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flow1972

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About flow1972

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    E-3 Seaman

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  • Military Rank
    E-4

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  • Service Connected Disability
    90%
  • Branch of Service
    USAF

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  1. I didn't purposely follow your advice, but I didn't want to waste my time on submitting the secondaries until I got the SC for the PTSD. I submitted those 2 months after. I just missed the Esophagus code when I did. I kept thinking it was part of the "severity" list for IBS or GERD; but realized later it was a separate code with a separate rating. So I got my SC for the PTSD Secondary to it, I was able to get Raynaud's Syndrome, IBS/GERD, and Supraventricular Arythmia immediately after the SC for PTSD. I'm SC'd on Asthma, HSV1, Allergic Rhinitis, and Tinnitis as well. Medications for Asthma or Allergic Rhinitis could easily secondarily affect Raynaud's or any one of the others as well. More than one way to skin a cat per se.
  2. There is. It's 7204 Esophagus, spasm of (cardiospasm). It doesn't fall under the "inclusive" codes for IBS/GERD 7319 and 7346 (7301- 7329, 7331, 7342, and 7345-7348 are inclusive in this schedule)
  3. Yep, this is what I found: Federal law under 38 CFR 3.310 governs these claims, and once granted, the secondary condition is considered a part of the original condition.
  4. I'm not aware of a regulation that states an SC'd "secondary" cannot be SC'd to another condition that it causes or aggravates. For example, I am SC'd for PTSD. I'm SC'd "secondary" on IBS/GERD. GERD is causing Esophageal spasm which I currently have a claim in for. As long as the rating structure is followed and not pyramided, I can't see how it can be denied.
  5. No, I hadn't seen that page. Thanks. For me, the difficulty was trying to understand the lingo between Legacy Appeals and New. Too many posts about legacy that don't really translate to the new. Weeding through all of it and understanding what was what in one place. As for the CUE, I'm still not clear on what the difference is between that and a NOD in the new process or if a "CUE" actually exists as a separate thing in the new process. For me...my awarded rating was clearly incorrect based on prescription evidence. Someone just didn't read the prescriptions and add up the amount of time each would add up to in "weeks in a year". I would think that would be a CUE, but I couldn't find "how" to submit that in the new process...or anything that told me what a "NOD" in the new process was. I ended-up just filing for a Higher Level Review and requested a phone conference so I could point out the mathematical error.
  6. I've never found so many conflicting answers on something that "should" be easy to understand. I read over and over about the Appeals process, filling a NOD, and CUE from Legacy Claims; but translating any of that under the new process isn't easy. What I found: After you receive your initial decision under the Non-Legacy Appeals Process you have 3 options. 1) The NOD isn't stated as such on the "Description of Review Options" sent out with your decision paperwork. The "Appeal to the Board" option is a "NOD" in the new system. It's VA Form 10182. Under the "New Process" you get to skip over to a direct appeal to the BVA on this form. The form actually says: DECISION REVIEW REQUEST: BOARD APPEAL (NOTICE OF DISAGREEMENT). For whatever reason, that info was just not easy to find. You can choose this directly or already completing a Supplemental Claim or Higher-Level Review. It's up to you if you want to skip over those. You can choose 3 options in the NOD: a) Direct Review by a Veterans Law Judge (no board hearing or additional evidence submitted) b) Evidence Submission Reviewed by a Veterans Law Judge (no board hearing, but you can submit additional evidence within 90 days) c) Hearing with a Veterans Law Judge (board hearing and you can submit additional evidence within 90 days after hearing) If you don't want to go straight to the BVA, you can: 2) File a Supplemental Claim (you have new evidence) - This decision can be requested to have a higher level review, a NOD, or both if you don't agree 3) File a Higher-Level Review request (you have no new evidence) -This decision can be appealed to the BVA (NOD) if you disagree. I hope someone else can better understand the process by reading this. If anyone has info on a CUE in the new process...I still am clueless on it. LOL
  7. Thanks for everyone's input. To clarify, I was NOT denied for this condition. It was awarded, but it was awarded at 10% when the evidence submitted clearly showed it meets the 30% criteria for rating. Based on all of the information, it appears that since this is not a legacy claim...the only two options are to Request For Higher Level Review (no new evidence) or Supplemental Claim unless I wanted to appeal to the BVA. So, I'm going to submit a Request For Higher Level Review with a teleconference. My understanding is that, this is basically like filing a NOD. If I have that incorrect...someone please correct me.
