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Service Connected Disability

  1. I was recently denied SC for coronary artery disease as a secondary to hypertension. I have since filed another claim for unrelated contention but when I was checking under "disabilities" in Ebenefits, I see were coronary artery disease is back under pending disabilities but this time is a new claim vice a secondary claim. Do anyone have any insight on this? Thanks
  2. I have a few question, but here is a little background first. I served in the Navy from 1993-2003. When I got out, I was awarded service connection and compensation for Asthma 30%, Acid Reflux 10%, Tinnitus 10%, and Hypertension 10%. I have a few others rated at 0% but do not remember them off the top of my head. In January/February of this year (2015) I went to VA medical with some complaints and was subsequently diagnosed with Cardiomyopathy. To be frank, I am a bit unclear about all my diagnosis; it has been a bit of a trial for my family considering I just turned 40 I feel shellshocked. In the initial diagnosis I was told I had an enlarged heart and from there I had an ECHO and was told that I have an EF<10%. Since then I have had a catherization and 2 stents placed in 1 artery. I go back in for surgery on June 12th to have another stenting procedure on a different artery. So perhaps I jumped the gun but in March I applied for compensation for the heart failure. I recently received back the denial notice. It was perhaps my understanding that because I had been diagnosed with service connected hypertension and have received compensation for it since I separated in 2003 that the heart failure would be related to that hypertension, especially since I was told by a VA doctor that part of my heart failure was related to the hypertension. I am going to file my appeal, but I wanted some advice before I do so, don't want to jump the gun again. What should I actually appeal? Their language in the denial notice speaks to not having any complaints or symptoms while active duty, do I need to spell out in my appeal that I am claiming the heart failure is a direct result of the hypertension? Any other items that I need to consider? Any advice is greatly appreciated.
  3. So I received a letter from the BVA today and basically says it has been remanded again It states that extra-scheduler consideration is warranted. This is what it says 1. Refer Veterans claim to the Director of Compensation and Pension Service or Under Secretary for Benefits for consideration of whether the additional symptomatology resulting from his service connected hypertension warrants an extra-scheduler rating. 2. If any benefit sought on appeal remains denied, issue a supplemental statement of the case. Then the case should be returned to the Board, if in order. What does this mean ? Does anyone know ? How long will this take now? Basically I have a 10% since 1996 for hypertension but have been having syncope episodes that are related to the hypertension and the medications I take for it and I was trying to get an increase for the hypertension. Please if anyone knows what this means would be of great help. Thank You
  4. I submitted a claim with a few new disabilities and to reopen the following disabilities shown below that were non service connected (as rated in 2007). To my surprise, I found the following statement on one of my C&Ps resutls. INCREASE CLAIMS: The veteran is claiming an increase in her service connected: " Hypertension " Asthma with allergic rhinitis " Migraine headaches " Mitral Valve Disorder " Right knee PFS " Lumbar Back Strain **Please note that the record currently does not show the veteran as service-connected for headaches, heart condition, right knee, or lumbar condition. However, errors were found in a previous rating decision, and service connection was warranted in 2007 based on her C&P exam completed within one year of service. Therefore, these issues will be treated as increase exams. Please have the examiner evaluate the current level of each disability, perform all tests as needed, and include results in the examination report. My question is how do I go about this? How do I get a copy of my C&P for 2007? I cannot believe that they made a mistake and never contacted me about it. My ebenefits still showing those disabilities as non-service connected.
  5. The VA's 'Experts' On Toxic Chemicals May Not Know What They're Talking About Veterans who were exposed to contaminated water are seeing a disturbing pattern of disability claim denials The Department of Veterans Affairs provided Burpee with medical coverage, including hospice, but repeatedly denied his claims for disability benefits. Burpee died not knowing whether his wife, four children and four grandchildren would be taken care of in the future. "They throw up so many roadblocks to you, it's unreal," said Brenda Burpee, Donald's widow. Among the chemicals, trichloroethylene (TCE), perchloroethylene (PCE), vinyl chloride and benzene are thought to be the most damaging to human health. Lejeune veterans have reported ailments including prostate and bladder cancer, as well as chronic kidney disease. Kidney cancer is not uncommon. Burpee's family found the VA's denial baffling. Given the science supporting a connection between exposure to TCE and kidney cancer, what was the rationale for withholding disability? A deeper problem at the VA The doubts about the SME program reflect wider concern about how the VA has treated current and former military personnel who may have been sickened by environmental exposures, including residual Agent Orange on repurposed aircraft, burn pit smoke in the Middle East and plumes of radiation following the Fukushima disaster. An aide to Sen. Richard Burr (R-N.C.), who has been a vocal advocate for veterans exposed to toxicants, described the SME program as "part of a broader institutional resistance" within the VA regarding environmental exposures. “Who can win in a game where your opponent is allowed to change the rules in the middle?" VA’s SME Heaney never actually saw Burpee, but she reviewed his file. In her first review, in February 2014, Heaney said exposure to the contaminated water could not be linked to Burpee's cancer or other medical conditions. Referencing Heaney’s opinion, the VA decided not to grant Burpee disability benefits. The report, which was commissioned by the U.S. Navy, seemed to absolve the military of