diabetes Chances Of Being Reduced ?

[Greg88]

I have been SC for the last 37 years with the VA, right out of the service at 40% with Diabetes Mellitus Type 1. I'm also have been Brittle (meaning my blood varies from low to high- in my case mainly low), for the last 37 years, I used the VA health care for 21 years, in 1996 I was bumped up to 60% because of Neuropathy in both feet, Proteinurea, and generally poor control due being unaware that sugar was going low (I passed out at work and lost my job in late 1996), I put in for 100% in 1997, Nov. 1997 I had my C&P.

In Jan. 1998 I was granted 100%, my VA endocrinologist (who was my MD since the very beginning 21 years) retired from the VA, after 6 months of seeing Endo residents, I stopped using the VA system. I started the to see my private MD (I had been seeing him regularly for physicals and general medical for a year before my VA doctor retired. After being awarded the 100% the only time I heard from the VA was for COLA increase's, in 2012 I receive a letter from the VA saying they are setting me up for a physical because my Diabetes Mellitus in not considered Permanent.

Sept. 2012 I see my private MD and have him fill out the DBQ for diabetes and peripheral neuropathy, he also includes letters from opthamologist showing I have Diabetic Retinopathy, he also writes a Nexus type letter (I know I'm SCed, but with the VA you have to hit the over the head) saying this disabilty and it's complications are permanent (My MD is not a general practioner, he is the head of internal medicine for a large prestigous hospital in NY), I have my C&P, I get a copy 3 weeks later, the C&P results are a carbon copy of my Dr.s DBQ and note. A brief overview, I take 7 shots a day, test my BS 12 times a day, my blood pressure is high (common in diabetics, 4 medications to control) the neuropathy is so bad I cannot stand or sit for more than 10 minutes, I sleep 3-4 hours a night and need 20 mgs of Ambien and a muscle relaxant to do that, my vision is poor, I urinate 40-50 times a day. My diet is strictly controlled, low protein due to protein urea, low fat due hyperchlosteroemia, and of course now I have Erectile Dysfucntion

I called the 1-800 in Nov. and was told they reached a decision, actually nothing was decided, the farmed out part of my for an Admin Review, that was decided 3 weeks later. By 2013 no decisions, in March 2013 a new claim. a Rating Review, of course the compensation claim is still listed as Diabetes Mellitus (New). DAV who is my POA has been totally useless, when you do manage to get someone on the phone they give you the info, on March 15 I see my Comp claim go from Gathering to Preparation for Decision.

To the present day on Friday July 19th, I decide to go down to DAV and ask whats going on (In Sept it will be 1 year since the C&P and the VA may declare it invalid), 9:00 in the A.M. DAV tells me to come back 2 hours later, I go to the RO across the hall (there in the same Building) and talk the VSO thats their, he's also a Diabetic and he's wondering why I'm not P&T, he calls up the Rater upstairs and she tells him that they are looking at each complication seperatley. So looking at Ebenefits and the unsolicited items I submitted ( under the things the VA solicited were just the C&P exam) the VA showed the Dr.s letters and DBQ and that was basically it.

My question is if the VA looks at my Diabetes at the 60% rate and starts adding the peripheral neuropathy and others complications using VA math, it does not add up to 100% and I know that in 3.5 years I'm at my 20 year mark and theirs nothing they can do at that point, I just have a feeling they are going to try and lower it just to save money. Any input would be appreciated.

Edited July 21, 2013 by Greg88

[Philip Rogers]

Based on what you've stated I think you're safe. This doesn't mean the VA may not try a reduction, tho. You may want to submit a claim for the retinopathy and the ED, if you're not receiving the SMC "k" award, already. Should they send you a proposal to reduce be sure to respond immediately by requesting a hearing. I would think they'd need to give you TDIU, based on your condition(s), if they tried to reduce. jmo

pr

[Greg88]

Phillip,

The C&P in Sept. 2012 included an eye exam by an optometrist, I had brought a letter from an opthamalogist (one of the best on the East Coast) because the letter in Jan. 2012 said they were looking at Retinitis (nothing to do with diabetes so proabley a mistake) but with the VA I know you have to cover your bases. I was researching the CFR and looked at the Ratings for diabetes mellitus in section 4.119.1, 7913 lists the disabilities and the breakdown from 100-10% but an interesting little thing is at the end. Note (1): Evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100 percent evaluation. now this is what they used to give me a 100%, but the VSO who I saw on Friday told me that the rater said they were going to break it down individually by disability, and they have changed how they do it. Now the copy of the CFR I downloaded was the 2012 revision and nothing has changed on how they rate for diabetes, so they can't just change things in midstream can they ? The ED was on the record when I talked to the VSO friday, the examiner noted more things on the C&P and lttle things were even accounted for, she covered 36 pages in progress notes (she was a Nurse Prac.) After reading the many Forums talking about the VA these last 2 years, I do not trust them legally or medically.

[Greg88]

So I went on Ebenefits and saw that they closeded my claim, I called my DAV office and was told they are proposing to reduce me from 100% to 40% based on improvement in my condition (what a joke), though they had a ton of evidence saying the other way around, this is what they do. What do I do next, get a lawyer, go back to DAV any help would be appreciated.

[Greg88]

Calling my MDs offices they have had no inquiries from the VA at all, so they just used the C&P which was negative in ways that showed my condition has gotten worse. Is their anyway to nip this in the bud, before they can implement a reduction. It's hard to believe a rater can do something like this all by themselves.

[carlie]

Calling my MDs offices they have had no inquiries from the VA at all, so they just used the C&P which was negative in ways that showed my condition has gotten worse.

Is their anyway to nip this in the bud, before they can implement a reduction. It's hard to believe a rater can do something like this all by themselves.

As soon as you receive the proposal - follow pr's instruction and request a hearing in writing

and that no reduction take place prior to this.

If you have additional supportive evidence that rebutts their evidence to support a reduction-

I would include copies of it.

If possible I would submit it at my VARO in person and get a date stamped copy.

JMHO

[Greg88]

Thanks Carlie, I'm thinking a lot of this could have been stopped if DAV took a more active role in it, I've spent the last hour and a half going over the C&P exam and my Dr.s note and DBQ, it should at least gone to IU in the least, actually it should have started there in 1997.