  8. I finally got my ratings for my secondaries and other assorted SC Conditions. Good news, I"m now at 90%. (literally 84.9 rounded to 90) One of the conditions was not rated correctly according to the schedule. It's the general skin condition schedule rating. They rated at 10% instead of 30%. The 30% rating states: -Characteristic lesions involving more than 20 to 40 percent of the entire body OR 20 to 40 percent of exposed areas affected, OR -Systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly, over the past 12-month period. I provided 5 separate prescriptions(42 pills each to be taken 3 times a day for 5 days as indicated) that would cover 10 weeks 8/2018 to 11/2019. Even if they dropped the 11/2019 rx, there would be enough meds to cover 8 weeks in a calendar year. I looked up whether they were trying to infer the med was not "systemic therapy", and I found Citation 1519469 where it specifically says it is because it's not a topical cream. Although the rating criteria mention corticosteroids or other immunosuppressive drugs as examples of systemic therapy, the term "such as" indicates that this is not an exhaustive list, and "systemic therapy" is not otherwise defined in the regulations. See, e.g., Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002) (holding that with respect to the criteria for rating mental disorders, "[t]he use of the term 'such as' demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating."). The common definition of "systemic therapy" would be treatment of a disease which affects the entire body. See Dorland's Illustrated Medical Dictionary, 1865, 1911 (32nd ed. 2012) (defining "systemic" as "pertaining to or affecting the body as a whole" and defining "therapy" as "the treatment of a disease"). As the Veteran was prescribed oral antiviral medications to suppress the herpes virus throughout the body, as opposed to a topical ointment, the Board finds that such treatment constitutes systemic therapy. That being said, should I file a NOD or Appeal? Or are they the same thing? Then how to file a NOD verses appeal? I've seen conflicting info... Thanks in advance. Getting to this point has been only doable with all of the info here.
  9. Not sure if you've already been through the C&P yet or not. I completely agree with how you feel....I am SC for PTSD due to MST, and the stress leading up to the C&P for it was very difficult. Not sure based on your OP if you're connected for it already and the C&P is for the Sleep Apnea or if you're C&P is for the MST. Either way...you'll be ok...hang in there. We all have to do it, unfortunately.
  10. I haven't gotten the letters in the mail yet, but va.gov shows the claim complete; and the "download your letters" shows me at 40% SC now. (I was only at 10 before). I am glad it's finally over at least for now. Such a stressful process that dug up so many things I didn't want to think about. I feel they came in right where I should be. My private doc had filled out the DBQ before we submitted for the C&P. She specializes in Sexual Trama cases, and I really like her. She and I both felt like 30% is where I fit in the criteria. I'm glad the VA agreed with her assessment. I am grateful to everyone on this site for all of the advice and guidance in the process. Now, I will move on to get the conditions I have that are affected by stress secondary connected.
