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glenda h

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    SFC ret

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  • Service Connected Disability
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  1. Since 2019 fighting for increase of GERD to include service connection for gastritis. I had gastritis with H pylori , prior to retiring but seem to ignore this one condition. Now It has gotten worse. I appealed, The RO (KY) reduced me back to 0% from 10%, after holding this rating since 2007. I filed for an increase to include this,(gastritis with h-pylori) but again only for GERD. The rater back in 2007 didnt forward my private doctor's documents and C-file to the examiner. Folks here say I dont have a CUE. Nothing said of my other conditions only GERD (7346) because I had a hiatal hernia. This time it is erosive esophagitis and erosive gastritis with multiple lesions, stomach polyp from prolong use of medication. I had the tests done at the VA hospital! Gave me an ACE, even tho evidence was there for a decision. CP Dr didnt even read my file, ignored the other conditions, rater ignored as well, gave me the 0%. Board gave my 10% back to me, but denied the increase, ignored the other info . I appealed to the Court of Appeals . Judge even stated case was problematic because of deficiencies in the opinion , C&P Dr (she didnt say too much at all) (rater didnt even say much) reviewed my whole file, and that BVA judge just copied info provided no rationale. Remanded back, and just learned that BVA, after two days (Per Ebenefits) remanded back to the same stupid RO. The same one who didnt even read my claim, who didnt go by the law, and a Dr whose online reviews are bad. I just hoped it wasnt the same BVA judge. I knew something was gonna get messed up, as the letter I received from the Board about additional argument I want to send- had a date they had for the decision was 7 Jun 2021 instead of back in May 2020, leaving me to believe now that they didnt read anything and just forward back to justify their stats. And who knows how long? I am 69 years old, and I am of the belief that they hope I die before this is settled. It states that for an increase- Where an increase in the level of a disability is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1994) meaning as of 31 Jan 2019 my condition was worse, but with a new remand, they will give me another EGD and then deny again, saying I'm a super trooper, all in my head. Im just fed up!
  2. I have a friend who was an ISG in Reserves. He was injured over in Iraq. He was given a Medical Board by the Army. He was rated 50% disability and was medically retired. He has the blue card yet DFAS keeps calling him a Gray area retiree. VA has rated him as 90%. He states that DFAS takes 90% of his retirement, gives to VA, which then gives it back to him. Would he be entitled to both full since he is rated over the 50% from the VA. ? I advised him to send in a copy of his DD 214/Med Board results to DFAS
  3. I have too! You would be surprise in how they make determinations. Cases of same illnesses, but completely different outcomes by judges. Makes you wonder if they dont base on their personal views rather than by the law.
  4. Back in 2019 this statement was made to another individual. I am puzzled. I am currently 70%. I became 50% back in 2016, 70% in 2019. I had health insurance and kept it after I retired, plus MEDICARE, TFL (mil retiree). I didnt pay any co pays due to having three insurances at the time, but VA billed my MEDICARE and civilian insurance, which paid the Dr visit and my prescriptions by civilian ins. TFL always came up with some excuse not to pay anything for years. But the payments dont go to the VA Dr I see, but someone else I've never seen at the RO billing office. I suspended my civilian health insurance this past January, therefore I will only have MEDICARE and TFL. So are you saying that they shouldnt be billing the companies. I do understand about the medications.
  5. Sometimes it is not the doctor, but that little ole nurse that comes in prior and sits and types in the computer that add words. Ive noted statements on mine that they never asked about.
  6. BrokenSoldier. Just had to add. You say "that should have been submitted the first time". I currently have a case going on at the court level. In my case I submitted docs in a timely manner, (Date stamped by VA as received)only for the rater not to forward to C&P. One that I didnt really need based on what I submitted. This back in 2007. I didnt get my Cfile until 2018 when I learned of this or I would have appealed,- I put my trust in the RO. I just thank God examiner was honest and stated that my Cfile wasnt there or reviewed and docs I submitted wasnt there and reviewed. Even though rater noted that they were. Fast forward I resubmitted for an increase from 10%, again based on docs, procedure done at VA. ACE given, but examiner did not note the docs in file, or all of the symptoms given. Guess what, I was downgraded-it was a protected rating which i held for over 10 years. Not handled corrected by law. Both RO didnt bother to check, C&P didnt bother to check the favorable evidence. BVA gave me back my 10%, but like the RO, did not even delve into the rest of my file for what I was requesting for. So yes, they sometimes are in the business of reducing. So yes, the veteran does submit documents, so not all works with what they have in front of them. On their rating the bullet comment can be about how they saved money, not the errors they made.
