hypertension Received New Rating

[Jayco]

Just received a final evaluation from the VA. My disability rating went from 40% in 2012 to currently 70% after they received a missing medical questionnaire sent by my doctor.

About 10 months ago I filed a NOD for sleep apnea being a secondary condition due to diabetes. There is no mention of the NOD in this final evaluation. It simply states that sleep apnea is still denied. Does this mean the NOD has been decided or do they address the NOD separately?

In my preliminary evaluation where they established the 40% rating they had my hypertension as service connected due to diabetes. In the letter I just received establishing a 70 % rating they are saying that the hypertension approval was done in error and they are withdrawing it as being service connected. They will now not pay for any treatment related to hypertension. I have not researched hypertension, so not sure if what they have done is valid or not. Should I file a NOD?

Thanks for your help.

[Philip Rogers]

I believe, once you reach 50%, the VA needs to take care of all your conditions, SC or NSC, but they are allowed to recover anything they can, from any insurance you may carry. Someone will correct me if I'm wrong. You need to fight the discontinuation, of SC, for hypertension, and you have a very short time to appeal, something like 21 or 30 days. You need to request a hearing, now. jmo

pr

[Gastone]

At 70% SC VA covers all your Medical and Prescriptions on a No charge basis. Your also covered for NON VA Emergency care to stabilize your emergency until you can get transported to the nearest VA Hospital. If you have Private Med Ins with no copays, VA Coverage for NON VA Hospital treatment isn't a big deal. However, If your looking down the throat of a $20K copay, don't give the NON VA Hospital your private Ins coverage info, just your VA info.

What does your VSO-Rep have to say about the status of your NOD? What are your current SC conditions and Ratings? The VA said the reason for the Rating Error was???

Semper Fi

Gastone

[Guest]

What am I missing here? Apparently you got an increase but for what disability?

[georgiapapa]

Jayco,

PR is right about the VA taking care of all of your conditions. Since you have a combined rating over 50%, you are in group one in the VA healthcare system and are entitled to free medical treatment and free prescriptions for any medical condition (service connected or non-service connected) including your hypertension. You no longer have to pay copays for appointments or prescriptions. In fact, you can go to the business office at your VAMC and request reimbursement of all copays you paid retroactive back to the date your most recent award became effective.

Congratulations and good luck to you.

GP

[iceturkee]

I believe, once you reach 50%, the VA needs to take care of all your conditions, SC or NSC, but they are allowed to recover anything they can, from any insurance you may carry. Someone will correct me if I'm wrong. You need to fight the discontinuation, of SC, for hypertension, and you have a very short time to appeal, something like 21 or 30 days. You need to request a hearing, now. jmo

pr

i believe you are correct on the 50 percent thing.

[Jayco]

Heart disease and diabetes was the basis for the preliminary 40% rating. In their decision letter they stated they were missing a questionnaire pertaining to diabetic neuropathy. I had a medical exam done and the questionnaire sent in. Neuropathy was found and best I can tell was the cause for the rating to go to 70%. Not sure if there were other factors.

The reason for the severing of hypertension from being service connected was given as follows: “The VA medical examiner provided a medical opinion that your hypertension is less likely than not related to your diabetes mellitus.” That was it. They specifically stated that they would not pay for hypertension treatment, but then maybe they were not taking into consideration my 70% rating assuming at that rate I am covered for everything. They also said that the severing of hypertension would not change my compensation payment. If the 70% rating will get treatment covered and my payment does not change, then I would think no need to file a NOD.

I retired overseas and under the Foreign Medical Program. I have to pay for treatment and then request reimbursement. I was sent a FMP Benefits Authorization stating the conditions that VA would pay for. Now that the rating has gone to 70% will I receive a new authorization stating that they will cover all conditions service connected or not?

I just received the ratings decision letter and haven't had a chance to contact my VSO concerning the NOD. The last 3 email requests to my VSO asking for help haven't been responded to. I don't send email requests often and don't feel like I abuse the privilege, so not sure why they are not responding. I'm reluctant to send another request, but will give it another shot. I may have to change VSO.