  11. It was a long day...literally 3 hours in that room. I'd been dreading it since I began this process. They honored my request for a female examiner. So, that was good. The questions she asked started with my childhood family life and moved forward from there. Basically, yes my parents were divorced...childhood sucked...no, I was never sexually abused...yes, my Father was married to someone who was physically abusive toward him and everyone in the house for a short period of time. No school problems, never in trouble, had a core group of friends, blah blah...Honor Graduate in Basic..moving on.... She asked if I dated in High School (uh, yeah...)..I wasn't "popular" or "unpopular"..just your average teen. One boyfriend mainly off and on thru High School. FFWD to service overseas..she asked about my EPR's 3's both years...I failed my first time testing for Certification after Tech School..Passed on second try...and I put on a little weight..so...I was on weight management program...3 1st year overseas. Second year...all of those issues were corrected, but I was given a 3 again anyway that was blamed on an old phone bill from my first 6 months in Country that somehow found it's way to the 1st Sgt just before I left Country...funny that I'd just reported a Sexual Assault right before that.... Were there any significant relationships while Stationed overseas...yes...one. I was in it when the incident happened. It ended immediately after. We moved on to my next duty Station...3 months after the Assault...magically, changing Command and pretending none of what happened actually did...I became a leader in my new Duty Station....elected Vice President of the BOSS program that year, Sat on Board for Post Improvement, President of Single Airman's Program, etc...I said it's amazing what happens when you leave everything that happened in another Country and shut it out and pretend it didn't happen. She asked about any other relationships or significant life events at my next duty Station...I married and had my first Child. She asked about that marriage..yeah...it ended shortly after my son was born..she asked why...well...he showed up at the Hospital to pick my son and I up after I gave birth with another girl. Oh, so he was unfaithful? Had a girlfriend? Yeah...he had many..she just happened to be the one at the time. Got out of military just before we divorced, officially. Next relationship...well..my second son's Father walked out the day I found out I was pregnant...yeehaw...I really had some relationship issues apparently. Then we discussed my current husband whom I've been married to for 19 years and how I feel like he thinks I'm not good enough or he's doing me some sort of kindness by being with me because "something is wrong with me". How he says I make him a worse person...etc... I have issues with anger, and I was forced to Anger Management many years ago by my then employer. The guy they sent me to decided I had ADD to explain my impulse control and asked my PCP to prescribe Concerta which didn't help because I don't have ADD. I saw him a total of 3 times. My PCP was trying to find the cause of my stomach problems at that time and had just diagnosed a "Spastic Colon" and then decided maybe Paxil would help...too many side affects...then Welbutrin...then Celexa....nothing really helped enough to deal with the side affects, but I was willing to try them all if they would help "fix" whatever was wrong with me. After years of struggling, I figured out that running helped more than anything...so that's what I do now and have done for years. Then she got in to the actual "PTSD" criterian type questions...anything I answered "Yes" to..she would ask something about "how often" or how many times in the last month does this or that happen...several times I had to tell her I didn't know how to answer that....I don't keep a spreadsheet. Describe a dream I'd had...how long was it taking to get to sleep (I don't know...sometimes I can't get to sleep at all..other times I eventually do and as long as I don't have a nightmare..I stay asleep). All very impersonal...clinical...and specific to the words..."within the last month"...then how much time have I missed from work in the last 12 months..for what? When was the last time I took a trip...we went on a Cruise this past summer...Was it fun?...Well, yeah...it was nice to get away from everything...Where did we go?...I don't know...it stopped several times...somewhere in the Carribean. I didn't even think to tell her about the Stand Up Comedian on the Cruise who did a whole set on how nobody had ever tried to Sexually Assault her and she had decided that it's because those people put out "Victim Vibes"....It took all I had not to walk out...and I sent the Cruise Line a letter after. She asked about current friend groups...I told her we have people we associate with, but I don't have any "close friends"...nobody I'd call up and just confide in. I don't trust people enough for that. Do I have any hobbies?...Yes, I ride a motorcycle... She asked why "all of this came up now"? I felt that wasn't an appropriate question. This isn't something that "just came up now"...it's something I've shoved in the back of my mind and tried to pretend didn't happen. I'm trying to understand