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Stroke Rating


Ricky

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My claim for 100 percent for six months for my Feb 05 Stroke was denied. During a May 05 CP they service connected the stroke because of my SCed hypertension and rated it for residuals at 10 percent. The rating letter stated" a rating of 100 percent is not warranted because of no indications of a current or recently active disease is present". 38 CFR states that for a stroke "rate at 100 percent for six months, the rate residuals no less that 10 percent. If my stroke was in Feb o5, my daughter filed the claim in Mar 05 with hospital records, MRI and IMO from 38 year board certified neurologist stating that the stroke happened in Feb 05, how can they say there was no active disease? According to my neurologist the residuals, all centeral nervous system, have cause complete loss of use of both my left hand and arm and left leg and foot plus incomplete parlysis of left side of face so the 10 percent for residuals is not even right. They gave me the 10 percent effective March 2003 the date of my re-opened claim. Now how in the he-- could they do this? The stroke happened in March 05 and had nothing to do with the 2003 reopened claim. I guess they felt guilty for screwing me out of the six month 100 percent so they decided to pay me a couple of extra years at the 10 percent rate! I submitted an appeal but this is really freaky. First they service connect it with an effective date of Mar 03 based upon a re-opened claim for an increase for back pain and hypertension, then tell me that although all medical records provide that the stroke happened in Feb 05 that in May 05 their is no recent disease and sum it all up by giving me 10 pecent for residuals which medical documentation clearly shows rating of 70-100 percent for residuals. HOLLY COW I AM CONFUSED or maybe I am just stupid. :D :)

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NO- you are NOT stupid----

that is what they try to make us think we are-

"how in the he-- could they do this?"

Because SCrewing vets out of a proper rating and retro

is what they Live for!

On the NOD you file-you have clearly stated here how it should read-

You have to really look over the DC codes too-

my husband's stroke was coded all wrong-

strokes can not only cause cognitive deficits but also the very severe

residuals that you have.

Make sure the if the evidence they listed and the stuff they said in the decision narrative-

if it isn't complete and /or stated wrong- challenge that in your NOD-

Make sure you tell them you fully intend to continue to appeal any further inappropriate ratings and decisions until the benefits are properly awarded-

Ricky -I recently received an "expert" VA medical opinion that is so deficient it is ludicrous-

it is the 4th -maybe 5th one I have gotten since 1995 and a picnic to medically knock down- maybe you got the same "expert" at that C & P-

you are RIGHT as those reaiduals are way above and beyond a mere 10%---

How dod they word the SMC part of the claim-

I sure hope they considered you for SMC- and then they denied that?

The NOD has to challenge every part of the decision that is incorrect-

I suggest you attach copies of any evidence that they failed to consider to the NOD and refer to it in the NOD.

I fear that vets often get a denial that not only denies SC but also SMC and often it is more than likely they buggered both of these claims-

SMC is a consideration that-when the situation warrants it- it shoud be considered as inferred claim whether the claimant asks for it or not-

Do you get SSA for the stroke or are you still able to work?

You are dealing with illiterates, people under severe pressure, and also some smart VARO people who know exactly how to manipulate evidence in decisions.

Do you have a copy of the C & P?

My husband's major stroke C & P, done in a VA hallway, took minutes-

the Neuro immediately declared him 100 % P & T like it was the Holy Grail-

his deficits were very similiar to yours.

I would get that report if I were you- and dont worry veteran- you have a very adequate basis to NOD this and

best case scenario- they could reverse on the NOD.

Again- cant stress this enough- when you file a NOD or a response to an SOC- I strongly suggest that you not only attack every point you can challenge but also provide them with either more evidence or evidence that they have refused to consider-yet

I am attaching to my response to SOC my 2 IMOS -printed on bright pink paper-this time in which they have never acknowleged (vet rep is dumbfounded on that- he checked my c file twice-they are there and even the VARO boss- when I raised hell about this in Sept assured him that their so-called expert would get these IMOs-but the VA IMO opinion was based on a mere handful of records- she also read them wrong anyhow)-

Use colored tabs tin the NOD and on the Evidence -I tag them as Exhibits A,B, C, etc-or colored paper if you have too-I made an envelope out of Orange paper once with a big note on it to VARO DONT LOSE THIS AGAIN-

The CFR that you mentioned- attach the actual rating regs too if you can Ricky-

This is so unfair to read your post-

my outrage just grows and grows-

just think it is almost another year and in decades that have passed the VA still refuses to do their job right- and THEY are the ones that are causing the backlog.

