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Found 731 results

  1. I have diabetes mellitus with peripheral neuropathy. I filed a claim for my cataracts due to the diabetes. Now I have an appointment for a C & P Exam. I learned the examiner will use a Peripheral Nerves Conditions (Not Including Diabetic Sensory- Motor Peripheral Neuropathy) Disability Benefits Questionnaire. I wondered why they would they require this exam when my new claim is for cataracts. Thanks for any input.
  2. At the urging of my father, who is a veteran, my grandfather applied for benefits roughly two years ago. He served aboard the U.S.S. Manley during the Vietnam War. He was aboard the ship when a powder case ignited in the breech of the forward gun mount. What I i understand from my grandmother, he was exposed to a chemical while near Da Nang. My grandfather faced a number of health issues once he returned. He suffered from heart vavle problems and diabetes. The reason my grandparents decided to appy in the first place was because my grandfather was battling liver and bio duct cancer. His doctor at the VA hospital in Delware said he had a strong case. Unfortunately, my grandfather lost his battle with cancer in late June 2013. My grandmother continues to fight the VA. She was initially rejected because they claimed he was no where near Vietnam. My grandmother highlighted that part of the rejection letter and sent back a letter from a high-ranking officer aboard the ship at the time attesting to the fact they were there as well as newspaper clippings aboard the explosion and the ship dropping off Senator Henry Jackson following the explosion in Da Nang. She has since been told by a Veteran's advocate that she will receive around $1,200 a month under the classification of diabetes. Although this seems like a step in the right direction, something still seems fishy about the whole situation, which is why I am posting it here. Should my grandmother consider herself lucky to get anything at all here? Is there anything else she could do? Would she receive just the monthtly payments or should she get retroactive payment from when they made the claim? I know absolutely nothing about his process and am asking for advice for her. What I have written is what I've been told over the years so if there are any inaccuracies please let me know. Thank you for your time reading this and thank you for your service to our country.
  3. I spoke with my DAV rep this morning to inquire about the status of my claims and he said that a rating decision had been made for both claims: 20% neuropathy (10% each leg) and 30% for PTSD. The claim still has to go through further processing for them to prepare my letter and to calculate retro pay which he said may take some time. I filed my claim for neuropathy in February 2011 and for PTSD in July 2011. I currently receive 20% for diabetes. If my calculations are correct for the "combined" rating, I figure my combined rating should be 60% (I think). Now, trying to figure out my retro pay for neuropathy and PTSD rating is beyond my pea brain. Does anyone know how the VA calculator works in this regard. Semper Fi Phil
  4. My father had a C&P exam for a claim to get some secondary condtions to Diabetes and PVD secondary to heart disease. The doctor wrote that his METs are 3-5 on an interview-based METs test. Since 2010 he's been getting 10% for the heart disease. He didn't file a claim for a rating increase on the heart disease. It says this. d. Is the METs level limitation due solely to the heart condition(s)? [ ] Yes [X] No If no, estimate the percentage of the METs level limitation that is due solely to the heart condition(s): [X] The limitation in METs level is due to multiple factors; it is not possible to accurately estimate this percentage e. In addition to the heart condition(s), does the Veteran have other non-cardiac medical conditions (such as musculoskeletal or pulmonary conditions) limiting the METs level? [X] Yes [ ] No Other medical condition #1: COPD Effect on METs level: unknown Should he file an increase after his claim is finished?. His claim is in preparation for decision. Thanks for any help.
  5. Just had c&p for pgw issues. I have not read this particular take on sleep apnea? Opinions? It appears VA Dr says at least as likely as not for sleep apnea, chronic fatigue, joint and muscle pain. 1. Medical record review ------------------------ [X] Other, describe: VBMS, VVA, CPRS with remote 2. Medical history ------------------ a. No symptoms, abnormal findings or complaints: No answer provided b. Skin and scars: No answer provided c. Hematologic/lymphatic: No answer provided d. Eye: No answer provided e. Hearing loss, tinnitus and ear: Hearing Loss and Tinnitus f. Sinus, nose, throat, dental and oral: No answer provided g. Breast: No answer provided h. Respiratory: Sleep Apnea i. Cardiovascular: No answer provided j. Digestive and abdominal wall: No answer provided k. Kidney and urinary tract: No answer provided l. Reproductive: No answer provided m. Musculoskeletal: No answer provided n. Endocrine: No answer provided o. Neurologic: Headaches (including Migraine Headaches) p. Psychiatric: No answer provided q. Infectious disease, immune disorder or nutritional deficiency: No answer provided r. Miscellaneous conditions: No answer provided 3. Diagnosed illnesses with no etiology --------------------------------------- From the conditions identified and for which Questionnaires were completed, are there any diagnosed illnesses for which no etiology was established? [X] Yes [ ] No Diagnosis #1: Sleep Apnea, both obstructive and central ICD code: 327.23, 327.27 Date of diagnosis: 9/13/2014 Name of Questionnaire: sleep apnea Diagnosis #2: Headaches ICD code: 780.79 Date of diagnosis: 6/11/2014 Name of Questionnaire: Headaches - already submitted and entered into VBMS 6/17/2014 4. Additional signs and/or symptoms that may represent an "undiagnosed illness" or "diagnosed medically unexplained chronic multisymptom illness" ----------------------------------------------------------------------------- Does the Veteran report any additional signs and/or symptoms not addressed through completion of DBQs identified in the above sections? [X] Yes [ ] No If yes, check all that apply: Fatigue, Muscle pain, Joint pain For all checked signs and symptoms in this section, provide pertinent information related to each (e.g. frequency, duration, severity, precipitating/relieving factors, physical exam, studies): See Veteran's Statement in support of claim dated 6/11/2014 which describes his chronic fatigue. His muscle and joint pains are random, never the same joint, flare transiently for about 1-2 days on average about once/month. Other than these short flares, he has no complaints about his joints or muscles. All this has been flaring since 1991. The Veteran is a reliable historian he gave a similar history to the C&P Gulf War Protocol examiner in 2002. 5. Physical Exam ---------------- Normal PE, except as noted on additional Questionnaires included as part of this report 6. Functional impact of additional signs and/or symptoms that may represent an "undiagnosed illness" or "diagnosed medically unexplained chronic multisymptom illness" ----------------------------------------------------------------------------- [ ] Yes [X] No 7. Remarks, if any: ------------------- The Veteran had a Persian Gulf Protocol exam (in CPRS) Sep 4, 2002, which documents his fatigue. He wishes to clarify today that he's applying for an increase rating on his headaches. Since the Headache DBQ was filled out by his PCP and logged into VBMS on June 17, 2014, this examiner assumes no additional headache DBQ is necessary, and it was not requested by VARO. Further questionning reveals the Veteran does not have chronic fatigue SYNDROME, but does have chronic fatigue. In addition he's requesting service connection for sleep apnea and Tinnitus. Regarding Tinnitus, this will require an Audio C&P consultation and opinion regarding tinnitus, and these have been requested. **************************************************************************** Medical Opinion Disability Benefits Questionnaire Name of patient/Veteran: Indicate method used to obtain medical information to complete this document: [ ] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file reviewed? No If no, check all records reviewed: [X] Military service treatment records [X] Veterans Health Administration medical records (VA treatment records) [X] Other: VBMS, VVA, CPRS with remote data MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Please provide a medical statement explaining whether the Veteran's disability pattern is: (1) an undiagnosed illness, (2) a diagnosable but medically unexplained chronic multisymptom illness of unknown etiology, (3) a diagnosable chronic multisymptom illness with a partially explained etiology, or (4) a disease with a clear and specific etiology and diagnosis. If, after examining the Veteran and reviewing the claims file, you determine that the Veteran's disability pattern is either (3) a diagnosable chronic multi-symptom illness with a partially explained etiology, or (4) a disease with a clear and specific etiology and diagnosis, then please provide a medical opinion, with supporting rational, as to whether it is "at least as likely as not" that the disability pattern or diagnosed disease is related to a specific exposure event experienced by the Veteran during service in Southwest Asia. Note: Veteran has verified service in the Gulf War, 8/1/1990- 3/15/1991. Please see his statement, dated 6/17/2014 and