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Eye Problem (cataracts)


chiefhouse00

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Greetings

I just found out that I have cataracts developing at a rapid rate in both eyes. I'm been complaining out floaters, watering eyes, and poor vision well before I got out of service (well documented medical records). The doc said normally people with diabetes’s get cataracts but I don't have diabetes. I have a follow-up in six months or sooner if needed. Is Cataract Disease rated and what are some of the causes of this disease.?

Happy Thankgiving

Chiefhouse

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My husband has a cataract in his right eye. Growing a little, but not real bad at this time. He does have a film over his eye at times. I filed a claim for his cataracts based on the fact that he has taken cortisteroids and steroids for years for his eyes and skin condition, both service connected. I did a lot of research and found that these drugs can cause cataracts. The VAMC eye doctor did not even want to discuss the cataract issue as to the cause. He just had an appointment today with an independent eye doctor. He told us that the cataract he has was not the type that you would normally see with the long term usage of steroids. I do believe him because he was very helpful in getting my husband service connected for his eye condition.

I do know that the VAMC likes to blame cataracts on age, if you happen to be an older person. Maybe some others can help with other causes of cataracts. I did file a claim for this, but I guess this issue for my husband is moot at this point.

Hope this helps you some.

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MSSOUP1, Thanks for your quick response...and Happy Thankgiving to the Family. I did 30 years and had my share of fuel spraying in my eyes and other eye injuries. I've taken over 20 types of medication for my many aliments to include steriod shots for my back problem andd sprays for asthma and sinus problems as well. I'll be crossing the 60 line in six years, hopefully. I kept complaining and no real answer to my eye problem until recently. I'v been out for five years now and all of my aliments seem to be catching up with me. So, I'm going to pursue this and submit a claim to the VA next week.

Best Regards

Chiefhouse

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Glad I could help some. My husband has terrible skin problems which he has been service connected for for years. About 5 or 6 years ago, he started developing severe eye problems. He had several surgeries with an independent eye doctor because at first he thought maybe the excess skin tissue on his eyelids and around his eyes could be a possible problem. Well, it didn't help. He has been prescribed all of the known medications for his skin and eyes and nothing helps. His eye doctor finally stated that it was his opinion that his eye problem was directly related to his skin problems. The VARO still denied his claim. Wanted to know where the eye doctor got his opinion. We appealed to the BVA and won an instant approval on his eyes. Took a long time to get this claim approved. The main thing with cataracts, it seems, is that there are different causes based on the type of cataract you have. As I said before, the VAMC wants to immediately use age as the cause. But you need to first find out what type of cataract you have, then figure out what the various causes are for that particular kind. Then if you have the problem, you can start from there with your evidence.

As you know, nothing is easy when you are trying to get a claim approved, especially when you are trying to get it approved as a secondary condition. I do know that sometimes cataracts can be caused by trauma to the eyes. I did a lot of reseach after I filed my husbands claim for everything I could find on cataracts. If you can get it documented that yours is due to the trauma you experienced, then you may have a chance. A lot depends on your doctor. Some are reluctant to give an opinion.

Keep us posted on how things are going and if I can be of any help, let me know.

Mssoup1

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Here are the rating codes but it does not give any percentages.

6027 Cataract, traumatic:

Preoperative.

Rate on impairment of vision.

Postoperative.

Rate on impairment of vision and aphakia.

6028 Cataract, senile, and others:

Preoperative.

Rate on impairment of vision.

Postoperative.

Rate on impairment of vision and aphakia.

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here is a site that might help, and below that is the percentages for the eye.

http://www.warms.vba.va.gov/bookc.html

§ 4.84a Schedule of ratings—eye.

DISEASES OF THE EYE

Rating

6000 Uveitis

6001 Keratitis

6002 Scleritis

6003 Iritis

6004 Cyclitis

6005 Choroiditis

6006 Retinitis

6007 Hemorrhage, intra-ocular, recent

6008 Retina, detachment of

6009 Eye, injury of, unhealed:

The above disabilities, in chronic form, are to be rated from 10

percent to 100 percent for impairment of visual acuity or field

loss, pain, rest-requirements, or episodic incapacity, combining

an additional rating of 10 percent during continuance of active

pathology. Minimum rating during active pathology 10

6010 Eye, tuberculosis of, active or inactive:

Active 100

Inactive: See §§4.88b and 4.89.

