hypertension Help With A Claim Upgrade Please!

[Navy ELT to EMT-P]

Hi all,

First of all I am so glad I found this forum. This call for help is for my wife's case, that I am helping with. Here is the background. She served from 1997-1999 in the navy active duty. While in boot she came down with mono. During 18 months of A school her symptoms persisted. She was seen dozens of times at sick call by corpsmen and each time had a pregnancy test and sent back to work. When she finally passed out at work and was taken to see an internal medicine doc, they found she was still positive for mono. In her report the doc stated that her current condition was caused by the poor care she received which was below the standard of care for any military or civilian health care. Nice huh? She was quickly found unfit for duty placed on TDRL to PDRL and got a VA rating. 20% sc CFS, and some ortho stuff that put her at 50 percent total.

Now 13 years later her symptoms have worsened, to where she cant work, is home bound 50 percent of the time and often is too exhausted to eat, shower or brush her hair. Before she got sicker she was a respected high school math teacher and this has been hard. Additionally she has been diagnosed with fibromialgia, depression secondary to CFS, her ortho has worsened requiring surgery in both shoulders, hypertension, sleep disturbances, hyperlipidemia. She has only seen civilian docs since leaving the service.

She submitted a claim to have her rating increased, she used the local Texas Vet commission VSO and they did a pretty crappy job. Specifically they only put her CFS, hypertension and one shoulder on her claim. Paperwork was lost, ext ect ect. Now it has been filed and she just got her C/P exam scheduled for June. So here are my questions:

1. VSO, we need help with the paperwork, she is to tired and forgetful because of her illness and I am working 60+ hours a week and taking care of 4 kids. Does anybody have a recommendation for a good advocate in the central texas area? We aren't very involved with the vet community. We have had a recommendation for the Jewish War Vets rep in Dallas and are willing to drive, but this recommendation was not based on knowing his record only because we are friends with the JWV Austin post commander. We will drive to Waco, Dallas, San Antonio for somebody that will do a good job.

2. Should she at this time add the additional claims? Fibro, the left shoulder? We have been waiting for 18 months and money is critical. We don't want to add them now if its going to push this all back another year.

3. Looking at the rating guide she really looks like a 60 or 100 percent for CFS, from what I'm saying what are your WAGs?

4. IMO, I think its worth it. Espically to nexus the depression and hypertension, the literature supports this. Who do you all like? Dr Bash, or is there anybody good in texas? What should this cost? Also should we do this before of after the C/P. Also if we don't add the additional claims should the IMO only cover whats on the current claim or everything so it can be used for the next claim as well?

I think thats it for now. Any other help you guys ave would be most appreaciated.

[Berta]

I assume she is a Gulf War veteran....

“Gulf War Veterans who develop
fibromyalgia do not have to prove a connection
between their illnesses and military service to be eligible to
receive VA disability
compensation. Fibromyalgia must have emerged during active duty
in the Southwest
Asia theater of military operations or by December 31, 2016, and
be at least 10 percent disabling. “

http://www.publichealth.va.gov/exposures/gulfwar/fibromyalgia.asp

As this BVA case shows CFS and Fibro
are rated separately.

VA might combine the ratings however,
not sure on that

http://www.va.gov/vetapp09/Files5/0945243.txt

“Additionally she has been
diagnosed with fibromialgia, depression secondary to CFS, her ortho
has worsened requiring surgery in both shoulders, hypertension, sleep
disturbances, hyperlipidemia. She has only seen civilian docs
since leaving the service. “

VA wont SC the hyperliedimia as it is a
symptom. And sleep disturbances is too vague a term to claim... it
could be from the depression or even her meds.

Does se get SSDI for any of these
conditions?

I think she should apply for TDIU .The 21-8940 form is here at hadit and we have an entire TDIU forum.

She cannot work and is obviously housebound ( SMC S award)

Why not see if any of her private doctors would be willing to write an IMO for her regarding each condition claimed.

We have the IMO format and the key wording it needs in our IMO forum under "getting an IMO:"

I hope you get a good VSO because they can do a lot with a claim like this. Their goal should be TDIU.

[Navy ELT to EMT-P]

Thanks for the thoughts. She isn't a gulf war vet but the CFS I already rated as sc as is the right shoulder.

We don't have a VSO worth anything and are trying hard to find one.

I saw the disability question forms on line. Can her docs (who don't know much about VA rattings) fill these out? We were thinking about Dr Ellis or Dr Bash for a full IMO.

[Berta]

Does she get SSDI for any of these
conditions?

“I realized the actual verbage isnt
in this post I made so here it is from tmoe :

"Is due to-
100%
More likely than not- Greater than 50%
At least as likely
as not- 50% (Benefit of doubt goes to Vet)
Not at least as likely
as not- Less than 50%
Is not due to- 0% from an post by carlie “

That wording is critical. The IMO
doctor , ( real shrink would be good for this) has to state for
example,

'this veteran's depression is as likely
as not due to her service connected CFS as it is well known in the standard
medical community that these dehabilitating illnesses cause
depression and I cite :

The doctor should use a strong reference from the APA or Mayo, Johns Hopkins etc for that.

Dont know Dr. Ellis but Dr. Bash gave me 2 excellent IMos. for my AO DMII claim.

He has done shows with us at the SVR radio archives up top of the main forum page.

Dr. BAsh is a former VA doctor and knows exactly (as Dr.. Ellis does too I am sure) exactly how to prepare these IMOs.

I am not sure how he could prepare the depression IMO but it might pay to contact him on that.

drbash@doctor.com

[Teac]

Sir, I would recommend that you seek out the assistance of the DAV in Waco. I am located in Kentucky, and about 3-4 years ago, A veteran had called me requesting assistance on her claim. I referred her to the DAV WACO office and she was very much pleased with her results.

Many on here are against VSO's and they have that right to be for what ever reason. I would suggest seeking this organization before obtaing a lawyer. that's like putting the cart in front of the horse. At leat obtain an appointment with them, bring all your documents and sit down face to face with them. Then make the decision on how you want to pursue your plight.You lose nothing.

I agree with some of the comments about VSO's. There are some that should just stay home and take up basket weaving. But, there are also many VSO's that are knowledgable and will bend over backwards to do everything in their power to assist.

Find a VSO that is always busy. There is a reason he/she is always busy versus the one sitting and waiting for someone to show up.

I used to be a DAV Service officer, I used to live in Killeen, and so I was very aware the DAV in Waco... like most places it really depends on how well the individual service officer does the job, how much he knows, and how much he cares.. Keep in mind if they work at the Regional Office they are being paid to do the job, and frankly most don't care one way or the other about your claim they just care about the paycheck. Oh the other hand if you can find a volunteer service officer, at the local DAV in Harker Heights, or the VFW in Killeen they might do a better job for you , and depending on the person they are likely to spend more time with you on your claim.The folks at the regional office are bombarded with questions from veterans all over the states and really have little time to do anything about any single claim. Of course this is just Opinion. Honestly, the last place I would be looking for help would be the DAV....

[Navy ELT to EMT-P]

Thanks all for the good feedback.

I this has given me a lot of information and a good place to start. I will probably ask more questions but more focused.

Any other input would be greatly appreaciated.

[meghp0405]

Thanks for the thoughts. She isn't a gulf war vet but the CFS I already rated as sc as is the right shoulder.

We don't have a VSO worth anything and are trying hard to find one.

I saw the disability question forms on line. Can her docs (who don't know much about VA rattings) fill these out? We were thinking about Dr Ellis or Dr Bash for a full IMO.

search for the DBQ'sthat represents her disabilities. there is a DBQ for each disability listed and some are combined together.