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paulstrgn

Submitted IMO Not Mentioned in Denial

Question

I recently had the VA deny my SA and HTN (via Higher Level Review). The rater mentions the VA IMO as the one of the reasons for my denial, but does not mention the IMO I had submitted. Should the rater have mention my IMO in the decision?

I also do not understand how they say I did not have an event, disease, or injury in service. I was not treated for HTN while in the service but should have from 7/92 - 2/1995 my average blood pressure reading was 150/85 which was Stage 1 Hypertension (this was the old standards now it is considered Stage 2 Hypertension). I should not be penalized if the service failed to diagnose me for HTN (my IMO mentions that I was un-diagnosed for HTN in the service). When my claim I had submitted every blood pressure reading my medical records listed. The VA did not have an IMO stating I did not have HTN while in the service, apparently they only looked at my records.

The VAs IMO (which was written by a PA) for my SA states I do need a C-PAP but found no link for service connection that the cause was more likely due to age and a higher BMI. The two DBQs and one medical opinion lists reviewing my medical and the buddy letter (I had three, one from my last NCOIC, ex-wife and the last by my adult daughter) as well as my statement and that I more than likely did have SA while in the service. My IMO talks about me having HTN that was not diagnosed while I was in the service along with me having a higher BMI while in the service. I made a chart showing all the weight readings I had while in the service and from 7/1992 - 2/1995 my BMI averaged 29.9 over weight (30 BMI is considered obese). along with my buddy letters and my personal statement. In my opinion the rater never took any of my evidence into consideration.

Since I do not see mention of my IMO should I assume they never looked at it?

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The HBP was done by a doctor who specializes in Pulmonary Disease, Critical Care Medicine, and Sleep Medicine, so no he was not  a cardiologist which looks like it may be a problem for me. I guess by thinking since my medical records show I had un-diagnosed hypertension and as long as the the medical opinion talks about it it would be enough (I guess you get what you pay for, I thought $450 was a lot but it is nothing compared to your's Berta).

I was surprised on how brief the decision was since this was supposedly a higher level review and the person would go into more reasons as to why my evidence does not support my claim. If they would say why it doesn't meet the criteria it would help me in deciding on where I may have gone wrong.

I am not sure if I have enough for a CUE to say I gotcha, mine is more that the examiner does not appear to have looked at my evidence that I had submitted. 

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5 hours ago, paulstrgn said:

This is as close to mentioning the IMO I can find in the decision "Disability Benefits Questionnaire, Sleep apnea Disability received March 16, 2018". Now that I am looking at it I did not realize the IMO was part of the DBQ, I thought it was a separate document which is a 6 page document. I guess by them mentioning the DBQ they are covered. I wished they had gone into detail as to why their DBQ out weighs my DBQs along with the buddy letters. It is a very short denial and not much effort was put into it.

 

I still think that you can appeal on the grounds that the favorable evidence for high blood pressure was not given enough weight, especially since a PA disagrees with a medical doctor.  Your sleep apnea may be harder to get approved since the VA is denying a lot of these claims.  

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Unfortunately you are probably correct on the sleep apnea and I will see what they say about the high blood pressure.  

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