VetsLady

Fire Courage.... Yes, you did mention having dealt with this since '95. Thanks for the link, I'm going to take a look at it, my husband is sc for DM2 due to AO exposure and does have fatty liver, plus. Keep us posted on what you find out.....ok? Thank you.

If it sounds too good to be true, it usually is. I would NEVER give any information out to some random person.......that's just me tho. It might be worth a call to IRS on Monday.

Fire Courage.... The "itis" means inflammation.....the "stea" is pertaining to fat deposits in the liver. If you are diabetic, it can cause fatty liver which could elevate your enzymes....Hepatitis will also, certainly they did check for Hepatitis. You would have to have a "diagnosis" for sc.....fatty liver can be residuals from a few different things. If you do a google search for gastro disease or fatty liver, it should bring up some articles for you to review. As yellownumber mentions, you should look into it....maybe it is thyroid related. Best bet, do a little research and see you doctor. Good luck to you. Did a quick google serach......for "Fatty Liver and elevated liver enzymes" - came up with this..... Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly. NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.” Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver. Both NASH and NAFLD are becoming more common, possibly because of the greater number of Americans with obesity. In the past 10 years, the rate of obesity has doubled in adults and tripled in children. Obesity also contributes to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH. Diabetes and high blood cholesterol are also becoming more common among Americans. I'm not a doctor, you should check with your own physician about this.

I'm not a doctor but, it sounds like your 'ole knee is giving way....to degenerative changes....which sounds like arthritis, the soft tissues wearing thin, et. Look up the anatomy of the knee....medical miniscus is the part of the miniscus in the center....anterior meaning the front, posterior meaning the rear. Cartilage is eroded so might be bone on bone. Good there are no tears in the ACL, PCL, MCL, LCl....anterior cruciate ligament, posterior cruciate lig., medial and the lateral. I had all 4 and major knee surgery a bit over 2 years ago due to a traumatic injury where I heard the ligaments rip. All good to go now. Arthur will probably be a visitor to my knee in the future but I don't think about it. You must have had some kind of traumatic injury to the knee at one time? Effusion means in simple terms the disc is thinning. If you 0% was done awile back and the knee has worsened, you can file for a re-opening I believe (chime in someone if I'm off base). Again, I'm not a doctor, have some knowledge of medical from my own research but if you google: knee injury - it should bring up sites where you can see a diagram of what the MRI results are referring to. You'll of course need to get the skinny from your ortho and what the recommendation is. Good Luck.

Carlie.... Thank you for posting. So many people in the world, so many different analogies, thoughts, opinions, rules, regulations, etc. and so on..... VA is special. I was speaking from private sector experience only. Thank you for posting the "for your record...." AMA rules, state rules, there are so many and that is why the judicial system is in place...to apply the rules accordingly. And, hopefully correctly BabyRay.... All said, I hope you win-win this and win it big and 1st time in. It will definetly give those behind you a boost to know that you receive what is rightfully yours. Good Luck to You.

I too noticed the typos....maybe he types them up himself. I know before I came along, my husband did his own and that was back before computers and spell check! Good Luck Baby Ray!!!! Go get 'em!!!!!

