Jump to content


  • veteranscrisisline-badge-chat-1.gif

  • Donation Box

    Please donate to support the community.
    We appreciate all donations!
  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

Question

ALS Variant?

 

I'm a Vet Wife. I post on behalf of my husband, I'm his note taker at doctor's appointments and consults.  I'm his support system and all around cheerleader. Lord knows we have had our VA battles. All these years after Vietnam, the onset of my husband's emerging illnesses, obviously percolating internally has emerged  one after another. We've seen subtle signs and some not so subtle. But didn't; know what those sign meant. The VA didn't do a very good job of educating the older veterans about what to be aware of regarding SC disabilities,

My veteran husband's a Purple Heart Vietnam Veteran  served in US Marine Corps. My husband  has several service connected disabilities. My husband diagnosed with Monomelic Amyotrophy recently; it is a Motor neuron (MND) disease that is the umbrella covering all type Motor neuron diseases and variants. To which ALS/ Amyotrophic Lateral Sclerosis and variants falling under the same umbrella as being classified as Motor Neuron Disease (MND). As exhibited in cases of muscle loss: Monomelic Atrophy.

ALS causes degeneration of nerve cells in the brain and spinal cord that leads to muscle weakness, muscle atrophy, and spontaneous muscle activity. The VA Doctors pondered whether my husband had ALS or MS. Yet, the Neuromuscular Head Physician conceded that my husband's illnesses was an ALS variant because his illness fell under the umbrella of Motor Neuron Diseases as did ALS......is a Motor Neuron disease. ???? We don't know how VA will decide.

Other complicating issues:

*Spinal issue (S Curve of spine)

*Multi focal motor neuropathy associate with Diabetes 2 is a part of the mix/entwined as well. 

 

However, most severely is the inability of identifying the exact reason for the monomelic atrophy.

Although it was hoped a more exact finding will be determined when all results of updated blood tests were in.

On May 2017: *Blood test are in; determination that no immune diseases are present

Possible treatment of an intravenous treatment once every three months or medications with steroids would be beneficial. No effective treatment available.

 

MMA

Diagnosis. 

Inflammatory Arthritis is Part of the neuropathy (Special kind of neuropathy)

As well as severe spine problems. Very rare complicated illnesses intersecting and exacerbating primary and/or secondary with veteran's service connected disabilities.

 

Monomeric atrophy......Veteran has lost the use of his right hand and right forearm weakened and wasting away.

One limb atrophy

See notes…..described as one limb muscle atrophy

 

Spinal cord (S curve of spinal cord) compression on top on addition the monomeric

 

Toxic agent like Agent Orange could more likely than not" a contributor for neuropathy.

 

Immune diseases (no)

 

Deterioration. Of bones on vertebra

Spondylosis...inflammatory arthritis 

Acts like spinal cord injury 

 

(Findings of EMG) EMG to confirm the diagnosis ( Neuromuscular VA Physician at Michael E. DeBakey VA Medical Center, Houston, Texas)

Table of Rated Disabilities

Disability

Rating

Decision

Related To

Peripheral Neuropathy, Left Lower Extremity

 

Not Service Connected

Denied as…. early as 2011… Yet, D to pinpoint as severe symptomatic complexities of Monomelic Amyotrophy variant of ALS in 2017….should be cued.

Peripheral Neuropathy, Right Lower Extremity

 

Not Service Connected

Denied as…. early as 2011…  Yet, ID to pinpoint as severe symptomatic complexities of Monomelic Amyotrophy variant of ALS in 2017….should be cued

Agent Orange - Vietnam

Neuropathy, Left Upper Extremity

 

Not Service Connected

Denied as…. early as 2011…  Yet, ID to pinpoint as severe symptomatic complexities of Monomelic Amyotrophy variant of ALS in 2017….should be cued

Bilateral Hearing Loss (claimed as diminished hearing)

0%

Service Connected

 

Tinnitus (claimed as ringing in both ears)

10%

Service Connected

 

headaches

 

Not Service Connected

 

depression

 

Not Service Connected

 

skeletal arthritis aching of the joints (unspecified)

 

Not Service Connected

Arthritis denied as…. early as 2015…  Yet, ID to pinpoint as being symptomatic complexity of Monomelic Amyotrophy variant of ALS in 2017….should be cued

post traumatic stress disorder (PTSD, also claimed as depression and anxiety)

30%

Service Connected

PTSD - Combat

Hypertension

0%

Service Connected

 

Neuropathy, Right Upper Extremity

 

 

Rectal carcinoma claimed as rectal cancer, a soft tissue cancer)

 

Not Service Connected

Agent Orange - Vietnam

Still on since  12/11/14 appeal

Remand 5/15

scar, shrapnel right knee

10%

Service Connected

 

09/18/2013

diabetes mellitus type II

10%

Service Connected

Agent Orange - Vietnam

07/06/2015

prostate cancer

100%

Service Connected

Agent Orange - Vietnam

07/06/2015

erectile dysfunction

0%

Service Connected

 

07/06/2015

 

Neuropathy, Right Upper Extremity Denied as…. early as 2011…  Yet.ID to pinpoint as severe symptomatic complexities of MonomelicAmyotrophy variant of ALS in 2017….should be cued Agent Orange – Vietnam

 

Edited by DonH
adding more details
Link to post
Share on other sites
  • Answers 53
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

Popular Posts

Peripheral Neuropathy is often related to DM.  But, before you run to the CUE axe, check and see if the 38 CFR 3.156 knife may just work better.  If they denied you because there was no evidence, then

Recommended Posts

  • 0
  • HadIt.com Elder

I couldn't read the right hand side of the 'related to ' part but were all denied.

