JustGettingStarted

CUE for Eczema-like condition denied :-(

7 posts in this topic

I sent this CUE to Berta on another thread and she thought it was really good.  However, I just got a denial from the St. Pete VARO today (they are really illiterate).

At issue is the fact that any conditions similar to dermatitis or Eczema are rated under code 7806.  These conditions can be rated on amount of body they cover, or more importantly, how often you have to take "systemic medication" for them.  Systemic medication is usually defined by the VA as oral medications or injections, but not topical medications and if you take it constant or near constant, the rating is 60%.

In the denial letter, I am still service connected for a skin condition at 0% as I was in 2009, but the VARO completely ignored the fact that I have been on constant systemic medication since 1998 and should be rated at 60%. The medication was completely ignored in the decision.  I provided military medical records from 1998 where I was put on constant medication, and Bluebutton pharmacy records from a military facility that date back to 2004.  All that evidence was submitted with my CUE.  

I thought this was going to be so cut and dried, and now I know why so many people complain about the VA ignoring the evidence and why the appeal system is so backed up.  I guess I will be getting on the hamster wheel and ask for a reconsideration/DRO Review/Appeal.  

Anyway, I attached a redacted copy of the CUE that I did in the event someone can use it as an example. I hope it works better for them than it did for me.

JustGettingStarted

Motion for Cue-REDACTED.pdf

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Dont get discouraged!  We have all received denials !!!!!! Or most of us!!!!!

The VA hates CUE claims. Do you have a Rep or VSO?

can you scan and attach their denial as to their rationale and the evidence list they used?

Cover C file # name, etc

 

 

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Posted (edited)

Berta,

Attached is the DBQ from my C-File and pages from the decision letter (I requested a copy of my C-File last July well before my CUE and it just arrived a week ago).

The main issue is on the DBQ; they did not check the block that says I am taking daily systemic medication - that is wrong, wrong, wrong!  

In the C-File, they have documentation I submitted.  1.  The MTF Bluebutton record that shows I have taken medication regularly since 2004, highlighted in yellow.  2.  Citations where the veteran was awarded higher than 0% for the exact same condition when on systemic medication (the ratings depended on how often they were taking medication).  3. MFV records showing my primary diagnosis in 1997 and being put on systemic medication in 1998 to prevent flare ups.

There were other errors in this decision, but not as big as this one.  They did not service-connect me for hemmorhoids although I provided military medical records from 2007 that showed a diagnosis, and civilian records from 1 month after I retired in 2009 to present.

They did not give me ICS, which I knew was going to be an uphill battle.  I was diagnosed for years while in the military with chronic constipation.  I did not get service connected in 2009 because there wasn't any "pathology" to show why I had chronic constipation.  One month after I retired I was diagnosed with IBS.

And finally, they deferred my CUE for SMC for loss of use of a creative organ so they can schedule an exam.  Do they honestly think my endometrium will grow back?  I provided them medical records when I made the claim.  

I also have another decision letter for peripheral neuropathy in my arms and hands that I am dealing with.  I was award 20% for each side but from what I read on the DBQ, many of my symptoms were rated moderate to severe so I believe I should be getting 40/30.  I also want to CUE that one because I was looking at my records and when I retired in 2009 I claimed neck condition and that I was taking neurontin.  A quick look in my records show that I was taking neurontin because of the numbness in my hands caused by the neck condition.  

Right now, I want to concentrate on the CUE for the eczema-like condition.  That is the big one, followed by the CUE for SMC. 

On the eczema condition - I have attached the two pages from the development letter, along with most of the skin diseases DBQ.  On the skin diseases DBQ, they made a major error when they did not list the medications I have been taking since 1998.  I noticed on the skin diseases DBQ, they do not list what evidence was reviewed - I see this on my other DBQs in section 3.  Why is this?

I have also attached my letter requesting reconsideration.

Thanks for any and all help.

JustGettingStarted

EczemaLikeforHadit.pdf

Request for Reconsideration-redacted.pdf

Edited by JustGettingStarted

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Posted (edited)

Berta,

My DAV VSO continues to be MIA.  I have emailed the DAV at St Pete to request help on this.  I sent my request to robert.anderson6@va.gov.

Robert “Dan” Anderson / Supervisor

DAV Regional Office | 9500 Bay Pines Blvd., Room 232 | St. Petersburg, FL 33731

Main Office (727) 319-7444 | Fax (727) 319-7775

Update - I met with my county VSO today and I like him.  He admits my claims are more complicated than what he normally sees, but he had a good friend at the VFW regional office at St Pete, Richard Epps, who he says is extremely knowledgeable and works well with the rating officers.  The local VSO seemed pretty knowledgeable and knows to ask questions if over his head.  He never said anything critical like "that will never work" or "don't waste your time".  I am going to change my POA and then meet with him again to give my claims a deeper look.  I also got my husband to go with me because he has some claims work to do too.

JustGettingStarted

Edited by JustGettingStarted

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Yeah..I know who he is....and you clarified his position at the DAV

He was on vacation the last week of May----I got an away message from him and then sent him more info he needed and someone had been picking up his email- or he came back to work...another matter ..deadline of May 30 2017 I dont know how that worked out yet. The DAV guy who told me to reach him got the whole skinny from me and knew exactly why someone at DAV had to act fast.

I made it clear I was covering their DAV butts, mine as an advocate, and also the VA's butt.

Not to mention this was a case of potential fraud.

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The DAV VSO I just "fired" is Michael Fuste.  The one before that the didn't follow up on my CUE for 10 months, despite several requests from me, was Michael Tolliver.  I hope I am doing the right thing by switching to my local VFW VSO.  I can at least sit down and look him in the eye and he seems like a nice, knowledgeable fellow that is willing to admit he doesn't know everything, but knows where to get help.  

If I am giving out too much info here with the names I will be happy to edit out.

JustGettingStarted

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