Va Bull Crap

[Fat]

I filed a claim for chronic sinusitis in May 2012.

I attended a C&P exam in late February 2013. The x-ray came back as normal; however the doctor stated, "you have inflammation in your nose".

I scheduled an appointment on March 5th with a private ENT doctor. A CT Scan was performed and the results were "mucosal thickening in both maxillary and right sphenoid sinuses"

I immediately forwarded the information to the regional VA.

The claim was denied in June 2013.

The claim denial read, (a) in lieu of a in service chronic sinusitis diagnosis, no residuals have been noted since and (b) in lieu of similar or like conditions, no chronic disability has been cited since.

I was furious; however I planned to attack the denial with medical evidence.

I requested a reconsideration of the decision, VA never acknowledged the reconsideration, however I filed the NOD in November 2013.

During the 21 month wait, I have 20+ documented visits for sinusitis treatments and one CT SCAN/ 2 x-rays all validate the diagnosis (mucosal thickening in sinus regions). My doctor even filled out a DBQ certifying pansinusitis.

Recently (July 25th), I received a letter (dated 7/23/15) stating we are working on your claim, please forward treatment notes (various doctors). If information isnt received, case could be decided within 30 days.

I forwarded information by VSO on July 28th and uploaded information to system on August 1st.

I received a letter dated July 31,2015 (Statement of Case) that the claim for chronic sinusitis had been denied.

WTH.................

Basis for denial was I was treated for sinus congestion, not sinusitis. In addition, C&P EXAM in 2013 showed sinuses to be normal.

They conviently forgot to include the chronic sinusitis diagnosis (IN SERVICE) in the NOD denial letter and even more the initial denial letter cited the chronic sinusitis diagnosis.

I am so mad I cant think straight. When I was initially scanning through my medical records I specifically saw chronic sinusitis as one of the issues I was treated for on active duty. Thats why I claimed the disability.

This is the why there is a backlog and why so many veterans are upset with the VA and its compensation process. Employees have to read material and make a determination based off of the evidence.

I guess I'm gonna file a Form 9 and get the issue before the VBA.

I already filed it out and Im including the waiver of regional office consideration form.

I'm going to see VSO this week to make sure everything looks good. I'm also gonna press them to file the Form 8 so the appeal wont stagnate.

I hope others better luck in the claims process and NEVER GIVE UP...........

[MarkInTexas]

Maybe back up a minute and go get a good IME/IMO, then take a run back at them with the new data, plus citing the rating errors. That might break things loose for you. Good luck and don't give up!

Mark

[Fat]

Thanks..............

[Buck52]

Fat sorry to hear that BS from the VA, you do what you got to do to win, If I was you I'd CUE there ass, when they get beat with a CUE Somebody in RO is gonna get an ass chewing!!

as to which we need more of.

just an example of a lazy rater pulling your old stuff and not reading the new.

When I send them anything I high-lite the parts I want them to be sure to read and number all my pages in Red.

jmo

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

Edited August 6, 2015 by Buck52

[Fat]

Thanks Buck52..............