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Jayco

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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.

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"You may submit medical or other evidence, to show that we should not make this change."

If I were you I would submit any evidence you can that shows you have HBP at a ratable condition and that it is due to your DMII...

Of course the best evidence for that would be an IMO from a real doctor familiar with endocrinology.

Do you have atherosclerosis? Renal disease, hyperlipedimia, ischemic heart disease , nephropathy, PAD ,PN?

Have you claimed all conditions possible that you have which could be associated to the DMII as cause?

There are countless articles and medical abstracts on the internet that support a relationship between DMII and HBP.But still for some reason VA fails to connect HBP to DMII without a strong medical rationale.

A few strong articles or treatises might be enough for the VA to reconsider the CUE they made.

Also the diabetes VA training letter is here under a search and it helped me considerably for my DMII AO death claim because there are so many secondary disabilitiers that DMII can cause.

http://hyper.ahajournals.org/content/26/6/869.short


http://jama.jamanetwork.com/article.aspx?articleid=194930

http://jama.jamanetwork.com/article.aspx?articleid=194930


Did the VA say your HBP eas "essential" meaning they dont know what caused it?

Did the decision they cued themselves on reveal any legal error you could raise, (like failing to consider all evidence they had)?

Do you have any SMR readings of HBP and/or has ANy doctor suggested the HBP is related to the DMII?

There is more info here on DMII causing HBP:


Sometimes the VA will say that a veteran's HBP had no service nexus and 'pre dated his/her DMII.

This case is a winner on that basis:

http://www.va.gov/vetapp05/files2/0509997.txt

The veterans proved his SC DMII 'aggravated' his HBP.

Can you scan and attach here the actual C & P exam that the original HBP was awarded on......

Did they give any Medical reason for the reduction of the HBP?

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Here is the DMII VA training letter:

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Thanks Berta. You are an invaluable source of information. Can't thank you enough.

Need time to absorb all. One of the problems is I don't have copies of the medical opinions or reasons for their decisions, so makes it difficult to rebut.

HBP was never rated at least separately. It looked like daibetes and HBP were rated together. The ratings were 30% Ischemic heart disease and 20% diabetes mellitus with hypertension. According to my VSO hypertension was never rated and is the reason it will not affect my rating or payment. If that is true, then all I am concerned about is getting treatment. Like diabetes HBP can cause many problems and because I have both diabetes and heart disease it is even more important to control. Here is how it is listed in the list of treatables:

1. diabetes mellitus w/ hypertension

2. mellitus w/ hypertension, diabetic

3. mellitus w/ hypertension

Thanks again.

Edited by Jayco
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