racemech

Hopefully this does not sound off topic. I have four Rated Conditions and another ten that are secondary and or, residual that have not been rated. With the DBQ process, do I submit the other ten as soon as I get them completed all at once, or do I submit them gradually? My overall total physical and mental condition has deteriorated so rapidly in the past three years, I can barely keep up with it myself.

Here is the Rating Decision letter. I hope that it is not too confusing. When I filed the claim 10/2009, I was under duress. My surgeon was denying anything was wrong. My PCP was really being a jerk. I now know that I should have been more clear on my claim, but my mind was shot. The depression was really kicking in. VARD0311010001.pdf

Berta, I will try to get the decision letter scanned and posted today.

Berta, No, this is not an 1151 claim. I have contacted two law firms, but both of them say that I do not have a case at this time. The incarcerated colon and muscle atrophy were discovered in an MRI from 11/2008, prior to the 1/2009 hernia repair. I have documentation in my medical record where the surgeon states in numerous follow ups that no hernia is present. However, there are multiple entries from the radiologist stating the exact opposite, hernia is present...includes incarcerated ascending colon...muscle atrophy and fat replacement in the lower right quadrant. The radiologist also references two other MRi's performed in 2010 and states that no changes have occurred since the original pre-surgical MRI. This is my reasoning for using the term "faulty". If I had hernia repair surgery, but the hernia and colon incarceration and muscle atrophy still exist, then what did the surgeon do? The other doctors that have examined me and requested surgical consults are being vague and only acknowledge that I have a hernia. I know that it is way past time to get an IMO. I cannot seem to find a doctor to get an IMO. I have until 3/15 to file a NOD. I can fax it to my VSO. When he gets it, he hand carries it upstairs to the VARO usually within an hour. There is so much more to this case that I have not even begun to tell anyone. I need to find a lawyer that will help. Sorry, but when I start talking about this stuff, my moderate depression becomes severe. Bear with me if my responses are delayed. Thanks

