hypertension Increase Claim Denied

[Charleese]

Hi Everyone,

Posted here the other day about Hartford Regional Office. Well Berta gave us a number and person to call and my husband did. Even though that person didn't call him back he received and e-mail from IRIS stating that Notification was mailed on yesterday. Today we received his decision and everything has been denied. Needless to say my husband is livid over this. They kept this claim for 22 months to deny everything. He has a brace that the VA has given him for his left knee servicer connected condition, which would give him and increase of another 10%. Decision is states "A higher evaluation is not warranted because these findings are not currently shown." As stated above he has a brace that the VA gave him, also at last C&P exam, Doctor changed the originally brace, to the brace that he has now, which is a better brace. Also, my husband gets a clothing allowance because of the wearing of this brace. This was documented in his application for an increase. No where in this Decision does it state that the C&P Doctor states that his condition has gotten worse and he needs a knee replacement and that he is unemployable. Everything he applied for: Right Knee, Left & Right Shoulder, Diabbetes, Hypertension, Bilateral carpal tunnel syndrome, cholsesterol, Gout, and ED were all denied. He gave them ample amount of evidence to prove these conditions, which are conditions that the VA treats him for, as well as private doctors, but they still denied him stating that they didn't occur in the service. My husband stated in his application for increase that his right knee has deteroriated as a result of him compensating for his left knee. Even C&P Doctor agreed with him on this. He has Osteoarthritis/Arthritis/Degenerative Joint Disese in his left & right knee, left & right shoulder. Also, the fact that he stated and attached an Article which states: "In fact, most studies now strongly suggest that carpal tunnel syndrome is primarily associated with medical or physical conditions, such as diabetes, osteoarthritis, etc. My husband has diabetes and is obese. Conditions that can lead to secondary osteoarthritis include obese, repeated trauma or surgery to joint structures,(husband was always falling because knee would lock up on him), gout, diabetes, and other harmone disorders. He let them know that because he was obese, and have stress and pain from left knee injury,high cholestero, hypertension he associated all with his diabetes. They denied all because they say he didn't have when he was in the service. For them to deny him ED because they said it did not happen when he was in the service, is a little bit too much, when they are the ones supplying him with medication for it. Decision goes on to state: You walk with a walker and cane for better weight balance." If they had read his c-file then they would of known that my husband fell last July and injured his whole right side, and because of that fall doctors discovered his spinal chord was damaged and he had a herinated disc wrap around his spinal chord. He had major surgery and had to be operated on immediately. He stayed in the hospital for 40 days. He gave VA a copy of his medical records pertaining to this fall. The surgeon doctor that attended him has writtern a letter stating that he is Permanent and Totally disable and cannot work at that job anymore.

I intend to help him NOD this decision. We are going Monday, to get a copy of his last C&P exam to see exactly what Doctor put in that report. If she didn't put in report about knee replacement and unemployable, then we will write her and ask her why. We also intend to use surgeon's letter as well.

What I need to know is how do we get them to look at all info in his c-file, and all evidence we send them. They overlooked about him having a Brace etc. and didn't report about what C&P Doctor said.

The person who did this claim is the one we made a complaint about through IRIS and I guess this is her way of retailiating by denying everything. How do we prove that all disabilities does not originate in the service, but can happen over periods of times from service connected injuries.

Please help us. Sorry for long Po0st.

Thanks

[vaf]

Is your husband receiving Social Security Disability? If he is, that would help you in his VA claims. This doesn't answer the immediate questions you pose, but if you're applying for TDIU status, it would certainly be relevant.

[broncovet]

I agree with VAF. If your hubbie gets SSD, and your SSD states that you are disabled for conditions that VA says are service connected, Berta cited a court case that they cant deny you TDIU.

I recommend you do a very thorough job of your NOD. List each condition you are disputing, and then cite evidence as to why you are disputing it. Look at the C&P exam..and it the C&P "doc" is really a Physician Assistant or Nurse Practioner, (this happens a lot..the VA hires QTC "docs" to do C&P exams..who are not doctors at all..they are just well paid nurses or docs helpers who get paid big bucks to write things in your chart to deny your claim. Remember, QTC is a company owned by Dr. James Peake, formerly the VA Secretary..so there is a conflict of interest.)

Bottom line. File a NOD, and then file it again after they shred it. Then keep filing it until the VA will finally admit to receiving it with IRIS. Then keep a copy of the IRIS email, because VA will claim they didnt get your NOD.

[Charleese]

My husband receives regular Social Security not SSD. All my husband wanted to do was to get the 10% for the wearing of a brace which would bring his rating to 70% so he could apply for TDIU P&T. The person working his case knew this because he let it be known through IRIS and inquiry went to that person. Don't understand this because Rating Deceision was issued without any signature(s) on it. Thought that it would have to be signed by someone am I right or wrong.

[Pete53]

Its time to get a Lawyer

[mags1023]

[sharon]

If you are claiming secondary conditions it must be stated as such. If you don't they treat the claim as if you are claiming it as a primary condition. Thus it will be denied as not occuring in service. File a claim for TDIU and they will have to look at the already service connected conditions for an increase.