Deleted

[Guest rickb54]

delete

Edited February 19, 2007 by rickb54

[Hoppy]

This is my opinion. The rater is not qualified nor anybody on this board to determine the relevance of the terms used by doctors to describe symptoms. Symptoms and disease entities often have the same name. The rater is playing doctor and should be reprimanded. Only in a situation where the SMR is silent for symptoms and diagnoses should a rater make a denial. This clearly should have been sent to a doctor for an opinion prior to the denial. This same problem occurred with one of my claims prior to the Veterans assistance act of 2001. If he has a post service diagnosis and an in-service record to take to a doctor for a nexus opinion it should be dome without the veteran requesting the exam according to the veteran’s assistance act of 2001. I know the raters have some interpretation of the facts prior to scheduling the exam. However, this is an extreme case of the rater making a decision that has the force of a medical opinion.

My recommendation is that he take his SMR to the head of the department that is treating him and have him review the SMR and post service treatment and write a nexus opinion. Do not wait for a C&P. When this happened to me I got a favorable opinion from the head of allergy and immunology at my local VA hospital and was awarded service connection without a C&P.

It appears to me the only justification this rater could cite is that there was no nexus letter in the file. Thus, some one with no ability to make a medical opinion could say the BS that the rater came up with. The bottom line is that there should have been a C&P prior to the denial. This is really old school rater BS that I ran into many years ago.

[Hoppy]

This is my opinion. The rater is not qualified nor anybody on this board to determine the relevance of the terms used by doctors to describe symptoms. Symptoms and disease entities often have the same name. The rater is playing doctor and should be reprimanded. Only in a situation where the SMR is silent for symptoms and diagnoses should a rater make a denial. This clearly should have been sent to a doctor for an opinion prior to the denial. This same problem occurred with one of my claims prior to the Veterans assistance act of 2001. If he has a post service diagnosis and an in-service record to take to a doctor for a nexus opinion it should be dome without the veteran requesting the exam according to the veteran’s assistance act of 2001. I know the raters have some interpretation of the facts prior to scheduling the exam. However, this is an extreme case of the rater making a decision that has the force of a medical opinion.

My recommendation is that he take his SMR to the head of the department that is treating him and have him review the SMR and post service treatment and write a nexus opinion. Do not wait for a C&P. When this happened to me I got a favorable opinion from the head of allergy and immunology at my local VA hospital and was awarded service connection without a C&P.

It appears to me the only justification this rater could cite is that there was no nexus letter in the file. Thus, some one with no ability to make a medical opinion could say the BS that the rater came up with. The bottom line is that there should have been a C&P prior to the denial. This is really old school rater BS that I ran into many years ago.

[Hoppy]

Continued from previous post;

Only a doctor can make an opinion as to the amount of time between inservice symptoms and the first post service treatment as to the relevence to continuity of a chronic condition etc. I made all these arguments on my claim and won. I had a rater that thought he could use his judgment to play doctor and I made him look like an idiot on appeal. These raters need to seek more medical information. I would not give them credit for knowing the difference between a disease entity and the sniffles. These guys should stick to broken bones and when it comes to diseases they should realize their limitations and get medical opinions to establish which symptoms go with which disease. Making a denial because the medical facts do not jump off the page and get them in a strangle hold is not reason to deny a claim. If there are symptoms and diseases being thrown around by many doctor over a period of many years it can only be resolved by a doctor. This kind of crap delayed my claim 8.5 years. I thought then and I think now this is a prime example of a rater seeking delays rather than the truth.

Edited November 19, 2006 by Hoppy

[Guest rickb54]

Lot of good input here.... I love Hadit....

Ok...

I have copies of the active duty medical records in my fat fingers....

I am goting to state exactly what they say as far as diagnoses and treatment you tell me what you think, that is if there is a diagnoses or not.

1. Impr: Asthma, probably at leaste an extrinsic compent sinusitis

Plan: Tedral, Brief couse of ampicillian 500 QID

2. A: URI syndrone with asthma excerbation

P: Qubiron 200 QID, suspherine 0.33 INJ, actifed

3. A: bronical asthma with sinusitis

P. epherfine 0.3, Chest xray, Dinetapp BID (7 days) ampicillian 500 MG 2 x 7days

4. Imp: URI & Sinusis headaches

P: RX CTM 8 MG 1 TID

5. IMP: URI

P: dinetapp 1 TID

6. Asthma attack & URI

P: Therdur 300 TID, Dinetapp 1/1 TID

7: It is recommended at this time that the patient's theophylline leved be placed within therapeutic levels, and the he be started on vancinase for a history of chronic sinusitis.

8. IMP: asthma & sinusitis

P: contuine on thedure and Vancinase

9. Report of Medical History Exam;

Sinusitis - Yes checked-

Doctors notes: ashtma, hay fever, sinusitis, allergies, knee injury

10. Report of Medical exam states;

Doctor notes: bronical asthma, rhinitis, logcconvitis, sinusitis knee pain wiht swelling

11. A: URI, early sinusitis

P: RX ampicillian 500 mg qid x10 d

Thanks guys with your help I might be able to put something together for this veteran.

[free_spirit_etc]

So isn't the VA required to give you reasons and bases for their determination that the sinutitis that he was treated for in service is not connected to the the sinutitis he now has? Something like medically SOUND reasoning....backed by medical opinion.

Free

[Guest rickb54]

Free Spirit,

Excellent question glad you asked.....

Here is what the va said on the denials:

denial #1:

Service medical records show veteran has complaints of sinusitis, but sinusitis did not occure on active duty

denial #2:

Service medical records show that you were seen on several occasions during service for sinus symptoms, service connection is denied because the evidence does not show sinusitis in service or show the current sinusitis to be the result of service. Sinusitis not actually diagnosed unit 12 Apr 1993, 7 years after discharge.

Seems to me the va is speaking out of both sides of their mouth, I am not sure how to rebut there findings. I don't understand how the va can say there was no active duty diagnose seems to me if he was treated there had to be a diagnoses. What say You.

Edited November 19, 2006 by rickb54