Results Of Initial Claim

Raybob · July 13, 2010

I just retired on Jun1, 2010 after applying for C&P determinationin Dec 2009 under the Benefit Delivery at Discharge (BDD) program. My C&P exams were all done in Feb 2010. Overall, I was pleased with my 90% rating and do not compalin at all about such a beneficial rating.

However, there are some claims they said were NOT SERVICE CONNECTED (SC) but they are 100% issues contained in my Service Medical Records (SMRs) when I filed my claim. All of them are supported by multiple visits to service medical doctors for the related issues while I was on active duty.

My question is; Should I go back to counter these as truly being SC? or just let them go because overall they will have little effect on my overall current 90% rating ( I probably wont get enough to reach 100%).

These include:

1. skull loss (due to removal during two surgeries ((but only one when I first filed my claim))... VA states no skull loss, but my surgery transcript clearly states skull removal as a part of the surgery.

2. irritable bowel syndrome (multiple visits to doctors from 2005 to 2009 together with Xrays, MRIs, prescriptions, etc)

3. sciatica (specifically indicated by military doctors on multiple occassions)

There are also other issues but I find them acceptable as not being sometthing to link to military duty (such as skin/displastic nevus issues, Vitamin D defficiency, etc) although they also did occur and got treated while I was on active duty.

I am OK with at least the IBS and Sciatica being non-compensable because the sysmptoms occur infrequently... but the skull loss is documented and that wont change...

But I would at least think that the VA might show them as SC at a zero percent in the event I have future issues with them... all history and symptoms occurrd while on active duty.

Should I be satisfied with the 90% and just leave well enough alone, or should I go back to appeal these particular findings? What do I focus on in my rebuttal when they already have everything in my SMRs?

Thanks for any advice.

Cheers,

Ray

*Bergie* · July 13, 2010

I just retired on Jun1, 2010 after applying for C&P determinationin Dec 2009 under the Benefit Delivery at Discharge (BDD) program. My C&P exams were all done in Feb 2010. Overall, I was pleased with my 90% rating and do not compalin at all about such a beneficial rating.

However, there are some claims they said were NOT SERVICE CONNECTED (SC) but they are 100% issues contained in my Service Medical Records (SMRs) when I filed my claim. All of them are supported by multiple visits to service medical doctors for the related issues while I was on active duty.

My question is; Should I go back to counter these as truly being SC? or just let them go because overall they will have little effect on my overall current 90% rating ( I probably wont get enough to reach 100%).

These include:
1. skull loss (due to removal during two surgeries ((but only one when I first filed my claim))... VA states no skull loss, but my surgery transcript clearly states skull removal as a part of the surgery.
2. irritable bowel syndrome (multiple visits to doctors from 2005 to 2009 together with Xrays, MRIs, prescriptions, etc)
3. sciatica (specifically indicated by military doctors on multiple occassions)

There are also other issues but I find them acceptable as not being sometthing to link to military duty (such as skin/displastic nevus issues, Vitamin D defficiency, etc) although they also did occur and got treated while I was on active duty.

I am OK with at least the IBS and Sciatica being non-compensable because the sysmptoms occur infrequently... but the skull loss is documented and that wont change...
But I would at least think that the VA might show them as SC at a zero percent in the event I have future issues with them... all history and symptoms occurrd while on active duty.

Should I be satisfied with the 90% and just leave well enough alone, or should I go back to appeal these particular findings? What do I focus on in my rebuttal when they already have everything in my SMRs?

Thanks for any advice.
Cheers,
Ray

Only you can decide whether to file a NOD, but keep in mind YOU earned the benefits. You have a year from the date stamped on your SOC, what you can do is get a secondary diagnosis from another doctor and submit that evidence. Also, you might make copies of all the doctor notes pertaining to the IBS and bone loss in your skull and submit them. What I do is use a 21-4138 and list each item I'm submitting along with the number of pages for each item. This lets whoever at the VARO know you have this many items of evidence and each item has this many pages. You have to make it as easy as possible for these people if you want to win.

Hope this helps,

Bergie

Notorious Kelly · July 13, 2010

Raybob,

Thank you for your service.

I don't know the How, but I would definitely fight it.

The decision needs to match the facts.

Philip Rogers · July 13, 2010

I agree w/Kelly!!! Get them changed now, as you may have more problems later and it will be much harder, to change, then. Plus, the difference, financially, between 90% and 100%, is substantial. jmo

pr

halos2 · July 13, 2010

Put in a NOD with Denovo review and you can request a DRO review and can ask for a personal hearing if you want to present evidence to the DRO in person too. Put in for TDIU as you can't work anymore too,right?

Time is money, and waiting makes you postpone getting more $. Any other evidence you may have that has not previously been submitted should be submitted here now too. Denial of skull portion is ridiculous. But we are talking about the VA raters/representatives who frequently miss imoportant things first time around.

Edited July 13, 2010 by halos2

Commander Bob · July 13, 2010

I just retired on Jun1, 2010 after applying for C&P determinationin Dec 2009 under the Benefit Delivery at Discharge (BDD) program. My C&P exams were all done in Feb 2010. Overall, I was pleased with my 90% rating and do not compalin at all about such a beneficial rating.

However, there are some claims they said were NOT SERVICE CONNECTED (SC) but they are 100% issues contained in my Service Medical Records (SMRs) when I filed my claim. All of them are supported by multiple visits to service medical doctors for the related issues while I was on active duty.

My question is; Should I go back to counter these as truly being SC? or just let them go because overall they will have little effect on my overall current 90% rating ( I probably wont get enough to reach 100%).

JMHO. Yes. Remember you have until Dec, 2010, to file a "Notice of Disagreement" NOD.

Berta · July 13, 2010

Are you employed?

If not what did the VA state as to why they did not consider you for TDIU (Total Disability due to Individual Unemployability)

"skull loss (due to removal during two surgeries ((but only one when I first filed my claim))... VA states no skull loss, but my surgery transcript clearly states skull removal as a part of the surgery."

Geez-

was the surgery done in service? Does this have a direct inservice nexus?

If you retired in June 2010 this should certainly be something that stems from your service. ????

"2. irritable bowel syndrome (multiple visits to doctors from 2005 to 2009 together with Xrays, MRIs, prescriptions, etc)

3. sciatica (specifically indicated by military doctors on multiple occassions"

How the heck did they miss this stuff in your SMRs???)

If I were you I would ASAP ask them to reconsider their decision. Tell them of these 3 disabilities they ignored ,refer them to the SMRs and attach copies of the SMRs themselves.

If you are unemployed I would also refer them to -with the reconsideration request- a TDIU form.

Does the decision state why they didnt consider you for TDIU?

What was the brain surgery for?

You are roight to get at least a "0" rating as SC for anything that could eventually get worse.