar, state if due to a 2nd or 3rd degree burn. Describe any limitation of activity or limitation of motion due to scarring or other skin lesions. NOTE: If there are disfiguring scars (of face, head, or neck), obtain color photographs of the affected area(s) to submit with the examination report. Hemic and Lymphatic: Describe adenopathy, tenderness, suppuration, edema, pallor, etc. Head and face: Describe scars, skin lesions, deformities, etc., as discussed under item #4. Eyes: Describe external eye, pupil reaction, eye movements. Ears: Describe canals, drums, perforations, discharge. Nose, sinuses, mouth and throat: Include gross dental findings. For sinusitis, describe headaches, pain, episodes of incapacitation, frequency and duration of antibiotic treatment. Neck: Describe lymph nodes, thyroid, etc. Chest: Inspection, palpation, percussion, auscultation. Describe respiratory symptoms and effect on daily activities, e.g., how far the veteran can walk, how many flights of stairs veterans can climb. If a respiratory condition is claimed or suspected, refer to appropriate worksheet(s). Most respiratory conditions will require PFT’s, including post-bronchodilation studies. Describe in detail any treatment for pulmonary disease. Breast: Describe masses, scars, nipple discharge, skin abnormalities. Give date of last mammogram, if any. Describe any breast surgery (with approximate date) and residuals. Cardiovascular: NOTE: If there is evidence of a cardiovascular disease, or one is claimed, refer to appropriate worksheet(s). Record pulse, quality of heart sounds, abnormal heart sounds, arrhythmias. Describe symptoms and treatment for any cardiovascular condition, including peripheral arterial and venous disease. Give NYHA classification of heart disease. A determination of METs by exercise testing may be required for certain cardiovascular conditions, and an estimation of METS may be required if exercise testing cannot be conducted for medical reasons. (See the cardiovascular worksheets for further guidance.) Describe the status of peripheral vessels and pulses. Describe edema, stasis pigmentation or eczema, ulcers, or other skin or nail abnormalities. Describe varicose veins, including extent to which any resulting edema is relieved by elevation of extremity. Examine for evidence of residuals of cold injury when indicated. See and follow special cold injury examination worksheet if there is a history of cold exposure in service and the special cold injury examination has not been previously done. Blood Pressure: (Per the rating schedule, hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm.) If the diagnosis of hypertension has not been previously established, and it is a claimed issue, B.P. readings must be taken two or more times on each of at least three different days. If hypertension has been previously diagnosed and is claimed, but the claimant is not on treatment, B.P. readings must be taken two or more times on at least three different days. If hypertension has been previously diagnosed, and the claimant is on treatment, take three blood pressure readings on the day of the examination. If hypertension has not been claimed, take three blood pressure readings on the day of the examination. If they are suggestive of hypertension or are borderline, readings must be taken two or more times on at least two additional days to rule hypertension in or out. In the diagnostic summary, state whether hypertension is ruled in or out after completing these B.P. measurements. Describe treatment for hypertension and side effects. If hypertensive heart disease is suspected or found, follow worksheet for Heart. Abdomen: Inspection, auscultation, palpation, percussion. Describe any organ enlargement, ventral hernia, mass, tenderness, etc. Genital/rectal (male): Inspection and palpation of penis, testicles, epididymis, and spermatic cord. If there is a hernia, describe type, location, size, whether complete, reducible, recurrent, supported by truss or belt, and whether or not operable. Describe anal fissures, hemorrhoids, ulcerations, etc. Include digital exam of rectal walls and prostate. Genital/rectal (female): Pelvic exam, including inspection of