Claim Denied

[ddj6969]

I just recieved my rating decision on my claim of athletes foot. I was given a service connection but given a 0% rating.

The only evidence used was my SMR's and a examination from my Dr., I was not given a medical exam by the VA.

The VA states "We have granted a service connection for your athlete's foot because your SMR's show you were treated for and diagnosed with athlete's foot while on active duty. We have assigned a 0 percent disability evaluation based on private medical evidence that reveals you have athletes foot on your left foot. It was noted you were prescribed topical medication for control. A noncmpensable evaluation is assigned unless there is difigurement; limitation of motion or fnction due to scarring; pain on examination of scars; frequent loss of covering of skin over scars; or dermatitis or eczema affecting at least 5 percent of exposed areas or requiring systematic therapy."

The part they left out was that my Dr. stated I have over 50% of my foot covered.

I have prepared my appeal letter but am looking for any advice on how to proceed.

Thanks

[luvHIM]

I am not one of the elders on this Hadit forum. I am pretty new to the Hadit family, myself. But, it is interesting that I was just in a conversation with a rating specialist on this same subject matter (not the foot...but the 0% SC decision).

He told me that most vets end up going years on a claim because it gets drug out through the process of NOD and appeal(s). He said there is a time to NOD and appeal; and there is a time when you simply file a new claim. In your case, I would think what he was telling me would apply.

He said anytime you file a claim for SC and it is awarded but you are not satisfied with the rating decision overall, don't appeal it. He said file a new claim for a rate increase because it gets "worked" a lot faster. He also mentioned that the new claim generally ends up with a "new" rating specialist (fresh eyes) and he has seen the "rate increase" almost given out in less than 3-4 months. I don't know if others here have heard this...but with all the things that are happening in the RO's these days...it might be worth a shot.

File a new claim for rate increase with your new info/medical evidence and let a "fresh pair of eyes" handle it. I still have a claim pending right now. If something comes back that I'm not happy with, I think I will take into consideration just filing a new claim it almost sounds more logical. Anyway, I know others will be along shortly to offer their advice and wisdom. Good luck in your endeavor, which ever way you choose to go.

[cloudcroft]

luvHIM,

I hadn't heard this before...thanks for the input.

Certainly something to consder.

-- John D.

[Sidney56]

I'm a newbie to the board.....that sounds logical, but wouldn't that nullfy any chances of retro pay?

[entropent]

hi ddj, you said, "my Dr. stated I have over 50% of my foot covered"

this would still be zero percent under the rating schedule, because the foot is a non-exposed area. exposed areas are the hands and face. if you had 5 to 20 percent of non-exposed areas involved, that would warrant a 10 percent. but if it only involves the one foot, no dice.

[entropent]

.....He said anytime you file a claim for SC and it is awarded but you are not satisfied with the rating decision overall, don't appeal it. He said file a new claim for a rate increase because it gets "worked" a lot faster. He also mentioned that the new claim generally ends up with a "new" rating specialist (fresh eyes) and he has seen the "rate increase" almost given out in less than 3-4 months.

luv,

what the rater told you is interesting, but i do not believe it would work in all cases. raters are assigned work based on the last two digits of your claim number. if your number is 123456789, then the rater who is responsible for the 89 digit will rate the claim, and will get the reopened claim as well. so i do not believe it is a given that you will get a fresh pair of eyes on the case.

on the other hand, you definitely get a fresh pair of eyes on the case if you appeal, because the case goes to the dro. and while appeals can certainly drag on for years, generally speaking (very generally speaking!) the initial review will take about the same amount of time as a reopened claim.

but in ddj's case, a fresh pair of eyes won't really help. athlete's foot is only going to be zero percent anyway, imho.

[cowgirl]

ddj, I have claimed for SC "rate increase" and it seems to work. The issue is already SC, so an increase is requested and for further justifcation backed up with the specific rating schedule, regulations and IMO as needed. Good luck,cg