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

[Greg88]

John, I have Type 1, the list of secondary conditions related to the disease are a mile long, with DMII, some may be related, but with Type 1 most medical professional's "say yes it's the diabetes" and after 37 years with disease, most of the Dr.s I visit with skin cancer, hypertension, say it was caused because your diabetic. According to Ebenefits, they never checked with the Bronx VA Hospital, that I had been going to for the 1st 22 years of the disease, if they would have checked, they would have learned that I'm a Brittle diabetic or as the term used these days uncontrolled, it's been this way for the last 37 years. I realize that the VA is overwhelmed now with claims, but a little due diligence on their part. The funny thing is I'm chained to an insulin bottle, the only thing that can cure me is an islet transplant and with my age and complications that was taken off the table 10 years ago.

[harleyman]

GREGG88

The ebenefits is not reliable, yet.

I just found out today that our VA Regional Office has only 3% of the Veterans information in the new VBMS system. (where ebenefits gets part of their info, you cannot work a file in this system in it's totality if the system does not have all the information). Therefore, only part of your claim is being worked in the VBMS system and part is worked in VETSNET. (By the way VETSNET is only about 7 years old. It replaced the old BDN system. It took 6 or so years before VETSNET was reliable and I suspenst it will take at least 4 or 5 years for this new system to be viable and just about that time, like now,it will just start working right and we will need to upgarde and change again.

The letter from VA will tell you what evidence the VA used to make their decision. VA has a direct link to any VA Medical Center for records. If the records were prior to the VAMC keeping electronic records then we have to do a 5131 request for archived records. (this takes time usually about 60 days wait). Generally speaking VA can have their hands on all your VA records in about 5 minutes if they know you have been treated at the VAMC or one of the satilite offices for the area. The only records VA might have to request besides your private records is records located at a "Vet Center", ususally for PTSD clinics/groups and military hospital records. We do need to request those records and we do need to have the Veteran fill out a VA form 21-4142, Release of Information, just in case. Some centers won't release without the signed form.

Ebenefits is not accurate because, VBMS is not completely online for working claims in thier entirety. VBMS does not list all your records yet, therefore ebenfits cannot list everything that is in your file for review. The VA is only giving Veterans a snipet, of information. Veteran's ebenefits program does not give all the information made available to a VSR or RVSR. Basically Veterans have a sensored look at of some of the informatin in our claims processing programs. Ebenefits was written for the Veteran, we as VSR and RVSRs do not use ebenefits for processing your claims.

Edited July 25, 2013 by harleyman

[Greg88]

Harley,

after looking at things on Ebenefits, I realize that not all things are making it there, but after calling my 2 MDs, Primary and opthalmologist and finding out no records have been requested makes me think someone made error and then carried it all the way thru. According to the DAV SO, this proposal is calling for me to be reduced from 100-40%, not 60% where I was almost 17 years ago, now DAV has been wrong before, last July I was told my 100% was being reduced to 0%, never heard about that either. But how many Type 1 diabetics start getting better after 37 years with disease, I have been unemployed for the 16 years due to being a uncontrolled diabetic. I see DAV on Monday, I'm bringing the Dr.s note I brought to my C&P (it explains my condition, how long he has treated me, and in his opinion, that I'm permanently and totally disabled due to the diabetes) I will also bring the DBQ he filled out, if you can think of anything else please let me know. I see my Dr. on Aug 12th and will get new documents.

[Chuck75]

Did you notify the VA in writing that you disagreed with any proposal to reduce?

Ebenefits has been really wonkers lately.

[harleyman]

Gregg88 said:

The problem is at this point in my life I cannot my blood sugar get to high, who know how much my kidneys have left.

Make sure you submit any lab tests you have had lately. Kidney disease is secondary to DM and should also be considered in any rating decisions. After 37 years of type 1 diabetes your Kidneys are surely going to show abnormal lab tests. Lab test results are what VA basis their s/c criteria on for kidney disease or loss of kidney function.

Also, I re-read your posts, and it appears you have not as yet, to date, recevied any notification from VA for the proposal to reduce. Am I understanding your post correctly? Please let us all know when you actually get the "proposal to reduce letter".

Remember, as others have mentioned more than once, you must request your hearing within 30 days of the date on the letter. So you actually loose a bit of the 30 days allowed to respond time, due to the mailing process.

Edited July 26, 2013 by harleyman

[Greg88]

Harley, received the letter today, it's dated the 22nd, filling out my hearing request this weekend and bringing it down to the RO Monday, I was right they are basing it on Type 2 instead of Type 1, they went no further then what I provided at the C&P. Never checked the 22 years of VA medical records before I started using a private MD and only checked the records I brought to the C&P. The kicker is the things they were looking at Retinitis, neuropathy of the hands and proteinurea, when I had my C&P in the 90's, those were not what I was complaining about, it makes me wonder if they even looked at that C&P.