hypertension C&p For Increase

[ronn]

Had two c&p's today. The first was with a general medicine doctor for hypertension . As expected , Don't think that went well at all.

The second was with a neuroligist for stroke. After a few questions and a short exam. He picked up his phone and in my presents dictated his report to the houston regional office.

. The main jist being " His stroke is least as likly as not related to his treatment for throat cancer due to radation therapy"

Where might i find the rating critera for stroke and neuropathy ?

[Berta]

If the throat cancer is SC this statement should definitely help get the stroke SCed as well as the HBP and PN- did the doctor write this down in your records?

who did he call?

I hope we have the Schedule of Ratings here at hadit-I keep referring vets to it- but I could not find it- it will tell you exactly how they rate stroke and its residuals -

My husband was rated for stroke at 100% per SSA and VA under Sec 1151.

well VA said NSC but the General COunsel said 1151 (Malpractice)

He was totally disabled and unemployable due to the stroke residuals.

[ronn]

Berta, The throat cancer was rated 30% With this i may get 100%. I've looked at title 38 rating codes 'but I don't see stroke or PN!

The neuroligist was dictating to ???

Sounded to me like this was his report to the houston regional office. I have know idea if it was direct to them or not.

I did notice he had my claim file! The c&p was done by the VA and not farmed out.

If the throat cancer is SC this statement should definitely help get the stroke SCed as well as the HBP and PN- did the doctor write this down in your records?

who did he call?

I hope we have the Schedule of Ratings here at hadit-I keep referring vets to it- but I could not find it- it will tell you exactly how they rate stroke and its residuals -

My husband was rated for stroke at 100% per SSA and VA under Sec 1151.

well VA said NSC but the General COunsel said 1151 (Malpractice)

He was totally disabled and unemployable due to the stroke residuals.

[Boats]

I had a TIA(Mini stroke) in 2004 and they gave me a temp 100% for 18 months, then residuals of headaches 10% PN left upper 10%, and left lower 10%. The rating code they used trying to remember now just looked at ita couple days ago was anougolous or something like that, because it was not defined in 38. Strokes are presumptive to Hypertension so they SC pretty easy for me.

Boats

[ronn]

I had a TIA(Mini stroke) in 2004 and they gave me a temp 100% for 18 months, then residuals of headaches 10% PN left upper 10%, and left lower 10%. The rating code they used trying to remember now just looked at ita couple days ago was anougolous or something like that, because it was not defined in 38. Strokes are presumptive to Hypertension so they SC pretty easy for me.

Boats

After calming down, i examind title 38 today and I think part 4 section 4.16 Paragrafe b applys

I'm still in a wheel chair to go any distance ! That was included in his report Think i may be able to get it back dated because of it being secondary to my throat cancer! I had my stroke one month after i filed the orignal in 2005 !

§ 4.16 Total disability ratings for compensation based on unemployability of the individual.

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(a) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination.

(Authority: 38 U.S.C. 501)

(:) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation and Pension Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue.

[40 FR 42535, Sept. 15, 1975, as amended at 54 FR 4281, Jan. 30, 1989; 55 FR 31580, Aug. 3, 1990; 58 FR 39664, July 26, 1993; 61 FR 52700, Oct. 8, 1996]

Please correct me if i'm wrong!!

[Berta]

http://www.warms.vba.va.gov/regs/38CFR/BOO...RT4/S4_124a.DOC

This should give you some idea of CVA ratings-

PN is usually rated at 10% per extremity (please correct me someone if I am wrong here)

Have you applied for TDIU yet ?

I feel you present a picture of 100% disability and unemployability due to this stroke- secondary to the SC disability.

I suggest you send the RO the TDIU form- and also under Question 18- check Yes and then apply for SSA disability benefits.

Has the VA given you any physical therapy at all regarding ambulation yet?

The VA-after my husband had a major stroke, said he would never walk again.

Then the doctor who told me this horrible info -by phone-said- 'dont tell the veteran this' I asked why not and he said -because of his PTSD -his HBP will raise and he will have even more problems-(yet they dont want to associate and SC PTSD to Stroke and HBP-yeah right)

I said I am telling the veteran and he said NO- this is against my medical advise-

I said get off the phone so I can call the veteran-(Rod had been hospitalized for weeks at that point.

