Secondary questions

[Bluslim]

Hi, and thank you all for any help. I am currently at 40%  and recently applied for Insomnia as a secondary condition. The CP exam ruled in my favor, but the VA said the Insomnia is caused by headaches which is a current secondary condition.I was denied. And to make matters a bit worse,  I asked for an increase for my headaches and sent in medical paperwork to show it got worse.  The CP exam there showed in my favor they were getting worse, yet the VA sent me a request for evidence to continue the rating. I wrote on my statement I have headaches, but its the tinnitus which keeps me up.  My doctor wrote some additional stuff, and said he doesn't know who reviews these things, but sometimes they reach. As far the headaches go, I don't think they even looked at what I sent. 

So my question is:   If my headaches are a secondary condition and they are part of another condition it is not rated? I mean the tinnitus is the epicenter of the causes. Any help or insight

[broncovet]

Welcome to VA where you have to fight for every nickel.  You will have to appeal this by filing a nod.  I suggest you read your file to know which path of appeal to take.  

1.  "If" you already have the Caluza elements (only 2 are needed for secondary SC, current diagnosis and nexus to your primary SC), then you may be able to get by without new evidence, but, remember, you dont know what evidence is "actually in your file" in real time except by viewing your VBMS file.  

2.  Or, if some of your evidence is missing, then you will have to appeal with new evidence.  

     In either case, my advice is to go to the BVA and skip the HLR or SCL, but you are welcome to try those also.  

[GBArmy]

Bluslim I think you should redact your personal info,name etc., and post it to this string. We need to see the wording on your decision letter. For a successful claim for a secondary condition, you must have a IMO from doctor, a specialist is best, that provide the rationale that x causes y. The doc has to provide sound medical evidence, like studies from sleep studies, medical journals, etc. and he has to state what degree of confidence that this pertains to you. Assuming that headaches cause insomnia (I have no idea), unless you already have a s-c disability that doesn't get you a pyramid effect, you should have a case. But we just can't do much with the info you have provided.

[trun10tion]

23 hours ago, Bluslim said:

Hi, and thank you all for any help. I am currently at 40%  and recently applied for Insomnia as a secondary condition. The CP exam ruled in my favor, but the VA said the Insomnia is caused by headaches which is a current secondary condition.I was denied. And to make matters a bit worse,  I asked for an increase for my headaches and sent in medical paperwork to show it got worse.  The CP exam there showed in my favor they were getting worse, yet the VA sent me a request for evidence to continue the rating. I wrote on my statement I have headaches, but its the tinnitus which keeps me up.  My doctor wrote some additional stuff, and said he doesn't know who reviews these things, but sometimes they reach. As far the headaches go, I don't think they even looked at what I sent. 

So my question is:   If my headaches are a secondary condition and they are part of another condition it is not rated? I mean the tinnitus is the epicenter of the causes. Any help or insight

Hi well we first need to know what are your primary conditions. Then i can try to.help you

My self i got up 70% with out a lawyer. Once i got a lawyer v.a. said opps we made an error

An bump me up to 80% before the lawyers papers ink dried. Lol on my profile is my email

If you want advise and diy or i can shoot to u me vet lawyer no fee unless win

Shes good.

[flow1972]

I'm not aware of a regulation that states an SC'd "secondary" cannot be SC'd to another condition that it causes or aggravates.  For example, I am SC'd for PTSD.  I'm SC'd "secondary" on IBS/GERD.  GERD is causing Esophageal spasm which I currently have a claim in for.  As long as the rating structure is followed and not pyramided, I can't see how it can be denied.

[broncovet]

Yes, flow1972, you can "daisey chain" secondary's.  Example:

You are sc for diabetes.  This can lead to secondary conditions for high blood pressure, which can lead to secondaries to kidney problems, which can lead to peripheral nueropothy, which can lead to loss of use of a foot.  

[flow1972]

6 minutes ago, broncovet said:

Yes, flow1972, you can "daisey chain" secondary's.  Example:

You are sc for diabetes.  This can lead to secondary conditions for high blood pressure, which can lead to secondaries to kidney problems, which can lead to peripheral nueropothy, which can lead to loss of use of a foot.  

Yep, this is what I found:  Federal law under 38 CFR 3.310 governs these claims, and once granted, the secondary condition is considered a part of the original condition.