The new AMA-Mobius loop?

[FormerMember]

https://asknod.org/2019/04/10/hadit-com-radio-show-the-ama-a-mobius-loop/

[broncovet]

Thanks, Alex, for the map.  I completely agree, and have posted the same, as far as HLR...avoid HLR at any cost.  

One "important" improvement, however, is requested:  Put the new appeal form numbers on the relevant map.  

More than one Veteran is confused about the correct form to use in all the various denials, and we can count on VA to deny us again, even with a case of merit, if we file the appeal on the "wrong form".  

[Buck52]

Funny but all so true.

Alex  here is a

Quote from Ms Berta on another thred

''John, I mentioned your reference to "essential " hypertension in last week's show , in a letter to the Secretary-''

What exactly do they mean by  this ''essential'' In regard to the new A.O. Presumptions? In accordence for Heart Diesease from A.O. 

Vietnam Veterans and other Veterans as well that was around the A.O.  With evidence to prove it.

Also why is it so hard to get a VA Dr's to help A.O. Veterans with presumptive disease  with their claims  when all they need to do is confer they read the veterans medical records and give their opinion as likely as not this veteran disease is caused by or related to his duty from Vietnam service  or where ever the veteran was exposed to this A.O. While serving in the military....The Dr's think they will be fired  and I just don't buy that.

Its not fair the Veteran seek a private Dr for this  when its in his/her military records. (jmo)

[Berta]

This is what I meant:

This is from my letter to Secretary Wilkie and anyone can make the same point it they write to him.I gave his Washington  address, twitter handle, and email addy here somewhere recently in the AO forum.

I prefaced this with quotes from the 2018 NAN (formerly IOM) reports.

The new report states "Sufficient evidence."The full report is here somewhere.

"Hypertension (category change from Limited or Suggestive in Update 2014)”

 

I feel “Sufficient evidence” is much stronger than the 2014 report regarding AO and hypertension.

 

I am aware how prevalent HBP is in the general elderly population.However that does not account for the Vietnam veteran's population separately, yet this newest report raises the nexus to hypertension as due to Agent Orange, regarding any incountry Vietnam veteran.Since HBP is treated so well these days, a VA rating due to HBP under this report,if considered as a presumptive, would not be as costly as one might think, as I would expect the ratings to be fairly low if the HBP is well controlled, medically. Most veterans have had their hypertension deemed as “essential” by VAdoctors , meaning there was no known cause for it, but now there is a cause and etiology- Agent Orange, based on the 2018 report."

My letter went on regarding ischemic stroke as a potential new AO and why, medically and I raised other issues comng his way.

(The big problem with HBP is the cost factor.)

Buck asked:

"What exactly do they mean by  this ''essential'' In regard to the new A.O. Presumptions? "

If the Sec picks Hypertention as a new AO presumptive, and

If Nehmer 2010 kicks in for a new Nehmer , and 

If it includes the Footnote One stipulation then any vet with past NSC hypertension and a rating of at least 10 % (maybe "0" would do as well that could become beginning of a retro staged Fenderson rating) who becomes an AO HBP vet via any new decision by the Secretary , then

that veteran might well get retro back to when the hypertension first appeared as NSC in a past decision.

Lots of ifs- and then there is the fact-

if Blue Waters succeed with proper regulations, as presumptive to AO, that too will be part of the HBP cost factor.

Nehmer applies to Vietnam incountry veterans. Blue Waters -if they are designated as incountry- will be under Nehmer-but I have no idea what their status will become.

There is so much to these issues- I dont have time to post all they involve- 

as soon as I hear anything on the BWN AO regs or from NVLSP on any new potentials, I will post it here.

Also NVLSP has something else in the works- re: AO and CUE----

Footnote one is explained here in our AO forum ad finitum.

I am a footnote one widow and many if not most of our Vietnam vets with IHD are /were probably Footnote One veterans. And NVLSP checked their retro to see if they got the correct EED.

 

 

 

[Berta]

This is why I suiggested in another post in th AO forum that now is the time for any Vietnam or BWN vet to see if their medical records reveal "essential" to describe their hypertention.

They might need that record for a proper EED.

And they should pull out any past denials and ratings sheets for HBP as well, if they are not SC for it under a different medical theory and rationale.

I believe that by mid June we will have the Secretary's decision. He could decide to put NONE of the 5 disabilities in the report on the AO list.

I  am still a little in shock that Shinseki did put IHD on the AO list.9 years ago. and it Was BIG News and involved lots of retro for many.

 

 

 

[FormerMember]

I keep hitting the wall on IHD. I have a doctor say he has CAD. I get denied. I have a dr say Arteriosclerosis throughout (including the coronary arteries and peripherals). I get denied. I say Atherosclerosis. Denied. So now, I just get the 12 ga. out and have the nexus dr. do the whole gig. I try to get my guys to go to a private  doc on Medicare and get the magic IHD words. I'm finding using IHD is too nebulous for VA. I don't even ask or want the doctor to opine. It's presumptive. I just want them to say the secret word =IHD.

The only VA type docs who will do an IMO/nexus is the VAMCs that share a nursing school with the  VA med center -i.e. Duke/Salem/Seattle etc. Those docs do not "work " for VA. But, if you do not have them say the magic words ('I reviewed the claims file') it's dicey. To begin, a VA medical examination report is entitled to no weight if it contains only data and conclusions. Nieves-Rodriguez v. Peake, 22 Vet. App. 304 (2008) If the VA Doc just says "It's more likely than not it's AO. " that won't win. Granted, AO is a presumptive and they aren't supposed to get in the weeds, but I'm talking about nasal cancer cases when they say it isn't in the respiratory canal or the lungs. If it's  small cell carcinoma, it's AO in my book. VA doesn't agree. That's when I'm forced to go get a good IMO. 

Edited April 11, 2019 by asknod

[john999]

I got SC'ed for CAD years ago due to AO exposure.   All I was claiming was some blockage in my leg veins which had showed up on a CT scan done by the VA when I complained about it.  I claimed this thing and some how the VA granted 60% for CAD.  I was pretty shocked.  My VA doctor at the time (8 years ago) did do a fantastic medical opinion like an IMO and I got connected.  She was soon dispatched to some other VA job away from patients.