Rod was furious with this news-and of course his HBP probably went up-but I knew my husband's will power-the VA was simply too lazy to start therapy-easier to leave him in a wheelchair for the rest of his life-

we came up with a plan-

I would raise hell by phone with the VAMC director and he would insist to every doc and nurse who came into his room-that they begin to give him some physical therapy-

2 days later they put him into physical therapy-

The therapist told me and also put into his med records- that although he was in excruciating pain

(he had been misdiagnosed for 4-5 weeks up to that point and his limbs had atrophied) -"the veteran was an excellent candidate for therapy"

and about 2 more weeks later the veteran-able to walk 3 steps -was sent home-

He taught himself by crawling how to walk better-

and his VA shrink was shocked when he walked into the shrinks office without a cane for his PTSD appointment about 2 months after he got home-

If they are not suggesting or giving you some physical therapy-

your limbs will atrophy to the point that they might never work again-

if this stroke made physical therapy completely impossible due to extensive paralysis-

they will probably also have to factor in SMC with the stroke rating.

I am actually wondering too why the cancer was only rated at 30%.

Does this involve your voice box and do you need a voice prothesis to talk?

This vet got 100% for about a year -then 30% due to throat cancer residuals-

http://www.va.gov/vetapp99/files1/9907431.txt

Is this cancer from Agent Orange?

If so did the VA ever deny the cancer as SC in any past decision prior to the 30% one?

When you got the 30% -did you file a NOD on that?

How did VA account for the fact that -prior to chemo or whatever they did as treatment- you were -as I understand this BVA case statement- SC 100% ?

This case falls under Nehmer -that is why I asked about the Agent Orange-

If you are Agent Orange vet did the 30% decision mention Nehmer at all and then apply Nehmer to your claim?

"Thereafter, in April

1996, the RO issued a rating decision granting entitlement to

service connection for squamous cell carcinoma of the left

false vocal cord. The RO based the decision on a finding

that the appellant incurred this condition as a result of in-

service exposure to herbicide agents while in Vietnam, which

therefore established service connection under Public Law

102-4. A 100 percent rating was assigned under Diagnostic

Code 6819-6516, effective from June 9, 1994, the date final

rules providing for presumptive service connection for

respiratory cancers (cancer of the lung, bronchus, larynx, or

trachea) associated with herbicide exposure were promulgated

on June 9, 1994. 59 Fed. Reg. 29723-24 (1994) (codified at

38 C.F.R. §§ 3.307(a)(6)(ii), 3.309(e) (1998)). A 30 percent

rating was assigned from August 1, 1995, pursuant to the

criteria under Diagnostic Code 6819 in effect at that time

(total rating continued for two years following cessation of

surgical, x-ray, antineoplastic chemotherapy or other

therapeutic procedure; if no recurrence thereafter, the

rating will be made on residuals).

TDIU_form.pdf

Edited August 25, 2007 by Berta

[Berta]

Something here really bothers me-

Ronn-did the VA ever rate you temp at 100% for the throat cancer?Did they use Diagnostic Code 6819?

Did they somehow catch it right away diagnose you and then immedtaly treat it?

I am just puzzled as to why you never got at least a temp 100% SC rating- or maybe you did---

or maybe I am just going nuts-

because I think -if they didnt pay you -100% even temp- they might owe you that as well as 100% in the future-

Whether you are AO vet or not-

"Subsequent to the regulatory changes, 38 C.F.R. § 4.97,

Diagnostic Code 6819 states that malignant neoplasms of any

specified part of the respiratory system exclusive of skin

growths will be assigned a 100 percent evaluation. The

language in the note following that code was changed and

states that:

A rating of 100 percent shall continue beyond the cessation

of any surgical, X-ray, antineoplastic chemotherapy or other

therapeutic procedure. Six months after discontinuance of

such treatment, the appropriate disability rating shall be

determined by mandatory VA examination. Any change in

evaluation based upon that or any subsequent examination

shall be subject to the provisions of 38 C.F.R. § 3.105(e) of

this chapter. If there has been no local recurrence or

metastasis, rate on residuals. 38 C.F.R. § 4.97."

from:http://www.va.gov/vetapp01/files01/0108903.txt

If you agree with my point-do you still have time to NOD the 30% decision?