hypertension First C&p Exam

[mbarker]

My husband filed a first-time claim in August (for DMII, hypertension), and he just got his C&P appointment dates. It looks like it is just tests the first appointment date(LAB and EKG), and the second appointment date says "SNAPP" - whatever that is.

My husband is relatively healthy - all the conditions we are claiming are under good control with medications. I'm not sure I understand the point of the examination, or the testing. My husband can re-state the things we stated in his claim about the course of his diseases, but the tests are going to (or should, at least) show normal test results. They are requesting blood pressure checks (twice a day on three different days) - his blood pressure should be normal - he's on lisinopril! What is the point?

I guess my questions are:

Does anyone know what SNAPP mean?

Will my husband be denied benefits automatically because he appears healthy and has normal test results?

How should he appear to the examiner?

And, do they care who performs the blood pressure checks? I'm in nursing school, can I do it?

Thanks in advance for your help!

This site has been a great service to us!

Mindy

[Guest rickb54]

mbarker,

stated:

Does anyone know what SNAPP mean? no never heard of this before....

Will my husband be denied benefits automatically because he appears healthy and has normal test results?

it is hard to say, I have seen it go both ways. But usually if there is a written history of care it will be awarded....

How should he appear to the examiner?

In his case since he has no apparent physicial ailments it really doesn't matter how he appears.

But remember to answer all questions to the negative side.. in other words remember his worse day, and the day he has his exam is going to be that day, as related to the examiner.....

And, do they care who performs the blood pressure checks? I'm in nursing school, can I do it?

It is hard to say if they will accept this from a nursing student, expecially since you are the wife.. to be safe.. go to the va, or if retired military a military hospital for walk in pressure checks....

Best of Luck

[Ricky]

If the disabilities exists the fact that they are under control should not be a problem but like Rick said I have seen it go both ways.

DMII under control = meds. Oral meds will rank a 20 percent rating. Insulin with restricted diet and RESTRICTED ACTIVITIES will rank a 40 percent rating etc, etc........ All that matters is the history of the disease and treatment and the service nexus.

Hypertension will be the same. A diagnosis of hypertension which is under good control with meds will rank a 10 percent rating so on and so on. Just make sure the history and service nexus is there.

As far as the testing goes - as an example - if the DM is in the service medical records along with the type of meds that it is being treating with I am sure they are just checking to determine if the disease has progressed since the diagnosis. They want to insure that all of the other systems such as kidneys and heart are still ok as DM tends to have a terrible impact on such organs.

As far as the hypertension they are just trying to confirm that a current diagnosis is present. I guess the medical records do not document this very well. Also the blood pressure checks will allow them to determine if it warrants a rating for continious meds (10 percent) or if a higher rating is warranted.

Now this being said - this would be the normal reasons for the exams. As to the real reason for the exams the anyones guess principal has to be applied for no one really knows what goes on in the mind of the raters at VA. Hope this helps clam you down a bit. Bottom line is that if your hubby has DM and hypertension that is well documented and has a service nexus you will not have any problems. Just make sure you attend the C&P exam and as Rick said be truthful but make sure that the doc knows the ture effect of the diseases on your hubbys life and understands how his worse day living with them is.

[Berta]

I have never seen that abbreviation before- can't find it in M21-1 search---

Ricky is correct- as long as the SMRs reveal diabetes or he was an incountry Vietnam veteran- they should service connected the diabetes and the HBP.

My former vet rep was SCed for DMII then denied for the HBP because it was controlled-however he fought this decision as -it has to be medicated to be controlled. He eventually got an HBP SC rating of 10% as it was secondary to his SC diabetes.

[mbarker]

Thanks everyone for your quick responses!

So, should I take it as a positive sign that we got an appointment? Is a C&P exam standard procedure, or does it mean things are going in his favor? And, is the C&P to confirm his condition NOW or to get the service-connection link?

Thanks again!

Mindy

[Berta]

Mindy - a C & P is standard procedure- to confirm the diagnosis and to help produce a rating for it.

The rating is determined by a rater officer using the Schedule of Ratings that Ricky referred to.

This is the VA's diabetes C & P exam:

http://www.vba.va.gov/bln/21/Benefits/exams/disexm13.htm

Is he an incountry Vietnam veteran who was exposed to Agent Orange or did he manifest diabetes during his service?

Most veterans find that they need to acquire their complete service medical records to prove a nexus factor.

If he was incountry Vietnam veteran or in certain Army units in Korea-exposed to Agent Orange- his diabetes will most surely be found as presumptive to his service.

If this is not the case and he needs to show in service nexus -he can get a copy of his SMRs at NARA:

http://www.archives.gov/

Clickk on Military records and then on evetrecs or the SF 180 link.

He can apply for them on line or use a copy of the SF 180 off line.

He will need to print out the bar coded thing that comes after the application, sign it, copy it, and mail it to where they say to at the site. This takes about 4-6 weeks to get them.

I dont know what VARO you deal with but the Buffalo VARO I deal with makes some decisions in months yet many decisions take years. I hope this is not the case with his claim.

When did he file it?

"is the C&P to confirm his condition NOW or to get the service-connection link?" The C & P doctor should make a statement as to whether the diabetes is linked to his service.

However-if he does not have presumptive diabetes due to AO, he will have to support that link with his SMRs. The VA will get them too but often they fail to read SMRs carefully

unless he got a medical discharge due to diabetes?

VA claims are mainly based on 2 factors:

1. current diagnosed disability

2. nexus (proven link) to service

Edited November 25, 2006 by Berta

[Guest terrysturgis]

I suggest you find the DMII traning letter that the VA uses for their people. I am not very computer savy or I would post the link. Use the search for DMII Traning Letter and it should come up. Be sure to claim all secondary conditions of DMII. I have Peripheral Neuropathy of my hands and feet. It is secondary to DMII.

It sounds to me like your husband was diagnosed by a private Doctor, if so get copies of the medical records, make copies of those and hand them to the examiner. I do not know what the abreviation SNAAP means. Take care. Terry Sturgis