diabetes So I Received The Proposal To Reduce

[Greg88]

So the VA sent the Proposal to Reduce my Diabetes Type 2 from 100% to 40%, theirs only 1 problem, I don't have Type 2 I have Type 1. I have been at 100% for the last 15.5 years and 60% before that. I used the VA healthcare for 22 years for my diabetes and then switched to my present private Dr. 17 years ago, I continued to use the VA till 2002 or 2003 for my eye checks. When I went to the C&P exam in Sept. 2012, I brought a DBQ for diabetes filled out by my Dr., a letter from my Dr. explaining my condition and present complications, and that in his opinion it was permanent and total (he is the head of Internal medicine for a big NY hospital) the only evidence that was reviewed was the Medical records going back to 2004 that I brought and the DBQ that I brought. I'm writing up the letter for the hearing, I'll bring it down Monday. I guess that battle begins now for real.

Edited July 26, 2013 by Greg88

[Philip Rogers]

You probably should get an atty because, as I've stated before, the VA does what they want. I'd request another hearing, as it sounds like you really didn't have a "hearing." Did they record the "hearing?" I'd also request a copy of all payments made to you by the VA. It should be in your c-file. Thinking about it, how long have you been taking insulin?? The reason I ask is if you take insulin more than once daily the rating says it's 100% and I would file a claim for CUE back to when they discharged you from the military. Sometimes the best defense is an attack. I'm sorry they're jerking you around. jmo

pr

[Berta]

Yeah PR ....I agree and also if this was not a hearing that conformed to M21-1Mr guidelines, Greg could ask them to CUe any negative response he gets from the "hearing".

I agree with jbasser too because as you stated, they don't know how to handle your case.

Greg ...do you have hard copy evidence of this? Or as PR mentioned, did they tape any of the 'hearing'

" my evidence was ironclad, 2 Dr.s notes, a new DBQ and they want 6 more months to fart around"

regarding the 'farting around ' part...in other words, they made no decision yet as to the 'hearing' situation.

And your DAV NSO is witness to them, saying ,in essence ,that they need 6 more months to' fart around' in?........

6 more months isnt a bad idea......if they can learn by then how to read the medical evidence ,and if the result is positive.

[harleyman]

Greg88, I know I have mentioned quite a few times that you should file a claim for all the conditions that your suffer from as secondary condtiions to your diabetes type 1. Although I have requested and advised that you do this, I have not read a response or confirmation that you indeed filed for those secondary issues. Please tell us what secondary issues you have filed for and whether or not your private doctor provided a DBQ for you to submit for those conditions.

The VA can reduce your diabetes type 1 per the rating schedule, but as I have stated before, you need to file for the secondary conditions as they rate those separately. It is fine to get an attorney, but the bottom line is you need evidence and DBQ examination findings are evidence.- Please enlighten me on the status of those secondary conditions.- Harleyman

[Greg88]

Harley, the VA has identified peripheral neuropathy of all 4 of my extremities and given percentages for each of them, they have identified ED, urinary incontinence and the examiner mentioned the hypoglycemic unawareness in her C&P report, and according to CFR 38. 3.343, they cannot lower a rating without showing a material improvement in my condition. They are also supposed to go through a vets total medical record before reducing someone, which they have not, they don't even have when I was made 100% right, you want me to start adding more pieces that don't get looked at.

The ratings schedule for Diabetes mellitus 7913 has no rating for 70%, 80% or 90%, it's either 60% or 100% there must be a reason for this, people think this is just your sugar going high, it's not, its a disease that beats your body down year after year. Harley if they want to reduce, they better legally follow all the rules of the CFR, after 16 years, they are not supposed cherry pick what one DRO thinks he or she knows about diabetes, they main secondary conditions I have the VA does not if have a category for. At this point there ignoring top Dr.s written notes and DBQs, at this point, it seems they just want to keep delaying making a decision because they don't understand diabetes Type 1 and you can Google Type 1 and 2 and see the differences, but even that seems like it's beyond them.

After 16 years at 100% and 37 years being service connected with Diabetes Type 1, I have to show them and pick up after their stupid mistakes. DAV follows the VA like a lapdog looking for a job, telling me no I don't have any protected status because, I've only been 100% since 2007. Is the rater getting stressed out as much about case as I'am, probable not, but it's their job and their getting paid to do a good thorough job and at this point it's been a piss poor inadequate done job.

[harleyman]

GREGG88, you stated,

Harley, the VA has identified peripheral neuropathy of all 4 of my extremities and given percentages for each of them, they have identified ED, urinary incontinence and the examiner mentioned the hypoglycemic unawareness in her C&P report, and according to CFR 38. 3.343, they cannot lower a rating without showing a material improvement in my condition.


