tinnitus Hearing Loss & Tinnitus N&m

[harleyman]

Has anyone had any luck with reopening a previously denied claim for hearing loss and tinnitus due to acoustic trauma. The claimant is highly probable for noise exposure due to MOS (Military Police).

Veteran filed a claim back in 2006 denied in 2008 for both HL and tinnitus, as the Veteran was honest and told the examiner he fired guns after his discharge from service. So of course VA blamed the hearing loss due to his after service recreational shooting of firearms.

Of course they ignored that he was an MP in Saigon during the TET offensive and exposed to loud blasts and gunfire during two tours in RVN.

Not sure if a private exam and DBQ or if just having VA do another exam based on the newer standard of MOS and presumed acoustic trauma is enough to have them give him a fair shot.

Any comments on how to have this re-opened and WIN is appreciated especially success stories, as he probably will only have one real shot at having this denial changed to a grant.

[Berta]

“Am I missing something Here? Doesn't he have 160 or more on three readings which would warrant 10%. “

YES, as I see that too:

“ or unless systolic pressure is predominantly 160 or more”... he has 3 systolic readings above that .

I think they should CUE themselves on that one.

I assume this is the reg the VA used:

7101 Hypertensive vascular disease (hypertension and isolated systolic hypertension):

Diastolic pressure predominantly 130 or more

60

Diastolic pressure predominantly 120 or more

40

Diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more

20

Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control

Source VASR

(diastolic pressure - the blood pressure (as measured by a sphygmomanometer) after the contraction of

the heart while the chambers of the heart refill with blood

blood pressure - the pressure of the circulating blood against the walls of the blood vessels; results from the systole of the left ventricle of the heart; sometimes measured for a quick evaluation of a person's health; "adult blood pressure is considered normal at 120/80 where the first number is the systolic pressure and the second is the diastolic pressure")

http://www.thefreedictionary.com/diastolic+pressure

I always get that mixed up so put the link here. First number systolic, second number diastolic.

“He claimed IBS due to his medications, and they agreed his diarrhea was due to his medication of Metformin, but they denied the IBS as it was due to medication and implied he should have stopped taking the medication to stop the stomach and bowel issues. “(?)

So he has to be his own MD??? Did they give him a NSC rating for the IBS?

“The Veteran claimed PN of the upper extremities that was not addressed in the decision at all. Like they totally missed it. Still going through the records.

Harleyman, what does the veteran claim as the etiology of his PN?

“The Veteran was very honest to say the least, but it does not appear they reviewed the STRs. “

Did they list the STRs as Evidence or just the discharge physical?

“He does not know if he had head trauma. Hell fell off his motorcycle a couple of times, and broke up bar fights that may have knocked him out for a few seconds but does not recall any changes in hearing as a result. He denies ear pathology and family history of hearing loss. He stats he does not have vertigo but gets dizzy. He attributes it to his medications and various illnesses. “

The STRs might reveal a possible TBI, as well as support inservice HL nexus.

Have you seen his STRs Harleyman?

“gets dizzy. He attributes it to his medications and various illnesses. “

Gets dizzy can mean MANY things.

What illnesses is he SCed for..... sorry if you already told us.....I forgot already.

What did the VA agree the inservice etiology was for his HTN?

Or was it filed secondary to something, and if so , for what?

I know I asked you many questions but I was on the old Prodigy Veterans BBS circa late 1980s and early 1990s when the internet first came into being

We were lucky to have ,as members, not only Alex Humphrey ( deceased hadit member and vets attorney, but also Bill Smith,former BVA attorney.

Bill always said he believed 99% of all claims can succeed. I would think that % would be a little lower. His point was ,if one digs for evidence they often can find it.But they cant leave any stone unturned.

That is how I won my claims. I think that is how this vets claim can be won.

And it might take a whole different approach to the HL situation, and even if that continues to be denied, there might well be more here to SC.