labeled under correspodence, on VBMS. b. Indicate type of exam for which opinion has been requested: sleep apnea TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. c. Rationale: There are no studies of which I am aware which correlate sleep apnea to Gulf War toxic chemicals, and sleep apnea generally is considered to be a condition in which loose, floppy tissues in the throat occlude the passage of air during the relaxation of sleep. This Veteran has a narrow posterior pharynx which is mildly and chronically inflamed as evidenced by the mild redness and swelling in his throat. The question is what's causing the swelling which causes the loose floppy tissues which in turn causes the sleep apnea? Toxic chemicals which possibly can cause the Veteran's symptoms are discussed on Form 21-2507 provided to this examiner. This Veteran's array of inflammatory ailments as likely as not have common origins in the metabolic dysfunctions which toxic chemicals can create. The Veteran's diagnosable but medically unexplained chronic multisymptom illnesses of partially-explained etiology are: Migraine Headaches and sleep apnea. Undiagnosed illnesses are: Fatigue, and random muscle/joint pains. It is at least as likely as not that these illnesses were caused by exposure to toxic chemicals during the Gulf War. Environmental toxins bind to proteins and are stored in fat and cause up-regulation of the immune system with inflammatory cytokines. Without detoxification, these toxic effects accumulate and can cause problems years after initial exposure, especially if patients are taking medication. The Veteran is taking Lexapro. My conclusions are biologically plausible based on the following explanation which is a brief outline describing several major biological responses to an element that the body perceives as toxic. Examples of toxic substances are burn pit smoke, formaldehyde in building materials, contaminated water, vaccines, drugs, food or drink containing toxic chemicals (for example, pesticides, artificial sweeteners, etc.). Illnesses usually develop gradually over many years. Up-regulation and depletion of mucosal protective secretory IgA (SIgA), is the first line of intestinal defense at the level of absorption sites. This leaves the absorption sites vulnerable to assault and commonly leads to a chronic condition called "leaky gut" (increased intestinal permeability). This cascade of events leads to depletion of intestinal bacteria crucial to the gut's ability to transport nutrients through the small intestine villi into the blood. (biochemistry reviewed in The Second Brain, by Michael Gershon, M.D.; other excellent references are "The Inside Tract", by Gerard Mullin, MD, "Clean Gut" by Alejandro Junger, "The Blood Sugar Solution", by Mark Hyman, MD, and "The Textbook of Functional Medicine", 2010) Chronic leaky gut leads to dysregulation of systemic immune globulins. As more toxins are allowed to enter the bloodstream, the immune system constantly must be "on guard". This constant catabolic influence up-regulates tissue damage at the same time the nutrient absorptive function is crippled by leaky gut. The tissue is not able to be repaired at the same rate it is broken down. Inflammatory conditions ensue. As toxins enter the liver through the portal vein, Phase 1 and Phase 2 liver detoxification functions are up-regulated and eventually depleted. This puts a toxic load upon the circulatory system. Replenishment of liver detoxification pathways depends upon optimum gut function and adequate, ingestion of sulfur-bearing foods and dark leafy greens to supply the crucial glutathione pathway. With compromised liver detoxification, the systemic immune globulins become chronically up-regulated creating auto-immune conditions. The chronic immune dysregulation which imposes a catabolic influence upon various tissues depletes adrenal cortisol and the adrenal production cannot keep up with the demand. The body's own anti-inflammatory process becomes inadequate. More and more of the body's cellular energy production is allocated to stabilizing the toxic degeneration. The adrenal glands produce more adrenalin in an attempt to derive energy from the muscles in order to meet the daily needs of the person. This excess adrenalin de-sensitizes the cellular insulin receptors and leads to insulin-resistance syndrome depriving the cells of optimum glucose transport. Blood glucose can increase and lead to diabetes and other inflammatory conditions, due to tissue glycation. The patient may rely more and more upon drugs in order just to "get by". This brief biochemical explanation explains the cascade of events that can progress from the toxic chemical exposure in the Persian Gulf to the veteran's current inflammatory conditions. This examiner understands that these conditions may not be listed as caused by exposure to toxic chemicals, but with continuing inflammation, the probability increases to develop more serious illnesses. This is why I've concluded that the veteran's conditions noted above at least as likely as not are related to Persian Gulf environmental toxins. This examiner has practiced medicine since 1969 and has postgraduate training in Functional Medicine and nutritional biochemistry SLEEP APNEA references http://www.gulfwarvets.com/cgi-bin/ultimatebb.cgi?ubb=print_topic;f=1;t=00017 7 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1061276/ http://usatoday30.usatoday.com/news/health/2010-06-07-apnea_N.htm?csp=34news http://www.national-toxic-encephalopathy-foundation.org/solvent.pdf http://www.huffingtonpost.com/2013/02/07/gulf-war-syndrome-veterans_n_2634838 .html http://donate.dav.org/site/PageServer?pagename=NewBilltoHelpTroopsExposedtoTo xicBurnPits ************************************************************************* **************************************************************************** Sleep Apnea Disability Benefits Questionnaire Name of patient/Veteran: Indicate method used to obtain medical information to complete this document: [ ] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file reviewed? [ ] Yes [X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: [X] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [X] Other: VBMS, VVA, CPRS with remote data 1. Diagnosis ------------ Does the Veteran have or has he/she ever had sleep apnea? [X] Yes [ ] No [X] Mixed, components of both ICD code: 327.23, 327.27 Date of diagnosis: 8/6/2014 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's sleep disorder condition (brief summary): The Veteran complains of tiredness since service in Desert Storm. He wakes tired. If allowed, he could sleep 16 hours and wake tired. He snores for at least the last 15 years. His wife says he thrashes and swings his arms in sleep. His wife witnessed him not breathing in his sleep. He rarely consulted doctors in service. There is no record of sleep apnea related symptoms in the STR or records in the few years post service. Polysomnogram 8/6/2014 diagnosed moderate OSA with AHI of 16.3. CPAP Titration sleep study on 9/13/2014 diagnosed moderate complex obstructive and central sleep apnea. CPAP failed to correct the AHI/CAHI so he's completed an Adaptive Servo-Ventilation study on October 8, 2014. No report is available as of today. b. Is continuous medication required for control of a sleep disorder condition? [ ] Yes [X] No c. Does the veteran require the use of a breathing assistance device? [X] Yes [ ] No d. Does the Veteran require the use of a continuous positive airway pressure (CPAP) machine? [X] Yes [ ] No 3. Findings, signs and symptoms ------------------------------- Does the Veteran currently have any findings, signs or symptoms attributable to sleep apnea? [X] Yes [ ] No If yes, check all that apply: [X] Persistent daytime hypersomnolence 4. Other pertinent physical findings, complications, conditions, signs and/or symptoms ----------------------------------------------------------------------------- a. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis section above? [ ] Yes [X] No b. Does the Veteran have any other pertinent physical findings, complications, conditions, signs and/or symptoms related to any conditions listed in the Diagnosis section above? [X] Yes [ ] No If yes, describe (brief summary): He has a narrow posterior pharynx and diffuse mild reddening of the mucus membranes indicating chronic non-specific inflammation. 5. Diagnostic testing --------------------- a. Has a sleep study been performed? [X] Yes [ ] No If yes, does the Veteran have documented sleep disorder breathing? [X] Yes [ ] No Date of sleep study: 8/6/2014 Facility where sleep study performed, if known: NeuroSleep Results: Moderate OSA with AHI 16.3. CPAP Titration report 9/13/2014 diagnosed moderate complex (obstructive and central) sleep apnea. b. Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No 6. Functional impact -------------------- Does the Veteran's sleep apnea impact his or her ability to work? [ ] Yes [X] No 7. Remarks, if any: ------------------- No remarks provided. Physician ------------------------------------------------------------------------- -------------------- DoD Military Service Information ------------------- Source: DoD No information was available that matched your selection. ----------- END OF MY HEALTHEVET PERSONAL INFORMATION REPORT ----------
