mayertucker

I've reached out ton...no dice so far. (Mostly not pracricing in Colorado) . Will keep on looking there though.

Talked to NVSLP....they said they do not handle Tort cases and couldn't refer me to anyone unfortunately. The search continues.

Thanks from the info. I did see NVLSP in my initial research but from what I saw they didn't do FTCA stuff so I just moved on. Will go ahead and call them and see what they say.

Thanks will do. Just need to find a lawyer or figure out what damages woukd be then can get started.

Thanks for the info. I don't want to file on my own, but will if I can't find a lawyer to help...basically my worse case scenario. Filing an 1151 will probably be the biggest waste of time since it is looking like it's already going to be service connected.

Yea someone else mentioned NOVA and have a lost I am going to send emails to this weekend. Didn't see alot in my area, but hopefully can get further pointed in the right direction. Thanks again.

Thanks for the reply. Could def be a possibility. Have to find that lawyer first, which is where the roadblock lies.

Yea....I'm trying to figure out how to do that at the moment. In my case it would be easier if they weren't since then wouldn't need the ftca. I believe there was a law passed recently where the VA has to disclose who they worked for once you submit the sf95 form. I'm trying to hold off on that part till either get a lawyer or can figure out realistic damages.

Thanks for the reply. I mainly need to find a lawyer to do it or at least help come up with potential damages. I figured all the other stuff over the past couple of weeks but never came across NOVA, so I will check them out. If this stuff wasn't on the way to already being service connected and wasn't already 90% TDIU P&T the 1151 would be the way to to I think. But since it isn't would probably be farting into the wind going that route. Def appreciate the info!