Still , was an MRi of your husband's brain done?

Was the PN claimed as secondary to the DMII?  as well as to the motor neuron disease?

The 10 % DMII is VERY low. But maybe it is correct...?????

 "Yet, the Neuromuscular Head Physician conceded that my husband's illnesses was an ALS variant because hiss illness fell under the umbrella of Motor Neuron Diseases as did ALS......is a Motor Neuron disease. ???? We don't know how VA will decide."

 

I assume you have that statement in the veteran's medical records?

Do you have a complete copy of his VA medical records?

 

What was the actual medical terminology the VA used to identify the Soft Tissue Sarcoma ( Rectal cancer)?

Please check out this link from Chris Attig:

https://www.veteranslawblog.org/als/ 

 

Chris Attig, a superb veterans lawyer and also a member here at hadit, won this case regarding a Motor Neuron disease.

I hope he comes aboard here today....

 

 

Link to post
Share on other sites
  • 0
  • Moderator

Peripheral Neuropathy is often related to DM.  But, before you run to the CUE axe, check and see if the 38 CFR 3.156 knife may just work better.  If they denied you because there was no evidence, then you simply reopen and resubmit the evidence retaining your "supertool" of the Benefit of the doubt/equipose.  Look carefully at both 3.156 B (pending claim) and the other winner winner chicken dinner of 3.156 C (missing service records) 

While I agree it isa compelling  arguement that he is SC for the PN for right upper extremity, but denial for the same condition on his lower extremeties makes "0" sense.  I guess VA is saying, "Ok, this is a miracalous PN that manages to affect the hands, but that PN that effects the feet must have been caused by something else that isnt service connected, as we dont wat to pay benefits on your FEET PN."    Duh.  If the PN is service connected for the hands, its service connected for the feet, too!    Your diabetes is not somehow causing PN in your hands, but, when (the same blood) goes to your feet, it then transposes and no longer causes PN.  ITS CRAZy stuff.  

If you are the note taker, hopefully you have access to all medical records.  However, you need to compare your records with those VA has by ordering a full copy of his cfile including medical records and Service records.    You need to try to determine what is going on here:

1.  Did VA deny you because they were lazy and top sheeted you, not bothering to read? or

2.  Did VA deny you because they were lazy and never got your records at all?  

Number 2 suggests you reopen due to n and m evidence, number one suggests CUE axe.  

  • Like 1
Link to post
Share on other sites
  • 0
  • HadIt.com Elder

to add; maybe I asked above

Was a Brain MRI done by VA?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794906/

 

There are many differential diagnoses for Motor Neuron Disease….

Hirayama disease ,for example…if you search  for  more info.

I am adding this link so I don’t forget it:

Dont know why this block came up in my post?

Quote

 

https://www.hindawi.com/journals/nri/2012/608501/

It regards MRIs of brain re: ALS.

In my case I was able to decifer my husband’s MRI of brain to succeed in my FTCA case, and 1151 claims.

After he died I was able to use a photo of an autopsied brain  and marked it as to the MRI findings as to 6-7 areas of VA induced brain damage, in support of the wrongful death claims. 

The VA medical records should reveal a narrative of the MRI findings.

The VA had a brief MRI assessment, typed ..but the true picture and the beginning of a VA cover (I proved) was within 6 pages of very hard to read handwritten notes regarding in part the MRI.

My point here is that MRIs can be very definitive -if a real VA neurologist reads and assesses them.

Edited by Berta
Link to post
Share on other sites
  • 0
  • Moderator

Remember to focus on stuff that will yield you the best result.  Lets use an example:

Lets say you are 90 percent SC now.  To get to 100 percent you need an additional 50 percent, not the 10 percent your second grade teacher taught you.  

So, with hearing loss, you are unlikely to get over 10 or 20 percent, unless hubby uses sign language to talk to you.  Fretting with the hearing loss rating, of itself is futile as it probably will not get you to 100 percent.  

However, if hubby is not working for example and is unable to work due to sc conditions, then you may want to pick the low lying fruit, which may be his PTSD which could have been lowballed at 30 percent, or it could be the low lying fruit is TDIU.  

Dont forget to think about yourself and your family, too.  DEA Chapter 35, and Champva are HUGE benefits.  DEA if your kids want to go to school, and Champva is the very best health insurance available.  