Your recent examination did not show you to meet the 100% criteria per the scheduler requirement ( according to the VA). Since, you have not been at the 100% disability for the protected 20 years mark, you condition is eligible for reduction based on current medical records and examination findings . In a previous post you stated the following…

I conform to 100% rating except for the hospital visits part, my wife gives me a shot of Glucagon when I'm unresponsive 2-3 times a month, thats the funny on the ratings, there the exact same as 1970, in diabetes we have progressed a little. what used to hospitalize you does not anymore …

The causation of improvement in a condition is not a determining factor in interpreting examination findings. Medicine can improve many conditions and there are cures, as well. The CFR states the condition must meet certain established facts and documented symptomatology, If you do not meet the scheduler and you are not protected due to longevity, the VA will proposed to reduce that condition based on examination findings. (if you had a VA examination and then your doctor sent in another examination, that does qualify as two examinations. If the DBQ from your doctor also shows a lower disability percentage for DM I, well it will confirm reducing your disability rather than bolster to keep the 100%. I a fairly confident the DBQ your doctor completed, when plugged into the evaluation builder for diabetes, show a lower level than 100%, as you stated you have not been hospitalized).

They are also supposed to go through a vets total medical record before reducing someone, which they have not, they don't even have when I was made 100% right, you want me to start adding more pieces that don't get looked at.

The VA has your claims file. They are responsible to review everything in it. Ultimately, they are held accountable for all evidence in the file. That’s why there are appeals and CUE’s. At this point you need to forget about what they have to do, and concentrate on what evidence you need to support your service disability at the 100% level.

The fact that they have the file, and they proposed to reduce, means they are stating they have reviewed the record and the records indicate a reduction is appropriate in this instance. Wrong or right, the VA can interpret the evidence in the file and make the proposal to reduce. You also stated…..

So I went to the hearing today and was told by DAV since I was only 100% since 2007, the VA could reduce me with only 1 exam.

The DAV service officer probably does not have a handle on your case. The service officer stating this tells me he doesn’t know what is going on, and he is probably doing you more harm than good right now. It has been my experience that the SO doesn’t really review a file until right before the hearing. All in all they spend 30 minutes looking at the file the day of the hearing and expect to help the vet. Quite honestly, it doesn’t matter what the DAV says, what matters is what the DRO/RVSR says. Just because the DAV says something, they are not speaking for the DRO or RVSR. The only think that counts is WHAT IS PUT INTO WRITING/the DECISION by the DRO or the RVSR. All the rest is just talk.

DAV does not understand ALL the issues involved in rating cases. You probably have a better handle on things than the SO at the DAV, just from being here on the forum, at Hadit. I would move on with your claim and ignore or leave the DAV SO out of the loop if you can. You are fully knowledgeable in supporting your claim. -IMO

The ratings schedule for Diabetes mellitus 7913 has no rating for 70%, 80% or 90%, it's either 60% or 100% there must be a reason for this, people think this is just your sugar going high, it's not, its a disease that beats your body down year after year.

Agreed, most people do not understand diabetes type 1, most people only know diabetes type II. The VA raters, however, must follow the rating schedule. Unless, your condition meets the 38 CFR criteria, the RVSR/DRO is bound by the law and the code of regulations, to propose the reduction. If your diabetes examination shows you do not currently meet the criteria they are bound by regulation to PROPOSE to reduce the 100% for Diabetes. It’s up to you to provide EVIDENCE as to why the reduction should not occur. (Evidence such as, IMO, private DBQ, recent research of Diabetes type I, who diabetes is 100% disabling). Your rbuttal needs supporting evidence for the 100% rating, not about what VA should or shouldn’t do. You will never win a battle with VA telling them what to do. You win with EVIDNECE and the 38 CFR.


Harley if they want to reduce, they better legally follow all the rules of the CFR, after 16 years, they are not supposed cherry pick what one DRO thinks he or she knows about diabetes, they main secondary conditions I have the VA does not if have a category for.

It appears the VA has more evidence than one DRO’s opinion. The VA examination findings, and then the DBQ you submitted, as well. I am sure they plugged in the examination findings for your private DBQ and it is not showing 100%.

I suspect they took an hour break during your hearing so they could quickly review the evidence you brought with you and submitted. They probably entered the DBQ into the evaluation builder and it did not show 100%. When they came back and told you they were still going to reduce the diabetes, but were giving six months to adjust you finances.

At this point there ignoring top Dr.s written notes and DBQs, at this point, it seems they just want to keep delaying making a decision because they don't understand diabetes Type 1 and you can Google Type 1 and 2 and see the differences, but even that seems like it's beyond them.

If you want to post your private DBQ here on hadit, I will plug it into the evaluation builder for you and tell you what the evaluation builder shows for you level of disability, or we can look at the DBQ answers and compare it to the CFR for diabetes and determine what the current level of disability should be.


After 16 years at 100% and 37 years being service connected with Diabetes Type 1, I have to show them and pick up after their stupid mistakes. DAV follows the VA like a lapdog looking for a job, telling me no I don't have any protected status because, I've only been 100% since 2007. Is the rater getting stressed out as much about case as I'am, probable not, but it's their job and their getting paid to do a good thorough job and at this point it's been a piss poor
inadequate done job.