introitus, vagina, and cervix, palpation of labia, vagina, cervix, uterus, adnexa, and ovaries, rectal exam. Do Pap smear if none within past year. If unable to conduct an examination and Pap smear, or if there is a severe or complex problem, refer to a specialist. Musculoskeletal: For all joint or muscle disorders, state each muscle and joint affected. Separately examine and describe in detail each affected joint. Measure active and passive range of motion in degrees using a goniometer. In addition, provide an assessment of the effect on range of motion and joint function of pain, weakness, fatigue, or incoordination following repetitive use or during flare-ups. (See the appropriate musculoskeletal worksheet for more detail.) NOTE: The diagnosis of degenerative or traumatic arthritis of any joint requires X-ray confirmation, but once confirmed by X-ray, either in service or after service, no further X-rays of that joint are required for disability evaluation purposes. Describe swelling, effusion, tenderness, muscle spasm, joint laxity, muscle atrophy, fibrous or bony residual of fracture. If joint is ankylosed, describe the position and angle of fixation. Describe any mechanical aids used by veteran. If foot problems exist, also describe objective evidence of pain at rest and on manipulation, rigidity, spasm, circulatory disturbance, swelling, callus, loss of strength, and whether condition is acquired or congenital. If there is amputation of a part, see the appropriate worksheet. With disc disease, also describe any neurological findings. Endocrine: Describe signs and symptoms of any endocrine disease, effects on other body systems, and current and past treatment. See endocrine worksheets for further guidance. Neurological: Assess orientation and memory, gait, stance, and coordination, cranial nerve functions. Assess deep tendon reflexes, pain, touch, temperature, vibration, and position, motor and sensory status of peripheral nerves. If neurological abnormalities are found on examination, or there is a history of seizures, refer to appropriate worksheet. Psychiatric: Describe behavior, comprehension, coherence of response, emotional reaction, signs of tension and effects on social and occupational functioning. (This is meant to be a brief screening examination. If a mental disorder is claimed, or suspected based on the screening, an examination for diagnosis and assessment should be conducted by a psychiatrist or psychologist.) State whether the veteran is capable of managing his or her benefit payments in his or her own best interests without restriction. (A physical disability which prevents the veteran from attending to financial matters in person is not a proper basis for a finding of incompetency unless the veteran is, by reason of that disability, incapable of directing someone else in handling the individual's financial affairs.) D. Diagnostic and Clinical Tests: Include results of all diagnostic and clinical tests conducted in the examination report. Review all test results before providing the summary and diagnosis. Follow additional worksheets, as appropriate. E. Diagnosis: Provide a summary list of all disabilities diagnosed. Include an interpretation of the results of all diagnostic and other tests conducted in the final summary and diagnosis. For each condition diagnosed, describe its effect on the veteran's usual occupation and daily activities. This basically says that the examiner will cover all disabilities by using the individual worksheets for other conditions except in certain cases. This means that a general medical doctor will be evaluating my husband on his diabetes, kidney problems, hypertension, GERD, Peripheral Neuropathy, Peripheral Vascular Disease, Chronic Congestive Heart Disease, CAD, Hypothyroidism, Bilateral Interstitial Pulmonary Edema, Arteriosclerosis, Edema and Erythema, Anemia, amputation of lower leg, Multiple Gastric Ulcers, Lumbar pain and limitation of mobility involving hip, legs, lower back. etc. This is a little scary! How can he do a good job when most of these problems should be evaluated by a specialist in each area of expertise? Do you think they would order a separate exam for the lumbar issue?

