Need Help!

[jessie0054]

Need help on what to do to stop the Va from cutting my son's benefits

He is receiving benefits for service connected Polycythemia Vera. Currently at 40% for having to have monthly blood draws and phelbotomies. The Va said that since his blood levels have been in the normal range for the past 4 months ne no longer has PV. How can they determine this as there is no cure for Polycythemia Vera. One you have it you have it for life. Do they not understand the disease?? It go's in to a remission state with repeated phelboties to get the level back to a normal levels and can stay in remissions for as long as treatment continues. Without the treatment the symptoms will come back along with the risk.

What can we do?

Thanks Jessie

[Philip Rogers]

I think he has 30 days to request hearing, which can briefly frostall the reduction. But whatever it is watch those deadlines.

pr

[carlie]

You can fill out this printable form to make your submission.

It is not mandatory to use this form- but VBA will probably acknowledge it easier.

http://www.vba.va.go...21-4138-ARE.pdf

As sharon posted the rating criteria must be met.

Anything less than that - will not work.

I would attempt to get an opinion or a note placed in his VAMC Progress Notes

that he continues to meet this criteria and a list of when he has had his phlebotomy's.

Also - is any consideration needed in regards to additional conditions that are covered

in the NOTE ?

Sec. 7704 Polycythemia vera:

During periods of treatment with myelosuppressants and for three months following cessation of

myelo suppressant therapy.. 100

Requiring phlebotomy... 40

Stable, with or without continuous medication.. 10

Note: Rate complications such as hypertension, gout, stroke or thrombotic disease separately.

[deltaj]

Need help on what to do to stop the Va from cutting my son's benefits

He is receiving benefits for service connected Polycythemia Vera. Currently at 40% for having to have monthly blood draws and phelbotomies. The Va said that since his blood levels have been in the normal range for the past 4 months ne no longer has PV. How can they determine this as there is no cure for Polycythemia Vera. One you have it you have it for life. Do they not understand the disease?? It go's in to a remission state with repeated phelboties to get the level back to a normal levels and can stay in remissions for as long as treatment continues. Without the treatment the symptoms will come back along with the risk.

What can we do?

Thanks Jessie

There are regulations found at 38 CFR 3.343 and 38 CFR 3.344 that pertain to reduction. I agree with Philip that your son needs to request a hearing in writing on the proposed reduction. I also think you need to immediately appoint a representative like DAV to help appeal this reduction. The notice that V.A. is giving you of the reduction is the 60 day notice of reduction found in 38 CFR 3.105 (e). One thing that could help your case is a quick medical opnion from a doctor that this veteran still has this medical condition and that the condition fits the criterion for his current rating according to the rating schedule. You need to become familiar with the rating schedule for this condition found in 38 CFR Part 4. There may be some medical treatise information online that indicates that this condition has periods of remission that you may be able to submit as new and material evidence to V.A. Your state may also have a state medical library where you can obtain copies of this sort of evidence. Be careful that what you submit as evidence is listed in your son's appeal and is favorable to his appeal of the reduction.

Edited March 15, 2011 by deltaj

[jbasser]

Within the scope of the VA ratings system, proposed reductions are always looming their ugly heads around the corner.

If a condition stabilizes, then they will propose to reduce the rating to the lowest allowed by law. In this case they will reduce it to 10 percent as they are saying is has stabilized.

What you have to do is show evidence to the contrary. Does he have any secondaries that are associated with this disease?

Remember they are not trying to sever service connection, they are trying to reduce. Does your son fall under any protection rules?

Hang in there.

J

[carlie]

Borrowed from elsewhere.

"10/20 Year Service Connection/Ratings Protection

The 10 year mark for is for service connection.

A condition that has been service connected for 10 years can not be severed unless fraud is involved. The clock starts ticking for conditions based on the effective date(s). This does not mean compensation can't be reduced.

The 20 year mark protects ratings.

Absent fraud, disability ratings can not be reduced after they have been going 20 years. See your award letter for effective dates on each disability. Combined ratings are also protected after a 20 year period.

Example: You have been rated 50% for Condition A since 1990.

You apply for SC for 4 more conditions and VA grants them in 2007.

Because of VA granting them your new combined rating is 100% as of 2007.

Condition A is protected from severance in the year 2000 and protected from reduction in the year 2010.

The new service connected conditions would be protected from severance in 2017 and reduction in 2027.

The clock started ticking on your combined 100% in the year 2007 so it would be protected from reduction in the year 2027.

If you apply for an increase for Condition A and are bumped from 50% to 70%, the 50% number is still protected from 1990 but the new 70% would start a new clock ticking (using the dates above).

Meaning until you have held that 70% rating for 20 years, the lowest they can reduce you is back to 50% based on the fact that it was in effect for 20 years. Even if a rater plugged the wrong numbers and wrongly awarded a combined 100%, they still can't reduce.

Again, this is all assuming no fraud is involved.

You can do the math by using the effective dates on your award letters. "P&T" can be established at any time regardless of how long ratings have been held (via 100% scheduler or TDIU).

If VA plugs all of your conditions and there are no future exams scheduled,

then entitlement to Ch. 35 and ChampVA will be granted.

If VA determines that there is a chance of improvement, there will be a future exam scheduled and "P&T" will not be established."

[jessie0054]

Don't get to excited you need to appeal but if it was me I would start talking to some Doctors. Good Luck. I wish I knew more about this condition but I will pray for you and your son.

Thanks Pete53!!