what I've been fighting all of these years. I'm being asked to move up at work...and I refuse...I can't control my environment when I move above where I'm at...at my age I've learned ways of mitigating issues at work by retaining control over meetings and who I'm forced to be in front of....but it creates friction when I don't want to take on more responsibility. We talked about how I always get dinged on my communication at work while I typically am rated high on the actual work that I do. How I have difficulty focusing on tasks when something triggers me, and the loss of focus causes me to make mistakes. I was given some True/False test to complete that asked all kinds of crazy things...I think that's to determine if you're high risk for malingering. Then she asked if there was anything we hadn't discussed that I felt we should. I explained the things about the event that really bother me...how his Commander treated me left me with zero trust in men in general (especially those in charge)and how I truly think that in the greater majority most of them don't think things like this are a "big deal" or somehow it's our fault in some way but would give lip service to how "horrible it is" in social circles..how I never go without being armed as long as it's not against the law where I am(because that will never happen to me again)...how I felt like her questions were geared toward something that "just happened" where I feel like I've had years and years to build deep-seeded beliefs that affect who I am and how I became this person. She said she'd take all of that in to consideration when she did her report.... All-in-all, she came off as very "mechanical" with no real "feeling" behind anything. I felt like someone sitting in front of a car insurance agency's legal team who was trying to find more reason to deny my claim than approve it....I was as honest as I could be...that's all I know how to be...she made a point not to get in to the specifics of my assault because she had the report and didn't feel the need to. I was at least glad for that. So now...I wait....I hope this helps to give someone an idea of the C&P for this if they've never been through it...
  12. Question: Do I need to submit every single URI occurrence "since service", or just 1 or 2 most recent where the word "Asthma" is used and/or an inhaler is prescribed? Also, do I "need" to get a doc to literally write something saying "the current Asthmatic Episodes" are related to the same condition as the ones in Service; or will the C&P do that? Asthmatic episodes don't "go away"..you either have reactive lungs or you don't..so not sure what "else" it could be related to.
  13. Really good info! The only thing I guess I need to do is get an "actual diagnosis" for whatever they want to call it. That provisional diagnosis was just before I got out; and they never sent me back for any other tests. (Never had a PFT before or during service). Never used an inhaler before service, but I'd meet the 10% criteria during and since service. The thing about Docs is...they just take the fact that you say.."I've been told I have Asthma or "Asthmatic something or other" and write that down. Then, they prescribe the inhaler and so forth. They never "Actually diagnose you with anything..that I've seen." They may write a note about Asthma symptoms or something...but not.."this person has Asthma" or whatever. I "do" however have proof they found me "Allergic" to dust while in service...never had an allergy test (or allergies that I knew of) before service. So..sounds like I need to see an Allergy Doc and get an "Actual Diagnosis" to then connect to the "Provisional" one. Oy...so ridiculous. Any person with a logical brain could look at the record and see..."Asthmatic Symptoms in Service"..."Asthmatic Symptoms after Service"...huh...these are likely related or the same condition. Duh.
  14. This will probably come up for me. My entrance exam notes Asthma "No issues since 7 years of age". It also notes 0 Medication and Zero Known Allergies. I believe I contracted RSV as an infant and had some "Asthmatic" episodes in early childhood just based on what we had happen with my own daughter and RSV. I never had any issues after 1st grade that I recall..and no inhalers or anything. There is even an entry in my records where they did a "Medical Records Review" as part of my security clearance where it states "No history of chronic medical issues". As soon as I got in to Tech School, I started getting URI's, Walking Pneumonia (once), and Bronchitis quite often. When I got back from Germany, they sent me to the allergy doc. It shows "Provisional Diagnosis" - alergic rhinitis and asthmatic bronchitis with allergy testing only showing reaction to dust. That's one of the things I'm working on getting SC for. I figure they're going to balk at it because it's on my entrance Exam..but they state in their own words..no issues since age 7..I was on no medications for anything...and they even did a full medical records review. So...it was "aggravated by service" at the least. One question I have is...do I need "another diagnosis" to file..or just show that I continue to be prescribed an Inhaler for episodes and meds for allergies?
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