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abhusal

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About abhusal

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  1. Pete, Thanks for the reply. Actually I have another 10%. Here is the break down: Mental Health: 70% + SA: 50% + Migraine: 50% + Stomach: 10% + Tinnitus: 10% = 93.93% Still does not make sense.
  2. Hello all,Initially I was 30% for Anxieety and Depressesion, 10% for Stomach. Later I was diagnosed with Sleep Apnea, claimed for it. VA asked C&P for Anxieety and Depressesion not for Sleep Apnea. They bumped my Anxieety and Depressesion rating to 70% and approved Sleep Apnea claim for 50% - combined 90%.I was 0% rated for migraine predischarge exam. This Februry I put new claim for Erectile Dysfunction, RLS and Traumatic Brain Injury after I was diagnosed with Erectile Dysfunction, RLS and Traumatic Brain Injury and Increase for migraine.This afternoon when I was looking at the ebenefit, I saw migraine increased to 50% (I had DBQ done by my civilian PCP) and 0% for ED, others Deferred. When I looked at the VA letters I saw 100% rating. I was shocked looking at it as I was not expecting it. It has review date of April 2020. 100% as of Feb 1, 2015 - $3172 with one Dependent ( I assume it is with ED)Now, I need your advise. I am working now for DoD. I did not apply for IU. Of course I do have some perfermance issues sometimes at work but I am dealing with it and I would like to continue to work. I believe I am not 100% schedular since my ratings are: 70%+ 50%+50%+10%=93.25% =90%. I haven't receive the letter yet.Can I continue to work now? Why they rated me 100% without me asking them?Please your opinion.Thank you.
  3. Berta, Thank you very much for your quick response. You are great as always. Here is my RO Decision made on 2008.
  4. Hello everyone, Seeking opinion weather to file claim for Residuals of TBI or just TBI. Really sorry for the long post but this will help you to understand my case to have your opinion if you like to render. I filed Disability Claim on 06/2008 while in service (BDD-Benefits Delivery at Discharge) for: PTSD, Short term memory loss, Unspecified sleep disorder, Headaches. Service Connection granted for Anxiety Disorder NOS (also claimed as short memory loss and sleeping disorder) and Tension Headaches (also claimed as Headaches) - Benefits Delivery at Discharge effective 9/2008. On 2010 filed claim for Bilateral Hearing loss, claim was denied - instead rated 10% for tinnitus (which I didn’t file at that time). Disability for Sleep Disorder re-claimed after diagnosis of Sleep Apnea at VA Hospital. Service connection was granted for Sleep Apnea effective 10/2013. I am planning to file a disability claim for Memory Loss requesting to rate separately which was combined with Anxiety Disorder NOS on 9/2008. Following diagnosis is made at VAMC but not service connected yet: Personal History of Traumatic Brain Injury (ICD-9-CM V15.52) Date Entered: 04 May 2015; Traumatic brain injury with loss of consciousness (ICD-9-CM 854.06) Date Entered: 22 May 2015; Irritability (SCT 55929007) Date Entered: 22 May 2015; Other ill-defined conditions (ICD-9-CM 799.89) Date Entered: 22 May 2015; Posttraumatic stress disorder (SCT 47505003) Date Entered: 13 Feb 2015 (1) Condition was noted during service POST – DEPLOYMENT HEALTH ASSESMENT - SEP 06, 2007 Headache, Ringing of the ears, Dimming of vision, like the lights were going out, Difficulty Remembering PRIMARY CARE - OCT 12, 2007 Foggy memory, Lack of energy GASTROENTEROLOGY CLINIC - NOV 29, 2007 Fatigue, Memory Loss, Foggy feeling, Blurred vision PHYSICAL EXAMINATION REPORT - REPORT OF MEDICAL HISTORY JUN 06, 2008 Loss of memory or amnesia or neurological symptoms – YES Frequent trouble Sleeping – YES Frequent or severe headaches - YES (2) Evidence of post- service continuity of the same symptomatology VAMC, CASE MANAGER NOTE – MAY 01, 2009 The veteran experienced Blast or Explosion IED (improvised explosive device), RPG (rocket propelled