Nod And Cue

[pacmanx1]

Just curious, I was looking at my disability code sheets and noticed that it said I was awarded 10% for IBS in 1997 but I was not. I was service connected for acid reflux 10% until I filed a claim for IBS in 2005, when I was awarded 30% for IBS. Now there is no mention of the code of acid reflux on my code sheets just IBS. I currently have in a claim for EED of IBS since VA requested my hospital records and received them in 1997. I am not sure why they didn't award me the 30% as of 1997 at that time. When I filed for my claim for increase and VA awarded me service connection for IBS with the evidence they had to rule to change my rating codes, why didn't they correct the EED date on the evidence they were actually reviewing. I filed a NOD and a CUE, a NOD for the current claim and a CUE for the claim in 1997. Since VA changed the rating codes from acid reflux to IBS shouldn't this prove I had IBS in 1997 and it was greater than my acid reflux? Keep in mind that VA had hospital records and a doctor diagnosing me with IBS prior to my award in 1997. It actually gives the exact date I claimed for my EED of IBS. Basically what I see is VA said I had acid reflux in 1997, when I filed a claim for IBS, VA awarded me my claim for IBS and changed the rating codes from acid reflux to IBS. Since I had/have been having the same symptoms and the C & P doctor for my IBS stated that my IBS symptoms have not changed just gotten worse shouldn't 1997 be the actual effective date and not when I filed for increase? Yes, I know I filed for the increase years after my original award but the original award was never appealed and was final so that is the CUE, VA failed to awarded me 30% instead of 10% which cost me a lot of money. Now with the NOD since I was awarded and filed my NOD for the EED in 30 days it also requested that VA review my entire file to prove that VA had in its possession pertinent evidence that was not reviewed that showed I was diagnosed and treated for IBS prior to 1997. Keep in mind that I have both acid reflux and IBS. The regulation states; § 4.7 Higher of two evaluations. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned.

Any thoughts or comments, please be tactful & respectful not in mood for silly comment?

Edited September 7, 2009 by pacmanx1 (see edit history)

[carlie]

pete992,

I am going to hold back on any C&UE opinion at this time but

in reading your post I came up with a question.

Can VBA pay for both as separate conditions IBS as one and GERD as two

or would that be pyramiding. I question this because, yes it is the same

body system but the two do have some different symptomology ?

carlie

[pacmanx1]

no problem, VA will not pay for two conditions within the same body system that is why I posted part of the reg that states of the higher of two condition. I feel that VA should have awarded me for IBS in 1997 instead of acid reflux. I also agree that the symptoms are different but for some reason VA rated me for acid reflux when I specifically requested that they get my records from my doctor which they did at the time and he had diagnosed me with IBS

Also why would they change the rating code from 10% acid reflux to 10% IBS for the effective date without paying me

Thanks for the reply

Edited September 8, 2009 by pacmanx1 (see edit history)

[darkhorse]

Yor already 100%. There's no fish left to catch.

DH

no problem, VA will not pay for two conditions within the same body system that is why I posted part of the reg that states of the higher of two condition. I feel that VA should have awarded me for IBS in 1997 instead of acid reflux. I also agree that the symptoms are different but for some reason VA rated me for acid reflux when I specifically requested that they get my records from my doctor which they did at the time and he had diagnosed me with IBS

Also why would they change the rating code from 10% acid reflux to 10% IBS for the effective date without paying me

Thanks for the reply

[pacmanx1]

There is a difference in the money, did you read my post and understand something about EED. VA basically said I was awarded 10% for aid reflux and it was evidence that I submitted that they had in their possession that proved I met the higher rating at the earlier date. In other words VA will not pay me any more money monthly but I feel they owe me the difference between 10% and 30% for a number of years. If the evidence proved that I should had been awarded from my earlier claim I would not had to file an increase because 30% is the max for IBS. Also this is not a new claim it is a remand from a long time ago.