Jangrin, "Is this the first claim that you have filed? Is your husband SC for any conditions since his discharge? I am assuming that he is a Vietnam vet". Yes, this is the first claim that we filed since his original filing while still in the Army on TDRL. He was evaulated by the VA (but looking at the reports I have the dates on the exams don't add up). This claim I sent in back in December 2005 was the first claim since his original ratings. He is not a Vietnam Vet. He got diabetes Type 1 while still in the service along with multiple other fractures, etc. He was given 20% for DMI and 10% for his wrist. His hand was almost ampuated from the injury. His wrist was broken and all arteries and viens had to be put back together. They really down played all of his conditions. The army did this as well. He had signs of kidney and heart problems during his TDRL exam but yet the doctor said his diabetes was completely out of control because he got it when he was only 20 years old. This is the same as ujuvenile diabetes, not adult onset. The doctors stated his pancreas was dead and is not producing any insulin. This type of diabetes is very difficult to control for many years due to the age at which he incurred the disease. Berta, Brandy -one of the significant medical errors VA made in my husband's case was to diagnose HBP but then fail to treat it properly-it was in my FTCA /Section 1151 claim. It looks like the same thing happened here. He went to the Va for all medical issues when we first came out of the military. They failed to treat him for his hypertension. As you know this could have worsened his diabilities with other complications because they did not treat him. HBP can lead to heart disease whether or not the veteran is a diabetic but I have seen where the VA tried to get out of paying comp for HBP and heart disease as secondary to diabetes-because the med recs showed the heart disease and HBP predated the DMII diagnosis. I don't think this is a problem. He got diabetes while in the service and is sc for this. All of his secondary conditions came afterwards. We just did not know that we could/should go back to va and claim additional disabilities. He did not have any HBP or heart disease or any other medical issues prior to his diagnosis of diabetes type 1. In my way of thinking- this means they probably did not diagnose the DMII when they should have and it already caused complications-HBP and heart disease- His diabetes is Type 1, service-conected rated at 30% for almost 30 years, caused complication of HBP, heart diseave, PVD, amputation, chronic kidney failure stage 4, GERD, PD, Arteriosclerosis, Anemia, Chronic Congestive Heart Disease (already had mycardial infarction) and triple bypass surgery last year, CAD, ulcers, Diabetic Retiopathy. This is most of them. When was he diagnosed with diabetes? In service 1979. Medically discharge to TDRL. I dont quite see any basis for CUE claims here -unless he had an older final claim decision on these conditions. Did he file a claim in 1980 that was denied for the HBP? I might have misunderstood your post. His claim in 1980 was for diabetes type 1, it was not for hypertension. But hypertension is a condition expected for diabetics. I would put the HBP info in the claim but also -would his private doctor be able to state that his heart disease, hbp, and vascular disease that caused the amputation were directly related to his diabetes? On the VCAA notice the va states that they are aware that diabetes causes other conditions such as: eyes, heart, feet, nervous system, and kidneys. Do you have all of his medical records and did he present evidence of diabetes via high glucose blood chemistry reports - in these records before the VA diagnosed him with it? When we left the service he only seen VA doctors. They have records of his B/P readings and one doctor stated at one visit that his problems were diabetes and hypertension. During the 9 years he seen them his BP continued to be out of control, but they never treated him for it. He only got treatment when he went to a private doctor about 10 years after leaving service. That would certainly be a a basis for a Section 1151 claim. This is what my present claim is about-years of high glucose as well as hyperlipidemia, high creatinine- and other well documented symptoms of uncontrolled diabetes (heart disease,vision problems, and strokes,which the VA documented but failed to treat back to 1988, evident in Rod's medical records. The records I have that show the local va said he hypertension back in the 80's but they did not treat him for it. He has always maintained his relationship with the local va. He goes to them for his annual eye and foot exams. He does not see them anymore for his other conditions. Back in October 2005 we ask them to provide all of my husband's medications. We cannot afford to pay for them (about 25 to 30 meds). They got it approved through the regional office to provide his heart meds. I noticed when I got a copy of his records that the doctor had to get him approved for "SC" for his heart problems in order to provide meds. He is listed as "service-connected" for his CAD since 10/2005. But we are not getting paid for this. Not easy to find this stuff sometimes-I would-if I were you- look through his VA medical records very carefully for anything -to include initial high glucose readings in his blood work that could indicate untreated and undiagnosed diabetes. After this claim has been rated I will persue 1151 on this. Possibly CUE regarding how they rated his diabetes in the 80's. You gave me the reference to 7913 as it was in 1980. He was labeled as severe and moderate to severe diabetes. He was taking high dosages of insulin and his dosage has continued to increase every since then. He was on a diet and had some reactions (high or low) blood sugar attacks. I guess my point is that the local va that was treating him for the first 9 years after medically discharged from service. They knew he had developed hypertension and did nothing about it. Isn't this a claim? If they would have treated him back then (about 20 or more years ago) he possibly would not have all of the medical issues he has today. He was not seeing any private doctors during that 9 year period. He counted on the doctors there at the va to attend to his overall medical conditions. Obviously, they were treating him for his sc diabetes, but one of the conditions caused by diabetes is HBP. They did nothing about it. There is also evidence that they knew that his creatine and BUN levels were high back then. This indicates kidney problems. This is also a medical condition that diabetes causes. Again they said nothing and did not treat him for this or run additional test to confirm or deny this condition may have existed.

