hypertension Disability Compensation Question

[usaf1970]

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.

[Buck52]

usaf1970,

you may want to go get copies of your medical records or wait until after the c&p ... if you don't need to be there then I recommend you go get the copies! & read what they said? jmo

[usaf1970]

britton - yes, i would love to be there and get a copy of the records they are reviewing. Do I have a right to do this? The lady at the va hospital I spoke to today acted like I didn't need to be there, but never said I had an option to be there. I'd love to get a copy of everything they are reviewing on Wednesday. I'm going to call them now.

[usaf1970]

so i called the VA regional hospital and they told me I am not permitted to be at the C & P exam. I'm guessing this is because they are maybe reviewing my claim for whether or not it can be re-opened. Because it was originally filed in 2008, and denied....the VA will only re-open it if there is "new & material" evidence. Am I understanding this correctly? I think I will still show up and just ask the physician if I can make a copy of whatever he/she is reviewing. What's the worst they can do, lock me up I guess??

[Berta]

"the VA will only re-open it if there is "new & material" evidence. Am I understanding this correctly?"

Correct. "new and Material" evidence is often not too difficult to submit because disabilities get worse in time.

But you need to carefully read the past denial because that contains what was lacking in the claim in the first place.

I assume but not sure, that this is to re-open something that was already established as SC , in order to try for a higher rating?

If so current medical records, or a chanfge in meds to higher dosages, recent X rays, or a recent hospital discharge certificate....etc etc there are many things VA will consider New and Material.

However VA is quick to say sometimes that evidence is redundant and accumulative...meaning they already considered it in the past denial. In that case, a different type of evidence would be needed.

The claim might not have had an inservice nexus and maybe that caused the denial in the first place.

Do you have a complete copy of your SMRs?

[usaf1970]

berta - thank you again for the response. I am grateful and very humbled that people take the time to respond to these questions and help out vets. A lot of good people in the world!

I do not have my SMRs. I asked the VA hospital who did my C&P exam yesterday if I could come there and get a copy of whatever the physician was reviewing. I was denied by 3 or 4 people. Went to their supervisor, and was again denied. With a nice explanation why that still didn't make sense...but oh well. After their decision is made I can request the C-file i guess. And if it doesn't go in my favor, i will appeal immediately. I have sent a request to the NPR office in St Louis for my entire OPMF file which i assumed would contain all my medical records. I was told that might not be the case, so i submitted another request on a 21-4138 requesting my medical records from Louisville, Ky.

I'm excited and hope to have closure on this either way it goes fairly soon. If it is denied, I will be better prepared for an appeal than I was going into this. I have requested a new VSO who will hopefully be as helpful as you people on here have been. If it gets approved, I am going to file a CUE to try and get my benefits paid back to my original claim in 2008. Either way I am happy that I am giving it my best shot.

btw Berta, I can't help but find your vast appreciation of music interesting. From Eminem to Zepplin & Hendrix to AmerIndian battle changs....that's really cool stuff!

[usaf1970]

I had a C & P exam yesterday that was closed to me (as stated above). I logged into eBenefits today, and my claim went from gathering evidence to "preperation for notification" in 1 day. Below is the note in ebenefits. Anyone know if this is a good sign/bad sign/or neither? My thoughts are that my original claim was denied in 2008. They reviewed my reopen claim yesterday, if they were going to approve it...they would be more cautious....so a notice sent out this fast is a bad sign probably???

Next Steps:

Your claim is currently located in our "Rating" phase. We will propose a decision on your claim when all outstanding requirements are satisfied.

Several factors will determine the duration of the "Decision" phase, including:

• type of claim filed
• number of disabilities you claim
• complexity of your disability(ies), and
• availability of evidence needed to decide your claim.