Question Concerning Submitting For New Disability

[meghp0405]

Good morning my fellow veterans, I received a telephone call last night from a veteran requesting my assistance. A little background on the vet, he is 100% disabled since 2001. He wants to file for ED. Kind of interesting that he called when a few of us were commenting about this on another post.

He has been on the fentynal patch for the last 6 years. It is his belief that this patch has caused him to have the ED. His worry is, if he submits for the K award, will this effect his claim in its entirity? He has 6 years to go before his SC % are "locked in", and submitting this would cause a re-evaluation on his other SC disabilities and perhaps lose his 100%.

I really didn't have an answer for him. I did tell him what we are told in our annual training, that when submitting for a new disability that the claim is opened in it's entirity. I know there are a few that have the opinion that the VA doesn't open the claim in it's entirity, simply because of the claims backlog. However, I have seen letters from the VA with a proposed decrease in their rating.

I also informed him that I believed that the diagnosis in itself would not warrant a positive award for ED and that his doctor would have to write a IMO stating why he/she came to that conclusion.

Any suggestions and or comments would be greatly appreciated!

[Berta]

Meg

(not a fellow vet ,as you know ,I am a civilian ,but we have discussed ED here many times and it is good that there is a comfort zone these days ,on these issues.)

You always go the whole 9 yards with the vets you help! You are truly a strong advocate for them!

The fentanyl patch,in some good medical info on the net, does not list any sexual dysfunction side affects at all:

http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=80248

http://www.rxlist.com/duragesic-side-effects-drug-center.htm

http://www.onlinelawyersource.com/fentanyl/side-effect/

I am thinking that, with his 100 % now, it certainly could be another med he takes that is causing the ED.

This link shows what I mean:

http://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysfunction

I think he should go over his meds carefully and see if there is a stronger basis for any VA med he takes to cause the ED.

Even a disability itself, such as diabetes, regardless of meds, can cause sexual dysfunction.

And of course HBP meds can sometimes enhance sexual ability, but sometimes can severely decrease it.

"I also informed him that I believed that the diagnosis in itself would not warrant a positive award for ED and that his doctor would have to write a IMO stating why he/she came to that conclusion."

You are right of course.

The IMO doesnt have to be elaborate if the doctor can give a full medical rational ,such as an example.....

stating 'the veteran's ED is as likely as not due to Diazepam , a medication, prescribed to the veteran for his service connected anxiety disorder of PTSD , , which has known side effects to include sexual dysfunction, in current standard medical literature..' And then the doc can cite any good med link from the net to support that conclusion and even copy the abstract to attach to the IMO.

Such as :

http://www.ncbi.nlm.nih.gov/pubmed/9160580

Anxiety. 1994-1995;1(5):233-6.

Clonazepam-related sexual dysfunction in male veterans with PTSD.

Fossey MD, Hamner MB.

Source

Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA.

Abstract

Medication-induced sexual dysfunction can significantly interfere with patients' quality of life and lead to poor compliance. This retrospective study examined the records of 100 male veterans with post-traumatic stress disorder (PTSD) selected in alphabetical order from an active treatment file of 230 patients. Forty-two patients had received clonazepam (mean maximum dose: 3.4 +/- 1.6 mg/day) at some point during their treatment. Of these, 18 (42.9%) complained of significant sexual dysfunction (primarily erectile dysfunction). Eighty-four patients received diazepam (mean maximum dose: 52.1 +/- 29.7 mg/day), nine received alprazolam (mean maximum dose: 5.2 +/- 2.8 mg/day) and eight received lorazepam (mean maximum dose: 3.8 +/- 2.4 mg/day). None of these patients complained of sexual dysfunction during treatment with these three other benzodiazepines. Our findings suggest that benzodiazepines, particularly clonazepam in the current study, can be a cause of sexual dysfunction in many male patients. Prospective studies comparing the overall clinical utility of various benzodiazepines are indicated in this and other clinic populations.”

One thing about meds...they usually have more than one name identifying them.

http://www.nhs.uk/chq/Pages/1003.aspx?CategoryID=73

For example I take a half of a astorvastin tablet twice a week . My doctor calls it Lipitor.

My husband was administereed Lorazepam. His doctor called it Ativan.

It pays to make sure either the generic name or the actual medical name of the med is used properly when searching the net for med info.

And these days vets themselves can find a wealth of info clicks away on good web sites ,on their meds., as well as saving any print outs that come with their meds.

[jbasser]

Here is a common list of meds that cause ED. http://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysfunction

J

[Philip Rogers]

At 10 yrs he's pretty much locked in and protected. I believe SC is locked in at 10yrs and at 5 yrs he can't be reduced lower than his previous rating. Besides it takes a couple of exams and some real strong evidence to reduce, at that point. As for ED, it can also be caused by hypertension & alcoholism, besides the effects of the drugs previously mentioned. If I were him I'd go for it. jmo

pr

[Aletta]

Effexor, GENERIC NAME: venlafaxine also causes ED, I did not see it on the lists above. Venlafaxine is given for Depression. Depression and Heart issues also cause ED. You said the Vet was 100% SC. Check with him if he is SC for Heart conditions including Hypertention or Depression. My husband is SC for ED secondary to PTSD/MDD. It is 0% but he get SMC-K added to his monthly benifit.

Edited March 9, 2013 by Aletta

[Teac]

As I usually say..... If a veteran has a valid claim they should submit it.. even if they are rated 100%.

Look the law requires more that one C/P exam to get a reduction, second in this case this veteran has been rated 100% for more than 10 years and a reduction is highly unlikely. I agree he needs medical evidence supporting an ED diagnoses, the cause of ED and if it is secondary due to the use of medications for service connected disabilities or if it is secondary to a service connected condition.

The longer you pounder a decision to help him file a claim, the more compensation he loses out on....

[broncovet]

You have gotten answers from the "best of the best"...Berta, PR, and the others have all given great advice. I would add:

I do think this is a "scare tactic" by the VA. You know, dont apply for any more benefits or you could lose the ones you already have. While I wont rule out this possibility, I think the reverse is probably more likely, and I will explain why.

The VA does not need an excuse to do a reduction. They can do it at any time, but, of course, they have to follow the rules or it will be reversed if the Vet contests the reduction.

I think when your claim is in appealate review, its difficult for the VA to do a reduction. Why? Remember, there is ONE paper copy of the Vets C file, and, if it is sitting at the BVA awaiting a decision, the RO will have a hard time proposing a reduction. And, further, I think the likeliness of going to appeals is very high, just because this is the way the VA does it. The BVA/CAVC does not do reductions in the first instance. I think I recall reading where the BVA can not "take benefits away", that is, unless the Ro tried to take them away first, and the Board merely affirms the RO's reduction of benefits. In the absence of a reduction by the RO, a Veteran can not go to the BVA and come back out with less benefits than what he started with. The BVA does not do reductions in the first instance.