Both of these require 100 percent P and T.    And, dont forget about DIC for you, too.  Many Vets think of this for their wives, but it sounds like YOU have to consider this as PTSD Vets dont always think clearly.  To get DIC you need to have him Service connected at 100 percent for 10 years before he passes, then it does not matter why he passes.   Under 10 years and he has to pass from service connected conditions for you to get DIC.  Dic will mean an extra 1400 per month or so for you, as his sc benefits will also pass when he dies.  If he was thinking clearly, he would want you to be taken care of after he dies. 

Link to post
Share on other sites
  • 0
  • HadIt.com Elder

What is his rating now? TDIU or 100%?

When was the DMII rating made?

Is that 10% still comparable to the VA Schedule of Ratings Here at hadit?

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Ads

  • Ads

  • Similar Content

    • By Berta
      I saw this article in the new News Section Tbird has put here:
      https://vanews.wpengine.com/
      https://www.erienewsnow.com/story/42619109/widow-of-vietnam-era-veteran-appealing-denial-of-claim-by-va
      In part:
      "Veterans Affairs states there’s no record of a cancer diagnosis while Richard served in the 1960s nor is there evidence of exposure to herbicides.
      “They actually want a photo of him standing by this particular plane that he guarded, however, that’s not possible because he was in a high-secured area,” Mary said.
      So tying the discovery of Agent Orange barrels to where Richard’s unit was stationed is strategic to the appeal."
      The VA wants to identify what planes he had worked on in Okinawa. It is unfortunate that often widows do not recall things their husband discussed with them, about their service, that could become highly relevant to a successful DIC claim, after they pass.
      ," that’s not possible because he was in a high-secured area,” Mary said." from the above link- but a highly secured area would be an ideal place for the AO to have been sprayed. I assume he worked close to the flight line.
      In the large stack of paperwork in the photo-I hope it includes the veterans SMRs and Personnel file.
      It often pays for veterans to try to find their unit buddies in their lifetime- if not for a VA claim, for the comradery. And one never knows when a unit buddy can help turn a denied claim around ,for living, and even deceased veterans.
       
