cetay

Thanks Broncovet, The decision was so long ago and my memory is`nt clear whether I received a letter notifying me of the decision. My c-file did not contain any notification of decisions. I guess I`ll have to request another privacy act request for those notifications, don`t know why they were not included in privacy act request. Thank all of you for your knowledge. Cedric

Thanks everyone, Berta, broncovet, Buck52, for your prompt reply. The ekg and the x-rays were done in conjunction with my filing of a claim for hypertension and enlarged heart. On active duty, there was concern about my blood pressure (long standing) and in evaluating it was found through ekg and x-ray i was a suspect for an enlarged heart. I was discharged in 6/1981 and filed a disability claim for hypertensive vascular disease, for which I was awarded a 20% disability for hypertension. The compensation examiner in his report (8/81) stated that I did not have an enlarged heart "The heart is regular, it is not enlarged." The doctor interpreting the chest x-ray, for the same compensation exam on (8/81), stated that the heart is enlarged (Chest films reveal that by measurement the heart is enlarged, the CTR is 17.5.32 cm). In 12/83 I filed another claim for hypertensive vascular disease for an enlarged heart (left ventricular hypertrophy) and was denied. The same x-ray physician again found "Examination of the chest shows by measurement the heart is slightly enlarged. The CTR is 16.5:31.2 cm" Now in 4/2018 I`ve been service connected for a disease which should have been service connected in 8/81 and 12/83. They did not rate the enlarged heart (LVH) because the examiner said I did`nt have it, when the diagnostic testing in my records showed that I did have LVH. The lab reports found a nexus between my in-service hypertension and enlarged heart. My concern is that " New and Material Evidence" has to be evidence that was not already in the record and was not available to the rater at the time. Is this scenario a " Clear and Unmistakable Error" or would filing of an " Earlier Effective Date" fit. I am already service connected for the enlarged heart (LVH) as of 4/2018. Once again, thanks Cedric

Are Missed Lab Reports/Diagnostics New and Material Evidence? Really wanted to thank everyone for their help in advising me. Since the last time I`ve posted I have went from 20% (for 30 years) to 80 %. My original claim for kidney disease was denied, with the help of a VSO, and is with the DRO to date. I decided no one would have the time to look at the 6000 plus pages and filed my other claims pro se. Following the guidance in this forum I was service connected for migraines (50%) tinnitus (10%), and left ventricular hypertrophy (30%) in addition to my original service connected HBP (20%). I really appreciate your help. I ordered my c-file and looked through all five-thousand pages and found that in 1981 and again in 1983 I had filed claims for hypertensive vascular disease (hypertension and enlarged heart disease). In the VA doctors evaluation of my claim, he mentioned there was no evidence of an enlarged heart.In the diagnostic ekg and chest xray reports, for 1981 and 1983, they both reported enlarged heart diagnoses. Could these reports be considered as new and material evidence because the doctor in making his decision didn’t take into consideration the material fact of conclusive evidence? Va just rated me with and enlarged this year (left ventricular hypertrophy) and gave me a 30% rating. Question: could this constitute an claim for an earlier effect date, a CUE perhaps? Not sure how to look at this revelation. Thank in advance for any replies. Cedric

Buck52, Thanks for your input. I am not a "vietnam vet" combat vet, I am a 74-81 "vietnam era" vet. Never was in country. I am in the process of getting an IMO from a specialist, but, think I cannot fully develop my claim without my c-files. It is taking about a year to date. Applied for my in-service records and only received 10 pages. Showed, at exit exam, complaints of HBP, LVH, Migraines and Tinnitus. Waiting to file those before one year expiration date on ebenefits. Really need C-file for conclusive evidence.

Sorry for the bold, not trying to shout, tried to turn it off?? pwrslm, I appreciate your response, very helpful with the research websites. What I`m looking for is some information that will require the VA to recognize the fact that the service connected Hypertensive Vascular Disease existed for 38 years and DMII started 14 years ago. Would getting an IMO be enough to refute the VA negative decision. In addition, n. Granting SC for Arteriosclerotic Manifestations Due to Hypertension If additional arteriosclerotic manifestations are subsequently diagnosed in a Veteran with SC hypertension, grant SC on a secondary basis through the relationship to hypertension for any of the following · cerebral arteriosclerosis or thrombosis with hemiplegia · nephrosclerosis of the kidneys with impairment of renal function, or · myocardial damage or coronary occlusion of the heart. Important: A claim for benefits is required to adjudicate a secondary SC claim for any of the arteriosclerotic manifestations. Notes: · Do not address SC for the above-listed cardiovascular conditions through the relationship to the hypertension when a sympathetic reading of the claims does not show a claim for SC for a heart condition. · Arteriosclerosis occurs with advancing age without preexisting hypertension, and may occur in some younger individuals who are predisposed to arterial changes. · The existence of arteriosclerosis does not imply/indicate prior hypertension. References: For more information on · secondary SC, see M21-1, Part IV, Subpart ii, 2.B.5 · intent to file and informal claims, see M21-1, Part III, Subpart ii, 2.C.1 · reopened claims, see M21-1, Part III, Subpart ii, 2.D, and · claims for increase, see M21-1, Part III, Subpart ii, 2. E. Does this section apply to my case, where i have a arteriosclerotic manifestation ( nephrosclerosis of the kidneys) but is consider not applicable because I have DMII? And is there any case law that defines the application? Thank you.