responsibility by concluding that the scientific evidence available at the time wasn't sufficient to determine a link between exposures at Lejeune and adverse health effects. But environmental health experts disagree. In fact, shortly after the report was published, the Agency for Toxic Substances and Disease Registry, part of the Centers for Disease Control and Prevention, expressed its disagreement with the NRC's methods and conclusions. Moreover, agency director Pat Breysse said that for the purposes of the SME reviews, the NRC's report is so out of date that its "conclusions are no longer relevant." Heaney also said that Burpee's obesity, hypertension and history of smoking were all more likely to have caused the kidney cancer than the water contamination. But according to Frank Bove, a senior epidemiologist at ATSDR, that claim also doesn't match the scientific consensus of recent years. "TCE causes kidney cancer. Period," he said. Bove explained that while TCE exposure alone might not be enough to cause cancer, it likely worked in concert with other risk factors such as genetics, smoking and obesity -- each of which are also unlikely to be the sole trigger. Any one factor, including the chemical exposure, could prove to be the final straw. To examine, and digest the full story for VA’s hired SME Thugs---my opinion only--that assist with delay, deny, ignore any or all relevant scientific exposure evidence favorable to veterans until he or she dies. (Jumpmaster) click on the link. http://www.huffingtonpost.com/entry/veterans-toxic-chemical-exposure_55b647a1e4b0a13f9d190d86 r
  6. I was wondering if this sounded right. We had a meeting with my fathers SO. They told my dad he basically is getting compensated well. That filing the new claims for the IHD the Parkinsons and the worsening of the Neuropathy. Would not benefit him at all. Only in the event of his death my mother would get compensated if he passed from sac disabilities. Dad also Inquired about the Aid and attendance he filed over a year ago. It's not in the system they said. So my dad asked how to get it. The person at the SO told him that he should wait and see how this goes. It don't feel 100%. For some reason with the crap the SO told us. And reluctance to file. I told him that my dad has the neuropathy in his arms from the elbows down on top of all the other stuff my dads compensation is Disability Rating Decision Related To Effective Date diabetes mellitus, type II with diabetic nephropathy and tinea pedis 20% Service Connected Agent Orange 02/2004 early peripheral neuropathy, left lower extremity 10% Service Connected 02/2005 early peripheral neuropathy, right lower extremity 10% Service Connected 02/2005 hypertension 0% Service Connected 02/2004 peripheral vascular disease left lower extremity 20% Service Connected 12/2008 peripheral vascular disease right lower extremity 20% Service Connected 12/2008 posttraumatic stress disorder (PTSD)/major depressive disorder 70% Service Connected 10/2008 Plus SMC L I don't know why I am not sitting easy with what the SO said. My dad also had the DBQ's filled out by the dr's and submitted them.
  7. I have applied for SSDI and found out today just after a few weeks that i was denied. No exams only the adult questionnaire that I filled out. They said they went off my VA records as evidence. Im unemployable and haven't been employed since August 2013. I also have a letter from my last job describing that I was laid off due to missing to much work and also due to all my conditions that I could no longer perform my duties. My VA PCP letter stating I'm unemployable, VA ILP home assessment counselor stating severe PTSD and unemployable, VOC rehab stating in unemployable and unemployment saying I was denied and unemployable. All this was submitted to SSDI as evidence as well. Conditions: PTSD Anxiety Depression Bilateral knee derangement Hypertension Lower back pain Left hand medial nerve damage SSDI said we do not have sufficient vocational information to determine whether you can perform any of your past relevant work. However based on the evidence on file, we have determined that you can adjust to other work and do not meet requirements for disability benefits. That really knocked me back. Guessing VA increase for all above will be denied as well, its just my luck.
  8. Lost my cdl because the meds I'm on for my knees and ptsd first I lost being a Emt/firefighter for hypertension and a heart attack now my drivers license I'm so down in the dumps not sure what road take now God bless all on here
  9. So.... July 2014 I was bumped from 40 to 70 percent. However I was denied sc for both knees...depression...sleep apnea and hypertension. March 2015 I started the quick claim process for those issues plus a few others where I will be submitting more evidence once ready. I decided that I should do a NOD for the issues that were not service connected in my July 2014 award letter since my one year window was almost closed. The point was to make sure I could secure my back pay on those issues in the case that the va does SC some of them. I explain why Im doing the NOD to the VA counselor and he tells me Im trying to screw his company. I said what company? He said the VA. I explained that hes not a car insurance officer who is telling me that they dont wanna pay for my busted car. I was very mad and pointed to the hearing aids ive been wearing 13 years since I was 22 and exclaimed.. Im xxxxxxx broken! Im not a car. Im a guy who did what I sighned up to do and you are here for me and not any xxxxxxx insurance company. I then told him Ive never complained about anything in my life but I was considering going to higher about his remark of me screwing his company. His composure changed very quickly and he filled out the NOD for me. Whew....I was pissed off!!!!! Anyways...is it true that a NOD can make me wait three years like he was saying? In the past I would just do a nod within one year to show I disagreed and then submit claims for the same issues I disagreed with and a year later Id get my award and retro pay for the issues that were now service connected. The nod was just used to lock in my origional claim date. Has somthing changed??? Why is he saying two to three years? Also. Can I just submit my new evidence for these decisions I disagreed with today into the quick claim process??? Or is somthing not gonna jive??? Thanks for any help and damn he pissed me off!!!!!
