deville905

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Awesome, I'm very happy for your win. Another glimmer of hope....

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Good deal on your partial...Keep up the fight and never let it go!

BigSarge, I just put your idea to the test. Sent Allison Hickey an email and so far, it wasn't kicked back by Google.....Kept it short and sweat, however, I did watch her a bit on YouTube so I could get a feel for her emotional state when she spoke of Veterans.....

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I'm preparing my email tonight and I figure I need to catch her or him in the first two sentences of a minimum of three or four paragraphs. I even thought of sending attachment of my evidence, but that may be too much time and involved on their end. Any suggestions?

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Awesome, just awesome. I'm very happy for you, and it also gives me a thought of hope. Relax and Enjoy!!! Scouts Out!

Berta, Thank you for the compliments and kind opening words. It's always better to have someone to proof read your work, and to make some well needed suggestions. No, I don't have a completed copy of my SMR and I kick myself in the XXX for not being better pro active in retaining a completed copy, so if they don't see it I don't know i'm just blowing in the wind. Yes, both individuals wrote statements for me and I feel that VA ignored them completely but listed them in evidence received. Both of the statements were on point with my roommates being very strong, and in detail. I also see my mistakes in the incomplete thought pattern and will fix it. I do remember getting in trouble a few times on the Army's famous article 89 (Appointed place of duty) Inside my denial packet was a Sleep apnea disability benefit questionnaire and was told by Nashville, TN rater to have my primary care physician fill out and attached to NOD, which he filled out and I will include in this packet. My medical doctor stated that based on all the evidence my OSA occurred while on active duty. When I read her rationale for her decision she just listed the symptoms of OSA, which just blew me away. Would it be too much to post the questionnaire from C&P with personal information removed or blackened out, and also post the counter questionnaire filled out by my medical doctor? Once they receive my NOD could they re-investigate and then rate fairly or will they send it straight to the appeal process? If I raise a reason of doubt, which I think I have done do I need more evidence on my NOD for OSA or wait for the VA Form 9 to strengthen my case at that time? My medical file arrived today and going through it, my claim should have been approved when I first filed. I will continue to read and put this in another order or just add deeper into it. I'll post back in a few days! I found her two internet sources that she used and she didnt even change one word but put her signature block on it as if she thought of the systems in that detail order. Isn't that plagiarism by a physician assistant? Thank you again for reading and your suggestions

