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]

You might be able to see the results of some of the more recent exams (for lack of a better word) here: https://www.myhealth.va.gov/index.html

Thank you. I went to that site again but cannot find ANY records except those that I created, name, address, favorite ice cream, etc.

Could I be looking in the wrong place? For the record though: only have an eye exam doctor. hearing aid doctor, psychiatrist and psychologist at the VA hospital for years, although I haven't even found them listed. I was all TRICARE before and now MEDICARE.

I was thinking of doing FOIA letters to all the VA facilities that could have or would have any records. Maybe even AF hospitals that I can think of.

Marty

[free_spirit_etc]

"but this my 1st appeal, so I have a long way to go."

Don't worry! If you deal with the VA you will get lots of experience appealing. ;)

You will be an expert in no time.

I wish Berta would have picked up on this thread - She is the one with lots of knowledge on Nehmer claims. I think she is back in school now - and her time is limited. (Speaking of school... I should be grading papers now... eek!)

Anyway -- at some point -- you might want to change the title of your thread to include the term and Nehmer Claim. She will probably find it then. When you are on the forum and click View New Content - it shows all the new posts. But if you aren't here much, then there isn't time to view them all. I know Berta said she would look for your other posts.

I think you can change the title if you click on edit on the first post and then click on full edit -- or something like that -- and then it opens the title up to be edited. But she knows a lot that could help you -- so I am hoping she will get back to this topic. But she is busy as heck!

[free_spirit_etc]

Thank you. I went to that site again but cannot find ANY records except those that I created, name, address, favorite ice cream, etc.

Could I be looking in the wrong place? For the record though: only have an eye exam doctor. hearing aid doctor, psychiatrist and psychologist at the VA hospital for years, although I haven't even found them listed. I was all TRICARE before and now MEDICARE.

I was thinking of doing FOIA letters to all the VA facilities that could have or would have any records. Maybe even AF hospitals that I can think of.

Favorite ice cream?? LOL I don't know much about the site. I don't think dependents can access records there. I think, technically, records about yourself should be requested under the Privacy Act. But most the agencies use the FOIA forms anyway. Whatever... I guess... it's the Government and all.

You can request records from the National Record Center -- and see if they have any of your medical records (from service) They also have the military personnel records. But I don't think hospital records are included in SMRs (or I think they call them STRs now...). So those have to be requested separately. For Post-Service records, they can be requested from the providers, or from the base if you got treatment on base. But I think they only keep records for so long. I am not sure how long that is. As far as the base, though, they should have contacted you and let you know if they were about ready to destroy any records and give you a chance to get them. My husband got some lab stuff that way.

I know for base records you should also request the doctors notes. My husband just requested his "medical records" and he just got computer print outs that were VERY brief. So he went back and asked -- and they told him he had only requested his "medical records"- he hadn't said he wanted the "doctor's notes" (which are apparently a different set of records.)

Geez!!

[free_spirit_etc]

I think they count on vets NOT having their medical records -- so then the vets just believe whatever the VA tells them the records said or didn't say.

[MartyL16]

I think that is a wise move. I would work on getting the conditions SCed first – and then appeal for an earlier effective date. No use having them dig in any harder than you have to right now. And you already should have some decent retro just on the latest claim.

The one that I really want is the sarcoidosis that was SC 0% from my discharge claim in '87. They obviously had the Active Duty med. recs. and they actually show I was finishing 2.5 years of continuous high dosage prednisone 100mg tapered to 5 in May '87. I was Stage 4 starting Sept. 1985 and Stage 1 at time of discharge and still on 5mg. It came back in '92-'95 starting at 60mg and "they" had those records, they ref'd to CIGNA for PVC in this rating. Denied for increase every time since 2004.

Maybe the backlog of claims is actually from all the retirees who just tolerated the BS because they reduced retirement pay dollar for dollar until 2004, who are now going back and reading their claims.

As for the Cushing's (it is the syndrome) I am aiming for as my SC records mention Cushing's Syndrome because of the very high dose prednisone for 2.5 years(100mg) while still on Active Duty, and again in '92-'95 (60mg). Among other things, the extreme weight gain from 206 to 330 with severe muscle loss, depression, etc was ALMSOT too much to bear.

I don’t know much about Cushings, but I know prednisone can really do a job on you.

Actually, the Cushing's comes from 'long term, high dosage corticol steroid treatment" Called Exo-Cushing Syndrome. Listed as such in my records listed above.

Never lost the Cushing's "look alike" except no hump and no moon face now. Meaning still morbidly obese but good looking. Sometime maybe I will upload the before and after photos. Got SNCO of the Quarter 6 months before prenisone so I have an official dated picture with date right on the award.

The before and after pictures might actually be good for your claim.

This and the sarcoidosis caused me to be forcibly retired at 20yrs, with loiss of World Wide Duty status, forced out of my 17yrs profession, had to change careers for the balance of my AF career. Became really almost impossible to find a job that I could do "physically" and who wants to hire the "fat" guy with lots of apparent medical conditions. Not to mention the fact that I could have made "big bucks" in my career field. Which is what I will throw at the VA later.

