Increasing Narcolepsy Rating

[scottishere99]

I have a few questions I'm looking at trying to increase my Narcolepsy rating and I'm trying to figure out what all i will need.   I already have 10 people that i work with whom are retired military and military members that have told me that they will write statements  to me falling asleep at work 5 to 7 times a day along with my wife's statement.  i was told that i dont need a Nexus letter when trying to increase a rating, so what would i have my Neurologist that's  been treating me the past 8 yrs. last question is when i was going through my VA appointment's (all done by civilian doctors) i had not noticed a mistake until last year, the mistake is when i was asked about the minor seizures i told the doctor i experience between 5 to 7  a day but last year i noticed that he had put 5 to 7 a week.  the difference from 40% to 80% disability.  I understand i should have reviewed the paperwork after receiving my disability letter in 2009, and I'm not looking to get back pay just want to get the rating i should have gotten with the right wording that should have been put in the report.  this is so confusing and i dont have the money for one of these law offices to take my case.  So I'm hoping with all the knowledge in this group i will at least get steered on the right track.

[GBArmy]

scottishere99 The good news is you have the rating s-c, so you don't have to obtain a nexus. Several Buddy letters are a good start on getting the increase you need.Obviously, your current symptoms have to meet the criteria for an increase. Berta posted a resource back on 1-6-17, but it is gone; maybe she could re-post or add to this string. You don't say what your rating is, but I assume your current rating for Narcolepsy is at 40%.  But whatever the situation is, if you can't work, then you should also be considering IU. If your appeal gets to a combined rating of 70% and you meet the IU criteria, you should be putting in for that if the VA doesn't start the process as they should. This is an easy claim to appeal the rating, but not necessarily an easy one to win. Your comment about not being able to afford a lawyer, though, is a little misguided. You're looking for a big increase in a disability rating on a not too common illness. If you hire a lawyer and they win, it will cost you about 20% of the BACKPAY. That is not going to be coming out of your pocket, it is a piece of new money coming in. You should talk to a few lawyers and see a)if they are interested in taking your case IMHO. If they are, then you have a reasonable expectation they can win; they don't take cases they expect to lose. B) if they don't want to take your case, find out what they think in addition you need to win.

[Berta]

Yes that link would not open GBA, for me either , but there are many claims decisions at the BVA for this disability-many more recent than that one in the 2017 link.

And I agree with you as to the 40%.

"As for minor seizures, the General Rating Formula for Major and Minor Epileptic Seizures provides that a 10 percent evaluation is warranted for a confirmed diagnosis of epilepsy with a history of seizures; a 20 percent evaluation is warranted for at least two minor seizures in the past six months; a 40 percent evaluation is warranted for averaging at least five to eight minor seizures weekly; a 60 percent evaluation is warranted for nine to 10 minor seizures per week; and an 80 percent evaluation, the maximum for minor seizures, for more than 10 minor seizures weekly. 38 C.F.R. § 4.124a, Diagnostic Code 8911. Note (1) to the general rating formula states that when continuous medication is shown necessary for the control of epilepsy, the minimum evaluation will be 10 percent. This rating will not be combined with any other rating for epilepsy. 38 C.F.R. § 4.124a, General Rating Formula for Major and Minor Epileptic Seizures, Note (1)."

 

https://www.va.gov/vetapp20/files3/20018187.txt

Scottishere-I am unaware of whether these ratings changed since you got the 2009 decision.

Do you get 40% now for this? Both I and GBA are assuming you do.

You said:

 

 "the mistake is when i was asked about the minor seizures i told the doctor i experience between 5 to 7  a day but last year i noticed that he had put 5 to 7 a week.  the difference from 40% to 80% disability.  I understand i should have reviewed the paperwork"

What triggered the doctor to put that into the record? Was this another C & P exam?

Have you filed a claim for a higher rating?

If you get less than 40% now I feel those co worker's statements will help you and I also feel maybe your private doctor might be able to write a brief IME to bolster your claim. 

 

 

 

 

[scottishere99]

6 hours ago, Berta said:

Yes that link would not open GBA, for me either , but there are many claims decisions at the BVA for this disability-many more recent than that one in the 2017 link.

And I agree with you as to the 40%.

"As for minor seizures, the General Rating Formula for Major and Minor Epileptic Seizures provides that a 10 percent evaluation is warranted for a confirmed diagnosis of epilepsy with a history of seizures; a 20 percent evaluation is warranted for at least two minor seizures in the past six months; a 40 percent evaluation is warranted for averaging at least five to eight minor seizures weekly; a 60 percent evaluation is warranted for nine to 10 minor seizures per week; and an 80 percent evaluation, the maximum for minor seizures, for more than 10 minor seizures weekly. 38 C.F.R. § 4.124a, Diagnostic Code 8911. Note (1) to the general rating formula states that when continuous medication is shown necessary for the control of epilepsy, the minimum evaluation will be 10 percent. This rating will not be combined with any other rating for epilepsy. 38 C.F.R. § 4.124a, General Rating Formula for Major and Minor Epileptic Seizures, Note (1)."

