tdiu The Va Can Be Evil...please Help

[ferris7060]

I am at a complete loss for words. I got my denial for TDIU last week. I was too busy fuming to post until now. I was diagnosed with Raynaud's Phenomenom in 2004. I was discharged for this reason and awarded 40%. There is no cure for Raynaud's. I seriously do have Raynaud's attacks every single day. I have stopped bringing it up at doctors appointments due to the fact that many Rheumatologists have explained to me that I have tried all treatment without improvement- so my only course of action is lifestyle change- wearing gloves- even in the house during the winter, not going outside for more than 5 minutes in the winter, holding a napkin when taking a cold can from the fridge. In the summer I avoid tempurature changes such as sun to shade, Showering in luke warm water rather than hot, and air conditioning. I do all these things. I have always noted these lifestyle changes when asked about Raynaud's, but I do not bring it up on my own at appts. It's a dead issue. It's not going away, and they can't help me. They have proposed to take the 40% away do to Raynaud's improving. I have no paper trail to offer. Only old evidence proving that I was tested, poked, and proded by specialists for 3 years before giving up hope of improvement. Each time I was tested, I was diagnosed with Raynaud's. The problem is there is no quick test to go take to prove symptoms are still as severe. Although Raynauds is uncomfortable/painful, I have never claimed that I cannot work due to Raynauds. There are certain jobs out there, inside work, that could be done with this disorder. I did work after medical discharge from the Army until my neck/migraines got worse- which brings me to my second complaint.

I am also service connected for DDD C5 & C6. I had surgery in 2006. They connected migraine headaches to my neck. I claimed in 2006 for connection and was denied. In 2009, due to CUE migraines were connected. I have literally 2 pages of dates where migraines were reported at doc visits, most stating 2 days a week, prostrating, and needing bed rest. I have had a Neurologist confirm (which lead to CUE). I have been on several medications that did not work. My migraines are at 30% currently (percentage stayed the same with new decision).

C&P examiner 10/2010

Employ opinion: It is at least as likely as not that the veteran's service connected disabilities would negatively impact his ability to obtain/maintain gainful employment. Veteran's DDD cervical spine and headaches are severe. Veteran's neck condition would prevent him from doing any heavy physical work, repetative lifting, or a job that requires repetative bending of the neck. The severe headaches would prevent any useful employment. He gets at least two bad headaches each week requiring bedrest all day due to pain, nausea, and emesis.

The C&P examiner did not ask hardly anything about Raynaud's and did no hand testing, other than to say coloring is good at this time. Did however mention the precautions I take to reduce attacks. Also noted Raynaud's happens less than once a week. Really? Who the hell told you THAT? Wasn't me. I would have had to have forgotten that I live with this and it definately happens every single day for some reason or another.

Now for the EVIL raters opinions, where he came up with them? I do not know!

For migraines:

A review of the evidence indicates confirmation of your service connected diagnosis with your subjective reports of weekly headaches with most being prostrating. A review of your VA outpatient reports from September 7, 2004 to the present is negative for any report of your having or needing bedrest other than the October 2010 examiner's statement based on your reported complaints. There was no evidence of any prostrating migraines since 2004 other than your current exam. Based on the evidence considered, the evaluation of service connected migraine headaches assiciated with DDD of the cervical spine, which is currently 30 percent disabling, is confirmed and continued. A higher percent of 50 percent is not warranted unless there are very frequent, completely prostrating, and prolonged attacks productive to severe economic inadaptability.

HUH? According to that I have never had a migraine in 7 years. Wonder how I got 30%, a CUE, tons of medications, Neurologist appointments, and two pages of specific dates where migraines were complained about, with every doctor noting the severity?