       
    • By Berta
      I feel like asking the BVA to CUE itself but I dont have a BVA case.
      There are 3 law judges here . 2 opining on an older NAs report and only one, the third case judge below ,  knows what he is talking about- as the remand in that third case here calls for the consideration of the 2012 report-
      Previously the HAS considered a limited and/or suggestive " association of AO to causing HBP- but after the 2010 , they found a "Sufficient" association between AO and HBP
      In this remand dated 04/28/20
        In part it states: "Furthermore, the Board notes that the Veteran has medical trainingIn this remand (dated 04/28/20) "Furthermore, the Board notes that the Veteran has medical training, and new research, memorialized by the National Academies of Sciences, Engineering and Medicine (NAS), shows a positive association between hypertension and herbicide exposure in service. However, there is insufficient evidence of record by which the Board can make a decision. The Veteran was not afforded a VA examination to determine the nature and etiology of his hypertension, and the Board affords the Veteran every benefit of the doubt. As the four McLendon elements are satisfied, the Veteran is entitled to a VA examination and medical opinion." Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files4/20029600.txt But in this case the BVA stated: "The Board previously denied this claim in a February 2019 decision finding the most persuasive evidence of record did not support a nexus between hypertension and service or his PTSD.   With regard to Agent Orange exposure, the Board noted recent NAS findings (the most recent Agent Orange update) indicative of “limited or suggestive” association between hypertension and herbicide exposure, but found such association was not conclusive in this Veteran’s specific case.  Rather, according to a June 2018 VA examiner’s opinion and the examiner’s research into the relevant medical literature, a connection between Agent Orange exposure and the development of hypertension would only be possible within individuals in the Army Chemical Corps whom directly handled herbicides. Since the Veteran served as an M-113 armored personal carrier and not in the Army Chemical Corps, the June 2018 VA examiner found a nexus in this case unlikely.  The Board denied the claim mainly relying on the June 2018 VA examiner’s opinion." Yet in this case ,the BVA stated: "The February 2019 Board denial was vacated and remanded by virtue of a February 2020 JMR.  Therein, the parties agreed that the June 2018 VA examination relied upon by the Board was inadequate.   In particular, the parties agreed the matter was previously remanded in September 2015 and again in September 2016 for a VA examiner to specifically consider the 2012 NAS conclusion that found suggestive evidence of an association between herbicide exposure and hypertension notwithstanding that VA has not added hypertension to the list of conditions presumptively associated with Agent Orange exposure.   In contrast, the June 2018 VA examiner noted review of the Journal of Occupational Environmental Medicine, but no specific mention or consideration of the NAS Agent Orange update.  The examiner found a nexus between hypertension and Agent Orange exposure unlikely because “[e]xposure to herbicides is not presumptive for service connection.”  While the examiner noted suggestive data of a connection between hypertension and Agent Orange exposure where a serviceman had more direct handling of herbicides, there is nothing in the VA examination report that indicates the examiner specifically considered the NAS Agent Orange update as directed in two prior Board remands." This case was decided  a little over 3 weeks later than the other one I posted first here.  SHEREEN M. MARCUS Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files5/20032464.txt BUT Yet the two AO Hypertension BVA awards ( maybe there are more by now) clearly refers to (as I did in the accrued claim I have pending) to the most recent AO HBP NAs report which I have posted here in the AO forum months ago: "In the alternative, as explained above, the Veteran is presumed to have been exposed to Agent Orange in service and the National Academy of Sciences (NAS) moved hypertension from the “limited or suggestive” category and indicated that there is now “sufficient evidence” of an association between hypertension and Agent Orange exposure. See Veterans and Agent Orange: Update 11 (2018). Also, early onset peripheral neuropathy is a disease that is presumed to be associated with herbicide agent exposure. Lastly, the Board has awarded service connection for diabetes mellitus and hypertension and neuropathy are recognized by VA as being potential complications of diabetes." And "The clinician must provide reasons for each opinion given. In this regard, the clinician should address the NAS’s determination that there is now sufficient evidence of an association between hypertension and Agent Orange exposure (See Veterans and Agent Orange: Update 11 (2018)). The fact that hypertension is not yet on the list of diseases presumed to be associated with exposure to Agent Orange should not be the basis for a negative opinion." https://www.va.gov/vetapp20/files4/20024447.txtIn this remand dated 04/28/20 "Furthermore, the Board notes that the Veteran has medical training, and new research, memorialized by the National Academies of Sciences, Engineering and Medicine (NAS), shows a positive association between hypertension and herbicide exposure in service. However, there is insufficient evidence of record by which the Board can make a decision. The Veteran was not afforded a VA examination to determine the nature and etiology of his hypertension, and the Board affords the Veteran every benefit of the doubt. As the four McLendon elements are satisfied, the Veteran is entitled to a VA examination and medical opinion." Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files4/20029600.txt But in this case the BVA stated: "The Board previously denied this claim in a February 2019 decision finding the most persuasive evidence of record did not support a nexus between hypertension and service or his PTSD.   With regard to Agent Orange exposure, the Board noted recent NAS findings (the most recent Agent Orange update) indicative of “limited or suggestive” association between hypertension and herbicide exposure, but found such association was not conclusive in this Veteran’s specific case.  Rather, according to a June 2018 VA examiner’s opinion and the examiner’s research into the relevant medical literature, a connection between Agent Orange exposure and the development of hypertension would only be possible within individuals in the Army Chemical Corps whom directly handled herbicides. Since the Veteran served as an M-113 armored personal carrier and not in the Army Chemical Corps, the June 2018 VA examiner found a nexus in this case unlikely.  