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There is no absolute bar to service connection (s/c) for W-P-W (or any other hereditary or familial condition) on either Direct, Presumptive, or Aggravated bases. Several VA Office of General Counsel Precedent Opinions (VAOGCPO) have clarified this.
That said, I believe he should address his claim on a Direct incurrence basis, and then Aggravated if necessary. Unless he was diagnosed with W-P-W or had additional verifiable heart related symptoms within one year of his separation from Active Duty, it would not appear that s/c on a Presumptive Basis is a player here.
If, as you say, your ex-husband did report to a military treatment facility for complaints of racing heart, whatever was written in the Service Medical Records (SMRs) has a great deal more bearing than buddy statements; if I were presented with only the buddy statements and no other evidence, I'd deny this claim.
I suggest your ex- get a copy of his SMRs and review them in detail. He then needs to have his cardiologist review them, and specifically those occasions when he reported to the ER/MTF for a racing heart. The cardiologist must review the records and then provide a medical opinion, or nexus letter, that the treatments on ______ (date), ______ (date), etc., were early manifestations of the W-P-W Syndrome that was diagnosed on ______ (date).
Service connection on an aggravated basis would be very difficult, IMNSHO, because of the time gap from separation to the date of diagnosis. For service connection on an aggravated basis, the familial/hereditary has to aggravated beyond its due course. Because of that 7 year gap, that might be difficult to prove.
As far as the actual rating goes, let's not put the cart before the horse here. I wouldn't care to give a specific number without knowing more information. FWIW, rating criteria for heart conditions are in 38 CFR 4.104 http://www.benefits....ART4/S4_104.DOC ; Diagnostic Codes (DC) 7011 or perhaps 7010 appear to be the most relevant at this time.
Hello everyone! I am helping the ex-hubby file a claim. He was active duty Army from 1983-1987. He was an 11B, airborne Ranger.
In 1995, he actually died and was revived at the local hospital. Turns out, he had Wofle Parkinson White syndrome (WPW). He never knew and his doctors in '95 could not believe he had even been let in the Army. WPW is present AT BIRTH!
In 1995, he chose to have what was at that time, still an experimental surgery rather than go on medications. The experimental surgery worked. He has not had any hearts issues since '95.
Since WPW is present at birth, I have finally encouraged him to file a VA claim. We have people that remember him going on sick call in '86, '87 for what he called a "racing heart" and they are willing to write letters. I don't think we need the letters since he was born with this.
Can anyone here advise me on how this claim would be rated via CFR 38? Would he be rated at 0% since he hasn't had problems in all this time?
Thanks so much!
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Let me quote the OP's last word in his paragraph: "THOUGHTS" ; perhaps I misunderstood his question whether he should file a CUE or not. Likewise, I may be misunderstanding your " ...asking a simple question of our thoughts of the situation." I understood the question to be whether the OP should file a CUE or not ... it that correct?
Although the knee-jerk reaction is always 'yes, file the CUE', I saw nothing in what little information that the OP provided that showed a CUE. While I suspect that a claim for increase might be in order, it is difficult to state that unequivocally without review of the veteran's unfiltered record.
However, if the intent of any suggestions on this forum is to sludge up the system even more with another claim that has little - if any - chance of success, please be my guest.
Now, if you want belittling, I draw your attention to the word "...reply's ..." . It should be 'replies." You're welcome ... just here to help.
(snip)
Interested;
Damn dude take a chill pill! The Brother was merely asking a simple question of our thoughts of the situation. Then you come and intensify the conversation by belittling the man. Your absolutely right, he probably doesn't care for your opinions. With reply's like that I wouldn't either!! Just sit back and relax. There's no reason for this.
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So, what was the percent obstruction (unilateral or bilateral) at the time of the VA examination?
Believe what you have to or want to believe. Do what you have to do.
Good luck, and don't hold your breath.
I beleave the ulceration would be as a early or late symtpon of the nasal polyps. Iv had all these problems since GUAM in 1967 The ulcer wasnt NEW---- NO it isnt a cold.
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6522 Allergic or vasomotor rhinitis:
With polyps 30
Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side 10
6523 Bacterial rhinitis:
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AND where is the one year rule ? If you have had rhinitus and sinusitis you will know this is an ungoing illness and one infecting the other.And of course these have been constantly treated by the va with steroid sprays and meds for the last 40 years . And now I do have deviation and obstruction from the continued infection and thickening from the scaring.
