hypertension Ro Remand Decision

[Charleese]

Hi all,

My husband had his C&P exam on May 11, 2011 for his Left SC Knee, SC Neck that BVA granted him, lower back disability and TDIU. BVA remanded his claim back to RO for vareious issues as well as these 3 things. The exam also was 1 exam for these 3 things.

Today he received from RO a SOC & SSOC for the other various issues.

SOC stated that (1) SC for hypertensive heart disease as secondary to hypertension denied; (2) SC for diabetic eye (retinopathy) as secondary to diabetes mellitus denied; (3) SC for cholesterol (denied); (4) SC for erectile dysfunction denied; and (5) Entitlement to SMC based on loss of use denied. Evidence: Service treatment records from 10/54-10/58; Duty to assist letter dated 11/3/08; VA treatment records from 9/8/83-11/08; and VA joint examination dated 11-13-08. It looks like they went back to there decision in 2010 denying everything but didn't issue an SOC and therefore BVA remanded back to them telling them to issue an SOC. He wants to appeal this decision because his primary doctor in 2010 wrote a nexus letter connecting his ED to the mumps that he had when he was in the service. His SMR documents his having Mumps in the Service. This 2010 letter they failed to use in this decision.

SSOC states (1) Evaluation of status post fracture left tibial tubercle with osteoarthritic changes and chronic chondromalacia and left thigh atrophy, which is currently 30 percent disabling, is continued; (2) SC for right carpal tunnel syndrome denied; (3) SC for hypertension denied; (4) SC for diabetes mellitus denied; (5) SC for mumps denied; (6) SC for right shoulder condition as secondary to SC disability of recurent subluxation left knee denied; (7) SC for gout as secondary to SC disabiity of recurrent sublluxation left knee denied; (8) SC for left shoulder condition as secondary to SC disability of recurent subluxation left knee denied; (9) SC for left carpal tunnel syndrome as secondary to SC disability of recurrent subluxation left knee denied; (10) Evaluation of recurrent subluxation left knee currently evaluated as 30 percent disabling (didn't say denied/granted or continued); (11) SC for osteomyelitis (didn't say denied/granted or continued). Evidence: BVA Remand dated 9/20/11 (they mean 9/20/2010); VA Joints exam dated 5/11/11 and VA spine exam dated 5/11/11. He plans to appeal this as well but we will wait in see if they deny/grant TDIU first if we can before he appeals.

He has yet to receive decision for his TDIU, Left Knee disability, lower back and Neck. We thought he would receive this decision first since VA gave him a partial portion of his appeal and FAST Letter states: There is a "FastLetter" dated Jan., 6 2010 that states they need to implement the granted BVA portion "first" and then work the appeals. Here they doing the opposite. We hope that they will issue decision on TDIU, Left Knee disability, lower back and Neck before the 30 day period is up for appeal of SOC and SSOC. We have asked for copy of 5/11/2011 C&P Exam but in a letter received yesterday they say we need additional time to determine whethr the VA has this record, etc. Imagine our surprise today to see that they do have this record and used it in their SSOC decision. Do you think he will get this decision soon or not? Do you think it will be a favorable one or a not favorable one?

Thanks in advance for your replies.

[Charleese]

Hi all,

Hubby received VSO letter this morning. Letter is dated June 3, 2011. Hubby spoke to VSO on Monday, the 6th. Evidently he forgot that he had sent letter already. As you can see we have had nothing but trouble with this VSO. He didn't want us to appeal, but I appealed anyway and its a good thing I did that for my husband. BVA acted in Hubby's favor.

The official letter from VA has yet to arrive. However, VSO letter states:

1. Service connection for residuals of cervical myelopathy, Brown-Sequard Syndrome with quadriparesis, status post anterior discectomy, fusion, and plating at C3-C4 (claimed as cervical spine condition) is granted with an evaluation of 20% effective 5/29/09. This seems to be a low rating especially when C&P Doctor told Hubby amongst other things that he should not drive anymore, because of his limited range of motion when it came to the turning of his neck on both sides left and right. He told me I should do all the driving because Hubby would have a hard time seeing anyone on his left and right. Just waaiting to see if C&P exam or official letter states that.

2. Service connection for left thigh atrophy is ganted with an evaluation of 10% effective 5/31/07.

3. Service connection for right knee condition is granted with an evaluation of 10% effectice 5/31/07.

4. Entitlement to inIdividual unemployability benefits is granted effective 5/29/09.

5. Basic eligibility to Dependents Educational Assistance is established from 5/29/09. Don't know what they mean by Basic eligibiliy. Is there an advance eligibility? I also assume this must mean he is P&T, even though VSO letter does not state so.

We are disappointed that nothing is mentioned about his Lower Back rating. At C&P exam Doctor examined him for Lower Back as well as took X-rays of it.

It also states that the DAV has reviewed the most recent VA decision concerning your claim for benefits. A combined evaluation of 80 percent plus entitlement to benefits at the 100 percent rate due to individual unemployability has been assigned as a result of the above actions. We assume its because of Bilateral.

When we get the official letter and we hope its not long from now, I will post the range of motion, etc. so that you will have the full account. I hope this answers all of your questions.

Once again thanks.

