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Rating Code 7913


Brandy

Question

Does anyone have a copy of the original Diabetes Mellitus code 7913? I found that they made changes to this code only once. I wanted to see exactly what the diffinition of "large" or "moderate" insulin dosage was vs the percent levels assigned back then.

This is the current 7913.

7913 Diabetes mellitus

Requiring more than one daily injection of insulin, restricted 100

diet, and regulation of activities (avoidance of strenuous

occupational and recreational activities) with episodes of

ketoacidosis or hypoglycemic reactions requiring at least

three hospitalizations per year or weekly visits to a

diabetic care provider, plus either progressive loss of

weight and strength or complications that would be

compensable if separately evaluated..........................

Requiring insulin, restricted diet, and regulation of 60

activities with episodes of ketoacidosis or hypoglycemic

reactions requiring one or two hospitalizations per year or

twice a month visits to a diabetic care provider, plus

complications that would not be compensable if separately

evaluated....................................................

Requiring insulin, restricted diet, and regulation of 40

activities...................................................

Requiring insulin and restricted diet, or; oral hypoglycemic 20

agent and restricted diet....................................

Manageable by restricted diet only............................ 10

Note (1): Evaluate compensable complications of diabetes

separately unless they are part of the criteria used to

support a 100 percent evaluation. Noncompensable

complications are considered part of the diabetic process

under diagnostic code 7913.

Note (2): When diabetes mellitus has been conclusively

diagnosed, do not request a glucose tolerance test solely for

rating purposes.

This is all I could find about the change they made.

We revised the evaluation criteria for diabetes mellitus (DC 7913) to make them more objective and base them on how well the diabetes is controlled. The frequency of insulin injection and medical treatment are valid measures of the severity of diabetes, and we have stipulated a requirement for more than one daily injection of insulin for the 100-percent evaluation level. We also specified the number of hospitalizations per year required because of episodes of ketoacidosis or hypoglycemic reactions and the frequency of visits to a diabetic care provider that warrant a 60- or 100-percent evaluation. We eliminated the requirement for a "large" or "moderate" insulin dosage at the 40- and 20-percent levels respectively because the severity of diabetes is better determined by the degree of control in response to treatment than by the amount of medication required for control.

We deleted from the criteria for the 10- and 20-percent evaluation levels under DC 7913 the requirement "without impairment of health or vigor or limitation of activity" because they do not affirmatively denote required criteria for those evaluation levels. A requirement for regulation of activities was formerly one of the criteria for the 40- and 100-percent levels but not for the 60-percent level. For the sake of consistency, we have made "regulation of activities" one of the required criteria for the 40-. 60-, and 100-percent levels. We clarified the meaning of "severe" complications of diabetes and how to evaluate complications by means of a note and by including a reference to complications that would and would not be separately compensable under the 100- and 60-percent criteria respectively.

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The earliest mention of the 7913 criteria I found at the BVA is:

The veteran has insulin dependent diabetes mellitus, rated under

Diagnostic Code 7913 of VA's rating schedule. A 100 percent rating

is warranted when the veteran has pronounced diabetes that is

uncontrolled, with repeated episodes of ketoacidosis or

hypoglycemic reactions, restricted diet and regulation of

activities; with progressive loss of weight and strength, or severe

complications. A 60 percent scheduler raring is warranted when the

veteran has severe diabetes, with episodes of ketoacidosis or

hypoglycemic reactions, but with considerable loss of weight and

strength and with mild complications, such as pruritus ani, mild

vascular deficiencies, or beginning diabetic ocular disturbances.

The rating schedule suggests a 40 percent raring for symptoms

comparable with moderately severe diabetes, requiring large insulin

dosage, restricted diet, and careful regulation of activities,

i.e., avoidance of strenuous occupational and recreational

activities. Although the record does not contain an assessment of

the frequency of the veteran's episodes of ketoacidosis or

hypoglycemia, the evidence reflects that as of early 1993 the

veteran had one below the knee amputation, and had three toes

amputated on the remaining leg. The Board finds that the veteran

suffers severe complications of his diabetes mellitus.