I apologize if this is a long one. It being so long is one of the reasons I am having difficulties finding a way forward. I am needing help in doing a FTCA or a lawyer who can do one or at least how to figure out damages. About 8-9 years ago symptoms started. VA did basic testing which didn't definitely show a condition, but various abnormal test results were found and disregarded, ignored, or treated. Started seeing non VA care and was diagnosed with small fiber/autonomic neuropathy caused by an unknown autoimmune illness in 2021. VA was sent my diagnosis in 2021. In 2020 was diagnosed by VA mental health with a somatic disorder since no medical cause could be found for my symptoms (disregarding previous abnormalities etc). My health continued to go downhill. In 2022 had first eye surgery (that is more and more looking to be caused by my autoimmune disorder) which double vision came back and was worse). Was told to do 2nd surgery to fix it. Double vision coming back again. Asked to see VA mental health marriage counselor (who blamed the issues on my somatic disorder (learned about it and its affect on my care) and me for my mental health issues causing serious suicidal ideation. Instead reached out to community mental health and got a therapist who told me to get the somatic disorder removed from my records and referred me to current immunologist. Talked to my current community care neurologist about the somatic disorder who wrote a letter to the VA asking for it to be removed as it affected my care and getting diagnosed/treated. Current immunologist within 4 months has found evidence of what autoimmune disorder I have and within the next 2 months will be starting me on a treatment. Asked VA to correct my records to include small fiber/autonomic neuropthy and make sure all records removed the somatic disorder since they only removed it from my problem list. Notified and sent PCP notes from immunologist. About a week later find somatization disorder re-added to my medical record (justification given they had no other diagnosis, when they had one since 2021) and nothing about the small fiber/autonomic neuropathy. See patient advocate with concerns and have an unproductive phone call with PCP's nurse. File congressional complaint with issues. 2 weeks later somatic disorder is once again removed, PCP changed, recorded call (CO is one party consent state) where VA congressional liasion states somatic disorder was put back on because of no other diagnosis. I am no longer suicidal, and actually hopeful that at least some of my symptoms will be resolving in the near future. I still have many deliberating symptoms pretty much daily in the mean time. VERY LONG POST I am needing help in doing a FTCA or a lawyer who can do one or at least how to figure out damages. Backgound Info: Currently 90% TDIU P&T SC (PTSD 50% /Migraines 50% (residuals of TBI)/Bilateral Flat Feet 50%/Knee Issue 10%/Keratoconus 0%/Nephrolithiasis 0%/Right Shin splints 10%/). Those are the non-autoimmune issues. Migraines and nephrolithiasis potentially could be part of my autoimmune stuff but maybe excluded. PTSD is from being married to a diagnosed Sociopathic/Psychotic/Bipolar wife with a heavy meth addiction. Partly from the abuse I got (trying to protect my son) as well as the blame of my command, judicial system being a male victim of DV (basically on my own no one believes it happened). Finally was granted SC in 2021 when got a copy of PMO report where she had smashed a glass mug against my head (I hadnt been physical or verbal with her), and I was made to stay in the barracks and away from her and my son and told I was the issue. VA diagnoses (VA problem list): My service connected conditions, until August of this year Somatization disorder (misdiagnosis/re-added 12/27/23/re-removed 1/16/24. Community Care Diagnoses: Small fiber neuropathy added 1/16/2024 (diagnosed by community care in 2021 and sent to them then (so was part of my records). New Diagnosis: Idiopathic Progressive Neuropathy (temp diagnosis to get me started on IVIG), In Novemeber had a moderate positive for Anti-nt5c1a (Inclusion Body Myosistis, Lupus, a couple of other autoimmune disorders). My immunologist said I have definite autoimmune dysfunction and an autoimmune disorder that is attacking my muscles. He wants me to see his neuromuscular/neurologist doc in his clinic and said my diagnosis will change to be more specific once those appts and more testing is done. I do have pending claims for the autoimmune stuff (C&P examiners said I was a textbook case of the chronic multi-symptom undiagnosed illness and was going to write the report saying that it should be service connected. Another C&P examiner said that she went through my 2k pages of health records and counted at least 17 issues that were never followed up on or ignored over the almost decade and she would be writing that it to should be service connected. So, I don't think I need help on that portion. In 2014 I started having daily 7-10 pain level headaches. My PCP care at the time sent me to a VA neurologist who did a bunch of testing. He did do basic autoimmune disorder tests which were negative. I did have some abnormal results (protein in cereberal spinal fluid, a syphillis test that was first mildly positive, then positive, then mildly positive, then negative, CSF was negative, a couple of more). The VA sent my stuff to infectious diseases who said no syphyllis. My neurologist said he couldn't figure it out and wanted to send me to Denver to see their neurologists. The neurologist there saw I had a PTSD diagnosis and said "just go to therapy and you'll start to feel better. During this time, I developed the double vision (separate from my keratoconus), kidney/urinary issues, dizziness/ligheadness, muscle twitches, the neuropathy symptoms, brain fog, trouble speaking, left side facial numbness/palsy, iron deficient anemia. My PCP sent my records for review with a VA hematologist who re-stated some of the abnormal stuff found and said the workup needs to be done and might not find anything but it is inexcusable with what was already had if something is found later. She treated me for the iron deficient anemia and my iron levels returned to normal but my hemoglobin was still low. She sent my blood to Denver again for more testing but then dropped out of my care and I have no idea what the results of that testing were/if it was completed. When I asked my PCP about my hemoglobin and some of the abnormal results she said "thats just my normal". She did send me to non-VA neurologists and VA's WRIISC (made some recomendations where some were implemented and others werne't, was also told by their gulf war illness specialist I need to let go of my buddies that died in the war so I could get over the PTSD, I was never in war but the in between times and wasnt why I had PTSD). I also started to have GI issues lots of diarrhea, constipation, oily foul stools, bloating, gas buildup. Was tested for H. Pylori and treated, was better for about 3 months. Then came back with a vengeance. Was sent to VA GI first GI doc said was somatic. 2nd GI doc thought was SIBO had me tested (positive) then started treatment. First treatment didn't help so she wanted to use different antibodies. Helped for about 3 months then back at it. She was going to do a 3rd round with different antibiotics then disappeared. 