6011 Retina, localized scars, atrophy, or irregularities of, centrally located,

with irregular, duplicated enlarged or diminished image:

Unilateral or bilateral 10

6012 Glaucoma, congestive or inflammatory:

Frequent attacks of considerable duration; during continuance of

actual total disability 100

Or, rate as iritis, diagnostic Code 6003.

6013 Glaucoma, simple, primary, noncongestive:

Rate on impairment of visual acuity or field loss.

Minimum rating 10

6014 New growths, malignant (eyeball only):

Pending completion of operation or other indicated treatment 100

Healed; rate on residuals.

6015 New growths, benign (eyeball and adnexa, other than superficial):

Rate on impaired vision, minimum 10

Healed; rate on residuals.

6016 Nystagmus, central 10

6017 Conjunctivitis, trachomatous, chronic:

Active; rate for impairment of visual acuity; minimum rating

while there is active pathology. 30

Healed; rate on residuals, if no residuals 0

6018 Conjunctivitis, other, chronic:

Active, with objective symptoms 10

Healed; rate on residuals, if no residuals 0

6019 Ptosis, unilateral or bilateral:

Pupil wholly obscured.

Rate equivalent to 5/200 (1.5/60).

Pupil one-half or more obscured.

Rate equivalent to 20/100 (6/30).

With less interference with vision.

Rate as disfigurement.

6020 Ectropion:

Bilateral 20

Unilateral 10

6021 Entropion:

Bilateral 20

Unilateral 10

6022 Lagophthalmos:

Bilateral 20

Unilateral 10

6023 Eyebrows, loss of, complete, unilateral or bilateral 10

6024 Eyelashes, loss of, complete, unilateral or bilateral 10

6025 Epiphora (lacrymal duct, interference with, from any cause):

Bilateral 20

Unilateral 10

6026 Neuritis, optic:

Rate underlying disease, and combine impairment of visual acuity or field loss.

6027 Cataract, traumatic:

Preoperative.

Rate on impairment of vision.

Postoperative.

Rate on impairment of vision and aphakia.

6028 Cataract, senile, and others:

Preoperative.

Rate on impairment of vision.

Postoperative.

Rate on impairment of vision and aphakia.

6029 Aphakia:

Bilateral or unilateral 30

Note: The 30 percent rating prescribed for aphakia is a minimum rating to be applied to the unilateral or bilateral condition and is not to be combined with any other rating for impaired vision. When only one eye is aphakic, the eye having poorer corrected visual acuity will be rated on the basis of its acuity without correction. When both eyes are aphakic, both will be rated on corrected vision. The corrected vision of one or both aphakic eyes will be taken one step worse than the ascertained value, however, not better than 20/70 (6/21). Combined ratings for disabilities of the same eye should not exceed the amount for total loss of vision of that eye unless there is an enucleation or a serious cosmetic defect added to the total loss of vision.

6030 Accommodation, paralysis of 20

6031 Dacryocystitis.

Rate as epiphora.

6032 Eyelids, loss of portion of:

Rate as disfigurement. (See diseases of the skin.)

6033 Lens, crystalline, dislocation of:

Rate as aphakia.

6034 Pterygium:

Rate for loss of vision, if any.

6035 Keratoconus: To be evaluated on impairment of corrected visual acuity using

contact lenses.

Note: When contact lenses are medically required for keratoconus, either unilateral or bilateral, the minimum rating will be 30 percent.

IMPAIRMENT OF CENTRAL VISUAL ACUITY

Rating

6061 Anatomical loss both eyes 1005

6062 Blindness in both eyes having only light perception 1005

Anatomical loss of 1 eye:

6063 In the other eye 5/200 (1.5/60) 1005

6064 In the other eye 10/200 (3/60) 906

6064 In the other eye 15/200 (4.5/60) 806

6064 In the other eye 20/200 (6/60) 706

6065 In the other eye 20/100 (6/30) 606

6065 In the other eye 20/70 (6/21) 606

6065 In the other eye 20/50 (6/15) 506

6066 In the other eye 20/40 (6/12) 406

Blindness in 1 eye, having only light perception:

6067 In the other eye 5/200 (1.5/60) 1005

6068 In the other eye 10/200 (3/60) 905

6068 In the other eye 15/200 (4.5/60) 805

6068 In the other eye 20/200 (6/60) 705

6069 In the other eye 20/100 (6/30) 605

6069 In the other eye 20/70 (6/21) 505

6069 In the other eye 20/50 (6/15) 405

6070 In the other eye 20/40 (6/12) 305

Vision in 1 eye 5/200 (1.5/60):

6071 In the other eye 5/200 (1.5/60) 1005

6072 In the other eye 10/200 (3/60) 90

6072 In the other eye 15/200 (4.5/60) 80

6072 In the other eye 20/200 (6/60) 70

6073 In the other eye 20/100 (6/30) 60

6073 In the other eye 20/70 (6/21) 50

6073 In the other eye 20/50 (6/15) 40

6074 In the other eye 20/40 (6/12) 30

Vision in 1 eye 10/200 (3/60):

6075 In the other eye 10/200 (3/60) 90

6075 In the other eye 15/200 (4.5/60) 80

6075 In the other eye 20/200 (6/60) 70

6076 In the other eye 20/100 (6/30) 60

6076 In the other eye 20/70 (6/21) 50

6076 In the other eye 20/50 (6/15) 40

6077 In the other eye 20/40 (6/12) 30

Vision in 1 eye 15/200 (4.5/60):

6075 In the other eye 15/200 (4.5/60) 80

6075 In the other eye 20/200 (6/60) 70

6076 In the other eye 20/100 (6/30) 60

6076 In the other eye 20/70 (6/21) 40

6076 In the other eye 20/50 (6/15) 30

6077 In the other eye 20/40 (6/12) 20

Vision in 1 eye 20/200 (6/60):

6075 In the other eye 20/200 (6/60) 70

6076 In the other eye 20/100 (6/30) 60

6076 In the other eye 20/70 (6/21) 40

6076 In the other eye 20/50 (6/15) 30

6077 In the other eye 20/40 (6/12) 20

Vision in 1 eye 20/100 (6/30):

6078 In the other eye 20/100 (6/30) 50

6078 In the other eye 20/70 (6/21) 30

6078 In the other eye 20/50 (6/15) 20

6079 In the other eye 20/40 (6/12) 10

Vision in 1 eye 20/70 (6/21):

6078 In the other eye 20/70 (6/21) 30

6078 In the other eye 20/50 (6/15) 20

6079 In the other eye 20/40 (6/12) 10

Vision in 1 eye 20/50 (6/15):

6078 In the other eye 20/50 (6/15) 10

6079 In the other eye 20/40 (6/12) 10

Vision in 1 eye 20/40 (6/12):

In the other eye 20/40 (6/12) 0

5Also entitled to special monthly compensation.

6Add 10% if artificial eye cannot be worn; also entitled to special monthly compensation.

RATINGS FOR IMPAIRMENT OF FIELD OF VISION

Rating

6080 Field vision, impairment of:

Homonymous hemianopsia 30

Field, visual, loss of temporal half:

Bilateral 30

Unilateral 10

Or rate as 20/70 (6/21).

Field, visual, loss of nasal half:

Bilateral 20

Unilateral 10

Or rate as 20/50 (6/15).

Field, visual, concentric contraction of:

To 5º:

Bilateral 100

Unilateral 30

Or rate as 5/200 (1.5/60).

To 15º but not to 5°:

Bilateral 70

Unilateral 20

Or rate as 20/200 (6/60).

To 30º but not to 15º:

Bilateral 50

Unilateral 10

Or rate as 20/100 (6/30).

To 45º but not to 30º:

Bilateral 30

Unilateral 10

Or rate as 20/70 (6/21):

To 60º but not to 45º:

Bilateral 20

Unilateral 10

Or rate as 20/50 (6/15).

Note (1): Correct diagnosis reflecting disease or injury should be cited.

Note (2): Demonstrable pathology commensurate with the functional loss will be required. The concentric contraction ratings require contraction within the stated degrees, temporally; the nasal contraction may be less. The alternative ratings are to be employed when there is ratable defect of visual acuity, or a different impairment of the visual field in the other eye. Concentric contraction resulting from demonstrable pathology to 5 degrees or less will be considered on a parity with reduction of central visual acuity to 5/200 (1.5/60) or less for all purposes including entitlement under §3.350(:)(2) of this chapter; not however, for the purpose of §3.350(a) of this chapter. Entitlement on account of blindness requiring regular aid and attendance, §3.350© of this chapter, will continue to be determined on the facts in the individual case.