 

https://www.va.gov/vetapp20/files3/20018187.txt

Scottishere-I am unaware of whether these ratings changed since you got the 2009 decision.

Do you get 40% now for this? Both I and GBA are assuming you do.

You said:

 

 "the mistake is when i was asked about the minor seizures i told the doctor i experience between 5 to 7  a day but last year i noticed that he had put 5 to 7 a week.  the difference from 40% to 80% disability.  I understand i should have reviewed the paperwork"

What triggered the doctor to put that into the record? Was this another C & P exam?

Have you filed a claim for a higher rating?

If you get less than 40% now I feel those co worker's statements will help you and I also feel maybe your private doctor might be able to write a brief IME to bolster your claim. 

 

 

 

 

Yes I've been at 40% since 2009,  that was my initial va exam when I got out it was with a civilian Dr. 

 No I haven't filled a claim for higher ever.  I know that I have people that will verify that I will fall asleep 5 to 7 times a day just at work let alone 3 to 5 times at home, has been this way since 2009.

I've been waiting for my service medical records for over 1 1/2 years and the last information I got on that was it would be out to me in May well August and still nothing.

I'm now on 2 of the strongest medicines for treatment and I still fall asleep at least 5ctimes a day at work or the same at home so that would put me around 30 times a week on the low side.  I've also have  missed work on 3 occasions this year due to not being able to wake up to go to work.

So what would be the best way to go at this? i have my old and new sleep studies, my Dr will write me a buddy letter or this IME you mentioned , and I have officers and retired military along with enlisted that will do a buddy letter approximately 30 people to write letters. (Would 30 be an over kill).  With out my medical record and time expiring from when I put the notice I was going to submit a claim in September of 2019. Should I submit what I have and see what happens or get a firm to take on my case?  

I'm only asking for advice and help in the direction of what to submit how to submit and if I do it my self and its denied can I still retain a firm to try again?

[GBArmy]

Yes, if it is denied you can submit a supplemental claim, providing you have new and relevant evidence.

[scottishere99]

1 hour ago, GBArmy said:

Yes, if it is denied you can submit a supplemental claim, providing you have new and relevant evidence.

So should I send all thenewreports on my new sleep exam this time 

[GBArmy]

You send everything that supports your contention that supports a worsening of your symptoms. I assume you never submitted buddy letters before, so yes, your wife should and you especially; how does this effect your work, with others at work and socially. If you go for IU, you want to start to build evidence about your issues at work, family and others socially. How about people in general. Any issues  about staying employed because of all the time you lose? etc. maybe a couple more. !0 is overkill. Get your doc to comment on your now current conditions as they compare to higher ratings. How it affects you at work. sleep exam is good; does it support your position and was done by a certified tech or whatever? It might result in you not having to do it again for the VA. At least is is evidence that they have to consider. As you already know, if denied,they will say why and you go from there.

[scottishere99]

42 minutes ago, GBArmy said:

You send everything that supports your contention that supports a worsening of your symptoms. I assume you never submitted buddy letters before, so yes, your wife should and you especially; how does this effect your work, with others at work and socially. If you go for IU, you want to start to build evidence about your issues at work, family and others socially. How about people in general. Any issues  about staying employed because of all the time you lose? etc. maybe a couple more. !0 is overkill. Get your doc to comment on your now current conditions as they compare to higher ratings. How it affects you at work. sleep exam is good; does it support your position and was done by a certified tech or whatever? It might result in you not having to do it again for the VA. At least is is evidence that they have to consider. As you already know, if denied,they will say why and you go from there.

Not going for UI at this time.  Yes I need to set down and try to write a letter.  How many buddy letters should I send and should my neurologist write a letter also and if so what should she put in it.  I dont mean to bug you im just been waiting for my medical recordand its been over a year and a half.  I want to thank you and everyone else that are spending time helping me 

[GBArmy]

I already answered both questions.You and your wife and maybe a couple more on buddy letters. If your doc can add to your evidence by commenting on your symptoms now meet a higher rating threshold, sure get that too. The more meaningful evidence the better. You said you weren't going for IU before. You're missing the point. If you are considering that as a future option, why not provide evidence of impact to work/social now to build that evidence ? It's like a game of chess; plan ahead.

[Berta]

Great advice from GBA and also- I noticed in the BVA decison above, that this veteran was unable to drive, due to the narocolepsy-so that could also be a factor if you ever apply for TDIU.

It will not be the strongest point you will need to make, but if one cannot drive that impacts on their ability to work and socialize.

It is great that your employer accommodates you.But one never knows when a company will change hands or change their managers or even change their policy on accommodations.

" It's like a game of chess; plan ahead."

Indeed!!! You are right GBA!