  6. I've had a diagnosed and rated condition (diabetes) for 20 years and am preparing to file for the following secondary conditions: peripheral neuropathy, diabetic retinopathy, autonomic neuropathy, and impotence. I sent in a request for my records from two hospitals a couple weeks ago. I'm hoping that since all my appointments aren't documented on myhealthevet that the facilities might have hard copies. The records span 3 years in DC and 9 years (previous) in another State does anyone have an idea of how long this process takes? Another question related to documentation for a condition, I copied the following out of my VA records, can you tell me if it will be accepted as a diagnosis (please note the comments in bold) The process of medication reconciliation was completed during today's visit. The veteran's current medications (including non-VA medications and any changes made today) were reviewed with the patient and/or caregiver. A written list was offered and/or provided. Assessment:5 2 yo male with type I DM on insulin pump presents with 12 yr history of water diarrhea, colonoscopy done with no colitis or microcolitis, normal biopsy. Celiac workup neg, cultures neg. Gastroneuropathy or "diabetic gut" suspected. ManagEment of symptoms is key. Recommendation: Start with loperamide 2mg take one in am, and then one after each loose stool for maximum of 8 a day. Cholestriamine unlikely to help and no need to continue. DR’s Name, Signed: 04/22/2013 / Doctor Somethin,MD, ATTENDING PHYSICIAN, GASTROENTEROLOGY, HEPATOLOGY ADDENDUM saw and examined Mr. Green and discussed his symptoms with him in detail. He is a 52 year old with 30 yr history of type I DM and longstanding diarrhea, 5-6 watery BM/day with fecal incontinence occasionally at night. Colonoscopy was negative for microscopic colitis. No evidence of bacterial overgrowth or infection. We discussed the management of diabetic intestinal neuropathy which is the likely diagnosis here. He will take loperamide as described, and if not effective, we can make further adjust Thank you so much for your help
  7. I Had My C&p Exam Last Week And I'd Appreciate Any Feedback On My Exam Summary. Semper Fi Diabetic Sensory-Motor Peripheral Neuropathy Disability Benefits Questionnaire Name of patient/Veteran: HOLLOWAY, Phillip Lamar Indicate method used to obtain medical information to complete this document: [ ] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file reviewed? [ ] Yes[X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with diabetic peripheral neuropathy? [X] Yes [ ] No Diagnosis #1: Diabetic neuropathy ICD code: 357.2 Date of diagnosis: 2011 2. Medical history ------------------ a. Does the Veteran have diabetes mellitus type I or type II? [X] Yes [ ] No b. Describe the history (including cause, onset and course) of the Veteran's diabetic peripheral neuropathy: The veteran states he was diagnosed with Diabetes about 10 years ago. He states he started getting numbness, tingling and burning sensations in his bilateral forefeet about 2011. He states this is worse at night and often it will wake him up while sleeping. He states he is now on Gabapentin daily for his symptoms. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% c. Dominant hand [X] Right [ ] Left [ ] Ambidextrous 3. Symptoms ----------- a. Does the Veteran have any symptoms attributable to diabetic peripheral neuropathy? [X] Yes [ ] No If yes, indicate symptoms' location and severity (check all that apply): Constant pain (may be excruciating at times) Right upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Intermittent pain (usually dull) Right upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Paresthesias and/or dysesthesias Right upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Numbness Right upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe b. [ ] Other symptoms (describe symptoms, location and severity): No response provided. 4. Neurologic exam ------------------ a. Strength Rate strength according to the following scale: 0/5 No muscle movement 1/5 Visible muscle movement, but no joint movement 2/5 No movement against gravity 3/5 No movement against resistance 4/5 Less than normal strength 5/5 Normal strength Elbow flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Elbow extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Wrist flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Wrist extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Grip: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Pinch (thumb to index finger): Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Knee extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Knee flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle plantar flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle dorsiflexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 b. Deep tendon reflexes (DTRs) Rate reflexes according to the following scale: 0 Absent 1+ Decreased 2+ Normal 3+ Increased without clonus 4+ Increased with clonus Biceps: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Triceps: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Lef t: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Brachioradialis: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Knee: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Ankle: Right: [ ] 0 [X] 1+ [ ] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [X] 1+ [ ] 2+ [ ] 3+ [ ] 4+ c. Light touch/monofilament testing results: Shoulder area: Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Inner/outer forearm: Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Hand/fingers: Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Knee/thigh: Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Ankle/lower leg: Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Foot/toes: Right: [ ] Normal [X] Decreased [ ] Absent Left: [ ] Normal [X] Decreased [ ] Absent d. Position sense (grasp index finger/great toe on sides and ask patient to identify up and down movement) [X] Not tested e. Vibration sensation (place low-pitched tuning fork over DIP joint of index finger/IP joint of great toe) Right upper extremity: [X] Normal [ ] Decreased [ ] Absent Left upper extremity: [X] Normal [ ] Decreased [ ] Absent Right lower extremity: [ ] Normal [X] Decreased [ ] Absent Left lower extremity: [ ] Normal [X] Decreased [ ] Absent f. Cold sensation (test distal extremities for cold sensation with side of tuning fork) [X] Not tested g. Does the Veteran have muscle atrophy? [ ] Yes [X] No h. Does the Veteran have trophic changes (characterized by loss of extremity hair, smooth, shiny skin, etc.) attributable to diabetic peripheral neuropathy? [X] Yes [ ] No If yes, describe: 1.) Dystrophic toe-nails. %%%%%%%%%%%%%%%%%%%%%%%%%%%%% 5. Severity ----------- a. Does the Veteran have an upper extremity diabetic peripheral neuropathy? [ ] Yes [X] No b. Does the Veteran have a lower extremity diabetic peripheral neuropathy? [X] Yes [ ] No If yes, indicate nerve affected, severity and side affected: Sciatic nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Moderately Severe [ ] Severe, with marked muscular atrophy Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Moderately Severe [ ] Severe, with marked muscular atrophy Femoral nerve (anterior crural) Right: [X] Normal [ ] Incomplete paralysis [ ] Complete paralysis Left: [X] Normal [ ] Incomplete paralysis [ ] Complete paralysis 6. Other pertinent physical findings, complications, conditions, signs and/or symptoms ----------------------------------------------------------------------------- a. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis section above? [ ] Yes [X] No b. Does the Veteran have any other pertinent physical findings, complications, conditions, signs and/or symptoms related to any conditions listed in the Diagnosis section above? [ ] Yes [X] No 7. Diagnostic testing --------------------- a. Have EMG studies been performed? [ ] Yes [X] No b. If there are other significant findings or diagnostic test results, provide dates and describe: HgA1c 6.5% - 06/14/2012 6.5% - 02/04/2013 7.4% - 08/22/2013 6.4% - 07/28/2014 %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% 8. Functional impact -------------------- Does the Veteran's diabetic peripheral neuropathy impact his or her ability to work? [ ] Yes [X] No 9. Remarks, if any: ------------------- 1.) Mild diabetic peripheral neuropathy of the distal bilateral lower extremities. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% **************************************************************************** COMPENSATION AND PENSION EXAMINATION MEDICAL OPINION ==================================== A STANDARD MEDICAL OPINION WAS REQUESTED. PROVIDERS RESTATEMENT OF REQUESTED MEDICAL OPINION. THIS IS NOT THE MEDICAL OPINION ITSELF: Is it as likely as not that the veteran's Neuropathy of the lower extremities was caused by his Service Connected Diabetes. Is it due to or a result of Service Connected Diabetes? WERE PRIVATE MEDICAL RECORDS REVIEWED: No WERE SERVICE MEDICAL RECORDS REVIEWED: No WERE VETERANS ADMINISTRATION RECORDS REVIEWED: Yes WERE OTHER RECORDS REVIEWED: No (STANDARD EXAMINERS MEDICAL OPINION) THE CONDITION/DISABILITY Is it as likely as not that the veteran's Neuropathy of the lower extremities was caused by his Service Connected Diabetes. IT IS AS LEAST AS LIKELY AS NOT (50/50 PROBABILITY) CAUSED BY OR A RESULT OF Service Connected Diabetes. RATIONALE FOR OPINION GIVEN: The veteran has had diabetes for approximately 10 years. His Hga1c levels show spikes indicating less than optimal control. His current complaint of neuropathic like symptoms to the distal feet is consistent with early onset mild diabetic neuropathy. It is as least as likely as not (50/50 probability) that the veteran's Neuropathy of the lower extremities was caused by or is related to his Service Connected Diabetes.
