1151 Denial

[LeroyJohnson]

After years of waiting I finally got a denial on my 1151 claim today. The denial was based on the fact that I had a cataract that caused loss of vision prior to surgery and the fact that I am now permanently blind in that eye they said there was no increase in disability since I had no vision because of the cataract prior to its removal and no vision now therefor no increase. I almost laughed at their reasoning. A cataract is not a permanent eye condition but what I have now at their hands is. Oh well what else is new with them. Have a NOD written and will send it in Monday. This is one fight I will not let go of. I know there are BVA cases where veterans have had cataract surgery and became blind from the surgery and won guess I will have to look them up again .

can someone tell me what wording I should use when sending in BVA cases as part of my evidence want to make sure I do it right.

Thanks Leroy

[LeroyJohnson]

Yes they pretty much dismissed Dr. Bash's IMO stating that he was a not a eye specialist that his specialty is radiology. In my NOD I am pointing out that even though Dr. Bash is a radiologist he is a certified doctor and as such is aware of what the standard medical community considers to be expected as a complication of cataract surgery and therefore his opinion should not be summarily dismissed. I have not contacted him yet but I am sure he will do a rebuttal on the subject this is the second time his opinion has been shot down by the raters in my claims in a other claim I have he gave an opinion and they shot it down based on the fact that he had not physically examined me. He will rebut that if and when I can get them to send me a complete copy of my C-file. I have requested it three times in the last 6 months for Dr. Bash.I also summited a IMO from a private eye doctor that I had back in the 90's and who was appalled by what the VA had done to my eye. Again they fluffed over his statement stating that he examined the retina and did not note any abnormalities he stated that the shape of my eye had become distorted. seems to me that is an abnormality.

I expect it will take a lot of work to get them to see that even though the pre-surgery level was light perception only and what I have now is light perception only without improvement possible are not the same thing. One was an improvable condition and the other is not.

Sorry Berta kinda feeling bummed out by this I know it is doable thing just not seeing how I can do it.

Leroy

(I wont give up on this just really bummed out)

[bigvic]

Hi Leroy, Please hang in there you are very close to proving your point just think of the best way to word your response to them. If they want to act like twelve year olds then treat them like twelve year olds. But make sure you prove your point. I know about getting bummed out it often happens to me six or seven times a day and I become uneffective and cant think straight but I also realize that a lot of how I feel is from the meds I take also so I just have to fight throught it...

[LeroyJohnson]

Thanks Bigvic wording is everything. I hit me as I set over the weekend bummed out by this. and I re-read the denial several times.

Berta and all I am going to write the last sentence word for word for and ask for your opinions.

"It is true that your current visual acuity is worse than that following the cataract surgery, however, it is no worse than the visual acuity shown prior to cataract surgery. As findings presently show no increase in disability over the pre-surgery level, entitlement to compensation under 38 USC 1151 is not warranted.

OK, now all of that is true to a point,and that point is "pre-surgery Level" was light perception only due to a cataract that condition was operable and it was reversible. As is shown in the records I had vision right after the surgery. NOW the light perception only visual acuity I have is non-operable it is permanent.

Is that not concidered a increase in disability to go from reversible to permanent in nature.

[bigvic]

I'd say that is a increase in disability!!! It's been operated on and worse in my book. Question? Why are you explaining to them that it worsened after the surgery and that they are relying on faulty data to make decisions about a situation that is now worse.... treat um like they are kids remember....

Bigvic

[Josh]

LeRoy,

You have a complex sentence to disect there but it appears what they are saying is that the decrease in vision was due to the "natural course of events."

Josh

Edited May 2, 2006 by Josh

[Berta]

Leroy- I thought they put in faulty lens?

You mentioned that they have not sent you your c file yet????

This is why I always say get copies of the c file before you file a Sec 1151 charge-

I would again ask for the file since they gave you a decision and they might send it now-

you also mentioned opinions in another post that it seems they have overlooked- they have to consider them all-

I would push them via the query system at the VA web site- for copies of your c file-

send it to attention of the Director-and say how many times you requested them and never received them-

It seems that Dr. Bash didnt have them-when he gave his opinion-they will hold this against a 1151 claimant-

and can knock down any IMO when the IMO doc doesn't have the c file.

The complete c file could reveal to you more than you thought-takes time to find it all- but worth the effort-

please clarify- I thought they put in the wrong lens and this contributed to your problem.