hypertension Rating Finally Received, Few ?s On New Claim, Appeal

[Nathan104]

It took 1 year exactly but I finally got the big envelope. I should have received it 2 months ago but a clerical error was found that had to be fixed. Heres the official results.

Essential Hypertension- 20%

DJD/DDD lumbar spine- 10%

Patellofemoral syndrome, right knee/post arthroscopy w/ clinical diagnosis chondromalacia 10%

Irritable bowel syndrome 10%

Gastroesophageal reflux disease w/ hiatal hernia 10%

Insomnia 10%

Bilateral planovalgus flat foot 0%

Mild seasonal nasal allergies 0%

external hemorrhoids 0%

scar residuals, left face 0%

scar residuals, right forearm/left knee 0%

history of achilles tendonitis, right DENIED

upper back shoulder pinched nerve, bilateral DENIED

remote injury right hip DENIED

hearing loss, bilateral DENIED

Tinnitus DENIED

TOTAL rating 50%

Since my C&P's, my lower back got much worse and I had a lumbar diskectomy that turned out bad and I now have a large amount of scar tissue formed around nerve roots and several new herniated discs (as shown in a recent MRI). I think my best bet is to send in the new info from after the surgery and request they reevaluate it instead of straight appealing it. Not sure though. Im also going to be sending in my TDIU form at the same time as I have not been able to work since getting out and can not even go to school anymore.

I never claimed hearing loss, only bilateral tinitus. I have constant ringing in my ears that drives me almost insane at times. Not sure how I can prove this though. I was a helicopter pilot and worked around the whine of the jet engines. Ill be appealing this decision.

The achilles tendonitis and right hip injury was a problem for a few years while in service but currently does not bother me. It was only on there because the VA guy I had to see before I got out said to claim it anyways. I will not appeal those two as they arent currently a problem. Maybe down the road if they act back up. Am I wrong or is my thinking ok on these?

The pinched nerve in my back is still a problem and acts up anytime I carry a backpack or even a heavy grocery bag. Its just an intense burning in a localized spot and it lasts about 30 minutes. Maybe this isnt bad enough for a rating, I dont know.

I believe the 10% rating on my stomach problems, insomnia, and reflux are rated as they should be and will leave those as they are. Same with the 0% for the scars.

The feet problems and hemorrhoids should both be at 10% I believe based on the criteria for the ratings on those. Ill appeal those two also.

Im not sure on the allergies. I have them horribly and they are terrible almost every day. Im allergic to almost everything. But, I felt kind of funny claiming this in the first place as even though I didnt have allergies before I entered service, Im not sure these can actually be atributed to my military service. But, if they were caused by my service then they sure as heck are a lot more troublesome than 0%. Not sure what to do on that one.

My right knee was operated on in service and is the reason I was put out on disability after 8 years in service because I could not fly anymore. Ill probably appeal this one. I have not looked at the criteria for ratings on it though. But, it gives out, catches and scrapes really bad when I bend it and hurts a lot.

My back is the main problem though. I had the surgery after my c&P so my range of motion measurments used in my rating where from before it got much worse. I did howvever write several letters updating my condition and send in the surgery reports. Not sure if I should request a new c&p to get new range of motion measurements or what. The surgery was done by a civilian.

My new claim I just sent in is Depression. I saw a counselor/psychiatrist for about 6 months while in service after my knee got really bad. I have not seen anyone since getting out because Ive had no insurance and the VA made a mistake and said I wasnt eligible for health care until I got my rating. I tried getting this cleared up several times but to no avail. Now that Im rated Im good to go though and can start going to the dr after the january enrollment according to them. I guess my question on this is, will it hurt that Ive not been seeing anyone for depression? Part of my reason for filing for this is to get seen and hopefully start to get some help on it. Im kind of lost and not sure what to do. If it werent for my wife and kids, I know for a fact I would not be here right now. Its pretty pathetic that dont give in only because of what it will do to three people but I guess its kept me here this long.

Im really sorry this was so long and hopefully its not confusing.

I talked to a local vet rep for help but the guy was a moron. He told me NOT to file the TDIU form but to just hint at getting TDIU in my appeal and they would give it to me. He also told me that I could not get a temp 100% rating for the 3 month convolescence period after my surgery. Those are only a few of his doozies, most of what he said was BS. Im thinking fo calling the rep in the next county and giving him a shot but just not sure. Ok, ill stop typing now. thanks.

[Nathan104]

Carlie- thank you for the info. The Little Rock VA has been really screwing me around on the health care angle. At first I was told I could not get care until I was rated. After a few months I found out this was not true so I called them to try and be seen. Thats when I was told I was not eligible. I had not applied yet but they said somehow I was already in the system and it showed that I was not eligible for VA health care. I spent two months trying to get that cleared up but they ended up telling me that there was nothing they could do and Id just have to wait for my rating decision in the mail before I could get it cleared up. I ended up paying to see a civilian dr to adjust my hypertension meds as my BP was extremely high even on my meds. Finally got my decision and called about health care again. This time they said my rating was in the computer and I was now eleigible for health care. BUT, they said the next open enrollment was for january and I could not make an appointment or walkin before then., He did say however that I could go to the VA ER if I needed to. So, I guess thats something. So, I guess Ill have to wait until after january to start being see for anything. I really dont understand a lot of what has happened as I though if you were a veteran, you could get care at the VA no matter what. For some reason, that wasnt the case for me.