6081 Scotoma, pathological, unilateral:

Large or centrally located, minimum 10

Note: Rate on loss of central visual acuity or impairment of field vision. Do not combine with any other rating for visual impairment.

RATINGS FOR IMPAIRMENT OF MUSCLE FUNCTION

Equivalent

Degree of Diplopia visual acuity

6090 Diplopia (double vision).

(a) Central 20º 5/200

(:lol: 21º to 30º:

(1) Down 15/200

(2) Lateral 20/100

(3) Up 20/70

© 31º to 40º :

(1) Down 20/200

(2) Lateral 20/70

(3) Up 20/40

Notes: (1) Correct diagnosis reflecting disease or injury should be cited.

(2) The above ratings will be applied to only one eye. Ratings will not be applied for both diplopia and decreased visual acuity or field of vision in the same eye. When diplopia is present and there is also ratable impairment of visual acuity or field of vision of both eyes the above diplopia ratings will be applied to the poorer eye while the better eye is rated according to the best corrected visual acuity or visual field.

(3) When the diplopia field extends beyond more than one quadrant or more than one range of degrees, the evaluation for diplopia will be based on the quadrant and degree range that provide the highest evaluation.

(4) When diplopia exists in two individual and separate areas of the same eye, the equivalent visual acuity will be taken one step worse, but no worse than 5/200.

6091 Symblepharon.

Rate as limited muscle function, diagnostic code 6090.

6092 Diplopia, due to limited muscle function.

Rate as diagnostic code 6090.

[29 FR 6718, May 22,1964, as amended at 34 FR 5062, Mar. 11, 1969; 40 FR 42537, Sept. 15, 1975; 41 FR 11297, Mar. 18, 1976; 43 FR 45354, Oct. 2, 1978; 51 FR 6411, Feb. 24, 1986; 53 FR 30264, Aug. 11, 1988; 53 FR 50955, Dec. 19, 1988; 57 FR 24364, June 9, 1992; 60 FR 7124, Feb. 7, 1995]

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My husband has been taking steroid medication for 13 years, he is 56 years old. He developed cataracts a couple of years ago, and had one removed last year. We've filed a claim but expect a fight. I wonder what age the VA considers "old enough" to develop age-related cataracts.

This is a perfect example of the importance of knowing the side effects of medication. For instance, long-term steroid use can also lead to carpal tunnel. Medical use of testosterone can lead to the development of gallbladder disease.

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Thanks Berta. The VA described my husband's cataracts as nuclear sclerosis cataracts. The decision you referenced discussed posterior subcapular cataracts. I understand that some cataracts are readily identifiable as not being related to steroid use, but I don't know if nuclear sclerosis cataracts fall under that category. Is 54 considered relatively young for this condition for it to be age-related?

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Greetings

I don't know the type of cataracts that are growing in my eyes...I was just semi-shocked that they were growing at a rapid rate. I have listed some of the medications that I have taken over the past 5 to 10 years. Wow! Could some of these drugs help to cause my cataracts.

Lisinopril (Prinivil)

Metoprolol (Lopressor)

Felodipine

Flovent (Fluticasone)

Albuterol

Cromolyn

Naproxen

Hydrocortisone

Bacitracin

Tacrolimus (Protopic EQ)

Allegra

Flonase

Peginterferon alfa-2b

Ribavirin

Steroid shots for my back pain

Best Regards

Chiefhouse

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I did a little online research regarding cataracts. Without looking up each of your meds, the steroid shots for your back, as well as your use of hydrocortisone, could be credible evidence of the cause of your cataracts provided they are the kind called "posterior subcapsular" cataracts. This particular type is known to develop much more rapidly than the other kinds, and steroid use is a recognized cause. Your doctor should be able to tell you what kind of cataracts he found. If they are, indeed, posterior subcapsular cataracts, you may want to go ahead a file a claim for bilateral cataracts based on your steroid meds.

