hypertension Putting BVA appeal together w/attorney but also new conditions to submit

[aws2000]

Sorry if this question/answer is already posted, but I couldn't find it. I have just received 10/05/26 another DRO De Novo denial for increase in PTSD [currently 50% PTSD 10% other] and approval for TDIU.  This has been going on for a decade and the local DRO has blatantly ignored 12 years of therapy and VA psych assessments which counter the one C&P doctor's 40min assessment.  But my question is;  I have been in contact with a lawyer to represent this appeal to BVA. I'm a Vietnam Vet and at 69 I will be 74 by the time the 5 year BVA backlog gets to it. So I need to do this right. I have recently been informed that Hypertension, which I have has since Vietnam can be secondary to PTSD. I also have heart arrhythmia which I read can also be aggravated by hypertension. I've had 4 TIAs since 2007 and my external cardiologist - who has done extensive work on me for over 5 years - I believe will attest to hypertension secondary to PTSD. And maybe other heart diseases.   

Finally, my questions is should I continue to file the BVA appeal addressing the 10/05/2016 denial issues?  Or, should I not file the appeal and submit my hypertension and heart issues as new claims?  The most significant problem I see is that if I don't file the BVA appeal claim now, and wait for the DRO decision on the new issues I might be dead, or clearly out of time to file the BVA appeal.

Semper Fi!  Art

[Berta]

Did your "external cardiologist see any link between the TIAs and the heart condition?

Did he/she in anyway consider that you have Ischemic heart disease?

The TIAs could be due to atherosclerotic heart disease (ischemia)(clots from heart causing brain trauma TIAs) as well as due to the HBP. (often caused hemorrhagic TIAs and stroke)

I am not a doctor but familiar some with cardio/neuro stuff and I always want to make sure Vietnam incountry vets know of the 2010 Nehmer provisions regarding the 3 presumptives they added to the AO list in 2010.

"  This has been going on for a decade and the local DRO has blatantly ignored 12 years of therapy and VA psych assessments which counter the one C&P doctor's 40min assessment. "

If you mean by "blatantly ignored", that the evidence (12 years of therapy which I assume included current med recs and maybe even the VA psyche assessment) and these were not listed as evidence nor mentioned in the decisions you received since filing this claim,it might be a CUE, but then again, you might need an IMO/IME to combat the lack of rating increase.I imagine you dont have much time left to even acquire an IMO, as far as a response period to this...? was it an SSOC? with a 30 day response period?

Have you checked the VA Schedule of Ratings here to make sure you definitely fall into a higher PTSD rating?

It would be worthwhile to see if the cardiologist would review the IMO/IME criteria here at hadit and state a brief medical rationale as to why the HBP is secondary to the PTSD...if in fact the medical evidence reveals that.  

edited to add:

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp09/Files2/0913044.txt

HBP granted as secondary to PTSD.......it shows how they weighed the evidence.

Edited October 23, 2016 by Berta

[aws2000]

Fantastic response - thank you!  I will be meeting with my nonVA cardiologist in a week to talk about the issues you have highlighted. He has handled my arrhythmia and hypertension for years, but I have never tied my heart issues to my PTSD.  I will also bring info on the IMO/IME.  I don't believe it is Ischemic heart disease, but cardiac problems yes.  As for contacting the Scheduling Director, my last DRO De Novo review that was denied, also indicated they saw no reason to send the request to the director. Honestly there has been nothing close to: "When the totality of the evidence supports the Veteran's claims or is in relative equipoise, the Veteran prevails on his claim. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990)." 

To my other question if you could let me know what you think of the filing deadlines?  That is, send in the BVA appeal to meet their time frames, and then send in my hypertension issue separately? 

Semper Fi!  ps: thanks for the link to the case file! 

[broncovet]

Given your age and heart condition, this should mean you get an advance on the docket to the BVA and, instead of taking 5 years, you may complete your appeal in as little as 4.999 years!!

Seriously, your attorney should begin pushing the advance on the docket through the RO, reminding you that more than half of the delay for the BVA is because of the Regional office taking a couple years to certify your appeal to the BVA.  

 Your attorney should be able to advise you on a possible hardship advance on the docket.  

Importantly, you should inform your wife and attorney that you want your wife to be substitution of claimant, in the event of your death, so that the appeal can continue.  

Edited October 24, 2016 by broncovet

[Gastone]

You haven't actually "Lawyer'd Up" yet, right?

