Chronic Condition- When To File

[ruby]

I have a question regarding filing for a chronic condition perhaps someone can help me understand what I need to do so I don't screw this one up

Wings posted this in another thread:

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 by merely isolated findings or a diagnosis including the word "chronic." When the disease identity is established, there is no requirement of evidentiary showing of continuity.

Continuity of symptomatology is required only for the condition noted during service 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. 38 C.F.R. § 3.303(.

The chronicity provision of § 3.303(B) is applicable where evidence, regardless of its date, shows that a veteran had a chronic condition in service or during an applicable presumption period and still has such condition. Such evidence must be medical unless it relates to a condition as to which, under the Court's case law, lay observation is competent. If the chronicity provision is not applicable, a claim may still be.... reopened on the basis of § 3.303(B) if the condition is observed during service or any applicable presumption period, continuity of symptomatology is demonstrated thereafter, and competent evidence relates the present condition to that symptomatology.

In 1975, I had ie a cyst that was documented in my SMR I also recieve a 0% for scar.

This cyst reoccurred and I took care of it while in the service, this was located in a area that would be embrassing to most. When I got out of the service within the first year it appeared again really bad and I had to get medical treatment from the VA. Antibiotics and pain meds. Over the past 30 years I have taken care of this problem by lancing them when need be.

Now 30 years later I am told this is a disease process, I have the scars to show that this condition has occurred many times. It can cause tunnelling from one cyst to another and you can have more than one. I can show that I have tunnelling which is bad.

I only have one doc that mentioned this cyst was a disease that probably caused my reactive arthritis. This is too complicated to file for at this time, I just want to file for the new dx of hidradenitis--

So do I file for an increase for the scarring or a new dx.

I know I need to get more docs to agree with this but whats the best way to get a higher rating for now--money is more important at this time. I can't fight for anything for a long period of time at this point.

[Wings]

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Hope this helps! ~Wings

1) Cite 38 C.F.R. § 3.303

See

BVA9421929

DOCKET NO. 93-03 255

http://www.va.gov/vetapp/files3/9421929.txt

Hidradenitis was incurred in service. 38 U.S.C.A. §§ 1110,

5107 (West 1991); 38 C.F.R. § 3.303(b) (1993).

-snip-

With chronic disease shown as such in service or within the

presumptive period 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. 38 C.F.R.

§ 3.303(b) (1993). For the showing of a 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." Id. When the disease entity is established, there is

no requirement of evidentiary showing of continuity, rather

continuity of symptomatology is required only where the condition

noted during service is not chronic or the diagnosis of

chronicity may be legitimately questioned. Id.

In light of the evidence of record that the veteran

currently has hidradenitis, the Board concludes that

the evidence concerning the veteran's claim for

hidradenitis is in relative equipoise, and as such,

the benefit of the doubt principle is applicable.

2) Cite 38 C.F.R. § 4.118

Research diagnostic criteria in the 'Schedule for

Rating Disabilities' with Diagnostic

Codes under 38 C.F.R. § 4.118 !!

See attached PDFE7_4914_1_.pdf

DEPARTMENT OF VETERANS

AFFAIRS

38 CFR Part 4

RIN 2900–AM60

Schedule for Rating Disabilities;

Appendices A, B, and C

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

SUMMARY: The Department of Veterans

Affairs (VA) is revising its Schedule for

Rating Disabilities, Appendices A, B,

and C to include all current diagnostic

codes. Appendix A is also amended to

include all the diagnostic code

historical information since the last

review.

DATES: Effective Date: This amendment

is effective April 19, 2007.

SUPPLEMENTARY INFORMATION: The

Schedule for Rating Disabilities, 38 CFR

Part 4, Appendices A, B, and C have not

been updated since July 1, 1988. These

Appendices are tools for users of the

Schedule for Rating Disabilities. The

Appendices reflect changes to the

diagnostic criteria in the Schedule for

Rating Disabilities.

Edited January 4, 2008 by Wings

[ruby]

Thanks Wings it helps.

[carlie]

Ruby,

You might want to study 38 CFR - Part 4 - Schedule for rating disabilities, prior to

filing a claim for increase on Scars, it will be good research.

jmho,

carlie

[ruby]

Thanks Carlie I will look at it.

I am confused as I am not sure if I should ask for an increase or go for a new SC based on the fact that this cyst now has a name(DX) as hidradenitis.

Since I am already rated at for the scar I am thinking that would be easier and faster.

[Rockhound]

Scars are not usually life threatening, but a cyst can be, I would go for the chronic condition of the cysts. The longer you wait to get the cyst service connected the harder it is going to be. get your condtion service connect now, not down the road when you feel like it or it becomes a certifiable necessity. A couple of scars won't bring you much if any more compensation, where as if you get your chronic condition approved, you probably will. If it gets worse, it will be easier to get an increase, because you will have addition documentation from the VA for its treatment.

Just my thoughts, from a hard nose procrastinater.

Rockhound

[sixthscents]

I owuld file for a new injury - chronic - the hidradenitis. I would demonstrate its existance as evidenced by the repeated pilonodial cysts (which is what I assume they have been mistakenly calling them). Show the new diagnosis, and request compensation for it.

Personally I had a pilonidal cyst that was surgically removed and then reoccured... I recently undewent yet another surgery to remove it - 6 months ago. The VA did a better job than the civilian surgeon I had the first time... they didn't leave a huge gaping hole at the top of my tailbone.... and so far so good - no reoccurence. However I dont think what you are referring to is you simple pilonodial cyst. I just had a relative get SSD for a cyst which tunneled into a total of 5 others... and its to big to operate on since it wraps around his whole leg.

Dont play the stubborn vet with this medically though, mine got inflamed and caused a systemic infection. I was in the hospital for a couple of days, and at the emergency room a couple more time till it got under control. The thing can kill you simply by infection you lymph nodes - which is what happened to me. So if it gets bad, go to a Doc immediatly. I would make certain of the diagnosis - get a cut and dried one and then file for an increase and just see what they do...

Sorry but thats my best advise. Sorry you got it, and where but its a LOT more common than you might think.