Keratoconus

[roses15534]

I was diagnosed with Keratoconus when I was in service they gave me glasses first then contacts the first kind was hard center and soft skirt perma-soft then hard ones after retiring is when i had transplants after my corneas ruptured and scared them I was 20/400 the day of surgery and now around 20/30 i think i can wear either glasses or contacts even tried both at one point so should I go back and try to get service connected? Now here is the thing since I had transplants I no longer have Keratoconus what all info I need to do this? I had corneal transplants in both eyes 2 years apart mine was not service connected they said it was genetic and denied it. I wear contacts and glasses either or and corrected vision is about 20/30 what process did you use? My decision is attached from 2001.

[jvretiredvet]

Do you have a specific point to make or a need to ask a specific question, or is this but a generalized rant?

well, 50 years later they grew, the one in the right eye was removed, the one in the left eye now has the complication of glaucoma,, not sure what wil happen,, I also have another problem with eye that had the cataract removed, a mole on the retina, but so far, it's ok for now... Well, right offhand, I'd say that appearance of a perhaps congenital cataract after a 50 year delay wouldn't strongly support a finding of aggravation but more due to the natural progress of the disease.

The claims people always throw the word congenital in, whenever you claim something, they also said my neurolgicial problems were congenital,, I had a dna test that happens to show it isn't congenital, well at least the dna test shows that the dystrophy is not congenital.. (a VA doctor diagnosed me with myotonic dystrophy). Yes, the word "congenital" is too often used inappropriately to deny service connection.

However, VA Precedent Opinions have affirmed that service connection for a familial/inherited/congenital condition can be granted, whether on a direct, aggravated, or presumptive basis. It depends on the facts of each situation. In other words, 38 CFR 4.9 does not always override 38 CFR 3.303. For the precedent decisions themselves, please see my first post in this thread.

in my case my neurolgical disease(s) can be real, and may not show up in dna tests.. which means it's wasn't inherited... Not necessarily so. DNA testing isn't all inclusive and DNA tests have not been developed to check all the various alleles, loci, and so forth, on the chromosomes. What cannot be diagnosable by DNA today may be diagnosable 10 years from now with newer tests. In any event, the clinical diagnosis, based on your physical presentation, muscle biopsies, EMG/NCS, etc., could still give a valid diagnosis.

no one in my family were ever treated of had neuroglical disease... That may be significant, but it doesn't mean that none of them didn't have the same neurological disease but perhaps with a lesser presentation. Or, your specific dystrophy may be an autosomonally recessive condition rather than dominant. Or, even if your condition is autosomonally dominant, each child only has a 50% chance of getting the defective gene because of gene shuffling during meiosis (unless of course, both mom and dad have the same defective gene). Or, it's not impossible to have a de novo, that is, a new mutation.

I was diagnosed with congenital cataracts when I was a child,, when I went through the exam to enter the USAF, I opened my big mouth and told them I have cataracts, but they were dormant, so I had to get a waiver for them...

the doctors said they had no idea if they would ever grow,,

well, 50 years later they grew, the one in the right eye was removed, the one in the left eye now has the complication of glaucoma,, not sure what wil happen,, I also have another problem with eye that had the cataract removed, a mole on the retina, but so far, it's ok for now...

since i have pancreas disease, and am fighting appeals for that, I haven't even bothered about the glaucoma.. as far as any claims go...

but, I saw the converstation about congenital eye disease, thought i would chime in...

The claims people always throw the word congenital in, whenever you claim something, they also said my neurolgicial problems were congenital,, I had a dna test that happens to show it isn't congenital, well at least the dna test shows that the dystrophy is not congenital.. (a VA doctor diagnosed me with myotonic dystrophy).

(funny thing is the lab had a note at the bottom of the results telling the doctor, that even if the results come back as 'read as negative' the doctor can still decide any way they choose... as the doctor has the last say whether a patient has the disease.... in other words, the patient can still have a disease, whether or not it is inherited.. in my case my neurolgical disease(s) can be real, and may not show up in dna tests.. which means it's wasn't inherited...

no one in my family were ever treated of had neuroglical disease...

(this acutally go back to my claim because I won a claim for problems from chemcials I worked with on active duty.. I have not won al the claims, and am in appeals for the rest or my health issues from the chemicals..).

[roses15534]

jvretiredvet long story short am service connected for heartburn at 0% for 11 yrs now was taking meds in service for it total of about 20 yrs now. Just had scope done and they say I have Barrets Esophigus and Hydial Hernia I called my VSO and he said we would have to go with secondary to heartburn but doctor needs to say it is connected to the heartburn and how it is. Will a VA doctor or PA do this?