And-as prior post on their salaries I made shows- they get paid some pretty good money to screw vets out of proper decisions-

You have to be of the attitude Ricky- that you ARE ahead of the game- as they have yet to properly award you-

You have a great claim and the evidence you need-

YOU have the power -not them-

I say file a strong NOD and make them earn some of their paycheck.

Yesterday a vet rep at the VARO who does adjudication from time to time- known him for years via 800-(I was calling for a veteran who asked me if the checks were in the mail) made an odd remark to me-he couldnt answer the vets question-Privacy act so I then asked him if my check was in the mail- if mine was the vets was- as he checked my claims stuff there too-on the PC=he said

"Mrs. Simmons you have always made us do a lot of work"-

yeah he is right- I have always forced them to-at some point-to do their job and then

make a proper award. the question is why should any of us have to do that- but we do-

You have an excellent basis for higher rating and also I believe for SMC too-especially for the 100% timeframe-

by the way did they do an MRI? any vision problems?

any ED, anything at all from the stroke that they dont know of yet?

Edited by Berta
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I just had a C&P exam for a stroke I had in April 1992, the doctor kept trying to get me to say the stroke happened lasy year, I gave him the notarized letter from my ex wife who was present when I had the stroke at Bojangles duirng lunch while at work during my career at the Post Office, they told her to drive me to the hospital in the mail truck. The doctor then asked me why I had a walker, I told him it was because I coundn't get a shopping cart in my trunk, the height is better for leaning, but since I have 2 herniated disks L5/S1 and the VA refused to operate on them due to my heart disease, I either needed to use my VA approved scooter or the walker since I get out of breath if I walk more than a block and I have to sit and rest. Since the VA would not approve my heart disease and SC me at the 100% rate I could not afford the truck to haul around the scooter so I use the walker, it won't fit on my new wife's saturn and we can't afford a new car. So I stayed home most of the time, and I don't like crowds anyway so, it wasn't all that bad. I am sure he isn't going to write up a good exam, if I get SC for the stroke I imagine it will be 10% but then it brings into play my basically useless cardio-vascular system, the needed nexus for the heart problems.

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Thanks guys.

Berta - I am able to work at this time even with the 24 hour per day pain and the inability to grasp things or walk correctly. My hand and foot, although in severe pain, has no feeling. My hand, if I close my eyes and you put some thing in it I feel the pain but can not tell if I am grasping it or not. The same with my foot, it is in constant pain but I can not tell when it touches the floor without keeping my eyes on it. I have a very good paying job, thank God, and my employer is understanding of my disability. The C&P exam, although only about 17 minuets resulted in a very strong write up. The VA doc emphasised the pain and effects of the damage to my hand, foot and face so I do not know where they came up with "no evidence of a current disease". They serviced connected the stroke as secondary to my hypertension and DMII but failed to apply the 100 percent for six months as required by 38 CFR part 4. The rating letter did not contain any disability rating codes. The residuals should have been rated for each body part affected or at least I think that is the way is goes according to 38 CFR. Oh well, a new year and a new battle. I just wish that for once we could truly defeat the beast (VA) and keep it tamed so that it obeys the laws set forth for it. I will keep you guys posted as to how it goes.

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Thanks guys.