[Charleese]

Hi all,

Finally at last hubby got his decision. Reasons for Decision states: As promise hear are the range of motion for his Cervical Spine condition if as secondary to his left knee injury.

No gross abnormal cervical curvature. Your range of motion findings were as follows: forward flexion 0-24 with pain, 0-34 with fatigue, extension 0-14 with pain, 0-10 with fatigue, left lateral flexion 0-16 with pain, 0-15 with fatigue, right lateral flexion 0-13 with pain, 0-10 with fatigue, left lateral rotation 0-26 with pain, 0-20 with fatigue, right lateral rotation 0-20 with pain, 0-30 with fatigue. There was no evidence of ankylosis. X-rays showed significant degenerative disc disease. The examiner linked your cervical condition to a fall as a result of your left knee/tibia injury. A 20 percent evaluation is assigned from May 29, 2009, your date of claim. A higher evaluation of 30 percent is not warranted unless there is forward flexion of the cervical spine of 15 degrees or less; or, favorable ankylosis of the entire cervical spine. There is no objective medical evidence warranting the higher evaluation.

We won't know until we get a copy of C&P if these figures our correct, because we thought he would of gottent a higher rating than 20%. However let us know what you think of these figures.

Once again thank in advance for your replies.

[Commander Bob]

Hi all,

Finally at last hubby got his decision. Reasons for Decision states:

Good morning 'Charleese'. Did the VA decision letter include TDIU?

Edited June 12, 2011 by Commander Bob

[broncovet]

Charlese

Congratulations!

According to what you posted, this means hubby will be rated IU (100 percent) and as they said you are eligible for Dependendents chapter 35. You dont get Ch 35 unless you are 100% combined or IU.

If you dont have children, that means 2823 per month. You should be getting retro from 5/09 or about 24 months worth...

about 67k, but you will have to subtract any monies you received from the VA during that period.

Edited June 12, 2011 by broncovet

[Commander Bob]

Charlese

Congratulations!

According to what you posted, this means hubby will be rated IU (100 percent) and as they said you are eligible for Dependendents chapter 35. You dont get Ch 35 unless you are 100% combined or IU.

If you dont have children, that means 2823 per month. You should be getting retro from 5/09 or about 24 months worth...

about 67k, but you will have to subtract any monies you received from the VA during that period.

Thanks for the clarification,'broncovet'. Sometimes it's difficult to follow some of our member's posts. Charlese mentions the VSO phone conversation and VSO letter stating TDIU, not the official VA TDIU notice, only the VA "Reasons for Decision on the range of motion for his Cervical Spine condition if as secondary to his left knee injury".

C.B

Edited June 12, 2011 by Commander Bob

[Charleese]

Hi all,

Once again I am sorry for not explaining my self better. We were so excited to get this official letter, that we overlooked the following:

Yes official letter does state that he is granted TDIU. It stated that "We enclosed a VA Form 21-8760 - Additional Information for Veterans with Service Connected Permanent and Total Disability", which explains certain factors concerning your benefits. We also encosed a VA For 21-8764 Disability Compensation Award Attachment-Important Information, which explains certain factors concerning your benefits. It also speaks about Service-Disabled Veterans Insurance (S-DVI), which maybe waived. It speaks about CHAMPVA and Education Benefits as well as Armed Forces Commissay and Exchange privileges.

I assume this means that he is TDIU with P&T. However it doesn't say whether or not if he will have anymore scheduled C&P exams. Does anyone know the answer to this. It speaks also about vocational rehabilitation and enclosed an application form. If you can't work why would a person enroll in this program. Does he need to fill this application or not.

Decision states: "At your spine examination, the examiner stated that due to your cervical inquiry you would not be employable in your former occupation as a chef because of your range of motion limitations would restrict your abilities to perform the job function. (He hasn't been a chef since 1995.) He opined that due to constant pain and limitation of motion, you would be unable to secure or follow a gainful occupation due to your service connected disabilities. The joints examiner stated that your knee and tibia issues render you unemployable because you are unable to sit or stand for prolonged period of time.

This is confusing because we don't know whether he is unemployable because of his left knee injury, or cervical spine, or both. What do you think, unemployable because of left knee, or cervical spine or both. We think that they low balled him with their 20% rating for cervical spine. Decision states: No gross abnormal cervical curvature. Your range of motion findings were as follows: forward flexion 0-24 with pain, 0-34 with fatigue, extension 0-14 with pain, 0-10 with fatigue, left lateral flexion 0-16 with pain, 0-15 with fatigue, right lateral flexion 0-13 with pain, 0-10 with fatigue, left lateral rotation 0-26 with pain, 0-20 with fatigue, right lateral rotation 0-20 with pain, 0-30 with fatigue. There was no evidence of ankylosis. X-rays showed significant degenerative disc disease. The examiner linked your cervical condition to a fall as a result of your left knee/tibia injury. A 20 percent evaluation is assigned from May 29, 2009, your date of claim. A higher evaluation of 30 percent is not warranted unless there is forward flexion of the cervical spine of 15 degrees or less; or, favorable ankylosis of the entire cervical spine. There is no objective medical evidence warranting the higher evaluation. What do you think, low rating or not.

Thanks in advance for your replies.