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Greetings Vicki

I reviewed my medical records and found three important set of documents relating to my eye problems: my retirement medical assessment which stated that I had poor eye vision; medical records (poor vision, floaters, etc.,) from 1970 thru 2005; and first VA decision on my eye claim in 2000. The VA confirmed a history of blepharitis, trauma, and trace of nuclear sclerotic cataracts in both eyes but denied the claim because "cataracts" wasn't noted in my medical records. I was recently diagnosed with PSC Cataracts by the Opthalmogist at Dewitt Medical Center. Should I process a reopen claim for cataracts since my first claim was denied in 2000?

List of Medications:

Lisinopril (Prinivil)

Metoprolol (Lopressor)

Felodipine

Atenolol-PO

Rabeprazole-PO

Olopatadine-OPT 0.1%

Carboxymethycellulose Sodium 0.5%

Meloxicam-PO

Diazepam-PO

Fluticasone-NAS INHA

Flovent (Fluticasone)

Albuterol

Cromolyn-PO

Naproxen

Hydrocortisone Valerate-TOP 0.2%

Bacitracin-TOP

Tacrolimus (Protopic EQ)

Allegra

Flonase

Peginterferon alfa-2b

Ribavirin

Epidural Steroid Injections

Best Regards

Chiefhouse

B)

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chiefhouse00:

You would have to get an IMO with supporting evidence that shows that your poor eye sight and other problems with your eyesight were early signs of the cataract condition while in service or during the presumptive period after service,

Good Luck,

Jim S. B)

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Absolutely Refile, Always Refile!!!

I'm not the most able person on this board to guide you, but after 13 years of arguing rates and dates with the VA, I can tell you what I would do. Apparently, you've got three issues regarding your eyes: 1) PSC (Posterior Subcapsular Cataracts), 2) A "trace" of nuclear sclerotic cataracts, and 3) Eye trauma

PSC (Bilateral)

1) These are reportedly most often steroid-induced and fairly fast-growing. They also occur as an outcome of diabetes.

2) If your opthamologist could be candid enough with you to render an opinion (preferably written) on how long these typically take to develop, that would give you information on the time frame between when you started taking steroids and when you started noticing problems severe enough that you made an appt. to have your eyes checked. Or you can read about them online, but I'd prefer a Dr.'s letter if I were you.

3) If you started taking steroids before you retired, I would ask for an effective date the first time I mentioned vision problems, either verbally or in writing, to the VA after retirement. If you started taking steroids for a service-connected condition after you retired, I would file a claim for PSC bilateral secondary to meds taken for a service-connected disability, effective the date you started taking any of your steroids. You may also want to file an 1151 claim.

Nuclear Sclerotic Cataracts

1) These are age related and take a long time to grow.

2) I'm not clear on how the VA can "confirm a history" of nuclear sclerotic cataracts but deny a claim due to no evidence of them in your medical files. Where did the history come from?

3) It appears you have what is called "mixed" cataracts - - more than one kind.

4) Get your opthamologist to examine you for sclerotic cataracts, and if they are there (or larger now), you've got new evidence to re-file the claim. I would seek an effective date to when they were first acknowledged by the VA. Just because the word "cataracts" isn't in your file, but a description of them is, that doesn't mean they don't exist. That's like saying a person's blood pressure is 180/104, but the word "hypertension" isn't in the record, therefore, that person doesn't suffer from hypertension. The history you mention must have come from somewhere! You need the initial date of when that history began.

5) Re-file a claim with your opthamologist's findings, add the earliest date in the "history" that the VA confirmed regarding these particular type of cataracts and use it as an effective date of claim. Being age-related, this type of cataract would probably not be considered "service-connected." That having been said, file for it anyway.

TRAUMA

1) What kind of trauma?

2) Did it occur before your retirement?

3) Was it treated at a military medical facility and in your military medical records?

4) Is there any mention of it in your VA records?

5) Was your vision impaired before the trauma? Worse after the trauma, and if so, how soon after?

6) PSC's can also be caused by trauma.

7) I would claim the date you first mentioned vision problems to the VA after your retirement.

Have you undergone an examination from a civilian opthamologist for a second opinion?

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Vicki,

Wonderful post! :D

Probably the best ordered and most useful I have seen in two years.

Very useful.

Keep up the outstanding work.

