Asthma Disability Question

[line6slinger]

Hello,

This is my first post on this site, first of all I think it is wonderful that people take time out of their lives to put together a community where vets can help each other, not for profit, but just to help a brother vet. Good stuff. Now my question. I ETS Sept 1, 2007. I was always one of those guys to "tough" it out and not go to the doctor so I don't have that many visits. But a couple months ago I had alot of breathing problems while running, they did a Pulmonary Function Test on me and concluded it was Asthma and on the doctors notes, after reviewing test results and his impression on me he called it "Severe". I have been to the emergency room twice in the last couple of months gotten a steroid shot in my rump once and put on a nebulizer the other time, it's also noted in my medical files that I have to use my albuterol 3 times week due to asthmatic attacks. My question is, I have my appointment at the little VA center where I am at on May 22, for a BDD (Benefits Delivery at Discharge) meeting with a counselor. Does someone have some experience with doing claims for asthma? From what I read on the VA schedule rating website there is 10%, 30%, 60%, and 100% for just asthma. Recently it was also added I have Allergic Rhinitis. Just trying to have a compass to go by so if I get rated too low I know what I need to do. Other things that aren't associated with asthma but I will be claiming is a Radioactive accident in which I was exposed to include a full report, but not a high enough exposure dose, Dermatitis in my feet, and as noted by the Doctor "Chronic Mid-Back Pain" which I had an X-Ray that showed abnormalities and an MRI that really didn't show anything and nothing else was done. If someone could give me some ratings information, it would definintely be appreciated.

I know that all figures are ball park but just wondering what I was looking at as I have no idea what I am doing with this.

***I sincerely apologize for the multiple post, I hit the enter button to move down a paragraph and it said something about flooding, my apologies***

Regards,

Soldier

Edited May 6, 2007 by line6slinger (see edit history)

[Hoppy]

Soldier,

The VA compensates chronic conditions that are the result of military service. At this time they might say your asthma has not reoccurred frequently enough to be chronic. That does not mean it cannot be service connected. If they do not consider it chronic at this time then continued medical treatment post service will need to be shown until they decide it is chronic. Keep going to the doctor and getting the meds if your asthma symptoms continue.

[Vike17]

Soldier,

As Hoppy stated, the VA compensates for any "chronic" residuals of any injury or disease that may have ocurred while on active duty. Since you're applying for compensation before your discharge, the VA will be looking to see if any of those claimed disabilities were "chronic" while were on active duty. One treatment notation in your SMR"s probably will not suffice. One must remember that VA doesn't compensate for the number of diagnosis or injuries per say, they compensate for the residuals of any injuries to a particular bodily etiology.

One of the regulations many veterans over look is the following;

§3.303 Principles relating to service connection.

(a) General. Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. This may be accomplished by affirmatively showing inception or aggravation during service or through the application of statutory presumptions. Each disabling condition shown by a veteran’s service records, or for which he seeks a service connection must be considered on the basis of the places, types and circumstances of his service as shown by service records, the official history of each organization in which he served, his medical records and all pertinent medical and lay evidence. Determinations as to service connection will be based on review of the entire evidence of record, with due consideration to the policy of the Department of Veterans Affairs to administer the law under a broad and liberal interpretation consistent with the facts in each individual case.

(;) Chronicity and continuity. With chronic disease shown as such in service (or within the presumptive period under §3.307) so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. This rule does not mean that any manifestation of joint pain, any abnormality of heart action or heart sounds, any urinary findings of casts, or any cough, in service will permit service connection of arthritis, disease of the heart, nephritis, or pulmonary disease, first shown as a clearcut clinical entity, at some later date. For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “Chronic.” When the disease identity is established (leprosy, tuberculosis, multiple sclerosis, etc.), there is no requirement of evidentiary showing of continuity. Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim.

© Preservice disabilities noted in service. There are medical principles so universally recognized as to constitute fact (clear and unmistakable proof ), and when in accordance with these principles existence of a disability prior to service is established, no additional or confirmatory evidence is necessary. Consequently with notation or discovery during service of such residual conditions (scars; fibrosis of the lungs; atrophies following disease of the central or peripheral nervous system; healed fractures; absent, displaced or resected parts of organs; supernumerary parts; congenital malformations or hemorrhoidal tags or tabs, etc.) with no evidence of the pertinent antecedent active disease or injury during service the conclusion must be that they preexisted service. Similarly, manifestation of lesions or symptoms of chronic disease from date of enlistment, or so close thereto that the disease could not have originated in so short a period will establish preservice existence thereof. Conditions of an infectious nature are to be considered with regard to the circumstances of the infection and if manifested in less than the respective incubation periods after reporting for duty, they will be held to have preexisted service. In the field of mental disorders, personality disorders which are characterized by developmental defects or pathological trends in the personality structure manifested by a lifelong pattern of action or behavior, chronic psychoneurosis of long duration or other psychiatric symptomatology shown to have existed prior to service with the same manifestations during service, which were the basis of the service diagnosis will be accepted as showing preservice origin. Congenital or developmental defects, refractive error of the eye, personality disorders and mental deficiency as such are not diseases or injuries within the meaning of applicable legislation.