Wonderful News all worth the wait

Awsome News

I would like someone to read my NOD I've created with there format. I was by rater per call to have my primary physician fill out DBQ which he did. Grade this attachment for me and any suggestions would be helpful. This is just one section. Notice of Disagreement 1. Service connection for sleep apnea: Your office continues to state not show an event, disease that my service records does or injury in service, but it should. I have stated previous of times that I went on sick call for snoring, throat and tonsils hurting. If you don’t see it in my medical file, they are incomplete and or not accurate. I recently found two individuals that I served with and one of them was my roommate from Korea. My claimed moved so fast, I don’t believe it was ever taken into consideration by the rating department or officer. My C&P exam was conduct at VA by physician assistant Lxxxx on Oct 3 2013. She never asked me any questions and made only two statements. (1) Hypertension does not cause sleep apnea, but untreated sleep apnea can cause hypertension but not the reverse. (2) Then she commented on the number of Lay Statements that was currently in my file, in which your office never stated one from Lxxxxxxxxxxxxx (step daughter). In physician assistant Leoras Rationale or justification of stating (less than 50 percent probability) incurred in or caused by the claim in-service, injury, event, or illness only addressed by secondary of sleep apnea to hypertension. All she stated was the evidence of what sleep apnea is. On July 18, 2014 at 09:15 I received a call from your claims office to answer any questions I had from my request on I.R.I.S. She told me that my sleep apnea case was denied because of the statement the doctor had made from my C&P exam, but in fact as I mentioned before concerning the exam and performed by a physician assistant and not a doctor. I asked the rater, how can the physician assistant answer questions without asking me any questions. Did physician assistant have any medical evidence for her medical opinion? The weight of a medical opinion is diminish where that opinion is based on an examination of limited scope and the evidence is not stated or fails to explain the bases of her opinion. Regulations require that any opinions rendered be supported by a rationale for the opinion. Bloom v. West, 12 Vet. App. 185, 187 (1999) Physician assistant Lxxxxxxxxxxx responded to a letter that I sent concerning a job with regulatory conditions set by FMCSA. Then reading your response from the examiners answers (The examiner also stated that you are able to work in any occupation that does not have regulatory restrictions preventing individuals with severe sleep apnea corrected by a CPAP machine and sleep apnea does not impact your ability to work. PA Lexxxxxxxx’s answers contradict themselves because FMCSA’s non qualifications is based on mild to severe obstructive sleep apnea and conditions in upper respiratory to include (asthma), and her response was to ask for a waiver. She received her information from a frequently ask question section but failed to read in entirely, because severe obstructive sleep apnea nor does asthma have a waiver. When PA xxxx noticed my prostate cancer, she told me to send in a disability questionnaire form to your office, then your office ask why did I send it in. You indicated that by a series of question marks. Lay Evidence: Competent lay evidence is defined as any evidence “not requiring that the proponent have specialized education, training, or experience,” but is provided “by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person.” Competency is a legal concept which determines whether the lay evidence is admissible before VA as the trier of fact; credibility is a “factual determination going to the probative value of the evidence to be made after the evidence has been admitted.” Prior to the enactment of the Veterans Claims Assistance Act of 2000 (VCAA),11 the general trend was to focus primarily upon medical evidence when adjudicating a claim. Cases such as Hickson v. West12 stated that establishing service connect generally required “(1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of incurrence or aggravation of a disease or injury in service; and (3) medical evidence of a nexus between the claimed in-service injury or disease and the current disability.”13 As a result, lay evidence played a limited role in the development and analysis of medical nexus evidence. Medical examiners were likely to discount a veteran’s lay statements as to the history of a claimed injury or disease on the grounds that service treatment records did not document the claimed disorder and/or because they found that there was a lack of medical documentation generated since the veteran’s separation upon which it could be determined that the claimed disability was “at least as likely as not” related to his or her service. Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Contrary to [CAVC’s finding], the relevance of lay evidence is not limited to the third situation, but extends to the first two as well. See Dalton v. Nicholson, 21 Vet. App. 23, 39 (2007) (holding that a Department of Veterans Affairs (VA) examination is inadequate where a VA examiner ignores a veteran’s lay statements of an injury or event in service unless VA expressly finds that no such injury or event occurred). Competent and credible lay evidence of record which establishes that the Veteran suffered from symptoms of sleep apnea during service, as well as the competent lay evidence of continued sleep apnea symptoms since service, the Board finds that the lay and medical evidence of record is sufficient to establish a medical nexus between the Veteran's sleep apnea and service. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009)

WOW! You got me thinking, because I've always been told about nasal passage swelling and a lump in my throat area, which may come from the meds. Very good point. So if I can link it all together, there maybe a winning chance for my SA, ed, and headaches. Can you look at my buddy statements for me? Thanks for the great thought!

Yeah, I just posted my letter a few minutes ago. It said the same thing as yours, but it could be different.