  8. Im going to file a claim for the first time for PCB exposure at Eielson AFB when I was stationed there. The exposure was dermal by way of leaking transformers. The exposure was noted in my medical records. The disability that I can connect to service is diabetes with neruropathy in my feet. My secondary effect is heart disease. EIELSON AFB is listed on the EPA SUPERFUND with PCB listed as the main contaminate.I would like to get some advise as to how to go forward and make the right moves to persue this claim.
  9. I'm currently 70% went in for cp on chronic fatigue and increase for headaches. Any thoughts? VA Doc seams to make good case for sc sleep apnea as well? 1. Medical record review ------------------------ [X] Other, describe: VBMS, VVA, CPRS with remote 2. Medical history ------------------ a. No symptoms, abnormal findings or complaints: No answer provided b. Skin and scars: No answer provided c. Hematologic/lymphatic: No answer provided d. Eye: No answer provided e. Hearing loss, tinnitus and ear: Hearing Loss and Tinnitus f. Sinus, nose, throat, dental and oral: No answer provided g. Breast: No answer provided h. Respiratory: Sleep Apnea i. Cardiovascular: No answer provided j. Digestive and abdominal wall: No answer provided k. Kidney and urinary tract: No answer provided l. Reproductive: No answer provided m. Musculoskeletal: No answer provided n. Endocrine: No answer provided o. Neurologic: Headaches (including Migraine Headaches) p. Psychiatric: No answer provided q. Infectious disease, immune disorder or nutritional deficiency: No answer provided r. Miscellaneous conditions: No answer provided 3. Diagnosed illnesses with no etiology --------------------------------------- From the conditions identified and for which Questionnaires were completed, are there any diagnosed illnesses for which no etiology was established? [X] Yes [ ] No Diagnosis #1: Sleep Apnea, both obstructive and central ICD code: 327.23, 327.27 Date of diagnosis: 9/13/2014 Name of Questionnaire: sleep apnea Diagnosis #2: Headaches ICD code: 780.79 Date of diagnosis: 6/11/2014 Name of Questionnaire: Headaches - already submitted and entered into VBMS 6/17/2014 4. Additional signs and/or symptoms that may represent an "undiagnosed illness" or "diagnosed medically unexplained chronic multisymptom illness" ----------------------------------------------------------------------------- Does the Veteran report any additional signs and/or symptoms not addressed through completion of DBQs identified in the above sections? [X] Yes [ ] No If yes, check all that apply: Fatigue, Muscle pain, Joint pain For all checked signs and symptoms in this section, provide pertinent information related to each (e.g. frequency, duration, severity, precipitating/relieving factors, physical exam, studies): See Veteran's Statement in support of claim dated 6/11/2014 which describes his chronic fatigue. His muscle and joint pains are random, never the same joint, flare transiently for about 1-2 days on average about once/month. Other than these short flares, he has no complaints about his joints or muscles. All this has been flaring since 1991. The Veteran is a reliable historian he gave a similar history to the C&P Gulf War Protocol examiner in 2002. 5. Physical Exam ---------------- Normal PE, except as noted on additional Questionnaires included as part of this report 6. Functional impact of additional signs and/or symptoms that may represent an "undiagnosed illness" or "diagnosed medically unexplained chronic multisymptom illness" ----------------------------------------------------------------------------- [ ] Yes [X] No 7. Remarks, if any: ------------------- The Veteran had a Persian Gulf Protocol exam (in CPRS) Sep 4, 2002, which documents his fatigue. He wishes to clarify today that he's applying for an increase rating on his headaches. Since the Headache DBQ was filled out by his PCP and logged into VBMS on June 17, 2014, this examiner assumes no additional headache DBQ is necessary, and it was not requested by VARO. Further questionning reveals the Veteran does not have chronic fatigue SYNDROME, but does have chronic fatigue. In addition he's requesting service connection for sleep apnea and Tinnitus. Regarding Tinnitus, this will require an Audio C&P consultation and opinion regarding tinnitus, and these have been requested. **************************************************************************** Medical Opinion Disability Benefits Questionnaire Name of patient/Veteran: Indicate method used to obtain medical information to complete this document: [ ] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file reviewed? No If no, check all records reviewed: [X] Military service treatment records [X] Veterans Health Administration medical records (VA treatment records) [X] Other: VBMS, VVA, CPRS with remote data MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Please provide a medical statement explaining whether the Veteran's disability pattern is: (1) an undiagnosed illness, (2) a diagnosable but medically unexplained chronic multisymptom illness of unknown etiology, (3) a diagnosable chronic multisymptom illness with a partially explained etiology, or (4) a disease with a clear and specific etiology and diagnosis. If, after examining the Veteran and reviewing the claims file, you determine that the Veteran's disability pattern is either (3) a diagnosable chronic multi-symptom illness with a partially explained etiology, or (4) a disease with a clear and specific etiology and diagnosis, then please provide a medical opinion, with supporting rational, as to whether it is "at least as likely as not" that the disability pattern or diagnosed disease is related to a specific exposure event experienced by the Veteran during service in Southwest Asia. Note: Veteran has verified service in the Gulf War, 8/1/1990- 3/15/1991. Please see his statement, dated 6/17/2014 and labeled under correspodence, on VBMS. b. Indicate type of exam for which opinion has been requested: sleep apnea TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. c. Rationale: There are no studies of which I am aware which correlate sleep apnea to Gulf War toxic chemicals, and sleep apnea generally is considered to be a condition in which loose, floppy tissues in the throat occlude the passage of air during the relaxation of sleep. This Veteran has a narrow posterior pharynx which is mildly and chronically inflamed as evidenced by the mild redness and swelling in his throat. The question is what's causing the swelling which causes the loose floppy tissues which in turn causes the sleep apnea? Toxic chemicals which possibly can cause the Veteran's symptoms are discussed on Form 21-2507 provided to this examiner. This Veteran's array of inflammatory ailments as likely as not have common origins in the metabolic dysfunctions which toxic chemicals can create. The Veteran's diagnosable but medically unexplained chronic multisymptom illnesses of partially-explained etiology are: Migraine Headaches and sleep apnea. Undiagnosed illnesses are: Fatigue, and random muscle/joint pains. It is at least as likely as not that these illnesses were caused by exposure to toxic chemicals during the Gulf War. Environmental toxins bind to proteins and are stored in fat and cause up-regulation of the immune system with inflammatory cytokines. Without detoxification, these toxic effects accumulate and can cause problems years after initial exposure, especially if patients are taking medication. The Veteran is taking Lexapro. My conclusions are biologically plausible based on the following explanation which is a brief outline describing several major biological responses to an element that the body perceives as toxic. Examples of toxic substances are burn pit smoke, formaldehyde in building materials, contaminated water, vaccines, drugs, food or drink containing toxic chemicals (for example, pesticides, artificial sweeteners, etc.). Illnesses usually develop gradually over many years. Up-regulation and depletion of mucosal protective secretory IgA (SIgA), is the first line of intestinal defense at the level of absorption sites. This leaves the absorption sites vulnerable to assault and commonly leads to a chronic condition called "leaky gut" (increased intestinal permeability). This cascade of events leads to depletion of intestinal bacteria crucial to the gut's ability to transport nutrients through the small intestine villi into the blood. (biochemistry reviewed in The Second Brain, by Michael Gershon, M.D.; other excellent references are "The Inside Tract", by Gerard Mullin, MD, "Clean Gut" by Alejandro Junger, "The Blood Sugar Solution", by