Don't know what to do with a Menieres claim

[Riplip]

So I am asking the Menieres gurus here about my situation. I have 70% bilat. hearing loss, tinnitus @ 10% and vestibular disorder rated at 30%(max). I have a diagnosis from a specialist that the VA sent me to outside of the VA stating I have bilat. Menieres. I think I want to claim the meneires because of how bad it is and I believe I could get more than the vestibular disorder and get me up to 100%. I'm nervous about making waves and opening up a can for the VA to somehow mess with my rating. Just wondering what others would do really just for thoughts. I don't think I have anything to lose but also I have no trust in the VA. Thank you

[broncovet]

GB Army:

    If the VA reduces your rating, they have to go through the "reduction" process that I posted.  If there is no "actual improvement" he has nothing to worry about a lower rating.  Unless your condition has improved, the VA can not reduce you.  

[Buck52]

Roger that GB

In this type situation you are correct  about the double dip

But

.if he files for increase on his hearing loss  then it all depends on how bad his hearing loss has got  if its a lot worse they should go by the hearing rating criteria  and increase to the proper rating   hearing loss don't get better or improve  it only gets worse.

they rate hearing loss even if its caused by his Meniere's or other injury to his ear drum  the rating is the same protocol the VA uses to rate hearing loss.

now with these other rating conditions he has   you are correct  no double dipping  or pyramiding conditions ..I am not familiar with his other s.c. conditions.

some times VSO will tell a veteran don't rock the boat,,a reduction is possible be happy with what you get  ect,,,ect,,,

Well if he has a s.c.condition that has worsen and wants to file for increase on that condition  to get a higher compensation  he just needs to add his evidence the condition has got worse and a Qualified Dr needs to opien that it has got worse after reading his medical records and examining him.

Edited November 21, 2019 by Buck52

[Buck52]

 This is a little long read but may help understand this better.

No cure exists for Meniere's disease. A number of treatments can help reduce the severity and frequency of vertigo episodes. But, unfortunately, there aren't any treatments for the hearing loss.

Medications for vertigo

Your doctor may prescribe medications to take during a vertigo episode to lessen the severity of an attack:

Motion sickness medications, such as meclizine or diazepam (Valium), may reduce the spinning sensation and help control nausea and vomiting.

Anti-nausea medications, such as promethazine, might control nausea and vomiting during an episode of vertigo.

Long-term medication use

Your doctor may prescribe a medication to reduce fluid retention (diuretic) and suggest that you limit your salt intake. For some people, this combination helps control the severity and frequency of Meniere's disease symptoms.

Noninvasive therapies and procedures

Some people with Meniere's disease may benefit from other noninvasive therapies and procedures, such as:

Rehabilitation. If you have balance problems between episodes of vertigo, vestibular rehabilitation therapy might improve your balance.

Hearing aid. A hearing aid in the ear affected by Meniere's disease might improve your hearing. Your doctor can refer you to an audiologist to discuss what hearing aid options would be best for you.

Positive pressure therapy. For vertigo that's hard to treat, this therapy involves applying pressure to the middle ear to lessen fluid buildup. A device called a Meniett pulse generator applies pulses of pressure to the ear canal through a ventilation tube. You do the treatment at home, usually three times a day for five minutes at a time.

Positive pressure therapy has shown improvement in symptoms of vertigo, tinnitus and aural pressure in some studies, but not in others. Its long-term effectiveness hasn't been determined yet.

If the conservative treatments listed above aren't successful, your doctor might recommend some of these more-aggressive treatments.

Middle ear injections

Medications injected into the middle ear, and then absorbed into the inner ear, may improve vertigo symptoms. This treatment is done in the doctor's office. Injections available include:

Gentamicin, an antibiotic that's toxic to your inner ear, reduces the balancing function of your ear, and your other ear assumes responsibility for balance. There is a risk, however, of further hearing loss.

Steroids, such as dexamethasone, also may help control vertigo attacks in some people. Although dexamethasone may be slightly less effective than gentamicin, it's less likely than gentamicin to cause further hearing loss.

Surgery

If vertigo attacks associated with Meniere's disease are severe and debilitating and other treatments don't help, surgery might be an option. Procedures include:

Endolymphatic sac procedure. The endolymphatic sac plays a role in regulating inner ear fluid levels. During the procedure, the endolymphatic sac is decompressed, which can alleviate excess fluid levels. In some cases, this procedure is coupled with the placement of a shunt, a tube that drains excess fluid from your inner ear.

Labyrinthectomy. With this procedure, the surgeon removes the balance portion of the inner ear, thereby removing both balance and hearing function from the affected ear. This procedure is performed only if you already have near-total or total hearing loss in your affected ear.

Vestibular nerve section. This procedure involves cutting the nerve that connects balance and movement sensors in your inner ear to the brain (vestibular nerve). This procedure usually corrects problems with vertigo while attempting to preserve hearing in the affected ear. It requires general anesthesia and an overnight hospital stay.