I did not know anything about how to submit a claim or very much information on the way VA handles claims when I put in this first claim. If I would have found this site and investigated prior to filing, I would not have claimed so many disabilities. I would have just covered the major issues and then waited to claim the others. Since the first claim I have found that he has even more disabilities that were not claimed on the first claim. I will submit those later as well as the NOD's and CUE's. I really want to get a copy of his c-file but I don't want to ask right now for fear that it will cause confusion with my claim. When a exam is ordered does the c-file get sent to the examiners so that they can review during the exam? I thought maybe this would be a good time to ask for a copy of the c-file. Last week my husband remembered some records he had from his army files and we searched everywhere for them and finally found them. So some of what I found answered many questions I had as to what happened when and where. Still we do not have a copy of the SOC for his VA exam from original filing in the 80's.

Cavman, Here is the link for exam worksheets. http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

Berta, Would this be a CUE and/or should I file 1151 because of failure to treat him for hypertension? I think there are a few issues in which I will have to file a NOD and CUE's on. The problem is right now we need for them to give us ratings for his amputation, heart and kidney problems because of our financial situation. I don't want anything to hold that up right now. He is going for exams on Nov.27th for GM, and Dec.13th for eyes. I am hoping this means they are really moving along on our case. My problem is since I am claiming the hypertension for him but do not want to stir them up right now, should I just make a statement about his hypertension being diagnosed back in the 80's by the VA clinic and attach records. This is just so they will know (they should have these records already) that I know the situation? hope this makes sense??

Jangrin, That's what I was thinking too. Yes, my husband has DMI and I filed around 20 or so secondary disabilities. The GM appointment is 15 minutes after another appointment in which they don't give me any clue as to what it is for. Maybe lab work? Yes, one of the secondary conditions is GERD, hernia, gastric ulcers. Do you know if they will just use the GM exam form or as it says on the GM form they will have to use other exam forms such as Cardiovascular, Endocrine, etc. Is this general examination a good thing? I don't know if I like the idea because my husband has so many issues I don't think one examiner will be able to cover it. We have sent them ECG's, EKG's, labwork and statements from his doctors regarding his renal failure, hundreds of medical documents just covering the last year. My husband has probably been in the hospital about 7 or 8 times in this past year.

Can anyone tell me what GM might mean? This is abbreviated like this after appointment date and time. C&P/GM C&P/EYE I know that the eye is for my husband's eye exam because we claimed diabetic Retiopathy. But I don't know what the GM stands for. The other question I have is, do the exam doctors really use the examination work sheets that are posted on the VA's website? If so, do they cover pretty much everything on the exam worksheet? Also, if they require lab work to be done, would they elect not to get labs done if in our records we have lab work dated about 5-months ago?

Berta, Yes, I have filed the amputation and TDIU on his claim. Looking at his clinic appointment notes from years ago, they did not diagnose his hypertension. They referenced that he had hypertension but did not treat him for it. Diabetes + Hypertension leads to many other medical problems such as what he has today. I cannot believe that they did not even put him on some medication to lower his BP. He finally stopped going to them, for all medical issues, after about 9 years and started seeing a private doctor. The private doctor put him on BP medication after seeing him a few times.