  10. I am a gulf war1 vet @80% I had a heart attack 2008 2 stents place in my heart I am not rated for my heart or hypertension I was reading that cardiovascular disease falls under the gulf war presumptions has anybody on here got rater for that thanks ahead and God bless us all
  11. I'm looking to see anybody on her knows anything about the va coving my claim for taking lariam in Somalia made me sick at the time trying to get my irregular heat beats and hypertension and heart attack rated i'm rated now 80%thanks ahead for the help God bless
  12. Folks: I've had Hypertension Issues since my early days in Kuwait and was hospitalized there for several days for a kidney stone and kidney issues. Recently, I was service connected at 0% for hypertension. Anyway, much later, I ended up with 3 large marble sized cysts on my Kidney's. Anyway, so, around 1998, when I was still active in the Army, I started having chest pains that would not go away. So, they gave me an heart echocardiogram back then and found some heart valve regurgitation problems. As a result, from that time on, I've had chest pains and carried around nitro to relieve the angina. Anyway, 30 days ago, I had another echocardiogram for my disability claim but they were done by the contractor QTC. Anyway, I've been having more issues over the last couple of days and wanted to know if anyone knows the best way to access that echocardiogram from a VA QTC contractor? Overall, l know the test costs around 3-4 K , so I was glad that the VA did the test mainly so I can get a status of how I am doing now and if my heart valve is Ok or getting worse? Anyway, I've been really tired and fatigued and figure it's just the sleep apnea getting the best of me? Frankly, I know it could take almost a year to get the QTC results...so does anyone know the best way to get these results for medical reasons despite being for CP exams? I would prefer that my Non VA-PcP get the results first , mainly because he knows my cardiac conditions better than anyone else at the VA? I've tried to avoid having the VA treat me because they are so busy now...but if it's my only option, then I could be seen by them as a last resort--to see the echocardiogram ----maybe? So, does anyone have any experience with this kind of thing and know what's the best way to get a contractor completed QTC echocardiogram that was done 30 days ago....Specifically for a CP Exam? Thanks in advance....rootbeer22
  13. My last decision date was Aug 18 2014. I was bumped from 40% to 70% Several of the claims received no rating due to not enough evidence Sleep apnea Both knees High blood pressure Depression secondary to hearing loss In Mar 2015 I started the quick claim fdc process. I have yet to submit my claims as Im waiting on IMEs from Dr Bash. The Va has assured me that I have a one year window to submit my quick claims. So from Mar 2015 till Mar 2016 My question is this??? How do I keep my one year date from my august 2014 decision date? I would like to receive retro pay on the hypertension knees depression ect. Will a simple notice of disagreement with these Aug 2014 decisions secure my retro pay? Or have I screwed my self with the quick claim process I initiated in March 2015?? Thanks for any help
  14. If one filed a claim in 2008 for hypertension (HBP) and was susequently service connected for hypertension through his military medical records (zero, controlled by meds), would it be unreasonable for them to have seen an enlarge left ventrical and an abnormal ECG also in the record, to also sevice connect for heart desease? And if they didnt, which they didnt, do I, Start a new claim for heart desease. Or, a cue? Or, what?? Thanks, Hamslice From what I read in 7000, you get 30% for enlarged heart by x-ray, which I have on record in 2004 with an x-ray. And I also have an abnormal ECG, however, dont know how that plays..
  15. I filed a claim for CAD secondary to HTN. I had my C & P on June 5th and I received my copy via release of information yesterday. My question is I thought CAD secondary to sc HTn was a slam dunk. The write up from the C&P doctor states: While HTN is a risk factor for CAD, the veteran also has other risk factors including male age over 45 years old, family history of heart disease, prior cigareete smoking (quit in 1997) and low HDL in 2002. Also accoding to UP to DATE: obesity and weight gain promotes or aggravates all the atherogenic risk factors and physical activity worsens some to them. predisposing subjects of all ages to CHD events. Given the preponerance of the evidence it is less likely (not as least as likely as not) that the veterans HTN is the etiology for CAD. I have had CAD symptons since I was 38 and while in the service. I have only gained 18 pounds since retiring from the Navy in 2002. I don't understand the thinking of this person. Any thoughts would be appreciated.
  16. Hi I have been watching this site for some time now below is what I'm dealing with along with allot of other disabilities I am 60% at this time allot of 10% I have a IMO from Dr Bash that I have already turn in to VA my claim was at Prep for decision now it when back to gathering of evidence can I please get some feed back on this. I thank you guys in advance!! Berta I think I'm dealing with the same thing that your Husband when though concerning his heart condition, I'm sorry for your lost. Ken Military: 1979- 1999 I started going to Womack Army Medical Center in the early 90’s not sure when my Hypertension started I would say sometime in 1993-1994 that is when I started having shortness of breath through out the years I when on sick call many times for S0B I was referred a Cardiologist who found that I had a echocardiogram showing left atrial enlargement and nonsutain V- tach assessment was Hypertension in need of better control no indication to treat why I don’t know. My weight went from 175 to 211 my Unit Commander put in a special request Medical treatment for pathological Disorder before putting me on the weight control program during all this time my Blood pressure had not have been under control still no tests to determine what could be the problem moving on I was given a P-4 profile where I didn’t have to do any exercise with the Company, basically doing what ever I wanted to do all this stuff is attach. I was given a Medical Broad where they said I was fit for duty along with my P-4 profile where I did whatever I wanted to do, time went on I retired in 1999 in 2000 I had a EKG that showed some abnormal signs, in 2002 I had another EKG that showed Left Atrial Enlargement, Left Ventricular Hypertrophy, Abnormal EKG no tests to determine what the cause. Through out the following years I was given different medication one after another in 2006 I was tired of nothing happening knowing that as my time goes by that this high blood pressure was causing damage. Decided to go to the Va hospital thinking things would be different from notes that I have read when I started going to Fayetteville VAMC my potassium level was low, potassium chloride was added which kept my potassium within range still no test to determine what was causing my Hypertension just went from one medication to the other. Which brings me to the present time. I would say sometime in 2013 Dec I think, I was given a series of tests I guess that’s when they found out Hyperaldosteronism was going on and I was diagnose with Hyperaldosteronism told that my Hypertension have been fluctuating and difficult to control for a long time I started asking question about Hyperaldosteronism which until this day no one from VA or Womack have discuss with with me I asked Dr Tan my endocrine did I need to be concern I was told told he had release me back to my PCP and I needed to get with her so I emailed her though secure messaging where I was told that I got the results from Dr