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Disability Compensation Question


usaf1970
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Question

Hi everyone. This is my first post. Thanks to everyone who takes the time to answer these message boards, there is a lot of great knowledge here.

So here is my situation, I separated from the Air Force in 1996. Approximately 3 months prior to separating I had a physical exam with lab results that came back with proteinuria and blood in my urine. I had no idea what this meant, so I asked the physician and he said "if could be caused by strenous exercise or it could be early signs of kidney disease. follow up with a civilian physician when you get out." He more or less acted like it wasn't a huge deal. I went to a civilian doctor a year later and he stated I still had proteinuria, and referred me to a kidney specialist. It turns out this was the early signs of kidney disease. I have had medical coverage through my civilian job since separating, and really never thought I needed to make a claim with the VA as long as I am receiving medical coverage.

So fast forward many years, and in the mid 2000's my kidney disease progressed. I now have hypertension and pretty severe gout. My kidney specialist believes these are secondary to my kidney disease. Again, I had no idea kidney disease could cause gout. I suffered through gout for a few years thinking I had tendinitis or a sprained foot or something else before a doctor smart enough said "yep, that's gout!" After learning how the kidneys work and how gout is related....now I feel I'm in a pretty bad situation and possibly looking at dialysis and possibly a kidney transplant. Thankfully so far I'm not that bad off. I have about 60-65% kidney functionality.

In 2008 I became unemployed and at the unemployment office, I spoke to a VSO. He listened to my situation and suggested I file a claim for disability. I completed the paperwork, signed medical release forms for my kidney doctor, etc... And a few months later got a rejection letter stating "lack of medical evidence". If I wanted to appeal it, please submit an appeal to the VA if I have NEW medical evidence. As far as I knew, they had received all medical evidence.

So a few months ago this year, I told my story to another VSO who said it doesn't sound right. That my kidney disease should have been service connected, and the secondary diseases should be considered connected as well. I submitted another claim to have it reopened and now I have a C & P exam scheduled. (never got that far in 2008). From most everything I have read, IF this claim is approved, the VA will only back date benefits to the date of this SECOND claim. This doesn't really seem right to me. I admit I was naive on the first claim, and didn't really understand the process. But it seems if this is considered service connected, the VA should back date benefits at LEAST back to 2008.

So I have 3 questions (sorry for the rambling).... 1) will I have a problem with the VA finding my kidney disease (acute glomerolnephritis) service related during my C & P exam? 2) if it is found to be service connected, and hypertention and gout are determined to be connected...how far back will the VA backdate benefits? 3) what is your best bet at what kind of rating I may receive? I have proteinuria, granular casts in my urine, reduced kidney functionality (40%), at least 5-10 gout attacks per year, some fairly severe...but never requiring hospitalization.

Thank you for any light you can shed.

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First off thank you for your Service!

I too was in a similar boat!! Got out in 1996 w/o EVER having a separation physical...fast forward to May 2013 I initiated my claim to include over 17 contentions...fast forward as of today I am going to be rated 60%!!!!! Woot Woot!! So Yes there is HOPE for you my friend!

With that being said here are the answers to your questions:

1) The C&P Exam is ordered by the VA Claims Department. Therefore make sure you have all your ducks in a row. Prior to my C&P exam I supplied supported evidence to the VA by submitting either through my DAV rep or on Ebeenies. Do you have copies of your SMR's to show the kidney situation? Do you have the sep. physical indicating the test results? If so make sure they are before the VA for your claim. You will also need to show continuity proving that you have been and are seeking treatment now and in the past since you got out.

2) You will only be paid from the date of your initial claim date. The 2008 claim is DEAD in the WATER if you did not appeal it.....

3) No one here can estimate your S/C% - you will have to go to the C&P exam and see how that goes - after the C&P exam post it on here redacting your name and doctor name and everyone here with knowledge/insight can help you!

Edited by Navy4life
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So I have 3 questions (sorry for the rambling).... 1) will I have a problem with the VA finding my kidney disease (acute glomerolnephritis) service related during my C & P exam?

