Atlcocky

Thanks for the info. It's a little disappointing to think that may kick some of these claims out. They are put together very well with all of the pertinent records.

Berta and Bronco, I really appreciate the time you both put into reviewing and letting me know what y'all think. Thank you for all you do on this board.

Good evening Hadit community, I am planning on submitting this on Ebenefits as a FDC. It is a huge claim that has 2 re-open request, 1 new claim and 4 secondary condition claims. 1) The basic question is If I have DBQ's for a particular claim, do I still need to submit the medical records? (in some cases they are pretty extensive.) 2) Two of the claims are request to re-open old claims. Can I summarize the medical information that is "new and material" to fulfill the re-open requirement or do I need to submit all of the medical documentation? My fear is If I submit hundreds of medical records pages, they will ignore it all and either partially grant or fully deny my claim. I would love to gather a few opinions from you all on this. I want to submit it by Friday of next week. Last question: ON Ebenefits, is there a way to tie the submitted documents with the specific claim and if so, can I put that info in a particular order (ie, explanation of request, DBQ's, chronology of conditions and followed by medical records or some order like that) Thanks all

Hello again Berta. Will you review the last bit of information I posted on this thread. I believe that this could potentially far under 38 CFR 4.6. I read you post from a few years ago and it seems that this may fit. Please advise.

Hello again all, I finally got my big claim together for the VA and will submit it by the end of next week. This allow me to reread and hopefully better explain what I think I see on potential CUE in my heart condition claim. OK, here you go...In my original decision letter that denied the claim for heart condition, it stated "In 4-95 the veteran was noted to have slight cardiac enlargement on chest x-ray. The remaining records were negative for any further finding concerning a heart condition." Sooooo.... There is evidence further in my medical record. On May 12, 1995, there is a Echocardiogram report that shows a "mildly dilated left atrium and top NL wall thickness". Does the fact that this evidence was ignored, missed or disregarded indicated a CUE claim? I believe that if it does, all of the other aspects of proving a CUE will be met. Based on this law: The majority of heart conditions are rated based on a set rating system. All the conditions will be listed below along with any deviations from this rating system. Note: It is very important that the physician performing your exam gets an MET (metabolic equivalent of task) test done for ANY heart condition. An MET test, more often known as an exercise test, checks for how much oxygen is being used by the body to perform increasingly strenuous tasks. 1 MET equals the amount of oxygen a person uses when at rest. There are a very few cases where an MET test is not required, but the majority of the time it is essential to getting a proper heart rating. Be proactive and make sure an MET test is done! The basic rating system: A 30% rating is given if there is one or more of the following: this seems to met the 30% level because the evidence was met in #2. The only thing that I am not sure about is, it does state in the notes that even if this evidence is available, that MET testing should be done. In my case, it was not done. Obviously, that leads to the question, since the VA did not order the necessary test during the initial exam, can they use that to deny the CUE since the rule of 'duty to assist" does not apply? or would the flexibility in the term 'should' allow them to rule in my favor? or could this be one of the 'very few' cases? I read back thru this entire thread and I understand that it is a HIGH hurdle to jump. I want to understand and explore this to the fullest before I move to the next step. I think this explains it as well as I can. Between this and the previous post, I believe the story is now on here to be looked at. Thanks all.

I am not sure which code fits best but, I believe it will be either be 7007 - Hypertensive Heart Disease or the catch all 7020 - Cardiomyopathy. They both seem to have the same rating system associated with them, which is, enlarged heart is a 30% rating. It does say that to award this rating you need the enlarged heart medically documented AND a METs test or EF Test. The VA did not order either.

Hey Buck. I am already connected for the Hypertension. I am trying to get connected for the "heart condition". I believe there was evidence in my service records. The VA did not do the necessary follow up exam that was necessary to complete the ratings. I want to see if this was CUE (not complying with the rule for needing another test to prove case) (Berta says she doesn't think so but I should wait for some of you guys to chime in). I have in my service records the Echo showing enlarged heart (which would have been a 30% rating). My issue now is should I try to fight for the CUE, knowing that I can reopen later..or Reopen now, establish service connection and then try to ask for an earlier effective date because of possible CUE. Second, If the consensus on here is No CUE, I will move forward.

