My Htn Claim Was Denied. Any Suggestions?

[bob_abad]

Hi gang,

Received the infamous Manila envelop yesterday, and my HTN claim as secondary to DM-II, and Diabetic Neprhopathy was denied. W/ private doctor IMO too!....sigh...I was sooooo confident for this one to be awarded as IRIS update indicated my claim was recently transferred to the 'authorization'....sigh again...

I even attached the warms.gov note which indicated to grant service connection to HTN claim if I was diagnosed after the DM-II and Diabetic Neprhopathy diagnoses, which was my case.

I was waiting for this HTN claim to be wrapped up so that I can follow up w/ my OSA claim. Now, its going to be a loooooong uphill battle.

QQs?

> Should I now consult or seek help from a DAV or VVA VSO(1st time!) for advice re: how to go forward or pursue this HTN claim onward? Or, is this a losing battle?

> @Sametime, should I proceed w/ OSA reopen claim(3+ decades after discharge)? Was originally denied due to no connection w/ AO exposure. I didn't do a meaningful job on this one as I was just learning the VA claim process back in early Y2007, etc.. I am willing to consult w/ an alternate Sleep Doctor for an IMO(w/ fee). Again, is this worth the effort also?

Hear from you soon. Thanks in advance for your time!

Bartender! Order up, please! 2 shots of Patron Tequila w/ Corona beer on the side....lol..

[bob_abad]

Pete,

> Sorry, BVA is ? and CVA is ? Can you forward also their respective url?

> Should I consider working now w/ a VSO(like DAV..) this time to get a better guidance or direction?

Thanks again.

[tssnave]

Bob,

Here are my suggestions (someone will post the URL to search BVA and CVA court cases - it's somewhere on the VA website if that helps you any):

1. Quote Nieves-Rodrigues v Peake in your NOD reminding the VA that they are no longer authorized to reject an IMO because the doc did not review your SMRs and entire cfile. You can find an explanation of it here: http://wvajustice.com/?m=200901

2. Buy the book Claim Denied by John D. Roche. Here is a link to a thread I started that explains why I think this is a great resource and tells you about some other resources I used during my claim: http://www.hadit.com/forums/index.php?show...c=23487&hl=

3. If they didn't quote the VA directive about assigning the sc then include it again in your NOD and request that they address why they failed to follow their own directive.

4. In conjunction with 3 above, ask for a VCAA letter outlining exactly what it is you need to provide them to prove your claim.

5. Ask for a SOC (Statement of Case). I am not certain exactly how and when you get a SOC in your claims process. Someone else can help you understand that. When I was denied service connection I appealed and was granted sc and rated 50%. I appealed the 50% and was rated 100% P&T. So, each of my appeals was granted and I never actually got a SOC, just the Decisions so it is still unclear to me just when they come into play but this is something that others will be able to explain better than I can.

Here's a link to a Veteran's Self Help Guide that one of our members, Vike17, put together. It was very helpful to me when I was working my claim and it addresses the SOC: http://www.hadit.com/veterans_self_help_guide.html

6. If you haven't already, get a copy of your cfile so you can see what's in there in case there's something hanging up your claim that you are unaware of. If you are like many of us, when you get your cfile you will actually find evidence in there that will support your claim.

7. Decide whether or not you just want a DRO review or an actual DRO hearing where you go to the VA and talk to the DRO. Lots of vets have had success with the hearings.

8. Going back to court cases, I believe there is one that addresses the part of the denial that said her opinion seems to be based solely on your reported history. It had something to do with a vet being able to, even as a lay person, describe medical issues. Sorry I don't have the citation. If it didn't pertain to my claim I didn't print stuff out (and even with that I wound up with two file drawers full of stuff). Somebody else may chime in with the relevant court case.

I hope this helps. Good luck with your claim and keep us posted on the outcome.

TS Snave

Edited February 11, 2009 by tssnave

[Pete53]

TS SNAVE:

Excellent suggestions. I agree with everything you wrote.

Thank you for being there to help a Veteran.

Bob if you use Hadit home page it will tell you where to go.

Good Luck

[bob_abad]

Tssnave/pete,

Thank you very much for this valuble information. Still upset about the denial, but I keep reminding myself: "Self, calm down, read up & learn more, get some help & stick w/ hadit for now!"

Let me read more up until I am confident. Not sure what's my next move here...

Keep you posted..

[Berta]

Something is wrong here-

"I even attached the warms.gov note which indicated to grant service connection to HTN claim if I was diagnosed after the DM-II and Diabetic Neprhopathy diagnoses, which was my case."

Did they list that as evidence?

Do you have a link to that document?

Did the VA denial include a medical opinion from a C & P doctor?

http://www.healthsystem.virginia.edu/uvahe...etes/kidney.cfm

In part this states:

“What causes diabetic nephropathy?

Hypertension, or high blood pressure, is a complication of diabetes that is believed to contribute most directly to diabetic nephropathy. Hypertension is believed to be both the cause of diabetic nephropathy, as well as the result of damage that is created by the disease. As kidney disease progresses, physical changes in the kidneys often lead to increased blood pressure.”

Often the VA looks for HBP due to diabetes as then as cause or aggravation of other disabilities-

Have you been diagnosed with any heart disease or

athersclerosis due to diabetes?

Once diabetes affects the heart, it can then begin to affect the brain, kidneys, etc.

If you click on this http://www.va.gov/index.htm then click on the Board of Appeals and then on decisions at bpttom of that menu you can search claims here for your condition.

Do you have the original VCAA letter they sent to you on this claim-telling you exactly what they needed?

[trailblazer]

I was deined the frist time I filed for HTN due to DDM-ll and diabetic neprhopathy and I appealed. I got a copy of my medical records from my Dr. that went back 10 years and provided the VA with them even though they already had a copy. After another C&P I was approved at 10%. The C&P examiner stated my HTN was caused by aggravation of the neprohpathy. What the C&P examiner says determines wheather you win or loose. If you haven't already, get a copy of your medical records and provide the VA with them. The results will most likely be better next time. Good luck.