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

[MartyL16]

I really want to get a SOC from the VA, as they never sent one,

I was thinking you got one SOC, but have not received one from the DRO review yet. They might still be working on that. That would be the SSOC (Supplemental Statement of Case). For some reason, I was thinking you said that they sent you a sheet to fill out with the names of your medical providers. So the reviewer might be looking for additional medical records before he makes a decision. This would be a good thing, I would think. It would mean that they actually wanted to look into some more information, rather than just copy and paste the previous denial.

From what I am reading in the "books", they still owe me a SOC. When I filed the NOD, the group that made the rating(San Diego under Nehmer) was responsible to send one to me. All I have is the rating, which all of you are privy to. I am not aware that can be a SOC according to what I have read. Tell me if I am wrong.

Marty

[MartyL16]

RE: what laws, rules, codes di the VA use for sarcoidosis in 1987 when I got my 1st rating

After reviewing about 40 cases from 1971 thru 1993, it appears that the SAME codes used in the cases you showed, were used from at least 1980 thru 1993. which works for me.

Also the laws appear to be the same thru 1993. What was also apparent is that even "back then" the VA was supposed to document "how this disability affected the person's ability to work". This from 1988:

A 60 percent evaluation is warranted when the disease is chronic with frequent exacerbations and multiple joint pain and organ manifestations productive of moderately severe impairment of health. 38 C.F.R. Part 4, Code 6350.

These codes are great for my 1st rating. And from the same case:

Initially, the veteran's sarcoidosis was rated by analogy to systemic lupus erythematosus under Diagnostic Code 6350.

Prior to the 1996 revisions to the rating schedule there were no published rating criteria for sarcoidosis. Thus, the condition had to be rated by analogy. See 38 C.F.R. § 4.20.

Also:

In the Board's judgment, the evidence of record is adequate to establish that the veteran's sarcoidosis was symptomatic during the period from January 1988 to July 1994 and as such would have warranted a 10 percent evaluation under the provisions of Diagnostic Code 6350

So I think that "nails" the code and laws for those years. Your research refs. put me on the "right path"

Also found(different case),this but confuses me somewhat: Maybe the residuals caused the code change.

The veteran's initial claim for compensation was received at the RO in February 1985. Service connection for pulmonary sarcoidosis with radiologic residuals of pneumonia was granted in a December 1985 rating decision, and a 10 percent rating under diagnostic code 6699-6600 was assigned, effective from February 1985.

In a February 1987 rating action, the RO increased the evaluation to 30 percent for pulmonary sarcoidosis with a history of pneumonia, effective from July 1986.

I. Sarcoidosis

Pulmonary sarcoidosis with a history of pneumonia may be rated as unspecified pneumoconiosis, which, when definitely symptomatic with pulmonary fibrosis and moderate dyspnea on extended exertion, is evaluated at 10 percent. When symptoms are moderate, with considerable pulmonary fibrosis and moderate dyspnea on slight exertion, and confirmed by pulmonary function tests, a 30 percent evaluation is warranted. 38 C.F.R. §§ 4.20, 4.97, Diagnostic Code 6802.

This ref is in exactly the same year and close to my July 1987 retirement date so this code is VALID for me:

In July 1987, the RO granted service connection for sarcoidosis and assigned a 10 percent disability rating under Code 6699-6802, effective from March 1, 1987, the day

after the veteran's separation from service.

Then I saw this:

In order for the veteran to receive a higher rating for sarcoidosis by analogy to pneumoconiosis, his symptomatology must meet the criteria set forth in Diagnostic Code 6802 for those ratings. To receive a 30 percent rating, there must be moderate disability as manifested by considerable pulmonary fibrosis and moderate dyspnea on slight exertion, confirmed by pulmonary function tests. For a 60 percent rating, there must be severe disability, as manifested by extensive fibrosis, and severe dyspnea on slight exertion with corresponding ventilatory deficit confirmed by pulmonary function tests, with marked impairment of health.

38 C.F.R. § 4.97, Code 6802.

The keyword here is the PFTs that, in my case, were one of the many things that were not accomplished in my rating at the time, nor was the following:

In reaching its decision, the Board has considered the complete history of the disability in question as well as the current clinical manifestations and the effect the disability may have on the earning capacity of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.16 (1994). The nature of the original disease has been reviewed and the functional impairment which can be attributed to pain or weakness has been taken into account. 38 C.F.R. § 4.40 (1994). Further, the Board has found that in this case the disability picture is not so exceptional or unusual as to warrant an evaluation on an extraschedular basis.

Why is this important to me? Because when I go back even to the earlier denials to increase requests as early 2000, I now have additional refs. to use. Why? Because my sarcoidosis was very active AGAIN in '92-'95 as I have stated in other posts.

Marty

Edited November 4, 2013 by MartyL16

[MartyL16]

It appears I may have been abandoned.

Also based on my E-Benefit page the AL failed to file paperwork on my documented PTSD from 2008 VAMC records and a 60 day extension request to the DRO and now it says its final. This should be interesting as the VA has had possession all this time but apparently because I didn't fill out their questionaire for PTSD and the above stated AL failure, I am not sure what to do. I requested this extension for returning anything to the DRO because of additional medical issues, and I was specific, as these are part of my appeal.

I also made it clear in the DRO conference that the VAMC had all those medical records for PTSD.

I just thought I would tell all of you that ALL of my posts have been with one finger on my left hand since the beginning of October. It takes me hours to type posts, reread, correct and repost. It is that turtle and rabbit thing. I think the warranty on my body and mind ran out years ago.

If this doesn't improve, I am going to install DRAGON software and try to use it.

Any ideas? Also I sure could use some ideas on lawyers that actually have success with the VA.

Marty

Edited November 6, 2013 by MartyL16

[free_spirit_etc]

Sorry. I have been much more busy that last couple days -- and will probably be this way until the end of the semester. I haven't had any personal experience with VA lawyers, but there are quite a few people on this forum who have. Most people generally recommend you get a lawyer for a CUE, especially a complex one. I will see if I run across some of the names that have been recommended on here. I thought the PTSD questionnaire was new this year. If you filed a request for extension, the VA should respond. But I don't know if they ever do.

[free_spirit_etc]

Good finds on the sarcoidosis cases. Are any of those CUE cases? Or are they just traditional BVA appeals?

[free_spirit_etc]

From what I am reading in the "books", they still owe me a SOC. When I filed the NOD, the group that made the rating(San Diego under Nehmer) was responsible to send one to me. All I have is the rating, which all of you are privy to. I am not aware that can be a SOC according to what I have read. Tell me if I am wrong.

I thought the decision you posted was your statement of case. I see now that it is just listed as a rating decision. But it does give the reasons they arrived at the decisions and the evidence used. It also tells you that you have the right to appeal within one year. Did it also include pages and pages of law? Most SOC do. Is this the decision that you filed an NOD to? The original RO doesn't send a SOC after an NOD. They send you a rating decision and SOC, then you file an NOD, then the case is reviewed again and you are sent a SSOC (Supplemental Statement of Case) after the DRO review.