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What Carries More Weight?


joeyjoeyb
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Question

Bottom line....

Does the fact that no reflux showed up on the UGI will be the key to not getting the increase? Or do the notes of the examiner override that? I am not sure if I am asking the right question here. But just wanted to know what is more important when it comes to getting rated for this. The xray or the examiners notes?

Just wanted to add that the reflux and hiatial hernia did show up on the first C&P exam I had back in Apr 2007.

I had a C&P exam for an increase for GERD on the 25th of September. I am rated for GERD but at 0%. I asked for an increase and they sent me back to get checked out. I had an UGI done and some labs. I had this appointment back in July, but got rushed to the hospital as I thought I as having the big one. I had a stress test done and all was good. It turned out it was my GERD. Now I have a couple of questions.

My CARDIO doc confirmed to me that my GERD was the cause of my rush to the hospital.

I am pretty sure that I am at the 10% rating level as I have 2 of the 4 symptoms of GERD for the 10% rating. Just like when they first examined me. But I guess they did not listen to me. The 10% would put me at 50%. I am not counting on it.....

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I sent for the report for my C&P exam on my GERD increase. I am not sure what to think of it. First of all, the UGI I had said it was normal. No reflux was noted flouroscopically. My reflux is probably the worst it has ever been. When I went for my first C&P exam for my initial claim, they did note reflux and a small sliding hiatal hernia. No mention of the hiatal hernia on my second exam.

No the report from the examiner said a few things in it:

"Veteran has a sore feeling in throat which is uncomfortable when I swallow"

"Veteran has constant pyrosis by history"

She mentioned about my episode that happened in July that I went to the emergency room because I thought I had a heart attack and my cardio doctor said it was most likey my GERD

"Veteran has reflux of stomach acid which occurs 3 times a week."

She also said in the report:

Interferes with working and iterferes with daily living, "Because I have to sleep with the head of bed elevated, I have to be careful with everything I eat because I really have burning all the time."

So I guess what my question is, do you think I have enough there to get an increase to 10%? Does the fact that no reflux showed up on the UGI will be the key to not getting the increase?

I have several other issues going, but I guess this was the last thing the VA needed to rate ALL of my claims at once. Let me know your opinion. Thanks

p.s. one other thing on the report...it says Examining provider: XXXXXXXX

Approved by XXXXXXXX on Oct 7 2008

Does this mean it was approved by them or that the approved person was just the examiner boss? Just curious

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Joey, the VA will always place more weight on confirming medical evidence - xrays, mri's etc.......

The notes you said she put in the report appear to all be self reported or based upon reported history and the rater will place little to no weight on these.

Did the C/P doc provide a diagnosis of GERD in the report?

Also the approved by sig is standard for a C/P exam. It simply means that the doc's boss reviewed and approved the report.

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