Polycythemia Vs. Polycythemia Vera

[vaf]

My husband was diagnosed by a civilian doctor with polycythemia as a secondary outcome of use of a medication to treat a service-connected condition. The VA examiner opined that the condition was at least as likely as not related to use of this medication for the service connected condition, so she triggered the doctrine of reasonable doubt. However, the VA denied the claim, stating that polycythemia vera is a ratable condition, whereas, polycythemia is "a laboratory finding" and not a ratable condition (there was no additional explanation as to how they reached this conclusion). I'm writing a request for a DRO review, thinking that polycythemia should have been rated analagously to DC 7704 (polycythemia vera, a more serious form of polycythemia). Does this sound like a credible defense, or am I overlooking some other strategy that might prove more useful?

Polycythemia has not been considered in any previous claim, so it has not received any rating consideration as part of another service-connected condition.

All feedback welcome, thanks!

[David L Sorrell]

Greetings VAF SR. chief PO -

I was diagnosed around 2006 with PV by a oncology diagnostic specialist brought in by the local VA. Since then, the VA has tried to downgrade the diagnosis and refused to do any more treatments after 2.5 years of warfarin and phlebotomies.. Should I suspect alterior motives here? I'm currently being reviewed by the VBA for the 4th time for disability due to the toxin and dioxin exposures. I ain't giving up. I worked for NASA for more than 5 years and had to resign due to this illness. Have more to say but, would appreciate a response from you on this.

thanks for your caring,

Dave Sorrell E-4 USAF 1970-1974

[Berta]

By VBA do you mean these were denials from a regional office or have you had denials from the BVA?

Is the 10% you get now from the PV?

"I worked for NASA for more than 5 years and had to resign due to this illness."

Did you apply and receive a SSDI award at that time solely for the PV?

Can you scan and attach here ( cover C file number, name etc) the last VA decision you received as to the "Reasons and Bases " Part and also the evidence list.

You claim cause of the PV as

"for disability due to the toxin and dioxin exposures. "

If by dioxin, you mean AO, this wont fly with the VA.

If you have medical proof (such as an IMO) that gives a full medical rationale that toxins in service caused the PV, and if you have proof of your direct inservice exposures to those specific toxins, then you have a chance to gain SC for this,

or an IMO might gain you a higher rating, if the 10% you have now is a service connected rating for the PV.

 

[Berta]

Also here are 2 recent BVA decisions regarding this disability :

http://www.va.gov/vetapp15/Files6/1546569.txt

http://www.va.gov/vetapp15/Files6/1547424.txt

In one the veteran successfully got COPD Sced, and then the PV SCed as secondary to the COPD, and in the other it is obvious why that PV claim failed.

 

[sharon]

Take the rating to the doctor and see what he has to say about it. Polycythemia can have different causes than Polycythemia Vera. In order to diagnosis Polycythemia Vera there has to be more test than blood. I am not sure what they are, but I think there are ex-rays.

[vaf]

Take the rating to the doctor and see what he has to say about it. Polycythemia can have different causes than Polycythemia Vera. In order to diagnosis Polycythemia Vera there has to be more test than blood. I am not sure what they are, but I think there are ex-rays.

We agree that my husband doesn't have polycythemia vera, just polycythemia in its lesser form, and the VA agrees. There doesn't appear to be any challenge to that. What I'm asking about is whether the reg on analagous ratings should have kicked in. I don't understand how the VA can say yes, he has polycythemia, and yes, we agree it's connected to his medication for a service connected disability, but since it's just a lab finding (without any explanation or documentation to back that up), the VA refuses to rate it. Polycythemia can be life threatening if left untreated (the same goes for polycythemia vera).

[Ricky]

First what drug and SC condition did the civilian doc relate this to?

Second in order to gain any hope of an analagous rating he would have to have a disability that is associated with polycythemia. What they are telling you is that the medical community does not know the exact cause of secondary polycythemeia and unless there is a disability caused by it, it is not ratable per cfr 38 part 4.

The below is a statement from a medical dic:

Causes:

The precise cause of secondary polycythemia is unknown. There are no apparent genetic or environmental factors that can be attributed to causing polycythemia.

As to the reasonable doubt it is assumed by the VA that it does not apply as they did not give any weight to your civilian doc's statement (I guess he did not provide a strong enough rational) due to the medical community's stance, therefore, the use of reasonable doubt is not necessary.

You are going to have to get the civilian doc to provide a very strong rational as to why he believes it is due to drugs being used to treat the SC disability. Then you are most likely going to have to show that although it is not

polycythemia vera your husband is going to need at least one of the items required by cfr 38 part such as treatment with myelosuppressants, phlebotmoy or continuous medication to treat his specific disability.

Just my opinion and I hope it helps you. Good Luck