The Board denied the claim mainly relying on the June 2018 VA examiner’s opinion." Yet in this case ,the BVA stated: "The February 2019 Board denial was vacated and remanded by virtue of a February 2020 JMR.  Therein, the parties agreed that the June 2018 VA examination relied upon by the Board was inadequate.   In particular, the parties agreed the matter was previously remanded in September 2015 and again in September 2016 for a VA examiner to specifically consider the 2012 NAS conclusion that found suggestive evidence of an association between herbicide exposure and hypertension notwithstanding that VA has not added hypertension to the list of conditions presumptively associated with Agent Orange exposure.   In contrast, the June 2018 VA examiner noted review of the Journal of Occupational Environmental Medicine, but no specific mention or consideration of the NAS Agent Orange update.  The examiner found a nexus between hypertension and Agent Orange exposure unlikely because “[e]xposure to herbicides is not presumptive for service connection.”  While the examiner noted suggestive data of a connection between hypertension and Agent Orange exposure where a serviceman had more direct handling of herbicides, there is nothing in the VA examination report that indicates the examiner specifically considered the NAS Agent Orange update as directed in two prior Board remands." This case was decided  a little over 3 weeks later than the other one I posted first here.  SHEREEN M. MARCUS Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files5/20032464.txt Yet the two AO Hypertension awards ( maybe there are more by now) clearly refers to (as I did in the accrued claim I have pending) tothe most recent AO HBP NAs report which Ihave posted here in the AO forum months ago: "In the alternative, as explained above, the Veteran is presumed to have been exposed to Agent Orange in service and the National Academy of Sciences (NAS) moved hypertension from the “limited or suggestive” category and indicated that there is now “sufficient evidence” of an association between hypertension and Agent Orange exposure. See Veterans and Agent Orange: Update 11 (2018). Also, early onset peripheral neuropathy is a disease that is presumed to be associated with herbicide agent exposure. Lastly, the Board has awarded service connection for diabetes mellitus and hypertension and neuropathy are recognized by VA as being potential complications of diabetes." And "The clinician must provide reasons for each opinion given. In this regard, the clinician should address the NAS’s determination that there is now sufficient evidence of an association between hypertension and Agent Orange exposure (See Veterans and Agent Orange: Update 11 (2018)). The fact that hypertension is not yet on the list of diseases presumed to be associated with exposure to Agent Orange should not be the basis for a negative opinion." https://www.va.gov/vetapp20/files4/20024447.txt This case was decided on 04/09/20 Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Right ---the 2012 report is clear-  "sufficient evidence of association between AO and Hypertension." The first two remands here are wrong -maybe I should contact the BVA ombudsman, because two of three of these decisions ( and maybe there are more) are in conflict, with the most recent NAS report,dated 2018 , In the final third BVA case lawyer correctly determined it had to be considered by the RO. This case was decided on 04/09/20 Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Right ---the 2012 report is clear-  "sufficient evidence of association between AO and Hypertension." , and new research, memorialized by the National Academies of Sciences, Engineering and Medicine (NAS), shows a positive association between hypertension and herbicide exposure in service. However, there is insufficient evidence of record by which the Board can make a decision. The Veteran was not afforded a VA examination to determine the nature and etiology of his hypertension, and the Board affords the Veteran every benefit of the doubt. As the four McLendon elements are satisfied, the Veteran is entitled to a VA examination and medical opinion."   Caroline B. FlemingIn this remand dated 04/28/20 "Furthermore, the Board notes that the Veteran has medical training, and new research, memorialized by the National Academies of Sciences, Engineering and Medicine (NAS), shows a positive association between hypertension and herbicide exposure in service. However, there is insufficient evidence of record by which the Board can make a decision. The Veteran was not afforded a VA examination to determine the nature and etiology of his hypertension, and the Board affords the Veteran every benefit of the doubt. As the four McLendon elements are satisfied, the Veteran is entitled to a VA examination and medical opinion." Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files4/20029600.txt But in this case the BVA stated: "The Board previously denied this claim in a February 2019 decision finding the most persuasive evidence of record did not support a nexus between hypertension and service or his PTSD.   With regard to Agent Orange exposure, the Board noted recent NAS findings (the most recent Agent Orange update) indicative of “limited or suggestive” association between hypertension and herbicide exposure, but found such association was not conclusive in this Veteran’s specific case.  Rather, according to a June 2018 VA examiner’s opinion and the examiner’s research into the relevant medical literature, a connection between Agent Orange exposure and the development of hypertension would only be possible within individuals in the Army Chemical Corps whom directly handled herbicides. Since the Veteran served as an M-113 armored personal carrier and not in the Army Chemical Corps, the June 2018 VA examiner found a nexus in this case unlikely.  The Board denied the claim mainly relying on the June 2018 VA examiner’s opinion." Yet in this case ,the BVA stated: "The February 2019 Board denial was vacated and remanded by virtue of a February 2020 JMR.  Therein, the parties agreed that the June 2018 VA examination relied upon by the Board was inadequate.   In particular, the parties agreed the matter was previously remanded in September 2015 and again in September 2016 for a VA examiner to specifically consider the 2012 NAS conclusion that found suggestive evidence of an association between herbicide exposure and hypertension notwithstanding that VA has not added hypertension to the list of conditions presumptively associated with Agent Orange exposure.   In contrast, the June 2018 VA examiner noted review of the Journal of Occupational Environmental Medicine, but no specific mention or consideration of the NAS Agent Orange update.  The examiner found a nexus between hypertension and Agent Orange exposure unlikely because “[e]xposure to herbicides is not presumptive for service connection.”  