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

[Stretch]

While you are getting the C&P records, you can request all of your records at that hospital. They will aslo print them out for you if you haven't done so already. They will print them out on the spot or mail them to you.

[Hoppy]

Tyler,

"I had told her about two days prior where I had to cut grass, it was real hot and humid that day, and I ended up flaring up for a day and a half straight. This is in her routine notes. That right there shows them that they "occur more then daily". They would have to give me the benifit of the doubt."

The benefit of doubt will not allow them to give weight to your subjective statements as though it was an objective observation by a doctor. Re-read the second BVA case I posted. These are not isolated cases. I could post hundreds of them. The benefit of the doubt applies when there is evidence for the claim that is equal to the evidence against the claim. What they are telling you is that there is NO evidence for your claimed increase in compensatrion until a doctor reports that you were seen with active symptoms that exceed the symptoms that you were originally rated for.

What she put in the notes does not confirm that you had a flare, all it confirms is that you told her you had a flare. The doctor can be 100 percent on your side and the RO can still deny your claim. Unless the doctor writes a report based on objective observations it does not confirm that the flare was for the same disease you are service connected for. What they are looking for is objective observations of symptoms by a qualified examiner. Until a qualified examiner reports the objective symptoms they will fight you.

If the doctor wrote a report that she observed symptoms gave the symptoms a diagnosis and noted in detail the extent of the symptoms then you might have a chance. They might allow you to testify how long the symptoms last. No guarantee. Most likely they will require that you go back the next day.

The reports I submitted for my claim were written by doctors. They listed all the symptoms that they saw that day and the diagnosis. At no time did any of these reports include any statement that I made to a doctor as to symptoms that came and resolved prior to my seeing the doctor.

In the first BVA case I posted they wanted the doctor to take the picture not the veteran. I am not sure they will allow the pictures unless they can tell for sure the pictures are of you and there is objective symoptoms noted as seen by a doctor. In my case the condition causes swelling around the eyes that is so severe as to cause my eyes to swell shut. So the pictures were of my face. The statements I got from my friends were that they took the pictures and the dates the picture were taken. I Had reports from twenty five visits to the hospital with active symptoms as seen and noted by doctors. When I went to the DRO he took the pictures out and showed me that he was looking at them during the hearing and made a comment that it was obvious the pictures were of me.

The problem I see is that if you are capable of making it to a C&P and your primary appointments they will expect you to get to the hospital for an examination on the day of a flare. As such the picture would only be allowed to support the objective evidence provided by a doctor. If you continue to argue the claim without any visits that confirm what you say you might make them mad. I am not sure of the specifics of your claim as to whether it was considered stable or not on the original rating. If a condition is not considered stable and there are no protections due to the length of time the previous rating was in effect they can reduce a rating. That is what they did in the second BVA case I posted.

Edited May 22, 2009 by Hoppy

[livingrock21]

Hoppy,

I completely understand what your saying.

I was laying on the couch thinking about all of this. There actually were two times that VA docs seen my flares. Once when I was admitted to the hospitals so they could try to figure out why my blood pressure is so high, and also at an ER visit due to kidney stones. When I was admitted, there aren't really any notes about it though. All it says is I was flared up, barely describes it, and says what kind of pain medicine she gave me for the flare. The ER visit mentions it, but not in detail by any means. Both times I was there for something else. I'm thinking that these doc notes should also help.

This is really getting me back over the edge again. Ever since I started having these problems it's been a struggle. First trying to get the docs to believe me, finally being able to prove it to them, being diagnosed with just about everything in the book till they found this diagnosis. It's like everytime I see a new doc... It's like a vicious circle thats never going to end. I can't hardley take this anymore.

[Hoppy]

Show those reports to your primary doc to see if she can make heads or tails out of them.

[Stretch]

The stall does happen sometimes.

http://www.vawatchdog.org/09/nf09/nfmay09/nf052209-5.htm

An anonymous tip to the Veterans Affairs inspector general's office alleged that four managers told the clerks to delay the claims so that everyone could get the $300 bonuses. The inspector general's office confirmed that the employees delayed some benefits claims and five of the seven employees interviewed said they delayed the claims at their managers' request.

[Jayg]

If you're in a hurry, slow down. Listen to these people. They know what they're talking about and are telling you what you need to do, what will get you there.

But in a hurry? Forget it!!!

Got your attention yet?

Follow me here... I have been working on my claim since 2004 when I was last able to work. My second year I charged at it. Wrote letters, called congressmen and senators, went to ombudsmen and newspaper. (got my picture on the front page and an article about the VA system flaws.) I learned that everything, everything I tried to hurry things up did nothing but slow it down. Yeah I went bankrupt, almost lost my house. We eat beans & rice and a lot of cheap hot dogs. Life sux and then you die.

I have severe debilitating arthritis, I too have pain. Believe it. To date, I am only rated at 40%.

"Outright lie" They do that. Long and often.

They will sit on your file and do nothing no matter how often you implore them to advance your case. I recall once they sent me the letter concerning the 60 days to submit new evidence. I submitted the form for them to "advance my case I had nothing new to add" 5 times! I mailed it, faxed it, sent it certified, they did nothing. They sat on it unmoving for the full 60 days.

They have also falsified my C&P exams. The comment "Gait is steady" was followed by "cannot raise feet sufficiently to test gait." And another exam said "Gait is steady." followed by "rolls like a sailor with significant truncal shift."

Then in one SSOC, they reworded my claim and denied me on that basis. I of course had to file NOD, not once but several times. I'm still waiting for them to acknowledge this one.*(see comment about DRO hearing)

I had two enlistments, the first beginning in 'the 'Nam years but they insisted on saying I was a veteran of peace time. (that put me in a slower bracket as I understand it.) I finally got them to straighten that out anyway.

I filed for financial hardship consideration a number of times. It changed nothing if it didn't actually slow things down.

I have many times checked with the 800# to be told, your file is with a rater. There should be a decision in 8-10 weeks. Then two months later, it's been sent to a different rater, there should be a decision in 8-10 weeks... Then three months later, it's been sent to a different rater, there should be a decision in 8-10 weeks... This has happened 5 times in a row now.

Then it's "you requested a DRO hearing and it's with them. No one will make a decision until then. So when's the hearing I ask. "don't know. you'll be notified." I was... months later and more weeks to wait on an appointment.

FINALLY! I get a DRO hearing.

*He acknowledges the errors in the SSOC and said (off the record) he's accepting my IMO and granting my secondary conditions (that they have thus far steadfastly denied). He did want to order a couple C&P's- that adds more time of course.

Too bad the DRO said that 'off the record,' because now he's been transferred elsewhere, my file is "with a rater. There should be a decision in 8-10 weeks." :o Is this beginning to sound familiar? Now my file is going to be judged by somebody who has never seen me just like those who have been denying me right along. I can of course request another DRO hearing but that will take "at least another three months."

It's been 5 years and the end I thought might have been in sight, just got flushed down the drain. I would not be surprised if this is just another dodge and nobody really got transferred. Anyway, I've had those C&P exams. It's been 3 weeks since the first and I still don't have the report yet. AND my file is flagged for "financial hardship."

Now!

......Calm down,

...............slow down

and...listen to these people. They know what they're talking about!

If you're in such a hurry you can't do that, you might as well quit and go home now.

Frankly, I wish I could! Unfortunately, I can't.

You never know. They may get lucky and I'll die first. They keep hoping anyway.

Edited May 25, 2009 by Jayg