Steve
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Some comments ....
1. A Clear and Unmistakable Error (CUE) has to be based on the laws and Rating Criteria in effect at the time of decision (or, in some cases, at the time the claim was made). Do you have a copy of 38 CFR and the Rating Schedule from then? I don't have a copy, and I don't believe I care to try to find out that information either.
2. So, I presume you are telling us that you developed an nasal septal ulcer a couple months after separation in 1970, and that you have had this septal ulcer for 40 years, and that you have had continuing treatments for this specific condition to this day?
3. OK, for discussion's sake, let's presume that the current criteria for rating nasal problems are the same as from 1970-71 .... under what criteria do you believe that a 10% might be warranted. Has your breathing been adversely affected for these 40 years? Is there disfigurement?
I know that you don't care for my opinion .. but I think you have too much time on your hands.
I came across this first rating decision of 2-2-71 that has this printed note on the top--
(for the veterans vasomotor rhinitis,because it cannot be distinguished from his sinusitis which was incurred in service.S/C for both ---then goes on to say service connection is denied for the ulcer of the nasal septum , because it was first noted after service.
10/1/ 70 I got out of service I believe the C/P was 1/5/71
I was only recieving 10% at that time so this could add another 10 % or more.
This wasnt even 4 months after discharge.Didnt go to 100% till 1994
A lot of this first rating was screwed up. THOUGHTS
thanks STEVE
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Some questions ...
1. Who is this mysterious Lady at VA Office? And, specifically what part of the VA does she represent, that is, the VA Regional Office, the VA Medical Center, or sumpin' else?
2. Who told you that they will only pay SC disability nothing else? This mysterious lady or someone else?
3. Did you recently, and I mean recently, get an upgrade to 100% from your friendly neighborhood VA Regional Office?
Lady at VA Office said I was 100% SC but they will only pay SC disability nothing else???
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Most folks think that all treatments they have in service are recorded in their Service Medical Records (SMRs) - not true. The SMRs record out-patient treatments only - in-patient records are not in the SMRs When a troop was admitted to a hospital for in-patient treatment, SMRs sometimes reported the fact of the admission but not the treatment. Post-discharge treatments are recorded in the SMRs though.
In-patient treatment records are maintained by the hospital/medical center for a certain amount of time, and then sent "elsewhere" - they are not destroyed. However, getting these in-patient treatment records can be tedious and long drawn out because you are asking for a file by file search by a real live person through the Records Center.
Unless you told the VARO about the hospital admission, it isn't likely that the VARO will ask for the search. When you tell the VARO, however, you have to be fairly specific about the dates. For example, you can't say that you were admitted to some military hospital in 1970. You have to say that you were admitted to Wiesbaden Medical Center in October 1970 for _______ treatment. At worst, the time span must be three months or less.
There were alot of dx's back in the Nam era that they had no idea what was what, which is one of the main reasons us older vets get screwed proving our claims. Among other reasons, the lost of records in our SMR. If I had all my hospital and clinic records that are missing, I would already be rated 100% either IU or schedular. Also Rick, I believe the max for apnea with use of cpap is 50%. Not sure where you heard 60% from, but perty sure it's 50%.
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I wouldn't necessarily view this as pyramiding.
Like John said, I would at least get in contact for legal advise from a malpractice attorney. Since she had her surgery outside the VA is probably the reason the va never contacted her for the 1 year postop exam. I'm assuming that was a C&P exam she had on 1/11, and if it was, it sounds like the ball is rolling towards your favor. The PN can be SC by secondary to the surgery, but if she get's the max rating of 60% for the TKR it might be considered as pyramiding. That would have to be an opinion from other members here that know the rules of pyramiding, as I don't have that knowledge. As far as the phone call, I wouldn't even venture to go there since I have no idea what it would be about. I prefer not to give you any false hope or sad news, since I would only be guessing. Did your wife happen to get a copy of the 1/11 exam? Also, is that yours or wifes profile showing 40% disabled?