(d) Postservice initial diagnosis of disease. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. Presumptive periods are not intended to limit service connection to diseases so diagnosed when the evidence warrants direct service connection. The presumptive provisions of the statute and Department of Veterans Affairs regulations implementing them are intended as liberalizations applicable when the evidence would not warrant service connection without their aid.

[26 FR 1579, Feb. 24, 1961]

If I'm not mistaken, "chronic" by VA defination means ocurring over at least a six month period. I'm not quite on that, but i think that's correct?!?!

The bottom line is if you're SMR's only show, for instance, one or two treatments of a condition over a period of a normal enlistment, the VA will probably state that it was "acute and transitory" unless there is a clear indication of some type of residulas/chronic condition thereafter.

Like Hoppy said, obtaining service-connection isn't impossible, you just need to establish that your claimed disabilities are chronic in nature. Since you're still on active duty, yo have an opportunity to rectify the situation before you ETS.

Vike 17

[Former Member]

The "Presumptives" are all in 38 USC 1112 and 38 CRF 3.309 (a) (2006).

I might have even posted the whole list here in the past- best to try the search feature.

This list doesn't mean you have to have something on this list- it means these are service connected by legal presumption if you had the disability and it was " chronic " and became manifested "to at least 10% or more disabling within one year after date of separation from service."

NVLSP recommends getting a strong medical opinion on these claims unless the service records show strong inservice symptomology or diagnosis.

Certain tropical disease are presumptive:

all in 38 USc 1101 and 38 CFR 3.309.

POWs have a different criteria for presumption (same regs above)

Certain radiogenic claims: 38 CFR 3.309.

These are difficult to prove as most dosages were too low.

In Lasovick V Brown the veteran was involved in the Manhattan project but VA denied due to his failure to meet "radiation risk activity".

I posted some info under Atomic veterans at hadit that states the types of radiation risk activity and dosages ,effects etc that they will service connect.

My neighbor was in Nagasaki occupation.

He was exposed to a radiation risk activity.

Fortunately he has no illness at all from this.

Other vets claiming radiation exposure at the BVA site-did not have documented dosage levels high enough to cause radiation disease.

[line6slinger]

Thank you all for your input. So far I have been to the emergency room 3 times for asthma attacks, I am on a daily inhaler, emergency inhaler, and I have been prescribed prednisone twice. They sent me to "asthma classes" at the post hospital which are very informative I might add. I have asked the doctors numerous times if I can get rid of asthma, their response is, "it's chronic, you will never get rid of it, we just need to try and control it". But for some reason he does not annotate that in the medical records. If asthma is indeed a chronic disease, why do they not put it down on paper? Seems like an injustice to a veteran, it's not my fault the army put me in a place that creates or stirs up this disease, even if it started just 3 or 4 months before I get out, still in my opinion it's not my fault. Now obviously I know my opinion doesn't cut the cake. Just wondering though, if this Benifits Delivery at Discharge thing doesn't work out, I will be at home on Transition Leave for about 46 days until I actually ETS (home is not where I am at now). I will be living right across the street from a VA, there is no Military Post around, so can I go there and establish a medical relationship if all else fails? Again thanks for the advice everyone.

[Hoppy]

Soldier,

Asthma is one of those conditions that can be touch and go for service connection. I am of the opinion that the defination of chronic is a medical question that can only be resolved by a doctor. There is no magic number of episodes or time periods that apply to all disabilities. Each disabling condition can vary as to the number of incidences and time period that would indicate chronicity.

With asthma, the problem is that there are both episodic triggers and then there can be underlying medical conditions that are known to be chronic that can be triggering the asthma. From what you have said about your treatments I am optomistic that they will rate your condition.

I would talk to this doctor and ask him not only why did he tell you it was chronic and not note it but try to find out if there are any underling conditions that he should also identify as triggering the asthma. There could be allergic triggers as well as auto immune disease triggers.

The frequency of asthma attack will most likely need to meet the frequency noted in the rating schedule before they would determine that it was chronic enough to rate. The diagnostic picture can take time to develop and I have seen post service initial diagnosis cited when the there was evidence the disease was incurred as the result of service and there were no post service causes that out weighed the inservice onset. Get a good SO to help you with this.