3 months later I called and was told she no longer works at the VA so they sent me to community care. I also started seeing another community care neurologist and he thought I had the small fiber/autonomic neuropathy caused by an autoimmune disorder. He tested me for it (was negative 1st skin biopsy (right side) as well as repeated the basic autoimmune testing. He decided to do a 2nd skin biopsy on my left side (my junk side) and it came back overwhelmingly positive. That was sent to the VA the day after he 2/20/21 got the results and was entered according to my VA records in November of 21. I was tried on prednisone (caused an ulcer) and he shortly left the practice and have been seeing his PA since then. I finally got the community care appt for the GI stuff and tested positive for e. coli and c-dif. She didn't see the ulcer on a scan so said it was probably small but to stay away from NSAIDs/prednisone etc. I also started to see a VA therapist and she eventually said therapy wouldn't do any good since I was still dealing with all of the medical stuff and her recommendation would be to come back after the medical stuff was handled. Found out in August of this year she put the somatic disorder in my records and said that I asked to stop the therapy. I continued to see my community care PA neuro but she couldn't figure it out but kept trying . Meanwhile I kept getting worse, I would have some periods when would feel ok for a couple of months but my symptoms would always come back. I also developed a pain in the joint of my little toe, which it was determined that I needed an AFO brace because I was having issues raising my foot when walking. I also was able to find out that when I was in the sun I would get a rash on my face and would definitely have a flare in symptoms. I went to see a neuro-opthamalagist for the double vision. He said it was caused by a lazy eye, that I had since I was a kid. He suggested surgery to correct it. I told him I never had one, offered to show him pictures, my MEPS exam (which would of disqualified me) but he wasn't hearing it. I'm guessing the somatic disorder diagnosis closed his ears. I told him I didnt want to do the surgery because if I was right I would probably need another surgery to reverse it if I was ever treated. Around December of 2021. Last year wanting to get some independence back went to see him again and same thing. I also started really entertaining thoughts about killing myself since it was started to seem like I would never get better. Since I couldnt go out in the day anymore and I couldnt drive at night due to my keratoconus (I had to have my wife drive me around everywhere), I went back to him and tried to get him to at least entertain the possibility it was related to everything else...it didnt work again and I agreed to the surgery desperate to some return to a semi normal life. When I met the surgeon had the same convo with the same results. Had the surgery and the double vision was gone but within 3 months started coming back and was worse then when I started. She recommended a 2nd surgery on the other muscles. I had the 2nd one in July of last year. Starting in November the double vision is now coming back. In August I reached out to VA mental health for marriage therapy as all this was causing issues with not just me but my wife. Our first appointment the therapist brought up the somatic disorder, said I was causing the issues because I wasnt doing enough. She said she has lupus and has to get infusions every month and still works 3 jobs. She didnt listen want to hear that I had a diasgnosis for the small fiber and an unknown/undiagnosed auto immune disorder. We decided not to see her anymore. This also sent me over the edge for a bit. I was actively trying to figure out a way to take myself out without traumatizing my family more than necessary. Between the utter hopelessness of not getting anywhere as for a treatment, being in constant near daily pain, and then being "blamed for it all" was too much. Luckily I reached out to a community mental health provider and they put me with my current therapist. My first appointment she referred me to my immunologist and at least restored some hope. She also told me I need to have the misdiagnosis removed as it is probably one of the main reasons I hadn't been diagnosed treated yet. She offered to write a letter to the VA in support of having it removed. MY community care neuro said the same and sent a letter without me asking. My immunologist redid some of the basic testing with the same results as previous testing. He did some more advanced testing and with some more abnormal bloodwork and came back moderately positive for Anti-nt5c1a (Inclusion Body Myosistis, Lupus, a couple of other autoimmune disorders). He wants to do more testing to further pin it down but the cost out of pocket is getting expensive. After my last followup some of the testing I would have to pay was 1.5k. He said and notated that I have definite immune dysfunction and evidence of an autoimmune disorder attacking my muscles. I initially paid out of pocket/medicare for my neurologist because I didnt want the VA med records to "taint" my immunologist visits. Since the cost for some of the testing is becoming outside of what I can pay out of pocket I looped the VA in and sent all of my records and signed releases to make sure the VA could/had everything. I ask the VA to update my records to include the previously diagnosed small fiber/autonomic neuropathy and any diagnosis coming from immunologist and to get a community care referral so I can keep seeing my immunologist and have the VA pay for testing/visits. MY PCP re-adds the somatic disorder. I contact the patient advocate to have it removed again, switch PCPs, get the community care referral for my immunologist, and add the small fiber/autonomic neuropathy to my VA records. I get a call from my PCP's nurse telling me the somatic disorder was re-added because they didn't have any other diagnosis in my records (again my community care neuro sent them the small fiber/autonomic stuff back in 2021) and they wouldn't remove it unless I got a new diagnosis. Was also told that my immunologist wasn't a part of Triwest so they wouldn't do a consult, but would send me to another immunologist (while having the somatic disorder still on my records) almost ensuring me a new imunologist wouldn't take me serious and start the whole process over. She also asked if I needed a consult to mental health because I kept bringing up how close I was to killing myself the months before. Told her I was very happy with my current therapist and if I saw VA mental health again I more than likely will be in the same boat again. After the phone call I filed a congressional complaint, and that has resulted in some changes. The somatization has been removed. A note was added to try and CTA by saying it was removed at my request due to my new diagnosis. The VA is going about getting my immunologist started with Triwest (my immunologist is completely onboard and had hos assistant reach out to the community care dept to get started. My last follow up with my immunologist was 1/17/24. He wants to start me on IVIG so he diagnosed me with Idiopathic progressive neuropathy to get the ball rolling. Once it is approved by medicare (or the VA) I will be starting it. It is a VERY expensive treatment so I can not cover it out of pocket. He wants me to see the neurologist/neuromuscular doc that works for him. He said after I have the appointment with his neuro my diagnosis will most likely be changing. Service connection wise...think it will already be so kind of rules out an 1151. Reaching out to lawyers found on the web, have resulted in I have a case, but they cant take it due to the complexity....but please find someone because of the statue of limitations. Potentially 2 malpractice suits... One FCTA against the VA and one against the community hospital/neuro-opthamalagist/eye surgeon for the 2 eye surgeries. Any help is appreciated. Sorry again for the long post.