B) :blink::huh:

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Absolutely Refile, Always Refile!!!

I'm not the most able person on this board to guide you, but after 13 years of arguing rates and dates with the VA, I can tell you what I would do. Apparently, you've got three issues regarding your eyes: 1) PSC (Posterior Subcapsular Cataracts), 2) A "trace" of nuclear sclerotic cataracts, and 3) Eye trauma

PSC (Bilateral)

1) These are reportedly most often steroid-induced and fairly fast-growing. They also occur as an outcome of diabetes.

2) If your opthamologist could be candid enough with you to render an opinion (preferably written) on how long these typically take to develop, that would give you information on the time frame between when you started taking steroids and when you started noticing problems severe enough that you made an appt. to have your eyes checked. Or you can read about them online, but I'd prefer a Dr.'s letter if I were you.

3) If you started taking steroids before you retired, I would ask for an effective date the first time I mentioned vision problems, either verbally or in writing, to the VA after retirement. If you started taking steroids for a service-connected condition after you retired, I would file a claim for PSC bilateral secondary to meds taken for a service-connected disability, effective the date you started taking any of your steroids. You may also want to file an 1151 claim.

Nuclear Sclerotic Cataracts

1) These are age related and take a long time to grow.

2) I'm not clear on how the VA can "confirm a history" of nuclear sclerotic cataracts but deny a claim due to no evidence of them in your medical files. Where did the history come from?

3) It appears you have what is called "mixed" cataracts - - more than one kind.

4) Get your opthamologist to examine you for sclerotic cataracts, and if they are there (or larger now), you've got new evidence to re-file the claim. I would seek an effective date to when they were first acknowledged by the VA. Just because the word "cataracts" isn't in your file, but a description of them is, that doesn't mean they don't exist. That's like saying a person's blood pressure is 180/104, but the word "hypertension" isn't in the record, therefore, that person doesn't suffer from hypertension. The history you mention must have come from somewhere! You need the initial date of when that history began.

5) Re-file a claim with your opthamologist's findings, add the earliest date in the "history" that the VA confirmed regarding these particular type of cataracts and use it as an effective date of claim. Being age-related, this type of cataract would probably not be considered "service-connected." That having been said, file for it anyway.

TRAUMA

1) What kind of trauma?

2) Did it occur before your retirement?

3) Was it treated at a military medical facility and in your military medical records?

4) Is there any mention of it in your VA records?

5) Was your vision impaired before the trauma? Worse after the trauma, and if so, how soon after?

6) PSC's can also be caused by trauma.

7) I would claim the date you first mentioned vision problems to the VA after your retirement.

Have you undergone an examination from a civilian opthamologist for a second opinion?

Greetings

In 2000, I was completely new to the VA process and didn't ask many questions about my ratings. Yes, I had and still have eye problems. Thanks to dedicated people like you, I've learn much more about what to do if you believe something needs attention. So, here I am ready to take care of business.

1) Trauma- finger poked in right eye twice, paint thinner and jet fuel spilled in both eyes, corneal abrasion, blurred vision dating back to 1970.

2) All occurred and documented before retirement in 1999.

3) Military medical facilities treated my eye problems before and after retirement.

4) The VA has copies of my military records from 1970 to 1999 which was used for my first claim that was denied in 2000.

5) My vision was 20/20 when I entered the military in 1969. I started having problems in 1970 and before my first trauma event in 1974.

6) My eye problems got much worst after the 1974 eye poking and spilling fuel in my eyes in 1975.

7) This would be my first claim to the VA after my retirement.

This last military ophthalmologist was straight to the point by saying that the type of cataracts I have is growing at a rapid pace and to follow-up in six months or sooner if needed.

Best Regards

Chiefhouse

B)

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Everyone here is glad to help. Since this is your first claim, be patient and pace yourself.

You're probably in for a less than pleasant journey through the muck that's called the VA disability rating system. Don't let it get you down. You earned your benefits. Come to this board whenever you feel lost, need information or just need a boost.

The perseverance that got you to the point where you lived to see the day you retired needs to be re-directed into this effort to be your own best advocate post-retirement.

OK, here we go:

1) Get copies of your VA medical records if you don't already have them. Use this link:

http://www.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf

I understand that the VA also has active duty outpatient medical records. Request all of those, too.

