What Warrants A Reevaluation Of A Sced Condition?

[Ron II]

What are the requirements for a veteran to have have his/her SCed condition reevaluated for a higher rating? In other words, can one just send the VARO a personal statement that he/she feels the condition has worsened and that a new evaluation is requested.

The reason I ask is because I included such a comment in my correspondence when I filed a NOD on a heart condition in September 2007 (this is currently on appeal since the DRO decision denied my NOD).

The DRO denial did not address my comment about the deterioration of my condition.

Thanks,

Ron

Edited September 30, 2008 by Ron II

[john999]

If you dont' get a VCAA letter on a claim then the VA is probably not considering it as a claim. When you make any kind of claim the VA is supposed to send you a VCAA letter that tells you what you need to win your claim.

[Ron II]

If you dont' get a VCAA letter on a claim then the VA is probably not considering it as a claim. When you make any kind of claim the VA is supposed to send you a VCAA letter that tells you what you need to win your claim.

Thanks John--After speaking with Carlie, I sent the following to the VA via IRIS:

I request information pertaining to a claim request I made to the Denver VARO in September 2007. This claim information is included in my NOD correspondence. In other words, my NOD included more than the disagreement, it requested an evaluation of my deteriorated condition.

On or about 11 Sep 07, I filed a Notice of Disagreement regarding the rating for Sick Sinus Syndrome with Sinus Bradycardia, Status Post Pacemaker, (claimed as cardiac pacemaker related to bradycardia/arrhythmia, and previously chest pains)--currently rated at 10 percent.

WITHIN THE NOTICE OF DISAGREEMENT LETTER, I indicated my cardiac situation had gotten worse and I requested a medical evaluation of my current status since my condition has deteriorated since the initial filing of the claim. I have not received any correspondence from the Denver VARO concerning this part of my claim (the evaluation of my deteriorated condition).

[carlie]

Ron,

Study M21-1MR, Chapter 5, Appeals, Section B - Notice of Disagreement

(About 3/4 of the way down) New Issues raised in a NOD.

http://www.warms.vba.va.gov/M21_1MR.html

<H5 style="MARGIN: 0in 0in 0pt; mso-list: skip">e. New Issues Raised on an NOD</H5>If the appellant raises issues on the NOD that have not yet been adjudicated

· do not delay sending an SOC covering those issues that were previously decided provided there is no outstanding evidence identified by the appellant or the VSR, RVSR, or DRO, and

· treat the new issues as a new claim, establish the appropriate end product (EP) control, and undertake the development needed to decide the new issue.

References: For more information on

· handling new issues, see M21-1MR, Part I, 5.E.24.

· including appeal rights with the decision of the new issue, see M21-1MR, Part III, Subpart v, 2.B.

[Ron II]

That is very helpful Carlie....thanks!!!!!!!!

[jbasser]

Ron, if you are SC'd for heart disease and you have a electro shocking device, then look at this:

7011 Ventricular arrhythmias (sustained):

For indefinite period from date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia, or; for indefinite period from date of hospital admission for ventricular aneurysmectomy, or; with an automatic implantable Cardioverter-Defibrillator (AICD) in place 100

Dont just ask for the increase, demand it per the regs.

J

[john999]

Ron

I got a cardiac exam from a PA at the VA. It was inadequate and a joke. I will be NODing the denial when I get it. I asked the VARO for another exam and they did not even answer me. Perhaps I will ask again but I fear I will have to go the NOD route. The PA said my stress test was the fact I could wash dishes and that is how she estimated METS. The disability exam sheet says you must have a stress test if you have certain kinds of heart disease. All I got was a echocardiogram which they preceded to misinterpret. I will get a specialist and just persist.

John