In my opinion, the rater is doing their job, based on the VA examination findings and private evidence submitted. If the evidence (VA and Private) shows you do not meet the criteria for diabetes at 100%, then then rater is doing their job by proposing to reduce.

VA knows you were discharged from the service with Diabetes type 1 at 40%. Once VA rates your condition according to the 38 CFR, VA does not consider you 37 years being service connected. You are service connected when your rating by VA is completed and the VA states the condition is service connected. I believe you said 15.5 years. Before you get mad at me let me share the following….

15.5 years ago, VA rated diabetes as one condition only. It included all known secondary conditions with the rating for diabetes. As medications improved and treatment improved, as you yourself stated, hospitalizations for diabetes became less frequent. A decision was made to rate each condition separately, once the secondary condition was severe enough to warrant a rating percentage of at least 10%.

The fact is, the disability from this disease remains far reaching in its debilitating nature affecting multiple body systems. VA is well aware of those issues. That’s why they give one rating for diabetes, and a separate rating for all body systems affected by diabetes. For example, diabetes, peripheral neuropathy, kidney, bladder, eyes, genitourinary, erectile dysfunction (K) award, and any other conditions your evidence shows is determined to be caused from your disease of diabetes. Each warrant their own rating based on severity and then they are combined.

Then IU is considered to bring the Veteran to the 100% if the service conditions show he cannot work. That is specifically why there is IU. Diabetes is a condition that affects multiple systems.

So by breaking these conditions out on their own, it is easier to get additional benefits. Such as loss of use for the K award. The loss of use of extremity(s) due to PN which can result in the auto mobile allowance (which was just raised to $19000.00 + effective Oct.1st), SAH/SHA for house adaptation for being immobile and more ancillary benefits. SMC and higher awards when the disabilities worsen to the point of additional scheduler rules, of one condition at 100% and another at 60% or more. That would not happen as easily if they rate your diabetes as 100% and include all those conditions in with your diabetes. You stated the following….

They are also supposed to go through a vets total medical record before reducing someone, which they have not, they don't even have when I was made 100% right, you want me to start adding more pieces that don't get looked at.

By the VA sending the letter sent to you for the proposal to reduce, which is a legal notification providing due process, it is assumed the VA representative reviewed your file in its entirety. VA knows exactly when you were made 40%, 60% and 100%. The DAV may not, but VA does. On appeal, the VARO will be held accountable for any mistakes in the interpretation of the law or regulations governing your claim, if there is an appeal and it is found a mistake has occurred. This issues at hand is to keep this from going to an appeal and to keep you paid at the 100% or more level. You asked……

you want me to start adding more pieces that don't get looked at.

YES, I think you need to add all the “pieces“to you claim. If you do not file a claim for all disabilities that the diabetes type 1 has caused you over the years, then you will not be service connected for those conditions. You need to receive your rightful rating based on all issues that are secondary to the diabetes.

I would file a claim for all of those issues. IMO-

These DRO’s and raters are not stupid people. Contrary to popular believe, most DRO’s and raters have at a minimum Bachelor Degree and/or Master Degree in business management, contract law, etc. NO, VA raters and DROs are not doctors. The VA has plenty of doctors who work for them, and they are bound by their Hippocratic Oath. to do harm to a patient, however, remember when you go to an exam they are not your treating physician, therefore you are not their patient, and remember who signs the paycheck for those doctor’s. Most of whom can’t make it in private practice- IMO-

VA employees are bound by 38 CFR and the evidence. And as taught here on HADIT, you need to fight at that level, using the 38 CFR and M21-1MR, and EVIDENCE, if you want a higher disability or service connection.

So IMO, you need to file a claim for ALL CONDITIONS related to your diabetes, even if you think VA isn’t bright enough to figure out the claim, because trust me, the JUDGE at BVA is bright enough.

Of course the news is not always pleasant when it come to the claims processing. I post here just as others post here, to help Veterans with their claim. I am not against you; I am on your side. These are my opinion, based on what you have shared here, and my knowledge of the VA system interworking’s, as I know them. - Harleyman

Edited September 28, 2013 by harleyman

[jbasser]

As far as secondary conditions, The VA has the ability to note the claims file when a veteran files a claim. In many cases they will see other issues that are of a secondary consition and infer those conditions. The Veteran still has to file for those conditions.

The VA in trying to reduce you should understand that with Type 1 diabetes you are never going to improve without a pancreas transplant.

I think they should be spending their time more efficiently and work on reducing the backlog.

We just had a report that the BVA has and increase of 250000 appeals. That means there were 250000 Notice of disagreements. EIther lowballed or denied claims.

Oct 1, the Congressional Veteran affairs committe will conduct a roundtable meeting. Only a select few are getting to see this. A speaker at this event will be Joseph Moore of Bergmann-Moore.