Just had my LHI c & p for Rhinitis. It lasted 5 minutes and they didn't do the Gulf War DBQ requested by the VA.

[talusians]

I applied for compensation for Rhinitis. Service connection is presumed based on my time in Iraq in 2003, but it is also noted in my exit exam when I left service. The c & p was set up through LHI and I had the appointment today. Service Requested on the appointment confirmation says DBQ General Medical Gulf War, DBQ ENT Sinusitis, Rhinitis & Other ENT Conditions, DBQ Medical Opinion - MED: ENT Sinusitis, Rhinitis & Other ENT Conditions. The appointment was supposed to last 75 minutes. I went in at noon and was out at 12:05. I know for a 30% rating for Rhinitis, I would have to have nasal polyps. I don't know if I do. I asked the evaluator about it and she said an endoscopy would need to be done and that she didn't know if I did, but probably not. Ok. How would the evaluator answer the nasal polyp question on the DBQ? I'm assuming she would need to leave it blank. Will the VA ask for an endoscopy before rating me? If I end up only being rated 0% after being properly evaluated, that's fine, but I do plan on adding my asthma, vocal cord dysfunction and Eustachian tube dysfunction as secondary to Rhinitis once it's on my record. Has anyone had success doing this? Also, I wasn't asked anything on the Gulf War DBQ. I did call the VA and report that it wasn't done as requested because I don't want to find out later that this doc turned it in with made up answers. Has anyone had this happen before where an evaluator does not do any type of exam or ask any questions for a DBQ the VA requested?

[broncovet]

May I remind you we are compensated for "symptoms" not diseases.  This is important to understand because pyramiding prevents you from being compensated for the same symptom twice.  

Example:  Lets say your rhinitis causes a symptom of breathing problems.  But your polyps also causes breathing problems.  Getting SC for polyps and rhinitis may not help your compensation level, if they have similar symptoms.  

Some Vets feel, "well I was diagnosed with abc so I should be compensated for that".  Not exactly.  

A great example of this is with mental disorders.  Lets hypothesize you have PTSD AND depression.  Lets say you are compensated as a symptom for "outbursts of anger" which harms personal relationships.  You wont get paid for the same symptom with MDD and PTSD.  

So, in this mental health example, it may not help you to apply for PTSD if you are already being compensated for the same symptoms with MDD.  

 

[talusians]

15 minutes ago, broncovet said:

May I remind you we are compensated for "symptoms" not diseases.  This is important to understand because pyramiding prevents you from being compensated for the same symptom twice.  

Example:  Lets say your rhinitis causes a symptom of breathing problems.  But your polyps also causes breathing problems.  Getting SC for polyps and rhinitis may not help your compensation level, if they have similar symptoms.  

Some Vets feel, "well I was diagnosed with abc so I should be compensated for that".  Not exactly.  

A great example of this is with mental disorders.  Lets hypothesize you have PTSD AND depression.  Lets say you are compensated as a symptom for "outbursts of anger" which harms personal relationships.  You wont get paid for the same symptom with MDD and PTSD.  

So, in this mental health example, it may not help you to apply for PTSD if you are already being compensated for the same symptoms with MDD.  

 

Hi broncovet. Thanks for the reply. I am familiar with pyramiding as I am rated the same for thoracic outlet syndrome and cubital tunnel issues because they affect the same nerve in my right arm, which is the ulnar nerve. I keep mentioning polyps because that is the rating criteria for 30% for rhinitis, which is the highest you can get for that issue. The rating is 10% without ployps, but with greater than 50% obstruction on both sides or full obstruction on one side. I don't think checking to see if I have them prior to a rating decision is too much to ask. Honestly, I don't know how they would rate my rhinitis without having that information. 

[deedub75]

Chronic rhinitis and chronic sinusitis are rated separately and I am service connected for both. I'm rated 30% for rhinitis and 50% for sinusitis. I don't really remember having C&P exams for either one of these. I had tons of record for both of these and I also had sinus surgery to remove polyps and open up the sinuses.  

Do you see an ear, nose and throat doctor? They can easily use an endoscope in the office and look for polyps. I think they would also show up on a CT scan of the sinuses.  

Edited August 27, 2021 by deedub75

[talusians]

46 minutes ago, deedub75 said:

Chronic rhinitis and chronic sinusitis are rated separately and I am service connected for both. I'm rated 30% for rhinitis and 50% for sinusitis. I don't really having C&P exams for either one of these. I had tons of record for both of these and I also had sinus surgery to remove polyps and open up the sinuses.  

Do you see an ear, nose and throat doctor? They can easily use an endoscope in the office and look for polyps. I think they would also show up on a CT scan of the sinuses.  

Thanks deedub. I'm sorry you have had so many issues with rhinitis and sinusitis. Hopefully you are doing well now after your surgery? I have seen an ENT through Kaiser for it. They were the ones that also diagnosed my asthma and vocal cord dysfunction. My next move, if the VA doesn't do an endoscopy, is to go back to them for it. I mean, I may not have any polyps, but I'd like it ruled out officially. I had already decided to go back to them anyways and get everything squared away, documentation wise, for the secondary conditions. My rhinitis started in service, but all of this other stuff has developed and continues to worsen in the 17 years since I left Iraq. I probably had asthma in service because I remember not being able to get enough air and passing out in the barracks after runs, but I never saw anyone for it so I can't prove it. Rhinitis can certainly effect asthma though. I've just mainly dealt with everything by taking allegra D every once in awhile since you're not supposed to take it daily, using my inhaler, avoiding caffeine...etc, but the heavy smoke Colorado has had the past few years is driving me bonkers. I can't stand not being able to get full breaths, having trouble swallowing, constant drainage, hoarse voice and having this constant clicking and plugged effect in my right ear, feeling sick and getting headaches every freaking day. It is exhausting and makes it hard to concentrate to work. So I finally filed after I saw the rhinitis presumptive service announcement come out, checked my records and put two and two together that all of this is easily service connected.

[deedub75]

I'm doing fine now because it's manageable. I am having a flare-up now and I'm on antibiotics and steroids. 

Chronic rhinitis and sinusitis can be very debilitating. At one point before I had surgery, I was having bad sinus infections every other week. I would get really sick with headache, vomiting, etc. It would know me out for a few days. It even cause me to have a really bad ear infections with vertigo. 

Mine developed in service as well. I guess moving from Mississippi to Fort Bliss, TX wasn't good for my sinuses because I had my first sinus infection after moving there. I got treatment for it there and fortunately the doctor I saw on base wrote in my records that that Afrin or whatever it was that I was given made my conditions worse and made them chronic. There was my IMO! Unfortunately when I was being discharged I didn't know a thing about filing a VA claim so I left active duty with a 20% rating. I didn't know I could file for things like rhinitis, sinusitis, tinnitus, etc. It wasn't until years later when I started working for the VA and I was processing claims for these very things and then I started filing claims for these. I already had the in service event in my STRs and I had extensive records from my ENT.  

[pwrslm]

If you have two conditions that would be considered pyramiding, you should still claim them. The higher rating between the two will be used, and the other will still get SC at 0%. Trust the rating officials, but if they do not rate it correctly you can correct it. CUE is much more common than people think.

 

If one or the other gets worse over time, raters are required to analyze and award whichever would be higher. Claim everything today because tomorrow is unpredictable. If something will kill you in 30 or 40 years, it will be much more difficult to claim in 30 or 40 years, so do it today.

Also, polyps can develop into cancer. I would think the VA would start monitoring them annually at the least for preventive care.

Edited August 30, 2021 by pwrslm