Edited September 8, 2009 by pacmanx1 (see edit history)

[darkhorse]

oh, ok I see now

Did your acid reflux turn into IBS? Just wondering since I have acid reflux

Dh

There is a difference in the money, did you read my post and understand something about EED. VA basically said I was awarded 10% for aid reflux and it was evidence that I submitted that they had in their possession that proved I met the higher rating at the earlier date. In other words VA will not pay me any more money monthly but I feel they owe me the difference between 10% and 20% for a number of years. If the evidence proved that I should had been awarded from my earlier claim I would not had to file an increase because 30% is the max for IBS. Also this is not a new claim it is a remand from a long time ago.

[pacmanx1]

No, acid reflux and IBS are totally different. As far as I know acid reflux can not turn into IBS, they have to be treated differently. Acid reflux is the esophagus and the stomach and IBS is the stomach and the intestines. They both cause problems with digesting food but as I had said I had been treated for IBS and acid reflux but the IBS caused me to be hospitalized several times before VA rated me for acid reflux and I don't know why. I think I read somewhere that acid reflux could cause cancer. So make sure you get treated. sorry had typo should be the difference between 10% and 30% with a combined difference between 20% and 40%.

Edited September 8, 2009 by pacmanx1 (see edit history)

[Berta]

I see what you mean as to the EED-

Does the original award contain the diagnostic code for the wrong disability? Is that your approach on the CUE claim?

http://www.va.gov/vetapp09/files3/0919318.txt this BVA decision shows the difference between GERD and IBS- definitely different disabilities- this vet got 60% but I am surprised the BVA did not give her extraschedular consideration and that could warrant 100%,

[pacmanx1]

Yes, 7346 was my original Service connected code from VA they completely ignored my records from my PCP at the time. I specifically asked VA to get my records which they did but the combined issue of having IBS and GERD was not applied. Now the code has changed to 7319, I can prove in my records that I had both acid reflux and IBS. I also can prove that I was hospitalized several times over the years with the same conditions. I did not know that VA could actually combined the two conditions and give a higher rating. All I was asking for was that, I felt that my IBS was the dominant condition but reading this award I met the combined 60% rating under the 7346. Since VA has to review my entire records and all the evidence at hand let's see what will happen.

Thanks Berta this is a great help to me.

[carlie]

Pete992,

Do you have handy what they stated in the Reasons and Bases Section

of the 1997 and the 2005 Rating Decisions ?

carlie

[pacmanx1]

It could take me a few days to find all of this, I only have the code sheet from 1997 telling me the code of 7346 GERD and the new code telling me that it is now 7319. I told myself to dig that stuff out but I did not think I needed it at this time. I will have to get back with you.

Separate note: Thanks for the information on the NeilMed (Sinus Rinse) at least I think it was you that recommended it to someone. It has helped me a little

[carlie]

It could take me a few days to find all of this, I only have the code sheet from 1997 telling me the code of 7346 GERD and the new code telling me that it is now 7319. I told myself to dig that stuff out but I did not think I needed it at this time. I will have to get back with you.

Pete992,

Yea, your more likely than not going to need all of that exact information from the

Rating Decision's and it can help us try to help you. That's will be the out;ine needed

to form your fight.

Separate note: Thanks for the information on the NeilMed (Sinus Rinse) at least I think it was you that recommended it to someone. It has helped me a little

Did you get the squirt bottle or the NediPot ?

Do you do better with cool or warm ?

carlie

[pacmanx1]

I still plan to look for the actual ratings but My claim has already been to BVA and has been remanded back to the RO for reconsideration. The board felt that I had successfully filed my CUE claims and they remanded several of my claims and ordered the RO to look at other claims that were never certified to the board. I was just surprised to find out that VA changed the rating codes but basically said I was 10% for IBS instead of 10% for acid reflux in 1997 and not 30%. DOCKET NO. 06-29 381, VA is reviewing a number of my claims this is just one of them. The ball is in their court, I have had all my new C & Ps. I am just waiting on the next rating decision to see what they say.

I have only used the squirt bottle with warm water

[carlie]

Pete992,

OK - do you have a link to your BVA Appeal ?

carlie

[pacmanx1]

I think this is it. I know I had posted this before

www.va.gov/vetapp08/files5/0845064.txt

[carlie]

Pete992,

Thanks. You probably posted it earlier but I didn't know.

TY.

carlie