Accordingly, a 100 percent scheduler rating is warranted. 38 C.F.R.

4.119, Diagnostic Code 7913 (1993).

This is from:

http://www.va.gov/vetapp94/files3/9421553.txt

It is significant to note also-that in 1997 the ADA criteria for glucose levels was lowered-when determining a diabetic condition.

FPG (Fasting Glucose Levels)levels prior to the 1997 change were considered 140 and over indicating diabetes-

the newer criteria of the ADA is FPG at 126 or over.

The VA howevere in the 1990s used anything over 110 as an abnormal glucose value.(at some VAMCs they used 105)

Also diabetes claims often involve many other diagnostic codes and ratings to account for complications to a ratable degree- suchas cataracts, atherosclerosis, stroke, and heart disease.

Edited by Berta (see edit history)
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Berta,

Thanks so much for the reference. I am looking to prove that my husband's SC diabetes was out of control (severe) at the time they made the decision (1980). His BG levels usually run very high or very very low. They only rated him at 20%. He was seeing a VA doctor for his diabetes about every two weeks during the time he was on TDRL and during the following year after discharge. They were continually changing his insulin dosage because he got diabetes at such a young age it was uncontrollable and the doctors said so. The TDRL doctor also said so but rated him at 20% also. We have a letter from the doctor that cared for his diabetes before he was placed on TDRL and his fasting blood sugars were all over 200.

On another post I listed all of the problems he has now. He had his leg amputated in 1998.

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If the 1980 decision is final-(I assume it sure would be by now)-

you could attempt to file a CUE claim on it. There is much info here at hadit on CUE.

The amputation is more surely a result of his diabetes- is this in his claim?

He presents a very disabled picture due to this and I hope he filed for TDIU too.

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Berta,

Yes, I have filed the amputation and TDIU on his claim. Looking at his clinic appointment notes from years ago, they did not diagnose his hypertension. They referenced that he had hypertension but did not treat him for it.

Diabetes + Hypertension leads to many other medical problems such as what he has today. I cannot believe that they did not even put him on some medication to lower his BP. He finally stopped going to them, for all medical issues, after about 9 years and started seeing a private doctor. The private doctor put him on BP medication after seeing him a few times.

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Berta,

Would this be a CUE and/or should I file 1151 because of failure to treat him for hypertension?

I think there are a few issues in which I will have to file a NOD and CUE's on. The problem is right now we need for them to give us ratings for his amputation, heart and kidney problems because of our financial situation. I don't want anything to hold that up right now.

He is going for exams on Nov.27th for GM, and Dec.13th for eyes. I am hoping this means they are really moving along on our case. My problem is since I am claiming the hypertension for him but do not want to stir them up right now, should I just make a statement about his hypertension being diagnosed back in the 80's by the VA clinic and attach records. This is just so they will know (they should have these records already) that I know the situation?

hope this makes sense??

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Guest jangrin

Brandy,

It seems like things are moving now on your husbands claims. Depending on how long it takes the C&P professional to get his report of findings back to VA, your husband's file should move into the rating phase right after he has the exams.

Once he is rated for the eyes and TDIU, which with his severe diabetes he should be awarded TDIU 100% at the minimum. Then file for addtional claims. Many of the veterans here at Hadit have said that adding another claim will surely slow the process down.

My husband just had his C&P exam in September and we are told his claim is with the raters. But we still wait, so I figure at leat 3 t0 4 months at raters. I have other claims to file also, but I will wait on them until my husband gets a rating on the current claim.

Good Luck , Jangrin B)

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I did not know anything about how to submit a claim or very much information on the way VA handles claims when I put in this first claim. If I would have found this site and investigated prior to filing, I would not have claimed so many disabilities. I would have just covered the major issues and then waited to claim the others.

