hypertension Response To Vike's Request

[Ricky]

Ok Vike here you go: Service connection is no problem. In Jan 05 I had a stroke. In Feb/Mar 05 after Hospital, MRI and neurologist verifed that it was a stroke that was causing the paralysis of the left face, hand and foot. All three MEDICALLY DIAGNOISED this paralysis as Dejerine-Roussy Syndrome resulting from the Jan 2005 stroke.

The claim was submitted in Mar 05 less than 60 days from the occurance of the stroke. In the claim it was asked that a claim be established for the stroke, secondary to ALREADY SERVICE CONNECTED hypertension and DMII under CFR 38 disability code 8008. As per 8008 it was asked that a 100 percent rating be assigned for six months effective Mar 06. (8008 provides "Rate for six months as 100 percent then rate residuals). Claim was submitted with the MRI results, neurologist's treatment records, PCP treatment records and hospital records. All records provided that in Jan 2005 I suffered a right thalamic CVA. The neuro records and PCP records provided the diagnosis of dejerine-roussy and provided their objective findings of the paralysis caused by the dejerine-roussy syndrome. Neuro and PCP provided IMO's tying the stroke to my service connected hypertension and DMII. All of this was submitted with the claim.

Since the dejerine-roussy had already been diagnosised the claim also asked that at the end of the six months the claim for dejerine-roussy be established as residuals of and secondary to the Jan 2005 stroke. It was provided that the dejerine-roussy (along with medical diagnosis and IMO's) affected the left face, arm/hand and leg/foot and the objective findings as to the level of paralysis of each body section.

In July 05 a C&P was scheduled. C&P results provided that the stroke did occur, and I had paraslyses in the left face and upper and lower extermities with constant pain. One examiner opined that forward propeltion and push off power of left lower was extermely limited. muscle strength was 1/2 of 5 yada yada yada...........

In a July 05 Rating Decision it stated that " you reported that in Jan 05 you suffered a right thalamic CVA. During a VA examination you were objectively found to have ..........A REPEAT OF THE DOCS STUFF FROM THE C&P.............

As a result a rating of 10 percent is assigned for CVA with the residuals of Dejerine-Roussy syndrome effective February 2004 (NOW THIS IS A YEAR BEFORE THE STROKE HAPPENED AND THE CLAIM WAS FILED. I guess some would say they were being generous to me). A higher rating of 100 percent is not warranted due to "an absense of a current or recently active disease". THAT IS ALL IT SAID. NO OTHER REASON WHY THE 100 PERCENT FOR THE REQUIRED SIX MONTH PERIOD WAS NOT AWARDED; NO REASON WHY THEY DID NOT AWARD SEPERATE RATINGS FOR THE FACE, ARM/HAND AND LEG/FOOT AS REQUIRED BY CFR 38. NO MENTION WHY THE MEDICAL EVIDENCE (HOSPITAL RECORDS, MRI AND DOCTOR STATEMENTS WERE NOT ACCEPTED NO IF THEY WERE PROBATIVE OR NOT. NOTHING - NADA - JUST A HERE YOU GO BUD TAKE IT AND BE HAPPY.

End of Aug 05....... Dejerine-Roussy had increased to a point that I could not use my hand or foot. They were there, however, outside the constant unrelenting pain I could not tell where my hand and foot were, falling and limited to daytime movement because I had to watch my foot as it moved. Neuro provided an IMO style report in that he readdressed the original cause of the disease and his new objective findings and diagnosis of functional loss of use of foot and hand.