If I was to follow suit with this line of inquiry with the VA, if approved, what would be the effective date? Original 1996 date or the date that you requested the review?

Thanks Berta and Buck for the feedback. Buck, I was thinking the error was concerning the heart condition and the denial of the claim. Soooo...should I just try to get it service connected via a reopening and take the date. or Is there another avenue to try to get an earlier date (I don't think so).

Berta, I have uploaded the original decision and my thoughts. Thanks in advance

Bronco, Can you review the rating decision and the following reasons I believe I may have a case and let me knwo what you think?

Yes sir Buck, I know that rule. I will only proceed if the case is strong.

Ok. What I am trying to find out is the "heart condition" denial.."...slight cardiac enlargement on chest xray." First, it was an Echo that diagnosed the heart enlargement. Second, my understanding is that any enlargement of the heart is a 30% rating regardless of how much the enlargement. Code 7007: Workload of greater than 5 METS but not greater than 7 METS results in dyspnea, fatigue, angina, dizziness or syncope, OR; evidence of cardiac hypertrophy or dilatation on electrocardium, echocardiogram, or xray.....30%. §4.100 Application of the evaluation criteria for diagnostic codes 7000–7007, 7011, and 7015–7020. This does state that a MET testing will need to be done, even if you have the echo data. They did not do that testing back in 1996. That is why I wanted to know the rules that were in place back then. Maybe, that rule was not in place in 96. I believe that if the VA would have applied the rule correctly, they would have either granted the 30% rating or if further testing was needed, they should have scheduled the test. Now, If CUE is not applicable, what should be my next step?

Ok all. This is the original rating decision. Hadit file.pdf

Berta, I have the reopening of the claim almost ready to submit. That, along with about 5 other conditions will be submitted by the end of the month. If connected, then i will either try the CUE riute in that case. The lastest question about CUE is on totally different issue. I will definitely give you all the paeticulars this evening.

Buck, Bronco and Berta, I will respond completely and thoroughly this afternoon when I get back home. I wanted to let you all know I am monitoring but out of position to fully respond. Talk to you all this afternoon and Thank you.

Hello Veterans, I have been looking for the 1996 version of the 38 CFR, especially Book C. I am trying to research whether or not I have a valid CUE claim. The original decision was in 1996 and I need to find out the rules at the time of my denial. I have looked online but, maybe I am not very good at the search. Thank you for your help

Thanks Saxman. Good Luck with your claim!

Hey Broncovet. Who is Peggy and Berta? I'm still a Hadit infant.

Thank you for the information. I will follow the order. I just wasn't sure about whether or not I could do the EED at the same time with a well written claim. Thank you again.

I am filing to reopen the neck and back along with the nerve condition. Same claim with 3 issues

First time poster. Forgive me if it's not very good! I want to find out the best way to attack a claim and EED issue. I have informally and formally requested a nerve condition claim (mainly neck, arm and hand). The condition was in my service medical records and missed or ignored when I got denied for the back, neck and shoulder issues back in 1996. Since separation, I have sent them several documents stating that I have a nerve problem. The American Legion has sent them a request to adjudicate the nerve condition. It is also mentioned in a SSOC and on a C & P exam. I believe that I have an extremely strong case on the service connection part. On the EED, should I just file the claim knowing that I will appeal or fight it on CUE? or is there a way to fight for the EED in the initial claim request? I have been reading the court proceeding on Implicit denial and pending claim doctrine. I still can't figure out if there is a way to get the EED upfront without the long drawn out CUE or appeal process. Thank you all for the information on the site and the hours many of you put into making it better everyday. I hope to be an aid to someone some day.