Tan so I needed to get with him until this day no one have discuss the disease with me I started reading and guess I found out why no one wanted to talk to me these messages that I had with them are enclose also what I have found out on my own and I was put on Spironolactone and that so far have kept my pressure within range for the most part. These are the disability that I have suffered while all of this have been going on: I have Hyperaldosteronism High Blood Pressure and Enlarge Heart Adnormal Heart Beat (sustain) ED Gout Headaches Weight Gain And allot of other physical things that I’m sure this hypertension have had somethings to do with. Thank you! I suffer from just about all the side affect of these disability from one time are other. And now I have Pulmonary heart disease. IMO Craig N. Bash M.D., M.B.A., Neuro-Radiology 4938 Hampden Lane, Bethesda, MD 20814 Phone: (301) 767-9525 Cell: 301-651-6392 Fax: (301) 951-9106 DrBash@Doctor.com INDEPENDENT MEDICAL EXPERT (IME) NEXUS OPINION 18 Dec 2014 To: Veterans Administration (VA) Claimant Name 1979-1999 This patient has several under-rated conditions and as a specialist in the fields of IMOs and diagnosis with 30 years experience as a physician and a PGY-7 level of training I have carefully and compassionately reviewed this patient’s medical records on longitudinal view to determine if his current rating are correct concerning his cardiac, sleep apnea and TDIU as they relate to his experiences in service or secondary (inferred/implied) to service connected conditions or service connected treatments. I understand that this opinion is partially justified based on the veteran's verified and corroborated account of what he experienced in service, much of that experience is within the competence of the veteran to report, and there is no reason in the record to doubt his credibility and many of his historical details have been corroborated by lay testimony. I have looked for any new/first time/secondary conditions as they relate to his service time and I utilize the concept of reasonable doubt in accordance with the three-judge VA Court case [case Polovick v. Shinseki (Kasold, Hagel and Davis--22 April 2009)] concerning credible evidence. (Please note that legally inextricably intertwined medical problems are medical problems that have significant impact on each other as these are known as secondary conditions in the medical lexicon. Also known within VA rate circles as inferred claims) I have reviewed this patient’s relevant and critical medical facts contained in patient’s medical records/testimony/lay statements/personnel records, conducted a 60-120 minute patient clinical interview history to document the effects of his disabilities upon his ordinary activities, imaging based medical examination (see below medical examination sections) and an in-person history/clinical interview. Thus I have had access to the critical relevant medical facts and have reviewed the pertinent relevant medical literature. I have advanced training including a 3-year Neuroradiology fellowship (2 fellowship years at NIH) following my 4-year radiology residency. I shred all records after this report is produced which is in line with Federal/VA policy on duplicative historical medical records. Facts/data: Patient entered service fit for duty without any doctor-diagnosed illnesses. Medical Diagnostic Codes OPINIONS: (Please note: That VA guidelines on benefit of the doubt allow for a causative opinion to be formed at the 50 to 50% probability which is a legal standard that is much different than the usual clinical medical causation of 95%. Thus any reviewing physician should be aware of the VA guidelines in causation so that the patient has a fair analysis of service connection and causation) Cardiac He is currently rated at 10% for his hypertension (HTN) effective 10/1/1999, which is incorrect as he has a large heart due to his longstanding HTN. For example, his 2002 EKG shows left ventricular hypertrophy, which is a form of cardiac enlargement. His recent chest x-ray of 18 Sept. 2013 shows”…cardiac silhouette at the upper limits of normal for size… Dr. Radiology…”. It is my opinions that his heart is enlarged due to his long-standing HTN and thus he should be rated at the 30% for his cardio-meglia as his records do not contain another more likely cause for his enlarged heart. This 30% should be retro-active as the patients records contained the 2002 EKG with left ventricular hypertrophy thus the rated erred (CUE). CUE; (a) Error . Previous determinations which are final and binding, including decisions of service connection, degree of disability, age, marriage, relationship, service, dependency, line of duty, and other issues, will be accepted as correct in the absence of clear and unmistakable error. Where evidence establishes such error, the prior decision will be reversed or amended. For the purpose of authorizing benefits, the rating or other adjudicative decision which constitutes a reversal of a prior decision on the grounds of clear and unmistakable error has the same effect as if the corrected decision had been made on the date of the reversed decision. Except as provided in paragraphs (d) and (e) of this section where an award is reduced or discontinued because of administrative error or error in judgment, the provisions of §3.500(b)(2) will apply. The above includes a three-pronged test to determine whether CUE is present in a prior determination: (1) "[e]ither the correct facts, as they were known at the time, were not before the adjudicator (i.e., more than a simple disagreement as to how the facts were weighed or evaluated) or the statutory or regulatory provisions extant at the time were incorrectly applied," (2) the error must be "undebatable" and of the sort "which, had it not been made, would have manifestly changed the outcome at the time it was made," and (3) a determination that there was CUE must be based on the record and law that existed at the time of the prior adjudication in question. This patient’s prior ratings decisions contain CUE for his heart rating as follows and this should be reversed: OPINION RE: DECISION 2013 Error is assigning 10% and not 30% for his hearts. 1. The correct facts were in his claims file, as they were known at the time, but the statutory or regulatory provisions in existence at the time were incorrectly applied because the rater did not fully read the patient’s records which un-mistakably show left ventricular hypertrophy. The rater should apply the equipoise rule and grant the claim. 2. The rater’s error is "undebatable" and of the sort "which, had it not been made, would have manifestly changed the outcome at the time it was made and the patient would receive more years worth of a higher level of disability. 