Mark Hyman, MD, and "The Textbook of Functional Medicine", 2010) Chronic leaky gut leads to dysregulation of systemic immune globulins. As more toxins are allowed to enter the bloodstream, the immune system constantly must be "on guard". This constant catabolic influence up-regulates tissue damage at the same time the nutrient absorptive function is crippled by leaky gut. The tissue is not able to be repaired at the same rate it is broken down. Inflammatory conditions ensue. As toxins enter the liver through the portal vein, Phase 1 and Phase 2 liver detoxification functions are up-regulated and eventually depleted. This puts a toxic load upon the circulatory system. Replenishment of liver detoxification pathways depends upon optimum gut function and adequate, ingestion of sulfur-bearing foods and dark leafy greens to supply the crucial glutathione pathway. With compromised liver detoxification, the systemic immune globulins become chronically up-regulated creating auto-immune conditions. The chronic immune dysregulation which imposes a catabolic influence upon various tissues depletes adrenal cortisol and the adrenal production cannot keep up with the demand. The body's own anti-inflammatory process becomes inadequate. More and more of the body's cellular energy production is allocated to stabilizing the toxic degeneration. The adrenal glands produce more adrenalin in an attempt to derive energy from the muscles in order to meet the daily needs of the person. This excess adrenalin de-sensitizes the cellular insulin receptors and leads to insulin-resistance syndrome depriving the cells of optimum glucose transport. Blood glucose can increase and lead to diabetes and other inflammatory conditions, due to tissue glycation. The patient may rely more and more upon drugs in order just to "get by". This brief biochemical explanation explains the cascade of events that can progress from the toxic chemical exposure in the Persian Gulf to the veteran's current inflammatory conditions. This examiner understands that these conditions may not be listed as caused by exposure to toxic chemicals, but with continuing inflammation, the probability increases to develop more serious illnesses. This is why I've concluded that the veteran's conditions noted above at least as likely as not are related to Persian Gulf environmental toxins. This examiner has practiced medicine since 1969 and has postgraduate training in Functional Medicine and nutritional biochemistry SLEEP APNEA references http://www.gulfwarvets.com/cgi-bin/ultimatebb.cgi?ubb=print_topic;f=1;t=00017 7 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1061276/ http://usatoday30.usatoday.com/news/health/2010-06-07-apnea_N.htm?csp=34news http://www.national-toxic-encephalopathy-foundation.org/solvent.pdf http://www.huffingtonpost.com/2013/02/07/gulf-war-syndrome-veterans_n_2634838 .html http://donate.dav.org/site/PageServer?pagename=NewBilltoHelpTroopsExposedtoTo xicBurnPits ************************************************************************* **************************************************************************** Sleep Apnea Disability Benefits Questionnaire Name of patient/Veteran: Indicate method used to obtain medical information to complete this document: [ ] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file reviewed? [ ] Yes [X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: [X] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [X] Other: VBMS, VVA, CPRS with remote data 1. Diagnosis ------------ Does the Veteran have or has he/she ever had sleep apnea? [X] Yes [ ] No [X] Mixed, components of both ICD code: 327.23, 327.27 Date of diagnosis: 8/6/2014 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's sleep disorder condition (brief summary): The Veteran complains of tiredness since service in Desert Storm. He wakes tired. If allowed, he could sleep 16 hours and wake tired. He snores for at least the last 15 years. His wife says he thrashes and swings his arms in sleep. His wife witnessed him not breathing in his sleep. He rarely consulted doctors in service. There is no record of sleep apnea related symptoms in the STR or records in the few years post service. Polysomnogram 8/6/2014 diagnosed moderate OSA with AHI of 16.3. CPAP Titration sleep study on 9/13/2014 diagnosed moderate complex obstructive and central sleep apnea. CPAP failed to correct the AHI/CAHI so he's completed an Adaptive Servo-Ventilation study on October 8, 2014. No report is available as of today. b. Is continuous medication required for control of a sleep disorder condition? [ ] Yes [X] No c. Does the veteran require the use of a breathing assistance device? [X] Yes [ ] No d. Does the Veteran require the use of a continuous positive airway pressure (CPAP) machine? [X] Yes [ ] No 3. Findings, signs and symptoms ------------------------------- Does the Veteran currently have any findings, signs or symptoms attributable to sleep apnea? [X] Yes [ ] No If yes, check all that apply: [X] Persistent daytime hypersomnolence 4. Other pertinent physical findings, complications, conditions, signs and/or symptoms ----------------------------------------------------------------------------- a. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis section above? [ ] Yes [X] No b. Does the Veteran have any other pertinent physical findings, complications, conditions, signs and/or symptoms related to any conditions listed in the Diagnosis section above? [X] Yes [ ] No If yes, describe (brief summary): He has a narrow posterior pharynx and diffuse mild reddening of the mucus membranes indicating chronic non-specific inflammation. 5. Diagnostic testing --------------------- a. Has a sleep study been performed? [X] Yes [ ] No If yes, does the Veteran have documented sleep disorder breathing? [X] Yes [ ] No Date of sleep study: 8/6/2014 Facility where sleep study performed, if known: NeuroSleep Diagnostics Results: Moderate OSA with AHI 16.3. CPAP Titration report 9/13/2014 diagnosed moderate complex (obstructive and central) sleep apnea. b. Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No 6. Functional impact -------------------- Does the Veteran's sleep apnea impact his or her ability to work? [ ] Yes [X] No 7. Remarks, if any: ------------------- No remarks provided. /es/ Physician Signed: 10/21/2014 14:14 ------------------------------------------------------------------------- -------------------- DoD Military Service Information ------------------- Source: DoD No information was available that matched your selection. ----------- END OF MY HEALTHEVET PERSONAL INFORMATION REPORT ----------
  10. Hi, I submitted a claim for DM1 last year and was denied due to presumptive condition. I served for about three years as an 11Bravo and had the following issues however was not diagnosed for DM1. After the Army it took a few years to be full blown Insulin Pump 24/7 Driven ex. super trooper. Timeline of events that I believe that I was undiagnosed for Pre-Diabetes/Diabetes. 15 June 1992 Issues leading to excessive Urinary Issues concludes with scoping (putting a camera) into my bladder. Figured I would suck it up and pee a lot after that.... 16 June 1992 Fasting Glucose Test is 104 (Pre-Diabetes according to NIH.Gov and the VA/DOD Clinical Practice Guidelines) 19 FEB 1993 Fasting Glucose Test is 144 (Diabetes according to NIH.Gov and the VA/DOD Clinical Practice Guidelines) 24 OCT 1994 ETS from the Army. Had a lot of problems with hypoglycemia, weight loss, thirst, urination fatigue and irritability. Finally diagnosed at age 34 in Jan 2005. I have done a lot of research and cannot find any really good info on DM 1 for VA claims in my personal situation. Are there any suggestions for me to make the Nexus between the issues above/argument that I had more than a 50% chance of being DM1 when I left the service. Thanks, M
  11. My name is Bill. I started asking questions with out posting here. I am a Vietnam Vet ( FO Army)with an 80% (PTSD 70% Diabetes Type ll 10%) current rating. I live outside of Buffalo NY.I am currently on SSDI and waiting for VA unemployabilty. I feel best when I'm riding my motorcycle and have to concentrate on those around me. I've ridden to the west coast and back and loved every minute. Going over the Rocky Mountains was exceptionally spiritual so to speak. Talk about reaching for the clouds! I have been playing games with the VA since 1993(maybe that's backwards lol) and hope that this is finally wrapped up soon. I had a great job when I had my melt down in 2012. Needless to say I've not worked since. I try to stay as active as I can. I look forward to not only asking, but giving help when I can.
