Could Very Easily Throw Up, I Feel Lost.

[livingrock21]

Please, please help me.

I just recieved a SSOC. They denied my new C&P. I think theres two factors. The doc, my treating physician, messed part of it up. Also, they misinterpreted evidence again.

________________________________________________________________________________

_______________________________

Here's the rating criteria:

7119 Erythromelalgia:

Characteristic attacks that occur more than once a day, last an average of more than two hours each, respond poorly to treatment, and that restrict most routine daily activities.................................................................. 100

Characteristic attacks that occur more than once a day, last an average of more than two hours each, and respond poorly to treatment, but that do not restrict most routine daily activities........................................................ 60

Characteristic attacks that occur daily or more often but that respond to treatment.......................................................30

Characteristic attacks that occur less than daily but at least three times a week and that respond to treatment....................10

________________________________________________________________________________

_____________________________

Here's what I recieved:

Decision:

Entitlement to increased evaluation for service connected Erythromelalgia currently 30% disabling is denied.

Reasons and Bases:

The veteran submitted treatment reports from the Naval Medical CEnter noting treatment for his Erythromelalgia while on active duty. VA treatment reports and examination note history of symptoms and diagnosis by exclusion. The veteran indicates that the symptoms occure at least once per day lasting two hours or more. VA examiners noted that the veteran's symptoms have never been observed while active. (This is a flat out lie. They were observed while I was active duty. I was able to go to my PCP many times because the hospital was 10 minutes away, and we had an agreement when it got really bad I could come in without and appointment. Now the closest VAMC is atleast an hour and a half away, and I'm not going to make that drive while in pain.). All clinical testing was negative but noted deep perivascular dermatitis and rare eosinophils. There were no chilblains. Skin was normal with no rash or talangectagias. There was no erythema found. Diagnosis of Erythromelalgia was made. Social Security Administration records also note the veteran's disability.

Review confirms current 30% evaluation for the veteran's service connected Erythromelalgia. The current medical evidence does not support entitlement to a higher evaluation.

________________________________________________________________________________

____________________________________

Obviously my treating physician (C&P doc) said nothing about treatment, or lack there of. No treatment has worked. Also, there is nothing on restricting activities, I can't work due to this condition, they even stated it with the SSA records. I also talked about how I can only play with my daughter for a short period of time before I can feel a flare comming on. There were many things that I mentioned about restriction. None of it made it into the exam notes though. The problem is, I had an appointment the day before the C&P, and then the C&P the following day. She decided to combine both appointments. She didn't do the traditional C&P. She wasn't even looking at the criteria when doing the C&P.

I'm not sure if the DRO screwed this up or what, but I also have been seen while flared up. Either my treating physician(C&P Doc) or they misconstrued that information. I haven't been seen at the VAMC while flared, but have been seen while flared (while active duty).

Here are my questions. Can I have the C&P doc ammend this examination and correct it? I know she would due to the errors, or lack of information. Will they look at it again, and issue a new SSOC or decision. I don't want my claim being certified for the BVA. I should be able to get this fixed at the VAMC. I'd be wasting a whole lot of time at the BVA when the evidence is all right there infront of them. What do I do here? Hopefully I can have her ammend this C&P, and get this fixed rather quickly.

Please, please help me. I'm over the edge right now. I had a distant friend OD last night. At this point, I can truely see how life gets to be too much. I can't take any of this. I need a solution, but am affraid I'm limited on time. I feel that if I don't get this taken care of now, it'll be another year before the issue is taken care of, and my family is barely scraping by as it is.

Please.

Tyler

Edited May 20, 2009 by livingrock21

[carlie]

Tyler,

Put the SSOC away.

Find something relaxing or something else to focus your mind

on other than VA - take a nap, sit outside, etc...

Tomorrow after you get up and moving around good

sit back down with the SSOC and re-read it,

keep a pencil and paper by you to make notes on.

You've just gotten a kick in the face, let the

emotion of that have a few hours -- then proceed tomorrow.

You have come a long way so far.

Remember, we usually don't do our best work when we are pissed off !

carlie

[livingrock21]

You know another thing.

The DRO didn't even touch all the bases under reasons and bases. He didn't list all the criteria for my condition. It didn't say either way whether it affected routine daily activity. It didn't say whether treatment is working. As I said, it does restric daily activity (working, playing with kids, physical activity). Also, none of the known treatment has worked, and even the experimental treatment hasn't worked (I'm willing to try anything to help with this condition, and I've made that very clear).