[jvretiredvet]

First off, I find it somewhat puzzling that you were given service connection for gastritis when your service medical records - and, more importantly, the narrative in the Rating Decision - showed an in-service diagnosis of gastro-esophageal reflux disease (GERD), GERD, also known as heartburn, is from acid passing from the stomach into the esophagus; GERD/reflux can be a symptom of an incompetent valve or (ta-da!) a hiatal hernia. GERD is usually rated using the criteria for Hiatal Hernia because GERD and HH symptoms are really the same.

OK, what to do ...

1. Not to denigrate a PA or a NP's opinion, but a physician's opinion is always way mo' better. You could ask your Primary Care Practitioner to link the two conditions by asking him/her to write something like: I have reviewed Mr. ______'s service medical records in their entirety, and specifically the treatment records dated xx/xx/xxxx, xx/xx/xxxx, xx/xx/xxxx (and so forth). His gastroesophageal symptoms exhibited then are more consistent with a diagnosis of gastroesphageal reflux disease rather than gastritis, and treatment record dated xx/xx/xxxx did in fact diagnose GERD and treatment with Prilosec followed by Zantec. In my opinion, it is more likely than not that the labeled condition of gastritis is and always has been gastroesophageal reflux disease and that his GERD at that time was an early symptom of a hiatal hernia and that the current Barrett's esophagitis is a direct result of long term GERD.

I have no pride of authorship, and the physician can change the phrasing any way he/she chooses.

2. Or, you could just file a request for increase of your currently labeled gastritis condition. In your request, state that treatment record dated xx/xx/xxxx in your Service Medical Records diagnosed gastroesophageal reflux disease and that Rating Decision dated xx/xx/2001 acknowledged it. Make sure that the VARO has the gastro-endoscopy report. See what happens.

FWIW, you are not service connected for a Diagnostic Code but rather a condition. You essentially had a gastroesophageal condition in service. It was service connected as gastritis on extremely slim evidence, and more legitimately it should be service connected as GERD.

jvretiredvet long story short am service connected for heartburn at 0% for 11 yrs now was taking meds in service for it total of about 20 yrs now. Just had scope done and they say I have Barrets Esophigus and Hydial Hernia I called my VSO and he said we would have to go with secondary to heartburn but doctor needs to say it is connected to the heartburn and how it is. Will a VA doctor or PA do this?

[roses15534]

jvretiredvet so would it be better to go for an increase or just try to file for Gerd? Or would they try to connect the 2 together? Could this be a CUE also if it is stated in my records and decision why would they have went with gastritis?

[retiredat44]

Do you have a specific point to make or a need to ask a specific question, or is this but a generalized rant?...00

I am sorry if you tookit as a rant, I was not at all ranting, I was telling you what my experiences are when the va throws the word congenital into your claim, for denial purposes..

I am defiently going to stop joing conversations,, all I get is problems for chatting in the conversations with my experiences..

I am sorry, no more from me..

[jvretiredvet]

so would it be better to go for an increase or just try to file for Gerd You won't get any increase because of the gastritis because (from the information you've provided), it would not appear that any increase was warranted because of gastritis.

One of my suggestions, to get the opinion from a physician, is the classical way of getting something service connected. My second suggestion, to apply for an increase for gastritis, though it might not work, included verbiage about the in-service diagnosis of GERD with the conceding of occurrence noted in the 2001 Rating Decision. It may (or may not) be sufficient for service connection.

If service connection is granted for GERD, it isn't clear to me at this point whether anything higher that 0% would be assigned. Furthermore, because you are retired military, you would not receive any money on a retroactive payment because of concurrent receipt (until you reach that magic 50% combined rating).

FWIW, if s/c for GERD/HH is granted, you won't receive a separate evaluation for GERD/HH because of the opening remarks from 38 CFR 4.114 http://www.benefits....ART4/S4_114.DOC . Instead, GERD/HH will be added to the gastritis issue.

Could this be a CUE also if it is stated in my records and decision why would they have went with gastritis? I don't particularly see it as a CUE, but you are welcome to pursue it if you wish. And, even if a CUE is determined, it isn't clear whether there would be retroactive compensation. That would require a review of your treatment records since 2001. And, of course, the concurrent receipt issue.

jvretiredvet so would it be better to go for an increase or just try to file for Gerd? Or would they try to connect the 2 together? Could this be a CUE also if it is stated in my records and decision why would they have went with gastritis?