In an Aug 05 NOD I addressed the issues with the rating decision - I pointed out that 8008 simply stated Rate at six months - 100 percent. It did not provided any required time line for the stroke, although I could understand if the stroke occured over a year ago could be a limiting factor in assigning the 100 percent rating, my claim had been submitted within 60 days of the occurance of the stroke. I also argued the point that the rating decision of an absense of a current or recently active disease was crazy since the hospital report, mri's, neurologist report, treating physician and VA examiners had provided in their medical evidence statements and opinions provided that the stroked occured in Jan 05 nor would it have been possible for the stroke to still be occuring in July 05 during the C&P as accepted medical lit and doctrine provided that a stroke was sudden and lasting only from a few minuets to a max of 48 hours. As a matter of fact the radiologist and neuro doc provided that no evidence of prior or older infarcts was present (this was important to my future treatment.( I provided a bunch of other arguments such as what happened to my evidence and why was it not used to establish the award of the claim; why did they not provide seperate ratings for the face, hand and foot as required per 38 CFR etc.......Berta reviewed it.

Based upon the increase of paraylsis and new medical evidence being submitted with the NOD I also asked that they now consider the claim for residuals under (oops forgot the correct code) which provides that loss of use of one foot and on hand be rated as 100 percent along with a rating for the face.

Sent it all off with new doc reports and IMO's. In Jan 06 (4 months after submission of NOD) I got SOC which provided no further detail than that of the rating (it was a true cut and paste job). Still no reason why the medical evidence failed to establish the award nor why the absense of any contary evidence held by the VA was provided/referenced by the SOC if that is what they used to deny the claim. STILL NOTHING - NADA

Now don't take this wrong Vike - I do not believe you can explain their actions. Plenty of medical evidence exist to merrit this claim (hell they did service connect it even established an effective date 1 year prior to the submission of the claim). All evidence provides a diagnosis of Jan 2005 CVA, Dejerine-Roussy syndrome affecting left side (face, hand, foot) and the objective findings of the docs along with their fully rationalized IMO's. As of todate the VA has not refuted any of the evidence - they simply have provided a rating without providing any reasons or basis for their actions. I understand your comments about medical evidence (I have being doing this for a while). I did not submit a claim (or I should say my wife cause she did the original claim for me)without merit or a claim that could be called frivious in any way. SO HERE WE SIT STILL WAITING OUT THE RO TO SEE WHAT THEIR NEXT STEP WILL BE. So far they have refused me a DRO hearing at the RO cause at first they lost the request and would not accept the green mailer where they signed for it. Then they stated they have a heavy work load so they do not conduct any such hearings (hmmmm did not know heavy work loads over ruled US Code and US Regulations-guess you learn something new every day); they have failed to take action on two other claims that have now been pending for over 30 months (in response to my last inquiry they told me that 30 months was still well within the timeframe alloted for initial claims). Neither of the claims are out of developement cause they say the appeal must be resolved first (this is kind of backwards from most RO's) and on, and on, and on rolls the wheel. I just want the opportunity to sit face to face with the idiots. Nope I am not mad. The only way I can deal with the pain on a daily basis (narcotic drugs has no effect on dejerine roussy so they have not and will not be prescribed) is to read and re-read the rating decision and SOC and laugh. Now I do not expect you to attempt to provide an explanation for my situation nor understand it. I realize that you and others like you are usually dealing with RO's that are slow but somewhat competent. However, I did want all to realize that such things do occur and just because a vets presents such a story does not mean he has sat around on his butt wishing for a hand out. Although I have a legal and law enforcement background does not mean my claim is any more well grounded than any other veterans but I can assure you that my claim, evidence and all other factors were in order before this event unrolled itself. I told a summary of this story on the other vet site a while ago..... jez did I ever take a licking. You would have thought I kid napped their god, good ole SEC Nic and held him for ransom. Now just like the old folk tales we used to hear as children, you can believe me or not. If you do thanks for your support; If you don't God bless you and I really did not need your support any way cause believe it or not I do kinda know what I am doing I just have to get around an incompetent RO (this was not to you personally Vike it was just a general statement.) I spoke with the VAIG about this. I was told we don't investigate these items. This is a non-adverserial system inwhich you have specific rights...... before he could get any further, I fell to the floor and went into a non-stoppable laugh...... thought I was going to pee-pee in my pants. The better half had to nearly carry me out of the office cause I could not stop laughing. Makes me think about the current situation in which the Prez has put ole Sec Nic in charge of the commission to review VA health care hahahahahahahahahahahahahahaha..... what the hell was he thinking? The wolf in charge of the hen house - what a novel concept.