I just filed this NOD yesterday, and I wanted some input from the Hadit members. I feel that I did everything but go to the VARO and walk them through it. This is just the tip of the iceberg. I am still having issues with the VAMC ignoring me for the persistent right flank hernia and my colon. I have had my PCP, two Gastro docs, a Urologist, and a Neurosurgeon, and a Patient advocate request multiple surgical consults with the doctor that performed the hernia repair in 1/2009. After six months, I am still being ignored. As a result of the faulty hernia repair, I have an incarcerated colon and lower spine damage. The spine issue is caused by massive atrophy of the right abdominal wall and makes me lean to the left. After two epidural shots and a discectomy, the constant pain is gone...but for how long? Sorry to get off topic. Please read my letter and offer suggestions. NOTICE OF DISAGREEMENT 3/6/2011 This is a notice of disagreement (NOD) to the VA letter/s dated 03/15/2010. I disagree with all the adjudicative determinations mentioned in the above referenced VA letter/s and any enclosed thereto, except for those, if any, that I specifically state here that I do not want to appeal. Therefore, my notice of disagreement specifically covers all the determinations made by the Regional Office unless specifically excluded. I also disagree with the RO’s failure to adjudicate issues and claims it was required to adjudicate. I am specifically referring to issues that I may not have discussed but which were reasonably raised by the evidence in my VA Claims file or in the VA’s possession that should have been inferred by the Regional Office. This appeal also includes adjudicative determinations that were mischaracterized by the Regional Office. I have multiple daily symptoms that have failed to be addressed with the proper severity rating. These include the following: 1. Multiple (4-5) small bowel movements daily, both diarrhea and constipation. Severe cramping and pain throughout the day. During bowel movements, I have sharp burning pain at the sight of the colon incarceration. VA Medical staff have previously diagnosed me with IBC on 11/24/2009. 2. Constant acid in my esophagus. This results in persistent coughing followed by vomiting, usually 2-3 times a week. I am awakened every night with stomach acid and stomach contents in my upper esophagus, which leads to coughing and vomiting. VA Medical Staff has previously diagnosed me with Barrett’s Esophagus 01/05/2010. 3. Daily panic attacks in the morning, followed by depression and exhaustion for the remainder of the day. My wife has to tell me things over and over until I get them done. She has to be involved in decision-making, as I usually just have a complacent attitude. I have violent outbursts 2-3 times a week. It has taken me 9 months with the help of my wife and others to write this letter. VA Medical Staff has increased my current Lexapro dosage, enrolled me in Anger Management classes and a PTSD screening is currently pending. 4. I have difficulty walking, sitting, standing and laying down caused by the constant pain starting in my lower back and traveling down my right leg and into my right arm. I have numbness and tingling down to my toes and fingers of my right side. My right leg will fail to come forward while walking, causing me to fall. On several occasions I have fallen and hit my head, injured my right wrist and hand, and sprained my right ankle. I use a VA issued cane and walker for walking and getting up and down from a sitting position. I cannot lift over 10lbs without pain from my back and my right flank. My wife has to do as much of the heavy lifting as she can, or wait for friends and relatives to assist. Duodenal Ulcer, current rating: 20%. The VARO decision failed to cover the fact that I have been diagnosed with IBS/ICS and Barrett’s Esophagus with restriction noted in my medical records by VAMC Asheville during 11/2009. According to VA regulations, my symptoms warrant the following ratings: (7305)Duodenal Ulcer : Moderately severe; less than severe but with impairment of health manifested by anemia and weight loss; or recurrent incapacitating episodes averaging 10 days or more in duration at least four or more times a year-40% (7203)Esophagus, stricture of: Moderately severe; less than severe but with impairment of health manifested by anemia and weight loss; or recurrent incapacitating episodes averaging 10 days or more in duration at least four or more times a year-30% (7319)Irritable colon syndrome (spastic colitis, mucous colitis, etc.): Severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress-30% Depression, current rating: 30%.Daily panic attacks, short term memory loss, confusion, staring off into space for hours. According to VA regulations, my symptoms warrant the following ratings: (9434) Major Depressive Disorder: Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships 50% Painful Scar, current rating: 10%. VA rating decision failed to address lower back injury caused and or aggravated by surgery, to include persistent hernia, major muscle atrophy and colon incarceration, sciatic nerve damage. Back injury secondary to Right Nephrectomy 7/1994 and Right Flank Hernia Repair 1/2009-MRI from 11/05/2009 clearly shows posteriolateral lumbar hernia that includes part of the ascending colon. VA is currently providing a cane and a walker to assist in walking. VA prescribed pain medication does not have a significant effect on pain. A private Neurosurgeon has performed two spinal injections in an attempt to relieve the pain. Pain is constant, day and night since 10/03/2009. VAMC Asheville is currently evaluating my current condition for possible corrective surgery of the persistent incisional hernia and incarcerated colon. Corrective surgery for Invertebral Disc Syndrome was performed on 12/13/2010, with additional surgeries required in the future. According to VA regulations, my symptoms warrant the following ratings: Group XIX. Function: Support and compression of abdominal wall and lower thorax; flexion and lateral motions of spine; synergists in strong downward movements of arm (1). Muscles of the abdominal wall: (1) Rectus abdominis; (2) external oblique; (3) internal oblique; (4) transversalis; (5) quadratus lumborum. Severe-50% Group XX. Function: Postural support of body; extension and lateral movements of spine. Spinal muscles: Sacrospinalis (erector spinae and its prolongations in thoracic and cervical regions).Cervical and thoracic region: Severe-40% Severe disability of muscles —(i) Type of injury. Through and through or deep penetrating wound due to high-velocity missile, or large or multiple low velocity missiles, or with shattering bone fracture or open comminuted fracture with extensive debridement, prolonged infection, or sloughing of soft parts, intermuscular binding and scarring. (ii) History and complaint. Service department record or other evidence showing hospitalization for a prolonged period for treatment of wound. Record of consistent complaint of cardinal signs and symptoms of muscle disability as defined in paragraph © of this section, worse than those shown for moderately severe muscle injuries, and, if present, evidence of inability to keep up with work requirements. (iii) Objective findings. Ragged, depressed and adherent scars indicating wide damage to muscle groups in missile track. Palpation shows loss of deep fascia or muscle substance, or soft flabby muscles in wound area. Muscles swell and harden abnormally in contraction. Tests of strength, endurance, or coordinated movements compared with the corresponding muscles of the uninjured side indicate severe impairment of function. If present, the following are also signs of severe muscle disability: (A) X-ray evidence of minute multiple scattered foreign bodies indicating intermuscular trauma and explosive effect of the missile. (B) Adhesion of scar to one of the long bones, scapula, pelvic bones, sacrum or vertebrae, with epithelial sealing over the bone rather than true skin covering in an area where bone is normally protected by muscle. © Diminished muscle excitability to pulsed electrical current in electrodiagnostic tests. (D) Visible or measurable atrophy. (E) Adaptive contraction of an opposing group of muscles. (F) Atrophy of muscle groups not in the track of the missile, particularly of the trapezius and serratus in wounds of the shoulder girdle. (G) Induration or atrophy of an entire muscle following simple piercing by a projectile. (Authority: 38 U.S.C. 1155 [62 FR 30238, June 3, 1997] Intervertebral disc syndrome-MRI from 11/05/2009 clearly shows damage to L1 and L5 discs caused by posture misalignment as a result of muscle defects and displaced colon as residual from both Right Nephrectomy 7/1994 and Hernia Repair 1/2009. A more current MRI performed 09/13/2010 by VAMC Asheville supports this evidence, and reveals a worsened condition, requiring additional surgeries to at least stabilize my health. 60% I request my claim be afforded a de Novo review by a Decision Review Officer and a Statement of Case (SOC) be prepared and forwarded to me. Thank you.