grenade), Land Mine, Grenade, etc. during OIF/OEF deployment The veteran had ring in his ears symptoms immediately afterwards Does patient have physical/mental/cognitive limitations that may affect learning ability: YES - Poor memory PRIMARY CARE PROVIDER NOTE – MAY 01, 2009 Exposure to blast waves from IED/vehicle born explosive devices: from a distance LOC/knocked off feet/tinnitus/hearing loss from blast wave exposure: temporary tinnitus Hx freq. throbbing headaches, esp when sinuses act up- gets blurring, photophobia and nausea- decongestants seem to help- pain gets to 7/10 Feeling depressed x 2 mos Nausea VAMC, MENTAL HEALTH CONSULT PROVIDER NOTE – MAY 01, 2009 He was exposed to mortar fire on base and was exposed to IED and small arms fire while on convoys. Isolation, feeling numb/detached, etoh abuse, unemployment, lack of direction, memory issues, irritability, distraction and sleep disturbances to include nightmares VAMC, MENTAL HEALTH CONSULT PROVIDER NOTE – JUN 06, 2009 Pt also reports memory deficits and fatigue Pt advised to f/u with PCP for yearlong fatigue and TBI clinic for memory and fatigue and irritability PRIMARY CARE PROVIDER NOTE – JULY 09, 2009 Taking Paxil but feels tired a lot, awakens mid-noc. Denies snoring but ‘make a lot of noise like fighting someone’; He has a new job and works 30 hrs. /wk. but does not like job and ‘I forgot everything’ PRIMARY CARE PROVIDER NOTE – OCT 30, 2009 He notes poor concentration and poor memory VAMC, PRIMARY CARE NURSING NOTE – OCT 20, 2010 Does patient have physical/mental/cognitive limitations that may affect learning ability: YES If yes, describe: short term memory loss. VAMC, MENTAL HEALTH CLINIC PROVIDER NOTE – OCT 20, 2010 Vet went off of paxil, it made him feel "memory and more anxious". Vet is back on effexor and reports and it helps with concentration He did want his Effexor increased as it "clears my head more" and helps him with focus. VAMC, MENTAL HEALTH CLINIC PROVIDER NOTE – JAN 18, 2013 Reports difficulty with focus and attention at work and states his performance has been questioned. Start methylphenidate 5mg bid for focus and attention. VAMC, SECURE MESSAGING TO PRIMARY CARE PROVIDER NOTE – JAN 22, 2013 Difficulties with memory and concentration Feeling extremely tired after exercise Muscle aches and light headache Numbness hands and feet Brain fog and Concentration problems Depression or mood problems (irritability, mood swings, anxiety, panic attacks) VAMC, MENTAL HEALTH CLINIC PROVIDER NOTE – MAR 04, 2013 Reports difficulty with focus and attention at work and states his performance has been questioned. VAMC, MENTAL HEALTH CLINIC PROVIDER NOTE – AUG 09, 2013 Also reports lack of improvement in focus and attention with dextroamphetamine. Writer will change back to dextroamphetamine/amphetamine, which he reports he had a better response with. VAMC, SLEEP MEDICINE PROVIDER NOTE – APR 18, 2014 This is 33 y/o M with hx of OSA CPAP fatigue symptoms and tiredness and is seeing a mental problem. Has memory issue. VAMC, PRIMARY CARE PROVIDER NOTE – APR 18, 2014 He feels 'mental fog'- no 'clarity in the head', forgets things easily, and tired all the time. He states his job told him he is 'poorly performing' and is at risk of losing job. VAMC, MENTAL HEALTH PROVIDER NOTE – APR 18, 2014 Pt is a 33-year-old MALE who c/o depression, anxiety that isn't going away, decreased libido, difficulty sleeping, difficulty concentrating, and stating that his medications are not working. VAMC, C & P EXAMINATION PROVIDER NOTE – JUL 22, 2014 He reports difficulty concentrating at work. He has been counseled regarding his job performance. He is more irritable. Mild memory loss, such as forgetting names, directions or recent events VAMC, NEUROPSYCHOLOGY CONSULT PROVIDER NOTE – SEP 10, 2014 The results of the current evaluation revealed mild to moderate impairments in learning and memory as well as mild impairment in an aspect of executive functioning. Attention and visuospatial functioning were intact. DIAGNOSIS: Cognitive disorder, NOS