Need Advice - active duty surgery had to be reversed after retirement and related complications

[JeanBean217]

Hello Hadit community.  I am new and think this is the place I can find some answers.  I'll try to make my question/scenario as brief as possible, because I know it's hard to keep reading long and complicated posts.  Here is my status and questions.

I retired in 2012.  Had an initial DR of 60%, later it was raised to 90% due to worsening PTSD (from 30% to 70%) and a couple of minor issues I had appealed.  I would like to file a new claim, based on a surgery I had in service for voiding dysfunction.  In 2010, I had a hysterectomy, combined with an A&P repair and a bladder sling.  The bladder sling corrected my voiding dysfunction.  Fast forward several year, I am retired and using Tricare as my insurance.  I had complications from the bladder sling.  It had moved through tissues in my body, and began to protrude into my vagina.  It had to be removed.  A civilian doctor did the surgery and removed the sling, which, caused my voiding dysfunction to return.  It has been a couple of years since this surgery, and I have not done any claim with the VA.  I tried to look up on e-benefits, my award letter, but apparently, they are either down right now, or I'm not looking in the right place, because I can't get anything to come up.  They may have either given me a SC at 0% for the bladder dysfunction, or they may have not rated it at all, totally overlooking that part of the surgery.  So, here are my questions.

1.  If I open a claim for the voiding dysfunction, will they then reevaluate all my other ratings?  I really don't want to go through that, and risk loosing what I have.

2.  Can I do a FDC, if I have all the medical records from the surgery to install the bladder sling (SR), and the ones showing that it needed to be removed and the surgery to remove it (Tricare/civilian doc).

3.  When I'm able to review my award letters, and if I find they totally overlooked this condition, and it was never rated or SC at all, is it considered a CUE?  (I don't believe they can combine a hysterectomy rating with a voiding dysfunction rating, even if they were performed during the same surgery.  Is that right?)

4.  If it is a CUE, I'm assuming there are other posts on here that explain how to handle that.  Can someone direct me to the correct page, if it is indeed a CUE?

I am a bit paranoid about messing with my rating and bringing attention to myself.  But I'm a single mom, not working, living off of my retirement and VA money.  I can't afford to have my rating lowered.  But I certainly could use the benefit of being 100%, as far as property taxes are concerned.  I'm in TX.  I will have to post my ratings here as well, as I have a hard time understanding if I can even reach 100% because of the crazy way they add up percentages.  It seems impossible to be 100%, and I wonder if doing another claim will even be worth it.  I also am unsure about IU.  Being at 90%, should I have awarded me IU or is that something I should ask for?

Edited July 8, 2018 by JeanBean217

[Berta]

Welcome - I am a CUerino- and have much advice here in our CUE forum.I think solid CUEs are the cat's meow

because they are a "front attack" ( per the BVA.) 

But a CUE in your case depends on this award letter that contains on the rating sheet and within their decision:

 "They may have either given me a SC at 0% for the bladder dysfunction, or they may have not rated it at all, totally overlooking that part of the surgery."

And what the outcome is ,if you file a new claim for it.Or re-open the older claim if they did give you gave you a  "0" %

I do feel these are certainly  separate conditions- bladder disability and hysterertomy-the bladder condition  might be rated as aggravated by the surgery to correct the sling problem....and from what I see here ,the bladder problem should be claimed that way.

The award letter should say if the "0" is NSC or SC.Even a Zero SC is far better than "0" NSC.

"Being at 90%, should I have awarded me IU or is that something I should ask for?"

The 70% is for PTSD- is that correct?

Were you employed when they awarded that?

If not they should have considered you for TDIU.

If they didnt- ( we would need to see the award letter)

that would be a CUE basis.

Others can help with your other questions- 

You get TRICARE - so, have you checked out CRDP/CRSC? yet?

I will find the info here on that and post the link for you.

CRDP is supposed to be autyomatic but they do make mistakes-

 

 

 

Edited July 8, 2018 by Berta

[Berta]

This link should have the skinny on CRSC and also CRDP

Edited July 8, 2018 by Berta

[Berta]

Gee- I find I am questioning my own advice above-

In essense this would have to be a new claim (re: the bladder  dysfunction ) because

"The bladder sling corrected my voiding dysfunction.  Fast forward several year, I am retired and using Tricare as my insurance."

So, this was while you were still in the Mil, and VA might  not have rated that- unless they saw it in your SMRs---

but, as I understand it, you left the Mil with no bladder problem...? But

"A civilian doctor did the surgery and removed the sling, which, caused my voiding dysfunction to return.  It has been a couple of years since this surgery, and I have not done any claim with the VA.  "

Someone will opine if they see this differently.

Have you ever appied for SSDI? (Social Security Disability Insurance?

Or VA Voc Rehab?