This is a copy of my denial I received yesterday. I notice my C&P exams are far from the truth of numbers and conversation. Looking for any advice, but I know I need to file NOD. I'm currently under Voc Rehab.: REASONS FOR DECISION 1. Evaluation of bronchial asthma currently evaluated as 30 percent disabling. The evaluation of bronchial asthma is continued as 30 percent disabling. {38 CFR 3.321(a); 38 CFR 3.321(b)(1)} We have continued a 30 percent evaluation for your asthma, bronchial based on: · Daily inhalational therapy · Daily oral bronchodilator therapy 5 of 11 • Inhalational anti-inflammatory medication Additional symptom(s) include: • Ratio of Forced Expiratory Volume in One Second (FEV-I) to Forced Vital Capacity (FEV-IIFVC): 86 (Not considered for compensable evaluation) • Forced Expiratory Volume in One Second (FEV-I): 122 of predicted (Not considered for compensable evaluation) A higher evaluation of 60 percent is not warranted unless there is: · Forced Expiratory Volume in One Second (FEV -1) of 40 to 55 percent predicted; or, · FEV-I to Forced Vital Capacity (FVC) (FEV-IIFVC) of 40 to 55 percent; or, · At least monthly visits to a physician for required care of exacerbations; or, · Intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids. 2. Evaluation of erectile dysfunction (claimed as lost of sexual desire) currently evaluated as 0 percent disablin1;:. The evaluation of erectile dysfunction (claimed as lost of sexual desire) is continued as 0 percent disabling. {38 CFR 3.32I(a); 38 CFR 3.32I(b)(I)} A noncompensable evaluation is assigned whenever evidence fails to show penile deformity together with loss of erectile power which would warrant 20 percent. We have continued a noncompensable evaluation for your erectile dysfunction based on: • Loss of erectile power Note: In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. {38 CFR §4.3I} A higher evaluation of 20 percent is not warranted unless there is deformity with loss of erectile power. 3. Evaluation of hypertension currently evaluated as 0 percent disablin1;:. The evaluation of hypertension is continued as 0 percent disabling. {38 CFR 3.32I(a); 38 CFR 3.32I(b)(I)} We have continued a noncompensable evaluation for your hypertension based on: • A diagnosed disability with no compensable symptoms. 6 of 11 Note: In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. {38 CFR §4.31} A higher evaluation of 10 percent is not warranted unless there is: · Diastolic pressure predominantly 100 or more; or, · Systolic pressure predominantly 160 or more; or, ·A history of diastolic pressure predominantly 100 or more and there is a requirement for continuous medication for control. 4. Service connection for prostate cancer. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for prostate cancer is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show that your disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. We did not find a link between your medical condition and military service. The evidence of record show you have a diagnosis of prostate cancer, however, there is no competent medical evidence which relates your prostate cancer to your military service. Therefore, service connection is denied. 5. Service connection for sleep apnea. The claim for service connection for sleep apnea remains denied, as the evidence continues to show this condition was not incurred in or aggravated by military service. The evidence does not support a change in our prior decision. Therefore, we are confirming the previous denial of this claim. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We did not find a link between your medical condition and military service. The evidence does not show that your condition resulted from, or was aggravated by, a service- connected disability. The evidence of record from your VA sleep study notes a diagnosis of 7 of 11 obstructive sleep apnea, however, there is no competent medical evidence which relates your sleep apnea to your military service. We also recognize that you are claiming your sleep apnea as secondary to chest pain, headaches and depression, however, you are not service connection for any of the listed conditions. The VA medical opinion found no link between your diagnosed medical condition and military service. The examiner opined hypertension does not cause sleep apnea. The examiner also stated you are able to work in any occupation that does not have regulatory restrictions preventing individuals with severe obstructive sleep apnea corrected by a CP AP machine and sleep apnea does not impact your ability to work. 6. Service connection for atypical chest pain (previously evaluated as chest pain under DC 5299-5297). The claim for service connection for atypical chest pain (previously evaluated as chest pain under DC 5299-5297) is considered reopened. However, the evidence continues to show this condition was not incurred in or aggravated by military service. The evidence does not support a change in our prior decision. Therefore, we are confirming the previous denial of this claim. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show an event, disease or injury . . III service. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. We recognize you are claiming your chest pain as secondary to posttraumatic stress disorder (non- combat) however, you are not service connected for posttraumatic stress disorder. We did not find a link between your medical condition and military service. Y our VA heart exam notes a diagnosis of atypical chest pain. You reported having chest pain near your heart which has become more frequent in the past. Your physical findings from the exam shows no evidence of congestive heart failure, cardiac arrhythmia, heart valve abnormality, or pericardial adhesions. Your heart rate and rhythm were normal. There were no evidence of hypertrophy or cardiac dilatation. Your Mets level were 10.10 with an ejection fraction of 60 to 65 percent. There is no competent medical evidence which show your atypical chest pain relates to your military service. 8 of 11 7. Service connection for headaches. The claim for service connection for headaches is considered reopened. However, the evidence continues to show this condition was not incurred in or aggravated by military service. The evidence does not support a change in our prior decision. Therefore, we are confirming the previous denial of this claim. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show an event, disease or injury . . III service. The evidence does not support a change in our prior decision. Therefore, we are confirming the previous denial of this claim. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show that your disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. The evidence does not show an event, disease or injury in service. We did not find a link between your medical condition and military service. Y our VA medical records dated December 2013, notes a reported history of chronic headaches, however, there is no competent medical evidence which relates your headaches to your military service. 