Yea so I have no friggin idea, what my status is. I tried calling the 800 number today and got the run around.

This is from the ChampVA VA website.... Am I eligible for health care through CHAMPVA? You may only be eligible for health care through CHAMPVA if you don’t qualify for TRICARE and at least one of the descriptions listed below is true for you. At least one of these must be true. You’re: The spouse or child of a Veteran who’s been rated permanently and totally disabled for a service-connected disability by a VA regional office, or The surviving spouse or child of a Veteran who died from a VA-rated service-connected disability, or The surviving spouse or child of a Veteran who was at the time of death rated permanently and totally disabled from a service-connected disability, or The surviving spouse or child of a service member who died in the line of duty, not due to misconduct (in most of these cases, family members qualify for TRICARE, not CHAMPVA). A service-connected disability is a disability that we’ve concluded was caused—or made worse—by the Veteran’s active-duty service. A permanent disability is one that’s not expected to improve. Note: A Veteran who’s the qualifying CHAMPVA sponsor for their family may also qualify for the VA health care program based on their own Veteran status. If 2 spouses are both Veterans who qualify as CHAMPVA sponsors for their family, they both may now qualify for CHAMPVA benefits. Each time they need medical care, they may choose to get care through the VA health care program or using their CHAMPVA coverage. and from the ch 35 VA website Am I eligible for education benefits? You may be eligible for VA education benefits (Chapter 35 benefits) if you’re the child or spouse of a service member and one of the descriptions listed below is true of the service member. One of these must be true. The service member: Died in the line of duty after September 10, 2001, or Is missing in action or was captured in the line of duty by a hostile force, or Was detained (held) by force while in the line of duty by a foreign government or power, or Is in the hospital or getting outpatient treatment for a service-connected permanent and total disability, and is likely to be discharged for that disability. A service-connected permanent and total disability is a disability resulting from your service that doesn’t go away. You may be eligible for VA education benefits (Chapter 35 benefits) if you’re the child or spouse of a Veteran and one of the descriptions listed below is true of the Veteran. One of these must be true. The Veteran: Is permanently and totally disabled due to a service-connected disability, or Died while on active duty or as a result of a service-connected disability If you’re a dependent who doesn’t meet the above criteria, you may still qualify for VA education benefits if the Veteran or service member transferred some or all of their Post-9/11 GI Bill entitlement to you while they were on active duty. Learn about transferred benefits They both mention being P&T but nothing on a rating. So I can get how someone with a 70% TDIU rating can be eligible if they are P&T, the problem is I have no idea if I am or not since I have a letter downloaded from ebenefits saying I am not P&T, another letter from the VA saying I am just permanent, and am eligible for the other benefits.