3. This CUE is based on the record and law that existed at the time of the prior adjudication in this patient. Sleep Apnea Pt has obstructive sleep apnea as per Dr.Grant ‘s 2014 note with a prescription of 6 Cm H2O CPAP. Pt had a diagnosis of asthma in 12/1996 with a code of 493.10 as per Dr. Torrens and in 1/1998 at Womack medical center medical visits for sleep disturbance and insomnia. . Obstructive sleep apnea is different than central sleep apnea. Obstructive sleep apnea is due to an obstruction in the airway and his obstruction is likely significantly due to her sinusitis. Please note, that it is well known standard medical knowledge that sinusitis and snoring are root causes of sleep apnea. In fact, the article below shows that nasal obstruction was associated with a two-fold increase in sleep arousals and deep sleep time was decreased from 90 min to 71 min. Zwillich CW , Pickett C , Hanson FN , Weil JV The American Review of Respiratory Disease [1981, 124(2):158-160] Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S. Abstract Highlight Terms Gene Ontology(1) Diseases(3) Anecdotal observations suggested that poor quality of sleep is a frequent complaint during upper respiratory infections (URI). Nasal obstruction occurs frequently during URI and causes sleep apnea in some infants. Sleep apnea disrupts normal sleep and could explain the complaints of poor sleep quality during URI in adults. Accordingly, 10 normal men had full night recordings of sleep stages and breathing rhythm before and during nasal obstruction. The order of obstructed and nonobstructed nights was randomized after a standard acclimatization night. During nasal obstruction, time spent in the deep sleep stages decreased from 90 +/- 11.2 (SEM) to 71 +/- 12.9 min (p less than 0.05), whereas significantly more time was spent in Stage 1 sleep (p less than 0.03). This loss of deep sleep during obstruction was associated with a twofold increase in sleep arousals and awakening (p less than 0.01) resulting from an increased (p less than 0.02) number of apneas (34 +/-19 during control sleep versus 86 +/- 34 during obstructed sleep). Apneas of 20 to 39 s in duration became 2.5 times more frequent (p less than 0.05) during obstruction. Oxygen saturation was studied in the last 4 subjects using an ear oximeter. Desaturation (SaO2 less than 90%) occurred 27 times during control sleep compared with 255 times during obstructed sleep. These desaturation episodes occurred only during apneas. All men complained of poor sleep quality during nasal obstruction. We concluded that apneas, sleep arousals and awakenings, and loss of deep sleep occur during nasal obstruction and may explain complaints of poor sleep quality during URI. It is my opinion1 considering every possible sound medical etiology/principle, to at least the 90% level of probability that his current sleep problems are due to his experiences that the patient had during military service with insomnia and sleep disturbance at Womack and his diagnosis of asthma for the following reasons . 1. Per his military records he entered the service fit for duty without any doctor-diagnosed illnesses. 2. He had medical visits for asthma problems in service and asthma can interfere with breathing should the CPAP should help nullify the asthma breathing complications at night. 3. He also has insomnia and sleep disturbance in service and this was likely the early symptoms/manifestations of his later in life diagnosis. 4. The literature below supports links between seep apnea and asthma due to airway collapsibility. Difficult‐to‐Control Asthma and Obstructive Sleep Apnea 2003, Vol. 40, No. 8 , Pages 865-871 HTML PDF (344 KB) PDF Plus (355 KB) Reprints Permissions Mordechai Yigla , Naveh Tov , Anna Solomonov , Ami‐Hai E. Rubin , and Dan Harlev 1Division of Pulmonary Medicine, Rambam Medical Center and Faculty of Medicine, Technion‐Israel Institute of Technology, POB 9602, Haifa, 31096, Israel This study tested the hypothesis that asthma can promote obstructive sleep apnea (OSA) by looking at the prevalence of OSA among patients with difficult‐to‐control asthma receiving long‐term oral corticosteroid (CS) therapy and examined some possible etiological factors. The study design was a prospective cohort study and was conducted in the pulmonary outpatient clinic of a tertiary care center in Haifa, Israel. Twenty‐two consecutive patients with severe unstable asthma, 14 on continuous and 8 on bursts of oral CS, in addition to their standard therapy for a mean of 8.9 ± 3.3 years, underwent a night polysomnography in a sleep laboratory regardless of sleep complaints. A standard questionnaire was completed upon attending the sleep laboratory. The OSA was defined as respiratory disturbance index (RDI) of ≥ 5 and typical complaints. The correlation between RDI to asthma and morphometric parameters was tested. All but one patient had OSA [95.5% prevalence], with mean RDI of 17.7 ± 2.5. The RDI values were significantly higher in the continuous CS therapy subgroup (21.4 ± 3.4 vs. 11.1 ± 1.6, p < 0.05]. The study group had above normal neck circumferences and body mass index. The former increased by 12.1% ± 3.1% to 29.8% ± 1% during the oral CS therapy interval but had no significant effect on RDI as a covariant. This study showed an unexpectedly high prevalence of OSA among patients with unstable asthma receiving long‐term chronic or frequent burst of oral CS therapy. It may be assumed that prolonged and especially continuous oral CS therapy in asthma increases airway collapsibility. Read More: http://informahealth...1/JAS-120023577 5. His service insomnia was likely due to his sleep apnea. 6. His current symptoms are per the attached lay statements, which show chronicity of sleep symptoms. 7. His records do not support another more plausible etiology for his current sleep pathology or other risk factors (in or out of service) to explain his problems other than his service time insomnia and asthma experiences. 8. This opinion is consistent with the patient’s subjective lay statements, the objective findings/imaging tests/diagnoses. 9. These disabilities and his total VA medical disabilities clinical problems affect his ability to be gainfully employed. 10. This opinion represents sufficient and competent medical data and is comprehensive enough for the VA to establish a rating and MDC for this organ system problem without the need for additional work-ups or development. 11. This illness is permanent in nature and thus is not expected to improve with time as he will likely need CPAP for life thus should be assigned P and T status. 12. He should be rated for his asthma as it began in service. Diabetes: Diabetes is know to occur secondary to sleep apnea thus he should be rated for his diabetes as his records do not contain another more likely cause. TDIU He has not been working for several years do to his VA related injuries and illnesses. He is not working and considering the effect of his disabilities on his employability his total medical pictures supports TDIU via the direct route due to the sum of his VA disabilities because the patient is unable to engage in employment of any type or in any situation due to his service-connected disability. It is my medical opinion that this patient has a severe impairment in the ability to obtain or retain employment that would be considered both substantial and gainful by VA standards. The patient’s current service connected disabilities. He is not able to work of any period of time due to his sleepiness. He also has serious cardiac dysfunction which requires medication frequent check-ups both of which interfere with his ability to work a regular schedule. *** If more information becomes available via the VCAA at a later date it may or may not change the opinions rendered in this evaluation. Or if the VA decides that my recent pair of opinions is somehow still somehow deficient, in fairness to the patient, it would be ethical to allow me the opportunity to provide another addendum to this report prior to any final VA decision in order to correct any deficiencies.*** Respectfully submitted, ELECTRONICALLY SIGNED Craig N. Bash M.D. ‘86, M.B.A. ’81, G.M.E. ‘95 10 years as a VA accredited Claims Agent with both PVA and DAV (1997 to 2007) Associate Professor of Neuroradiology *****Please note that this opinion is academic in nature and as such is not meant to reflect negatively on any other professional who might hold an alternative professional opinion. The purpose of this report is also not meant for medical care or treatment and my opinions do not explicitly or implicitly guarantee that the VA will award any particular rating or benefit to the patient.*****
