Going to file NOD, DAV rep disagreed with my research findings

[Palma114]

I went to see my DAV rep this morning, to let her know that I was going to file a NOD on my kidney disease decision that VARO awarded me in Aug 2016, and I was telling her that I believed that the VARO erred in their decision in rating me on kidney disease stage 3, because when I initially got really sick with kidney disease, I was at stage 4 and of course

the VAMC put me on several medications to stop the kidney disease from progressing higher, so after the VAMC aggressive approach, my kidney disease dropped to stage 3 within about 35 days. This occurred in 2006, and I filed my claim in 2006. So I showed the DAV rep 4 pages from VAMC where they initially diagnosed my kidney disease stage 4. The DAV

rep told me the VARO are not going to consider when you had kidney disease stage 4, because you've had stage 3 for about 10 yrs. I told her its not my fault that the VARO dragged this claim out for so many years. So I ask the DAV rep, how do you think I went down from stage 4 to stage 3, she said because of the medications that they gave you. I said doesn't

that fall under the Ameliorative effects of medication (CAVC Jones vs Shinseki, 26 Vet. App. 56, 63 2012) the board may not deny entitlement to a higher rating on the basis of relief

provided by medication when those effects are not specifically contemplated by rating criteria. She seem to not know about this court ruling, then she says they're still not going to do it. But as I've researched I did not find anything, that kidney disease stages, have to be for a certain amount of time.

[Berta]

I had multiple lawyers tell me I could not sue VA and my FTCA case would never succeed.1995.

Awarded 1997.

And another vet rep who told me my DMII AO death claim would have to go to the CAVC because it was so weak.

He read the claim very  fast because he had a question for me.

They were all wrong.DMII award 2009.

His question was 'who are Blue Water veterans' he heard me talking to one of the VA Patients about before my appointment with him.I was stunned that he didn't know.

Then he asked me to help with a claim he had already screwed up big time.He told the vet he was awarded 100% P & T but it was an award for a NSC pension, and after deductions, it was a very small monthly amount. This rep should work for the VA. He cant read either.

 

 

 

 

 

 

 

 

 

[Gastone]

Is it "Normal" for a Stage 4 to regress to a Stage 3 or less with meds only, no surgery?

Not sure, no real knowledge of Renal Rating procedures, but I would think your going to find yourself in a protracted battle with the VA.

How about posting the DX 123&4 timeline? Have you found any BVA Decisions that come close to mirroring your situation?

What type of NOD Appeal Path are you considering? Did the Rater address in your Award/Denial Letter,  why you didn't qualify for or meet the Stage 4 Rating criteria?

Semper Fi

[Palma114]

17 hours ago, Gastone said:

Is it "Normal" for a Stage 4 to regress to a Stage 3 or less with meds only, no surgery?

Not sure, no real knowledge of Renal Rating procedures, but I would think your going to find yourself in a protracted battle with the VA.

How about posting the DX 123&4 timeline? Have you found any BVA Decisions that come close to mirroring your situation?

What type of NOD Appeal Path are you considering? Did the Rater address in your Award/Denial Letter,  why you didn't qualify for or meet the Stage 4 Rating criteria?

Semper Fi

No its not normal for kidney disease to regress from stage 4 to stage 3. But with all of the meds vamc gave me, brought it back down to stage 3, after 35 days at stage 4. You stated I'm going to find myself in a protracted battle  

with the VA. There is a lot of Veterans, including myself, that believe that there is, pretty much always a protracted battle with the VA, over your claim or their C & P Exam procedures. At least you did state, that you have no real knowledge of renal procedures. Because for me, this is not just about some VARO, I feel very comfortable with my claim or case going to the BVA and CAVC, because the law is clear, Jones vs Shinseki, 26 Vet. App. 56, 63 (2012).

My claim is probably a little outside of your knowledge Gastone. But thank you for your opinion.

Edited October 7, 2016 by Palma114

[Gastone]

Not a little, a lot.

Your 90% SC indicates a Serious, if not Severe Disability picture. Your Schedule Eligible to file for IU, have you considered filing for IU?

You opined as to winning at the BVA or CAVC, that could be 5+ years. I think we can both agree, there are no Decision Certainties at the BVA or CAVC. If you do prevail on appeal, does the Stage 4 SC % get you to 100% SC with SMC S (1), about an additional $1500 over your 90% Comp? % years of Retro would be about a $90K pay day, not bad, definitely take the edge off. 5 years is 5 years!

If you qualified for IU, Comp is paid at the 100% Rate and you may be eligible to get the SMC S (1). You could still prosecute your Appeal, just get the $$ in front, instead of on the come.

Besides the aggressive meds, are you on a regular Dialysis regime? A friend had to have a kidney removed a number of years ago, can't recall her discussing what stage her disease was, had to be right up there.

As an aside,Vets that have SC Prostate Cancer, receive 100% Comp as long as they keep their Prostate gland. If they have it removed, no metastasis, Comp drops to area of SC 30%.

Semper Fi

 

[Gastone]

On my previous post, I asked about Dialysis, hadn't looked at 38 CFR 4 ratings for Kidney conditions. After reviewing the 38 CFR 4, it appears that your GFR number and need for Dialysis play very large factors in your SC rating. In addition to the "Probative Value" of your Dr's Tests and Clinician notes.

Maybe you mentioned it, don't recall, did the Dr that DX'd you at Stage 4 complete a 21-0960J-1 Nephrology (Kidney Condition) DBQ? Could you post a redacted copy of the DBQ or his/her's Clinician Notes.

From the (5) Stage 4 Kidney Disease DXing Med Articles I read, your GFR has to be tracked over a 90 day period to establish Stage 3 or 4/5. How long were you at Stage 4 before the Aggressive Med treatment began? All your GFR Blood work was done by your VMC, right?

Your treating Dr's response to DBQ 2A, 3A & B and 5 C would be very informative, when compared to the C & P DBQ.

Semper Fi