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If you have not already filed a claim for disability compensation, fill out a VA Form 21-526 http://www.vba.va.go...-21-526-ARE.pdf and mail or hand-carry it to the closest VA Regional Office. Or, you can file an on-line VONAPP application https://www.ebenefit...ts_myeb_vonapp1 . (Personally, I find the VONAPP somewhat confusing.) Don't forget to add the hand surgery.
If you have already filed a claim for compensation, you certainly can use either the 526 or VONAPP. However, you can also use the much simpler VA Form 21-4138 http://www.vba.va.go...21-4138-ARE.pdf or even a simple letter.
Whichever way you go, just write something to the effect of: I request service connection for sleep apnea. If you want to get fancy, you can also add that treatment records prior to separation showed the condition, which was verified by polysomnogram on ______.
I just came off active duty orders about a month ago(title 10),I seen the doc on active duty and the doc said I had all the symptoms.Scheduled the sleep test after I came off orders(because on tricare you have to have a referral from your pcm,so that set me back) luckily I still have tricare for six more months. Now Im on my way to get my cpap machine. HOW AND WHAT DO I SAY FOR A SERVICE CONNECTION LETTER.MORE INFO BELOW IF NEEDED!
The reason I went for the sleep study was my ortho doc told me to see one. I had two major surgeries and one minor surgery done on my hand. I had a scaphoid fracture (BONE IN THE HAND)that would not heal until the second surgery and the ortho doc done a bone graft from my hip the second time, it supposely healed. The first time was a bone graft from my forearm it did not take. So I could not sleep without chronic pain in my hand going straight up my arm and from my hip down to my knees. That is what lead me the sleep study, so maybe this cpap machine will let me sleep and get my meds regulated and I will be fine. Thankful enough I still have tricare for six more months. I also have some nerve damage where the doc had cut on my hand three times, and range of motion is limited without pain.So needless to say Im spending alot of time at the doc office trying to get these matters taken care of. Im in the air guard so im using civillian docs.
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OK then ... why did you continue with the examination if you perceived the examiner to be so incompetent?
If this doctor did not have this office worker instructing him, he would be incapable of performing the exam.
Papa
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If you believe that the potentially assigned evaluation is too low, you should send in your Notice of Disagreement (NOD) after you receive the formal Rating Decision. As part of the disagreement, state that you had an inadequate exam. Also, it helps to specifically state what your limitations from Parkinson's are.
Note: while it's always nice to have a specialist do a C&P examination, it isn't always mandatory - if the examiner follows the exam sheets, which does not appear to be the case here.
I do not have official word from the VA, but only from the DAV that my PD was rated at the min. of 30%. My C&P exam at QTC was a joke. They brought a young GP that lived over 200 miles away. He had no ideal on how to perform the examination, so he had some young Lady tell him how to conduct the test. She was an office worker, my wife ask her if she was a Doctor. The GP apparently had zero experience in Neurological disorders. On a lot of the test, hew said I was unable to perform, but it is not documented on the report. Would this be worth initiated an NOD? That is once I get the official notice.
Papa
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Thank you for the clarifications.
Without knowing any other information about your situation, I would say that service connection for sleep apnea will be granted. The rating criteria for this condition are in 38 CFR 4.97, Diagnostic Code (DC) 6847 http://www.benefits....PART4/S4_97.DOC .
Although you were diagnosed after you separated, the medical treatments from the sleep doctor serve to show presence of the condition on active duty. Besides, it's generally difficult to deny any condition that manifests during the year following discharge.
If you have not already filed a VA claim based on residuals of the fractures and the surgeries, don't forget to add those.
Diagnosed today, released about a month ago, Active duty title 10 medical contuiation orders ( when first seen the sleep doc) and no it was not a va doc. I have not even seen the va yet. I feel lost over the va!
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Some clarification, please:
1. When were you diagnosed with sleep apnea (month and year are OK)?
2. When were you discharged from Active Duty (month and year are OK)?
3. What was your status (Active Duty, Active Duty for Training, ie., Reserve or Guard) when you first saw the sleep doctor and what was your status when you had your sleep test (polysomnogram) that diagnosed sleep apnea?