While the examiner noted suggestive data of a connection between hypertension and Agent Orange exposure where a serviceman had more direct handling of herbicides, there is nothing in the VA examination report that indicates the examiner specifically considered the NAS Agent Orange update as directed in two prior Board remands." This case was decided  a little over 3 weeks later than the other one I posted first here.  SHEREEN M. MARCUS Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files5/20032464.txt Yet the two AO Hypertension awards ( maybe there are more by now) clearly refers to (as I did in the accrued claim I have pending) tothe most recent AO HBP NAs report which Ihave posted here in the AO forum months ago: "In the alternative, as explained above, the Veteran is presumed to have been exposed to Agent Orange in service and the National Academy of Sciences (NAS) moved hypertension from the “limited or suggestive” category and indicated that there is now “sufficient evidence” of an association between hypertension and Agent Orange exposure. See Veterans and Agent Orange: Update 11 (2018). Also, early onset peripheral neuropathy is a disease that is presumed to be associated with herbicide agent exposure. Lastly, the Board has awarded service connection for diabetes mellitus and hypertension and neuropathy are recognized by VA as being potential complications of diabetes." And "The clinician must provide reasons for each opinion given. In this regard, the clinician should address the NAS’s determination that there is now sufficient evidence of an association between hypertension and Agent Orange exposure (See Veterans and Agent Orange: Update 11 (2018)). The fact that hypertension is not yet on the list of diseases presumed to be associated with exposure to Agent Orange should not be the basis for a negative opinion." https://www.va.gov/vetapp20/files4/20024447.txt This case was decided on 04/09/20 Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Right ---the 2012 report is clear-  "sufficient evidence of association between AO and Hypertension." Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files4/20029600.txt But in this case the BVA stated:   "The Board previously denied this claim in a February 2019 decision finding the most persuasive evidence of record did not support a nexus between hypertension and service or his PTSD. With regard to Agent Orange exposure, the Board noted recent NAS findings (the most recent Agent Orange update) indicative of “limited or suggestive” association between hypertension and herbicide exposure, but found such association was not conclusive in this Veteran’s specific case. Rather, according to a June 2018 VA examiner’s opinion and the examiner’s research into the relevant medical literature, a connection between Agent Orange exposure and the development of hypertension would only be possible within individuals in the Army Chemical Corps whom directly handled herbicides. Since the Veteran served as an M-113 armored personal carrier and not in the Army Chemical Corps, the June 2018 VA examiner found a nexus in this case unlikely. The Board denied the claim mainly relying on the June 2018 VA examiner’s opinion."   Yet in this case ,the BVA stated: "The February 2019 Board denial was vacated and remanded by virtue of a February 2020 JMR. Therein, the parties agreed that the June 2018 VA examination relied upon by the Board was inadequate. In particular, the parties agreed the matter was previously remanded in September 2015 and again in September 2016 for a VA examiner to specifically consider the 2012 NAS conclusion that found suggestive evidence of an association between herbicide exposure and hypertension notwithstanding that VA has not added hypertension to the list of conditions presumptively associated with Agent Orange exposure. In contrast, the June 2018 VA examiner noted review of the Journal of Occupational Environmental Medicine, but no specific mention or consideration of the NAS Agent Orange update. The examiner found a nexus between hypertension and Agent Orange exposure unlikely because “[e]xposure to herbicides is not presumptive for service connection.” While the examiner noted suggestive data of a connection between hypertension and Agent Orange exposure where a serviceman had more direct handling of herbicides, there is nothing in the VA examination report that indicates the examiner specifically considered the NAS Agent Orange update as directed in two prior Board remands." This case was decided a little over 3 weeks later than the other one I posted first here. SHEREEN M. MARCUS Veterans Law Judge Board of Veterans’ Appeals https://www.va.gov/vetapp20/files5/20032464.txt Yet the two AO Hypertension awards ( maybe there are more by now) clearly refers to (as I did in the accrued claim I have pending) tothe most recent AO HBP NAs report which Ihave posted here in the AO forum months ago:   "In the alternative, as explained above, the Veteran is presumed to have been exposed to Agent Orange in service and the National Academy of Sciences (NAS) moved hypertension from the “limited or suggestive” category and indicated that there is now “sufficient evidence” of an association between hypertension and Agent Orange exposure. See Veterans and Agent Orange: Update 11 (2018). Also, early onset peripheral neuropathy is a disease that is presumed to be associated with herbicide agent exposure. Lastly, the Board has awarded service connection for diabetes mellitus and hypertension and neuropathy are recognized by VA as being potential complications of diabetes." And "The clinician must provide reasons for each opinion given. In this regard, the clinician should address the NAS’s determination that there is now sufficient evidence of an association between hypertension and Agent Orange exposure (See Veterans and Agent Orange: Update 11 (2018)). The fact that hypertension is not yet on the list of diseases presumed to be associated with exposure to Agent Orange should not be the basis for a negative opinion." https://www.va.gov/vetapp20/files4/20024447.txt This case was decided on 04/09/20   Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals   Right ---the 2012 report is clear- "sufficient evidence of association between AO and Hypertension." Geez, if the BVA judges are not all up on the latest NAS report- they have denied some vets of their rights- because the report might not award all AO exposed vets for HBP, but it is still at a high level that should prompt consideration. "Sufficient" is a higher level of association then many past AO disabilities have had in NAS reports.
      Any takers on this?????? I was stunned to see how two of these law judges were not aware of the NAS 2018 report.
      Tomorrow I might find more BVA judges don't know about it either---- this means on remand, the veteran might get a lousy C & P exam and be denied again, unless the veteran finds out about the NAS 2018 report.
       