I need to comment on this...... IME - Independent Medical EXAM IMO - Independent Medical OPINION These are two very different things. The IME examining doctor (the MD in the same room with you who does the exam) can form an IMO independent based on his examination of you. He/she can also form an ".....in my opinion" - often they will read "In my opinion, based upon the patient history, the physical examination performed by myself, past medical records, radiological reports, lab results, etc., it is my opinion the Veteran......." I have typed so many of these reports I could do them verbatim. Often times an automobile insurance company will send a file to an IMO doctor to review, they call this a "paper review" = IMO (and only an In my Opinion) An IME with an IMO from the IME doctor will hold alot more water than any doctor, no matter how high the credentials are. I agree with Bronco.....take it to your personal doctor, ask him to exam you and form his opinion based on the medical record, the examination and he can certainly concur with Dr. Bash's findings. If you have a history with your personal physician, he/she knows you and sees you in their office. This holds alot more credence than a doctor who has never laid eyes on you. VA will more than likely send you to one of their doctors who will see you "in person". The VA IME doctor can't concur with any other findings from another doctor.... that is why it's called an Independent Medical Examination. Play their game, get your own IME from your personal doctor and have he/she add their IMO to a report they write on your behalf. Your personal doctor's opinion will bear more weight in your claim than a doctor who only does a paper review (IMO). I'd rather see you send your evidence in correctly the 1st time with all the weight it bears because the VA will send you for an IME, no doubt about it. I can understand completely your thoughts, but I would suggest you send in your evidence correctly the 1st time anticipating the VA will send you for an IME. Your personal doctor will definetly have more weight bearing on your claim than a doctor who has not even seen you. You should consider your doctors specialty also. If you have a claim for an orthopaedic issue (and this is a very extreme example) and your doctor treats digestive diseases, he won't do an IME anyway. He can't form an opinion that will hold any water at all if it's beyond or not in his scope of practice. I'd rather see you win your TDIU claim first time in, no VA IME, on your claims merits and with your own doctor's IME & IMO with the added bonus of having a 2nd IMO from Dr. Bash. It's just advice and you make the decision on how you want to handle it. If you have any other questions or need any further advice, please ask. We're all here to help you succeed. Bronco is correct. IMO.

Husband is AO sc for DM2 and PN. HBP, high lipids, high tri's, all controlled by meds. EKG done this past summer, showed incomplete right bundle branch blockage, no change from prior EKG in 9/04. I'm thinking, that on his original claim, my husband listed HBP (Hypertension) but, he was not rated with it as a secondary to the DM2. I wonder if he should re-open that DM2 claim and file for the HBP? Ironically, he came downstairs as I was reading this thread and told me he's been feeling dizzy with a fluttering feeling where his heart is and attributed it to anxiety. That's because I have anxiety and he knows I feel these same symptoms (heart disease ruled out on me) so I think in his mind he thought it must be anxiety. Needless to say, I made an appt with his Primary on Monday. His DM2 claim was an appeal we won, but they never addressed the HBP, only the PN. Just found this on the web: Autonomic Neuropathy (also called visceral neuropathy) Autonomic neuropathy is another form of diffuse neuropathy. It affects the nerves that serve the heart and internal organs and produces changes in many processes and systems. My husband has a confirmed dx of this from his DM2 doctor. Don't you think it should have been rated as a 2ndary to the DM2? He claimed it in 03, why didn't they rate it or even mention this or the HBP? Ok, not messing around with this.....made an appt with his Primary for Monday. If need be, I know how to dial 911. Any other ideas - very welcome. Hmmmmm.

Bundle Branch....? My husband has had 2 EKG studies done and both show incomplete left bundle branch block....he's DM2, HBP, etc....perhaps we need to get his DM2 claim re-opened. He is DM2 AO sc... Lzjump....thanks for lighting the bulb above my head on this. I'll check into this with his doctors this week.

I'd want to know what those liver enzymes test test results were all about.....high lipids and triglicerides can elevate liver enzymes and high numbers in the cholesterol and tricligercide arena are not good for the liver at all....fatty liver. As Berta mentions, it's not the DM2 that's the killer, it's the complications and more importantly, not doing anything about them. I'd get on that one like now. Creatinine measures your kidney function so were I you, I'd want that Hemoglobin A1C test done, and even then....it only gives the doctor an "average" blood sugar for the previous 3 months....it's the highs and lows, the peaks in sugar and the drops in blood sugar that do the damage. Keeping your blood sugar within guidelines as much as possible to avoid those peaks and valleys are best - and, if you do so, your A1C will always be within the norm. My husband was dx diabetic in 1992, sugar over 400, classic symptoms of excessive thirst, nighttime leg cramps, lost his crystal clear eye sight for 4 months....and it wasn't until then he finally went to the doctor (doctors are the worst patients). As soon as the sugar levels dropped, his eyesight came back, leg cramps ended and he did eventually need insulin. Diet and exercise was not enough. AO destroyed his pancreas and so be it. Without insulin, he wouldn't be here today. We used to treat the diabetes as a daily battle......now, 17 years later, we treat it as a daily "adjustment". His endo doc is private practice and the smartest cookie in the jar with absolutely no personality. We don't need a doctor with personality, the smartest cookie (no pun intended) is more important. This guy can figure out exactly how many calories my husband is consuming by looking at his weight, his blood tests, A1C and his log book. It took my husband the former doctor to realize after 10 years he wasn't getting anything by this guy and so he now listens to his advice and follows it. Good Luck to you....