  17. Saw on another Vet forum that a member wrote that heart disease is automatically assumed as a secondary condition if you are service connected for high blood pressure. Tthen another member wrrote that not just any heart diseasee, it was limited to myocardial damage and coronary occlusion. "Essentially we are talking about coronary artery disease. If you have this heart disease the connection to service connected hypertension has already been made for you by the Secretary. This is spelled out in their operating manual, M21-1MR. Any other type of heart disease, except for hypertensive heart disease of course, will require a medical opinion from your doctor" I was service connected for hypertension, and filed a claim for atrial fibriallation, carotid artery disease (coronary artery diesease- CAD), and hypertensive heart disease. They were denied as not service connected, even though I had extensive heart tests 5 months after came off AD to confirm had enlarged heart, and CAD. I am on appeal and have filed new claim for cardiomapathy, cardiomegaly and re-filed the CAD again. Has anyone ever hear of automatic connection for heart disease if you have SC hypertension? The actual M21-1MR was part III, Subpart iv, Chapter 4, Section E. Sounds like a CUE has been made in my claim, but not sure?? Or could have been judgement call on the part of the C & P examiner?? Vern2
  18. My Vocational Rehab counselor has put me in the Independent living program. I was given a letter entitled"Subject:Disability Determination of case rated 100% and found Not Reasonable Feasible for Vocational Rehabilitation. In the letter it was stated the following- The case of the above -name veteran is forwarded for your attention because of a determination of being found not reasonably feasible for rehabilitation services. This veteran has a 80% SCD rating based upon 60% heart issues, 30% foot issues, 20% lumosacral strain, 10% hypertension, 0% cervical strain(fusion), 0% bilateral hearing loss, and other issues. He also has secondary chronic pain and radiculopathy issues. The Veterans SCD heart/hypertension and orthopedic issues-significant heart issues, severe foot issues, lower back, and neck issues impact his ability to walk,stand, bend, stoop, carry, lift and has difficulties doing home activities. Due to the neck issues and fusion of C6-C7 , he has limited range of motion and has radiculopathy down both arms and hands. This impacts his ability to grip, do repetitive motion, type, and do other activities. HE worked in a call center for 5 years and had multiple accommodations; however, due to his chronic neck and back issues as well as the fatigue related to his heart issues, he could no longer do sedentary work. Veterans tinnitus and hearing loss also impacted his ability to work as he cannot work in a loud, noisy environments, or do a lot of telephone work, which he h ad to do in the call center. In addition he got frustrated easily as he could not hear people well and could not understand the conversations, this made mistakes on cases. When reviewed individually, each of his issues, Heart issues/hypertension, Tinnitus/hearing loss, neck/cervical issues with radiculopathy, lower back issues, foot issues, would not prevent him from working in a sedentary supportive environment with accommodations, however, due to the combined effects and complexity of his disability issues along with the secondary chronic pain, fatigue, and related focus/memory issues, he is not able to return to work in any setting. It is unlikely that he will be able to return to work for at least several years, if ever, due to the severity and progressive nature of his disability issues. Further training would not render the veteran employable. In addition, this VRC determined, given his history, that returning to work and/or school anytime in the near future could exacerbate his health issues. This VRC recommends that he be granted 100% for Individual Unemployability(IU) He has been referred to SSA for SSDI. This VRC recommends that he be granted SSDI. VR&E is working with the veteran under an independent Living Plan to assist him with maintaining his independence at home and in the community. With this letter which I already faxed to the claims dept as my claim is still pending decision. will this given me a good shot at 100%. I have been told it is 1 VA dept telling another to give it to him. Thanks
  19. asknod responded to a post located here on hadit This response made such a huge impact on me as to its importance; that I had to respond to it and start this thread: asknod wrote: You won because you took the time to learn the twisted system. Far too many come here and merely try to get others to do their footwork. Advice is one thing. Asking for a complete book of Cliff Notes is far more. No one is more invested in your claim, more knowledgeable than you about the actual facts, nor capable of bringing the proper legal arguments to the table. It took me 14 years to recognize my 1994 claim was actually still open in 2007 and not a "reopen". VA naturally fought me all the way to the CAVC arguing the opposite. Evidence is king. When they create a c-file, they inadvertently give you a Rand McNally roadmap of all their stupidity. You, of course, are tasked with the job of decyphering it and pointing out the errors. No VSO and few law dogs can find the "magic moment", let alone recognize its significance in your battle. I commend you for following Phil Roger's sage advice on the purchase of the VBM. That's exactly how I won. I went one better and "gifted" it to a young gal in Florida who won her 1975 CUE claim. Pay it forward. Now consider the next chapter--The Independent Living Program. A free computer is one of the obvious low-hanging fruits first off. My response: asknod…You sure hit the nail with that statement….And a homerun at that. When I finally received my “C” File it came in a box about 6 inches thick. I thought OMG I sure am going to have a good time here. (not). I took this huge mass of papers and put each piece of paper in its correct order and place. This took many nights, but Oh so worth the time. After putting it all in order, I made a working copy of every section so I could make notes and still have the “clean” originals the VA sent me. Of course there were lots of holes in what was sent (of which I made note of) and some duplicates. Then I went though each and every piece, looking for ANYTHING that might help my case, making notes with different colored pens as to what I considered relevant and the level of importance. And since I am a packrat, I also had some of my old SMRs from when I was in the Navy, which I used to fill in the holes, and also all of the VA denial letters (which also were in my “C” File). A yellow pad was used to keep track of ANYTHING, no matter how small that might help me win. The VA had denied me, for Hypertension among other things, when I first submitted in 1992. Then during the C&P of January 2012, the doctor put down that the primary cause of some of my major contentions was Hypertension (BUT, I was not Service Connected). So, now I needed to figure out a way to Service Connect my Hypertension. And then I found it….My MAGIC MOMENT. So in going through my SMRs from the “C” File, page by page and entry by entry, I found all of my Blood Pressure readings. I wrote then down as to date, time, reading and the reason for visiting the Sick Bay. A C&P was conducted in April 2013 where I took all my findings from going through my “C” File including a list of where all of my Blood Pressure readings were located in my SMRs, for the doctor to look at. He could then compare and verify the readings from my list to his copy of my SMRs and then enter the information in the C&P report. The doctor DID IN FACT make the judgment that I had Hypertension while on Active Duty and thereby Service Connected me for benefits. If I had not gotten my “C” file, I never would have gotten the ammo to fight the VA. Yes, asknod is correct when he says that the VA gave us all a map and it is up to us to use it for our claim. OSC