Nathan, if you were flying very much, and if you were in the nam, then I'd be willing to wager that you were exposed to Agent Orange.........?

Si?

Larry, no Im a young pup. Im 28 and spent 8 years in service up until dec 2005.

[Berta]

" I think my best bet is to send in the new info from after the surgery and request they reevaluate it instead of straight appealing it. Not sure though. Im also going to be sending in my TDIU form at the same time as I have not been able to work since getting out and can not even go to school anymore. "(from Nathan's post)

Yes- send in the TDIU form- and if I were you I would also send them a letter -

Put this is caps on it with your c file number

Request for Reconsideration

Tell them you request reconsideration of a recent decision (give the date and attach the award letter) due to

the attached probative evidence (and attach the new evidence regarding the surgery you had as well as evidence on anything else they should reconsider).

This type of request does NOT stop the clock on the formal NOD- keep that date in mind and don't let it pass- however this type of request could certainly save time and could produce a faster and better award----

Also you could refer them in the Reconsideration Request to the TDIU form and attach that too.

I also suggest that you claim the convalescent benefit if your situation falls under those regs-

38 CFR 4.30---

The VBM suggests strongly that a convalescense statement from the doctor should be obtained ASAP to support a claim under TDCC.

I hope your vet rep didnt bugger this by saying what he said-

Do you have this in email from him?

Also if you were hospitalized for 21 days or more due to SC condition they should owe you temporary TDIU under 38 CFR 4.29 (2006) and that has to be applied for by separate claim.

"Since my C&P's, my lower back got much worse and I had a lumbar diskectomy that turned out bad and I now have a large amount of scar tissue formed around nerve roots and several new herniated discs (as shown in a recent MRI"

If the VA did this surgery and caused you additional disability(several new herniated discs) due to medical error -you should file a claim under 38 CFR,Section 1151 ,too.

I think you certainly should seek a better vet rep.

This claim here presents something that always bothers me--in the time it takes for a vet to get a C & P -the initial disability they filed on could have progressed- yet the C & P report- by the time VA gets to that -reflects what might have been the degree of disability a year or more prior to the decision and that report is possibly a very outdated assessment of the claimed condition.

[Nathan104]

Berta, thanks for the reply.

I actually met with the vet rep for the neighboring county today. Much better experience this time around.

He agrees that the best route for my back it to request a reconsideration and a new c&p so we can submit the post surgery evidence. He also wants to submit the TDIU form at the same time.

Ill be submitting those and appealing my tinnitus denial right off the bat and probably waiting on the rest of it for later.

I got the convalescence statement of 3 months from my surgeon and already sent in the request for the temp 100% rating for that.

I got to reading through the blue pages of my rating and came up with a question just now(actually two questions but I just posted the other in Cavman's tinnitus thread on the first page). Im at 20% for Essential Hypertension. The decision states

"evidence shows chronic hypertension in service and cited VA exam diagnoses the same. Evidence shows you currently take 10mg Lisinopril (this is wrong, im taking 30mg) daily for treatment of this condition, and three random blood pressure readings show: 142/104, 144/120, and 143/121 warranting an eval of 20%. 20% is assigned if diastolic is predominently 110 or more. A higher eval of 40% is not warranted unless diastolic pressure is predominently 120 or more"

Ok, two of the three reading stated are 120 or more diastolic. Would this not be predominently 120 or more?

predominantly

adv : much greater in number or influence; "the patients are

predominantly indigenous"

Maybe Im looking at this wrong? Could they have also used the readings from my c&p visits and just not stated them in the decision?

[Berta]

I am thrilled that the vet rep sees it this way!

"Ok, two of the three reading stated are 120 or more diastolic. Would this not be predominently 120 or more?'"

That is exactly how I see this too.

"Maybe Im looking at this wrong? Could they have also used the readings from my c&p visits and just not stated them in the decision?"

Do you have those readings? They could be quite significant to the rating-

When I say the VA manipulates C & P results etc- this is example of what I mean-

they focus on negatives or just make up something like this that is not born out by the evidence-

and their own criteria-

I imagine they get away with this more than we know.

I commend the way you are handling this claim-

"predominantly

adv : much greater in number or influence; "the patients are

predominantly indigenous"

I have used medical and other professional definitions also in claims-and attached the reference from

Medilexicon or any good dictionary too-

GREAT move-

and also great that you could assess the Blue Rating sheet-

Obviously the actual lisinpril dosage you take--that they listed wrong- indicates higher level of HBP than the 10mgs.

