Denied

[Disenchanted]

Good morning, new member here recommended by a fellow shipmate. We were all in the same squad at the same time as our admin @Tbird was. So you know it’s been a while since we were at 34 together.
I was an AMS and worked in airframes. 
I just found out my disability comp was denied. Zero percent service related disabilities. I’m fn numb. 

My claim included lumbar disc disease, but someone in their infinite wisdom at the VA put cervical spine, not lumbar. I don’t have any concerning issue with my neck. The reams of documentation I submitted all said LUMBAR.  
 

It got bad enough to require surgery because of non-existent discs, so a fusion was done S1-L5. My second claim was interstitial lung disease. We all were exposed to so many chemicals - we were dumb enough to douse our skin with freon to cut the hydraulic fluid. When I went for my C&P exam (drove an hour to get there), I get there and the nurse practitioner is conducting the exam 10 feet away from me from behind her desk. I ASKED for her to do a pulmonary function test on me, bet she said she couldn’t because, Covid. She never even listened to my lungs with a stethoscope. I was out of there in under 5 minutes

I keep getting worse every day. I had a cardiac catheterization because I bad an 80% blockage on my left ascending coronary artery. I never ever had a cholesterol issue and my lipid profile has always been pristine. 
 

Guys and gals, I don’t know what to do.
Do I request to open up a new claim? 
Do I appeal? I assuredly will be dead before the decision. That’s what they wast, I’m sure. Thin that heard.

thank you in advance for your recommendations!

Disenchanted
 

[ShrekTheTank]

13 minutes ago, Disenchanted said:

Hey guys! I’m back to provide you with my beautiful denial letter. I never did get it in the mail so I jumped through flaming hoops to download it. They don’t make ANYTHING Vet friendly. 
The letter does not mention the fk up they made by my claim of lumbar radiculopathy and chemical exposure at all.

But here it is. Thank you all for your guidance!! 
D.

This is not the denial letter.  This is only talking about the possible benefits.  The letter you are looking for will talk about everything in your claim and give their reasoning for the denial.  

[Disenchanted]

40 minutes ago, shrekthetank1 said:

This is not the denial letter.  This is only talking about the possible benefits.  The letter you are looking for will talk about everything in your claim and give their reasoning for the denial.  

Hi Shrek, as I looked at it more and used the “Blue Button” on the site, I realized that there were no diagnoses/ problems listed on this letter in order to send in the appeal. On the site, it said decision has been made but it didn’t give me a percentage rating, only a link to go to another site where I found this. Sorry I jumped the gun and thank you for clarifying this. 
I’ll keep you all posted!

D.

[Disenchanted]

On 10/2/2021 at 9:09 AM, Disenchanted said:

Hi Shrek, as I looked at it more and used the “Blue Button” on the site, I realized that there were no diagnoses/ problems listed on this letter in order to send in the appeal. On the site, it said decision has been made but it didn’t give me a percentage rating, only a link to go to another site where I found this. Sorry I jumped the gun and thank you for clarifying this. 
I’ll keep you all posted!

D.

 

Hi friends,

Ok here it is, the denial letter in all its glory. I want to fn throw up. 
 

Disenchanted to the 10th power

 

[Disenchanted]

4 minutes ago, Disenchanted said:

 

 

[Disenchanted]

28 minutes ago, Disenchanted said:

The lung scaring thing - I submitted a list of 15-18 chemicals I was exposed to. When I had my VA exam for my lungs, the nurse practitioner did not even come out from behind her desk to even listen to my lungs. I asked her if she planned to do a pulmonary function test (PFT) and she said sarcastically that she would love to do a PFT, but, because of Covid…I didn’t get it done.

Cervical radiculopathy was in my original claim, but I also claimed “radiculopathy” which lead to having a spinal fusion in 2020. It got worse from an initial injury while in service. I went to sick call many times regarding it. The numbness in bilateral legs was a result of this lumbar radiculopathy. 

[pwrslm]

Prior to your claim, did you get copies of your Navy medical files from St Louis?

Documenting the event in service for visits to the sick call is in the file. You also need to get copies of your DD201 file, showing your duty assignments, and link exposure to the records. You also said there were people that you knew before that you are in contact with. They can give you buddy letters confirming certain details about your service. Everything they denied appears to land on a connection to your service. Your lay statements on each individual part of your claim should be very detailed and give dates (from and to), assignments, and job description when the exposures occurred. Your statements should coincide with your active duty records and the medical evidence for a win. Example:

Lay statement intro

     1. info on claim 1

     2. info on claim 2

     3. info on claim 3

     4 info on claim 4

Summary and sign

Keep it within reason, no 10 page documents, maybe 2 would suffice, a single concise paragraph on each. You have up to 1 year to submit supplemental claims with new evidence.

The errors in your claim on the cervical/lumbar issue should be addressed in a supplemental claim. Present info on your lumbar condition, and add a lay statement telling them about the sick call visits. They will need to address the error, and include as new evidence the info connecting the lumbar to your active duty service. Should get cleared quickly.

On exposure to chemicals, you need to clearly document where and when you were exposed, and link it to the records in your 201 file and/or the military medical records. Research some of the chemicals because some of them were commonly used in 66. Try to add info on exposure into your supplemental. You must document that for the idiots that run the circus so to speak.  Get your pulmonary specialist to directly address the effects of some of the chemicals and how they affect lungs (like JPS) included in your letter. The confirmation of cause and effect from your MD will seal that deal with documentation of your duty position in your 201 file.

Was your C&P examiner a VA or outside contractor? Non-VA contractors can be BAD. After you get the mess cleared, maybe think about an IG complaint.  Veterans deserve better service than what you got, there is no excuse for the failure of the examiner missing documented medical facts like that. If IG gets enough complains on the issue, they will check it out and maybe get it addressed.

Edited October 6, 2021 by pwrslm