 

[JeanBean217]

Hi Berta.  Thanks for answering.  Sorry if the initial post was a little confusing.  Let me see if I can state it more clearly.

The surgery for the bladder dysfunction was performed while I was active duty, by a military doctor at BAMC, Ft. Sam Houston, TX.  It should be documented in my SMRs.  I say "should", because my medical records can fill two copy paper boxes and I'd have to dig around in them to find it.  The VA knew about it, they obtained the complete copy of my SMR, and all aspects of the surgery were on my list of things that I wanted to be evaluated for when I retired and went through the VA's initial rating process.  I forget the form number, but it basically gave them a list of all my conditions/diagnoses.

It wasn't until after I retired that I began to have complications from the sling.  That is why a civilian doctor did the removal surgery, because I was retired and using Tricare.

Yes, I am currently 70% PTSD.  I haven't looked over my award letters in a few years, so I will have to dig them up. (I thought they would be on e-benefits, but I keep getting error messages on the site.)  The only income I had was from some lesson plans I listed for sale, online.  Certainly not gainful employment.  I don't remember the if VA even asked that question.

I believe I receive CRDP, if I understand it correctly.  Concurrent pay - retirement monthly payment, plus a VA payment.

After my initial claim, I did all my NODs, appeals, etc... on my own.  My representative (I forget the acronym ya'll have for them) was not a lot of help, so I did it on my own.  I ended up winning the three things that I was after.  The VA sided with me in the end and awarded me the ratings.  I did a lot of reading online to help myself through the process.  I bet this site would have been a big help.

No, I haven't applied for SSDI.  I didn't know if I should, since I'm not at 100%, and really don't know where to begin with that.  I was wore out by the time I got finished fighting with the VA last time, and just didn't have it in me to start another big process.  I guess that is why I've let this bladder thing go on for so long without filing anything.  The claims process is just hard, and draining.

[JeanBean217]

I was able to find a copy of my first rating decision.  I'm listing everything that was SC, including the updated % since then that I won on appeal:

1.  SC hysterectomy - 30% with SMC

2. SC PTSD - 30%, but is currently 70% after a re-evaluation

3. SC R hip tendinitis - 10%

4. SC tinnitus - 10%

5. SC Bilateral post bunionectomy - 0%, but later won on appeal, because they overlooked the residuals - now rated at 20%

6.  SC L ankle sprain with instability - 0%

7.  SC R ankle sprain with instability - 0%

8. SC Several Scars - 0%

9. SC Scar with persistent open wound - 10% - originally 0% with my other scars, but FDC proved open wound problem

10.  SC urinary stress incontinence - 0%

11. SC post A&P repair - 0%

12.  SC Bilateral conjunctivitis - 0%

13.  SC Atopic Dermatitis - 0% - originally denied, but later won on appeal and rated at 30%

14.  SC Thoracic spondlyosis with scoliosis - 10%

15. SC bilateral pes planus with arthritis - 0%

So, apparently 70, 30, 30, 20, 10, 10, 10, 10 = 92%, according to the calculator I looked at, so I'll need another 30% rating to bring it up to 100%.  I'll have to see what the CFR says about the bladder issue.

Edited July 9, 2018 by JeanBean217

[Buck52]

Jean Bean217

did you happen to get a rating sheet with your award letter? usually they don't send it but some times they do when a Veteran has muliti claims.

Do you have your ''up dated C-File? if not Request it ASAP.

You need to see what the ratings criteria for each one of these s.c. conditions/disability's rating  are and what the rating codes they gave.

  You can determine if you got a fair rating by the rating criteria set by the CFR'S and the Criteria for what you should be rated at a %

They are suppose to give us Veterans the highest possible rating allowed by law  AND SOME TIMES THE FAIL TO DO THAT  and when we quote these laws back to them...this is what helps us get these increases OR  a fair rating. but we need to know what the rating criteria is.

if this is what your asking ?but don't know how to look the rating criteria up for all your s.c. conditions

I would certainly look up the rating criteria for all your 0% that you got S.C. FOR.

  you should be able to get enough ratings from those alone to boost you up to the 100% level...since you do have some SMC's  if you have not been rated or given the SMC for some of these other conditions  like loss of use of organs, or Drop Foot b/c YOU SHOULD BE ABLE TO GET SOME MORE OR HIGHER UP THE SMC LATTER

and yes you may have a possible CUE if you could not work when they rated you the SMC and they knew you couldn't work  that is a possible CUE, but beings you never ask for IU   may present some problems but I think if they knew you could not work because of some of your S.C. Disability's rated over the 40%to 60%  then they should have inferred the IU to you back then.

OTHER MEMBERS CAN CHIME IN

one way or the other we will see that you get your fair ratings.

All is not lost b/c you should get the IU and the retro with it.

Edited July 9, 2018 by Buck52