Thats what I would think....especially since to my knowledge there is no permanent rating by itself. Also to my knowledge with Ch35/Champ VA etc you have to be 100% P&T to be eligible, though the VA is telling me I am eligible with the 70% TDIU Permanent. Especially since I was ineligble for them 2 years ago. edit: spelling

I tried to make it clear that the ebenefits letter shows am not permanently and totally disabled. Since apparently I was made permanent in December of last year according to the VA I would think that that would update. Then I get the letter today saying "Are you considered to be permamentally disabled due to your service connected disabilities: Yes at 70%." .

Why I am confused since I am only 70% with TDIU and now apparently permanent. But according to the VA I am eligible for those benefits.

Hello, I am currently 70% TDIU (since February of 2016). Apparently the VA changed me to a Permanent status (am eligible for CH. 35, ChampVA, and dental through the VA), I was never sent anything saying Permanent and Total or eligible for Ch 35 etc. I found out last month when I went to get plates for my new vehicle and they contacted the county veteran's office who told them I was permanent (saying nothing but total). I talked to the county veterans office and they had me fill out an app for Champ VA because they saw in the VA's systems that no further exams are required and they wern't sure if it was P&T or just permanent. Ebenefits letter says not permanent and totally disable. Today I received a letter from the VA with my benefits and ratings and where it would say about being Permanent and Totally Disabled it says "Are you considered to be permamentally disabled due to your service connected disabilities: Yes at 70%. So I have established ChampVA/CH 35, dental etc eligibility. But does that mean I am P&T? DO I qualify for ID card, space A travel etc? If not P&T from my understanding the VA doesn't have just a permanent its either P&T or not, and also wouldn't be eligible for ChampVA, dental, or ch 35. Any help is appreciated. Semper FI

DID you get travel reimbursement for checked baggage or anything like that? I just got back Friday and am getting told different stories. Overall I have to agree with your review.