Have the copies sent to yourself. Reason would be "VA Claims" Remember to also request any films like CT scans, etc. (they're put on CD). Say you want all records regarding all visits, not just for your eyes.

2) If you were ever hospitalized while active duty, you can obtain records by requesting them through this link:

http://www.archives.gov/st-louis/military-...al-records.html.

You would want all records for any and all hospitalizations, along with any film that was taken. Again, the reason would be "VA Claims." The less said, the better.

3) Since your cataracts are bilateral, I would base a claim to initial entitlement for cataracts that developed as result of injury from jet fuel spilled in both eyes, then add the poke to your right eye and the corneal abrasion incidents to the mix. Include copies from your medical records referring to your visits to the doctor for these incidents. The effective date would be the day after you retired, since the military treated you for them while you were active duty. Get a letter from your opthamologist that discusses his diagnosis of PSC. If he won't give you one, entries from your medical records will do.

4) As a back-up, I would also claim entitlement for cataracts effective the date you were first prescribed steroids for a service-connected condition. If that was while you were active duty, the effective date would be your first day of retirement. If you were prescribed steroids after your retirement, you still had injuries to your eyes while active duty, and because PSC can occur either from injury or steroid use, it would be very difficult for the VA to definitively determine the exact cause. They're suppose to resolve the benefit of the doubt in your favor, and go with the earlier effective date of the two. That doesn't always happen, but you need to know that's the way it's suppose to happen.

5) Nail down what's going on with your bilateral nuclear sclerosis cataracts. If there was no discussion of them during your visits to the opthamologist about your PSC's, then make another appointment to determine their status. If you had them some years ago, you still do and they've probably grown. Review your records and include any documentation you can find about them. Ask your opthamologist to give you something in writing about them. Again, if he won't, you'll need an office visit for the record, and get a copy of the notes. As I stated previously, file a claim for them with the effective date that coincides with the beginning of the "history" you said the VA confirmed regarding this condition.

6) If you can swing a visit to a civilian opthamologist for an examination and a second opinion, that wouldn't be a bad idea.

7) How's your hearing, did you have an exit hearing test? Do you know your scores? I've yet to meet a 20+ year vet without tinnitus, and I'm in a place where there's an Air Force Base and lots of retirees.

8) In the "firm grasp of the obvious" department:

1) Mail anything you send certified, so you get a confirmation of delivery and a signature.

2) Don't be tempted to mail anything by normal means, they'll deny they received it. I've had them deny receipt of mail when I was holding the certified receipt in my hand while talking to them over the phone!

3) Get a receipt if you hand deliver anything, even if you have to make one up yourself before you leave the house, and just get their signature on it.

4) Don't take no for an answer. Press it as far and as long as you can.

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Also, don't forget the possibility of filing an 1151 claim...

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Everyone here is glad to help. Since this is your first claim, be patient and pace yourself.

You're probably in for a less than pleasant journey through the muck that's called the VA disability rating system. Don't let it get you down. You earned your benefits. Come to this board whenever you feel lost, need information or just need a boost.

The perseverance that got you to the point where you lived to see the day you retired needs to be re-directed into this effort to be your own best advocate post-retirement.

OK, here we go:

1) Get copies of your VA medical records if you don't already have them. Use this link:

http://www.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf

I understand that the VA also has active duty outpatient medical records. Request all of those, too.

Have the copies sent to yourself. Reason would be "VA Claims" Remember to also request any films like CT scans, etc. (they're put on CD). Say you want all records regarding all visits, not just for your eyes.

2) If you were ever hospitalized while active duty, you can obtain records by requesting them through this link:

http://www.archives.gov/st-louis/military-...al-records.html.

You would want all records for any and all hospitalizations, along with any film that was taken. Again, the reason would be "VA Claims." The less said, the better.

3) Since your cataracts are bilateral, I would base a claim to initial entitlement for cataracts that developed as result of injury from jet fuel spilled in both eyes, then add the poke to your right eye and the corneal abrasion incidents to the mix. Include copies from your medical records referring to your visits to the doctor for these incidents. The effective date would be the day after you retired, since the military treated you for them while you were active duty. Get a letter from your opthamologist that discusses his diagnosis of PSC. If he won't give you one, entries from your medical records will do.