  12. : (18 August 2014 - 09:26 AM)Looking For Feedback. I Have Applied For Iu. Was Told To Come In For A Psych Eval And Diabetes Clinic. Received A Call From Va They Were Cancelling The Psych Eval As The Doc(?) Who Did It In March(Ptsd Increase) Was Asked For His Opinion And He Was Going To Submit That. This Is The Same Individual Who Told Me Off The Record About Iu And To Contact My Service Officer. Sounds Positive To Me, But I May Be A Little Bias. Thoughts?
  13. HI, I am rated at 60% for Tinnitus, PN, Diabetes II. I filed a clam last November with the DAV, for PAD secondary to the DM II. I had a C&P at the Saginaw MI. VA on April 25,this past Friday my claim was denied. I sent in 2 Drs. statements along with the ultra sound of my legs, with the claim in November. My DAV rep suggested we send in a Reconsider with new medical evidence. I have never gotten a IMO from a Dr. who did not exam me. Is it worth getting one? How much weight could it have with the VA rating person when this Dr. is out of state, and never examined me? Thanks, Hugh
  14. I'm new to the forum. I'm trying to get a IME for high blood pressure secondary to diabetes type 2. I belong to a HMO and they don't know I'm a veteran. My doctor verbally told me once the HBP was due to the diabetes, but won't write a diagnoses on it. Is there any doctor on the west coast, I am in Washington State. If there is someone in WA state that would be great. CAD/IHD 30% Diabetes mellitus with ED 20% Peripheral neuropathy left and right extremity 10% each – 20% High Blood Pressure secondary to diabetes mellitus type 2 - denied Joe
  15. C&P physical scheduled for diabetes, bladder cancer, hearing and tinnitus. Battle Creek Mi is where it is going to be held but this is supposedly the worst place for hearing and tinnitus claims because the 2 doctors don't think any vet should qualify for either claim. Any recommendations for the examination
  16. Greetings I will meet the VA Traveling Board Judge next month for the following contentions: - LEFT ARM NEUROPATHY DUE TO EXPOSURE TO AGENT ORANGE HERBICIDE - DIABETES MELLITUS TYPE II DUE TO EXPOSURE TO AGENT ORANGE HERBICIDE - BILATERAL BIG TOE CONDITION - LOW BACK PAIN WITH MILD DEGENERATIVE CHANGES - LEFT LOWER EXTREMITY RADICULOPATHY - RIGHT LOWER EXTREMITY RADICULOPATHY - CHRONIC ARTHRITIS - ISCHEMIC STROKES AND SEIZURES How should I prepare for this once-in-a-life time meeting...I've wait nearly four years for this day. Please provide some pointers because I want to win my case. Thanks Best Regards Chiefhouse
  17. Today was a good day; I received the direct deposit on today. 30% DAV with twelve months of back pay. Not bad for my first claim. 10% chronic bronchitis 10% tinnitus 10% Pseudofolliculitis barbae I have also been diagnosed with sleep apnea, diabetes II and high blood pressure by the VA. I am also currently starting the PTSD counseling class recommended by my primary counselor. I am looking at advice on the direction for any claims on the above. I didn’t have any while in service, but feel are aggravated by the chronic bronchitis.
  18. Submitted claim for PTSD Nov 13. This past Thursday my DAV rep called me and notified me I won and rated 70% for ptsd 80% combined. He also stated retro date back to 2009 and to expect a nice chunk of change. Checked my ab8 letter and it states effective date 1Jan14. Wondering if he got me mixed up with one if his other Vets. I guess I'll wAit for the Envelope! What do you guys think? It was also a bitter sweet call. He stated the VA wants me to come back in and file for diabetes and high BP. I had no idea I had diabetes! Now it makes sense why I'm always extremely tired and shake on a daily basis. I remember seeing my personnel provider at the VA and had a full work up last year. I guess she didn't think it was important to notify me of the results. I will be going to her office first thing in the a.m! Gotta love that VA healthcare : / Thanks everyone for your help! God bless
  19. Newbie looking for general Idea of compensation: I was thinking 30%, but not sure how the secondary illness' affect it. VA Notes Source: VA Last Updated: 22 Aug 2014 @ 0346 Sorted By: Date/Time (Descending) VA Notes from January 1, 2013 forward are available 3 calendar days after they have been completed and signed by all required members of your VA health care team. If you have any questions about your information please visit the FAQs or contact your VA health care team. Date/Time: 18 Aug 2014 @ 1200 Note Title: C&P MENTAL HEALTH 16257 Location: PALO ALTO HEALTH CARE SYSTEM - PALO ALTO DIVSION Signed By: Co-signed By: Date/Time Signed: 19 Aug 2014 @ 1639 Note LOCAL TITLE: C&P MENTAL HEALTH 16257 STANDARD TITLE: MENTAL HEALTH C & P EXAMINATION CONSULT DATE OF NOTE: AUG 18, 2014@12:00 ENTRY DATE: AUG 19, 2014@16:39:32 AUTHOR: EXP COSIGNER: URGENCY: STATUS: COMPLETED Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only * Name of patient/Veteran SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [X] Yes [ ] No ICD code: 309.81 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD ICD code: 309.81 Comments, if any: The veteran's depression and anxiety are considered to be, at least as likely as not, secondary to his PTSD. Mental Disorder Diagnosis #2: Unspecified Depressive Disorder ICD code: 311 Comments, if any: Ongoing anxiety for ~ 5 years - anxiety started during pre-mobilization- served in Iraq -2009-2010. Depression began in 2010. Mental Disorder Diagnosis #3: Alcohol Use Disorder ICD code: 303.90 Comments, if any: Sober for 3 years. At peak drank a 6 pack + 8-10 shots several times a week. His alcohol abuse was, at least as likely as not, exacerbated by his PTSD. He states he normally only drank a few drinks with friends before service. b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): See below ICD code: See below Comments, if any: "----------------------------- PLL - All Problems ----------------------------- 13 Problems ST PROBLEM LAST MOD PROVIDER A Generalized Anxiety Disorder (ICD/DSM 300.02) A Depressive Disorder NEC (ICD-9-CM 311.) SA Alcohol abuse, in remission (ICD-9-CM 305.03 A Unspecified Sleep Disturbance (ICD-9-CM 780.50) A Posttraumatic Stress Disorder (ICD/DSM 309.81) A Other and unspecified hyperlipidemia (ICD-9-CM 04/18/2014272.4) A Erectile dysfunction associated with type 2 diabetes mellitus (SCT 428007007) (ICD-9-CM250.80/607.84) A Esophageal Reflux (ICD-9-CM 530.81) A Cervicalgia (ICD-9-CM 723.1) 04/18/2014 A Lumbago (ICD-9-CM 724.2) 04/18/2014 A Tobacco Use Disorder (ICD-9-CM 305.1) 04/18/2014 A Plantar fascial fibromatosis (ICD-9-CM 728.71) 04/18/2014 A Unspecified Sleep Apnea (ICD-9-CM 780.57) 04/18/2014 Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [X] No [ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: Overlapping symptoms and interaction of symptoms prevent attribution of symptoms to one specific diagnosis. That stated, it is, at least as likely as not, his depression is secondary to his PTSD, and his alcohol use was exacerbated by his PTSD. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] Not shown in records reviewed Comments, if any: Denies hx of LOC or coma 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with reduced reliability and productivity b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [X] No [ ] No other mental disorder has been diagnosed If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: Overlapping symptoms and interaction of symptoms prevent attribution of symptoms to one specific diagnosis. That stated, it is, at least as likely as not, his depression is secondary to his PTSD, and his alcohol use was exacerbated by his PTSD. The veteran is currently employed on a full-time basis as a maintenance mechanic for the range at Fort Hunter-Liggett. He is not currently in school. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes [ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes [X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [X] Other: VBMS (electronic C-file) was reviewed. Records available in CPRS were reviewed. The veteran and his wife provided history and clinical information. b. Was pertinent information from collateral sources reviewed? [X] Yes [ ] No If yes, describe: The veteran was interviewed with his wife. 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): The veteran was born in Penn and grew up in Penn, Albuquerque NM, then Georgia. He was reared in somewhat chaotic circumstances - parents divorced when vet was 4 yo - grew up with his stepfather; financial constraints - 7 children; father was an alcoholic. The veteran had 6 biological siblings + 1 stepbrother. He reports he went through the 12th grade, graduating HS with C academic marks. No college before service. The veteran states he had friends. He denies behavioral problems/ arrests. He endorses alcohol abuse occasionally and later drug abuse - MJ, methamphetamine (30 - 31 yo- episodic). The veteran denies a history of emotional, physical, and sexual abuse. The veteran has been married 3 times, to his third wife for ~ 2 years, and has 3 biological + 3 stepchildren - "all grown and out of the house". He states he is close to his 3rd wife. The veteran remarks he occasionally talked with his first wife in rearing the children. Could not be friends with his second wife. First wife became a drug addict and left him for a 19 yo. Second wife wanted a divorce due to his being gone so long, and she had to undergo surgery without him. The veteran has contact with his children and describes himself as close to them. He describes close relationships with his siblings when they are together. Currently he rents a house on Post where he resides with his wife and dogs. The veteran notes that he has friends. b. Relevant Occupational and Educational history (pre-military, military, and post-military): Military History: Enlisted into the Army Reserves at 37 years old. Had planned to go into service after HS but was in a MVA and ended up working at a papermill. He was trained as a truck driver, serving in Iraq as a truck driver between 2009-2010. The veteran did drink during service - to excess when he came back. He has served for ~ 8 years to date from 2006 to Present - currently ETS is an instructor for truck drivers. He was given an Honorable discharge from Active Duty. The veteran was exposed to combat. Denies a history of MST. Education: The veteran notes he did go back for job specific education after service attaining no degrees with good academic marks. He did not obtain any degrees in-service to date. Occupation: The veteran is currently employed on a full-time basis for the Department of the Army as a maintenance mechanic for the ranges, last working Friday. He describes his work performance as fair, his attendance record as excellent with no missed time from work in the last 1 year due to mental health problems other than appointments, and his ability to get along with his supervisors as well and his coworkers as "95% of the time well". The veteran is still in service as a TPU soldier - actively drilling and doing his Reserve status. He admits to being fired from Wal-Mart Distribution Center in 2012 due to workplace violence - "threw a shop rag" after being employed there for 5 years. He mentions he has held ~ 2 jobs since service. The veteran is not on State Disability or Social Security Disability. He transferred from another Army job due to inability to get along with his superiors. Activities: "Watch TV". c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): The veteran reports a history of family mental health problems including father was an alcoholic. The veteran denies pre-military mental health problems. To reiterate, he does have a history of +/-childhood trauma to which he does not endorse clinical symptoms -Stepbrother was killed in a MVA - "not that close - lived States apart". Stepbrother was killed in a MVA in NJ - vet was in Georgia at the time. He denies developmental problems or learning disabilities. The veteran states he was treated in-service for mental health or substance abuse issues - after 2nd wife said she wanted a divorce, vet went into a depression - OP MHC x 3 months in-service and has been "treated ever since". He reports his first mental health treatment was in-service in 2010 at the Combat Stress Center in Speicher, Tikrit for depression. Pre-Deployment Health Assessment dated 08/08/2009 (page 15) does indicate the veteran had sought care or counseling in the year prior to deployment. The veteran endorses 1 previous psychiatric hospitalizations 11/2010 - Iowa City VAH for anxiety, depression, and PTSD like symptoms. He endorses 1 previous substance abuse program - Rock Island, Illinois at the VA - Intensive OP Treatment - for alcohol. The veteran has been in previous outpatient mental health or substance abuse treatment. The veteran is currently in outpatient treatment with the Monterey CBOC (WITTLIN,BYRON J: CHAPMAN-GOREY,STACI). Previous diagnoses have included: See above. The veteran is taking psychotropic medication currently: Paxil, Welbutrin. He does report a history of previous psychotropic medications. STR's of 7/10/2014 indicate a history of "PTSD, Anxiety and depression" and treatment with Welbutrin and Paxil. The veteran reports he has not made any previous suicide attempts or acts of self mutilation. He comments he "did have a self destructive nature when got back - drinking and driving". The veteran denies a history of physical violence. Last fight: "Why left otherjob" - 04/2014 - verbal altercation with a supervisor. Last physical fight - HS. Denies domestic violence - "swings" in his sleep, per wife. Denies history of anger management classes. Current MSE is negative for expressed psychotic symptoms or acute suicidal or homicidal ideation. Last CRRS Mental Health Progress Note: JUL 28, 2014. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): Endorses history of pre-military behavioral or legal problems- DUI - in 2000 on Superbowl Sunday. Denies history of military behavioral or legal problems. Endorses history of post-military behavioral or legal problems - 04/2011 - DUI and reckless driving. Denies history of being on parole or probation. Denies current legal problems. e. Relevant Substance abuse history (pre-military, military, and post-military): Endorses history of pre-military substance abuse. Endorses history of military substance abuse - did not drink on Active Duty. Endorses history of post-military substance abuse. Any previous substance abuse-related legal charges: Yes. Last drink: 04/30/2011. Last drug use: 2003- Methamphetamines. f. Other, if any: No response provided. 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: Shot at, rockets on the base , mortared, 4 convoys hit by IED's- only once was his company's truck involved - minor damage Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military Or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No 4. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #7 - Other symptoms. The diagnostic criteria for PTSD, referred to as Criteria A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings). [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, Or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) thatarouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or others. [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning: Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [X] Stressor #1 5. Symptoms
  20. Can anyone tell me if it's normal to not be sent to one? I naturally assumed they would want to see the level I was at with DMII. I wasn't diagnosed with Diabetes in the service, however while I was pregnant during service I did have high blood sugar, 8 months after my discharge I was diagnosed with gestational diabetes for my second pregnancy. As far as I know the only records they have are from the VA Medical Center I was treated at, I wasn't sent for a C&P and my claim is at Preparation for Decision all in a months time.
