diabetes Got C And P Exam Results For Ibs

[Guest jangrin]

Any comments would be appreciated about this C&P exam, thanks:

Opinion:

Veteran does not have the typical pattern of Irratible Bowel. He deveoped diarrhea upon the initiation of Metformin (he could not make the connection, although he states he told his MD Diarrhea began when medication for diabestes was began and that his MD took a BM sample). He's had no work up for diarrhea, of course the simpliest way to know what's cause diarrhea is to stop the Metformin which is commonly complicated with diarrhea.

Veterans diarrhea (not IBS) is less likely than not related to Diabetes Mellitus, as likely as not related to Metformin.

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When my husband filed the claim he filed for:

Gastrointestinal /diarrhea due to adverse effects of medication

The VA changed it to IBS

Edited March 10, 2007 by jangrin

[Chuck75]

I assume that the claim was denied. I also assume that the medical treatment and metformin is by the VA. (I take the same drug, but it was prescribed by my private doctor, not the VA). Since the VA changed the complaint to IBS, The VA reply (I believe) should be NOD'd, and the original claim reinstated. The experts on this forum should be able to tell you more than I can. The problem as I see it is that IBS is compensatable, and drug adverse reaction is not of itself likely compensatable, unless some long term or irreversable harm to the patient occurs. So changing the complaint to IBS was an attempt to move the problem to the nearest compensatable area, and the VA's take on the doctors opinion prevented successful award. Saying the patient does not have the "typical pattern" does not say that he does not have "IBS".

http://www.medicinenet.com/metformin/article.htm

Metformin

SIDE EFFECTS: The most common side effects with metformin are nausea, vomiting, gas, bloating, diarrhea and loss of appetite. These symptoms occur in one out of every three patients. These side effects may be severe enough to cause therapy to be discontinued in one out of every 20 patients. These side effects are related to the dose of the medication and may decrease if the dose is reduced.

DRUG INTERACTIONS: Cimetidine (Tagamet), by decreasing the elimination of metformin from the body, can increase the amount of metformin in the blood by 40%. This may increase the frequency of side effects from metformin.

There are other drugs than can be used instead of Metformin, or with a reduced dose of Metformin.

If the VA is providing medical treatment, why haven't they provided alternate therapy? Not doing so may open up another avenue for a claim.

Any comments would be appreciated about this C&P exam, thanks:

Opinion:

Veteran does not have the typical pattern of Irratible Bowel. He deveoped diarrhea upon the initiation of Metformin (he could not make the connection, although he states he told his MD Diarrhea began when medication for diabestes was began and that his MD took a BM sample). He's had no work up for diarrhea, of course the simpliest way to know what's cause diarrhea is to stop the Metformin which is commonly complicated with diarrhea.

Veterans diarrhea (not IBS) is less likely than not related to Diabetes Mellitus, as likely as not related to Metformin.

________________________________________________________________________________

____

When my husband filed the claim he filed for:

Gastrointestinal /diarrhea due to adverse effects of medication

The VA changed it to IBS

[Guest jangrin]

Chuck75,

Thanks for the imput-this was a recent C&P exam and report that the VA just did-no decision on award as yet-based on this report we suspect that the VA will defer a compensation decision until they get more recent medical records and treatment records addressing the side effect issue and possible change of medication.

This was one issue regarding a claim for multiple physical/mental issues. I am sure once we get any type of inital rating

from the VARO we will be filing multiple NODs. Your commentws have given some direction for the future. Thanks!!

Jangrin