8. Service connection for depression (now claimed as non- posttraumatic stress disorder/ personal trauma). The claim for service connection for depression (now claimed as non- posttraumatic stress disorder/personal trauma) is considered reopened. However, the evidence continues to show this condition was not incurred in or aggravated by military service. The evidence does not support a change in our prior decision. Therefore, we are confirming the previous denial of this claim. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We did not find a link between your medical condition and military service. Y our VA treatment records show a past medical history of depression. Y our VA posttraumatic stress disorder examination shows a diagnosis of adjustment disorder with mixed anxiety and depressed mood, however, there is no competent medical evidence which relates your depression to your military service. We recognize you are now claiming your mental disorder as a claim for posttraumatic stress disorder. We have considered but denied service connection for posttraumatic stress disorder because there is no evidence of a current diagnosis for posttraumatic stress disorder or an in- 9 of 11 service stressor linked to the claimed condition.We have not found that you experienced a stressful event in service, including fear of hostile military or terrorist activity. Service connection for posttraumatic stress disorder may be granted if the evidence demonstrates (1) a current diagnosis of posttraumatic stress disorder rendered by an examiner specified by the regulation; (2) an in-service stressor consistent with the places, types, and circumstances of service that indicates the Veteran's fear of hostile military or terrorist activity; and, (3) the Veteran's posttraumatic stress disorder symptoms have been medically related to the in-service stressor by the VA psychiatrist or psychologist, or one contracted by VA. VA will now rely on a Veteran's lay testimony alone to establish occurrence of a stressor related to fear of hostile military or terrorist activity, provided that the claimed stressor is consistent with the places, types, and circumstances of service, and a V A psychiatrist or psychologist, or contract equivalent, determines that the claimed stressor is adequate to support a posttraumatic stress disorder diagnosis and that the Veteran's symptoms are related to the claimed stressor. If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, occurrence of the claimed in-service stressor may be established by the veteran's lay testimony alone. If the evidence establishes that the veteran was a prisoner-of-war under the provisions of38 CFR 3.I(y) and the claimed stressor is related to that prisoner-of-war experience, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, occurrence of the claimed in-service stressor may be established by the veteran's lay testimony alone. {38 CFR Sections 3.1(y), 3.304(f), 4.125(a)} Credible supporting evidence that the claimed in-service stressor occurred" means that there is a legal standard that must be met and that the veteran's report of the incident must be supported by service or civilian documentation of the incident, or if that is not available, there must be other evidence that would lead to the reasonable conclusion that the incident occurred. Such other evidence would generally include military or civilian documentation of behavioral changes after the incident which could reasonably be expected from a person who had undergone a personal assault. Such changes include, but are not limited to: sudden requests for other duty assignments without justification, obsessive behavior (such as over, or under, eating), increased disrespect for military or civilian authority etc. According to your recent VA examination dated December 27, 2013 . You reported experiencing difficulty falling or staying asleep and exaggerated startle responses, irritability with anger outbursts. During the psychological examination you were appropriately dressed and cooperative 10 of 11 toward the examiner. You were oriented to time, person, and place. Your thoughts process and thought contents were unremarkable. There were no reports of hallucinations, panic attacks, episodes of violence or obsessive ritualistic behaviors. You reported having chronic sleep impairment, diminished interest in participation of activities, recurrent distress, problems with concentration and the inability to recall important aspect of trauma. The examiner notes you meet the DSM- V stressor criterion for adjustment disorder. The examiner gave a diagnosis of adjustment disorder with depressed mood which do not meet the DSM-IV criteria for a diagnosis of PTSD. The examiner states your claimed stressors are not related to your fears of a hostile military or terrorist activity, however, your claimed stressors do not adequately support a diagnosis ofPTSD, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV or V)) criteria. The examiner stated your reported stressors are related to your health conditions and not your military service. 9. Entitlement to individual unemployability. Entitlement to individual unemployability is denied because the claimant has not been found unable to secure or follow a substantially gainful occupation as a result of service connected disabilities. Service connected disabilities currently evaluated as 40 percent do not meet the schedular requirements for entitlement to individual unemployability. 38 CFR 4.16 provides that individual unemployability may be granted where there is one disability evaluated as 60 percent disabling, or two or more disabilities, one of which is 40 percent with a combined evaluation of 70 percent or more. These percentage standards are set aside only when the evidence clearly and factually shows the veteran has been rendered unemployable solely due to service connected disabilities regardless of their individual and combined percentages. Such cases are submitted to the Director of the Compensation and Pension Service for extra-schedular consideration. This case has not been submitted for extra-schedular consideration because the evidence fails to show the veteran is unemployable due to service connected disabilities. (38 CFR 4.l6) You reported not being able to work due to asthma and sleep apnea. You reported your respiratory condition impact your ability work due to shortness of breathe. You reported having difficulty when washing your car, doing yard work or even playing with your children. However, there is no evidence which show you cannot perform sedentary employment. Since you do not meet the schedular criteria and the evidence does not show you are unable to gain an occupation in a sedentary or physical environment because of a service connected condition, we cannot grant entitlement to individual employability (IU).