I was diagnosed with mild sleep apnea, will be given a cpap machine. I went to the sleep doctor and done the interview and the doc said I had all the symptoms. The doc scheduled the test. This was all on active duty orders. I done the sleep test and was diagnosed with mild sleep apnea and will be issued a cpap machine. The sleep test was not on orders but I was still covered by tricare. The reason I went to the doc was i could not sleep because of a fracture and a couple of surgerys(all done on active duty). So now I found out I have sleep apnea. Can you win a claim with this!!! I can not find a straight answer.
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Although tinnitus is pretty much a subjective condition, there are round about ways to determine if it's there. Based on your statement
After I was denied my primary care VA doc sent me to an audiologist who found no evidence of hearing loss or tinnitus, next my doc set me up with a neurologist and after lots of testing the neuro doc came up with nothing. In my last appointment with the neuro doc, he said he would set me up with an ENT. A few weeks have passed and today I called the VA to check on the ENT appointment and they told me they would not see me because the ENT doc reviewed my chart and said it would not be a justified exam?
it appears that a moderate-to-great deal of work up has been done. You will have to overcome or at least match the above findings to prevail.
You can certainly proceed with your NOD with the evidence as if, but I wouldn't recommend it. I suggest that you get your own Independent Medical Opinion (IMO) from a paid gun that counter values the audiologist and neurologist. I think this would be difficult.
FWIW, some antidepressants have tinnitus as a temporary side effect, that goes away when the medication is discontinued.
The ringing started when I was overseas. I am a pilot, so yes I was exposed to alot of loud noise. However they say that I don't have any hearing loss and therefore not have the ringing because of noise. I did start on a antidepressant while deployed..
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Although you said that you were being boarded primarily for your feet, I suggest that you fight - and fight strongly - to have sleep apnea as one of your duty limiting conditions for the MEB and the PEB. Note: you do have a diagnosis of some sort of sleep apnea, conformed by a sleep study (polysomnogram), don't you?
I say this because with only feet as your disability, you may be discharged with disability severance pay. However, if you get above 30% from the PEB, you likely will retire from the Army.
If your feet are as bad as you wrote, you may well receive that magic 30% based only on your foot/feet. However, it wouldn't hurt to have the OSA mentioned also.
so next month marks my 6 years in the army. its been a roller coaster ride with my medical. in saying that my feet i guess
wasnt used to the demands of the army, ruck marching, running, anyways, the bottom line, im being med boarded for
sleep apnea and flat feet, mostly flat feet because my feet have cronic swelling. and ever since basic over the years
its just been getting worse and worse. im on my 2nd reenlistment and am in hawaii for a medboard. what kind of
percentages am i looking at right now if anything? and whats the whole process of treatment for this after the army?
any knowledge on these situation will be greatly apreciated.. thank you in advance
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I am guessing that your "VA screwballs" are following the Nehmer Decision and specifically the implementing requirements in the Federal Register http://edocket.acces...f/2010-6549.pdf . Based on some somewhat less than stellar early Rating Decisions on this issue and some "additional training", I'm guessing that the VBA is taking a more liberal view of the claimants and the Nehmer class.
You state that you filed a claim for a heart condition in 1985, and I am presuming that you have verifiable boots-on-the ground Vietnam service that could potentially make you a part of the Nehmer class.
So, .... from what you wrote and with some astute guessing on my part, I'd say that whichever VARO is processing your inferred Nehmer class IHD/CAD claim is trying to verify a current diagnosis of IHD/CAD. Even though you claimed some sort of vague heart condition in 1985 that was denied, it doesn't matter for purposes of the Nehmer decision.
If you are so adamant that you don't want service connection for IHD/CAD,
a. Don't go to the C&P.
b. Send a letter to the VARO stating that you DO NOT WANT ANY CLAIM FOR IHD/CAD UNDER NEHMER TO PROCEED AND TO CANCEL THE CLAIM IMMEDIATELY.
However, I suggest that you proceed with the claim.
The VA sent me a letter a few months back about making a claim based on Nehmer Vs Dept of Veteran Affairs and if I didn't want to submit a claim to ignore the letter-which I did. Now they sent me recently another letter setting me up for an exam regarding the subject court case. I don't know why, I filed for heart condition in "85 when I got out of the military and it was denied and I let it go. I had hypertension and chest pain in thes ervice and underwent a ETT which was abnormal/borerline and it was suggestive of CAD (Coronary artery disease) but not proven. Now after so many years have gone by I'm sure with the high blood pressure that I have CAD an that in some degree is associated with Ischemic heart Disease (IHD). Does anyone know why the VA screwballs want an exam on me? I don't believe it's to my benefit except to undergo the cardiac testing and find out that I have some sort of heart problem that they might render medicine to control. Please, someone reply, thanks.