  21. Hello All! It is an honor to be a part of yet another group that understands what it means to be a veteran. I am a veteran of 12.8 years of the US Navy, SC @ 60% with a whole host of issues, as I'm sure most of you have, however, chief among my ailments is ESRD (Stage 4), coupled with Diabetes II (mellitis). I have had a terrible time adjusting to getting ready to be on dialysis, though I have had plenty of time to think about it (diagnosis in 1998), it still remains an emotional battle for me and my family. Neurapathy, along with the other issues that come along with ESRD, like chronic fatigue, malaise, zero energy, have made it challenging for me to work. This is extremely tough for me as I HATE sitting around waiting for stuff to get done! I was advised to file for SSD, as I am headed for dialysis soon. I did, and was awarded SSD without a hearing, and within approximately 4 months. (That was unbelievable, and quite surprising) I was also advised (AMVETS) to apply for Individual Unemployability (IU), as my PCP has cited (in record) that I am unemployable for a variety of reasons, mainly because of the ESRD, though. I made, what I consider, a feable attempt at understanding the ratings table and how to calculate increases, and became sick to my stomach after about 30 minutes of that 'crap'. Old Medical Status and Current Disability Rating %: ESRD-30% Knees-20% Other-10% Total 60% I am currently hoping the VA sees it clear to grant me an increase in disability comp, as I have introduced new evidence via the Fully Developed Claim system, that clearly shows what the claim proposes. Based off of new (4 month old) labs, I now fall into another category (my Creatnine is 4.67), which says if Creatnine is between 4-8 mg, that qualifies for 80% on its own. (CFR) Current Medical Status and Current Disability Rating %: ESRD-80% Knees-20% Other-10% Total ??? Other than that, I am working hard to follow a strict diet (low animal protein), excrcising everyday, and following Nephrologist's advice tot he 'T'. My hope is to stave off dialysis for as long as it takes to receive a transplanted kidney. In the meanwhile, I also hope the 'powers that be', are able to get the process done quickly, and fairly. That's all for now! Thanks for allowing me to share a little. Peace!
  22. I am boots on the ground Vietnam veteran 1969-1972. I have successfully handled my own compensation filings with the Veterans Administration for Diabetes type II, renal disease, liver disease, hypertensive heart disease, bilateral peripheral neuropathy in legs, and bilateral peripheral vascular disease. I am currently rated 90% with 10% added for unemployability, Permanent and Total. In December 2013 I began having urinary difficulties which resulted in medication and orders for a PSA from my primary care doctor at Michael E. DeBakey VA Medical Center. The prostate biopsy performed in May revealed stage 4 prostate cancer with a Gleason score of 9 (4+5 for 6 biopsies and 5+4 for six biopsies). I have sent a letter request to the Veterans Administration for compensation requesting that Prostate Caner, presumed caused by exposure to Agent Orange, be added to my list of service related disabilities and this effort is ongoing. Their response is expected in the next month. I am also pursuing an SF-95 claim suggesting malpractice as a result of failure to diagnose. These are my positions; 1) Physical exam performed in 2008 by Kelsey Seybold noted asymetrical prostate with PSA at 1.5. 2) These records were provided VA for compensation and copied to my primary care physician in 2009. 3) UCDavis/Norther California VA Medical Centers study published in Cancer in 2008 shows that Vietnam Veterans exposed to Agent Orange are 200% more likely to get prostate cancer, 75% more likely to have aggressive prostate cancer, and 400% more likely to have mets. I believe this information should have been shared with primary care physicians throughout VA determining that in country Vietnam veterans were high risk for prostate cancer. Another study published in 2013 from Portland VA shows the same results as UCDavis. 4) VA medical center guidelines state that annual counseling regarding prostate cancer should be conducted. 5) A review of all medical records from May of 2009 to January of 2014 do not show counseling, digital rectal exam, or PSA. My claim of malpractice is that given evidence of asymetrical prostate, study results indicating Vietnam Vets at high risk of prostate cancer, and VA guidelines to annual counseling at a minimum, the annual counseling should have been conducted which would have resulted in detection of the cancer at a much earlier stage. My question is this; Given the type of claim that I suggest above, will I still need an IMO? In reading posts on this forum it seems to me that I may need an IMO for review of my records confirming no counseling and supporting "standard of care" as counseling on an annual basis as a minimum.
  23. I need HELP. The VA saids that I had a stroke following a steroid injection to my spine which also caused diabetes type 2, and blindness to my left eye causing a hole in the middle of the retina which causes me a great deal of lost vision. They told me that there is nothing they can do for me and that I would live like this from now on. My right eye is also weak since the left eye was injured so I have to wear glasses just to get around the house and also drive. Does anyone out there know where I might go to see if I can get my eyes fixed? I used to be seen by the VA every six months, but when I was rated 100% they dropped the Ball and don't even call me anymore. I also have diabetes type 2 which changed my life completely, but under control with oral medications. I am currently seeing a doctor at Pacific eye institute every six months, but he never gives me any or options on what or whom to see. Seems to me that all he wants is the insurance money. I would really appreciate any feedback. thanks.
  24. Greetings I received the following options in a letter from the VA today and need your advice. - Continue to wait for a Traveling Board (2010 and 2011 Appeals pending at BVA, both appeals submitted to BVA May 2014) - Request a Video Conference (much quicker than a Traveling Board hearing) - Request a Hearing before BVA in DC (much quicker than a Traveling Board hearing) - Withdraw my Hearing (withdrawing my hearing request could result in a quicker decision by BVA) VA received my notice of disagreement (NOD) on March 8, 2010, for the following issues: -left arm neuropathy due to exposure to Agent Orange herbicide -diabetes mellitus type II due to exposure to Agent Orange herbicide -bilateral big toe condition VA received my NOD on August 12, 2011, for the following issues: -low back pain with mild degenerative changes -left lower extremity radiculopathy -right lower extremity radiculopathy -chronic arthritis -ischemic strokes and seizures Your advice good or not-so good is welcome Best Regards Chiefhouse
  25. I am service connected 100% PT for type 1 diabetes with retinopathy and have recently filed for SMC due to loss of use of bilateral shoulders due to adhesive capsulitis associated with my diabetes, I have provided evidence along with a nexus letter from my VA doctor for the shoulder issue but have never filed for these other conditions because I was told it was a part of the diabetic process. My question is should I file for these other conditions or do I only file when there is a loss of use. Osteoarthritis * 715.90 Shoulder Pain 719.41 Mood Disorder (ICD-9-CM 296.90) 296 Hyperlipidemia 272.4 Peripheral Nerve Disease (ICD-9-CM Limb Pain (Arms, Legs, Hands) 729.5 irritability, apathy , low energy, Diabetes Mellitus Type I 250.01
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