I am assuming he has not been diagnosed with any AO disability?

The VA's statement on the IBS make no sense at all and their HTN statement is clearly wrong, per the VA rating schedule.

If a vet makes one single inconsistent statement the VA will often pounce on that and disregard sometimes the rest of their evidence.

So, one can assume, since VA seemed to disregard the STRs, err in the HBP rating ,and also make a ridiculous statement as to the IBS meds, one can assume the VA buggered more in this decision then meets the eye.

I think Bill Smith's believe in the 99% is too high but I have had personal experience with VA that proves that NOTHING is impossible.It just takes long hours of research, hard work, persistence, and most often these days, a strong independent medical opinion.

[harleyman]

I owe myself a quarter!

From discussion at

Walker V Shinseki:

This is very informative. And certainly the Veteran will need a IMO as he has neither a chronic condition while in service but has a very slight change in hearing at discharge. I am sure his hearing was affected more than what is shown however proving it will be another issues. If he canget an IMO or two stating it is more likely than not related to his military service while in RVN he may be able to sway the decision in his favor. If not I do beleive he would have a very tough time of it on appeal. This is deffinately going to be reopened with N&M evidence but I don't think I wold recommend appealing the deicision.

The current rating decisions are pretty much "canned" statements as the VA found out that generlzed statements are better than specific statements as it leaves the VA more wiggle room. I am sure you have already noticed the Very general ize statements on decision over the last 1 year. when compared to the Very detailed decisions prior to that.

"This part of the Fed Cir decision

bothers me:

“and that Walker was exposed to

recreational noise by hunting game without use of hearing protection

“

It' funny most people who do recreational hunting or target shooting ALWAYS wear hearig protection.I have never been to a range where is wasn't mandatory. So how many time does one fire a gun to hunt. This Veteran only hunted and killed with a BOW. Something about fairness of the sport. go figure.

That is BS. A qualified hunter only

takes a shot when the perfect situation presents itself. Ammo is expensive and not to be wasted.I used to

do the deer push every year . It is highly unusual for any hunter to

take multiple shots ,even over the course of the entire hunting

season.. Is hunting gunfire loud? Sure. It IS recreational noise.

But I highly doubt hunting itself would

cause serious hearing loss, otherwise all of the Colonist would have

been deaf."

I am serious as to using that part of the Fed Circuit opinion in Walker....basically I said in this link what I already said here.

The Veteran told me when he was on the pistol team they used hearing protection, but out in the field they did not have it. That should help some.

The key is that NO protective gear was issued in Vietnam as far as I know of ,for acoustical trauma protection.

Not only would all of the Colonists been deaf, how about all those cowboys and Indians shooting for game out West before the conquest of the West of American began. Walker only hunted game.

I got a proposed reduction turned around once for my husband using the regs they used for the reduction and then plain old common sense.in the NOD I prepared for him.

I typed it just like I talk but did edit the bad words. It might be the same scenario this vet can use...common sense.

In Harleyman's vet case, I assume the recreational stuff was hunting or maybe being at a firing range.Also he had two tours in Vietnam, ie : double exposure.

Double exposure- I think this is a good point as he was there twice as long as the typical service member at the time. Hearing loss happens with time due to trauma and sometimes does not show up right away. I suspect his heairng just got wors and worse with aging but it was helped with the exposure to trauma in service.

I am thinking what actual stuff was he near (I assume he fired off an M 16 himself) such as RPGs ,bazookas etc. etc.

The noise levels in all sorts of military artillery has been tested and rated..I know there must be tests like that on the net.

That is why there is acoustical protective gear these days.

He doesn't talk about his experiences in RVN and it is difficult getting information about his time there. This is true of most of RVN Veterans., as you know.

I also believe regular gunfire from guns like mine has been tested too for the extent of sound they make. This stuff can be compared.

Then again a lot rests on the actual last decision and how he can get around it now......