Berta - I am able to work at this time even with the 24 hour per day pain and the inability to grasp things or walk correctly. My hand and foot, although in severe pain, has no feeling. My hand, if I close my eyes and you put some thing in it I feel the pain but can not tell if I am grasping it or not. The same with my foot, it is in constant pain but I can not tell when it touches the floor without keeping my eyes on it. I have a very good paying job, thank God, and my employer is understanding of my disability. The C&P exam, although only about 17 minuets resulted in a very strong write up. The VA doc emphasised the pain and effects of the damage to my hand, foot and face so I do not know where they came up with "no evidence of a current disease". They serviced connected the stroke as secondary to my hypertension and DMII but failed to apply the 100 percent for six months as required by 38 CFR part 4. The rating letter did not contain any disability rating codes. The residuals should have been rated for each body part affected or at least I think that is the way is goes according to 38 CFR. Oh well, a new year and a new battle. I just wish that for once we could truly defeat the beast (VA) and keep it tamed so that it obeys the laws set forth for it. I will keep you guys posted as to how it goes.

Ricky- if you have a service officer, he.she might have gotten the blue rating paper with the codes- I am surprised they aren't attached to the decision-the VA with a letter to their Records Access Officer, should be able to send you a copy of it-what is and isnt coded shows them in the NOD what they forgot---

Boy-one more way-if they start failing to attach them- for the VA to give wrong codes and then wrong rating-and how would we know?

I am not familiar with that 100% for 6 months for strokes-

Do you mean a Temporary convalescent rating?

I will have to check that all out-

you have numerous deficets due to the stroke for DMII-

did they mention if they applied Special Monthly Compensation consideration at all?

You can sure use a copy of that C & P to combat their "no evidence of a current disease".

Another example of the VA manipulating a C & P exam's results-they only do that when the C & P is strong for the vet.

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Forgot this- I am sure the VA did an MRI?

Unfortunately strokes can cause brain trauma, evident on an MRI- that would show you still have a current disability-

I guess they think they cured your "disease"?

The MRI narrative should be in your VA med recs.

Lots of medical terms- neuro talk- it should show exactly what infarctions you have had and where-

cerebellem,Pons , occipital, temporal - stuff like that- this could be very useful to have -a copy of the MRI results- if you ever have any more problems like this due to the DMII and HBP- Hope not though.

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Berta ,

This is what 38 CFR states:

8007 Brain, vessels, embolism of.

8008 Brain, vessels, thrombosis of.

8009 Brain, vessels, hemorrhage from:

Rate the vascular conditions under Codes 8007 through 8009,

for 6 months................................................. 100

Rate residuals, thereafter, minimum........................... 10

My stroke was a thrombosis located in the thalamus. As you can see the only rating percentage is 100 percent for six months. I have the blue rating sheet and it does not contain even one disability code. They accepted the MRI interpertation and actual MRI film (with big circles drawn around the areas with the thrombosis) from the local hospital that I was taken to. As far as the 10 percent rating they did give me it simply states that absent an active disease 10 percent is the highest allowed by current law.

The only other paperwork they sent with the rating was the form for clothing allowance since I now have to use a cane to walk. I guess that you were correct in that maybe they felt that the C&P exam cured me on the spot. Even if it had that still would not have done away with the fact that I suffered a stroke. Maybe they do not understand that stroke is the common name for thrombosis!

I could understand their rating, to a point, if I had suffered a stroke 3 years ago which just now showed up on an MRI. I have had previous MRI's looking for evidence of stroke because of my HBP and DMII. All have been negative until late January of this year when I had a spell in which I could not walk, talk etc.... and was rushed to the hospital while at work. The ER conducted an immediate MRI and said you are having a stroke and began treatment. After all was over with the claim was submitted in Feb 05. The C&P was conducted in June 05. Although I could talk and walk with a cane 4 months later during the C&P does not mean that the stroke did not exist. Per the rating codes above there is no other requirements such as veteran can not talk, walk chew gum etc.... or any other signs other than the fact that the stroke occurred. The rating code simply states: stroke = 100 percent x 6 months. This should have been approved back to the original date of my claim in Feb 05. However, the rater approved the 10 percent residuals rating all the way back to March 2003. What the h--l was they thinking? I did not have a claim pending for a stroke in March 2003. It seems like an easy win/fix at the DRO level but the way things are going I only expect a rubber stamp and SOC. Sorry guys did not mean to be so long winded but I am just dumb founded over this one. No recent disease, giving a general 10 percent rating for residuals without even attempting to to deny a proper rating for the 3 body componets affected by the stroke and then giving it an effective two years before the disease happened. Who knows, maybe the DRO will approve the 100 percent and give it an effective date of December 1939! If he does look out hadit cause we are going to have one big party.