  20. Hello everybody, I have asked for an increase on one of my disabilities that was rated a 0% in 2006. The VA received my claim for increase on 3/18/2013 with medical evidence. The original claim completion date was 1/13/2014 to 7/9/2014. I now have an updated claim completion date of 9/28/14 to 3/30/2015. The VA further states that they never received my 5103 waiver. I contacted the VA at the 1-800 number in July 2013, the day I received the notification about the 5103 waiver. They basically said it is just a form to see if I had anymore evidence to send in. I stated that I have already sent in everything. The lady at the VA 1-800 number stated to me that she could take my statement over the phone saying I have no further evidence to submit, and to go ahead and process my claim. This took place in July of 2013. Now, e-benefits is stating that they have never received a reply from me in regards to the 5103 waiver...which is posted below. I contacted the VA today at the 1-800 number and the person states that they have in the computer my statement from July 2013 stating I have no further evidence to submit and to process my claim. So, now e-benefits has backed up my claim completion date, and saying that my claim needs further review. I received a letter from the regional office (RO) today saying the average processing time is 9 months, and they apologize for the delay . I am now over 12 months and counting, with my claim showing gathering evidence. I don't see how the VA is going to meet their processing goal by 2015 with this kind of lackadaisical work ethic. Any ideas/thoughts in regards to all this. P.S. I am sort of new here and this is my first post. Claim Received: 03/18/2013 Claim Type: Compensation Estimated Claim Completion Date: 09/28/2014 to 03/30/2015 Contentions: hype hypertension (New) Claims Status Process Change of Status: We determined that your claim needed additional review. If additional evidence is needed from you, you will receive a letter from us explaining what is needed. Next Steps: We will review all available evidence and make a decision on your claim upon receipt of all requested information as outlined in the headings, "What Do We Still Need from You?" and "What Have We Done?". Several factors will determine the duration of the "Development" phase, including: type of claim filed number of disabilities you claim complexity of your disability(ies), and availability of evidence needed to decide your claim. Additional Details Your Designated Power of Attorney AMERICAN LEGION Regional Office of Jurisdiction: Montgomery Send Documentation To Department of Veterans Affairs Regional Office Regional Office 345 Perry Hill Road Montgomery, AL 36109 What Do We Still Need From Others? This is a list of all items that have been requested from 3rd parties. Items From Date Requested Due Date Follow-Up Dates 03/17/2014 05/16/2014 What We Have Never Received from You (solicited) This is a list of items that have never been received from you and that have been closed. Items Date Requested Date Closed 5103 Waiver Review 07/01/2013 03/17/2014
  21. I realize there are quite a few threads going on about SMC and I didn't want to hijack any of them with my question...Which is pretty simple (LOL) Am I eligible for SMC based upon my last VA award??? 60 Nephropathy w/Hypertension 60 PN Upper Left 40 PN Lower Left 40 PN Lower Right 30 IHD 20 DMII 20 PAD Lower Left 20 PAD Lower Right 10 PN Upper Right 10 Scar L/R Carotid 10 Scar Abdomen 0 Hypertension 0 Surg Rt Ring Finger 100% P&T plus SMC (K-1) OSC
  22. Recently I sent Ms. Allison Hickey an email on 11 March 2015 on my backlogged NOD and claims. This is part of one email that the Director sent me. My claim has been ongoing since 2003. I am currently rated 30% SC for hypertension. I filed 11 new contentions, including request for increase in my HTN rating in July 2012. The VA rater also added three more contentions to my list. extract from email from St. Pete Director today-13 March 2015 VA examinations were previously requested for the claimed conditions, however, additional information is needed before a Decision Review Officer decision can be rendered. A request for five aggravation opinions, a request for reevaluation of his service-connected hypertension with pulmonary hypertension, and a request for 1 secondary/aggravation opinion was submitted to the Pensacola VA Outpatient Clinic on March 11, 2015. When we receive this information back, we can review and make a decision on your appeal. I am sure it is just a coincidence, but this happened the same day that I emailed Ms. Hickey. What exactly does the highlighted statement mean? I have another C & P exam next Wednesday, which would be #7, all for basically same thing, HTN, heart disease and secondary conditions caused by HTN and heart disease. I have nothing new to tell the C & P examiner, just re-state same information that i gave on 8 August 2013. I have some new info, such as DBQ's by two cardiologists, and several tests results. I did complain to Ms. Hickey about the sheer number of C & P exams. I have disputed every C & P exam with data to counter act the misstatements by the VA examiner. Oh well, can anyone enlighten me as to the highlighted statement? Feeling depressed again, time for more Prozac Vern2
  23. This is 28 April 2015 results of my C & P exam for heart disease. I have been trying since 2003 to get SC for heart disease. I had 6 tests less than 6 months after came off AD DBQ CARDIO Heart: MEDICAL OPINION REQUEST TYPE OF MEDICAL OPINION REQUESTED: Aggravation of a nonservice Connected disability by a service connected disability. OPINION REQUESTED: Aggravation of a nonservice connected disability by a service connected disability. Was the Veteran's atrial fibrillation and ischemic heart disease At least as likely as not aggravated beyond its natural progression by his/her Service connected hypertension with pulmonary hypertension? Discussion of above question: The above question requires that the Atrial fibrillation and ischemic heart disease exist prior to military service and be aggravated by his hypertension. His atrial fibrillation did not occur until 2013 and proof of ischemic heart disease until 2015, occurring long after his military service, and therefore this does not seem to be the appropriate question. If we stay with the above question the opinion is that his atrial fibrillation and ischemic heart disease were not aggravated by his hypertension and pulmonary hypertension. The more appropriate question is whether the atrial fibrillation and atrial flutter are secondary to the hypertension with pulmonary hypertension. Opinion: It is at least as likely as not that the atrial fibrillation/atrial flutter/ischemic heart disease are secondary to his hypertension and pulmonary hypertension. Rationale: The veteran had long-standing hypertension that began During his military service. He is service connected for hypertensive heart disease. Hypertensive heart disease damages the muscle and electrical system of the heart which can lead to atrial fibrillation and atrial flutter. Hypertension also damages the arteries which causes the cholesterol to adhere and cause ischemic heart disease. It is therefore logical and in agreement with his cardiologist's opinion that the hypertensive heart disease caused his atrial fibrillation/atrial flutter and also his ischemic heart disease. **************************************************************************** in 2003, and results showed had hypertensive heart disease, yet rater only rated me for aggravated hypertension. Been on various appeals since 2007. This exam seems more favorable than prior exams. Any thoughts? I am currently rated 30% for hypertension. I am trying to get 60% at least for the hypertensive heart disease.