Hopes this meets the mark and clears up the fact that I have not submitted claim lacking merit without any medical documentation.

Edited March 8, 2007 by Ricky

[Vike17]

Ricky,

Now I remember your claims!!! If my memory serves me correctly, I did explain what happened to your claim(s). I do remember that your situation is/was a mess!!! You had nuemrous NOD's going at different times with different issues (residulas of the stroke with a mysterious effective date, back claim, missing evidence ect...) Go back to my response to you in regards to all of this in your thread "Actions during appeals," which is currently on page 71 of this forum. There are also responses from on your claims on pages 70-68 also.

If there have been any additional things that may have come up since those post in July and August, go ahead and post them and maybe I can be of some more help.

Vike 17

Edited March 8, 2007 by Vike17

[Ricky]

Yes Sir, you did offer some explanations and I appreciate that. Sorry I took up your time. There is one VA 9 pending, one Nod pending. The Nod is a result of the SOC they issued. I did not want two appeals pending at the same time but my 60 days was running out on the first NOD then the 1 year period was running out on the SOC issue so I had to go ahead and send in the second NOD on the EED and increased rating on my back issue. It is not that I tried to clutter the system but I had to comply with the time lines established by the VA. The only new information is that a recent IRIS inquiry provided that I would get my DRO hearing. They stated that the DRO hearing would allow for the discussion of all issues contained in the Form 9 and the NOD. I guess I am back on track with them if they hold true to their word. I have some new medical evidence to provide. However, I am afraid they are going to try an change the EED on the VA 9 issues. The loss of use occured in Aug 05 while the first NOD was pending so I provided that evidence at that time. Since that time they have braced my left leg in an attemp to allow me to ambulate effectively. The brace provides support for my ankle whis is so weak it just folds over when attempting to walk and also provides shock viberation which travels up my leg to a point that has feeling. This allows for me to tell when the foot strikes the ground therefore allowing me to walk without having to watch my foot. Sure makes a world of difference. However, like I said the medical evidence establishes the loss of use effective Aug 05 and then I have all of this recent new evidence and I am afraid, based upon their past performance, they are going to accept the evidence and say, hey yep you do have loss of use of the foot based upon medical evidence provided at the DRO hearing so your rating is effective 15 April 07 the date of your DRO hearing. My question to you and all my HADIT buddies is should I just hold this new evidence and and continue to fight the claim with the evidence in the file that they have up until this point ignored or should I submit the new evidence to support the claim now. Any comments from all would be appreciated. I promise guys this is the last you will hear about this whacky claim. I know we are all at the point to where we think, jez Ricky yep you got problems as you have shoved them down our throats hahahahahahahahahaha. At this point it looks like things are on track and I willl have the opportunity to sit with a DRO and ask him why the evidence appears to have been ingnored yada yada yada, these same questions I have been bugging you guys with over the past two years. Bottom line without the concern and compassion of you guys I would not even be to this point and I truly appreciate all of you guys input. THANKS.

[Vike17]

Ricky,

Just a couple of things;

"I did not want two appeals pending at the same time but my 60 days was running out on the first NOD then the 1 year period was running out on the SOC issue so I had to go ahead and send in the second NOD on the EED and increased rating on my back issue"

You got the two time frames mixed up. You have a year to file the NOD from the date of the rating decision you're disagreeing with and you have 60 days from the SOC to either "perfect" your appeal by sending in VA Form 9, or sendng in "new" evidence.