Since the first claim I have found that he has even more disabilities that were not claimed on the first claim. I will submit those later as well as the NOD's and CUE's.

I really want to get a copy of his c-file but I don't want to ask right now for fear that it will cause confusion with my claim. When a exam is ordered does the c-file get sent to the examiners so that they can review during the exam? I thought maybe this would be a good time to ask for a copy of the c-file.

Last week my husband remembered some records he had from his army files and we searched everywhere for them and finally found them. So some of what I found answered many questions I had as to what happened when and where. Still we do not have a copy of the SOC for his VA exam from original filing in the 80's.

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Brandy -one of the significant medical errors VA made in my husband's case was to diagnose HBP but then fail to treat it properly-it was in my FTCA /Section 1151 claim.

HBP can lead to heart disease whether or not the veteran is a diabetic but I have seen where the VA tried to get out of paying comp for HBP and heart disease as secondary to diabetes-because the med recs showed the heart disease and HBP predated the DMII diagnosis.

In my way of thinking- this means they probably did not diagnose the DMII when they should have and it already caused complications-HBP and heart disease-

When was he diagnosed with diabetes?

I dont quite see any basis for CUE claims here -unless he had an older final claim decision on these conditions. Did he file a claim in 1980 that was denied for the HBP? I might have misunderstood your post.

I would put the HBP info in the claim but also -would his private doctor be able to state that his heart disease, hbp, and vascular disease that caused the amputation were directly related to his diabetes?

Do you have all of his medical records and did he present evidence of diabetes via high glucose blood chemistry reports - in these records before the VA diagnosed him with it?

That would certainly be a a basis for a Section 1151 claim.

This is what my present claim is about-years of high glucose as well as hyperlipidemia, high creatinine- and other well documented symptoms of uncontrolled diabetes (heart disease,vision problems, and strokes,which the VA documented but failed to treat back to 1988, evident in Rod's medical records.

Not easy to find this stuff sometimes-I would-if I were you- look through his VA medical records very carefully for anything -to include initial high glucose readings in his blood work that could indicate untreated and undiagnosed diabetes.

And nothing is better then getting an IMO- I did not have one when I succeeded in my Sec 1151.That claim was hard work - a re-open of Rod's pending 1151 claim.

This time I have three IMOs.

I was able to specifically reference where the evidence was in the med recs that supported my present claim and I tagged these records and highlighted them for Dr. Bash.

He also had past SOcs and SSocs that helped a lot.

Knowing that IMos are often costly (but maybe your husband could get a free one from his private doctor)

I made sure before I contacted Dr. Bash in 2004 that I had a good claim and his initial email to me -based a few statements I made as to the medical evidence -stated it sounded like a good claim.

Within 5 days after reading the med recs etc, he called me and I knew what he would say.

Rod had been misdiagnosed and had diabetes mellitus from Agent Orange which contributed to his death.

The fact that in 1997 the ADA lowered the criteria for diabetes and that since then there has been renewed interest in the fact that ,per the ADA, there still might remain over 6 million adults with undiagnosed diabetes.

http://www.diabetes.org/diabetes-statistics/prevalence.jsp

How long ago did he present to VA symptoms of high glucose that they might have overlooked and ,if he was not diagnosed properly when he should have been,this medical error more than likely caused caused his additional complications.

Edited by Berta (see edit history)
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Guest jangrin

Brandy,

Is this the first claim that you have filed? Is your husband SC for any conditions since his discharge? I am assuming that he is a Vietnam vet.

Jangrin

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Brandy -one of the significant medical errors VA made in my husband's case was to diagnose HBP but then fail to treat it properly-it was in my FTCA /Section 1151 claim.

HBP can lead to heart disease whether or not the veteran is a diabetic but I have seen where the VA tried to get out of paying comp for HBP and heart disease as secondary to diabetes-because the med recs showed the heart disease and HBP predated the DMII diagnosis.

