spazbototto

I appreciate the responses. I will wait the current claim out until a decision is made, follow-up with my compliant and request a updated c-file. From there I will appeal to the BVA.

I was service connected for Herpes simplex dermatitis in 2022 for 10%, after reading the decision letter & CFR I was very confused on the diagnosis they gave (erythema multiform) and requested my C-File right away. After receiving the C-File the skin DBQ the Dr. never checked erythema multiform and the ICD10 code he used was herpes simplex virus unspecified. So, I did some more digging, in my research it appears the rater was using an old policy prior to 2018 and coded this as 7899-7827 opposed to what it should have been coded as under the general rating for skin and given a rating of 60%. Further, the rater didn't even use the skin DBQ or IMO! As that was not listed in the decision letter-only the appointment with the optometrist (which was another C&P exam the following week). I submitted a Higher-Level Review in July 2023 stating I was not submitting new evidence and explained the issue (via a 4138) that the coding is incorrect per the CFR and the favorable exam, waited over a year and the HLR was “confirmed and continued” (this time they did list the skin exam as evidence so I knew they had it) -they also did not accept my statement and labeled it "new evidence". I immediately opened a supplemental stating the same information and they sent me to a un-needed skin exam yesterday. When I got the exam notification, I submitted a compliant thru the white house hotline and given a case number and suspense date of September 20th but I do not have faith its going to be corrected. I was thinking about requesting a hearing for the supplemental next week if the Whitehouse hotline complaint is not updated but given how long it took for the HLR to amount to nothing I fear maybe someone somewhere will read and correct the issue and the hearing will just delay the issue further.