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CUE for Eczema-like condition denied :-(

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JustGettingStarted

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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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I got clarification from my VSO on what the new C&P exam is really about.  The VA wants an opinion from the examiner on whether I really need the medication constantly, or if I am taking it just to get a higher rating.   Wow, they are looking for any excuse to deny my claim.  At least they realized they cannot deny my claim based on a policy change.

Now that I know this, I can focus my sights on the medical paperwork I need to show the examiner.  The fact is that I was put on suppression therapy (constant use) in 1998, 11 years before I retired.  It wasn't until 2002, 4 years later, that Code 7806 was changed.  In 2002, skin conditions like eczema first became rated at 60% for constant use of systemic medication.  My medical records and pharmacy records clearly show my constant use to the current date.  

Hopefully, my next examiner will be someone that listens and will get the DBQ/Medical Opinion correct for me.  I will do my best to point them in the right direction.

JustGettingStarted

 

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It would be good to have, at the C & P exam, anything with you from your VA med recs that shows this:

. " It wasn't until 2002, 4 years later, that Code 7806 was changed.  In 2002, skin conditions like eczema first became rated at 60% for constant use of systemic medication.  My medical records and pharmacy records clearly show my constant use to the current date.  "

That would show the VA that your med usage was systemic and also an established fact in VA's possession- at time of the  decision containing the CUE.

Good for you to have your Pharmacy records.

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1 hour ago, Berta said:

It would be good to have, at the C & P exam, anything with you from your VA med recs that shows this:

. " It wasn't until 2002, 4 years later, that Code 7806 was changed.  In 2002, skin conditions like eczema first became rated at 60% for constant use of systemic medication.  My medical records and pharmacy records clearly show my constant use to the current date.  "

That would show the VA that your med usage was systemic and also an established fact in VA's possession- at time of the  decision containing the CUE.

Good for you to have your Pharmacy records.

That information was in my military medical records at time of decision when I retired in 2009.  But VA had my military medical records in their possession and it is all in my C-FILE.  My 2009 decision letter even states I was taking the medication daily.  St Pete chose to ignore all that when I submitted my claim for the increase until I got my own DBQ.  The bogus denial based on a policy change didn't work so they are trying to find other ways to deny my earlier effective date.  Since that failed, I guess their tactic is to prove I am committing fraud, either by not actually taking the meds or by taking them just to increase my rating.  Since I started taking the meds 11 years before I retired from the military, and doctors since have said I need to be on the medication "chronically", the VA doesn't have a case.  If they try to go that route, the first thing I will do is have my husband write a spouse letter and submit that as new evidence to reopen again.  Maybe I need to remind the VARO they are supposed to be non-adversarial.  (The Veterans Claims Assistance Act of 2000 (VCAA) reaffirmed that the VA benefits and disability claims process up to the Board of Veterans’ Appeals (BVA) process must be non-adversarial. See, 38 C.F.R. §§ 3.102, 3.103, 3.105, 20.700 (2007).)

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