My laughable denial..a comparison to a parapelegic

[JKWilliamsSr]

Just when I thought I heard it all I get my final denial letter and It is so stupid I find it funny.  It is just further proof that raters will look for anything to deny a veteran.   In this instance I attempted to tie my obesity to my service connected disabilities which led to other issues.  Here are my ratings (for now)

10% left knee (increase denied will appeal)
10% right knee (increase denied will appeal)
10% Bilateral Pes Planus (will appeal I should be at a minimum 50% they did not adjudicate my Plantar Fasciitis either)
30% Asthma

My contention is that as my disabilities got worse my activity lessened.   I can't even walk without pain let alone exercise and that led to my beginning to gain weight.

So the rater that took my claim made the following statements.

"The examiner further stated that your service connected condition does not preclude all forms of exercise.  For example paraplegics exercise and maintain appropriate  Body Mass Index (BMI)

"Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, which is a choice"

First of all comparing my situation to a paraplegic is irresponsible and to be honest just flat stupid.   A paraplegic gets no muscle stimulation in their legs and sadly they lose muscle mass and their legs are nothing but skin and bones.  Their exercise is limited to upper body exercise and it is easy to maintain that the active muscles in your body are minimal. 

The fact that the examiner and rater state that my excessive food intake and lack of physical activity is a choice I made shows they ignored my statements.  In my personal statement, a statement from my spouse and ex-spouse we all stated the pain I am in when I try to exercise and we also all stated the numerous diets that we tried and was unsuccessful in my losing weight.   Then you have to take into account I have asthma and I have to take medication daily to control it.  My asthma is service connected as well.  I have a lot of shortness of breath when I exercise.

What a complete joke.

[Hucast21]

Raters are special to say the least. Every time I read a veteran got a fair rating on their claim, I wonder why I, and many other vets like yourself, couldn’t be so lucky.

I’ll share my current claim process: filed a claim in 2018 for migraines, depression, and knee pain. My SMRs show numerous sick calls every time I had a migraine, even stating my only relief was to lay down in a dark, quiet room.

My separation physical examination states a diagnosis of severe migraines by my PCP. VA treatment records show continuing treatment for migraines.

The initial claim was denied because of an unfavorable C&P exam where the contracted NP said “veteran health records has been silent about migraines.” Filed a NOD and submitted an IMO with nexus and was denied again because the rater said my IMO was “telehealth.”

There is no excuse for the amount of bullshit veterans have to jump through so many hoops just to get service-connected, but it happens way too often.

[brokensoldier244th]

I won one very similar on an appeal due to a combination of pain, and side effects of some meds. The double whammy of lethargy and that they only leveled out pain they didnt make it magically go away, plus I had been keeping track of my eating for several months helped. That and that once you get above a certain BMI your hormnoes make it almost impossible to lose weight effectively. being told you have a 10 lb lifting restriction and to limit movement due to a 40% percent back rating and 20@ peripheral neuropathy from the same helps, too. 

[pacmanx1]

1 hour ago, JKWilliamsSr said:

Just when I thought I heard it all I get my final denial letter and It is so stupid I find it funny.  It is just further proof that raters will look for anything to deny a veteran.   In this instance I attempted to tie my obesity to my service connected disabilities which led to other issues.  Here are my ratings (for now)

10% left knee (increase denied will appeal)
10% right knee (increase denied will appeal)
10% Bilateral Pes Planus (will appeal I should be at a minimum 50% they did not adjudicate my Plantar Fasciitis either)
30% Asthma

My contention is that as my disabilities got worse my activity lessened.   I can't even walk without pain let alone exercise and that led to my beginning to gain weight.

So the rater that took my claim made the following statements.

"The examiner further stated that your service connected condition does not preclude all forms of exercise.  For example paraplegics exercise and maintain appropriate  Body Mass Index (BMI)

"Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, which is a choice"

First of all comparing my situation to a paraplegic is irresponsible and to be honest just flat stupid.   A paraplegic gets no muscle stimulation in their legs and sadly they lose muscle mass and their legs are nothing but skin and bones.  Their exercise is limited to upper body exercise and it is easy to maintain that the active muscles in your body are minimal. 

The fact that the examiner and rater state that my excessive food intake and lack of physical activity is a choice I made shows they ignored my statements.  In my personal statement, a statement from my spouse and ex-spouse we all stated the pain I am in when I try to exercise and we also all stated the numerous diets that we tried and was unsuccessful in my losing weight.   Then you have to take into account I have asthma and I have to take medication daily to control it.  My asthma is service connected as well.  I have a lot of shortness of breath when I exercise.

What a complete joke.

Just a question, Did you have a IMO that your condition is at least likely as not cause by your service connected conditions and or the medications that treats your service connected conditions?

[JKWilliamsSr]

1 hour ago, pacmanx1 said:

Just a question, Did you have a IMO that your condition is at least likely as not cause by your service connected conditions and or the medications that treats your service connected conditions?

Yes I did. From a board certified MD and they a Nurse Practioner more weight.

[Hucast21]

1 minute ago, JKWilliamsSr said:

Yes I did. From a board certified MD and they a Nurse Practioner more weight.

The same happened to me - the DRO gave more weight to the NP than the IMO by a board-certified specialist.

Take it to the BVA like I did, and then both of us just have to wait for our win.

It’s ridiculous but this is the game the VA wants us to play.

[pacmanx1]

Unfortunately, there are many times when veterans have to appeal to BVA or higher to get his/her claims granted.