Secondary Condition Or Not

[betrayed]

Thanks to this board and the people on it I have

learned that there is a real good probability that my vertigo is a secondary condition caused by

my herniated disc in my cervical spine. http://www.hadit.com/forums/index.php?showtopic=2798&hl=

So my question is, am I better off trying to pursue the vertigo as a secondary condition or as a seperate issue? Both are currently rated at SC 0%

:) B) MORONS

[Guest Morgan]

I might not have understood your question, but if you are asking if it is better to have a manifestation of a disabling symptom rated separately, the answer is yes. Always point a symptom toward a separate diagnostic code when one applies based on your medical evidence. You can bet the VA is going to lump conditions any time possible, so go on the offensive in your claim. If you simply list symptoms, or even list medical statements (sometimes they sound like just a list of symptoms, or hearsay from the claimant) without rationale to support a rating as a secondary condition, it will be left to VA discretion where to plug in that symptom.

Dizziness is one such symptom; it can manifest in many conditions. In certain manifestations it is insignificant, while in others it might push the rating higher. For instance, lay people may refer to dizziness, but the medical record may show vertigo, or even synscope. This is why it's important to know the rating criteria that applies to your condition and why the criteria or manifestation of certain symptoms or signs guide the VA toward deciding your condition is more disabling. (Well, that's the theory anyway. But we all know they don't know that, and besides, some of them don't know how to read.)

A secondary condition is a separate condition and is considered SC. The interesting thing is the rating for a secondary condition can meet criteria for a rating increase without the primary condition doing so. In such instances, it's important not to allow VA to lump together compensable conditions as if one is a mere symptom of another. Also a certain manifestation may help meet the critieria for an increased rating for one diagnostic code and not for another, so be sure to know what is causing it. I'm dealing with this now in my husband's claim. Hypertension has caused severe renal dysfunction that meets the 100 percent criteria--not due to need for dialysis but because of cardiovascular involvement that precludes more than sedentary activity. (Either of these manifestations rate at 100 percent.) But the VA lumped the renal dysfunction with DMII at 20 percent, saying it is commonly related to DMII. That's true; however, he had hypertension-related renal dysfunction long before the VA diagnosed DMII. No matter, I still can't get them to change the rating. Even sent a copy of the rating schedule for DMII that clearly says renal dysfunction should be rated separately if an organ system is involved. I NODed, but they have denied again.

Hypertension is another one to watch closely for secondary conditions. VA rates hypertension based on readings on medication. BP must increase significantly to go from 20 percent to 40 percent rating, yet the BP readings that meet the criteria for 20% can cause a stroke or heart attack. Heart or renal damage secondary to hypertension can go to 100% without the hypertension rating changing. Even the medications to control HBP can cause secondary conditions, such as erectile and renal dysfunction. And hypertension can seriously aggravate and complicate the management of other conditions totally unrelated to cardiovascular system disease. Such as conditions that cause chronic pain. Most pain medications increase the BP so cannot be prescribed. But don't get confused and say the pain makes the BP go up (thought it does). The knife doesn't cut that way. :) Aggravation is for SC aggravating NSC conditions, not NSC aggravating SC conditions.

Also, the key to remember with claims is how the different manifestations of disease affect you in the workplace.

[Hoppy]

FLHRCI,

It is possible that vertigo associated with tenitus is generally less severe than vertigo associated with a disc problem. It could be vice versa. Try to understand the medical principals. The rating you found for 60% is pretty high. Is there a rating that high associated with tenitus. Another word you can search is "ischemia".

[Hoppy]

FLHRCI,

I did some ischemia searchs and got to much information. It is a general word used to describe loss of blood flow. I get positional ischemia. My neck gets out of wack and compresses the cervical arteries. The dizzyness get rather extream. It happens when I am trying to change the oil on my car. It got to the point where I will not get under a car for any reason. A funny thing about the way the VA rates disability is they count episode during a time period. I could never figure this out. In my case the best way to not have episodes is not to work. Thus, being unemployable causes me not to be disabled because the VA counts episodes. Episodes deminish when I do not work. Its a catch 22. The VA never really dealt with this on two of my claims. They have an option to do an extra schedular rating. Maybe they threw all the possibilities into the mix and rated me. Maybe they counted the number of episodes during a time period when I tried to work.

[betrayed]

You can bet the VA is going to lump conditions any time possible,

A secondary condition is a separate condition and is considered SC. The interesting thing is the rating for a secondary condition can meet criteria for a rating increase without the primary condition doing so. In such instances, it's important not to allow VA to lump together compensable conditions as if one is a mere symptom of another.

Dizziness is one such symptom; it can manifest in many conditions. In certain manifestations it is insignificant, while in others it might push the rating higher. For instance, lay people may refer to dizziness, but the medical record may show vertigo, or even synscope.

They already did this to me the lumped my vertigo in with tinnutis

This is why it's important to know the rating criteria that applies to your condition and why the criteria or manifestation of certain symptoms or signs guide the VA toward deciding your condition is more disabling.

I do understand this and under my understanding I beleive I qaulify for

Cervical Spondylosis at 60%

Menieres disease at 60 %

Peripheral vestibular disorders at 30 %

I can tie the vertigo the Cervical Spondylosis as a secondary condition and bolster my evidence for Cervical Spondylosis

Or I can push the vertigo as Menieres or at a minimum a Peripheral vestibular disorder

Which way is best?

Still Confused, of course the drugs keep me that way :)

[Guest Berta]

If you have medical documentation stating the Meniere's as well as evidence to tie the vertigo in with your

spondylosis-I would claim both as potentially causing this.

A claimant can submit evidence to support any logic behind service connection and use two or more approaches-

for example-

vet has 50% PTSD and DMII-

The VA rates the DMII at 20% in 2002.

The vet also has atherosclerotic heart disease which he never mentioned in his DMII claim.(although his med recs show it but the VA doesn't look for anything not claimed)

Then his private doctor tells him that the atherosclerotic heart disease ,with his HBP,is more than likely due to the DMII.

Then his shrink also tells him his PTSD is causing him so much anxiety and anger outbursts that it must defintely be contributing to his HBP.

The veteran could claim not only that the SC DMII has caused his HBP and heart disease but that his PTSD has substantially affected it too-

Say this vets private doc dies before he can give a full medical opinion on the DMII and heart disease-

The vet could ask the shrink (if they are a psychiatrist) for an IMO to support the PTSD to HBP- heart connection in his situation as well as

submit the latest study from Dr. Boscarino on that.

The VA recognizes the significance of DMII in causing atherosclerotic heart disease. He could submit their own training letter on that whether he has an IMO or not.

[carlie]

How ever you go about this, be sure not to be pyramiding any of your conditions

or you'll get knocked out of the ball park down the road.

Only my opinion,

carlie