  24. Recent had C & P exam and noted several disabilities that VARO added to my claim. This is what doctor opined on spirolactone, which VA started me on in 2007 for hypertension. I am not sure if have claim or not, unless it is 1151 claim. OPINION REQUESTED: Aggravation of a nonservice connected disability by A service connected disability. Was the Veteran's diverticulitis with constipation at least as likely as not aggravated beyond its natural progression by his/her service connected hypertension with pulmonary hypertension? Medical opinion: It is at least as likely is not at the veteran's constipation and diverticulitis were aggravated beyond its natural progression by the medical treatment of his hypertension with pulmonary hypertension. Rationale: Diverticulosis which leads to diverticulitis has a strong genetic component, but the veteran had no significant history of diverticulitis prior to his antihypertensive treatment with spironolactone. The veteran developed severe constipation and was treated for diverticulitis with antibiotics. His CT scan confirmed the presence of diverticuli. Although he reports that he now has no symptoms, it did briefly aggravate the diverticulitis beyond its natural, gradual progression. **************************************************************************** My medical records show that Pensacola JACC started me on Spironolactone in 2007 to help control hypertension and pedal edema. It caused severe constipation and diverticulitius. Still not sure if I have claim or not, as I did not file for this disability.
  25. My this has been a long , tiresome road but with a lot of interesting turns and twist. Though I have been gone for several years, it is so good to be back. My commitment to our Veterans has not changed since I have been gone and if anything has increased and though gone for a while, I have been actively involved in working with Veterans, their dependents and their claims. Though a lot has befallen me over the last 3 years with my health heading south it has not deterred me from my love for helping our Veterans. I am going to be posting LOTS of research for our Archives. As many of you may know that the archives are our Veterans wealth of information here at Hadit and a key to propelling a Veterans Claims. Most of the research will be involved with Fort Greely , Alaska and Agent Orange and Nuclear Radiation and there will be more added. As many of you know Hadit's Jerrel Cook of the SVR show was also a past resident of Fort Greely. There is no mistake of his or mine exposure issues. Fort Greely is still one of the most contaminated places on the Earth , with a multibillion dollar cleanup bill. Nuclear , Agent Orange , Chemical Weapons, Asbestos, and a slew of other COCs. It is no mistake that many of us from Fort Greely are suffering from the exposure issues. Since I have been gone , I successfully settled a very intense Medical Malpractice Claim (FTCA) SF95 against the US government and am appealing the Section 1151 claim that I also have filed. I am one of only about 400 veterans that successfully have won or settled the FTCA SF95 Malpractice road last year and the year before. I will try and post an informative section for that under Hadits FTCA, Section 1151 topics. Some of you will find this very intriguing and informative and it will be there to help others to watch the VA and their sometimes illegal treatments. I am at presently service connected for Lungs under Diagnostic Codes 6604 and 6845 (COPD and Restrictive Lung Disease) and Ulcerative Colitus/IBD, and Tinnitus/hearing loss. Am awaiting a C and P exam for Heart and Sleep Apnea service connection. The VA has not yet awarded the SMC awards but will pursue that course on the fight We are still battling the VA on other issues including Neurological , Peripheral Neuropathy(all 4 extremities) , Ischemic Heart Disease, Acute Myocardial Infarction(2010) Chronic Congestive Heart Failure, CAD , Atherosclerosis, Hypertension, Renal Failure, Rheumatoid Arthritis, Granulomas lungs, Pulmonary Fibrosis, Benign Tumor Nodule on Thyroid(Nuclear Exposure), Prostate Tumors, Stage 3 Carcinoma, Prostate Cancer, Aid and Attendance, Home Bound, Home Health Care(Nurses and Providers), VA Telehealth monitoring, Defibulator with Satellite monitoring, Chronic Obstructive Sleep Apnea, Pulmonary Hypertension, Cor Pulmonale, Edema in feet and hands, Dyspenia, Home Oxygen Therapy for life, Scooter/wheelchair with ramps at house , and lift for vehicle, Walker/Cane assistance. Hopefully the new reports and some of my victories will be posted to help so many Veterans here at Hadit. This has been a long hard battle and one that could not have been won without the encouragement over the years from so many of our members here at Hadit. I have been involved in the making of a documentary and am co producing it, that is growing leaps and bounds and will hopefully end up as a tool to inform , help and to guide our Veterans and our Nation in striving to take care of our Veterans , and our Service men and women. Last, my story and trials and trails could not have gone down this path had not the Lord taken such a roll in guiding me and opening doors which I could not open. "Trust in the Lord, lean not unto thine own understanding. In all thy ways acknowledge him and he shall direct thy path". Proverbs 3: 5-7 If I could give any advice to any of our Veterans going down the trail of the VA and the claims process is simply down to this..................NEVER GIVE UP.................... it feels good to say that again here at Hadit. Thank you Tbird, jbasser , Jerrel. and so many others.
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