In my way of thinking- this means they probably did not diagnose the DMII when they should have and it already caused complications-HBP and heart disease-

When was he diagnosed with diabetes?

I dont quite see any basis for CUE claims here -unless he had an older final claim decision on these conditions. Did he file a claim in 1980 that was denied for the HBP? I might have misunderstood your post.

I would put the HBP info in the claim but also -would his private doctor be able to state that his heart disease, hbp, and vascular disease that caused the amputation were directly related to his diabetes?

Do you have all of his medical records and did he present evidence of diabetes via high glucose blood chemistry reports - in these records before the VA diagnosed him with it?

That would certainly be a a basis for a Section 1151 claim.

This is what my present claim is about-years of high glucose as well as hyperlipidemia, high creatinine- and other well documented symptoms of uncontrolled diabetes (heart disease,vision problems, and strokes,which the VA documented but failed to treat back to 1988, evident in Rod's medical records.

Not easy to find this stuff sometimes-I would-if I were you- look through his VA medical records very carefully for anything -to include initial high glucose readings in his blood work that could indicate untreated and undiagnosed diabetes.

And nothing is better then getting an IMO- I did not have one when I succeeded in my Sec 1151.That claim was hard work - a re-open of Rod's pending 1151 claim.

This time I have three IMOs.

I was able to specifically reference where the evidence was in the med recs that supported my present claim and I tagged these records and highlighted them for Dr. Bash.

He also had past SOcs and SSocs that helped a lot.

Knowing that IMos are often costly (but maybe your husband could get a free one from his private doctor)

I made sure before I contacted Dr. Bash in 2004 that I had a good claim and his initial email to me -based a few statements I made as to the medical evidence -stated it sounded like a good claim.

Within 5 days after reading the med recs etc, he called me and I knew what he would say.

Rod had been misdiagnosed and had diabetes mellitus from Agent Orange which contributed to his death.

The fact that in 1997 the ADA lowered the criteria for diabetes and that since then there has been renewed interest in the fact that ,per the ADA, there still might remain over 6 million adults with undiagnosed diabetes.

http://www.diabetes.org/diabetes-statistics/prevalence.jsp

How long ago did he present to VA symptoms of high glucose that they might have overlooked and ,if he was not diagnosed properly when he should have been,this medical error more than likely caused caused his additional complications.

Jangrin,

"Is this the first claim that you have filed? Is your husband SC for any conditions since his discharge? I am assuming that he is a Vietnam vet".

Yes, this is the first claim that we filed since his original filing while still in the Army on TDRL. He was evaulated by the VA (but looking at the reports I have the dates on the exams don't add up). This claim I sent in back in December 2005 was the first claim since his original ratings. He is not a Vietnam Vet. He got diabetes Type 1 while still in the service along with multiple other fractures, etc. He was given 20% for DMI and 10% for his wrist. His hand was almost ampuated from the injury. His wrist was broken and all arteries and viens had to be put back together. They really down played all of his conditions. The army did this as well. He had signs of kidney and heart problems during his TDRL exam but yet the doctor said his diabetes was completely out of control because he got it when he was only 20 years old. This is the same as ujuvenile diabetes, not adult onset. The doctors stated his pancreas was dead and is not producing any insulin. This type of diabetes is very difficult to control for many years due to the age at which he incurred the disease.

Berta,

Brandy -one of the significant medical errors VA made in my husband's case was to diagnose HBP but then fail to treat it properly-it was in my FTCA /Section 1151 claim.

It looks like the same thing happened here. He went to the Va for all medical issues when we first came out of the military. They failed to treat him for his hypertension. As you know this could have worsened his diabilities with other complications because they did not treat him.

HBP can lead to heart disease whether or not the veteran is a diabetic but I have seen where the VA tried to get out of paying comp for HBP and heart disease as secondary to diabetes-because the med recs showed the heart disease and HBP predated the DMII diagnosis.

