Error In Denial

[Sidney56]

I am hoping that someone can shed some light on this situation. I am in dire need of some help! I was rated for a traumatic head injury for 10%. That rating was increased to 20% for residual effects of head injury. I filed a NOD for an increase in my rating considering new evidence from VA doc and independent doc. Submitted new evidence with filing. I was denied on the basis of the head injury and not mental condition as requested. Following is excerpt from SOC.

DECISION:

The initial evaluation of 10 percent for residuals of head injury to include claimed headaches, sleep problems, blurred vision, and memory loss is proper.

REASONS AND BASES:

Rating decision of 03-22-06 granted service connection for the residuals of your hrad injury because your service medical records show treatment after you had a loss of consciousness.

During the VA examination conducted on 02-08-06, you reported a history of striking your head with subsequent unconsciousness in 1974. You stated that you have had headaches since that time. YOu described constant headaches that are aggravated by bright light and stress. The neurological examination was normal. Theexaminer stated that post traumatic headaches were not foundon the examination.

The medical record from Dr. Jabbour shows a reported history of a sustained head injury after you fell off a flight deck of the aircraft carrier while you were in the service. After the mental status examination was conducted, Dr. Jabbour diagnosed mood disorder due to general medical condition and cognitive dysfunctiondue to gerneral medical condition and alcohol dependence. He stated that you developed mood instability along with a change in your cognitive fuction, loss of concentration, and loss of function from the head injury.

Risiduals of head injury are evaluated based on the neurological disabilities or based on the subjective complaints. Purely neurological disabilities, such as hemiplegia, epileptiform seizures, facial nerve paralysis, etc., following trauma to the brain, will be rated under the diagnostic codes specifically dealing with such disabilities, with citation of a hyphenated diagnostic code.(e.g., 8045-8207) Purely subjective complaints such as headache, dizziness, insomnia, etc., recognized as symptomatic of brain trauma, will be rated 10 percent and no more under diagnostic code 9304. This 10 percent rating will not be combined with any other rating for a disability due to brain trauma. Ratings in excessof 10 percent for brain disease due to trauma under diagnostic code 9304 are not assignable in the absense of a diagnosis of multi-infarct demetia associated with brain trauma.

The evidence of record does not show that you have neurological disavilities that have been attributed to your head injury. Thus, the residuals of your head injury are evaluated on your subjective complaints. The initial evaluation of 10 percent is proper nased on your subjective complaint of headache as a result of the head injury.

The evidence of record does not show that you have been diagnosed with mult-infarct dementia associated with brain trauma as a result of your head injury. Thus, a higher evaluation is not warranted.

I did not request a rating on my head injury, but on a the diagnosed mental condition. Isn't this erroneous on their part? I filed a form-9 and was told that it will take 2-5 years to reprocess. I will be homeless by then. Is there anything I can do to expedite this process. I have contacted my Congressman and Senator, but I am getting the impression that they can't do anymore than I can. HELP!

[Berta]

Sidney _I dont have any template that you could use but I think with the input you got here -you will do fine-

I recently had to define an issue to the RO and it ended up taken 5 pages-

But 3 of those pages were inserts from M21-1MR and various other VA regs-copied and pasted into my response.

You stated it all clearly here-

I suggest that you even make sure the Director or the head VSM of your VARO gets this letter too-

Do you have any vet rep to help with this?

Things like this situation must be cleared up as soon as possible-

we are not limited to NODs, SOC responses and Medical evidence.

Ironically the VA in Jan 2006 attempted to clarify my issues vuia the VSM- but they still didnt have them right-

Yesterday I found out that my CUE claims are on hold- which is OK- it has only been 3 years in with them- as the DRO is focusing solely on my main AO issue and I got to a DRO in weeks- due to my clarification letter and sent my IMOs again for the 7th or 8 th time at least-

but since my POA revoked me-last week--- they could not interfere with my evidence anymore-as it appears they have been doing for years.

Tell them exactly what yu said here and I think you will be fine- give them your email addy in the letter and your phone number.

[Sidney56]

Thanks Berta for your response. I saw my county VSO this morning and explained the situation to him. At first he said I needed to open another claim, then after I told him the information I received here, he decided to send a letter. It was only about 4-5 sentences as far as I could tell. It did say what my concerns and request was, but I thought he would have entered more info. He just referenced the SOC and Form-9 and gave the changes I was requesting.

The first VSO I talked with upon arrival, told me that I should get the ones that was giving me all this outside info to help me. I immediately requested to speak to another officer, and voiced my disdain at the first officer's comment.

To be honestly truthful Berta, I just don't trust these VSO's , because they act as if they are not that concerned with our issues. Oh well, maybe I am just paranoid. He said he would send the letter today, which is on a VA statement form.

Thanks to all you guys for your help and concern. I guess I will start the waiting game again

[cowgirl]

Hang in here with us Sydney, some of us have experienced help more or less from VSOs. Well I guess I use alot of 'salt' to sort out genuine people, be it the VA,VSO or person standing in line behind me at the grocers. I've had a VSO who talked a good talk, but tripped up the walk. What works for me, combination of a freindly Hadit family and a quiet but steady VSO. Sure I run questions by VSO and get truthful answers as best as he knows.Then here at Hadit, I can ask teh question several times and discuss until blue in the face and get 'I've been there sister and this is what worked for me' stories. Heartfelt and genuine.Honestly, I got my deserved rating increase because of finding Hadit! Still working claims here too, many years after disability rendered in my SMRs.yours,cg

Edited October 20, 2007 by cowgirl