Berta, Thank you for your prompt reply, I do have a history of diabetes from 2003, I also have a history of uncontrollable hypertension since 1981 and to date take six different medicines to try a control it. Service connection for hypertension started in 1980 ( diagnosed in 1978 in service, 23 years before dmII was detected. After filing for ckd secondary to hypertension. I received a C&P report in 01/03/2017 from Nurse Practitioner, on opinion if chronic kidney disease secondary to service connected HTN. Her Rationale: In review of VA treatment records Nephrology note 11/30/2016 annotated chronic kidney disease "due to" type 2 diabetes mellitus. Therefore it is less likely as not the Veteran's chronic kidney disease stage III/IV is proximately due to or result of his service connected hypertensive vascular disease. The Rationale quote, supporting her rational is really from the endocrinologist (diabetic doctor who saw me one time) not the nephrology doctor. Endocrinologist surmised that my stage III renal problem was because I had diabetes since 1981 ( which is in his treatment notes, which in incorrect) ( dmII started in 2003). Nephrology doctor stated on 30 Nov 2016 @ 13:40: " diabetic nephropathy with hypertensive nephrosclerosis", rationalized it was a combination of both htn and dmII. Nurse Practitioner`s rational mixed up the diagnosis of the endocrinologist with that of the nephrology doctor. I`ve been service connected for hypertension since 1981, didn't develop dm II until somewhere around year 2003. Had high creatinine levels in 1995 of 2.4, which are pre-diabetic era. There are statements by two other doctors in my treatment records stating: (1)("Note Title: NEPHROLOGY PROGRESS NOTE: diabetic nephropathy with hypertensive nephrosclerosis. But will check proteinuric w/u next visit." (2)("Emergency room: 03 May 2016 @ 1336, YOUR DISCHARGE DIAGNOSIS: Diabetes (your hemoglobin a1c was 9.5% which is above the goal of 7) High blood pressure, TIA (Mini stroke) Kidney disease likely from your blood pressure and diabetes"). I have tried to get my C-file since 07/2016, but have not received them to date. Before I file an appeal, I would like to go through all my files for addition information. Kidney scan showed: Unremarkable sonographic evaluation of the kidneys with no evidence of hydronephrosis. Va decision: Issue/Contention diabetic nephropathy (claimed as kidney condition) ***"wrong, I claimed ckd secondary to htn" Explanation · The evidence does not show that diabetic nephropathy (claimed as a kidney condition) is related to the service-connected condition of Hypertensive vascular disease, nor is there any evidence of this disability during military service. · Your service treatment records do not include evidence of treatment for or diagnosis of a chronic kidney condition during service. Your treatment records from the Northern Florida VA Healthcare System show you was diagnosed with diabetes mellitus with renal(kidney)manifestations in May 2003. There is no evidence of a link between this condition and your service connected hypertensive vascular disease. In the report of your examination of January 3, 2017. the examiner confirmed the diagnosis of diabetic nephropathy and expressed the opinion your current kidney condition is less likely than not related to your Hypertensive vascular disease and more likely than not caused by diabetes mellitus.\Because the available evidence does not show your current kidney condition began during or was caused by service or is secondary to a service connected condition, service connection cannot be granted.

Hi everyone, I have two questions: I`m receiving a 20% compensation for hypertensive vascular disease (1) Recently received another decision by the VA and am curious about the wording of the decision in the last paragraph. What We Decided We made the following decision(s)........ We reviewed the evidence received and determined your service-connected condition(s) hasn't`t/haven`t increased in severity sufficiently to warrant a higher evaluation." NOTE: If you wish to claim service connection for an eye condition as secondary to your hypertension, please submit a claim on a standard form." I was wondering if the rating was trying to hint to a compensable eye injury that i could claim? (2) On another C&P, the NP filled out the DBQ and answered the question: 3. Renal dysfunction b. Does the Veteran have any signs or symptoms due to renal dysfunction? [X] Yes [ ] No If yes, check all that apply: [X] Proteinuria (albuminuria) [X] Constant c. Does the Veteran have hypertension and/or heart disease due to renal dysfunction or caused by any kidney condition? [ ] Yes [X] No In my VA treatment records there is evidence of 20% disability for hypertensive vascular disease, left ventricular hypertrophy, "Hypertension with nephropathy - poorly controlled." Am I interpreting the question incorrectly ( c. Does the Veteran have hypertension and/or heart disease due to renal dysfunction or caused by any kidney condition?) to mean: Is there other renal dysfunctions caused by CKD? And should the NP have checked "YES" to that question? Any feedback would be greatly appreciated.