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What To Do? Ratings (Multiple)...incorrect Information?

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MDB1968NM

Question

Hello Everyone....

I will apologize up front but things have been less than stellar on my end (not anyone's fault) but health is not doing so well.....

BACKGROUND:

Retired 1 June 2010

Submitted my claim under the Benefits Delivery at Discharge program with a VSO here in town. Had my C&P exams stretching from July 10 - Sept 10. They took a bit of time to get through but were professional and the providers that saw me seemed like they truly gave a darn about my conditions.

I enrolled in VA healthcare in August of 2010. This was NOT an easy process and have shelled out several hundreds of dollars to see a doctor at times with the VA. (all prior to the rating decisions, some of the funds have been returned so that is a good thing).....

My initial rating (date on letter 25 Jan 2011) was determined to be 80% but 11 (eleven) issues were deferred...." We have deferred a decision on the following issues because we need additional information or evidence"

I elected to just wait things out because of the 11 ratings that were deferred....not entirely certain (at the time) on just why these items were deferred but figured it was part of the process.

In March (approx) I got an unexpected phone call from the VA doctor stating that he made a mistake and did not "hit the submit" button or something to that effect, on my claim. He indicated that the VA had sent all of my records BACK to him to review. I did not have an issue with this as sometimes "things happen" and we all make mistakes.....I was VERY appreciative of him taking the time to personally call me and notify me of the "issues" with my claim. Good on the VA for at least letting me know what was up!

I underwent some other C&P exams, blood tests, etc later in March 11 and awaited the results.

May of 2011....I received another "envelope" with more ratings on the claims that I had submitted originally. The overall rating of 80% had not been changed but there were several 10 and 0 percent ratings awarded.

CURRENTLY:

My health situation since leaving service has been on a downhill slope. I have two non-VA specialists that have been treating me for autoimmune issues for over two years. Getting the VA to talk with them has been a sore subject even though they are located within 10 miles of each other distance-wise.

ISSUES:

In the first "Rating Decision Packet" received in January 2011, I have some reservations on some of the information that they put forth. I was denied some claims that truly, I believe anyhow, were just plain incorrect.

1. Serologic negative auto-immune disease arthritis with multiple joint pain...... 0%

I have had positive ANA tests while on active duty. I have also been placed on Methotrexate injections for the past 1.5 years to alleviate symptoms. Non-VA doctor has diagnosed this as Reactive Arthritis/Reiters Disease. There are many issues that are tied in with this to include abnormal hormone levels, elevated metals in the blood, strange red blood cell counts. The pain associated with this condition renders me incapable of even moving around the house about half of the month.

Rating decision stated : A higher evaluation of 10% is not warranted because the VA examination and service treatment records did not show there is limited motion of a major joint or a group of minor joints.

Comment: At the time I was being treated by a Non-VA Pain Management Doctor. 80 MG of Morphine per day and 10/325 Oxycodone 6 times per day probably had something to do with me NOT feeling extreme pain during the exam. I have subsequently stopped all narcotic medication, due in part to severe gastro intestinal issues, and simply cannot function for long periods of time walking, standing, etc w/o them but the relief from some of the gastro intestinal problems has been a good trade off for now.

New Developments:

Currently diagnosed with Raynaud's Syndrome....VA doctor (who did my exam for C&P stated I should file for this as it was not diagnosed at the exam time)....where my hands and feet turn colors and are extremely painful. Non-VA doctor states that this is part of my autoimmune condition.

2. Major Depression....

I have been treated on active duty and through the VA (thank god for my doctors) with many types of medicines and counseling. These have had varying success rates and to be honest, things have been going down hill. It takes a great deal of effort to communicate with family/friends and even respond to emails at times. I am not certain WHY I am this way but I attribute a bunch of this to my chronic pain and other medical issues that leave me staying at home for extended periods of time.

Currently: Doctor has had me use several medications (effexor, Celexa, Wellbutrin) and has now placed me on different meds to try and relieve the affected mood/depression. Not particularly comfortable talking about these issues but they are personal and I have no idea why they are going on.

