Correcting Ostomy Rating

[AshMur]

Hello! Long-time lurker, first-time poster. I've gained a lot of valuable information from this site in the past, and I am hoping to gain some insight on my particular issue/question.

I went through an MEB in 2013/2014. I was found UNFIT for a neurogenic bladder condition (complication during a total colectomy) and rated at 40%. I had several other conditions claimed and rated as part of the MEB. Ulcerative Colitis (they combined it with GERD and a permanent ileostomy) rated at 20% and many other minor conditions related to my joints and scars at 10% each. This all added up to 80% (a year later, I was summoned for a C&P exam to check on my bladder which resulted in an increase from 40% to 60% which raised my overall rating to 90%). At the time, I was confused as to why my UC was only rated at 20% since it led to me losing my colon completely, but I was urged by a Senior Chief working alongside my PEBLO to accept the findings since it granted me a medical retirement and to appeal anything after I was out of the military. Hindsight 20/20--I probably should have appealed the findings when I was still active duty and made sure things were correct before signing anything. However, I didn't know anything about the Schedule for Rating Disabilities/VASRD/38 CFR, so I didn't know any better back then.

Fast forward several months, and I now realize that the VA may have made a mistake in my claim (or that there was important information missing from my medical records). According to the VASRD, ostomies are rated under code 7333 (which is for colostomies) making it look like my permanent ostomy should have been rated at 100% from the start. I met with a DAV rep at the North Chicago VA who helped me submit a claim including a DBQ filled out by a GI noting the reason for my ostomy, the fact that it's permanent, and the date that I had it created. My rep didn't seem interested in hearing about how I felt the original rating was probably incorrect. He kept interrupting me to tell me to just get the DBQ filled out and that we would submit the claim. "Let's keep this simple," he kept saying. He either knows that the VA will see my claim for an ostomy, review my current ratings and see that I have had this ostomy for a while, and will notice the error (is this likely? I'm asking honestly), or he didn't understand what I was saying. I haven't received a return call from him in weeks and he is always out of the office when I make the 45-minute drive up to the VA where he works. I have been following my claim on eBenefits and taking the info with a grain of salt. It's being worked on in the National Work Queue (mostly out of San Diego), and I've been at PFD since the end of June and it's past the ECD of July 15, 2016, with no new ECD listed. It would have surprised me to have a closed claim by July 15th, so I am trying to be patient and see how long this takes.

Anyway, my main question is this: since I've had this ostomy since the original award letter, do I have a reason to make sure the results of this current claim has an effective date of that original rating decision from 2014? Or, have I missed that window because I didn't appeal the VA's decision within one year? Also, I'm curious to know if there are any other veterans with ostomies here and how the VA rated theirs.

Thanks in advance for any info/discussion on this topic!

Edited August 1, 2016 by AshMur

[Highninjapie]

Any update? I'm about to be in your shoes, having my surgery next week for permanent ileostomy. I'm a bit nervous about filing my paperwork, but pretty sure I have it all set. 

[AshMur]

On 11/22/2016 at 11:14 PM, Highninjapie said:

Any update? I'm about to be in your shoes, having my surgery next week for permanent ileostomy. I'm a bit nervous about filing my paperwork, but pretty sure I have it all set. 

Hello, Highninjapie!

I found out on October 24, 2016, that the VA did not see any evidence to warrant increasing my ileostomy rating from 20%. Don't be too disheartened by this, though, as my DAV representative filed a request for an increase when I actually should have been filing a CUE claim this whole time. So, after I received the decision packet in the mail, I contacted a law firm specializing in VA disability cases and now have a lawyer working with me to file a CUE claim to get my rating corrected.

Since I don't know the details of what you're going through, I'll just encourage you to make sure it is documented that you have an ileostomy which is analogous to a colostomy as far as the VA disability ratings are concerned (as far as I know right now, there is no specific rating for ileostomies, so they get rated as if they are an colostomy). Since your stoma will be permanent like mine, BE SURE that this is stated clearly in your paperwork that your stoma will be permanent for the rest of your life. This may help ensure you get the correct rating for your stoma the first time.

I will update this thread once I work with my lawyer and submit whatever we will be submitting over the next several weeks. If you have any personal questions about the procedure in general or anything else, please feel free to message me! I have only had my stoma for a little over 3 years now, but I am an open book about my surgery, recovery, medboard, and adjusting to life with a permanent ostomy. Good luck to you! 

Edited November 26, 2016 by AshMur

[Wlaing]

Any other updates. I say this as I had an Ileostomy in 2006, ten years after I retired. I submitted all my paperwork and medical reports both active duty and post retirement. I was immediately rated at 100% permanent and Total. It is important that you get the right rating and the back compensation. One that it missed is that Student loans can be forgiven. I hope you received the proper rating. 

Bill

[Berta]

Great point-our state Department of Higher Education sent us a form here in NY-my husband took it to his PCP at VA who signed it due to his 1151 P & T stroke.

They probably have the waiver form at any state Department for Higher Education.

It is one of the few things VA ever did right for him.