4) As a back-up, I would also claim entitlement for cataracts effective the date you were first prescribed steroids for a service-connected condition. If that was while you were active duty, the effective date would be your first day of retirement. If you were prescribed steroids after your retirement, you still had injuries to your eyes while active duty, and because PSC can occur either from injury or steroid use, it would be very difficult for the VA to definitively determine the exact cause. They're suppose to resolve the benefit of the doubt in your favor, and go with the earlier effective date of the two. That doesn't always happen, but you need to know that's the way it's suppose to happen.

5) Nail down what's going on with your bilateral nuclear sclerosis cataracts. If there was no discussion of them during your visits to the opthamologist about your PSC's, then make another appointment to determine their status. If you had them some years ago, you still do and they've probably grown. Review your records and include any documentation you can find about them. Ask your opthamologist to give you something in writing about them. Again, if he won't, you'll need an office visit for the record, and get a copy of the notes. As I stated previously, file a claim for them with the effective date that coincides with the beginning of the "history" you said the VA confirmed regarding this condition.

6) If you can swing a visit to a civilian opthamologist for an examination and a second opinion, that wouldn't be a bad idea.

7) How's your hearing, did you have an exit hearing test? Do you know your scores? I've yet to meet a 20+ year vet without tinnitus, and I'm in a place where there's an Air Force Base and lots of retirees.

8) In the "firm grasp of the obvious" department:

1) Mail anything you send certified, so you get a confirmation of delivery and a signature.

2) Don't be tempted to mail anything by normal means, they'll deny they received it. I've had them deny receipt of mail when I was holding the certified receipt in my hand while talking to them over the phone!

3) Get a receipt if you hand deliver anything, even if you have to make one up yourself before you leave the house, and just get their signature on it.

4) Don't take no for an answer. Press it as far and as long as you can.

Greetings

This will be my first claim for this aliment but I've submitted claims for other problems (HCV, Sleep Apnea, Asthma, Skin Rash, sinus problem, severe lower back pain) and received three increases and a few pending VA decision. I'm currently rated at 70%. As you can see I have my share of medical problems but I'm very proud to have served our country for 30 years. I have all of my medical records and pushing ahead with a reopen claim for Bilateral Eye Problem. I don't know what my hearing score was but the C&P doc said I passed the test. I need to get the ears recheck to be on the safe side...what is a passing score? Also, I'm not familar with the 1151 form process...I need to get smart on it. Thanks for your patience and help. "Keep Pumping the Knowledge"

Best Regards

Chiefhouse

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There's a lot of information available regarding tinnitus and hearing loss. What I pasted below is from:

http://www.bchealthguide.org/kbase/topic/m...815/results.htm

Just a note about doctors saying you passed a test. My husband filed for bilateral tinnitus and was initially turned down because he "passed his test." He was an air traffic controller and had radios plugged in his ears for years, plus runway and engine noise, etc. I went through his active duty medical records and bar charted his hearing scores for each ear for every hearing test he was ever given. Numbers don't lie, they steadily increased, which indicated a clear hearing loss when compared to what is considered normal hearing scores. We resubmitted with the bar chart scores, some information about tinnitus from the American Tinnitus Association, and received 10% (we're appealing for 20% per the Court of Veterans Appeals recent decision regarding Smith vs. Nicholson).

The following table relates hearing thresholds (how loud a sound of certain frequency must be for a person to hear it) to the degree of hearing loss for adults:

Hearing threshold (in decibels, dB)

Degree of hearing loss

Ability to hear speech

0–25 dB

none

no significant difficulty

26–40 dB

mild

difficulty with faint or distant speech

41–55 dB

moderate

difficulty with conversational speech

56–70 dB

moderate to severe

speech must be loud; difficulty with group conversation

71–90 dB

severe

difficulty with loud speech; understands only shouted or amplified speech

91+ dB

profound

may not understand amplified speech

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§3.361 Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital

care, medical or surgical treatment, examination, training and rehabilitation services, or compensated work therapy program.

Here's the link:

http://www.warms.vba.va.gov/regs/38CFR/BOO...ART3/S3_361.DOC

I'm not checked out on 1151, so if you have questions, I'm sure other members better versed on that subject will be glad to help you.

But definitely get in gear about your eyes.

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