A Bva Win

[qwiksting]

Sorry, I had to put that in Caps. It has been since june 2008 (claim filed) to BVA to AMC then back to BVA. Each C&P exam was heavily stacked against the evidence of record! Hoppy, the genius he is, saw right through the BS and assisted me. He deserves all the credit on this one. I originally filed a claim for GERD with esophageal ulcer secondary. My PCP ordered endo scope December 2005, (it was denied until I filed this claim in 2008) I got scoped in 2008, with a new finding of hiatal hernia. I filed another claim for that. So, I have 2 claims going that pertain to the same anatomical area. The Gerd/ulcer claim was denied and a month later the hernia claim denied. I filed a NOD, long story short, it ended up at BVA in 2010. Got remanded in 2012, then back to BVA 2013. And the decision was.....to grant service connection for GERD and Gastric Ulcer. Deny service connection for Hiatal Hernia.

My question now for anyone who has experienced this, How the heck do they rate something if it isn't in the 38 CFR rating schedule? And are these two things considered 2 different conditions to rate? My Cfile was sent back to St. Pete for them to do what they do....whatever the heck that is. I called the VA yesterday and was told to keep an eye on ebenefits, for a NEW claim to open. I am guessing it is for this descision from BVA.

Any input from the experienced ones would really be appreciated. This claim goes back only 60 months.

[jbasser]

Same body system. they wont pyramid ratings.

J

[JT24usn]

Gerd is normally 7346. Check pyramiding regs under digestive. Gastric ulcer 7304/5

Edited May 18, 2013 by T8r

[JT24usn]

§4.114 Schedule of ratingsdigestive system.

​Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.

§ 4.14 Avoidance of pyramiding.

The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent, so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation, and the evaluation of the same manifestation under different diagnoses are to be avoided.

[qwiksting]

Yea, T8r, I seen that but it is confusing to me. Hard to wrap my head around.

So would that mean I would recieve 2 different ratings?

After reading the descision again, It appears that the GE Ulcer, which was categorized as a Gastric ulcer was said by the board to be acute, and at some point it had resolved. However, medical evidence of last Endoscopy done by a Private Gastro Dr. said I had:

2 April 2012 Endoscopy performed by VA (Dr. Fabian)/Moderately severe esophagitis/34-37 cm level. Esophagitis; Hiatal hernia37-40 cm level; Erosive gastritis in Antrum
25 April 2012 Endoscopy performed by Dr. Denby (West Florida Hospital) /1 cm hiatal hernia; ulcererosive gastritis;mild antral erythema and erosion.

The descision reads: Resolving all doubt in the Vetrans favor,the criteria for service connection for GERD with ulcer are met.

The criteria for service connection for a hiatal hernia are not met.

In the descision it refers to the ulcer as acute, and that it had resolved during the pending appeal. What the heck does this mean, I have ulcer erosive gastritis?

Edited May 18, 2013 by qwiksting

[qwiksting]

I guess, I am asking should I just wait to see what the RO rates me for? In the descision it has ulcer erosive gastritis mention all through it. Would I need to file a seperate claim for that?

[GuaymasJim]

quicksting you asked"How the heck do they rate something if it isn't in the 38 CFR rating schedule?" My condition did not receive even an ICD-9 code until last year. I have had my permanent and total rating for 33 years. They rate "by analogy" which can be very dangerous for the vet because the different requirements for the various %s don't fit the vet's condition some analogous conditions have % caps in the rating schedule.

For the filthy minded (like me), the terms "analogy" and "analogous" are almost perfect for telling the VA what you really think by way of creative typos!