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Your "Ro has there (sic) own method for issuing the travel pay ... Perhaps an audit caught this at my Varo. " is an incorrect statement.
Other than the indirect issue of assigning disability percentages, your friendly neighborhood VA Regional Office - a part of the Veterans Benefit Administration (VBA) - has nothing to do with the payment of any travel pay for medical purposes. The VA Medical Center - a part of the Veterans Health Administration (VHA) - manages the travel pay.
It is interesting how each Ro has there own method for issuing the travel pay. Since this is run by the Federal Government I expected all to confirm to the same format. They must have lee way on how they do it. Otherwise the co-payment issue would have been the same for them as well. It is obvious for all the confusion of why some were charged a co-payment and some weren't. Perhaps an audit caught this at my Varo. Surprised if a bill isn't issued for all the years they should have been charging me a co pay.
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a. Disability - for pay purposes - is determined by Table i, 38 CFR 4.25 and by 38 CFR 4.26.
b. Yes. Anyway you compute the three 10%s will round up or down to 30%
c. Yes
Also, at 30%, you qualify for the additional kicker for dependents (if you are married and/or have dependent children). In your award package, there should be some statement about this and also a VA Form 21-686, Declaration of Status of Dependents. My suggestion ... fill it out.
(snip)
So now I will have 3 ratings at 10%. How does theVA determine the total disability pay for this? Will my rating still be 10% orwill increase? And if so will I get back pay to Jan 09?
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A Decision Review Officer (DRO) Statement of The Case (SOC) is a continuation of a previous Rating Decision and is in effect a denial of the issues you claimed. It is issued ONLY for the continued/denied issues, as a prelude to being forwarded to the Board of Veterans Appeals (if you so choose).
Is it possible that the four issues not mentioned are being granted? If this is the case, the DRO will issue a Decision Review Officer Decision. A DRO Decision is identical in format to a standard Rating Decision, with the exception of the words " Decision Review Officer Decision" on the front. For multiple administrative reasons, you likely would receive the SOC before you receive the DRO Decision.
SOMETIMES and SOMEWHERE (usually at the very end) of the SOC will be some cryptic statement somewhat similar to "Other issues within your claim are being addressed in a separate decision."
Alternatively, they could have been overlooked. It is not impossible, particularly with so many appealed items.
I issued a NOD with 31 issues to be considered. I received a SOC (Statement of Case) from the DRO addressing only 27 issues.
On this NOD I also mentioned bilateral and secondary conditions to consider. In the SOC it mentions no consideration, denial or reasons for denial of anything bilateral or secondary. It practically restates what the original award/denial letter did.
They didn't get all of my medical records, and I didn't think I would have to supply the VA records. But I did and I know that part now-that's water under the bridge.
I still have time to get an appeal in, but I'm wondering where to go from here concerning the actions of the DRO and the Regional Office. Do I appeal what they have done and not considered?
Does my appeal to the BVA cover my disagreement with the original decisions or does it cover my disagreement with how the NOD was handled. 2 appeals? A CUE? I have no idea where to go from here.
Very discouraged and frustrated.
Draggin'
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My (short) review of medical/surgical literature fails to show me that one of the complications from a CABG or other chest-cracking surgical procedure is a hiatal hernia. However, as I am not a thoracic surgeon - and I doubt anyone else here is, I can't definitively say there is no correlation.
If you want to pursue this tack to service connection, don't bother with sending in reams of internet information. Although it might be interesting reading in an objective sort of way, it will not prove anything in your situation. What you will NEED is a medical opinion (Independent Medical Opinion, the proverbial nexus) stating that YOUR present condition was caused by YOUR surgery. For this IMO to have any validity, it should be from a cardiothoracic surgeon, that is, someone who knows the territory.
