diabetes Nod & Cue?

[atlb685]

Hello all!

I am in the process of filing a NOD for my finace. He has been rated for Diabetes Insipidus (DI) secondary to a head injury he obtained in service. As I have been researching his disease, all the research has shown that DI presents itself almost immediately after the injury (within 3-5 weeks). He was in service for more than a year after the accident (which occurred in 2002) and the DI diagnosis was not awarded to him until 2008--when we requested that he be formally evaluated for it. He was not back-dated for it. Since the disease is directly related to the head trauma (by their own admission) and it would have presented itself within weeks of the accident, could this qualify as a CUE? I even have lab results from 6 months after the accident showing that he was clinically dehydrated, yet the military never followed up on this. He should have been diagnosed while he was in-service.

Is it appropriate for me to point all of this out in his NOD, or is there a completely different process that I have to go through? I don't want to put the cart in front of the horse if it is going to hurt him...

Thanks in advance for your help!

Jami

[Berta]

Here is the TDIU form-

Check Yes to # 18 and then he should definitely apply for SSA

Under Remarks # 25, refer them to separate page and tell them anything at all that would warrant a TDIU rating-like side affects of his SC meds, the fact he must urinate often, and any other other information that would show his SC would render him unable to attain substantial employment.

If he is not working the VA should have sent this to him themselves.

Did he ever claim this same condition, and then get a denial that he failed to appeal?

Was the new decision based on a re-opened claim?

TDIU_form.pdf

[atlb685]

Berta, I apologize, I am just now seeing this.

He is not currently working, and has not in several years. He has not formally requested TDIU. I have suggested that he do so, but I think he is nervous. He feels shame over his condition and so badly wants to be "normal". I think, in his mind, TDIU is "giving up". I don't know what to do. :-( He has not applied for SSA either.

He was granted service connection for the DI, and there were in-service medical notes showing clinical dehydration. This was some months after his head injury, so it makes sense. He would have been showing the symptoms of DI at that time.

He gets a total of 90%, though he is only rated at 20% for his DI.

I wish there was more I could do for him, but it sounds like we have no choice, other than to file unemployability. I wish he would do it, but he is only 32 and seems to have great anxiety whenever I mention this to him...

[atlb685]

Oh, also, he never filed for this before. When he was discharged originally, he had only a 20% rating. I did not know him at the time. He basically holed up in a studio apartment for several years, letting his depression grow and grow. He did not associate with anyone, and mostly sat in bed all day every day. He moved to another city and worked for a short time (approx. 6 months) which is where I met him. The more time I spent with him, the more I realized something wasn't right. He had a hard time remembering things, and even had to call me several times for directions to his own house. And the constant urinating... It just seemed strange to me. So i encouraged him to go to the doctor (he hadn't been in years) and that is when he was finally diagnosed with the DI (in 2007) and it was so bad by that point that they found they can't even control it with medication.

So, once we got the DI diagnosis, we filed for an increase. They approved it the first go-round, but definitely low-balled us. The C&P examiner wrote over 7 pages about his DI and how debilitating it was. He was definitely on our side. But for whatever reason, they only gave him 20%, though we had evidence to support at least a 40% rating. It's all very frustrating to me, as i just don't understand how they can get away with this. Some people laugh it off and say "it's no big deal, he just pee's a lot" but it is SO much more than that... It's humiliating for him. Not to mention that he is constantly dehydrated. If he gets a simple stomach virus, he could die from dehydration quickly. What makes me the most upset is that if this had been caught before he was discharged, we could likely manage it with medication. But since it went on so long undiagnosed, his body won't even respond to the DDAVP, and he is taking 4 times the maximum dosage! I just wish I could look these people in the eyes and tell them that because of them, this man's spirit is practically dead.

Sorry for ranting... I just don't know what else to do.

[Berta]

I sure understand that-he is so young.

One of my husband's worse days was when SSA called him to say they were sending him an award letter.

That is when it began to set in that he knew he would never work again.But he still believed he would recover one day.

You can only guide this vet as best as you can. He has to decide what his next step is.