The only new information is that a recent IRIS inquiry provided that I would get my DRO hearing. They stated that the DRO hearing would allow for the discussion of all issues contained in the Form 9 and the NOD"

Generally, that's what VA will try to do if you have mulitple issues on appeal with different NOD/SOC/SSOC dates. They will try and resolve everything all at once if they can.

"I have some new medical evidence to provide. However, I am afraid they are going to try an change the EED on the VA 9 issues. The loss of use occured in Aug 05 while the first NOD was pending so I provided that evidence at that time. Since that time they have braced my left leg in an attemp to allow me to ambulate effectively...However, like I said the medical evidence establishes the loss of use effective Aug 05 and then I have all of this recent new evidence and I am afraid, based upon their past performance, they are going to accept the evidence and say, hey yep you do have loss of use of the foot based upon medical evidence provided at the DRO hearing so your rating is effective 15 April 07 the date of your DRO hearing"

I suspect if this was a claim you didn't actaully file for and just came up during the appeal, then the effective date could be Aug 2005 or the date you present the evidence and claim to VA. However, if you actually claimed this with all of the other issues the VA will assign the date of the original claim as the effective date.

"My question to you and all my HADIT buddies is should I just hold this new evidence and and continue to fight the claim with the evidence in the file that they have up until this point ignored or should I submit the new evidence to support the claim now"

Why on earth would you want to hold onto any additional evidence that may help your claim; especially if you supposedly sent it in and they got misplaced and weren't available to the decision maker at the time of their decision. You would kick yourself in the ass if you withheld those evidence and then received a denial. Then at some point in time sent them in on further appeal and your claim(s) were granted on the basis of those evidence!

Vike 17

[sixthscents]

Vike,

He's not the only one.. I obviously have misunderstood this myself...

You got the two time frames mixed up. You have a year to file the NOD from the date of the rating decision you're disagreeing with and you have 60 days from the SOC to either "perfect" your appeal by sending in VA Form 9, or sendng in "new" evidence

Could you please go a bit more in-depth here, because I have laways thought you had 60 days to file a NOD, or you couldn't file a NOD. As far as a form 9, I thought that was for a formal appeal... maybe I havent looked at it enough either...

I'm not doubting you, but I have been putting out the wrong information and would like to have the reference for myself.

Thanks

[Ricky]

Six, Vike is totally correct on the time frames. I just threw the post together to fast. Once you receive a decision you have one year from the date of the decision letter to file a nod.

Once you receive a SOC on issues that you have appealed you have only 60 DAYS to perfect the appeal by submitting a completely filled out Form 9.

Sorry my non-proof reading dumbass confused you my buddy.

Vike - when the doc diagnosed the loss of use in August 05 I sent a letter to the VA with the medical evidence and stated that I now wanted to claim my paralysis of the left upper and lower as loss of use based upon the medical evidence attached to the cover letter. My assumption is that this was effective in establishing a claim for loss of use for one foot and one hand.

Up until Aug 05 the medical evidence provided that the effects of my disability was incomplete severe paralysis of the left upper and lower. However, in August 05 I developed a complete loss of preprositional sense in the limbs causing me to lose complete feeling in both. This resulted in my inability to grip and hold items, my hand is now clinched. On the foot, I was unable to walk without watching the action of the foot (so I could tell where it was) along with the inability to tell when the complete weight bearing of the foot struck the ground.

I HOPE MY AUGUST 05 LETTER IS GOOD ENOUGH TO ESTABLISH THE EFFECTIVE DATE AS AUG 05 FOR A RATING UNDER 5111 Loss of Use. My disability due to the residuals of the stroke was progressive. The doctor suggested that every time there was a worsening of the disability I go ahead and submit the evidence to the VA so I did. What do you think about the August 05 letter? Will it be good enough to set the loss of use date at Aug 05?

