diabetes Reason For Denial Need Help Finding Errors

[ruby]

The comp exam was done by a PA--my rheum was the chief of staff MD with 30 yrs. I had an IMO from a dermatologist MD for 30 yrs who provided the literature that connects the 2 and a statement more likely then not.

form 119 report of contact dated feb 5-needed to know what joints

your sc treatment records don't show trmt for reactive arthritis (actually the initial symptoms were there they were not together. had eye issue couldn't find why r/o diabetes-it was, cystitis unknow orgin this was the initial start.) the symptoms were never connected and the disease was most known by rheum docs only at that time.

a letter dated 2/9/08 was sent to you advising you of the vcaa and informing you of what evidence is required to complete processing your claim. This leter also furnished you information regarding disability ratings, factors affecting eval and how the va determines the eed.all reasonale efforts to assist you in pursuing your claim have been exhausted etc.

a review of virtual va records was conducted 4/27/09 the results of this review were negative results for medical records pertinent to your current claim.(it appears they missed records by another rheum doc on 8/08--10/08--2/09 he mentioned the reactive is due to the hs.)

Medical statement, Dr V dated 12/6 includeing progress note, and statement dated 1/15/2008 notes that he believes your recurring cyst is chronic condition called hidradenitis suppurative and that you have reactive arthritis due to hs. In the record dated 12/26/2007, he noted that you are unable to sustain gainful employmnet of any sort due to physical, mnetal, emotional and psychological limitations.

Va examiner addendum dated 4/809 was reviewed. the examiner noted a diagnossis of bilateral knww arthritis, the examiner opined that is less likely as not that your current reactive arthritis of the left knee is due to your sc hidradenitis. The examiner noted the rational is a review of the medical literature revealed that hs is a disease of the aprogra glnd bearing skin etc. The examiner noted that there was no medical evidence in the literature to indicate that hs causes reactive arthritis in myltiple joints. The examiner noted that xrays of the knees revealed early osteoarthritis which is normal for your age. It is the opinion of the examiner that you have multi joint osteoarthritis found on x-ray and no reactive arthriis related information found on medical literature, therefore, your claim of multi joint reactive arthritis is unrelated to and not aggravated or worsened by your hs.

although there is a positive opinion from Dr V that your reactive arthritis is due to hidradenitis suppurative, the examiner did not have access to your entire claims folder including complete service treatment records.

Thats the denial---they did not mention anything else.

In the evidence section they mention an IMO from the Derm doc but nothing about his statements or literature to support this opinion tat hs causes reactive arthritis.

The PA stated to me when I walked in "i see your trying to connect hs to reactive arthritis and your out of luck on that one, its not in my derm book" I ask him out old his book was but he never looked it up. I then ask him how much he knew about reactive and he said "very little"--this was my competent medical person who did a legal comp exam.

The VA takes the word of a PA over 3 MD's who doesn't know the difference from osteo from reactive. This where I might be able to get a new comp exam with a competent physician---This idiot doesn't realize that you can't determine the difference by xray. One of the hall marks of reactive is bone spurs on xray and reactive arthritis looks like osteo---osteo is given if your arthritis started after the age of 50. I have had mine for 30 yrs.

Any flay's with this denial

Since Dr R's notes are not listed in the evidence section and they missed them on there virtual review is that a cue.

they did not use the benefit of the doubt rule----

there rational for not giving any credence to the other md's appears they didn't have the complete file.

they had records that pertained to this issue and they documented those in there letters.

any help with errors would be great.

thanks ruby

[vaf]

When you provide evidence that is neither listed as evidence nor discussed, or when the evidence you provided is listed, but in fact was not discussed, cite the following:

VA is required to consider all the evidence of record, including medical records and all pertinent lay statements. See Harder v. Brown, 5 Vet App. 183 (1993).

The Board of Veterans Appeals cannot rely only upon evidence it considers to be favorable to its position. It must base its decision upon all the evidence of record. See Smith v. Derwinski, 2 Vet.App. 137,141 (1992) citing Willis v. Derwinski, 1 Vet.App. 63, 66 (1990).

And my favorite:

The Board of Veteran’s Appeals’ failure to address evidence in its decision is indicative of whether it considered such evidence. See Douglas v. Derwinski, 2 Vet.App. 435, 440 (1992).

Also, regarding continuity of symptomatology (or formal diagnosis vs. symptoms without formal diagnosis and treatment):

The Court of Appeals for Veterans Claims has made clear that symptoms, not treatment, are the essence of any evidence of continuity of symptomatology.” See Savage V. Gober, 10 Vet.App. 488, 496 (1997), citing Wilson v. Derwinski, 2 Vet.App 16, 19 (1991) (“regulation requires continuity of symptomatology, not continuity of treatment”).

[john999]

Ruby

Did you compare what the PA did on your exam to the official requirements for the C&P exam for your problem. When a PA did my exam for cardiovascular problems secondary to DMII the PA did not ask for the necessary tests. When I got the tests I went from a rating of 0% to 60%. We use the same VARO. The standard of C&P exams is shocking.