aceup... SSDI is 100% disabled or 0% disabled. If your sc disabilities are a chunk of the pie for your SSDI claim and you meet all the TDIU rules, I'd go for it. If you don't try you'll have a 100% chance of not getting it. If you do, your chances are at least 50/50. Those nsc issues are a snag in the line. As an example, my husband filed a claim with VA in '02, received sc in '08 at 70% Filed for SSDI because he could no longer perform and never would be able to again the job he is trained to do and, due to nsc disabilities (currently on appeal, not yet sc), he filed for SSDI. They saw him at 100% disabled 1st go around. When the decision came back from VA on the TDIU, they denied. Why? Because part of the reason he is no longer able to work is because of the issue on appeal but....it it's not sc yet. If he does end up getting it sc, then we could refile...but, my hunch is that if he were sc for it it, it would pull him over the 100% mark anyway and TDIU would be a moot subject as he medically is permanently and totally disabled. Definetly get those quacking ducks in a row and if you meet the criteria, file.

Good work - Congratulations on receiving what you deserve! May this great news bring some stability to you and your family as you continue to fight your battles with health. God Bless You.

Berta..... I completely understand. This part of my husband's claim has been in the system for a long time, Feb. 2010 will mark the beginning of year 7. After reading your post, I don't see any reason to not send a copy of the whole enchilada to BVA and AMC. You have answered my question. Thank you. Perhaps if AMC knows BVA has what they have, they may take a much closer look at the evidence the RO didn't even send. Better safe than sorry. AMC has their copy and BVA will get one also Widow1.... I hear you. It's expensive when you are on a fixed income (as we are) to send to 2-3 different places. This last batch was almost $50.00 That is alot of groceries for us. I hope that in the end it will be worth it. I feel it is or I wouldn't spend the money to send special delivery. Re MF: Now you both have me LMAO because I too was not thinking that when reading the post....Mysterious Force - I won't forget that one. Curious what the RICO act is?

Was this a recent denial? You could ask for a DRO - a Decision Review Officer to take another look at it. There is a time limit when this has to be requested after receipt of the denial, it's been awile for us so perhaps someone else can jump in and answer. I know it's not less than 30 days for sure. A Nurse Practioner? Hmmmmm......VA would not accept my husband's medrecs from a Psychiatric Nurse practioner he sees, wonder why they sent you to one for on a C&P exam?

I'm no expert but, perhaps the reason was the condition why he was hospitalized didn't have anything to do with his military service? Did they deny the entire claim or, a portion? You didn't mention if the denied claim was appealed and eventually sc. In 1976 and 1977, I have no idea what the protocol was for a C&P examination. I graduated HS in '76 and was going to college and working PT then. I hadn't met my husband yet....he came into my life in 1990. In today's world, at least here on the West Coast, a company named QTC who is owned by doctors, and I hear VA higher ups and who knows who else, they contract doctor's in all medical and psychological fields to perform C&P exams. I'm sure someone will come along and provide an answer to your question. I'm going to follow this thread as I'm interested in the answer. VetsLady