I was just going to file a NOD regarding a March 2010 Rating Decision, when the VA popped up and sent a new response to an earlier (June 2009) NOD that I thought had expired. The VA had sent me a letter in December 2009 stating that the NOD was denied and the decision stood. I did not pursue the original NOD because I had bigger fish to fry with my conditions. I had decided to pursue a new NOD regarding a decision resulting from a C&P exam that had missed several secondary conditions resulting from VA surgery and VA doctors diagnosis. In short, I want to know if having more than one NOD in the system will cause complications?

I had an incisional right flank hernia repair (01-14-09) as a result of a kidney removal which is service connected. The surgery has resulted in a new hernia in the new incision. As a result of this,I have lost my job, I am suffering multiple medical problems including depression, lower back problems, walking with the aid of a cane, digestive problems, and constant pain at the surgery site. First, the doctor claims that my surgery is not service connected, yet I am rated at 30% for the kidney removal. Second, the doctor states there is nothing wrong with me and he has done the best he can do. Third, he states the difficulties I am having are a result of excessive weight gain since the surgery. But according to my VA medical record, I weigh .6 lbs less now than the day of the surgery.

For what it is worth...I have my own computer business, and frankly...AVG Free makes me a fair amount of money. The majority of my customers that come in with virus problems, have AVG Free. The AVG website even tells you what the Free version covers. In my humble opinion, you get what you pay for. I am not disagreeing with anyone, or trying to scare anyone. Just what I see on a daily basis. The Big Three, Norton, McAffe, and Trend Micro are true resouce hogs. These guys will pig out your system and rob it of performance. We sell Kaspersky to all of our customers. We are a direct reseller of Kaspersky products. They have just begun letting us offer Kaspersky for three computers with a two year subscription for $49.95. I think that is the best deal on the market. All that being said, no matter what virus protection you have, it's only as good as the PC user. They are not bullet proof by any means.

I too just recently got rated at 0% for hypertension. They decided 0% based off of a single reading at a C&P, of which I had been on VA meds since 11/2008. I have filed a NOD, trying to get them to look at the readings that led the VA to medicate me in the first place. The real kicker is that the VA ignored my SMR since 1994 that clearly stated that I had hypertension. Kicker #2, I only have one kidney. Seems like I heard that the VA's standards for hypertension and the associated pressure readings have not been updated since 1946. I could be mistaken...

Congrats! I just got my letter of acknowlegement of a NOD today. IT'S ON!!! Looks like we are going to go before a DRO review shortly. The VA doesn't know just how bad they stubbed their toe on my decision.

VAF, To answer your questions, I have been an automotive and heavy equipment mechanic for the past 10 years. As a result of this surgery, I will no longer be able to pursue this occupation. The VA has even approved me for Voc Rehab. My short and long term disability is through my employer. Here is the catch...my employer has been paying me short-term since my sugery. The report I got today from my doctor now states that I was able to return to full duty back in March. My question is, if that were true, then why have I been out of work, why has the VA approved me for Voc Rehab...? This doctor is really trying my patience, and my life. This is getting harder to deal with day by day. The VA just "ignored" major parts of my claim. I also have hypertension, medicated by the VA, coupled with the fact that I have one kidney. The VA brushed off my hypertension claim, even though there is evidence in my SMR. They even claim it was a result of my kidney removal, even though, my SMR states that I was diagnosed prior to the kidney removal. Depression has also set in, but that is through my personal doctor. I haven't even tried to claim that yet.

I had surgery in January to repair a right flank hernia and incarcerated colon as a result of surgery done while in the USMC. Well...I finally got Temp 100% for Feb and Mar just last week. Now after repeatedly requesting that my doctor fill out the required paperwork for my employer's short-term disability, he finally came through. Now he retacts all of his earlier statements (in writing) about the lifetime 5 lbs lifting limits, possible reinjury and no second repair. I think he got pissed because I had to get the patient advocate involved to get the paperwork completed. What now? I will get the ball rolling on a second VA opinion and probably an IMO. This guy has been a surgeon for over 50 years, and pretty opinionated. This is a major setback for us. I have changed my daily living habits, my employer does not want to take the risk of me re-injuring myself. Frankly, neither do I. At this moment, I am disgusted, unemployed and confused.

Well...bittersweet success. I received "the" letter on the 16th, granting two months convalescent. The deposit was in the bank the following day. However, there were several issues denied by the VA and the doctor. So, I've already started the NOD with my VSO. One battle victory...on to the next.

Just wanted to know if anyone has any insight on this. I have been approved for Voc Rehab due to a serious employment handicap. My original Temp 100% claim is almost done. My VSO wants to get TDIU for me. Can you get TDIU and Voc Rehab? If so does one offset the other?

Just got word from the 800 number this morning. My claim finished the rating process on Friday 6/12/09, just waiting for supervisor sign off. I do have the patient advocate involved with the other situation. The doctor suddenly changed his tune this morning...more to follow.