NEUROLOGY OUTPATIENT PROVIDER NOTE – APR 17, 2015 34 yo man with H/o migraines x 7 years s/p Combat/blast related TBI with LOC, OSA, and mood d/o, PTSD, and memory problems. Reports having several blast exposures during military service, with one episode LOC. He complains of worsening irritability, depression, attentional problems, and short-term memory problems; affecting work and personal life. Post-TBI syndrome. Worsening HAs, worsening depression, anxiety, and depression. Memory problems. Likely 2/2 to TBI and depression, with attentional problems AMC, REHAB LONG TERM CARE CONSULTS PROVIDER NOTE – APR 17, 2015 Veteran with h/o blast exposure and with dx of MTBI here reporting worsening of memory issues, chronic headaches. Seen By neurology last week. Reports having several blast exposures during military service, with one episode LOC. He complains of worsening irritability, depression, attention problems, and short-term memory problems; affecting work and personal life. Veteran reports low mood, not interested, initially thought due to PTSD, but following with psychiatrist on Zoloft for many years. Still feels no energy, mood is low Chronic headaches, has to leave the work couple of times a week due to severe headaches. He also c/o difficulties with attention/focus IMPRESSION: h/o blast exposure/MTBI with depressive symptoms, Chronic post traumatic headaches, PTSD and Mild cognitive problems VAMC, CONSULT SPEECH PATH EVALUATION OUTPT PROVIDER NOTE – MAY 22, 2015 34 you male with h/o mTBI 2/2 multiple IED blast exposures (one with +LOC) was seen today for cognitive-linguistic evaluation. Assessment reveals overall moderate deficits (some in the severe range) in functional memory and attention skills. Veteran would benefit from cognitive-linguistic intervention to address memory, attention, and organizational needs. Prognosis is good given motivation to succeed (+), current although declining job status (+), and mental health needs (-). Recommend individual SLP 1x/week for 3-4 months, Thank you for reading. Your opinion will be highly appreciated. Thanks in advance for your opinions.
  5. Thank you very much Carlie and Phillip Rogers for your replies. Back then I didn't know what the OSA is, so I just applied for Sleep disorder. Now I am diagnosed with OSA , Unspecified Sleep apnea (ICD-9-CM 780.57). Now my question is: Should I still file for Sleep Disorder or Sleep Apnea. Which has the best chance to win based on my symptoms-Medical Record Summary.pdf Thank you very much.
  6. Thank you very much Phillip Rogers for reply. This is the details of the claim I filed: Decision by the VA: Could you please look at the attached and your suggestions please!!!
  7. Any advice Carlie, Berta after reading my above reply, please...
  8. Thank you very much Carlie. It make sense. But I think I did have sleep apnea symptoms while in service and they continued post-service. Please look at this attachment OSA-Medical Record Summary.pdf to see if I should file CUE or regular claim. Thanks
  9. Thank you very much Berta. I could only see one page of the report but am surprised that the diagnosis was not PTSD. - I have attached the remaining part of the decision. What diagnostic code did VA use for the 30% anxiety rating? 9413? - I think it is 9413.
 Have you formally filed a sleep apnea claim? - Not yet, I am developing the claim. Do you have a copy of the C & P exam that warranted the 30%? No I don't have copy of C&P, by the way how do I get it. What is the date of this decision , Abhusal, and did you file a NOD in time? - 10/2008, did not file NOD. Back then I didn't know about sleep apnea. If you do file the OSA claim as a new claim do you have a copy of your SMRs to support that for a direct SC award? - Yes I do have copy of SMR. I have attached the summary of record here. OSA-Medical Record Summary.pdf Are you sure the VA received it? - I mailed them two weeks ago by USPS- Priority-Certified mail with tracking. I see from tracking that they received mail but haven't heard anything from them.