  7. I am currently appealing to the US court for my denial of increase in GERD to include Class C esophagitis, erosive gastritis. I am currently being rating for 10% since 2007, up from 0% in 1998 or over 13 years, even though Ive had GERD, gastris with H pylori in service and then again with the claim I made in 2007. I didnt know of the bad C&P until I got my C-file in 2018. It is very important to get yours, as you can find out a lot of things. Like they didnt forward your VA file and your civilian paperwork to the examiner. I was very lucky the examiner noted this, as rater said he did in the decision. Had an ACE in 2019 which examiner stated she reviewed, but omitted what was found on the EGD in 2019 and ignored the 2007. There are articles pertaining to the use of Zantac that contains NDMA as well as other medications such as Nexium. For the 30% rating for GERD it included the wording "impairment of health" I used this same information in my argument concerning this. I dont have cancer, but long term I could have. Ive also included in my argument about the long term use of Nexium-I dont have long term kidney issues, but I could have. I took Rabeprazole for a few times, which can cause fundic gland polyps (growth on stomach lining) which I had one. I listed the side effects of my current meds Im taking now, which IS joint pain, stomach pain, headaches. So...Im giving it a try, as with these medications we are taking, and NOW finding out serious side effects, I would think it would cause a considerable impairment of health.
  8. I've had a contracted C&P done by LHI last year. My examiner was a prior Navy NP, so I was lucky. Got my claim approved. Having a prior svc person helps as they know what you went through. Ive dealt with this company when I was civil svc employee. Most are civilian doctors with no mil exp., they are contracted to do Army reservist annual physicals. If you are to go thru this company, beware of the questions they ask. For example, what happened to the reservists, "do you have a headache", Yes, Boom, the PULHES would have a "3", then the Reservist would have to go through the hoops, getting medical documentation to prove it was nothing so he/she would be fit for duty. Be truthful, aware, when they ask specific questions concerning your condition, as they told to put down exactly what you say. But on the bad side, this examination doesnt show in your med records, at least mine didnt. So I dont know exactly what the examiner said-which could be a reason they are doing this as well. To keep yourself from being on top of it.
  9. I would think they can request a new C&P if they are on the roll to reduce ratings, especially those under 5 years. Back in Jul 2018 there was a report by the OIG: IG Report Unwarranted Medical Reexaminations for Disability Benefits. Yet they are still doing it. With my son, they used that good ole "sent to an old address" trick. He didnt show and bam conveniently reduced for "failure to show up". Because he was a person back in 2016 that had his Ebenefits acct hacked, he then deregistered. Because of that he couldnt get in it to see what the issue was.
  10. "When was the decision which reduced you from 10 percent to 0 percent? (Was it within a year so you can appeal it?) Also, did they give you an increase in some sort of "GERD" alternative rating? Such as gastritis diverticulosis? If you will post the decisions "reasons and bases" (redact your name and address), then maybe we can help more". C&P given 7 May 2007-Examiner-"The veterans C-file has not been provided and is not reviewed." Veteran states that currently being followed by a gastroenterologist in private practice who performd EGD on Nov 2006. That report is not available for review." Yet this report is in my Cfile stamped with " VARO Received Apr 19 2007 Mail Clerk #3" Rater in decision 29 May 2007- "at the recent VA examination, your medical history was reviewed. On direct examination, the VA examiner reports diagnosis of hiatal hernia and reflux" 10% was given for GERD (7346)only in 2007-no mention of the gastritis. Filed increase 6 Mar 2019 to include the gastritis again and the diverticulitis. Given 0% on 27 Mar 2019, based on an ACE. Examiner did not mention the gastritis nor the diverticulitis on the GERD worksheet. I would assume did not have the 2007 info or 2019. Examiner would have access to the medical info, as I had the EGD done at that hospital in Jan 2019. "(2019) Rater: We have assigned a noncompensable evaluation for your gastroesophageal reflux disease based on: Pyrosis. ACE on 27 Mar 2019-Examiner: (1)the VBMS -with info from the initial 1998 C&P - (Mild GERD) (2) "does the veteran have any other pertinent physical findings..... "NO". (3) Does the Veteran have any of the following signs or symptoms due to .....Yes, Pyrosis, reflux. (did not mention the medium sized hiatal hernia) (4) VAMC records 1/31/19- EGD pathology, esophagitis, gastritis, hiatal hernia (Esophagitis listed on EGD as being Class C) (5) Does the Veteran now have or has he/she ever been diagnosed with .....Gastroesophageal reflux disease Yes-(GERD), ICD code: unknown, Date of diagnosis: see prior exams" That is what I am complaining about as well-I had gastritis with H-pylori a year prior to when I retired from Service, but never mentioned in the "well-grounded claim" in 1998. I submitted a civilian's Gastroenterologist's report that I had GERD , small hiatal hernia as well as chronic gastritis with H-pylori when I filed for an increase in 2007. The C&P states examiner did not have my VA records or my documentation. Rater did not mention the other