Carlie, Could You Please Take A Look At This

[bm6546]

Carlie,

I would appreciate it if you would please look at this and tell me what you think. I know you deal a lot with claims that involve a CUE.

I would like your take on this.

Thanks in advance,

Brian

[carlie]

Carlie,

I would appreciate it if you would please look at this and tell me what you think. I know you deal a lot with claims that involve a CUE.

I would like your take on this.

Thanks in advance,

Brian

bm6546,

It is always best to just address questions to the board in general

because no one person has all the answers and the entire board is a wealth of knowledge,

it's best for you if many eyes take a look at it.

First - this isn't a SOC - this is simply a Statement In Support.

I can understand your contention of CUE in the decision that reduced the 10% to zero percent.

It would be best to post the exact Reasons and Bases,

or for your time period the exact Narrative from the original decision that granted the 10%

and the decision that reduced to zero %.

Any evidence that was not of record at the time the claimed CUE was made

can not be applied to the claim for CUE.

JMHO

[71M10]

I am by no means an expert in CUE. But in your statement you are pushing a viewpoint that CUE exists because the exam or medical opinion that was used to reduce was not as complete as the exam that put that rating into effect. Your statement indicates the Holter monitoring was done while in service. Did they also do holter monitoring for your initial compensation exam? If the VA never gave you a Holter exam for the inital SC and rating, then the second C&P can't be declared inappropriate due to the lack of a holter study. The holter study would have been medical evidence from service supporting your claim but not part of the original exam. If they did do a holter study on the initial C&P you should revise your statment to bring this fact out more clearly.

I don't believe an unfavorable opinion from a clinician is CUE persay. What was the medical conclusion of the clinician? If the conclusion doesn't match the medical facts that creates a strong basis for throwing out the exam. I assume this wasn't appealed in 68 due to lack of knowledge of the VA regs. If there were clearly multiple, regular occurances. When was the next request for a increase or compensable rating filed?

I was given a 0% rating in 88 for a Bone Disorder (5099)in response to a back claim. Didn't appeal (wanted to be done with the Federal Government) years later I find out they identified arthritis on the xray. They didn't survey any other joints besides thoracic spine. Now I know they didn't use the code for arthritis and call it arthritis because you tell a 22 year old he has arthritis in his spine but its zero percent, he appeals because that is a disease old people have. You tell him a bone disorder and if you ever need medical care come see us(A LIE) he shruggs his shoulders and moves on. Only filling for an increase 20 years later after he tries to get medical care and is told he cant be treated by VA because his SC injury is rated at 0%. Is this CUE? no because they only looked at one joint, even though the regulation states to survey all major joints in cases of arthritis. The fact the clinicial failed to do a complete and proper exam doesn't necessarily indicate CUE.

Best regards,

Edited November 18, 2011 by 71M10

[Hoppy]

I have been thinking about jumping in on this thread. I have been reading related BVA cases. However, as carlie suggested it would be best to read the exact reason and basis for the reduction. I do not believe the mere fact that you had a halter test on the intitial rating exam and no halter test on the reduction is a slam dunk CUE. It would depend on how instrumental the test was in making the original diagnosis and if there were other objective tests that the C&P examiner thought were equally capable of measuring symptoms used for the reduction. From what you have posted their appears to be no justification for the reduction. I am curious if the C&P examiner did not say something negative that you are not posting.

Also, I would like to comment on the GAD claim. My suggestion is that you front load as much evidence as you can and not rely on the VA to develop the evidence. This could prevent many long delays. You did not cite any medical reports in your statement. If you have a current diagnosis of GAD and any nexus statements you should reference them in your statement and attach them to your statement.

[bm6546]

I have been thinking about jumping in on this thread. I have been reading related BVA cases. However, as carlie suggested it would be best to read the exact reason and basis for the reduction. I do not believe the mere fact that you had a halter test on the intitial rating exam and no halter test on the reduction is a slam dunk CUE. It would depend on how instrumental the test was in making the original diagnosis and if there were other objective tests that the C&P examiner thought were equally capable of measuring symptoms used for the reduction. From what you have posted their appears to be no justification for the reduction. I am curious if the C&P examiner did not say something negative that you are not posting.

Also, I would like to comment on the GAD claim. My suggestion is that you front load as much evidence as you can and not rely on the VA to develop the evidence. This could prevent many long delays. You did not cite any medical reports in your statement. If you have a current diagnosis of GAD and any nexus statements you should reference them in your statement and attach them to your statement.

Here is the "Rating Decision" that determined my award of 10% SC

In view of the length of service and worsening of the condition, aggrevation is conceded.

1. SC 38 USC 331 (aggr. PTE)

10% from 11/26/66

PAROXYSMAL ATRIAL TACHYCARDIA

10. Not entitled 38 USC 336.

And here is the wording when they reduced me from 10% down to 0%:

Cited examination.

Evaluation of SC tachycardia.

Cited exam discloses the veteran is steadily employed but complains of occasional dizziness, a heavy feeling in the chest and that his heart flutters. Blood pressure was 120/68, 130/64, 102/70 and there is no precordial thrust, no enlargement to percussion. Heart sounds are regular, there is a soft, systolic murmur at the apex with no radiation, no thrill and a rate of 78 to 80. EKG is normal.

Current examination does not disclose a compensable condition.

Rating of 3-3-67 amended as follows:

1. SC 38 USC 331 & 310 (agg. PTE; VE from 10-1-67)

10% from 11-26-66

0% from 5-1-68 7013

PAROXYSMAL ATRIAL TACHYCARDIA

10. Not entitled --38 USC 336

There is no mention of any holter monitoring and I do not remember any holter monitoring taking place at this C&P exam.

Hope this makes sense.

Brian

PS I just commented in a different post that after reviewing my service records, I noticed that at least 2 times they mentioned Sinus Tachycardia with Anxiety. Another reference was to Paroxysmal Atrial Tachycardia secondary to anxiety.

I was diagnosed by the SSDI that my:

Primary Diagnosis - Anxiety Disorders

Secondary Diagnosis - Chronic Ischemic Heart Disease with or w/o Angina

Brian

[Hoppy]

I will be working on a reply over the next couple days. If I do not get interrupted I might finish today.

[Hoppy]

I was not able to continue my research because the VA search engine has not been working. I have found that your reduction may have several issues that are not addressed in your statement which I feel need to be developed. I will see what more I can do this weekend.

I still feel that the notes in your SMR showing positive symptoms of heart rate acceleration documented by the halter tests can provide very strong evidence to show that the reduction was not legal. However, even if the halter results were not used to make the initial rating you still have strong arguments to show the reduction was not legal.

It would help me focus if I were to know the following.

Did the halter monition document heart rate acceleration in excess of 100 beats per minute? If yes, how many times was this event documented?

Where did the BP and heart rate results cited by the raters come from? Were these noted in post service treatment records or were they from the SMR. Check the evidence list noted in the decision and review you medical records to figure this out.

Your claim is very complex. However, I feel it is obvious that the reduction was a railroad job by raters who went outside the facts and failed to properly apply relevant laws to determine that you did not have a ratable disability.