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Sorry forgot to mention. I have the C&P. I quoted it verbetim in the NOD and attached a copy to the NOD. My neuro doc also wrote an IMO to go along with the NOD describing the defecits caused by the stroke and reemphasised that it occurred in Feb 05. His bottom line was that the damage to the central nervous system has resulted in a complete loss of use/function of both my left hand and foot along with other damage to my mouth and face.

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Sorry forgot to mention. I have the C&P. I quoted it verbetim in the NOD and attached a copy to the NOD. My neuro doc also wrote an IMO to go along with the NOD describing the defecits caused by the stroke and reemphasised that it occurred in Feb 05. His bottom line was that the damage to the central nervous system has resulted in a complete loss of use/function of both my left hand and foot along with other damage to my mouth and face.

Ricky- it sounds like you did a great job covering it all in your NOD!-

this is why I say to expand whenever you can- the argue for the benefit- in the NOD-

And, as Ricky did here- by all means send them more evidence-if you can-and clearly point out how deficient their statements are-

I would point blank ask them for the DC codes too- if they fail to send them to any of you-

This decision Ricky- it is as bizarre as the ones have I gotten lately-

But let's face it- many claimants accept this crap because they are unable to challenege it-

That is where a good SO comes in- but where the heck are they when vets need them-

They are suggesting 'disease' but you have a ' disability'

I bet you are correct that they do not know what a thrombosis is.

Why would you need a cane, and clothing allowance if you didnt have residuals from this stroke?

I agree that this sure is a bizarre decision Ricky but bizarre seems to be SOP for some claimants-

and they are the ones who often seem to have the most valid medical evidence-

You certainly -if this is all secondary to SC DMII- should be getting SMC too-

what did they say about that- Special Monthly Compensation.

I just got the third denial letter for SMC for my husband-

They refuse to address the CUE I filed on it.

The CUE is supported by a General Counsel pres op and a letter they sent to CHAMPVA.

They just restate Under No circumstances was the veteran entitled to SMC-

no circumstances my a--!

He was eligible under Sec 1151 and also under Nehmer decision.

I never buy what they are selling unless I like it.

You did a great job breaking down that decision-and combatting it's weaknesses.

At my VARO I dont think literacy is a DRO job requirement-I sure hope it is at your VARO.

Berta

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I hate it that anyone has to suffer through the problems with stroke, but Mr. Sharone should have gone the to Birmingham VA Med center and saw one of the C&P doctors there followed by a review of his mishap one of the almighty healers at the Montgomery VARO. Surely they would have cured him just as instantlay as they did me. I think I will email congress and let them know that he should be rushed to Alabama as soon as possible.

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yeah---- after all Sharon is a Vet too!

(Not USA vet though)

I am following his illness on the news- it is rather alarming that they didn't do more for him when they discovered the hole in his heart. And I heard about 6 AM that he was transported by car and not ambulance and was unconscious by the time he arrived at the hospital.

I too was thinking that maybe he could get excellent care in the US of A but I sure am kidding when I agreed that the VA should treat him-

I am preparing my response to SSOC on SMC claim today,naming the VA docotr who told me (after he had just gotten the ECHO report) that "nothing" was wrong with Rod's heart- he is a VA Cardiologist-

one of the few remaining screw up docs that is still employed by the VA.I checked them all out.(maybe he is the only one left)

The VA did diagnose Rod's heart disease 3 years after his death- they owe SMC on that and his brain trauma residuals. It was caused by Peripheral Artery disease (DVD) that Dr. Bash said was one more condition he had due to his undiagnosed and untreated DMII from AO.

I don't want any US vet or Sharon to ever go through those medical screw ups.

Edited by Berta
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