I was diagnosed with angioedema three weeks before my discharge. Fortunately, I was able to get the head of an immunology clinic to write that there is no known cure and that the recurrent attacks that I have had over a thirty year period first occurred while serving in the armed forces and the disease can not be attributed to any cause other than exposures to organic chemicls while in service. The immunologist ran many blood studies to try and isolate a cause in my case. I also submitted a report from the Center for Disease Control (CDC, a federal agency) that stated that people who work with organic chemicals are 12 times more likely to develop chronic Ige, Iga, type III and IV allergic reactions and angioedema than the general public. I was service connected 2003 which was 34 years after my discharge. If I had a good attorney or hadit in 1970 I would have been service connected in 1970. My condition is severe and life threatening. I have been in an ER over twenty times and administered life saving treatments ( I.V. prednisone and I.V. benedryl and epinephrine all at the same time). I have been advised not to live or travel in any area where there are no EMTS and emergency medical services.

Being diagnosed in the military for the first time will work in your favor in the long run. Asthma can be triggerd by organic chemicals. Such chemicals can be so common in every day life that the disease will continue to be chronic. I am not sure about any stastics that will apply from the CDC. You can start some interesting research by clicling on the link below. There is plenty more info available if you know how to use google.

http://www.nontoxic.com/nontoxic/

[Pete53]

Soldier:

Welcome to Hadit. From your description of what has happened you should have no problems getting the condition service connected when you ETS. And it is important that you do that as it is much easier than than if you try a few years later.

Good Luck and thank you for your Service to America.

[Scottyp65]

Soldier,

I have asthma and have a 30% rating. My rating was based on the need for daily Advair and Singulair to control symptoms. Still have difficulty breathing, especially in moldy, damp, and cold weather ares. pulmonary Function Studies showed FEV-1 to be 93 percent predicted and fev-1/FVC to be 74 percent predicted. The interpretation shows mild airway obstruction with significant improvement after bronchodilators.....

For and evaluation fo 30%: "for forced expiratory volume in one second (FEV-1) of 56-70 percent of predicted value; or .... (FEV1/FVC) of 56 to 70 %......or daily inhalational or oral bronchodilator therapy: or inhalational anti-inflammatory medications. A higher rating of 60% is not warranted unless there is FEV-1 of 40 to 55 percent predicted; or FEV-1/FVC or 40 to 55 percent: or at least monthly visits to a physician for required care of exacerbations; or intermettent ( at least thre per year) courses of systemc (oral or parenteral) corticosteroids.

Mine is basically because of the daily meds I have to take. In my record is a letter from the Allery doc and the pulmonary clinic on how the "refused" to give me a histamin challange test as I had over a 25% change in FEV-1 with a bronchodialator..... i.e. they might have killed me by inducing an asthma attack. This is strait from my award letter, on the Blue sheets.

Hope it helps.

[line6slinger]

Thanks all for the continuing flow of information. It always helps to hear everyone elses situation and what they went through so I can predict what I have to possibly endure.

Scotty, They only did phase one of my testing as well as they said if they did a methacoline test it could trigger a dangerous asthma attack. It was noted in my records that I had a severe increase in airway function after use of the brochodilater. It will be interesting to see what comes from it. I am not some money hungry thief like unfortunately I've had to witness some people act like, it would just be a blessing if the military covered all the medication I needed to get by in life. Again thanks for the info brother and sister vets.

Soldier.

[Hoppy]

Soldier,

I am not sure as to how the legal profession views the adaquacy or necessity of protecting an individual with asthma from triggers in the work place. If you continue to have prolems in work environments, you might consider researching this both with online support groups and talking with doctors.

I had extream difficulty with employment and my condition. When you tell an employer that you have a medical condition that has put you in the ER the employer gets real nervous. I had a college education and work experience in school administration by the time my angioedema became life threatening. I applied for jobs and told employers I had this condition. I went over a year without getting a job. I was sent to specialists by the State of California who told me that I was making an argument for total disability. I was not interested in going on SSD and just quit telling people I had this condition.

I worked for fifteen years until I was injured in a car accident at work and had to have surgery under workers compensation. I told the vocational rehab people after the accident I had a life threatening medical condition. They wanted to keep me in rehab and failed to note in their reports that I told them about the condition.

Eventually, the rehab people sent me into a work environment that would have put me a great risk. I complained to my workers comp attorney that we needed to develop a plan that would not put me at risk. When my attorney read the medical reports on my angioedema he took me out of vocational rehabilitation and told me that no employer was qualified to provide me with the protections I needed and told me to apply for SSD. MY SSD attorney was ready to battle to get me SSD. However, I did not work enough to get SSD. I was getting a Non Service connected pension from the VA. The VA fought me tooth and nail for 7 years before awarding me 100% service connected. I was of the opinion that everybody involved in the VA system was so far out of the loop as to how labor law views people with life threatening disabilities that I actually started submitting legal opinions along with my medical reports to the RO.

Angioedema may not be as easy to control with medication as asthma. Thus, you might not have as much difficulty with employers. I really do not know. This is a situation you might want to research.