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.

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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

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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.

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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

[yoggie2]

livingrock21, carlie is correct don't look at it right now we can help you pick up the pieces tomorrow. I know first hand what your going through and it hits home, I feel your pain.. They interpret things there direction almost all the time if you know what I mean. I was crushed by my denial so hard I hit my knees where I stood and cried "a grown man" how could they do this to me, the truth is they do it to us all and we have to educate our selves to fight them with there own tools and trust me it can be done. At the face of it it looks solid but when you look again after the pain you feel is passed the cracks start to show, trust me there to my claim went from a straight across the board denial to 180 turn. Good luck my friend put it down for now and we all can fix it together....YOG

[livingrock21]

Thank you all for the quck responses.

Here's truely what I want to do.. I need to know if it's possible..

I want to go back to the C&P doc (my treating physician) and get her to amend this C&P. I'm going to provide the rating criteria to her. Then let her fix the exam. I just need to know if it is possible to do this. If I get the doc to amend it, will the VA then accept it and either grant what I want or provide another SSOC.

I need to get this ball rolling as fast as possible. I'm racing against the clock right now. My appeal is going to go back to the certification stage to be sent off to the BVA. I'd request a DRO hearing, but don't want to do that if I can fix it the way that I want to. I truely believe this is the obstical I'm hitting right now. I left a message for the Doc to call me back, it was only an hour and a half before quiting time, so I figure she'll call me tomorrow mourning.

After I post this, I'm going to get out the older two SOC's and compare them to this SSOC. I'll prost back within the hour and let you guys know what I find. I've cooled off a lot, it's time to take care of business. I have to take care of business now.

Tyler

[livingrock21]

I found the problem. Now I just need to know what to do, and what my options are.

In reasons and bases it says "veteran indicates that the symptoms occur atleast once per day lasting 2 hours or more." Now when she asked me this question, I answered they occur atleast once per day, but often occur more then once per day, and I also told her that one flare can last multiple days.

I'm pretty sure since they seen that they automatically put me in the 30% catagory. If you look at the rating criteria in my first post, it says for 60 and 100 % the flares have to occur more than once daily.

Now, here's some more food for thought. As I said above, I explained to her atleast once daily, and that's how it's worded. But I also went on to state they can occur more then once a day, and can also last multiple days. If you look at the 100% rating criteria. It states "responds poorly to treatment", mine does not respond to treatment at all. Last more then two hours, it even states in the SSOC that they last "2 hours or more", and mine restrict daily activity (I can't work, play with my kid extensively, or do anything to physical).

So, optimally, if I could get her to amend the once per day, to say what I said would be optimal. Even if I couldn't. Shouldn't they rate me at 100% under the "reason of doubt" rule. Their supposed to give the veteran reason of doubt. Even with out my dr. amending the C&P, my symptoms fit the 100% criteria 75% of the way. Even more really since they occur daily also. I could see if I only flared up 3 times a week, but had all the same symptoms why they wouldn't give me reason of doubt, but under these circumstances, I should have gotten it, should I not?

I hope this all makes sense to you. I'm 100% sure that's what happened here. What do I do? I want to get this fixed before it goes to the BVA. Do I write the VA a letter? What regs do I use, ect.? You guys have been greaat thus far.

Carlie, you were def. right. I cooled off completely, and then found all this. I would have never caught it if I were still in the "heat of the moment".

Thanks for the help in advance.

Tyler

---EDIT---

Lol.. I kept saying reason of doubt. I meant to say "benifit of doubt". Sorry. I want to leave it in there though. It's actually kind of funny.

Edited May 21, 2009 by livingrock21

[Stretch]

Lliving,

I had a similar situation in my claims. I didn't even have the copy of my C&P when an SSOC showed up. The C&P wasn't even in my evidence yet.

You need to see the copy of your C&P, before you go jumping on the doctor. She might wonder what you are talking about. Then you will know if it was used, in your decision, or evaded.

My guess is that it was temporarily evaded.

[livingrock21]

Stretch,

I'm def. not trying to jump down the docs throat. I'm sure she would be just as apt to think she may have made a mistake as myself. The other C&P exams I had, the examiner had the rating criteria infront of them. She didn't. Also, I was supposed to have a scheduled appointment with her one day, and the following day the C&P. Well she decided to do both of them the same day. Which I'm not complaining about, and I agreed to, but there was a lot of stuff said. It could have been very easy for her to shorten things up and just say atleast one a day either due to not remembering the other part of the conversation or due to trying to keep the report short.

Irreguardless, she's an excellent doc, and she knows that's how I feel. Like I said, I left a message for her on her voicemail asking her to call me back at her earliest convenience. I haven't gotten a copy of my C&P yet, but I may ask her for some of the details, and then go into the specifics about everything.

Do you know if it's possible for her to send an updated/amended C&P to the VARO? If there was a mistake, or misunderstanding I don't see why it shouldn't be possible.

You were also saying about it possibly being evaded. How would I get this fixed? I can think of one way which has gotten me results thus far, my congressman. I know that the DRO didn't address a lot of the rating criteria in the reasons and bases, but I don't know if that due to it not being in the C&P, or if he felt it didn't need to be included. I'm really looking for a solution to all this madness.

Thanks again.

Tyler

[Stretch]

I just suspect that when a claim has all the criteria for an award, that the only thing the VA can do is stall. I think this is why everyone is saying pick it up tomorrow.

If you try to read to much in to it, then it will cloud you mind.

If you look at the SSOC it is most likely the same as the SOC with a few mis-spelled words in it.

Heck, my SSOC said that I had a truck stuck in my nose. I couldn't figure out what they were talking about.