condition (gastritis) as well, but I did get 10%. In the 2019, I again filed for increase to INCLUDE the now erosive gastritis and diverticulitis, but again it was not mentioned on the ACE or the rater even noted it. It seems VA is completely ignoring the other digestive condition I have and for years. It wont change my rating if they just keep me at 10%. But, at the time I filed this I was temporary 100% due total knee replacement, plus I was given a housebound rate. With them reducing it, I lost the housebound. It was to end 1 Jun 2019, so I lost two months worth. I filed with Board of Appeals so I hope I get my 10% back-It is the principal of it. They never notified me they were doing this, and I dont even think they even noted how long I had this 10% rating. Absent was the fact that the rater didnt mention this in the decision nor that they supposedly sent me a letter 60 days prior. I'm just upset that they keep ignoring this other symptom, shown in black and white. Thank You
  11. This is clear error "unless" this was some sort of temporary or convalescent rating". The VA is required to give you 60 days notice and an opportunity for a hearing, as well as notice of proposed reduction. I was rated 0% for GERD only when I retired. Had gastritis with h-pylori a year before I retired, but it wasnt mentioned in the initial C&P. In 2007 I submitted EGD results from my Gastro Dr, but it wasnt provided to the examiner, to include my VA record. I had GERD as well as chronic gastritis with h-pylori. The C&P examiner noted that he was not provided any records to review. Found this out when I requested my Cfile and it stated this on the C&P exam. But yet the rater in the decision stated that my records were reviewed, which contradicts. "At the recent VA examination, your medical history was reviewed". VA mailroom date stamped my info I submitted as received and shown on the documents in my file. I was given 10% for GERD only and have held this rating since 2007 or 12 years. Again, in the 2019 request for an increase I noted Class C esophagitis. erosive gastritis diverticulosis. This was based on a EGD I had done by the VA in Jan 2019. An ACE was done, and again only GERD was mentioned and I was downgraded to 0%. And no notification that they were going to do this.
  12. Had an upper and lower GI that was requested by the Primary care Dr in Jan 2019 at the VA hospital. Due to the results I then filed a request for an increase on 6 Mar 2019. Ive been rated 10 % for GERD only, since 2007, even tho Ive had gastritis as well, even before I got out of service. I find out on myhealthvet that an ACE was completed on 27 Mar 2019. Im curious as if this was really necessary as the procedure was done by the VA system and all rater had to do was view the evidence. And they downgraded to 0% on 27 Aug 2019. Nope, did not receive notification that they were going to do this. Since I received my Cfile Ive learned to view my BlueButton every chance I get. I found out that the info I submitted back in 2007 from a civilian Dr, as well as my VA records was never given to the examiner during a C&P,. Which I understand, by regulations a C&P wasn't necessary then. This is two different VAs.
  13. "Keep in mind that due to the nature of the digestive system, VA would most likely combined your conditions and pay you at the higher rate to avoid pyramiding". That is one of my main gripes. They are only listing the GERD with hiatal hernia and ignoring the rest of my gastric issues such as the gastritis which I also had in service. I included it in my 2007 request for increase and again in 2019. The info from the civilian dr that stated I had the gastritis with H pylori was not even provided to the examiner in 2007, nor did he have my VA health records. The 2019 request was based on an EGD I had AT THE VA in Jan 2019. I filed for an increase 6 Mar and they did an ACE on 27 Mar and downgraded to noncompensable on that date. The only reason I was thinking CUE: 38 CFR § 3.326 - Under Examinations it states (c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination".
  14. Kinda tossing around if I actually have a CUE from a 2007 C&P. Back then your records wasnt on file so you didnt know what was in it and had to depend on what the rater stated. I got a copy of my Cfile recently and learned that the C&P I had, the examiner stated he did not have my VA records, nor the civilian Dr info I submitted. Yet in my cfile the civ info is date stamped by the VA mailroom. I had requested an increase in GERD from noncompensable given in 1998 to compensable to include the gastritis with H pylori again, something I had in service as well that was ignored in my initial exam. I was only approved for 10% for GERD with small hiatal hernia. Ive held this rating for over 12 years. I recently Jan 2019 had another ECG which noted erosive gastritis, no h pylori. and class C esophagitis, a medium size hiatal hernia. So I filed for an increase. Instead of increase, or just stay as it is, they made it Noncompensable effective the date of an ACE!. Again no mention of my gastritis. Did not even include on the form that I had a hiatal hernia. I had filed an initial claim for a different disability in Jan, the request for increase of GERD I completed 6 Mar. They stated online that they combined these claims together. The ACE done on 27 Mar. No notice was sent that they were going to reduce. I didnt know of this until I received my SOC 28 Aug. I do have an appeal for this last one at the BVA. " Poor records mean poor defense, no records mean no defense"
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