I don't think this is a problem. He got diabetes while in the service and is sc for this. All of his secondary conditions came afterwards. We just did not know that we could/should go back to va and claim additional disabilities. He did not have any HBP or heart disease or any other medical issues prior to his diagnosis of diabetes type 1.

In my way of thinking- this means they probably did not diagnose the DMII when they should have and it already caused complications-HBP and heart disease-

His diabetes is Type 1, service-conected rated at 30% for almost 30 years, caused complication of HBP, heart diseave, PVD, amputation, chronic kidney failure stage 4, GERD, PD, Arteriosclerosis, Anemia, Chronic Congestive Heart Disease

(already had mycardial infarction) and triple bypass surgery last year, CAD, ulcers, Diabetic Retiopathy. This is most of them.

When was he diagnosed with diabetes? In service 1979. Medically discharge to TDRL.

I dont quite see any basis for CUE claims here -unless he had an older final claim decision on these conditions. Did he file a claim in 1980 that was denied for the HBP? I might have misunderstood your post.

His claim in 1980 was for diabetes type 1, it was not for hypertension. But hypertension is a condition expected for diabetics.

I would put the HBP info in the claim but also -would his private doctor be able to state that his heart disease, hbp, and vascular disease that caused the amputation were directly related to his diabetes?

On the VCAA notice the va states that they are aware that diabetes causes other conditions such as: eyes, heart, feet, nervous system, and kidneys.

Do you have all of his medical records and did he present evidence of diabetes via high glucose blood chemistry reports - in these records before the VA diagnosed him with it?

When we left the service he only seen VA doctors. They have records of his B/P readings and one doctor stated at one visit that his problems were diabetes and hypertension. During the 9 years he seen them his BP continued to be out of control, but they never treated him for it. He only got treatment when he went to a private doctor about 10 years after leaving service.

That would certainly be a a basis for a Section 1151 claim.

This is what my present claim is about-years of high glucose as well as hyperlipidemia, high creatinine- and other well documented symptoms of uncontrolled diabetes (heart disease,vision problems, and strokes,which the VA documented but failed to treat back to 1988, evident in Rod's medical records.

The records I have that show the local va said he hypertension back in the 80's but they did not treat him for it. He has always maintained his relationship with the local va. He goes to them for his annual eye and foot exams. He does not see them anymore for his other conditions. Back in October 2005 we ask them to provide all of my husband's medications. We cannot afford to pay for them (about 25 to 30 meds). They got it approved through the regional office to provide his heart meds. I noticed when I got a copy of his records that the doctor had to get him approved for "SC" for his heart problems in order to provide meds. He is listed as "service-connected" for his CAD since 10/2005. But we are not getting paid for this.

Not easy to find this stuff sometimes-I would-if I were you- look through his VA medical records very carefully for anything -to include initial high glucose readings in his blood work that could indicate untreated and undiagnosed diabetes.

After this claim has been rated I will persue 1151 on this. Possibly CUE regarding how they rated his diabetes in the 80's. You gave me the reference to 7913 as it was in 1980. He was labeled as severe and moderate to severe diabetes. He was taking high dosages of insulin and his dosage has continued to increase every since then. He was on a diet and had some reactions (high or low) blood sugar attacks.

I guess my point is that the local va that was treating him for the first 9 years after medically discharged from service. They knew he had developed hypertension and did nothing about it. Isn't this a claim? If they would have treated him back then (about 20 or more years ago) he possibly would not have all of the medical issues he has today. He was not seeing any private doctors during that 9 year period. He counted on the doctors there at the va to attend to his overall medical conditions. Obviously, they were treating him for his sc diabetes, but one of the conditions caused by diabetes is HBP. They did nothing about it. There is also evidence that they knew that his creatine and BUN levels were high back then. This indicates kidney problems. This is also a medical condition that diabetes causes. Again they said nothing and did not treat him for this or run additional test to confirm or deny this condition may have existed.