I correct myself, they did rate him back to 1 year prior, but only at 20%. From the date of the C&P is when the 70% started. The medical evidence from his private doctor supports an EED of at least the 70% and this will be what I'll re-open for an EED of the sc of DM2 at 70%. I think they "thought" or maybe missed, who knows really...., the evidence supporting a 70% sc from the initial claim date. VetsLady

It was alot of work. Worth it. I submitted maps, photos (while in port at DaNang), we had several buddy statements....VA had no choice but to concede. Given the Top Secret authority my husband was privvy to with beingthe CO's Orderly, I'm certain there was a way VA substantiated the meetings and since it's on the list of presumption, they had to sc him. Yes, we have him rated, even tho at a 0% for a residual of DM2, and rated sc for 4 other residuals of DM2. When his appeal is done (it's on a separate medical issue, not related to DM2), I plan to re-open the claim as they rated him from the date of the exam for DM2, and we have tons of evidence showing these conditions were present on the date he filed his original claim which was in early '03, backdate 1 year for the presumption, so basically sc and retro paid from early '02. His C&P for DM2 was in Feb. 08 and that is the date they used to compute his retro. Wrong. With the medical evidence we have, it's easily proven that the residuals were present long before Feb. 08. Why they waited sooooooooo long to do a C&P is besides me. If I lived my life with the glass half empty rather than half full, I'd guess they "thought" delay the exam, less retro and the Veteran goes away. I think they are stuck with me. LOL! I'd rather wait until the appeal is complete which should be very soon, then file for re-opening on the DM2 claim. We don't need another delay on the appeal. VetsLady

FYI You link listed to this article is broken.

Seems to me you should be able to file to re-open your original claim due to worsening of your sc condition. I'm not an expert, but the hip bones are connected to the spine bones, the leg bones are connected to the ankle bones. You would need a written medical opinion on this for certain, from an Orthopaedic Physician. They are the bones Docs. I worked for a bone doc for over 30 years but the type without the M.D. behind his name. Gravity and aggravation place added stress on the body over the years....those disks start to disenegrate and place greater pressure on the hips. It makes sense but, not to sound cynical, the VA will kick it around from here to there and back. I'd have every piece of evidence you can find, suggestions from others here on this board may come along with more information. Try going into the National Health Institute web-site....NIH.org. You aren't a doctor and even if you were, you wouldn't be able to form a dx of yourself....so best advice I can offer, see your doctor and get a referral to an Orthopaedic and get that medical opinion in writing. Good Luck, VetsLady P.S. I just checked Laser Spine Institute's web-site: laserspineinstitute.com/back_problems/arthritis_of_the_spine The spine is the supporting structure of your body. The hips are weight bearing joints of the body. I know you said you are sc for DDD of the Lumbar spine and limited bilateral mobility of the ankles....but, I think you may find some worthwhile reading in their web-site. You'll still need to see a doctor.

Finally. Never ever seemed fair that a sailor or Marine who served along the DMZ, in the Gulf of Tonkin and anywhere else AO was used in what is considered "blue waters" may get their chance at validating their claim. AO was everywhere, in the water, the food, on the choppers landing on the ships, etc. My husband was "considered" blue water as he was part of the Marine Detachment onboard a cruiser and the CO's Orderly. Many Top Secret visits to DaNang where he was required to accompany the CO were made and it was through photographs, buddy statements and a 50/50 equipose that he did in fact leave the ship with the CO, he was sc for AO related DM2. I hope this goes all the way and those who are deserving, will receive their benefits. Finally.

Is there a "Training Letter" for all conditions of the body and, if so where can they be found? I've seen the C&P exam forms, but nothing as comprehensive as this.

Why not add the verbage "at this time" ? I've never seen this form either. I wouldn't sign it either, how does anyone REALLY know what evidence is in your claim file? You know what you sent in, you knew you sent it via USPO with CMRR, or FedEx or UPS with the package being signed for by the receiver. But....... the only way you really know what is in the file when the VA reviews the evidence is when you get the SSOC and it's listed in the evidence section. If the all of the evidence you sent in isn't listed, they didn't consider it for one reason or another....