Berta, Thanks so much for the reference. I am looking to prove that my husband's SC diabetes was out of control (severe) at the time they made the decision (1980). His BG levels usually run very high or very very low. They only rated him at 20%. He was seeing a VA doctor for his diabetes about every two weeks during the time he was on TDRL and during the following year after discharge. They were continually changing his insulin dosage because he got diabetes at such a young age it was uncontrollable and the doctors said so. The TDRL doctor also said so but rated him at 20% also. We have a letter from the doctor that cared for his diabetes before he was placed on TDRL and his fasting blood sugars were all over 200. On another post I listed all of the problems he has now. He had his leg amputated in 1998.

Does anyone have a copy of the original Diabetes Mellitus code 7913? I found that they made changes to this code only once. I wanted to see exactly what the diffinition of "large" or "moderate" insulin dosage was vs the percent levels assigned back then. This is the current 7913. 7913 Diabetes mellitus Requiring more than one daily injection of insulin, restricted 100 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.......................... Requiring insulin, restricted diet, and regulation of 60 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.................................................... Requiring insulin, restricted diet, and regulation of 40 activities................................................... Requiring insulin and restricted diet, or; oral hypoglycemic 20 agent and restricted diet.................................... 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 (2): When diabetes mellitus has been conclusively diagnosed, do not request a glucose tolerance test solely for rating purposes. This is all I could find about the change they made. We revised the evaluation criteria for diabetes mellitus (DC 7913) to make them more objective and base them on how well the diabetes is controlled. The frequency of insulin injection and medical treatment are valid measures of the severity of diabetes, and we have stipulated a requirement for more than one daily injection of insulin for the 100-percent evaluation level. We also specified the number of hospitalizations per year required because of episodes of ketoacidosis or hypoglycemic reactions and the frequency of visits to a diabetic care provider that warrant a 60- or 100-percent evaluation. We eliminated the requirement for a "large" or "moderate" insulin dosage at the 40- and 20-percent levels respectively because the severity of diabetes is better determined by the degree of control in response to treatment than by the amount of medication required for control. We deleted from the criteria for the 10- and 20-percent evaluation levels under DC 7913 the requirement "without impairment of health or vigor or limitation of activity" because they do not affirmatively denote required criteria for those evaluation levels. A requirement for regulation of activities was formerly one of the criteria for the 40- and 100-percent levels but not for the 60-percent level. For the sake of consistency, we have made "regulation of activities" one of the required criteria for the 40-. 60-, and 100-percent levels. We clarified the meaning of "severe" complications of diabetes and how to evaluate complications by means of a note and by including a reference to complications that would and would not be separately compensable under the 100- and 60-percent criteria respectively.

On my last notice from the VA they said I would need to use this form to inform them if my husband received treatment at any other VA facilities. I called the 800# and they told me that I should not have to fill out this form because if I told them the location of the VA clinic that my husband goes to that they could just pull up the information on the system and print it out. They are confused and confusing???? I have not used this form to submit additional evidence. I did fill it out listing the Va clinic that my husband goes to and what dates they should go back to. Just in case....

Congradulations John! I am very happy for you and want to thank you for your help with me and others with our claims. Brandy

Berta, I posted a question about this form on November 3. If you look at that posting you can see some of the responses and what my issue was with this form regarding what the people at the 800# told me. Brandy

Hey Bob, Nice to hear from you. I know you've been busy. I had sent an e-mail to Tbird asking him if I could get a user name and password so that I could join. Do you want me to call at 7 your time or mine?

Berta, He has been unemployed for about 9-years now. He is getting SSDI. He got approved for this when his leg was amputated. I believe the paperwork from the doctor to SSA stated severe PVD because of his diabetes. When I sent in my initial claim I did ask to be considered for IU. Then in March, along with a packet they sent me they also included the form for IU which I filled out and returned. "Understanding all the med symbols and abbreviations can help a claim considerably". I am still learning all of the abbreviations and everything I can about the codes and how the VA works. I truely believe that because I claimed so many disabilities they probably don't know what to do with his case. My husband jokes and tells me they probably think based on his disabilities that he will drop dead any day. I hate it when he says this because once I got copies of his medical records I could not believe what all is wrong with him. I had always worked and was not with him when he went to doctor's appt's. So I only got his version and not the whole story. I don't think this was on purpose on his part, I think he only tends to hear what the doctor says "well I am going to give you this? med for this latest finding". He just does not retain anything else and/or he did not want to worry me. Also, I don't think the doctor's always told him everything they found. I have been educating myself in medical terms, symtoms, what this all means in relation to his major disabilities. Now, I have not worked for over a year and am waiting to hear from SSA for my disability and trying to work on his VA case. Already went through our savings. It is getting tougher every day... I wish I would have found this site before I put in our first claim to VA. I would not have claimed so many disabilities. I would have started with just a couple of the major issues and addressed the others later. Oh well, can't go back now.