Okay. Now I am interested. What was your career field? The mention of big bucks lets me know it isn’t teaching. ;)

As for the 'big bucks" , I was certified for EXIDE 400KW UPS systems, Diesel, gas, tubine Power Plants (electricity), qualified in Digital Electronics, and some computer systems. Now: some just say I am certifiable, but they are not my friends anymore.

Have DM II SC since 2004 presumptive to AO and believe I can get closer to 100% for that one than 60%. Even my doctor agrees and records will show.

Again – I know you mentioned they said you did not need injections – and you actually need them multiple times a day. So I agree. There are also lots of conditions secondary to DMII. So some things increase your rating for DMII, and some things are secondary conditions (caused by DMII) that are ratable on their own. There are lots of people on this board with lots of knowledge about DMII and secondary conditions.

Just recently found a few court cases where sarcoidosis was "as likely as not" presumed to be AO caused. Then I also saw DM II secondary to sarcoidosis. I get pneumonia almost evey 1.5 years so I am claiming secondary to sarcoidosis and bronchitis sercondary and chronic. I dol insulin injection 5 or more times a day.

Just want what is due to me.

I agree. Actually, it is what you EARNED.

Do I just get the records from them and page by page show them the errors, or "that is someone else", etc.

You will want to fill out a request for you ENTIRE C-file. Anymore, they also have electronic records too. I think you can also request those. They should send you a copy of everything they have. It will include your medical records (in service and post service), letters, decisions, etc. You will probably find a lot of surprising things when you look through them. And you can use those to make your arguments – and point out what evidence supports your claim.

PLUS – back in the day, if you filed for VA benefits when you retired they sent your SMRs directly to the VA. That means they have the ORIGINALS. That means if you do not have a copy and something gets lost, misplaced, or shredded – there goes your evidence. (My husband’s discharge physical disappeared).

If you live close enough to the RO, you can also make an appointment to go view your C-file. You can get copies of some of the documents when you view it – but not the whole thing. Someone will stay with you while you view it – but if your C-file is semi-organized, and you know what you are looking for (some specific documents) you should be able to find them fairly easily.

My RO is out of state as I was a VA emplyee for a very short while so I think I will try to use the FOIA SYSTEM to get all records. Have asked for the C&P EXAMS before but not in writing. I am learning a lot from these posts and I never knew about a lot of these things until recently.

There are some people who say to go ahead and ask for your C-file and it doesn’t hold up your claim. Other people will say it will hold up your claim because they have to pull it to make a copy, etc. Personally, So it is a call you will need to make.

I really want to go back to '87 records and show them the "Stage 4" records(that they repeatedly ignore), along with '92-'95. I see vets getting 30% for less in citations for sarcoidosis. Also have PFTs from '90 thru 2013 that are much worse than the VA claims.

It sounds like they are ignoring a lot of your evidence.

To clarify "exams never had" i.e. in March of '10, sent them 2 MRIs, one of the cervical stenosis and one of the DDD of the lumbar, plus VRE official evals from a psychologist and physical therapist, radiologist report stating "mild scoliosis". The Va sent to a rating doctor for ROM and I sat there while he recorded his "findings" into a recorder on the phone. Ignored my obvious pain, lack of flexion, radiating pain through arms, told him about my twice weekly pain and cortizone shots plus 3 times per week traction, and the neurosurgeon's report, my claims of being dizzy when neck hits a nerve, etc. all of which never showed up in this rating. As far as the cervical rating from 10% to 20% and the reasons for it. They do not come close to the PT/ROM before and after July 2010. Mild pain my butt!

You might have a valid complaint about this. If he just turned it in as an exam, but didn’t really examine you – plus, if he was just going off the reports, he should have included ALL the information.

Do you have copies of the actual C&P exams? It could be he didn’t include the stuff in the report and it could be that he did and the RO ignored it. For instance, my husband’s decision said “The VA examiner gave a diagnosis of chronic sinus disease…A review of service medical records showed diagnosis of sinusitis in September 1982. A chronic disability associated with sinusitis is not shown by service medical records.”

Later, when we got the record, we found out the examiner actually said my husband underwent an x-ray of his sinuses on September 3, 1982 and the x-ray was shown ethmoid and maxillary inflammatory changes of the chronic type. They sometimes twist things.

All of your comments and suggestions mean a lot to me, so keep them coming! I actually cut and paste them into my notes on "what to do". Again, I never ramble! and I never extrapolate.

LOL – I hope I can help some.

Yes, thanks

Edited October 28, 2013 by MartyL16

[MartyL16]

I am wondering if you should have your private doctors fill out DBQs for you -- and connect the dots for them. You can make sure that everything is correct on the DBQ - including the doctor noting conditions that were already treated in service.

http://benefits.va.gov/COMPENSATION/dbq_ListBySymptom.asp

Another thing to do. My current Internist and Pulmonologist are going to do the questionaires. Have to see the Podiatrist and the Cardiologist, and the Neurosurgeon. In the past I have had doctor's that "didn't want to get involved".

Another suggestion that will help. Thanks

Marty