I just received my BBE full of denials, and I see the reason my hypertension was denied. The C&P doctor shaded my bp readings. She only had 1 reading out of the 4 she took. I haven't had one bp reading below 144/102 since Dec 19 14. I even started writing down all of my BP readings and even recorded one nurse on my phone saying if the BP pressure was to high I would have to do paperwork and send you to er, so sit their and don't move 15 min late she took bp again and that was the only one I didn't see. "Memphis". This would be considered evidence that I need but then there's their word against mines. The VA even have the wrong date of when my C&P was...What's going on here? Then I move over to sleep apnea and I was only ask one question by the doctor concerning sleep apnea. She even made a comment about my lay evidence that she could see in the system and wrote down all the evidence down every bodies name for me as lay evidence. Then she stated"Hypertension does cause sleep apnea, but untreated sleep apnea causes hypertension as a secondary" That was the only statement the VA used in there decision of sleep apnea. WTF! This denial is all jacked up.Then I pulled my medical file down from www.myhealth.gov and started looking at the codes, dates etc. Going to work on my appeal.

You just gave me a battle of hope. They disapproved my total claim with plenty of evidence that should have lock an approval in.

My diastolic numbers were 110, 105 & 107 at my c&p exam and they still denied my claim for BP....

My claim closed as your did, and had the same information concerning appeal. I went to ebenefits, and checked my acct and nothing has changed. My % stayed the same as well as my balance. I guess I will be appealing my decision, although I haven't received my BBE yet.