The "nexus" or inservice beginnings of this disease will have to be proven via your SMRs

2) if it is found to be service connected, and hypertention and gout are determined to be connected...how far back will the VA backdate benefits?

Only to the date you filed the successful claim BUT see my note below***

3) what is your best bet at what kind of rating I may receive? I have proteinuria, granular casts in my urine, reduced kidney functionality (40%), at least 5-10 gout attacks per year, some fairly severe...but never requiring hospitalization.

Best to go to our VA Schedule of Ratings link here to determine how your condition falls into those rating criteria.

While in service did you have calculi of the kidney ,bladder, or gallbladder diagnosed?

While in service did they ever diagnose (and document it in your SMRs)Nephritis.?

If so these are two presumptive conditions under the Chronic presumptives, 38 CFR 3.309 and proof of them in your SMRs would establish the nexus.But you might have proof of the beginnings of acute glomerolnephritis , if there is no other evidence of the 2 diseases I mentuioned above.

Do you have a complete copy of your SMRs?

This BVA case tht might help you undertstand the rating system for your condition:

"ORDER

An increased 30 percent rating for glomerulonephritis with

arterial hypertension is granted."

http://www.va.gov/vetapp03/files/0325315.txt

There is considerable info on the net associating Gout and HBP with your condition.

http://www.kidneyfailureweb.com/symptoms-complications-others/410.html

*** you might be able to successfully recover a better EED with a CUE claim on the older denial.

Best thing first to do, is to succeed in the SC claim at this point.

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This bears repeating something I have said before here.....

When a vet has been denied in the past for a condition that they re-open a claim for and if they succeed, and it is the same disability, it is often a situation ripe for a CUE claim.

If the same disability was denied , but at a ratable level of NSC at least at 10% or more (NSC)on the past denied rating sheet,

then becomes SC, our CUE forum info here should be devoured!!!!!!

I won CUE on that scenario

The worst CUE claims of all are the ones that have never been filed .

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I'm thinking you may have a CUE, in that the VA denied you rather than sending you a VCAA letter, explaining what you needed to win your claim, which would bring your claim date back to 2008. You should have filed a claim back when you were discharged but shoulda, coulda, woulda, applies here and that date is gone. If only we knew then but then the VA works hard to make sure we don't (jmo). If you showed proteinuria and hematuria then, you should have no problem but that doesn't mean it'll be easy. Maybe w/our "new friendlier VA," things will be better. You will need a continuity of care trail, showing your care since 1996 and the more of it the better. Also a IMO, from your kidney specialist/current care provider, would help tremendously.

The VA only requires that your disease/disability be 10%, at the time you were discharged, to qualify for SC, which means that your proteinuria and hematuria should meet the requirements. That 10% has nothing to do w/the percentage the VA will rate you at later, but rather shows you were in the early stages of your disease at the time of discharge and therefore it relates to your military service.

You also may want to check to see if maybe some chemicals you handled, or were exposed to, in the AF, show a link. Just a thought!

On a personal note, if you feel like it, maybe you can help me. My kidneys are running about 67%, early kidney disease, and I have been having gout problems lately and maybe you can help point me in the right direction as to how I should handle this gout stuff. I also have diabetes, type II, well controlled w/oral meds and one dose of insulin at night. My email is VAslayer2002@yahoo.com. Thanks in advance, if you can.

pr

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Wow, you guys are fantastic. Thanks a lot for the quick responses.

So to respond to your all's responses:

Nay4life - I do not have my SMR's. I have requested them multiple times, but they have never shown up. I am a slow learner, but I have learned well that I have to write down who I spoke to, when I requested, and follow up. To me this seems a lot like me making sure others are doing their job... but the answer is no, i don't have my SMR's yet. My original VSO had them but they were blurry and hard to read. He submitted a request back in 2008 for a "clearer copy". And that's the last I have seen or heard of them.

Berta & Philip - thanks a lot on the clue on CUE. ..I will read up on this, and it sounds promising. I'm not holding my breath....but I will definitely look into this.

Thanks again for your responses, and I will definitely post updates as I get them from the VA.

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I think he can be service connected without a rating...he needs to get SC first thing!

carlie is great doing CUE!..

I would think he can get EED!

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