This brace thing is the brain child of one of my many docs. The dejerine-roussy syndrome also causes a weaking of the muscles and ti has affected my ankle. Based upon this he ordered a special AFO which goes all the way to my knee level. The heal of the brace has a special piece on it that helps to send viberations up the brace to a level on my leg that I can feel. When I feel the viberation I know my foot has made contact with the ground. This is just a continuation of the situation that occurred in Aug 05 and is not new. It has really helped and will assist me in keeping my employment a while longer cause I do not want to quit at this time. Work helps me focus and keeps my mind off the constant pain. As I can still function to a degree except I now have to put in a 200 percent effort to complete my tasks and stay up with my coworkers, my employer, U.S. Gov is very understanding of my disabilities so I plan on working until they put me in the wooden box for that final sleep.

Edited March 9, 2007 by Ricky

[Vike17]

Sixthesense,

Many veterans get the time frames messed up when it comes to appealing a decision from the VA even though they tell the claimant exactly what, how, and when.

O.k. When a veteran receieves a rating decision from VA regardless if it grants or denys service-connection the VA also attaches, I think, the VA form 4107, "Your Rights to Appeal our Decision." Normally it's pink so you can't miss it. Anyways, on that form it states;

"How do I start my appeal? To begin your appeal, write us a letter telling us you disagree with our decision. This letter is called your "Notice of Disagreement." If we decided more than one claim for a benefit (for example, if you claimed compensation for three disabilities and we denied two of them), please tell us in your letter which claims you are apealing...

How long do I have to start my appeal? You have one year to appeal our decision. Your letter saying that you disagree with our decision must be postmarked (or received by us) within one year from the date of our letter denying you the benefit. In most cases, you can't appeal a decision after this one-year period has ended...

What happens after VA receives my Notice of Disagreement? We will either grant your claim or send you a Statement of the Case. A Statement of the Case describes the facts, laws, regulations, and reasons that we used to make our decision. We'll also send a VA Form 9, "Appeal to the Board of Veterans Appeal," with the Statement of the Case. You must complete this VA Form 9 and return it to us if you want to continue your appeal"

On the back of the VA Form 4107 it also states in big bold, italizied text " If you want to appeal, don't forget the one-year time limit!"

With the insructions that come with the VA form 9 when a Statement of the Case is issued, it specifically states that the claimant has 60 days to submit the Form 9 to the VA. Also on the top of VA Form 9 it shows in big text "Appeal to Boeard of Veterans Appeals."

Many veterans will also use VA Form 9 as a Notice of Disagreement, even though like I just said its states at the top the form is for an appeal to the BVA after receiving a SOC. Doing this is technically wrong. However, when this happens, VA does contrue this as the NOD from the veteran and starts the appeals process, even thought this is not the intent of the Form 9. Also many veterans will request a hearing at their RO on the Form 9, even though it states in block 8 in big lettes "DO NOT USE THIS FORM FORM TO REQUEST A HEARING BEFORE VA REGIONAL OFFICE PERSONNEL."

Many veterans piss and moan that the VA doesn't read their evidence and paperwork, but this also goes both ways as many, many veterans don't read what VA sends them. Then many times they will bitch because the VA somehow screwed them because they didn't appeal on time, when in fact the claimant dropped the ball and didn't bother to follow the attached instructions. Also many veterans wonder why VA screws up their appeals and can't make heads or tails of what they want.

The VA has one of the most, if not the most, liberal appeals policy and system there is as far disability compensation. I know of no other disability compensation system that allows a claimant one year to appeal a decision. Look at Social Security, you have only 60 days to appeal the first decision, then after that to continue the appeal on a further denial, I think the claimant only has andditional 60 days or maybe its even only 30 days. I forget which one, but at any rate, it is much more stringent than VA. I also beleive Workmans Comp and most of the insurance compnay out there are also similar with allowing a shorter period of time than VA does. This is also the same as far as being able to submit additional evidence.

If you want, i will look up the actual regulations for the appeals timeperiods ect...

Vike 17