       
             
    • By Foxhound6
      Berta and all. Here is what I have so far from my friend and his mother that I was speaking about the other day. From what I can tell, They do have the DD214 and DD215's. However, there DD214 itself does not show any type of locations of service as the newer ones do.It does show a previous command which I assume is the one he deployed with. I took notice of the "Foreign/Seas service" section of his 214 and noticed he has Foreign service for 11 months and 20 or so days, just long enough to be in Vietnam... However, I feel I may have to dig up records pertaining to that unit at the time in order to prove it? I am unsure on that exactly. It was also strange they had 2 DD215's, also unsure what to make of that. *edit - I remember the wife speaking about the veteran making a stop in Okinawa before Vietnam. I found a unit that fits that timeline of when the veteran would have arrive in Okinawa to link up with as a support engineer. I dont have a way to confirm, but it fits...:
      " On July 4, 1965, 2nd Battalion, 9th Marines was ordered to Vietnam. During this first year 9th Marines took part in approximately 45 battalion-sized and several company-sized operations. During the next four years 2nd Battalion, 9th Marines operated in or around Danang, Hue, Phu Bai, Dong Ha, Camp Carrol, Cam Lo, Con Thien, Than Cam Son, Quanq Tri, Cua Viet, Vandergrift Combat Base and Khe Sanh. For its actions in Vietnam 2nd Battalion, 9th Marines was awarded a third Presidential Unit Citation, a bronze star in lieu of second award of the National Defense Service Medal, the Vietnam Service Medal with two silver stars, and Vietnam Cross of Gallantry with Palm. In August 1969, 2nd Battalion, 9th Marines left Vietnam and returned to Okinawa. Its role in the Southeast Asian Conflict ended with the recapture of the Mayaquez and the landing on Koh Tang Island in May 1975 (Veteran completed his training sometime in 1969). In February 1979, 2nd Battalion, 9th Marines became the first battalion to rotate to the United States as part of the unit deployment program. " via http://www.2ndbattalion9thmarines.org/About_Us
      As far as medical is concerned, I believe I have enough to prove the VA wrong. The mother has HUNDREDS upon HUNDREDS of medical records pertaining to his disability. I couldn't copy them all but I found many pertinent ones that show the initial DX plus ongoing treatment. I am posting all of it here in hopes someone might make more sense of it along with the Rating decision. Sorry for some of the photos, the mother found more docs after I left and sent them via her phone.
       








