Jump to content

Ask Your VA Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules 

  • tbirds-va-claims-struggle (1).png

  • 01-2024-stay-online-donate-banner.png

     

  • 0

IMO from Dr. Anaise, CKD

Rate this question


Palma114

Question

On 8/24/2016, VARO made a decision on my Chronic kidney disease claim. They granted me a 60% rating, on CKD stage 3, and Definite decrease in kidney function. I was initially at stage 4 CKD and sick, so they put me on several medications to get my numbers to come down, well after about 45 days it drop from stage 4 failure to moderate stage 3. So I initially filed my claim back in 2004, as all of this was occurring. So I just recently filed a NOD, which states I should have been granted 80%, for stage 4 CKD.

So the C&P Examiner in 2015, never mentioned that I was ever at stage 4. So they only rated me on my now medical status, which is stage 3. So I got an IMO from Dr. Anaise, and he states: A BVA decision in a similar case dated October 26, 2012 states (David Jones, Appellant v. Eric K. Shinseki, Docket No. 11-2704):

The court holds that the Board committed legal error by considering the effects of medication on the appellant's IBS when those effects were not explicitly contemplated by the rating criteria...As this Court has made clear, the Board's consideration of factors which are wholly outside the rating criteria provided by the regulations is error as a matter of law. "Massey v. Brown, 7 Vet. App. 204, 208 (1994); see also Drosky v. Brown, 10 Vet. App. 251, 255 (1997) (finding legal error where the Board, "in essence, impermissibly rewrote" the regulation by considering factors wholly outside the rating criteria); Pemorio v. Derwinski, 2 Vet. App. 625, 628 (1992) ("In using a standard that exceeded that found in the regulation, the Board committed legal error").

Conclusion

After reviewing all of the veteran's medical and military records, it is my expert medical opinion that the veteran's service-connected renal dysfunction warrants an 80% rating. It is abundantly clear from the record that the veteran was diagnosed with stage IV renal failure with a creatinine of 4.5. It is true that the creatinine has improved once medication allowed for some recovery of kidney function. Yet, the rating specifically states that the veteran is entitle to 80% disability when his creatinine rises to 4.5, with no disclaimer to that statement.

A higher evaluation of 80% based on renal function is not warrant unless there is:

* Persistent edema and albuminuria; or, * Creatinine 4 to 8mg%; or, * BUN 40 to 80mg;

Edited by Palma114
Link to comment

Recommended Posts

  • 0
  • HadIt.com Elder

Where is your IMO doctor located?  I got my IMO's so long ago most of my doctors I used are retired and some may have even passed away.  I got IMO's for mental health issues.  I would not have won without them, so nothing besides original evidence is better than a good IME/IMO.

Link to comment
  • 0
15 hours ago, john999 said:

Where is your IMO doctor located?  I got my IMO's so long ago most of my doctors I used are retired and some may have even passed away.  I got IMO's for mental health issues.  I would not have won without them, so nothing besides original evidence is better than a good IME/IMO.

www.danaise.com---office (520) 219-7321,  fax (520) 844-1452

Link to comment


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • spazbototto earned a badge
      Week One Done
    • Paul Gretza earned a badge
      Week One Done
    • Troy Spurlock went up a rank
      Community Regular
    • KMac1181 earned a badge
      Week One Done
    • jERRYMCK earned a badge
      Week One Done
  • Our picks

    • These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.

      Service Connection

      Frost v. Shulkin (2017)
      This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected. 

      Saunders v. Wilkie (2018)
      The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.

      Effective Dates

      Martinez v. McDonough (2023)
      This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.

      Rating Issues

      Continue Reading on HadIt.com
      • 0 replies
    • I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful.  We decided I should submit a few new claims which we did.  He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims.  He said that the VA now has entire military medical record on file and would find the record(s) in their own file.  It seemed odd to me as my service dates back to  1981 and spans 34 years through my retirement in 2015.  It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me.  He didn't want my copies.  Anyone have any information on this.  Much thanks in advance.  
      • 4 replies
    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
×
×
  • Create New...

Important Information

Guidelines and Terms of Use