I REALLY need you guys help on rating!

[garion]

I got my rating back.  I went from 60% to 90%.  The problem is they denied my pancreatitis that would have given me 100%.  I want to know the quickest way to get them to correct this? 

The VA stated "medical evidence of record fail to show that this disability has been "clinically diagnosed". The evidence does not show a current diagnosed disability".

This is wrong!  The C&P doctor diagnosed me with pancreatitis and this statement is directly from her notes 8.  Remarks, if any 1. Veteran's current claimed and diagnosed GI symptoms is at least as likely as not (50 percent or greater probability) a continuation and/or progression of the Veteran's already service connected Chronic Cholecystitis, S/P Cholecystectomy with Acid Reflux.

Also this as well... 4. Pancreas conditions: signs and symptoms - a. Does the Veteran have any of the following symptoms attributable to any pancreas conditions or residuals of treatment for pancreas conditions? [X] Yes [ ] No If yes, check all that apply: [X] Abdominal pain, confirmed as resulting from pancreatitis by appropriate laboratory and clinical studies If checked, indicate severity and frequency of attacks (check all that apply): [X] Severe (disabling) Indicate number of attacks of Severe (disabling) abdominal pain in the past 12 months: [ ] 0 [ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ] 6 [ ] 7 [X] 8 or more [X] Other symptoms, describe: Veteran states he awakens at night he awaken and loses his bowel(defication) . b. Does the Veteran have any of the following signs or findings attributable to any pancreas conditions or residuals of treatment for pancreas conditions? [X] Yes [ ] No If yes, check all that apply: [X] Steatorrhea If checked, describe frequency and severity: Veteran states greacy foul smelling stools 3 times per week. [X] Diarrhea If checked, describe frequency and severity: Veteran states has loose and watery diarrhea. Veteran states his last severe episode was 4 days ago.

Also, I have additional clinical diagnoses from a private specialist which I didn't submit to the VA because I thought the C&P exam would be enough.  I haven't had these records long.  This is what the Gastroenterology studies reported. DATE OF PROCEDURE: 09/03/2012 Operative Report The patient underwent an endoscopic ultrasound today. PREOP DIAGNOSIS: History of abdominal pain, high pancreatic enzymes.

POSTOP DIAGNOSIS: Chronic pancreatitis.

Prior consent was obtained from the patient after the alternatives, benefits and risks were explained including, but not limited to the risk of bleeding, infection, perforation, aspiration, missed lesion, drug reaction, death and surgery.

Patient was placed in the left lateral position. Bite block was placed. Versed and Demerol were used for this test. A radial endoscopic ultrasound scope was used and advanced into the small bowel without complication. This was limited study with his history of gastric bypass. Parts of pancreas that were evaluated grossly appeared normal except for multiple hyperechoic strands and foci and lobularity of the gland suggestive of chronic pancreatitis. IMPRESSION: As above. Continue low fat diet. I would get a follow up MRCP to further evaluate the pancreatic biliary ductal system. In the future if his symptoms persist in spite of medical management, further and therapy would be an option. Unfortunately his presentation is compounded with history of gastric bypass and if the symptoms persist and above has to be undertaken it has to be through a gastrostomy tube placement. Again, time will tell where his symptoms take us. SA/NB

[Navy4life]

First off, congrats on the increase!

3 hours ago, garion said:

Veteran's current claimed and diagnosed GI symptoms is at least as likely as not (50 percent or greater probability) a continuation and/or progression of the Veteran's already service connected Chronic Cholecystitis, S/P Cholecystectomy with Acid Reflux.

Sounds to me that the C&P exam basically confirmed your prior diagnosis and that it is a continuation of the GI Symptoms.  I am not an expert but that jumped out at me.

3 hours ago, garion said:

Also, I have additional clinical diagnoses from a private specialist which I didn't submit to the VA because I thought the C&P exam would be enough.  I haven't had these records long.  This is what the Gastroenterology studies reported. DATE OF PROCEDURE: 09/03/2012 Operative Report The patient underwent an endoscopic ultrasound today. PREOP DIAGNOSIS: History of abdominal pain, high pancreatic enzymes.

This is where I see Veteran's make mistakes.  Always submit anything and everything!  Since you did not submit it, I would immediately file an NOD and submit this documentation.

[flores97]

Garion, I agree with Navy. Immediately submit a NOD, with the additional report from the endoscopic ultrasound. Also submit a copy of the positive c&p exam and HIGHLIGHT the at least as likely as not statement, as well as the statement "confirmed as resulting from pancreatitis,etc". Heck, i would also underline that statement and draw a big arrow pointing to it, as evidently the rater did not read that far.

[garion]

Thanks guys!  I was shocked that the rater looked right pass what the C&P examiner reported. 

[allan1351]

Hey garion

Great you got an increase.........Don't forget your dealing with the VA......Allan

[garion]

Thanks allan1351.  I been dealing with them a long time.  Hopefully it will come to an end soon...

[flores97]

Good luck, garion! Please keep us updated!