I posted (typed) the decision in a post above, with some other interesting verbaige on other issues claimed where the VA screwed up. I feel this case will rest on the efficency of the IMO from the private audiologist. I am putting some feelers out about who to contact for this Veterans case. We'll see what I get and then have him set up an appointment if he decides to pursue the HL & tinnitus claims. I deffinately think the tinnitus should be considered a s/c condition as his exit exam the doctor annotated breathing problems and nose fracture during service which implies blows to the ehad region. Also when Veteran's were tested for AUdio the results were documented on a form, but there was also a printout on a data card with the actual results. This Veterans STRs do not contain the data card. The veteran also stated he had an achilles tendon tear that they wanted to MEB him out. It did heal but those records are not part of his STRS. I think we have incomplete STRs. The Army was not very good at keeping the records together back then, So alot will have to be based on the Veteran's word and the simple confirming documentation as annotated by the exit exam doc.

“without use of hearing protection”

I think all combat vets who were in theatre Vietnam, with( No issue of protective acoustical gear) can now get HL

Sced by using that exact statement, from the Fed Cir. opinion re: Walker, if the VA tries to deny

their HL claims!

Evidence can come from very serendipitous places.

I owe myself a quarter!

From discussion at

Berta, this decision is very interesting, and it probably explains why we at the VA got training on chronic conditions and showing chronicity, and why so many veteran's are not currenty getting exams for their claims. It's a whole other topic and I started one a while back about the exam criteria changing and I am positive this decision is why. I didn't know about the "asknod" web site. He does have a lot of information and I did puruse the site. My Veteran's STRs are very spartan and he will need IMO's for just about everything, I have used Dr. Bash for myself in the past but I think he can be expensive as well. I'd like to save Dr. Bash for the big guns however, I can see needing more than one IMO in this case, and I could see getting Dr. Basghto weigh in, although it is not his field of expertise. I have received alot of information on this tread and I am still reading the links others have provided.

[harleyman]

“He claimed IBS due to his medications, and they agreed his diarrhea was due to his medication of Metformin, but they denied the IBS as it was due to medication and implied he should have stopped taking the medication to stop the stomach and bowel issues. “(?)

So he has to be his own MD??? Did they give him a NSC rating for the IBS?

Yea, stop his Metformin and have his DMII kick into high gear and cause even more problems.

“The Veteran claimed PN of the upper extremities that was not addressed in the decision at all. Like they totally missed it. Still going through the records.

Harleyman, what does the veteran claim as the etiology of his PN? DMII- they s/c on this decision at 20%

“The Veteran was very honest to say the least, but it does not appear they reviewed the STRs. “

The decision listed the STRS as evidence. The copies of the claims file the VA sent to Veteran when he asked for a copy of his c-file only have STRs from the Presidio in San Francisco from May of 1969 through july of 1969 with actual treatment for headaches and a right knee injury and a discharge physical. There are no other records no entrance exam, nothing from basic, or AIT, or RVN records. it is obvious STRS are missing.

Did they list the STRs as Evidence or just the discharge physical? STRs

“He does not know if he had head trauma. Hell fell off his motorcycle a couple of times, and broke up bar fights that may have knocked him out for a few seconds but does not recall any changes in hearing as a result. He denies ear pathology and family history of hearing loss. He stats he does not have vertigo but gets dizzy. He attributes it to his medications and various illnesses. “

He complained and was treated for headaches in San Francisco. Also the Veteran checked boxes in the exam exam for eye, ear, foot, tumor/growth/ cyct,. The examiner made notation for headaches, eye myopia, fracture of nose 3 occations in 1967 & 68 Some obstruction nasal breathing, pulled achilles tendon asymptomatic at present / and hand written 00005 /00005 for audio tesst. (?) whichj I think is a guesstimate. Alo noted was a scar on forehead, scar on the riht hand. He said vision was 20/25 on right and 20/20 on left corrected to 20/20 and 20/20 with glasses. But later onanother page states the Veteran does not have glasses. I suspect the audio exam was a guess as well.