1st thing 1st, never let a significant ($$) claim die. You can request a BVA Hearing on you own, then at some point get with a  Lawyer at 20% of your Retro. If you were to be Awarded tomorrow, what do you think your Retro would Be?

I don't see any mention of you having applied for VA Vocational Rehabilitation and being turned down due to your SC PTSD. No mention of you turning in A Voc Rehab Denial Letter to your RO as New & Material Evidence in support of your IU Claim.

Don't know about it, never heard about it, forgot about it, Dog Ate it, what's your excuse?

A good friend, Nam Vet, think he was 70/71 at the time 06/30/14, told me he was sitting on the Voc Rehab Denial Letter. I had prompted him to apply to Voc Rehab in order to get the Denial Letter for N & M Evidence for his IU Denial DRO Hearing. I had just been Awarded all Major $$ issues at a DRO Hearing 06/29/14 to include IU T & P back to 12, I was 67.

The DRO said the Voc Rehab Denial Letter "Sealed the Deal" on the IU Award. My friend finaaly had his DRO Hearing 09/15, IU T & P Awarded based in large part, on the VR Denial Letter. It takes the possibility of Sedentary Work producing in excess of the SGI ($12,400) off the table.

It would be very informative, if you could post redacted copies of your Denial Decisions and SSOC's. There is always the possibility that you don't meet the IU or PTSD increase requirements.

Hypertension & TIA's are tough sells as Secondary to PTSD. No CAD yet, are you a Vegan?

Semper Fi

[aws2000]

7 hours ago, Gastone said:

 

Thanks guys, I've in denial of PTSD for decades and began wandering the maze of C&P compensation on my own--learning new things all the time. Gastone, I have never heard nor told by any VSO about the Voc Rehab Denial Letter-- that's not an excuse. I haven't signed with any lawyer yet, and will definitely think about sending in the BVA on my own - I have all the data. At the same time checking on the Rehab letter.  As for each of my appeals to the DRO their answer continues to focus on one C&P GAF of 62. Ignoring 10 years of numerous VA Psychiatrist assessments, and old GAFs never higher than 56 that clearly counter the C&P exam. I don't wish this process on any Veteran.  I'll keep you posted - Semper Fi!

"You haven't actually "Lawyer'd Up" yet, right?

1st thing 1st, never let a significant ($$) claim die. You can request a BVA Hearing on you own, then at some point get with a  Lawyer at 20% of your Retro. If you were to be Awarded tomorrow, what do you think your Retro would Be?

I don't see any mention of you having applied for VA Vocational Rehabilitation and being turned down due to your SC PTSD. No mention of you turning in A Voc Rehab Denial Letter to your RO as New & Material Evidence in support of your IU Claim.

Don't know about it, never heard about it, forgot about it, Dog Ate it, what's your excuse?

A good friend, Nam Vet, think he was 70/71 at the time 06/30/14, told me he was sitting on the Voc Rehab Denial Letter. I had prompted him to apply to Voc Rehab in order to get the Denial Letter for N & M Evidence for his IU Denial DRO Hearing. I had just been Awarded all Major $$ issues at a DRO Hearing 06/29/14 to include IU T & P back to 12, I was 67.

The DRO said the Voc Rehab Denial Letter "Sealed the Deal" on the IU Award. My friend finaaly had his DRO Hearing 09/15, IU T & P Awarded based in large part, on the VR Denial Letter. It takes the possibility of Sedentary Work producing in excess of the SGI ($12,400) off the table.

It would be very informative, if you could post redacted copies of your Denial Decisions and SSOC's. There is always the possibility that you don't meet the IU or PTSD increase requirements.

Hypertension & TIA's are tough sells as Secondary to PTSD. No CAD yet, are you a Vegan?

Semper Fi

7

 

[Gastone]

In days of yesteryear (DSM IV), GAF's were a determining Factor, no longer under the DSM V Criteria.

At 1 time, yrs ago, 3 diff VA MH clinicians gave me GAF's ranging from 50 to 58 within a few days of each other. The PTSD C & P Psychiatrist gave me a 51.

Refuting your Old GAF of 61, based on the removal of its importance and Validity discussed in the New PTSD Ratings using DSM V, shouldn't be that difficult.

Your homework, should you decide to do it, review the VA Vocational Rehab Program requirements. How do you stack up? With an eye towards proving your possible VA IU Qualifications, needs to be addressed.

Still need to see redacted copies of your Award/Denial Letters and any SSOC's.

Semper Fi