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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

Previous Fields

  • Service Connected Disability
    90%
  • Branch of Service
    USAF

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  1. Every interaction with the VA Claims people makes me want to pull my hair out. I was granted SC for Asthma last year at 10% as worsened by service. 10% because I was on an Albuterol Inhaler as needed. I submitted a Claim to increase the rating to 30% because I was recently put on an inhaled cortiso-steroid which would put me at 30%. I'll be damned if they didn't even examine me for it...they requested a DBQ from a Dr I've never seen who "decided" that basically it never should have been SC'd in the first place because though it does show I had to be treated in service and prescribed an
  2. I hear you. It's mind-numbing. I am a nerd, so I actually have a spread sheet I keep track of "current ratings" with a formula to give me what my "actual score" is using "VA Math". I'm currently at a real score of 92.23 Condition Connection Total Rating Raynaud's Syndrome 40 40 Arythmia 30 58 IBS/Gerd 30 70.6 PTSD 30 79.42 Cervical Strain With Degenerative Arthritis of spine 20 83.54
  3. Thanks, broncovet. Pretty sure I was able to answer my own question by reviewing the regs. Background is...I'm already SC'd on both IBS and GERD (as hiatal hernia). Both of those are SC'd as secondary to PTSD. I submitted the claim for esophageal spasm on its own as a secondary to GERD. All elements of SC have already been met with the primary conditions. They didn't "deny" the connection only that it was already included in already rated conditions. What I've found is that the symptom list for the schedule rating under hiatal hernia doesn't use the words "esophageal spasm", but it
  4. So, I am SC'd on GERD 10% and IBS 30% which they grant at a 30% combined rating since (according to the VA) codes 7319 and 7346 (Hiatal hernia is what they use for GERD) fall in the inclusive rating categories according to this: Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.
  5. I agree with GBArmy. Beat them at their own game...Obesity is linked to PTSD in common Medical Literature. It's can be due to medication taken for PTSD, Stress Overeating, etc.. That would make the Obesity a symptom/secondary condition of the PTSD which (by VA Legal Language) makes the Obesity a "part of" the SC'd PTSD directly making your OSA secondary to the PTSD.
  6. I've personally never needed an actual "Nexus Letter". Even with my PTSD due to MST. I got a diagnosis from a Private Doc (I have other Health Insurance than VA). She was very sympathetic to the VA issues, and she was willing to fill out the VA Form for me that normally is filled out at the C&P. I already had proof of the incident that occurred in service by way of Police Report. My Therapist is awesome and filled that one paper out for me, no charge. Everything else, I did on my own. Secondary conditions were actually pretty easy (at least for me). I knew I needed to prove d
  7. 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. Medica
  8. 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)
  9. 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.
  10. 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.
  11. 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
  12. 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"
  13. 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...
  14. 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 imm
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