The STRs might reveal a possible TBI, as well as support inservice HL nexus.

Have you seen his STRs Harleyman?

“gets dizzy. He attributes it to his medications and various illnesses. “

Gets dizzy can mean MANY things.

What illnesses is he SCed for..... sorry if you already told us.....I forgot already.

What did the VA agree the inservice etiology was for his HTN?

Or was it filed secondary to something, and if so , for what?

I know I asked you many questions but I was on the old Prodigy Veterans BBS circa late 1980s and early 1990s when the internet first came into being

We were lucky to have ,as members, not only Alex Humphrey ( deceased hadit member and vets attorney, but also Bill Smith,former BVA attorney.

Bill always said he believed 99% of all claims can succeed. I would think that % would be a little lower. His point was ,if one digs for evidence they often can find it.But they cant leave any stone unturned.

That is how I won my claims. I think that is how this vets claim can be won.

And it might take a whole different approach to the HL situation, and even if that continues to be denied, there might well be more here to SC.

I am assuming he has not been diagnosed with any AO disability?

The VA's statement on the IBS make no sense at all and their HTN statement is clearly wrong, per the VA rating schedule.

If a vet makes one single inconsistent statement the VA will often pounce on that and disregard sometimes the rest of their evidence.

So, one can assume, since VA seemed to disregard the STRs, err in the HBP rating ,and also make a ridiculous statement as to the IBS meds, one can assume the VA buggered more in this decision then meets the eye.

I think Bill Smith's believe in the 99% is too high but I have had personal experience with VA that proves that NOTHING is impossible.It just takes long hours of research, hard work, persistence, and most often these days, a strong independent medical opinion.

The Veteran was S/C for the following as follows:

RVN exposure to AO conceded:

CAD/IHD 2nd to DMII = 30%

DMII= 20%

PN Right Lower 2nd to DMII=10%

PN left Lower 2nd to DMII= 10%

HTN= 0%

loss of use of creative organ due to DMII

IU granted effective date claim was received-(six months after initial claim)

Chapter 35

Overall rating 60% TDIU

NSC- Hearing loss

tinnitus

hyperlipidemia

IBS

PTSD/depression

Following a very successful Appeal his was service connected as the followng:

depression/w/PTSD symptoms = 50%

PN right lower extremity= 40%

PN left lower extrmeity=40%

loss of use of right lower with automobile grant

Veteran is currently 90% TDIU

[killemall]

From what i saw on his hearing loss scores that is a 0% rating for hearing loss if rated.

Possible that is from several years back and now hearing has worsened

[harleyman]

From what i saw on his hearing loss scores that is a 0% rating for hearing loss if rated.

Possible that is from several years back and now hearing has worsened

[

He will need a private Hearing Loss and Tinnitus exam and an IMO. I think we will be able to get him S/C as the VA examiner did not want to resort to speculation, but a private examiner will as that is why you hire them. And then it will be a matter of equipoise and the tie should go to the Veteran. Then with HL & tinnitus and the 10 % for the HTN he will be close to 100%. I know this Veteran has some health issues and we are working toward the SMC award for him. The vet's initial rating was back in 2007.

editied for spelling

Edited August 19, 2013 by harleyman

[lugnut]

I had the same problems with denial of both HL & tinnitus. In the end, I got an exam from a private audiologist, (the numbers were almost the same as VA's). I also got an IMO from an ENT Doctor who reviewed my SMR's VA health records, C&P exams, etc. He rebutted the VA audiologist reasons for denial & restated why she was incorrect in her rational. He also went into detail about the ears function and why my MOS would cause trauma that she would not be aware of. Of course it was medical jargon and it worked. I was very fortunate to find this Doc, he loves Vets. I wish you all good luck Thank you for your service.