Alternatively ... you might pursue service connection on a direct basis. In one of your earlier posts, you said that your service medical records reported treatment for heartburn and indigestion ... have you had continuing medical treatments for that since discharge from service? Has it been an on-going problem?
If you want to go this route, you likely will need an IMO as well. You will need the physician, likely a gastro-enterologist this time - to review your Service Medical Records and any other treatment records since your service. The GI doc then needs to state that the condition and treatment rendered on ______, ______, _____ and that continued with civilian treatments on _______, ________, ______, etc., are/were the start of the condition that you have now.
I filed for hiatal hernia with the VA this is how it was worded " Service connection for Hiatal Hernia; gastroespphageal reflux disease as secondary to the service-connected disability of artherosclerotic heart disease with residuals of coronary artey by grafting".
The question is that one VA Doc said on his Upper G I (visiual) test with the scope said it was possiably CABAG, In wich I am more prong to believe because he seen what he is looking at through the scope. The C&P Doc only did an MRI and a Ultra sound of the stomach area and he said that he didn't find out any thing that is secondary to the By-pass. Is stated in my Medical records that I had heartburn and indiguestion quiet often while in the military. filed Oct 09, denied Jan 2010.
To me after reading an article on the internet it said that most of the time if a person is having a by-pass or open heart surgery. They would normally find it on the post-operation screening of the by-pass, when the Doc. find it the next year after performing the Upper GI scope test?
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I believe you should be more careful with your medical advice. My copy of Netter's shows the right gastroepiploic (also known as the right gastro-omental) artery relatively far away - well, far as concerns inside the peritoneum - from the esophageal hiatus.
This interested me, because I had a coworker who had gastric bypass and then diagnosed with hiatal hernia or hiatal hernia was suspected. I know gastric is stomach and CABG is heart. I did a search on the internet of hiatal hernia after CABG and saw this statement......
"the right gastroepiploic artery (RGEA) has been used as a second reliable arterial graft for coronary artery bypass grafting (CABG)"
I think you would be right to go over your medical records and investigate exactly what arteries were used in the graft. My guess is that any weakness of tissue or after removal of that artery could cause a hiatal hernia. Also research more on CABG and hiatal hernia. You might be able to find the connection or get doctor statements/IMO. Just my opinion.
Good luck,
Susan
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deleted
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Yes, if you have keratoconus.
My question is simply, can I get contact lenses from the VA?
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Without guessing too much on my part, what is your question?
And, you do realize that your previous claim, which apparently was adjudicated in January 2010, is now closed and that you will need "New and Material" evidence to reopen it?
I filed for hiatal hernia with the VA this is how it was worded " Service connection for Hiatal Hernia; gastroespphageal reflux disease as secondary to the service-connected disability of artherosclerotic heart disease with residuals of coronary artey by grafting".
The question is that one VA Doc said on his Upper G I (visiual) test with the scope said it was possiably CABAG, In wich I am more prong to believe because he seen what he is looking at through the scope. The C&P Doc only did an MRI and a Ultra sound of the stomach area and he said that he didn't find out any thing that is secondary to the By-pass. Is stated in my Medical records that I had heartburn and indiguestion quiet often while in the military. filed Oct 09, denied Jan 2010.
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FWIW, for what it's worth.
What is FWIW?
Waiting It Out
in VA Disability Claims Research
Posted
Some thoughts and comments ....
Does your VA Regional Office have your current mailing address? Though, as you say you have the DAV as a VSO, that may not be a problem or issue.
WRT the back conditions .... the answer, is, as always, ... it depends. If the Degenerative Disc Disease, Bulging Disc L3-5 w/arthritis, Synovitis and Scoliosis are all in the same segment of the back (lumbar), you will receive only one rating for the back. However, it's theoretically possible to be service connected for all segments (cervical, thoracic and lumbar). As for the bilateral leg pain, it's can be possible to separate that into two separate evaluations. Though, if the discectomies were successful, it's likely that any evaluation for bilateral leg pain would be 0% and would be incorporated into the back evaluation.
Now, to complicate things a bit ...you had a lumbar disectomies/decompressions post separation. Is the VARO running your pending claim aware of the surgery? Do they have a copy of the surgical report? I say this because convalescence under 38 CFR 4.30 http://www.benefits....PART4/S4_30.DOC may be an issue.