  10. Hello everyone, Under Benefits Delivery at Discharge (BDD) Program, I filed claim for PTSD, Short Term Memory Loss, and Unspecified Sleep Disorder. I had C&P only with VA contracted Mental Health Provider. I never had C&P for the unspecified sleep disorder claim. I was awarded 30 % for service connection for anxiety disorder NOS (also claimed as short memory loss and sleeping disorder). Symptoms (reported to physicians and documented) related to sleep disorder while in service continued after discharge and documented well on VA medical record. After 5 years discharged from service, I had sleep study and diagnosed as Sleep apnea (ICD-9-CM 780.57). I am using APAP now. My concern is: With same symptoms in service continued after discharge and diagnosed with Sleep Apnea. When I filed a claim for sleep disorder 5 years ago, if VA had conducted sleep study on me, I would have diagnosed with Sleep Apnea while in-service. VA failed to do it. Isn’t it a CUE?
  11. Chek this out if you are seeking Sleep Apnea secondary to PTSD http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp14/Files4/1427733.txt
  12. On my claim decision RO mentioned several times private treatment record but I never visited hospital outside VA. Is it same or different? Your thoughts please..
  13. Berta, Thank you very much again "You certainly have, in my opinion, evidence of chronic sinusitus with evidence that VA should have considered in their past decision." VA proved by themselves on 2011 saying: A review of your private treatment records does indicate that there is evidence during active duty of chronic sinusitis with continued treatment after discharge from service. The examiner reported that your sinusitis is the same condition which was present during active duty. And they granted 0% on 2011 "I seem to understand some of the treatment records were from a private doctor....." Is VA medical records also called private treatment record? All my Dr. visits were at VA Hospital, so I don't have any medical records outside VA hospital. "Did the VA have ALL of your private medical records when they made that older decision?" Older calim was processed by Benefits Delivery at Discharge (BDD) unit which was denied on October 10, 2008. Having said that decision is soley based on service medical records which are: 2006 (4 DR. VISITS / 1 TIME ANTIBIOTIC PRESCRIBED) 01/14: sinus headache pressure behind eyes, stopped up nose (hard to breathe), Headache pain constant and sharp Antibiotic Prescribed? YES/10 DAYS 09/05: throat, nose and eyes burning, headache, mild body ache, dry mouth, nasal and throat congestion 09/09: sinus pressure headache, body ache, nose and whole face burning 09/12: Presents to TMC with c/c of meds not working after 9 days of sinus pressure 2007 (5 DR. VISITS / 4 TIMES ANTIBIOTIC PRESCRIBED) 02/17: sore throat, nasal congestion and lethargy x 3 days Antibiotic Prescribed? YES/7 DAYS 04/23: Chills at night, eyes are burning, lightheaded and nasal congested for past week Antibiotic Prescribed? YES/8 DAYS 08/09: Problem started as runny nose, sneezing a lot, and chills, sinus pain/pressure Antibiotic Prescribed? YES/7 DAYS 11/29: Nasal discharge; Post nasal drip; Sneezing; Throat Pain 12/14: Sinus pain; Nasal discharge mucinous; Nasal passage blockage increased; Cough Antibiotic Prescribed? YES/7 DAYS 2008 (2 DR. VISITS / 2 TIMES ANTIBIOTIC PRESCRIBED) 02/25: Sinus pressure, Headache, Body ache, Cold Antibiotic Prescribed? YES/10 DAYS 06/17: Fever and chills; Headache and sinus pain; Itching of the eyes and eyes watering; Earache, nasal discharge watery, mucinous, nasal passage blockage, sneezing, and sore throat; Myalgia Antibiotic Prescribed? YES/5 DAYS
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