Denied Acid Reflex Claim???

[ronnieusmc0311]

Hello, I have a question regarding a Claim for Acid Reflex/GERD denial, but first I will start with my story: Letter for intent to file sent on FEB 2019, Filed claim for Acid Reflex July 2019, sent another claim for increase in Asthma (was at 30% for this) on September 2019. Increase in Asthma was granted 1 month later with increase to 60%, Acid Reflex Gerd was deferred. 2 weeks later, Acid Reflex/GERD claim was denied and was stated as "not service connected" with an arrow connecting it to my Asthma. When I sent medical documentation from my Private doctor, she connected my Acid/Reflex/GERD to my Asthma and  corticosteroids inhaler usage. When I had the C&P exam, I stated the exact same thing that it started in the Marine Corps after being prescribed  corticosteroids inhalers, I have been on them since and was Medically retired for Asthma. This rating would have put me at 95% thus rounding to 100%, so as you can tell I am bummed but determined to set this right, I feel as If someone made a mistake somewhere. What should be my next step? NOD? I'm not to experienced on the process, I will be faxing the Claims intake center for my C-FIle, but what should I do next? Thank you!

[Vync]

@ronnieusmc0311 Yeah, the rationale must be adequate. I found this link below that explains a possible link:

https://www.webmd.com/asthma/guide/heartburn-asthma#2

Quote

How Asthma Affects Heartburn

Some asthma drugs may raise your chances of getting acid reflux because of the way they affect different muscles in your body. Prednisone and albuterol may affect the muscles that control the opening between your esophagus and your stomach. This may allow acid to leak into your esophagus.

Other asthma drugs have an impact on the muscles that make up the walls of your esophagus -- and keep it from working the way it should.

Of course, the article does not cite any scientific studies.

 

However, I found this scientific article stating oral steroids (i.e. prednisone) have been linked to increased stomach acid: https://www.ncbi.nlm.nih.gov/pubmed/11834680

Quote

CONCLUSION:

Prednisone, 60 mg/d for 7 days, increased esophageal acid contact times in this small population of people with stable asthma; however, the mechanism for this finding is unclear.

The "small population" part may look bad unless your NP indicates she feels this is what you have.

Keep in mind too that steroids are great for controlling asthma, but can cause Cushing's either while taken or in long term. 

 

Your condition has to be really bad or has persisted for 5+ years with no persistent improvement for the VA docs to state the condition is not expected to improve.

Phoenix VA has been in the news a lot, especially for the secret waiting list that caused some veterans to die due to lack of diagnosis/treatment.

 

 

 

 

 

[Vync]

22 hours ago, ronnieusmc0311 said:

Thank you for the response! I am waiting for the packet this week. I spoke to my local DAV regional office (they still take care of my claims but I did this one on my own) and the VSO told me they denied because the PA who examined me did not believe my inhaler meds did not cause my Acid reflex/GERD. My Private NP believed that my Asthma meds "more likely than not" contributed to me developing Acid Reflex. The VSO said that along with the PA, they had a MD write a lengthy statement about how my meds due not contribute to the development of Acid reflex, which is just bogus because there are studies that reject that claim. The VSO also said, if my NP would have gave her reasoning, then it probably would have worked out better. So now I'm going back to my NP and I'm going to ask that she give reasoning and possibly add a study onto it.  I feel like they really did not want me at 100%, lol.

The VSO at the DAV tells me that I should go straight for a board appeal, this is where I'm conflicting.

Glad to help!

If you were denied on an initial claim, going to the board next may not make much sense. Usually veterans go for a supplemental first, then an HLR or BVA if they do not succeed. Yeah, the BVA tends to offer much better results for many veterans because they take the time to supposedly read everything. The drawback is you could be tied up in that lane for years. My initial claim in 1995 got denied quick and my VSO told me to appeal to the board. They never told me I could file for a reconsideration (not available any longer). It took about two years for my board hearing. Then it took them about two more years before I got new C&P exams. After that, it took about two to three months to get everything finalized and approved. BVA might not take that long today, but you need to talk with your VSO and ask them why they feel that way. It never hurts to get a second opinion either. It might be a good idea to ask the VSO if they reviewed the NP's opinion before they sent it off? If they had, they could have seen the medical rationale was sketchy. When I had DAV, I would work up everything on my own and present it to them for their guidance, but I started out very green and didn't engage DAV until around 2008 or so when I learned more about the way things work.

[rsm-esq]

I agree with the elders' advice above - there is an awesome group of experienced vets here!

Has your condition had an impact on your ability to be employed or maintain a job?  If so, in terms of obtaining a 100% rating, a you may want to also consider raising the issue of total disability due to individual unemployability (TDIU).  TDIU is essentially an alternate method to obtaining a 100% rating:  it's a determination by the VA that the claimant should be considered "totally disabled" (100%) due to their inability to secure or maintain substantially gainful employment.  All the best...

[vetquest]

I would not go directly to the BVA unless you have a bullet proof IME/IMO.  If you have one of these you have a good bet at the BVA.  You need one that says that they have read all of your records, that they believe that it is more likely than not that your condition is due to your service condition and then they have to provide a rational for their decision.  My last IMO simply stated that the VA had not treated my condition and therefore they did not have enough knowledge of my condition.  It worked but I would try for more than that normally.