Have A Few Ratings Over The Years, All Basically The Same?

[MartyL16]

All the way back to 1987. Usually with the same denials. Never did they ever go back to the active duty records to "confirm" what I was telling them.

Rating usually stated "...is continued at %". or "remains denied" and you know what. I was too depressed and sick, and ignorant of how to proceed, how to fight for me, until lately!

My questions: Since they referenced no "codes", never explained why, and even when I stated extreme pain, on movement, did the wincing, refused to go past my "pain point", the ratings always said "mild pain". Since 2009 they stated they had no access to my records on the computer, so the only info that they had was my verbal answers to their questions.

Have to mention that I have NEVER seen "them" use a worksheet from the VA. Always saw them scribble a word or two on a regular tablet. Also never had an exam that went more than about 15 minutes.

I am thinking maybe since the info does not actually reflect what is in my "actual" records(that are only) referenced by "clinic name" but no specifics confirming my claims, shouldn't I have other appeal or legal rights?

Maybe their failure, over at least 4 separate ratings, to give me my rights of "due process", or whatever.

Since they always failed to describe the details, or use codes, maybe I can submit as "reopened claims" based on facts that they "missed"? Afterall, they now at least "mention" records that they have and should have had since 1967 and beyond.

For the record, I have an SC 0 from active duty, DM II from 2004 with a marginal SC % presumptive to AO from 'Nam and Thailand.

Thanks

[free_spirit_etc]

I saw that. But I wasn't seeing the AO connection with those. I was thinking you were granted SC for sarcoidosis because it occurred in the service, not because it was caused by AO. If so, your sarcoidosis is not considered an AO condition, as far as your claim goes. Since sarcoidosis is not an AO presumptive condition, you would need a doctor to state it is more likely than not your sarcoidosis was caused by your AO exposure, in order for them to consider it SC because of AO. (And even then, they might not). But that would be a lot to go through, since you already have SC for sarcoidosis anyway. If a doctor says your PVCs are caused by your sarcoidodis (and the VA doesn't argue that point) then you could be granted SC on the PVCs as secondary to the sarcoidosis. But again, that wouldn't be an AO condition -- as your sarcoidosis has not been considered an AO condition by the VA (in your case).

The only reason I can think of to try to get it connected to AO, is that I am thinking that you still have a pending appeal on the Nehmer claim. In that case, it may be possible to get retro on the condition -- but I don't really know -- because I am not familiar with Nehmer claims enough to know if they are readjudicated on the evidence in the file, or if you can keep adding evidence. In any event, you would need a doctor's statement to make those connections.

I believe I may have explained this in a later post or reply. I am not sure where the confusion came from but the sarcoidosis and the PVC are only possibly related because of possible AO connection, as is the DM II is already confirmed. I haven't asked the cardiologist for his opinion lately.

Marty

Edited November 4, 2013 by free_spirit_etc

[free_spirit_etc]

It sounds like you are on top of the diabetes one. And yes, they are supposed to give you the highest possible rating without making you have ALL the symptoms. I just saw a case recently on the regulation of activities part. But I don’t remember exactly what it said. It is good to read the BVA cases on both denials and granted claims, to get a good sense of the reasoning they use. I don’t recall the specifics of the case, but the doctor had even written the veteran had regulation of activates, but the BVA said the kind of activities that needed to be regulated weren’t regulated. Again, I don’t recall exactly what it was – but it is good to read some of the denials, or the why we didn’t grant X percent decisions, so you can make sure that those reasons are well explained in your own claim.

The BVA will read arguments. When dealing with the RO – they generally don’t get all into all that stuff that I know of. If you are trying to get something granted at the RO level – basic is better. The rule says ___. My evidence shows ____.

[free_spirit_etc]

Nice thread here:

[MartyL16]

http://www.healthvermont.gov/prevent/Sarcoidosis.aspx

What are the signs and symptoms?

Many people who have sarcoidosis have no symptoms. Often, the condition is discovered by accident only because a person has a chest x ray for another reason, such as a pre-employment x ray.Some people have very few symptoms, but others have many. Symptoms usually depend on which organs the disease affects. Symptoms from sarcoidosis in the lungs and lymph nodes include shortness of breath, a dry cough, wheezing, and enlarged and sometimes tender lymph nodes. Changes in sarcoidosis usually occur slowly (e.g., over months). Sarcoidosis does not usually cause sudden illness. However, some symptoms may occur suddenly. They include:

• Disturbed heart rhythms
• Arthritis in the ankles
• Eye symptoms.

Thanks for this reference. Actually, since this vertigo problem came up(internists says because of worse conditions from cervical nerve impingement (part of new claim), I can't go driving but I need to get to my pulmonologist sometime before this appeal ends.

In my case(sarcoidosis) appears to have taken maybe more than 4.5 years to "get nasty".

Just thought of this: Multiple PVCs in mid 1980, started having shortness of breath late 1983, all 3 pneumonias beginning late January 1985, confirmed diagnosis pulmonary sarcoidosis Sept. 1985

Marty

Edited November 4, 2013 by MartyL16

[MartyL16]

There is a case here that discusses the restriction of activities required for higher ratings for diabetes.

http://www.va.gov/vetapp13/Files3/1327679.txt

Thank you

Marty

[MartyL16]

I am also in a quandry about the '87 sarcoid rating for reopen on "new material" claiming the lack of any rating to actually refer to '85-'87 in service, and again in '92-95, after service. BTW, the SAME CIGNA records hold the recurrence in '92-95 and actually have PFT EXAMS, one per year, the treatment and the Stage 4 references, or doing a CUE as they never followed my request for reconsideration/increase or anything else. Advice would be appreciated.

Are you still on the prednisone now? NO For some reason I was thinking you were because your note on the SOC says “Still on…” But now I see it says “Still on 5-10 mg per day prednisone on retirement. So now I am wondering if you meant you were still on it when you retired (but aren’t on it now) or if you were still on it at retirement AND are still on it now. When you put in for an increase, they will see what level you are functioning at that point. So with your current claim for increase, they aren’t going to go back to what your 4 PFTs were in 1990 – 2004. They will go by what the current PFTs show. .. and whether you are on medicine for it now (or since the time you put in for your latest increase).

I have a NEW PFT exam from my new pulmonologist and in my exam room, after the results printed out, he compared that one to the 3 PFT exams that were done in '92-'95 by CIGNA and put it in his computer that there was significant loss of lung function/capacity from then to now. He has also requested ALL my AF thru now records from the VA.

So I am sorry if I misunderstood what you said and led you to believe you should have a higher rating now if you really aren’t on medicine now and your PFTs now are not showing decreased function.

You may be able to file a CUE on the initial claim if the evidence shows that you were on predisone at that time to control it and they granted you zero percent anyway IF the rating schedules were the same back then. Rating schedules change from time to time, so you would need to find out what the rating schedule was for sarcoidosis in 1987 before filing a CUE on it.

Found lots of CUE STUFF, that is relavent, useful, and informative, here on HADIT, earlier this evening

I am not sure what you mean by they never followed your request for reconsideration / increase. Are you saying you have appealed previous denials and they didn’t respond to the appeal? Or that you file for increase before and they did not adjudicate it? I think I actually replied in a later post. I hope you will read it.

Marty