Edited by Brandy (see edit history)
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Guest jangrin

Brandy, THIS IS A RECAP OF YOUR CLAIMS CASE AND CURRENT STATUS, LET ME KNOW IF THIS IS CORRECT...please

Thanks for responding to the questions posed. It helps everyone who is on the forum. Each person has a life experience to share with you and your husband. When you can relate to the forum members some of the specifics you will get much better responses.

We aren't being nosey, as much as no one wants to give you bad or incorrect advice. So by sharing (I call it spilling your guts), by sharing info you'll get more imput.

The forum has been dealing with so many vets from RVN that have been diagnosed with DMII, I thnk we all assumed your husband was a RVN veteran. So now......

Your husband was diagnosed with Diabetis TYPE 1 (one) also known as Juvenile Type 1 diabetis. He has been on insulin since he was initially treated, also while in the service he had a severe wrist injury.

A long time ago he was service connected (SC) for 20% DM Type 1 and 10% wrist. Then over the years since he was discharged he has been treated by the VA. He has medical records with the VA for many years. Than about 9 years ago you switched to private doctors for your husbands treatment.

Everything has been rolling along and things have continued to worsen for your husband and his medical conditions. Then in 2005 you filed a claim for new ratings for the Diabetis and you listed 20 (or so)secondary conditions that have evolved due to the diabetis.

Your claim is in, and your husband is getting ready for C&P exams (one for his eyes) and (one that we think is a GM (General Medicine).

Let me know if this is the BIG picture.

Jangrin B)

Edited by jangrin (see edit history)
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Brandy, THIS IS A RECAP OF YOUR CLAIMS CASE AND CURRENT STATUS, LET ME KNOW IF THIS IS CORRECT...please

Jangrin,

Thanks for responding to the questions posed. It helps everyone who is on the forum. Each person has a life experience to share with you and your husband. When you can relate to the forum members some of the specifics you will get much better responses.

We aren't being nosey, as much as no one wants to give you bad or incorrect advice. So by sharing (I call it spilling your guts), by sharing info you'll get more imput.

The forum has been dealing with so many vets from RVN that have been diagnosed with DMII, I thnk we all assumed your husband was a RVN veteran. So now......

Your husband was diagnosed with Diabetis TYPE 1 (one) also known as Juvenile Type 1 diabetis. He has been on insulin since he was initially treated, also while in the service he had a severe wrist injury.

This is correct. He was severely injured in a automobile accident and almost did not make it. He had a collasped lung, wrist almost amputated, many fractures of pelvis, broken ribs.

A long time ago he was service connected (SC) for 20% DM Type 1 and 10% wrist. Then over the years since he was discharged he has been treated by the VA. He has medical records with the VA for many years. Than about 9 years ago you switched to private doctors for your husbands treatment.

They discovered he had incurred diabetes while still in the hospital recouperating. Our claim right after he got out of the hospital was for (7913) diabetes-20%, (5215)major wrist fracture-10%, (5299) chest injury/fractured ribs with pulmonary contusion-0%, (5299-5255) pelvis injury/fracture right pubic rami-0%. After emergency surgery on his wrist they flew him via chopper to another hospital to be put on a respirator and chest tubes there until he could breath on his own. This was the VA rating. The army put him on TDRL at 40% diabetes and 10% wrist. Then evaluated by military one year later and they reduced him to 20% w/severance. Reduced rating due to reduced insulin. This was not documented correctly. They had a much lower dosage on his a.m. NPH. By about 20 units. He was on two shots per day. When he was evaluated by the VA he was on one shot per day. We did not file an appeal for either. (young and dumb). We just did not understand it all. My husband had just signed up for another term with the Army again two months before this all happened and we were making plans to be relocated to Hawaii.

