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Armyfor9

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Hi,

I am hoping someone with a lot more knowledge than me can figure out if I am misinterpreting the rating descriptions or if someone made an error. I will copy and post from what I read at the end of this. I will omit just one section that is irrelevant.(actually I will include it, just in a small font. I have highlighted the areas I feel are important.

 I have cystitis with recurrent UTI's causing constant (pain, discomfort, urgency) 

I also have incontinence (aka voiding dysfunction)

My claim I stated bladder urinary problem. I wasn't sure how to state it. Clear medical evidence and documents provided to be approved service connection at 40%. My question is that I felt it should be 2 separate ratings. #1 Chronic Cystitis causing frequency meeting 40% AND

#2 Voiding Dysfunction meeting requirements for 60% (Or at minimum 1 rating at the higher of the 2 at 60%.

 

I'm curious as to your take on my rating for the "Urinary System" 
 
Facts: I have a diagnosis of Cystitis 7512(Interstitial Cystitis) which causes pain, frequent urination, urgency, etc.
 also I have recurring and frequent UTI's
 I also have  Urinary incontinence 7542(which is not technically a symptom of cystitis, I suppose unless due to urgency, which is different than mine.)
 
On my claim I claimed "Bladder Condition" Note I was rated at 40% My question is looking at this couldn't I have two ratings? One for the Cystitis at 40% under frequency and also one for Voiding dysfunction at 60%. If not at least rating at the higher 60%????? What do you think? Please let me know if I'm mistaken or if I should submit in hopes of correcting and by what method. Thank You

 

 

Urinary Rating Systems

 

There are three different urinary rating systems.

 

Urinary Frequency: A condition is rated under this system if it causes the body to urinate more often than normal. If you have to urinate 5 or more times during the night, or if you have to urinate more than every hour during the day, it is rated 40%. If you have to urinate 3 or 4 times during the night, or if you have to urinate every 1 to 2 hours during the day, it is rated 20%. If you have to urinate 2 times during the night, or if you have to urinate every 2 to 3 hours during the day, it is rated 10%.

 

Obstructed Voiding: A condition is rated under this system if there is something in the way that makes it hard to urinate, like a kidney stone. If the condition makes it so you cannot urinate at all and must always use a catheter, then it is rated 30%.

If there are obvious symptoms (slow or weak stream, hesitancy to start urinating, etc.) and if there is one or more of the following: 1) more than 150 cc (cubic centimeters) of urine left over in your bladder after you urinate, 2) less than 10 cc of urine per second are passed through the ureter, 3) there are regular urinary tract infections because of the obstruction, or 4) the urethra becomes narrow because of an infection and requires regular dilatation (stretching) treatments every 2 to 3 months—then it is rated 10%.

If there are only obvious symptoms (slow or weak stream, hesitancy to start urinating, etc.) but none of the other 4 conditions listed above, then it is rated 0%. This 0% rating is still given even if there is narrowing of the urethra that requires regular dilatation (stretching) treatments only once or twice a year.

 
Voiding Dysfunction: All urinary conditions that cannot be rated as urinary frequency or obstructed voiding are rated by this system. If the condition requires the use of a catheter to remove urine from the bladder, or if the condition requires the use of absorbent materials (like pads or Depends) that must be changed more than 4 times a day, then it is rated 60%. If it requires absorbent materials that must be changed 2 to 4 times a day, then it is rated 40%. If it requires absorbent materials that must be changed only once a day, then it is rated 20%
 
 
 
Code 7512: Chronic Cystitis is the swelling of the bladder most often due to infections, but it can be caused by other things as well. If it is caused by a urinary tract infection, then it is rated as described for that condition. All other causes of this condition are rated under this code.
 
Code 7542:A Neurogenic Bladder occurs when a person looses control over urination because of damage to the nerves or the brain.

 

Edited by Armyfor9
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Amy posted, " I am aware that several of my SC(IBD,PTSD,Migraines) are common with fibromyalgia. I just feel getting Fibro SC is too much of a battle. "

   These are choices we must make.  I am on board with you 100 percent...its not always worth fighting VA for every last benefit.  One way to do that is simply hire an attorney and let him do it.  80% of what the attorney gets for you  is always more than 100% of nothing if you dont apply.   