      Matt Spina Bifida_Redacted.pdf
    • By Persistant
      I uploaded (last week) some of the decisions my late husband had gotten and Berta spotted a couple CUEs and gave me some help in drafting them.  Berta if you are able to help with a few more questions Please?  
      I have only 2 more days till my year is up from the DIC/Accrued benefits claim where DIC was awarded and Accrued denied saying there aren't any.  At that time also, I intended Substitution but the VA form got separated (my fault) and didn't get submitted. I, however, wrote it into the 21-534EZ form and checked it. I also included a cover letter that said explicitly I was substituting for any and all accrued benefits...  They didn't address substitution in their decision.  Now with the CUEs which aren't an accrued yet, do I need to address those 2 forms immediately before the deadline?
      Here are some questions I still have if you could clarify these for me please:
      A.      Is a NOD for accrued benefits claimed with DIC a year ago needed – to appeal their conclusion that there are no accrued benefits? Would any backpay from these CUEs be considered accrued benefits that I would have to NOD the decision now for?
      B.      Is Substitution needed to do CUE claims or to receive any backpay on them?
      C.      What happens when future presumptions of ao are added to the list going forward (as a surviving spouse) does it affect anything I can act on?
            1.        Conditions claimed before – either rated or denied sc          
            2.       Would conditions listed in the C-File but never claimed come into play ever as a presumptive?
      D.      If CUE is successful:
           1.       then qualifying for housebound or A&A will need to be judged and evidence has never been presented before…
                a.       does the judgement come only from the C-File?  And if so, should I include printouts from C-File to bring attention to issues pertaining to them? 
                b.      Can any evidence be added (from that date and before) since it was never considered before?  And if so, do I include it with the CUE claim?
      E.       IHD was first decided as 30% and went back to one year prior to our first claim – effective 2004…the bump up to 60% was effective   .  But the 100% was effective 2006…Should any of those effective dates be different because:
           1.       SSDI was in place for IHD qualification date of 12/2000  
           2.       TDIU decision being effective 2006 (but he was unemployable per SSDI in 2000?) 
           3.        100% decision?   
           4.       100% effective date adjusted back due to Nehmer 2010 addition listing it as a presumptive
           5.       Combination of all the above?
      F.       Many of the evidence documents we submitted are not in the C-File and none of the forms we submitted are there to prove what we submitted or said.  Is that normal?
      G.     Also, the only SS docs in the C-File are the ones where I outline his conditions and behaviors in answer to the many questions on the intake paperwork for that SS claim.  There’s 4 pages of handwritten (including along margins due to space shortage)  that I doubt anyone is going to wade through but it’s filled with problems he was having.  Should I type it all out and attach it to the handwritten forms?
      H.      We submitted the whole SS file but can’t prove it.  We even wrote a letter to our Congressman to help us get a particular letter sent to us by SS along with their decision listing a myriad of restrictions to employment they concluded for him.  I couldn’t find it and neither could SS but the Congressman did try for us. I have those communications too, but don’t want to drown them in paperwork with this claim.  Any thoughts?
      Again, thank you Berta. I did try the other people you suggested without success.   
      And thank you to everyone here who has helped  me or does going forward!  
    • By Persistant
      Berta told me about Footnote One Nehmer yesterday and I had not heard about that although I do know about Nehmer.  And yes my husband was rated for Ischemic heart disease before it was added to the presumptive list. And his death certificate signed by his GP at VA saying long term heart disease.  It was rated as secondary to diabetes (which was rated 20% initially) and was already a presumptive condition. He had applied for both at that time - about 2003 or 2004.  He was rated 30% initially for his heart even though he had had a quadruple bypass (Dec 2000) with neurological complications, extensive scar tissue from many previous heart attacks that had to be cleaned out before the bypass could proceed in surgery.  He had a TIA on the operating table and post pump syndrome from being on the heart lung machine so long (due to the cleanup) for surgery.  He was told by his heart specialist he could no longer work at what he was skilled to do. He was granted SS Disability as a result 9 months later.  
      He filed his first VA claim a couple years later when his buddy finally persuaded him to do it.  He had been diagnosed with Type II Diabetes in 1997.  They didn't address any of the neurological stuff (from the heart surgery) as I recall at all or the post pump syndrome (which usually goes away rather quickly but was a problem for at least a couple years for Don).  The lower left ventricle of his heart was dead already before surgery from previous attacks we didn't know about - silent due to diabetes.  And his ejection fraction was 25 before and right after surgery and then came up to 30-35.  It bounced around some over the years but was usually 30-40. He had an echocardiogram every year which approximated it. After 2 hospitalizations for Congestive Heart Failure over the next few years, they finally rated him 60% heart and 40% diabetes (when he became insulin dependant.  Shortly after starting insulin  - a few months -  Don was put on an insulin pump because he was needing so much insulin and put him on the U500 insulin which is very closely monitored because of being so very strong) and VA rated him for 10% each leg for Peripheral Neuropathy.  Don also claimed PTSD, which should have been granted, as we had a few years worth of records already from a private practice psychologist the VA had recommended whose report said he had it and it was from VietNam (non-combat).  But Va's C&P psychologist or psyciatrist said he wasn't sure of that origin. He agreed Don had it. They asked us to prove Don's stressors.  We searched for months for other guys Don remembered being there, found one but couldn't prove the stressors.  They never contacted us when the requirement to prove stressors was lifted to re-evaluate his claim.
      In 2006 they rated  him TDIU and his heart 100% by itself in the same decision with effective dates a few months apart???  Makes no sense to me since the TDIU was then dropped due to the 100% rating.  That was his last rating - 2006. He developed kidney failure late 2010 with a hospitalization of a few weeks for Congestive Heart Failure because the kidneys weren't removing the fluid with normal types of hospital treatment. He was treated by a team consisting of his heart specialist,  his GP who had admitted him, and the new Nephrology group the GP brought in. All Private Practice doctors and hospital. They finally tried something rather bold, I'm told, that started the fluid draining.  After discharge, at home, he had a few weeks of digital monitoring of his stats, reports I had to give them on weight and output amounts etc. and nurse visits and was told to prepare for dialysis.
      About that time his doctor at VA called, alarmed, at his rapid decline in kidney function. That is in the medical records at VA along with numerous notations of him being on dialysis and having a port in his abdomen for it, every time he went in for a 6 month checkup.
      As you know, Berta, we asked about rating his kidney failure (which his doctors say was from diabetes making it another secondary condition of diabetes and so service connected..) and 3 different VSOs in 3 locations each said we couldn't go above 100%. I didn't know about these kind of forums then.  And only discovered the blog I reference below, by accident.  We also asked his doctors at VA and they didn't know either.  But one of them (unbeknownst to us) requested payment from VA for the 'dialysis treatment plan' and they agreed to pay for supplies, treatment, bi-monthly clinic followups with the 'team' (nephrologist, nurse, dietician, social worker). They also covered delivery of supplies to our home bi-monthly (huge amount of heavy bags of fluid and much more.).  He had started dialysis April 2011 and they began paying April 2013 and continued until his death Dec 6, 2015.  In March 2015 I saw a blog about Special Monthly Compensation and about rating conditions beyond the 100% level. I asked for an analysis of Don's case and the attorney agreed requesting Don's C-File from VA in March. It didn't arrive until late Aug 2015.  The analysis  wasn't quite finished when he died.  A & A was definitely something he qualified for as well and I have many statements from friends, relatives, our pastor etc as well as notes in VA's files and doctor statements about it. But that's another story.
      I don't know if Nehmer affects anything I've said here or not.  Does anyone else?  Berta?  And we were not ever contacted by VA or NVLSP about it.  Maybe because he was already 100%? 
      I did apply for DIC and Accrued benefits within the year following his death and was granted DIC and denied accrued because they said there weren't any.  They never checked his C file or medical records or Treasury to discover anything really. I had thought the attorney would represent me in an appeal but he's decided not to.
      My DIC was granted at the higher level due to Don having been 100% for over 8 years.  I'm not sure what you thought I interpreted wrong about that Berta.  
  • Ads

  • Our picks

    • Post in New BVA Grants
      While the BVA has some discretion here, often they "chop up claims".  For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.  

      I hate that its that way.  The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.  
    • Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!

      My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.

      Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
        • Like
      • 13 replies
    • I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,
    • This is the latest Compensation & Pension (C&P) Clinicians Guide dated 20180719. The only other one I've seen is dated 2002, including the one on this website and the VA website. I got this from my claims agent, who got it from the VA.

      VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
        • Thanks
        • Like
      • 12 replies
    • I don’t say thank you enough to all of you...
      You, yes you, are the reason HadIt.com has remained a resource-rich resource. Thousands come each month to read, ask questions, or to feel a sense of community.

      Last month June 2020, we over 50k visitors they viewed over 160k pages. Veterans and their advocates, spouses, children, and friends of veterans come looking for answers. Because we have posts dating back 15 years and articles on the home page, they usually can find an answer or at least get pointed in the right direction.

      You all made that possible. Thank you.
        • Like
      • 8 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines