diabetes My Diabetes Claim Was Denied With No C&p Exam

[brentakar]

I come to Hadit for advise since I am fairly new here and try and obtain some great advise with fellow Veterans.I was rated 50% service connected when I retired. I just filed my first claims since I have been out of the military. I claimed an increase in my HBP from 0% service connected to 10% service connected.I was awarded 10% for this. I retired in 2005 and was diagnosed 2 years ago with Diabetes 2. I was diagnosed through the VA Hospital here in Florida, and no, they did not mention why they thought why I have Diabetes 2. I kept 2 full packet copies of my medical records before I retired from the military. Once I was diagnosed with Diabetes 2 at the VA hospital, I took my records while on active duty to the diabetic clinic at the VA and had the nurse who gave the 4 hour orientation on Diabetes look at my records to see if I had any high blood sugar numbers. The nurse had highlighted about 10 different dates while on active duty and suggested I file a claim. Claim was denied and on top of that, NO questions or exam during my C&P.I made copies of my sugar readings that were highlighted from the Diabetic clinic, and submitted them with my claim. A physician conducted my C&P exam and only questioned my High blood pressure>Please advise.After I found out my rating for my HBP, I called the VA and requested a copy of my C-File like you had mentioned earlier right after I joined HadIt.com. I need some advise on what steps I need to take.Do I file a NOD now or wait till I get my C-file in the mail.I am going to the Diabetic clinic Tuesday to talk to a Diabetic nurse to go over my blood sugar readings again to verify they were high and then I need to request a nother C&P i assume.Please advise. Thank you again.

[Chuck75]

In my experience, the VA intentionally ignores "pre-diabetes", and has done so for quite a long time. The reasons are obvious, since by the DOD/VA treatment documents, it may exist ten or more years before the formal diagnostic level is reached. Further, during this time frame, other serious conditions, such as heart conditions (IHD, etc.) can develop or become more severe as a result of the undiagnosed diabetes.

It's also true that many VA practitioners have evidently had the "FOG" treatment in relation to what they may or may not say or write that would be in a veterans favor.

This seems to trump any of the written guidance. Given the situation, there is no practical way (nor would I want to) force a VA practitioner to write something that they do not want to write.

The only thing I can see to do is to file an NOD as soon as possible. It may very well be necessary to obtain qualified legal representation.

[Bigred122]

In my experience, the VA intentionally ignores "pre-diabetes", and has done so for quite a long time. The reasons are obvious, since by the DOD/VA treatment documents, it may exist ten or more years before the formal diagnostic level is reached. Further, during this time frame, other serious conditions, such as heart conditions (IHD, etc.) can develop or become more severe as a result of the undiagnosed diabetes.

It's also true that many VA practitioners have evidently had the "FOG" treatment in relation to what they may or may not say or write that would be in a veterans favor.

This seems to trump any of the written guidance. Given the situation, there is no practical way (nor would I want to) force a VA practitioner to write something that they do not want to write.

The only thing I can see to do is to file an NOD as soon as possible. It may very well be necessary to obtain qualified legal representation.

Chuck75, you are oh so right about the diabetes. I've been going to the VA for about 18yrs now and no one ever mentioned about diabetes. No one in my family has ever had it. Then in 08/2009 I went into diabetic shock with a blood sugar of 1100. Once I learned about Blood sugar levels, I went thru my VA medical files and it has been high for several years and no one said anything. Unfortunately, I am finding this true on so many levels.Many times here you have seen other Vets say to get your medical information.Yesterday, I received a CD of Cervical Xrays that were done in 12/2010 for my C&P exam that day.I also asked for the radiologist report on those xrays because my C&P exam was very vague with info. In Bold letters was a notation saying that there was a large growth on the right side of my thyroid.Since I had the left side of my thyroid removed with a large growth on it in 09/99, I was abit upset.Thirteen months have passed since that xray and no one has said anything to me. About a year ago I started getting similiar problems that I did the first time around. Pressure behind the eyes and if I slept wrong,I would suddenly wake up not able to breathe even with my CPAP. All this was reported to my PCP.The VA is too overwhelmed with patient to give us the care we deserve. Hell, we are lucky if they remember our name. So EVERY time you get care from the VA get a copy of your report for your health and records.As we all know too many Vets have passed away that we know who never treated for known problems that eventually killed them.mike

[carlie]

Hello carlie,

up at the top the only thing it says is Hypertension.

Only thing I see on the evidence section is SM filed past one year after he got out of the army, diabetes claim denied.

I will try and talk to the doctor or nurse and explain the situation.carlie, I am a fighter like you are, I do not give up easily.If I honestly felt that this was not a possiblity of being service connected , beleive me I would not have ever filed a claim.I just feel I was not given an adequate exam or asked any questions about my Diabetes, I am still very surprised by this.I served in the army 20 years plus, I thought I knew what to expect but I suppose this is different with claims.

If all else fails, should I still submit a NOD and explain the reason is that I was not given an C&P exam, or the evidence I provided was either overlooked or not considered?

I wonder how long my C-file takes till I get a copy of that?I probibly should not file a NOD untill I receive my C-file is this correct or has no bearing either way?Please reply back.Thank you again for helping me out, I sure need it.

bren,

In the evidence section does it show a VA examination dated XX/XX/XXXX -

which would probably be the date of the C&P in question.

Again - I think you need to visit your rep & get an IMO.

Didn't you post that a nurse had highlighted you sugar reading on active duty ?

[Hoppy]

Below is an interesting case that was denied and won on appeal due to pre diabetic conditions in the SMR. The BVA search

engine has tons of cases. I did not have time to read many. In fact this is the first one I found. I used the search term "pre diabetes".

Citation Nr: 1133889

See the full decision at

http://www.va.gov/ve...es4/1133889.txt

In July 2010, the Veteran was afforded a VA examination. At the outset of the examination report, the examiner indicated that she had extensively reviewed the claims file. In this regard, the examiner noted that, in June 1992, the Veteran had an elevated FBS of 122, and in October 1996, he had an elevated FBS of 119; however, she went on to point out that no diagnosis of DM was made during service. Additionally, the examiner noted that there were no reports of blood sugar monitoring from 1997 to 2001, and that his blood sugar levels were within normal limits from 2002 to 2003. The examiner also reported that the Veteran's VA treatment records showed that he was first diagnosed with DM in August 2004. At his examination, the Veteran reported that his DM symptoms included jitteriness, weakness, and sweating.

After discussing the findings of her physical examination and the results of diagnostic testing, the examiner diagnosed the Veteran with DM. The examiner then went on to provide the opinion that, insofar as the Veteran's in-service FBS levels were indicative of hyperglycemia, not DM, and because there was no continuity of care from 1997 to 2001, it was less likely than not that the Veteran's DM had its onset during active service or was related to any in-service disease, event, or injury. Significantly, however, the Board notes that the July 2010 VA examiner appears to have relied, at least in part, on the lack of a continuity of care/treatment following service in providing her negative opinion. In this regard, VA regulations require a continuity of symptomatology, not a continuity of treatment, for the grant of service connection. Moreover, the Board notes that, insofar as the July 2010 VA examiner failed to discuss whether the Veteran's currently diagnosed DM is any way etiologically related to his in-service hyperglycemia, this opinion is inadequate.

The Board obtained an expert medical opinion from VA endocrinologist, Dr. C.C., in August 2011. After carefully reviewing the record and relevant medical literature, it was Dr. C.C.'s opinion that the Veteran's current DM was related to an in-service disorder, a disorder of glycemia, which presented as elevated blood sugar levels noted during service at his June 1992 and October 1996 annual physical examinations. Dr. C.C. noted that the disorder is a group of metabolic diseases characterized by elevated blood glucose (hyperglycemia), and that based on the degree of hyperglycemia at the time of diagnosis, the disorder was designated as either diabetes mellitus or pre-diabetes; the blood glucose levels were abnormal in pre-diabetes but not as high in diabetes mellitus. Impaired glucose tolerance (glucose intolerance) and impaired fasting glucose were other terms used to represent pre-diabetes.

ORDER

Entitlement to service connection for diabetes mellitus, type II, is granted.

Edited January 22, 2012 by Hoppy

[Pete53]

When I served during boot camp I had a couple of instances of fainting and when I was on Christmas Leave a DO diagnosed me with hypoglycemia. During my enlistment I had three instances where I had extensive glucose tolerance tests the Army Physician noted that my blood sugar was abnormal but ruled out hypoglycemia. For a while I felt that that it was that and not that I had panic disorder.

I still feel that the abnormal blood sugar levels were DM or as later called latent DM. Today I think there is no such thing and you are either diabetic or not.

Although I am already 100% and don't really need to pursue this I am still very interested and fell that VA has mis diagnosed many Veterans who have had the same problems.

Just my two cents

[john999]

Boomer

With numbers like what you have I think you will probably get classic DMII in the future. I started out with those type of numbers back in 2000 when I went for AO Registry Exam. That is like saying you have high blood pressure if you are 140/90 but not if you are 139/89. I think I would seek treatment for DMII outside the VA because you may have damage via secondary disorders by the time the VA gets around to saying you have DMII. Your eyes, your feet, and your heart are places you are vulnerable.

John