Need advice on denial and appeal

[joevet]

I filed for VA benefits secondary to diabetes related to Agent Orange exposure for glaucoma, cataracts and hypertension. I am receiving 70% for diabetes and stents in my heart. The VA has denied my filing for secondary aliments because they say I have no proof that they are caused by diabetes. In their words they are "at least as likely not caused" by diabetes. My question is how does one prove that they are at least as likely caused by diabetes since all medical evidence reports they can be caused by diabetes? I have my claim under NOD. Any advice would be appreciated. Thanks.

[joevet]

49 minutes ago, Gastone said:

Joe, when was your last VMC Echo-Cardiogram? Have there been any changes Noted from the pre-1215 Echo's?

If you haven't already done so, stop in at your VMC Med Record Dept and request a CD copy of your complete VMC Med Record. That will include all the Radiology Results and Clinician's interpretations.

There just may be something lurking in your Echo tests that could get you a CAD bump to 100%.

I just tried to open the AskNod attachment, sorry about that, hard to read.

Semper Fi

My local doctor did one EKG after my heart stents but nothing since by either them or the VA. I only go once a year to see the local doctor. They have me on a strict low fat, no red meat diet. They said I have some small heart arteries blocked but they are too small for stents. I have never discussed my VA report with the local doctor. I don't know if they agree with the decision of the VA doctor. My local doctor used to work with the VA.

[joevet]

1 hour ago, Gastone said:

Joe, just eyeballed the VA M21-1 part III change date 4/6/15. You have to be 85 for an Age expediting of your claim. See the AskNod 08 attachment for much more through discussion of Expediting Criteria and required Evidence.

There appears to be no actual VA form for requesting the 'Expediting" of a claim based on being or about to be homeless, Financial Hardship, imminent Death or Age. You submit a 21-4138 (Statement in Support of Claim) along with the supporting Medical and/or Financial Evidence.

IU is not aged based. Your current 60 + 20 + 10% SC's make you VA Scheduler eligible to file for IU, which if Awarded would pay you at the 100% Comp Rate. You need to do some IU Requirements Reading. As of today, over the past 12 months, have you had "Earned Income" in excess of the VA SGI amount of $11,400 (Vet's over 65)? What about 2014 & 15?

Not considering your Age or the fact your on SSI, do you believe that your current SC's make it impossible for you to do "ANY and ALL" types of work? Even doing "Sedentary Work" like sitting at a desk for 5 or 6 hrs a day?

38 CFR § 20.900(c) Hardship Claim _ Asknod Veterans Claims Help.html

I have not had any earned income since I retired in 2015. I have pension income from my former employer, social security and VA benefits. I would not qualify for applying for Expediting under the above criteria. As far as the question concerning "any and all" types of work, I don't know. I will do some Internet research on the IU requirements. The "any and all" sounds a lot like the Social Security disability requirement of total disability.

[joevet]

1 hour ago, Buck52 said:

I will take a gander at this

''Again, thanks Gastone for your input. Sorry to say, but I don't follow what CAD, Sa, DX, FDC, means. I don't fully understand the IU.''

I believe Gastone means =

CAD (coronary artery disease) Sa (Sleep Apnea) DX (Diagnoses) FDC (Fully Developed Claim)

A lot of us vets don't fully understand the IU  its intended to help the veterans that are below the scheduler 100%  that can't work due to their S.C. disability's to be paid at the 100% level.

As Gastone has mention above as REQUIRED to get the IU.

Thanks Buck! Your comments were very helpful.

Hey, I like good ole traditional country music, too.

[jbasser]

Your diabetes and ischemic heart disease (blocked arteries) are presumptive to Agent Orange exposure, See Nehmer decision attached. http://www.leagle.com/decision/1999120732FSupp2d1175_11060/NEHMER v. U.S. VETERANS ADMIN.

You are a member of this action and the VA refusal to grant your claim is nothing but a plot to deny your benefits.

You should fire your reps and pick up an attorney or claims agent who will become vested in your claim and fix it for you.

 

J

[joevet]

48 minutes ago, jbasser said:

Your diabetes and ischemic heart disease (blocked arteries) are presumptive to Agent Orange exposure, See Nehmer decision attached. http://www.leagle.com/decision/1999120732FSupp2d1175_11060/NEHMER v. U.S. VETERANS ADMIN.

You are a member of this action and the VA refusal to grant your claim is nothing but a plot to deny your benefits.

You should fire your reps and pick up an attorney or claims agent who will become vested in your claim and fix it for you.

 

J

I have not been refused compensation for diabetes and CAD. I have been denied benefits for hypertension, glaucoma and cataracts as secondary to diabetes. They said I had no record of having these ailments while in the military service. I seriously doubt if any young, healthy twenty year old in service would have such a record.

[jbasser]

You do not have to prove you had secondary conditions in service as many arise years later. All you need is a doc to state that your conditions are related to diabetes.

Are you service connected for heart disease? You should be and that should SC your HTN.

 

J