I recenly completed my C&P exam for Keratoconus a week ago. I was diagnosed in Septer of 2013, with Kerotoconus. During my entrance med exam, my vision was 20/20 in both eys. About 2 years into my service, I started seeing double, and bluriness. I made an appt with the eye doc in 29 stumps, and was diagnosed with asigmatism. At the time of that exam I was 20/40 in my left eye and 20/20 in my right eye. I had two ofher eye exams while in, and while I do not remember what my visual acuity was My perscriptions changed again. During the second exam a Keratometry was performed. Here are the notes from previous eye exams. "22 AUG1997 Plan-075 x 178 -050-100 x 041 3 NOV 1998 -025-050 x 180 -050-100 x 045 Keratometry : no comment on quality of mires 41.87/43.25 x 093 42.50/44.87 x 113 14 JAN 2000 Plan -050 x 175 +025-100 x 064". I didn't go back for any eye exams until 2013, due to lack of money or vision insurance. I just dealt with the double vision and bluriness. Finally I found out I could get my eyes checked through the VA since I was alred 20% service connected for flat feet and my knee, and made an appt. That was when I was given the diagnosis of Keratoconus. I am in the process of getting a contact to help correct my vision, though the C&P doc said I would probably be better off getting the corneal transplant. I applied for service connection in November 2014, and am awaiting the decision. I wanted to know what the board thinks of it being granted since from my perspective, it started during my time in service and was never diagnosed until my visit in 2013. Thanks for any help in this. I am including the relevant notes from the exam below if anyone can make sense of them. "Describe the history (including onset and course) of the Veteran's current eye condition(s) (brief summary): history of astigmatism. No one used the word "keratoconus" while in the service. Never turned down for refractive surgery. Dx of keratoconus first used at VA in 2013. No family history Last eye exam at VA by Mar 27, 2015. Patient not dilated at this visit. SECTION III: PHYSICAL EXAMINATION --------------------------------- 1. Visual acuity ---------------- a. Uncorrected distance: Right: [ ] 5/200 [ ] 10/200 [ ] 15/200 [ ] 20/200 [ ] 20/100 [ ] 20/70 [ ] 20/50 [X] 20/40 or better Left: [ ] 5/200 [ ] 10/200 [ ] 15/200 [X] 20/200 [ ] 20/100 [ ] 20/70 [ ] 20/50 [ ] 20/40 or better b. Uncorrected near: Right: [ ] 5/200 [ ] 10/200 [ ] 15/200 [ ] 20/200 [ ] 20/100 [X] 20/70 [ ] 20/50 [ ] 20/40 or better Left: [ ] 5/200 [ ] 10/200 [ ] 15/200 [ ] 20/200 [ ] 20/100 [X] 20/70 [ ] 20/50 [ ] 20/40 or better c. Corrected distance: Right: [ ] 5/200 [ ] 10/200 [ ] 15/200 [ ] 20/200 [ ] 20/100 [ ] 20/70 [ ] 20/50 [X] 20/40 or better Left: [ ] 5/200 [ ] 10/200 [ ] 15/200 [X] 20/200 [ ] 20/100 [ ] 20/70 [ ] 20/50 [ ] 20/40 or better d. Corrected near: Right: [ ] 5/200 [ ] 10/200 [ ] 15/200 [ ] 20/200 [ ] 20/100 [ ] 20/70 [ ] 20/50 [X] 20/40 or better Left: [ ] 5/200 [ ] 10/200 [ ] 15/200 [ ] 20/200 [ ] 20/100 [X] 20/70 [ ] 20/50 [ ] 20/40 or better 2. Difference in corrected visual acuity for distance and near vision --------------------------------------------------------------------- Does the Veteran have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse? [ ] Yes [X] No 3. Pupils --------- a. Pupil diameter: Right: 4 mm Left: 4 mm b. [X] Pupils are round and reactive to light c. Is an afferent pupillary defect present? [ ] Yes [X] No d. [ ] Other, describe: No answer provided 4. Anatomical loss, light perception only, extremely poor vision or blindness ----------------------------------------------------------------------------- Does the Veteran have anatomical loss, light perception only, extremely poor vision or blindness of either eye? [ ] Yes [X] No 5. Astigmatism -------------- Does the Veteran have a corneal irregularity that results in severe irregular astigmatism? [X] Yes [ ] No If yes, complete the following section: a. Does the Veteran customarily wear contact lenses to correct the above corneal irregularity? [ ] Yes [X] No b. Was the corrected visual acuity determined using contact lenses? [ ] Yes [X] No If no, explain: patient not a contact lens wearer, has been referred for RGP fit through fee basis 6. Diplopia ----------- Does the Veteran have diplopia (double vision)? [X] Yes [ ] No a. Provide etiology (such as traumatic injury, thyroid eye disease, myasthenia gravis, etc.): Monocular double vision in left eye b. The areas of diplopia must be documented on a Goldmann perimeter chart that identifies the four major quadrants (upward, downward, left lateral and right lateral) and the central field (20 degrees or less). Include the chart with this Questionnaire. Report the results from the Goldmann perimeter chart below: Indicate the areas where diplopia is present (the fields in which the Veteran sees double using binocular vision): [X] Central 20 degrees [ ] 21 to 30 degrees [ ] 31 to 40 degrees [ ] Greater than 40 degrees c. Indicate frequency of the diplopia: [ ] Constant [X] Occasional If occasional, indicate frequency of diplopia and most recent occurrence: No answer provided d. Is the diplopia correctable with standard spectacle correction? [ ] Yes [X] No If no, is the diplopia correctable with standard spectacle correction that includes a special prismatic correction? [ ] Yes [X] No 7. Tonometry ------------ a. If tonometry was performed, provide results: Right eye pressure: 9 Left eye pressure: 9 b. Tonometry