DDD was increased and an additional 10% is granted for forward flexion of the cervical spine being 15 degrees or less. (Now DDD is 30%)

Individual Unemployablity:

A small number of you disabilities that were examined were found to warrant a change in the evaluations. Your DDD was determined to meet a higher criteria, however Raynaud's was found to have improved, based on the outpatient treatment reports (meaning I have not had any or complained about an untreatable condition- lessoned learned on that one- it should always be the worst day of your life when dealing with the VA). It should be noted that the evaluation of the migraine headaches disability was not warranted as the objective evidence in your OPTs failed to support the examiner's determination which were based on your subjective reports. All OPTs were reviewed (definately not the case) and none could support claims of prostrating attacks as the result of the weekly migarine headaches claimed.

As stated earlier, in order to be entitled to IU, your combined evaluation must be at least 70% disabling with one of those SC disabilities being at least 40%. Receipt of SSA information strongly support this criteria as it was a condition stated in that SSA decision, it is also service connected, and it is 40% disabling. However, as all service connected conditions needed to be examined, the previous rating, as well as this rating did not warrant that evaluation. If anything, it has been proposed to be 10% disabaling. In accordance with the VA regulations, you are provided 60 days to provide evidence showing that this reduction is not warranted which will also assist your claim for TDIU.

Okay, for starters they claim that both the past two C&P evaluations did not warrant 40% for Raynauds. The 2008 C& P stated "Raynaud's is still problematic and would limit veteran's ability to work. (even though I wasn't saying I could not work due to Raynauds). 2010 C&P all sounded great in my favor until the guy put down an answer of "once a week" to a question he never even asked me!

Okay...HELP! What to do?

[ferris7060]

Does anyone think it would be helpful to submit pictures of the Raynaud's attacks with hand laid on a newspaper showing the date of every attack? The attacks are visable, my hand gets very red with a distinct line across them where the bright red ends and my fingers from knuckle and above get bright white.

[carlie]

A review of the evidence indicates confirmation of your service connected diagnosis with your subjective reports of weekly headaches with most being prostrating. A review of your VA outpatient reports from September 7, 2004 to the present is negative for any report of your having or needing bedrest other than the October 2010 examiner's statement based on your reported complaints. There was no evidence of any prostrating migraines since 2004 other than your current exam. Based on the evidence considered, the evaluation of service connected migraine headaches assiciated with DDD of the cervical spine, which is currently 30 percent disabling, is confirmed and continued.

My understanding from what I've read above is that the decision maker has pointed out that your

you feel a need to lay down when you have the headaches (which make them prostrating/bed rest)

but finds no where in the evidence of record that a DOCTOR has stated this is needed.

Without having that in writing from a doctor, I would not push for higher than the current 30 % SC for

DC 8100 - Migraines.

JMHO

[carlie]

Does anyone think it would be helpful to submit pictures of the Raynaud's attacks with hand laid on a newspaper showing the date of every attack? The attacks are visable, my hand gets very red with a distinct line across them where the bright red ends and my fingers from knuckle and above get bright white.

YES - I would submit photographs ASAP.

What is the Diagnostic Code for Raynaud's?

[Pete53]

Don't give up. Do you get SSD?

[brokensoldier244th]

I don't think they are necessarily evil, Ferris, but you didn't give them a whole lot to work with. If you want them to rate you with prostrating headaches you need to get your doctor to write about it, not just you.

[ferris7060]

Okay, so looking back at what I wrote I can see why you were all under the impression that it was 2 pages of just ME saying I needed bedrest and migraines wre prostrating. That is not the case though. I've had two Neurology appointments with two different doctors. One service connected my migraines and stated they required bedrest. The second, opined that there was no change in what the last neurologist diagnosed, but added, migraines are frequent and prostrating in nature.

My PCP Progress notes show, on two different dates, that my migraine attacks require "laying down in a dark room" and "weekly attacks".

Plus, I have the C&P doctor who says my migraines prevent any gainful employment.

This comment especially bothers me. "There was no evidence of any prostrating migraines since 2004 other than your current exam." I was given 30% for "prostrating" migraines. They were decided as prostrating due to my doctors, Neurologist, and examiner's opinions. VA does not give away 30% without any proof. I proved my headaches were prostrating. I was going for 50% rather than 30%, because all notes, mine and my doctors mainly state twice weekly. How do they decide on their own that it's 2 - 3 a month?