Callover, Did you send them a seperate letter stating all of this info. Or did you just use their reconsideration form to list all of this? Thanks.

Vike, I have a question as well. Does the veteran have to specifically claim for P&T in order for them to consider it? Even if they have already filled a claim for IU? Brandy

Berta, The PVD- I assume you mean peripheral arterial disease? This is peripheral vascular disease Does this cause the loss of use of his leg? He had below knee amputation over 8-years ago and left leg is in bad shape. His brochial index is very low in some areas and a lot of pain. He falls down a lot. He cannot walk or stand for long. Has it been determined to be peripheral neuropathy? Yes. PVD and PN is due to diabetes too -in most cases.

Berta, He is sc for DMI at 20% for the last 27 years. Well because we did not know to ask for increase or secondary conditions, when we found out I did not know about VA procedures, regs, etc. So I sent in a claim for all (about 25) disabilities. I think this was a mistake and the reason it may take longer for a rating. I have sent them hundreds of medical pages from surgeries at hospital, records from GP, surgeon, cardiologist, kidney doctor, diabetic doctor. I know that these other conditions are related to his diabetes. It causes one disability, then that disability causes another and so on. I have recently responded to their 2nd VCAA notice. They have already informed us that they plan on scheduling an exam. I assume this will be done once they process the info I recently sent to them. They seem to be accepting the conditions that typically come with DM. It was a few of the others that they questioned this time. Brandy

Jangrin, We just got a letter from the VA and they want to deduct co-pays from my husband's monthly VA check. I will call them and ask for "Hardship" as I have with the RO. Our claim has been there for about a year. He takes about 25 or more different med's. Most for nsc conditions that we have claimed as service-connected. He only gets a couple of sc med's for his DMI. We are having difficulty keeping up with monthly expenses. Mortgage, utilities, etc. Well see what they say..... Thanks, Brandy

Berta, This is good information for diabetes wondering if there GERD is related to DM. My husband is DMI and has GERD, CAD, chronic kidney failure, hypertension, hypothrodism, PVD, ED, CCHD, multiple ulcers, arteriosclerosis, RBKA, basically little or no use of left leg. I thought this GERD was going to be difficult to prove connected to DMI, but he recently went into hospital due to gall stones in bile duct between gall bladder and liver. They had to first remove the stones, then remove the gall bladder. Brandy (This would not show up on the most recent for the last couple of days??)

Thanks, Berta!

Jangrin, You said they paid you back for co-pays back to date of when your husband was unable to work. Is the date your husband was unable to work the same date that they awarded or increased his compensation to? I am curious because I have a pending claim(s) for my husband and he has been disabled and unable to work for the last nine years. The disability date is also what SSDI agreed to as a effective date. I am curious if the VA approves our pending claim(s) for disability will we get reimbursed for his NSC medications. Brandy

Berta, This is good information for diabetes wondering if there GERD is related to DM. My husband is DMI and has GERD, CAD, chronic kidney failure, hypertension, hypothrodism, PVD, ED, CCHD, multiple ulcers, arteriosclerosis, RBKA, basically little or no use of left leg. I thought this GERD was going to be difficult to prove connected to DMI, but he recently went into hospital due to gall stones in bile duct between gall bladder and liver. They had to first remove the stones, then remove the gall bladder. Brandy