3. Tinnitus....

Tinnitus was diagnosed in service in 2008. I was sent to civilian audiologists (records submitted with claim) who also diagnosed the same thing. I was exposed to loud acft noise (crewmember on AC130s) in the form of props, 105mm, 40mm, and 20mm gunfire for numerous years and continued c-130 engine noise til my retirement (approx 18 years total). Subsequent to a surgery in 2006, the symptoms (tinnitus) became exponentially greater than it had been. I am not entirely certain if it is because I was not flying during this recovery period of about 6 months or if it was the pain medication I was on. I am not a doctor...just a flyer. The tinnitus increased significantly after the surgery on my leg.

VA stated: VA exam you reported onset of constant tinnitus after respiratory arrest/major surgery in 2006. Objective findings at the VA exam showed a normal audio exam. VA examiner diagnosed tinnitus and stated your tinnitus is not related to military noise exposure. You reported tinnitus began after major surgery in 2006 so may be related to this incident. Without medical evidence showing a current diagnosed disability and link to an in-service disease, event or injury, we cannot establish service connection.

THOUGHTS: The tinnitus was on-going since the late 90s. At the time, it was not a severe issue to preclude me from flying. However, the tinnitus increased exponentially after the surgery that was accomplished at a military hospital (where I experienced respiratory arrest and spent a week in the ICU)...AND.....continued to get worse while continuing to fly C-130s until retirement. I am NOT a doctor as stated previously, however, how can this NOT be service connected????

I have no beef with the raters or the VA. I am just a bit confused as to how this process works. Several vet friends have stated that I should be applying for things or resubmitting my claim.....a bit overwhelming for me at this point. I think that I have to do something within the year (if I recall from this site...thanks!) so I assume I have a few months to get things squared away if needed.

Finding work has been a non-issue at this time. I just cant right now. My biggest job right now is getting healthy. VA doctors have actually recommended that I try and see the Mayo Clinic soon to evaluate the strange blood readings and physical issues (many of them not mentioned in this post). This is a serious consideration as both my civilian and VA doctors are at a loss and both suggest a more intensive workup.

4. Migraines:

Awarded 10%.....

VA stated that...A higher evaluation of 30% is not warranted because the medical evidence available for review does not show characteristic prostrating attacks occurring on an average of once a month over the last several months.

My question is.....I have attacks now down from 2 per week to about once every 10 days or so. The times vary but they happen at least "once per month"...sometimes they happen in succession over a week to ten days and other times they hold off for a couple of weeks. I am prescribed Imitrex for them, I was on Zomig while on active duty for them, so just what does the VA need??? I think at times they just look at VA healthcare records.

As a note: I typically "suck it up" and hunker down in the house for the majority of the issues. I have not and probably never will be a person that runs to the doctor when pain or issues hit. Have I made a mistake? These are issues that affect my life, my family, and my livelihood.

I was diagnosed with TBI on the VA rating at 0% but there is no link to the migraines to this even though they started 6 months after my aircraft incident where the TBI occurred (both shoulders and jaw damaged).

Any suggestions would be appreciated.....

Thanks for letting me vent folks.....

My primary questions are.....

What should I do?

Thanks for the help and taking the time to read this.

:)

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  • HadIt.com Elder

You just have to keep plugging and don't give up. If it were me and I was able I would disagree and ask for a Hearing to bring up the issues face to face with a DRO. Don't overlook time limits for filing NOD with Form 9

Good Luck

PS If you have not done it file for TDIU and ask for effective date when you separated

Edited by Pete53
Forgot to add TDIU note

Veterans deserve real choice for their health care.

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You just have to keep plugging and don't give up. If it were me and I was able I would disagree and ask for a Hearing to bring up the issues face to face with a DRO. Don't overlook time limits for filing NOD with Form 9

Good Luck

PS If you have not done it file for TDIU and ask for effective date when you separated

Pete,

"keep plugging and don't give up"

What do you mean by that?

Also not entirely certain what you mean by the Form 9.

My VSO has not been of much help and we are moving 500 miles away from this area in about 6 weeks.

Also, some of the vets at the VA have said I should "Try for TDIU" but I explained to them that I have two areas that are 30%, nine that are 10%, and eleven that are 0%. Some may be, as I mentioned, should probably be at least 10% or at least reconsidered.

Not entirely certain what TDIU is or if it is something I should even pursue. I do not want to waste the VA's time but to be honest, if I could pursue work at this time believe you me I would be! It is just really hard to have days that I feel good and then 24 hours later I am in the bed almost in tears. Pretty tough for someone who was always the first to volunteer and the last to go.

Cheers :)

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