method used: [ ] Goldmann applanation [X] Other, describe: NCT 8. Slit lamp and external eye exam ---------------------------------- a. External exam/lids/lashes: Right [X] Normal [ ] Other, describe: Left [X] Normal [ ] Other, describe: b. Conjunctiva/sclera: Right [X] Normal [ ] Other, describe: Left [X] Normal [ ] Other, describe: c. Cornea: Right [X] Normal [ ] Other, describe: Left [ ] Normal [X] Other, describe: thinning d. Anterior chamber: Right [X] Normal [ ] Other, describe: Left [X] Normal [ ] Other, describe: e. Iris: Right [X] Normal [ ] Other, describe: Left [X] Normal [ ] Other, describe: f. Lens: Right [X] Normal [ ] Other, describe: Left [X] Normal [ ] Other, describe: 9. Internal eye exam (fundus) -------------------- Fundus: [X] Normal bilaterally [ ] Abnormal 10. Visual fields ----------------- Does the Veteran have a visual field defect (or a condition that may result in visual field defect)? [ ] Yes [X] No a. Was visual field testing performed? [ ] Yes [X] No b. Does the Veteran have contraction of a visual field? No answer provided c. Does the Veteran have loss of a visual field? No answer provided d. Does the Veteran have a scotoma? No answer provided e. Does the Veteran have legal (statutory) blindness (visual field diameter of 20 degrees or less in the better eye, even if the corrected visual acuity is 20/20) based upon visual field loss? No answer provided SECTION IV: Eye conditions --------------------------- 1. Conditions ------------- Does the Veteran have any of the following eye conditions? [X] Yes [ ] No If yes, check all that apply: [X] Corneal conditions 6. Corneal conditions --------------------- a. Has the Veteran had a corneal transplant? [ ] Yes [X] No b. Does the Veteran have keratoconus? [X] Yes [ ] No If yes, indicate eye affected: [ ] Right [ ] Left [X] Both c. Does the Veteran have a pterygium? [ ] Yes [X] No d. Does the Veteran have another corneal condition that may result in an irregular cornea? (For example, pellucid marginal degeneration, irregular astigmatism from corneal scar, post-laser refractive surgery, acne rosacea keratopathy, etc.) [ ] Yes [X] No e. Is the Veteran's decrease in visual acuity or other visual impairment, if present, attributable to keratoconus or another corneal condition, if present? [X] Yes [ ] No [ ] There is no decrease in visual acuity or other visual impairment If yes, specify corneal condition responsible for visual impairment: irregular astigmatism f. Does any eye condition identified in this section cause scarring or disfigurement? No answer provided 14. Other eye conditions, pertinent physical findings, complications, conditions, signs and/or symptoms --------------------------------------------------------------------- Does the Veteran have any other eye conditions, pertinent physical findings, complications, conditions, signs and/or symptoms related to the condition at hand? [ ] Yes [X] No SECTION V: Scarring and disfigurement -------------------------------------- Does the Veteran have scarring or disfigurement attributable to any eye condition? [ ] Yes [X] No SECTION VI: Incapacitating episodes ------------------------------------ During the past 12 months, has the Veteran had any incapacitating episodes attributable to any eye conditions? [ ] Yes [X] No SECTION VII ----------- 1. Functional impact -------------------- Does the Veteran's eye condition(s) impact his or her ability to work? [X] Yes [ ] No If yes, describe the impact of each of the Veteran's eye condition(s), providing one or more examples: poor vision in left eye: Unable to do work involving fine depth perception 2. Remarks, if any: The question is asked if the patient has keratoconus that is as least as likely as not incurred in or caused by double vision or blurred vision during service. Keratoconus is a degeneration of the cornea which leads to distortion and thinning of the front of the eye. As a result, the cornea steepens (this is measured by keratometry or corneal topography) Keratoconus is not caused by blurred vision or double vision. It is instead a degeneration. Review of the STR reveals no diagnosis of keratoconus. The three refractions done over the course of three years were consistent. Keratoconus patients will often fluctuate. Keratometry done in 1998 was not indicative of keratoconus. The cover test done at the visit with the complaint of double vision revealed no motion and no further workup. At Mr. Mayer-Tucker's first visit to the Cheyenne VA in Sep 2013, he reported monocular double vision (overlapping images in one eye) and that he had good vision with previous glasses. The exam previous to that had been three years earlier. VA Records Sep 2013 OD: plano-1.00x175 20/20-2 push OS: -1.25-2.25x020 20/40+2 NO IMPROVEMENT WITH PINHOLE Corneal topography OD: steep K: 46.60D @97 Flat K : 42.44D @7 Astigmatism: 4.16D OS: steep K: 48.93D @99 Flat K : 42.26D @9 Astigmatism 4.67D Mar 2014 OD: -0.75sphere 20/25-+ OS: -1.25-2.25x020 20/50- ph 20/40- Corneal topography OD: steep K: 46.35D @99 Flat K : 42.37D @9 Astigmatism: 3.98D OS: steep K: 49.01D @96 Flat K : 44.64D @6 Astigmatism 4.37D Prescription history from STR 22 AUG1997 Plan-075 x 178 -050-100 x 041 3 NOV 1998 -025-050 x 180 -050-100 x 045 Keratometry : no comment on quality of mires 41.87/43.25 x 093 42.50/44.87 x 113 14 JAN 2000 Plan -050 x 175 +025-100 x 064 Cover test was ortho. Patient did not bring glasses to that visit.

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