[Cavman]

It took 1 year exactly but I finally got the big envelope. I should have received it 2 months ago but a clerical error was found that had to be fixed. Heres the official results.

Essential Hypertension- 20%

DJD/DDD lumbar spine- 10%

Patellofemoral syndrome, right knee/post arthroscopy w/ clinical diagnosis chondromalacia 10%

Irritable bowel syndrome 10%

Gastroesophageal reflux disease w/ hiatal hernia 10%

Insomnia 10%

Bilateral planovalgus flat foot 0%

Mild seasonal nasal allergies 0%

external hemorrhoids 0%

scar residuals, left face 0%

scar residuals, right forearm/left knee 0%

history of achilles tendonitis, right DENIED

upper back shoulder pinched nerve, bilateral DENIED

remote injury right hip DENIED

hearing loss, bilateral DENIED

Tinnitus DENIED

TOTAL rating 50%

Since my C&P's, my lower back got much worse and I had a lumbar diskectomy that turned out bad and I now have a large amount of scar tissue formed around nerve roots and several new herniated discs (as shown in a recent MRI). I think my best bet is to send in the new info from after the surgery and request they reevaluate it instead of straight appealing it. Not sure though. Im also going to be sending in my TDIU form at the same time as I have not been able to work since getting out and can not even go to school anymore.

I never claimed hearing loss, only bilateral tinitus. I have constant ringing in my ears that drives me almost insane at times. Not sure how I can prove this though. I was a helicopter pilot and worked around the whine of the jet engines. Ill be appealing this decision.

The achilles tendonitis and right hip injury was a problem for a few years while in service but currently does not bother me. It was only on there because the VA guy I had to see before I got out said to claim it anyways. I will not appeal those two as they arent currently a problem. Maybe down the road if they act back up. Am I wrong or is my thinking ok on these?

The pinched nerve in my back is still a problem and acts up anytime I carry a backpack or even a heavy grocery bag. Its just an intense burning in a localized spot and it lasts about 30 minutes. Maybe this isnt bad enough for a rating, I dont know.

I believe the 10% rating on my stomach problems, insomnia, and reflux are rated as they should be and will leave those as they are. Same with the 0% for the scars.

The feet problems and hemorrhoids should both be at 10% I believe based on the criteria for the ratings on those. Ill appeal those two also.

Im not sure on the allergies. I have them horribly and they are terrible almost every day. Im allergic to almost everything. But, I felt kind of funny claiming this in the first place as even though I didnt have allergies before I entered service, Im not sure these can actually be atributed to my military service. But, if they were caused by my service then they sure as heck are a lot more troublesome than 0%. Not sure what to do on that one.

My right knee was operated on in service and is the reason I was put out on disability after 8 years in service because I could not fly anymore. Ill probably appeal this one. I have not looked at the criteria for ratings on it though. But, it gives out, catches and scrapes really bad when I bend it and hurts a lot.

My back is the main problem though. I had the surgery after my c&P so my range of motion measurments used in my rating where from before it got much worse. I did howvever write several letters updating my condition and send in the surgery reports. Not sure if I should request a new c&p to get new range of motion measurements or what. The surgery was done by a civilian.

My new claim I just sent in is Depression. I saw a counselor/psychiatrist for about 6 months while in service after my knee got really bad. I have not seen anyone since getting out because Ive had no insurance and the VA made a mistake and said I wasnt eligible for health care until I got my rating. I tried getting this cleared up several times but to no avail. Now that Im rated Im good to go though and can start going to the dr after the january enrollment according to them. I guess my question on this is, will it hurt that Ive not been seeing anyone for depression? Part of my reason for filing for this is to get seen and hopefully start to get some help on it. Im kind of lost and not sure what to do. If it werent for my wife and kids, I know for a fact I would not be here right now. Its pretty pathetic that dont give in only because of what it will do to three people but I guess its kept me here this long.

Im really sorry this was so long and hopefully its not confusing.

I talked to a local vet rep for help but the guy was a moron. He told me NOT to file the TDIU form but to just hint at getting TDIU in my appeal and they would give it to me. He also told me that I could not get a temp 100% rating for the 3 month convolescence period after my surgery. Those are only a few of his doozies, most of what he said was BS. Im thinking fo calling the rep in the next county and giving him a shot but just not sure. Ok, ill stop typing now. thanks.

I have claims in for gerd/hiatal hernia and insomnia as secondary to ptsd. How did you get 10% for those. Curious as to what evidence you had.

Cavman

[Nathan104]

Cavman,

I was diagnosed with acid reflux in service. Thats what my claim was for. While in service I got to drink that nasty chalk/elmers glue mixture and get Xray'd which showed reflux. I was on Aciphex for it for 2 years in service. Had the same test done at the C&P for it. Ive actually never heard of a Hiatal hernia before and didnt claim it and hadnt been told anything about it in service. I guess its something they saw from the test at the c&p.