ptsd Seeking Opinions

[rentalguy1]

Hi all. Hope everyone is as well as can be. I have a few questions, and I value your opinions. This board got me to where I am today, and I once again need guidance. For those that don't know me, or for those who have forgotten, I have a total combined rating of 90%, and TDIU. I have been P&T since 24 October 2008. I was recently diagnosed with fatty liver disease, and severe obstructive sleep apnea. I am considering filing a claim for each of these conditions. My main disability is lumbar spinal stenosis (IVDS), which is rated at 40%. I have several secondaries to this condition, which are all nerve related. It should be fairly easy to establish a secondary service connection between both of these issues and my SC'd IVDS, due to my inability to get any exercise becuase of my disability. Over the years, this has caused me to gain weight, and my metabolism to change. I am not looking for any monetary gain from these claims. All I need is at least a 0% rating for each, in case one or the other should kill me, ensuring that my dependents would keep their DIC and DEA.

I watched my father die this past December from cirrhosis that was caused by fatty liver disease. He lasted about a year and a half from the time he was diagnosed until he passed. We know that he had dealt with it undiagnosed and untreated for many years prior to that, though. I am lucky, because the VA constantly checks my lipids and liver panel due to the narcotics that I have to take. My AST/ALT have been off some in the past, but came back within limits on their own. My triglycerides have been constantly high at about 300, and my cholesterol was high as well. Statins keep the cholesterol in check, but nothing helped the tri's. They spiked to 780 last fall and my PC doc put me on fenofibrate. When rechecked last December, the tri's were back down to 300 but my AST/ALT and billirubin were higher than they had ever been. That was followed by a ultrasound which confirmed fatty liver disease. I don't plan on checking out any time soon, but after losing my own father and my wife's father within the last year, I know that such things can't be predicted.

My wife has complained about my snoring, and telling me that I stop breathing in my sleep for a couple of years. When staying overnight at my parents' house to help care for my dad in his final days, my brother and all of dad's home health nurses expressed concerns about it, too. I finally had a sleep study last month and confirmed the severe OSA. I just got my CPAP a few days ago, and I hope it starts helping pretty soon. I still have severe insomnia, but with Ambien and Sertraline, I am able to get some sleep now. But, even with the CPAP, I still wake up feeling like I haven't slept at all. I know this condition can cause all kinds of cardio conditions, and my blood pressure has crept up to borderline high in the last year.

Anybody that knows me here, knows that I don't just file one claim. I shotgun them. On my last round of claims, where I went from 20% to 90%, I won all but to issues. I appealed both, and lost the hip issue. On the GERD issue, I likely would have won it, but the rater wanted me to have a EGD. My PC doc and I decided that it wasn't worth going through the EGD for no gain, since I had already been granted TDIU P&T, so I dropped that claim. Since then the issue has gotten much worse. It was so bad from Thanksgiving 2013 through last summer that I lost 38 pounds because I could not eat. I ended up having the EGD done for that reason and found out that my stomach does not empty as quickly as it is supposed to. I never received a firm diagnosis, but it can easily be tied to long term use of narcotics (specifically hydrocodone) for my SC'd IVDS. I am considering submitting new evidence and reopening this claim if I do a claim for the liver and OSA.

I am also considering reopening the claim for my left hip, which has been diagnosed with bursitis. I have had several cortisone injections over the last few years for it, and I am positive that I could get a "at least as likely as not" statement from my PC doc relating it to a change of gait due to my SC'd IVDS. Also, I tripped over my right foot (I have a foot drop), in 2008 and landed on my right palm, with my arm outstretched. This jammed my shoulder pretty good, and I sought treatment from my PC doc. I have had problems with it since, and have been diagnosed with shoulder impingement syndrome. I am pretty sure I could get a statement from my doc on this as well. I am rated at 10% for sciatica, which I am thinking of asking for a increase since I now have a foot drop (I have to wear a AFO), and have some muscle atrophy. I am rated at 30% for a mood disorder. That has gotten worse, and is well documented. I also received the additional diagnosis of PTSD last year. I am considering asking for a increase in this rating as well. I would gain nothing monetarily, but this could conceivably raise me to a combined schedular rating of 100%. All I am looking for is added cushion, should the VA decide to attempt lowering one of my other ratings, allowing me to preserve my TDIU rating.

I know the rule of thumb is to not poke the hornet's nest once you are P&T. If the liver disease weren't basically a eventual death sentence, and the OSA didn't have the potential to cause life threatening conditions, I would not even consider this. So what do you guys and gals think? Should I go down this rabbit hole or let sleeping dogs lie?

[Chuck75]

There is a lot of differences in opinions. But, I'd pursue any issue that you can document and have reasonable proof of a nexus. It sounds like you will be concentrating on "secondary to".

Be warned that the VA may try to say that your liver problem is an inherited one, if they have knowledge of your father's liver problems. An IMO connecting the drugs to the liver problem

will be helpful. In an ideal situation you might end up being entitled to at least SMC-S.

[Buck52]

I would file for it for the reasons you mention...you could file for SMC's also if you get SC for these newer disabilitys & if they keep you housebound or your current disability's has worsen then why the hell not file?

It would be hard for the VA to take away your current 100% P&T

They need to prove without any doubt your current disability's has improved.

jmo

........................Buck

[Navy04]

Sorry to hear of your issues bud, just be careful. As everyone knows on here, I too have been granted close to 30 conditions in the last 2 years, with 4 FDCs. The wins were good, but also the VA thought I was rocking the Boat as I was 100% SC already. So beginning in Feb 15 the VA has reviewed all of my high conditions even though I was not up for review until Feb 2016, including this week they reviewed my Scars and Cranial Nerve Damage. Now in my case it back fired in the VA's face as all were continued, and in fact my TBI/Migraines was Increased. The Re Exams were brutal though especially the PTSD Review. Only you can decide what to do. Good luck and God Bless

[Buck52]

I Am fairly sure a veteran can use the evidence he had when he was awarded his claim & the VA must take into consideration that the evidence used was correct other wise how could the VA Propose such a proposal?

other than the below mention

This is why we need to check our C-file from time to time to make sure what's in it and this is usually why the VA Does random checks into the veterans C-file to send out those letters to propose a reduction because someone fiddle farted around with our C-file and added something in it to make the VA think our disability's has shown an improvement .or a VA PCP & an a C&P Examiner gives a veteran a fraudulent report

some think that it rocks the boat to ask for increase or file new claims for SC...I Think differently if the truth is told.

Most of the time its just a miss understanding or a miss -communication....and can be corrected back to its original form...this is specially true for the veteran with 100% P&T with no future exams scheduled and with a static or of nature Disability or Disability's

Sometimes it helps to email Allison Hickey to help solve a problem like this.

My way of thinking is I am content with my 100%P&T rating.

So until something comes up that maybe SC and is a danger to my health Yes I will file for it to help my spouse if I die before her.

....................Buck

Edited May 30, 2015 by Buck52

[georgiapapa]

rentalguy,

It is a gamble. As you are aware, you never know what the VA will do. You are about 3 years and 5 months away from your 10 year P & T date when your family would receive benefits regardless of cause of death. If you feel like you can make it until October 2018, you might want to leave things as they are. If you don't, definitely file for the condition(s) that may cause your death. You could also have a claim(s) package ready to be submitted in the event you take a turn for the worse. Regardless of our opinions, you are the one who knows your health situation better than anyone else.

Good luck with whatever decision you make.

GP