Regarding the va clinic; when he was discharged we moved back home and he began seeing the doctor at the local VA clinic because he was still in the military. He was not dicharged until 22 months after we got back home. So we did not have health coverage other than the military/VA. He seen the VA doctors for abvout 9-years. Then by this time we were both working and financially stable and had health coverage through employer. So he began seeing a private doctor about 18 years ago.

Everything has been rolling along and things have continued to worsen for your husband and his medical conditions. Then in 2005 you filed a claim for new ratings for the Diabetis and you listed 20 (or so)secondary conditions that have evolved due to the diabetis.

He has been complaining and going to emergency room etc. for various problems over the years. About 8 1/2 years ago, he lost his leg from below the knee down. Then the other conditions started as well or at the same time. Except for the hypertension. He had that back when he was going to the VA.

Your claim is in, and your husband is getting ready for C&P exams (one for his eyes) and (one that we think is a GM (General Medicine).

Yes, the claim has been in for 13 months now.

Brandy

Edited by Brandy (see edit history)
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Guest jangrin

Brandy,

Yes, I think I get it now and I think they rest of the folks will too. Ya might have to go through this a few times here and there but everyone means well and we all learn and absorb stuff differently.I just find I repeat things alot. B) It bugs my husband , but what the heck.

I think you have a really strong case. I beleive you will get 100% schedular on the claim. In my opinion, your husband's DM is 100% wilth all the hospitalizations and then the heart surgery and the systemic things going on and then the leg amputation and of course the PN.

I am very familiar with what DM can do to ones body. My family has a history of juvenile diabetes. It is very devastating to a young person and their family. If all the secondary conditions are not treated along with the diabetes the effects are severe to many of the bodies main systems, heart, brain, liver, kidneys,eys,peripheral nerves and more.

I believe the Hadit Elders will help you to prepare either a CUE, which I think you might get because of the change to a VERY LOW DM RATING REDUCED TO 20%. But more likely you might have an 1151 case (which I believe to be mal-practice) for the HBP that was never treated, but diagnosed. You will need to get a copy of the records showing the diagnoses and then medical records showing no formal treatment, then an independent doctor to provide an IMO that indeed your husband was diagnosed and not treated by the VA.

And that their actions of not treating him caused his heart condition and whatever else they can link to the VA not giving your husband proper care. Berta won her 1151 claim when the VA caused her husbands death. I'm sure she will have loads of info. I think an 1151 claim would go back to when your husband was first diagnosed with hypertension an HBP, but I'm not sure, that would be a lot of retro.

So I really think you need to do a POST for Berta or one of the ELDERS and they will direct you. Only thing I would recommend is for you to not cloud the water yet. I would wait for the claim you have working to be rated. Get the money coming in for that. Then fight the good fight and see if you can get retro or 1151 or CUE.

Having an income will help more than anyhting. It takes the presure off. Also, it Service connects the secondarys and that will help if something happens to your husband. It will be a bit of a safety net for you.

I truly understand because we have had a really rough time over the past few months financially. I too, wish I had found this web site before we filed our claim.

I think right now just start gathering ALL the records from every doctor, imaging center, VA, hospital, dentist, everything you can get your hands on. Try and get ALL the SMRs also. Then corelate and tab and index it all. Once that is done Berta and the rest will guide you through case law, CFRs, and court rulings to aid in building your case.

Good Luck, if you ever need an ear, just PM me.

Jangrin :)

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jangrin,

Yes, I agree. Once I found out that we could make another claim for all the secondary conditions, I immediately started researching. Researching was part of my job for many years. I have been doing this research since late last year. I have obtained all of his hospital, doctors, VA, etc. info thru September of this year. I sent form to the national archives and they told me that his SMR's were at the VA regional office. This past week my husband remembered that he had some of his military records that could obtain medical records. So I went on a search and found them. This has statements in support of his request for TDRL from a captain at the hospital where he was treated. He at least listed all of the conditions, dates, etc. But he down played the severity of the injuries, just like the other VA and military doctors. There was one note from a doctor that treated him for his diabetes as soon as he got out of the hospital which went completely against the captain's (from hospital) statement had to say regarding his diabetes. The captain that was treating him said he was on a reduced diet and had his insulin listed correctly and showed his fasting blood glucose levels on three different dates and I think three different times of those dates: His BG was 250, 280, 161, 215, 520, 257, 150, 185, 305. He stated "Control is not optimum at the present time and further insulin adjustments (increase) are likely.

I have to go back now and get the latest medical records. Because he was just in the hospital last month again. He was sick couldn't eat too much, stomach hurt all the time, various pains everywhere. Found out that he had two stones blocking the duct between his gallbladder and liver. They first thought is was the liver then the gallbladder. Finally after tons of test they found out where the problem was. They first went in and took out the stones which they said that area was full of infection and they didn't understand why he was not screaming with pain. After they did this they went in and removed his gallbladder. It's funny that in 2004 we had a doctor who specializes in this and he was doing all kind of tests to find out why his alkaline phosphatase was so high. They have been high for many years. After I got all of his records I noticed that when they tested him for something else they found this massive "sludge" surrounding the walls of his gallbladder in April 2006. The doctor that was checking found this as well in 2004 but ruled it out of being the problem. I'm wondering why his PCP did not check this out further as it was recommended by the doctor who analyized the test results in 4/06. By the way, I believe the VA had noted this in their records as well. They also noted that his creatine and BUN levels were high. Back when they wrote everything by hand they did not give me those lab reports during those first 9-years. I sent them a another request asking specifically for those lab reports. Those are critical to backup what the doctors stated and to see prove of lab work results. They do show the BP each visit. They also seen my husband on average 2 times a month. I know this is part of how they rate diabetes today but not back then. How often you have to see your diabetic doctor in order to keep control of your diabetes.

I know I have some additional claims to file for various reasons. Since I have to give the VA some additional information in support of my claim that I did not send with this last VCAA notice, I really wanted to find out if I should bring up the records that I have from the local VA where they had diagnosed his hypertension. Not in a threatening way, but just to make them aware that I am aware of this.

Edited by Brandy (see edit history)
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Diabetes and loss of a limb due to Diabetes. If the vet developed heart disease and hypertension, The directive clearly states the CAD will be secondary service connection.

Just in case you need this Brandy.

Getting Hypertension and CAD service connected is Key for someone with Diabetes. Once the CAd is diagnosed, Other conditions that the CAD excarbates can also be connected.

From what I have read on the original claim, I feel that the VA did not adjudicate the claim properly using the correct rating criteria for the severity of your husbands condition. Then state the severity criteria and ect. and issues you do have. Do not budge. They went as far to tell me I could not file a Cue Claim and I proved them wrong.

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Diabetes and loss of a limb due to Diabetes. If the vet developed heart disease and hypertension, The directive clearly states the CAD will be secondary service connection.

Just in case you need this Brandy.

Getting Hypertension and CAD service connected is Key for someone with Diabetes. Once the CAd is diagnosed, Other conditions that the CAD excarbates can also be connected.

From what I have read on the original claim, I feel that the VA did not adjudicate the claim properly using the correct rating criteria for the severity of your husbands condition. Then state the severity criteria and ect. and issues you do have. Do not budge. They went as far to tell me I could not file a Cue Claim and I proved them wrong.

John,

I did read that about CAD will be secondary service connection. The funny thing is when we were switching all of my husband's med's to get them from the VA due to our financial situation and could not afford them. The VA doctor said he needed a copy of the EKG and a statement showing the ejection fraction. We got that to him and he said he needed to send it to the regional office for approval. We got it approved. Now that I have the clinics records they show that his CAD is service connected. But the renal failure, hypothyroidism, peripheral vascular disease, hypertension are not. How can it be listed as service connected when we have not received a rating decision or any compensation. The amputation is not service connected yet. These are all part of the current claim. He goes for a C&P the 27th of this month.

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