    The other way is to give up and let VA win.  I look at is a mistake for me to not give my grandchildren an education, or at least give it my best shot.  This is my best shot.  Im expecting a BVA decision in the next 30 days, and if its bad, I already have an attorney lined up to take over.  I cant fight any more either, but I am handing the sword to my attorney who is younger and stronger to fight for me.  

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Amyfor9

Yes it is a hard fight  but eventually you will win...find you a good experience Veteran Attorney and let him/her fight for you as brocovet mention

Some very good attorneys& members of hadit come to my mind

''Dr Bash'' Veterans medical Adviser .

Attorney's ''Robert Walsh'' (asknod mentor'')

''Chris Attig''

''John Hill''  -Hill & Ponton

or just about any member attorney from NVLSP

When the Veteran points out the CFR's and is stilll denied  its attorney time.

JMO

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

 

Edited by Buck52
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OK, I appreciate the feedback and advice. I hate to sound stupid, but that fibro fog can be a b**ch. It sounds like you agree it was an error regarding the 40% vs 60%?

Do you think an attorney can get fibromyalgia SC or is there a way to get compensation due to the increased pain to SC arthritis? I don't want to waste anyone's time if it is not likely to change.  The rating for the "voiding dys" 60% vs their "cystitis" 40% I feel was"innocent" human error. I don't still understand if there is a simpler, quicker way to correct it. I agree an attorney will be the best bet to deal with the fibro. issue. I am unable physically to continue on my own. I got to 93+%(rounded to 90%) now I have nothing but pain left. It's killed my fight. 

Writing this takes rereading and editing multiple times to make sense of it for someone else.

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Yes, I think you should seek 60% or more.  If you are not working, then 100% is highly probable for TDIU.  

Its difficult for us to know your full case without reading your file.  Is your Regional Office Rating decision within the past 12 months?  If so, you want to file a NOD and dispute the 40 percent rating for 60% for the reasons you posted.  

There are at least 2 kinds of errors, at VA:

1.  CUE errors.  Clear, Unmistakable Errors is a legal defination and a "standard of review".   These have to be undebatable (not a judgement call), based on the evidence at the time of decision, and the error has to be "outcome determinative".  It is not CUE for VA to forget to dot an i in your decision.  That would not affect the outcome.  Also, percentage evaluations are rarely Cue, I may think you deserve 60%, someone else 40%, and a third party thinks you should be at 100%.  These are judgement calls, not subject to revision by CUE.   To repeat, CUE errors are undebatable.  

2.  "Regular" errors.  These are any kind of error the VA makes that does not fall into the above category.  

     You can "correct" BOTH types of errors when you file a NOD within a year.  CUE is normally used when you did NOT file a NOD within a year.  

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Broncovet,

I was surprised to see on E-Benefits my "closed claim" which had several conditions, is back active with just the condition I mentioned here now pending. I won't get too excited, till I see the final rating. It says "Preparation for decision" All 4 other conditions remained closed. I think it may have fallen under the "CUE". The rating is clearly determined, not debatable. It states what section to use for my condition and the severity of my condition is clearly measured and documented. If rated under section the regulation quotes it would be 60% based on multiple documentation. If rated in a very similar section but NOT the one identified to be used for my condition I would get 60% which is the max for my condition.

However I believe they used another section which does max out at 40%. The reasoning was stated for the 40%"maximum allowable by law". 

I'm unsure how long it will take to complete again, but last time from "preparation for decision" to complete was just days. 

I will still remain at 90% but hoping that unemployability will have a better chance of approval. I haven't been able to work for 8 years and have been receiving SSDI for 4 years. With this claim I've gone from 50% to 90%. Which was rounded from 88% now if rating goes to 60% I'll be at 94.28% so I feel comfortable submitting that TDUI? or what ever it's called. 

I'll update when I see the rating listed once it closes again.

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Great News. I received a PHONE CALL today, from the VA. I was informed that they had indeed reopened my claim. They wanted to apologize for what was a "Clear and Unmistakeable Error". They also said that my rating would be going up!:huh:  This surprised me as I thought even with the correct rating being 60 versus 40 that I would remain at 90%(rounded from 94.28).

I checked ebenefits and saw the expected increase, but ALSO previously denied conditions TWO now confirmed and service connected as secondary!! 100%.:biggrin:  What a nice surprise. Mind you I had just sent an email on Sunday which wouldn't have been received till Monday! Today is just Wednesday! Fixed in 2 Days! I have to say that I am impressed. I call this SUCCESS!

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