More Health Issues - question about claim

[toomnyhats]

My original decision is attached.  I posted later regarding the lack of connection for my neurogenic bowel (ileostomy with colectomy).  My VSO advised me not to rock the boat since my STRs didn't have any neck documentation.  That was dealt with in the IMO I submitted and was successful in getting the neck connected and the cascade with it.  My health has been up and down and I have not gotten around to filing for the neurogenic bowel. We're in the process of the Specially Adapted Housing grant right now...long process to get bid from contractor but not complaining at all!! Feel blessed to have it.  However, I talked to my VSO once again, about my concerns of my neurogenic bowel not being rated and I was told not to worry because if I had a bowel obstruction, rupture and died from sepsis, the Death Certificate would link it to the spinal cord injury.  I think that was a crock but...now I have other issues and am ready to take them on.  

 Issues I would like to file for are:

1. Neurogenic bowel requiring ileostomy and subsequent colectomy due to disuse syndrome.
2. Gastroparesis.  This has been brewing for awhile along with my GERD but it is to the point now where I'm losing weight too quickly and sometimes can't get anymore than 600 calories in a day even using high calorie supplements recommended by the dietician.  I feel as if I've eaten a Thanksgiving dinner all the time.  A few weeks ago, it resulted in a hospitalization and my small intestine had ileus for a couple of days where nothing moved.  Not sure if Gastroparesis is a ratable and connectable condition to my SCI.
3. I'm scheduled for a suprapubic catheter to be placed on November 14 because I leak around my foley. I can no longer Cath intermittently because my hand is getting to weak to manipulate clothing and I don't have 24 hour help.  Am I correct that a suprapubic is ratable at 100% especially since I already have a 60% Neurogenic bladder rating (not related to my neck issues)
4. Is is worth it to file.  My husband is 60 and taking care of me is becoming very taxing.  The VA covers some home care/homemaker through the standard care but not near enough.  So I don't know if these issues, if granted would bump me higher than an M w/K.  
5. Also does anybody know if Loss of use of both bowel and bladder sphincter control plus paralysis requires the paralysis to be complete (as in ASIA A) or does it also apply to incomplete. I'm listed as a C1 ASIA C SCI. It is not clear in the regs which state,  "(2)Paraplegia. Paralysis of both lower extremities together with loss of anal and bladder sphincter control will entitle to the maximum rate under 38 U.S.C. 1114(o), through the combination of loss of use of both legs and helplessness. The requirement of loss of anal and bladder sphincter control is met even though incontinence has been overcome under a strict regimen of rehabilitation of bowel and bladder training and other auxiliary measures." 

Any advice or thoughts would be greatly appreciated.

Blessings,

toomnyhats

toomnyhatsRedacted.pdf

[Buck52]

I would file for everything that your entitled to.  IF your denied on some  you can always Appeal  but it starts your claim date for EED.

NOD the decision that you got and ask for the A&A That the VA Should have inferred that in the first place..... and ask that you be given your  Correct EED.

After we get a decision and don't like it or get low balled  defiantly appeal that decision ,  they are hoping you don't. (jmo)

They are not doing their job right and also can be a CUE in some circumstances when they don't infer a Veteran claims correct.

Edited October 27, 2018 by Buck52

[toomnyhats]

Thanks much!! I think right after my suprapubic is placed, I will do just that.  File for the neurogenic bowel/ileostomy, the suprapubic and increase pain which they can't find a drug that will control it.  I suspect they may connect but if they don't calculate the SMC correctly, I'll appeal.  One last question - you've been so much help and encouraging, do you know how the VA defines paralysis in the clause for SMC O?

(2)Paraplegia. Paralysis of both lower extremities together with loss of anal and bladder sphincter control will entitle to the maximum rate under 38 U.S.C. 1114(o), through the combination of loss of use of both legs and helplessness. The requirement of loss of anal and bladder sphincter control is met even though incontinence has been overcome under a strict regimen of rehabilitation of bowel and bladder training and other auxiliary measures." 

Do they mean complete loss of motion or loss of use?  I can slide my legs a bit, can't hold them up very long against gravity and certainly not at all against resistance.  I can't bear any weight so they are pretty useless.  Just wondering if that rating would apply to me or if you have have a complete - can move them at all or if my circumstances qualify.

Many thanks!!!