Thanks for the help in advance, guys/gals. You all have always been more then helpful before. I just have no idea which direction to head now, and how to do it. I truely think getting this C&P ammended is my only option. I haven't seen the C&P, but if the DRO didn't list any of this other rating criteria, I'm willing to bet it's not in the C&P. My treating physician (one that did the C&P) gave me her business card a while back and told me feel free to contact her. I left a message, and am waiting for her to call me back. If I don't hear anything back today, first thing tomorrow mourning I'll be heading down to the VAMC to get a copy of this C&P so I can know for sure whether she included this information. Irreguardless, even if she did, the DRO still didn't address it. Like I said, she didn't even have the rating criteria infront of her when she did this C&P so I have a feeling she didn't even include it in the Exam.

Tyler

P.S., any and all help is greatly appreciated.

[livingrock21]

Carlie,

I understand the SSOC completely. The problem is some of the rating criteria isn't even addressed like I said in the previous post (think I was posting while you were). So either the doc or dro messed up, or possibly both.

I just need to know if it's possible to get the C&P amended, and re-submited so they can make a decision with the correct information, or I guess I should say with all the information. If not, what are my other options? I'll also be contacting my congressman about this issue again. It's the same thing as it has been. They based everything off a f'd up C&P. Atleast this time the C&P was the correct one, I just don't know if the doc forgot to include some of the rating criteria, or if the DRO didn't address what she included.

Thanks for the quick response Carlie.

Tyler

[carlie]

Tyler,

To understand the SSOC completely -- we have to understand the why's

of all the other stuff your in question of too.

Since your not going to take a time-out to let the emotions settle down,

then start back tracking now - get the denial, the SOC and sit down with the SSOC.

Study carefully to find out(hard to do when emotionally upset) if it's just been rubber stamped

or if VA has made any different statements in regards to your issue's and evidence.

carlie

[Hoppy]

If this were my claim this is what I would do.

If you feel that the response that you have to take to avoid the onset of symptoms is more disabling than they are rating it, then you need to seek an extra schedular rating. Get doctors to make statements that the changes in your behavior as a result of this condition are medically prescribed.

If doctors back up medically prescribe changes in behavior and the VA still tells you you can work get an IMO or talk to a labor law attorney and show the attorney the medical reports. Outside the VA lawyers determine if you can work or not. Doctors write reports for the lawyers to read. Sometimes the doctors think you can work yet the lawyers know the specifics of the laws governing labor.

The fact that they say you have not been seen with symptoms post service would justify the need to get medical opinions based on the symptoms inservice that your current changes in behavior are medically prescribed. They brought this problem up because it makes it hard for them to rate and they do not understand the condition well enough to figure out that an extra schedular rating might apply. Additionlly, if you seek this type of appeal they might be required to schedule C&Ps. If they refuse to schedule C&P's then you are on your own.

Make sure you are seen with current symptoms if they occurred. Call paramedics or a doctor of your choice. Have one on call to do a house call. This evidence is more valuable than what they will charge you. If you are not seen with current symptoms then how can they determine if it is responding to treatment or poorly responding to treatment. The VA does not assume the worst. You have to provide the medical evidence.

I have a condition that I can can feel coming on. If I do not control the condition it will kill me. This fact is established in all literature and backed up by doctors reports. Even before I realized it was service connectable doctors told me I had to live and work in a protected environment and that employers were not trained nor certified to provide the protections. Later, I got employers to write letters that they could not hire me. You need to surround them with evidence.

If the doctors will not medically prescribe the changes in behavior you take to control your condition then the last resort might be to seek a diagnosis for an anxiety disorder or adjustment disorder secondary to the medical condition.

Edited May 20, 2009 by Hoppy

[Eric_M]

If it were my case I would contact your doctor, or go visit, take the decision and reason for denial with you.

Ask you doc to document your increased problems. When I've shown a doctor the rating criteria they seem to have a better idea of how to properly document the condition(s).

I would then send that doctor's statement back to the RO, and ask for reconsideration.

It is frustrating to see a decision that you know is not correct, but remember the law works both ways. The VA is nice enough to give you exactly what you need to move to the next rating %. Now you just need to use that info to your advantage.

Good luck with your claim.....Eric