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Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

Certain self-care tactics can help reduce the impact of Meniere's disease. Consider these tips for use during an episode:

Sit or lie down when you feel dizzy. During an episode of vertigo, avoid things that can make your signs and symptoms worse, such as sudden movement, bright lights, watching television or reading. Try to focus on an object that isn't moving.

Rest during and after attacks. Don't rush to return to your normal activities.

Be aware you might lose your balance. Falling could lead to serious injury. Use good lighting if you get up in the night. A cane for walking might help with stability if you have chronic balance problems.

Lifestyle changes

To avoid triggering a vertigo attack, try the following.

Limit salt. Consuming foods and beverages high in salt can increase fluid retention. For overall health, aim for less than 2,300 milligrams of sodium each day. Experts also recommend spreading your salt intake evenly throughout the day.

Limit caffeine, alcohol and tobacco. These substances can affect the fluid balance in your ears.

Coping and support

Meniere's disease can affect your social life, your productivity and the overall quality of your life. Learn all you can about your condition.

Talk to people who share the condition, possibly in a support group. Group members can provide information, resources, support and coping strategies. Ask your doctor or therapist about groups in your area or look for information from the Vestibular Disorders Association.

Preparing for your appointment

You're likely to first see your family doctor. Your primary care doctor might refer you to an ear, nose and throat (ENT) specialist, a hearing specialist (audiologist), or a nervous system specialist (neurologist).

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before a test. Make a list of:

Your symptoms, especially those you have during an episode, how long they last and how often they occur

Key personal information, including major stresses, recent life changes and family medical history

All medications, vitamins or supplements you take, including the doses

Take a family member or friend along, if possible, to help you remember the information you're given.

Questions to ask your doctor

For Meniere's disease, some basic questions to ask your doctor include:

What's likely causing my symptoms?

What are other possible causes for my symptoms?

What tests do I need?

Is my condition likely temporary or chronic?

What's the best course of action?

What are the alternatives to the approach you're suggesting?

I have other health conditions. How can I best manage them together?

Are there restrictions I need to follow?

Should I see a specialist?

Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you several questions, such as:

When did your symptoms begin?

How often do your symptoms occur?

How severe are your symptoms and how long do they last?

What, if anything, seems to trigger your symptoms?

What, if anything, seems to improve your symptoms?

What, if anything, appears to worsen your symptoms?

Have you had ear problems before? Does anyone in your family have a history of inner ear problems?

By Mayo Clinic Staff

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Symptoms & causesDoctors & departments

 

 Source:The Mayo Clinic 

[Riplip]

OK I have read all of that. First I'd like to say I am not trying for an increase in hearing because I just got that a couple months ago up to 70%. My hearing is really bad. The next step is implant which I don't want to do. I also have the peripheral disorder at 30%, tinnitus at 10% and MH at 50%. I have all those symptoms stated above but I have been on so many medicines and supplements and have completely changed my diet to help with the symptoms I don't get the full rotational vertigo as much. Meaning maybe once a week now but constantly get dizzy and lose my balance and catch myself almost everyday a couple times a day but its manageable. I stopped running outside completely 2 years ago and only use machines that have rails to exercise just in case i lose my balance. With that all being said I understand both points here. If they grant the Menieres and my hearing loss, tinnitus and vestibular disorder are higher then they would opt for the higher rating ? which means I wouldn't have a reduction but the meneires would still be connected?  I feel that I understand but I also am trying to figure out what I would gain by doing it? Really nothing until, and hopefully it doesn't, the Menieres gets worse. It took me a battle to get to the 90% and to lose any of it at this point would suck. If anything, I am learning a lot here. I'm 40 years old so I have a long time to deal with this. Thanks Buck and GB

[Buck52]

Well the point is you need to get what you deserve and if all your conditions have got worse   then apply for the increase....don't worry about a reduction   besides the CFR as for as rating goes the raters are suppose to look at what the highest rating possible for the level of condition or percentage to give the Veterans  some times they don't do that  ,>so we kick start it so to speak  check the criteria for each of your conditions..if they show separate then they are separate and not suppose to be wrap together. so-to-speak

so here is the thing to do.

1.  Look at your conditions and the severity and symptoms .

2. Check the rating criteria for each of your conditions

3. Look and see what the best rating % for each condition is?  the critera that best fits your condition.  and let them know you expect to be given the highest percentage rating allowed by Law for which your S.C. Condition has the criteria for. or quote your conditions to the VA Criteria as to what you should be rated.

You will be surprised at what you need to be fairly rated for, so if your conditions warrant a higher rating...why not file for the increase?

I doubt you will lose what you already have  if they don't think you meet the higher level of rating your conditions  then you more than likely will be denied the increase and stay the same rating as you are now.

My Question to you is   why is it you don't want to be increased? if your conditions warrant it?

[GBArmy]

I guess I'm a little dense this morning (or any morning for that matter): I understand about the VA reduction process. What I am concerned about is you can rate M by itself or, with a combo of the other three separately. He already has the rating for 3 separately. Because of pyramiding, he can't claim those AND go after a disability for M. IMO. He can if rating is higher, say 100%, then I assume that he has to give up the other 3. If M is evaluated and comes out to be less that his current combined disability rating of 80%?., do they rate M as 0%.