Appeal Certification

[Lee_USAF]

Filed claim in March 2009 - Denied; Submitted NOD electing de Novo review and had my DAV Rep request conference with DRO. Never got the conference and the original denial was upheld. Claim was for amendment of original rating of Cardiac Arythmia (PVC) to Mytral Valve Prolapse and service connection for Stenosis of 3 coronary arteries of 50 - 60 percent.

Submitted VA FORM 9 and received letter "Substantiating" my appeal in November 2007. Hasn't moved since. Meanwhile, submitted additional medical evidence of Stent implants (2) in Aug 2007, and received Supplemental Statement of the Case (total of 1 form original AO and two from DRO.)

No one can/will tell me why my case is still in DRO. AMC doesn't even know me, thus my appeal has not been sent there nor has the Board of Veteran Appeals received anything on my "Substantiated Appeal."

Any ideas/suggestions?

[Lee_USAF]

My original DIC claim started out as cardiology claim.That claim took over 3 years for award.

The VA was relentless in telling me that I was not competent enough to give lay medical testimony and evidence.

I did prove that case.

But these days it is usually too difficult for a vet to do this on their own-

I spent month after month studying cardiology and autopsied hearts etc-to get that claim resolved but I missed something-because I am not a doctor.

Similiar BVA cases make no difference to VAROs because the medical info is only specific to the BVA vet's claim.

What I missed in that older DIC claim was something I found at the very last minute.

I had re-opened for cause of death, had 3 IMOs and had just paid more money for a cardiology IMO-and found the most single overwhelming piece of evidence that I should have found sooner-

it was the only word in the autopsy I never looked up for over a decade-

My award came perhaps before the BVA even got this evidence-

although I sent it to them right away-

I hope you can get a good IMO here- because IMO docs know just how to take claims like this step by step and can determine chronicity.

Also they read the evidence carefully- this is one point the BVA made in my award letter- that the IMOs I had were based on careful study of all available med recs.This is what the VA means by having a full medical rationale.

When an IMO doc can give a full medical rationale that favors the claim -the VA usually has no way to combat the opinion.

I take it (Sorry but it's been over 16 years since I retired) "IMO" is Independent Medical Official, right? My cardiologist has given a medical opinion, as did two of the other civilian Cardiologist. All three stated it was their medical opinion that my cardiology problems were Mytral Valve Prolapse with Mytral and Tricuspid regurgitation. However, the "ejection fraction" is within normal, thus the VARO denied that part. I must add, theey accepted my "request to amend original rating from Cardiac Arythmia to MVP" was approved, but maintained at the original rating. Every BVA ruling I have researched (16) on MVP, CAD, Atheroscorlosis (sp), the verbiage for the diagnosis are very similar to my Cardiologist.

I never saw a Cardiologist my entire 22 years in service. Was never told I had any problems until I begin having chest pains and palpitations. Repeated trips to clinic resulted in "You're overweight and out of shape." Changed my diet to poultry, fish and veggies, started running and returned to Martial Arts. Maintained my weight as previously stated until my kness got worse.

My current appeal is already 3 years old and has sat in DRO office for almost 2 years (November 07) with no explanation. I've been to BVA before - took almost 5 years - and I am beginning to believe VA is waiting for me to die, thus my appeal becomes moot and my wife looses DIC because basis for my appeal, my CAD and MVP, are dropped due to my death.

You people on here are super and I really appreciate your help and support. Wann represent me at St Petersburg VARO? I'm ready to fire the stupid NSO I have.

[Berta]

Did the Cardio docs give a nexus statement?

This is critical to claims like yours.

A nexus statement can rule out any other cause or etiology but for in-service events as primary manifestations of this type of disability.

Did they refer to any medical texts, treatises or abstracts stating this type of heart disease can take years to develop and is consistent with reported inservice events?

Please read my posts here under IMO forum-"Getting an Independent Medical Opinion"

I assume the VA gave you a NSC rating.

What is their NSC rating percentage and what rating codes did they use?

[carlie]

Wann represent me at St Petersburg VARO? I'm ready to fire the stupid NSO I have.

Lee USAF,

I also am at St. Pete VARO. Have I said today, St.Pete VBA sucks!

It's a really tough VARO.

Just putting St.Petersburg VARO into the BVA search engine

or checking out their Monday Morning Workload Report's is mind blowing.

jmho,

carlie

[john999]

I am in the process of waiting for my CUE claim to be certified to the BVA. The VARO says they got our form 9 in April and are reviewing my file to certify it to the traveling board when that is set up. I am using a lawyer. I advise those with tough claims to get a lawyer if you are eligible. The Claim sits at the VARO until it is certified to the BVA. This could take a long time, but my lawyer says we will win. If we win I get money. If we lose I get a case of the ass. Forget these VSO's if you are in your appeals. See if you can get a lawyer to help you unless you are really up to the fight and know what you are doing. The VA is going to bust your &^%%$ no matter what happens.

[Lee_USAF]

Did the Cardio docs give a nexus statement?

This is critical to claims like yours.

A nexus statement can rule out any other cause or etiology but for in-service events as primary manifestations of this type of disability.

Did they refer to any medical texts, treatises or abstracts stating this type of heart disease can take years to develop and is consistent with reported inservice events?

Please read my posts here under IMO forum-"Getting an Independent Medical Opinion"

I assume the VA gave you a NSC rating.

What is their NSC rating percentage and what rating codes did they use?

That is where in my biggest obstacle lies. CAD was not addressed in my initial retirement exam. High cholesterol was not addressed. According to the rating subsection that covers high cholesterol, the Veteran must specfically address and request consideration for high cholesterol/lipd levels.

Again, I remind you...I was totally unaware of any elevated lipid levels or cholesterol problems until my first exam by a cardiologist. I never saw a cardiologist while on active duty inspite of my repeated (and rather vehement at times) requests for the same. I was called on the carpet by the hospital administrator for my repeated visits and requests for consult to cardio and informed that my continuing to "waste the time of his medical staff" would result in his requesting my CO take non-judicial action against me. Even recommended my seeing a shrink.

[Berta]

"I never saw a cardiologist while on active duty inspite of my repeated (and rather vehement at times) requests for the same. I was called on the carpet by the hospital administrator for my repeated visits and requests for consult to cardio and informed that my continuing to "waste the time of his medical staff" would result in his requesting my CO take non-judicial action against me. Even recommended my seeing a shrink. "

Is there any documentation at all of any of above-

the hospital visits would have to be documented wouldn't they?

If I were you I would attempt to locate the hospital administrator as well as your former CO and anyone else who could possibly render a buddy statement for you- to prove that you had sought medical help.

Your former CO might well be a disabled vet himself by now- understanding fully what the VA claims process is all about.

Other then that I still suggest that you get an Independent medical opinion that somehow can support the inservice nexus factor-relying on medical documentation that would support a cardiac condition like yours as being longstanding enough to have begun in service.The IMO has to rebutt any attempt by VA to say chronicity did not occur.

"Claim was for amendment of original rating of Cardiac Arythmia (PVC) to Mytral Valve Prolapse and service connection for Stenosis of 3 coronary arteries of 50 - 60 percent."

I assume the stenosis factor was results of an ECHO test?

Can you give us the BVA citation and docket numbers?