Correcting Vso Error And Vcaa Errors

[ruby]

I would send in a notice to cancel and then start over. Then you type and send in the new claim yourself. You want to word it like this:

I wish to change the diagnostic code for my sc cyst from DX CODE XXXX TO DX CODE XXXX. This more closely approximates the true disability that I have always suffered from. Medical opinion supports this claim. This is in accordance with the provisions listed in 38 CFR 4.13. This IS NOT a request for an increased evaluation for my sc cyst. This is an effort to change an erroneously listed condition from which I suffer.

The part that I have in caps, you need to put in caps and then highlight it.

Fill out a 21-4138 explaining what your doctor has told you regarding the HD and the cyst, but nothing else. Then send it all in with your medical evidence,

The reason I say this is because they are going to pull the old update the c&p for the cyst, find nothing additionally wrong, therefore we can't increase your rating routine. Then they will find a reason not to rate the hd because you are sc with the cyst, which will lead them to say they can't grant sc for the reA as secondary to hd because the hd isn't sc'd. They pulled that crap on me...in a somewhat similiar case.

Rental, I need to do several things now, I had to rescind my POA and correct this VCAA notice -- you said "Fill out a 21-4138 explaining what your doctor has told you regarding the HD and the cyst, but nothing else." I am taking this literally. i want to try and keep my original date.

I want them to rate my ReA as secondary to the HD.

I would write a letter like this:

In response to VCAA notice etc. I am writing this letter to correct the misconception in this notice. I AM NOT REQUESTING SC FOR HD, REA OR INCREASED SERVICE CONNECTED COMP FOR CYST R THIGH as indicated in the VCAA notice.

To make my claim clear on what I am asking the following is submitted for clarification.

I wish to change the diagnostic code for my sc cyst from DX CODE XXXX TO DX CODE XXXX. This more closely approximates the true disability that I have always suffered from. Medical opinion supports this claim. This is in accordance with the provisions listed in 38 CFR 4.13. This IS NOT a request for an increased evaluation for my sc cyst. This is an effort to change an erroneously listed condition from which I suffer.

I am also requesting that my Reactive arthritis be rated as secondary to my sc cyst that I am requesting a change in the diagnostic code from XXXXX to XXXX which more closely approximates my true disability.

Previous evidence to support this claim was filed with my claim which you have in your possession as indicated in this VCAA notice.

Any Opinions

[luvHIM]

Ruby, I have one question: Have you already filed a claim for the HD? Has that already been service connected? The four docs in agreement about your HD are willing to connect the dots for the ReA to be considered secondary, is that what you are saying?

I respect rentalguy1's opinion. But I just don't agree that everything he advised is the best approach for what you are trying to accomplish, which is (if I still understand it) ultimately being service connected for the ReA, whether directly or on a secondary basis, right?

See, here's the deal. If you do what is advised and you are denied, then what? So, you file an appeal. Now you're waiting years for them to decide on changing the diagnostic code for a condition you are not officially service connected for. I think you need to get that out the way first. In fact, if you were legitimately service connected for the cyst, why tamper with that one at all? You can have more than one DC. I say leave it as is. Just get the condition (HD) diagnosed by VA physicians (today) service connected.

But if all your ducks are on the table and you haven't been service connected for what the docs say is the problem, which is now the HD diagnosis; and you are denied on all issues...what will be your "new and material" evidence?

The HD should be your primary goal right now, IMHO, because it has not been service connected, yet. You have the four docs in agreement in your favor. It should be a win win. Get that service connected and then file a claim seeking ReA as secondary (which would actually look more like filing for an increase).

I'm not trying to confuse you and think you should do what "feels" right for you. I'm not going to get into a battle of who is right and who is not. I would do it differently and that is all I am willing to say about it anymore. Whatever you decided...best regards.

[rentalguy1]

What's actually going on here is the effective mis-diagnosis of the cyst for many years. It has only recently come to light that the cyst is actually a symptom of another disease; HD, which is causing the ReA, also. The VA (et.al.) do this all the time. The most important thing, medically speaking, is to have a accurate diagnosis of any illness. The VA has made provisions for circumstances such as these:

§ 4.13 Effect of change of diagnosis.

The repercussion upon a current rating of service connection when change is made of a previously assigned diagnosis or etiology must be kept in mind. The aim should be the reconciliation and continuance of the diagnosis or etiology upon which service connection for the disability had been granted. The relevant principle enunciated in §4.125, entitled “Diagnosis of mental disorders,” should have careful attention in this connection. When any change in evaluation is to be made, the rating agency should assure itself that there has been an actual change in the conditions, for better or worse, and not merely a difference in thoroughness of the examination or in use of descriptive terms. This will not, of course, preclude the correction of erroneous ratings, nor will it preclude assignment of a rating in conformity with §4.7.

In other words, the cyst can remain SC, but the VA also needs to recognize and SC the parent illness, which would effectively cause the cyst to become a secondary condition. This would also allow for the ReA to be a SC'd on a secondary basis. This will be tough to get the VA to admit, surely, but it can be done with the proper medical documentation. This claim will also have to be worded very well, and it will have to be very "to the point."

[ruby]

I understand where both of you are coming from. There are different ways to approach this issue and I am going to have to decide which is best----

I am sc for cyst rated as a scar for 0%---The cyst was infected with staph which is a normal bacteria for HD. Basically that infection alone could have been the nexus (even if it wasn't HD). I have had cyst throughout the years and there is documented bridging(indicates chronic, long term)

4 doctors have seen these cyst and all agree its HD. Only one is willing to state the original cyst is the begininning of the HD.

The derma doc, stated he was never ask to do this before --to connect the first cyst to the HD and he said they have comp docs that do that.

I told him I wanted a medical opinion, he would have agreed to sign the paper and started too, then decided he needed to ask the clinic director. I am sure he won't do it now.

I will probably have to get a IMO other then my rhem doc who made the connection.

But it was the derma doc that said why does it matter you have a documented staph infection and that alone could have caused the ReA.

I have 2 other infections during service that can cause ReA. While I think its a no brainer to connect I can see how it will take IMO's to connect the other 2 infection.

My best chance is the infected cyst (HD).

I filed a new claim for--I am currently sc for cyst that my doctor states is HD I am reqesting SC for HD and REA secondary to the HD.

The VCAA notice came back with we are working on your application for service connected compensation for HD, ReA and increased service connected for cyst r thigh.

I need the HD as I am only SC for cyst r thigh, the HD is is bilateral groins and axilla.

I understand if denied its years of fighting, luvHIM is right I want the ReA the sooner the better.

I need to think about this.