Suggestions for Doctors to give diagnosis?

[Wico1337]

Hello all,

I have tried to use the VA for this, but they have failed me. I have had about 8 years on record with VA of chronic coughing, headaches/pain, ear pain, sinus issues. At beginning of year, all of these were resolved via allergy medicine prescribed by my Primary Care physician. An ENT doctor called me over the phone, without seeing me in person, diagnosed me with Allergic Rhinitus. I think they purposely refused to give diagnosis for Sinusitis because it typically gives Benefits where Rhinitus barely does only if Polyps exist, which I dont have any. I then scheduled another ENT clinic exam. The ENT specialist told me flat out that since I had not been prescribed Antibiotics for my Sinuses, he will not diagnose me with Sinusitis. He said that he does not recognize Allergy Medicine as preventing Sinus issues and could not give me Diagnosis.

 

So now I am stuck. Does anyone know of a reasonable doctor that I can call/email and they provide a diagnosis for Sinusitis?

 

Can anyone give advice on Do's/Don't for getting an outside of VA diagnosis for a condition? 

 

[ShrekTheTank]

This is the part where you might need and IMO.

When I had to get two from outside the VA, I went to them a few times and I explained what was going on.  I did not lead them on, I only asked what the issue was as I needed a diagnosis for the VA.  

I know there are doctors out there who will do just IMO and they do it well.  I also know there are doctors who do not normally do this, but they will do it durring a doctor visit.  Now this was years ago.

I am sure there are people here who have used resources from doctors who do IMO's all the time.  They will review you records and they can give a detailed IMO.  

The thing you are missing is you already have a diagnosis and the VA does give disability for Allergic Rhinitus.  Below is a link from an award.  I think it can go up to 30% disablility rating

https://cck-law.com/blog/va-disability-benefits-for-allergic-rhinitis/

How VA Rates Allergic Rhinitis

VA rates allergic rhinitis under 38 CFR § 4.97 – Schedule of Ratings, Respiratory System, Diagnostic Code (DC) 6522.  The rating criteria includes 10 and 30 percent evaluations, based on the following symptomatology:

• 30% – with polyps
• 10% –without polyps, but with greater than 50 percent obstruction of nasal passage on both sides or complete obstruction on one side

If you believe the severity of your allergic rhinitis is not accurately reflected in the rating criteria, you may be eligible for an extraschedular rating.  An extraschedular VA disability rating may be warranted for veterans who experience unique or especially severe symptoms of a service-connected condition.

Again, to receive an extraschedular rating for rhinitis, the veteran’s symptoms must not already be contemplated (i.e., taken into account) in the rating criteria set forth under DC 6522.  The criteria for an extraschedular rating fall under VA regulation 38 CFR § 3.321(b)(1).

 

[Wico1337]

20 minutes ago, shrekthetank1 said:

This is the part where you might need and IMO.

When I had to get two from outside the VA, I went to them a few times and I explained what was going on.  I did not lead them on, I only asked what the issue was as I needed a diagnosis for the VA.  

I know there are doctors out there who will do just IMO and they do it well.  I also know there are doctors who do not normally do this, but they will do it durring a doctor visit.  Now this was years ago.

I am sure there are people here who have used resources from doctors who do IMO's all the time.  They will review you records and they can give a detailed IMO.  

The thing you are missing is you already have a diagnosis and the VA does give disability for Allergic Rhinitus.  Below is a link from an award.  I think it can go up to 30% disablility rating

https://cck-law.com/blog/va-disability-benefits-for-allergic-rhinitis/

How VA Rates Allergic Rhinitis

VA rates allergic rhinitis under 38 CFR § 4.97 – Schedule of Ratings, Respiratory System, Diagnostic Code (DC) 6522.  The rating criteria includes 10 and 30 percent evaluations, based on the following symptomatology:

• 30% – with polyps
• 10% –without polyps, but with greater than 50 percent obstruction of nasal passage on both sides or complete obstruction on one side

If you believe the severity of your allergic rhinitis is not accurately reflected in the rating criteria, you may be eligible for an extraschedular rating.  An extraschedular VA disability rating may be warranted for veterans who experience unique or especially severe symptoms of a service-connected condition.

Again, to receive an extraschedular rating for rhinitis, the veteran’s symptoms must not already be contemplated (i.e., taken into account) in the rating criteria set forth under DC 6522.  The criteria for an extraschedular rating fall under VA regulation 38 CFR § 3.321(b)(1).

 

Thank you for the response Shrek. I apologize for not being more clear in my initial post. I already have a VA Service Connection to Rhinitus due to Burn Pits. My problem is that for years I have suffered extreme headaches, ear pain, chronic cough and other things due to my Sinus issues which are now resolved via Allergy Meds. Sinusitis is what casuses all of these conditions, not Rhinitus. 

But a VA doctor is not giving me a proper diagnosis for Sinusitis. If I had a diagnosis, I will be considered to be "presumptive" a being service connected for Sinusitis due to Burn Pit Exposure. That is why they are drawing back diagnosing people with it.

So now I just need to find someone who will look at my records and give me an evaluation if I honestly do or do not have Sinusitis. From what I have read though, there is no dispute that I have sinusitis. I am looking for a private doctor who can put that on paper for the VA.

[ShrekTheTank]

Have you gone through the burn pit registry?  I know they will give you a diagnosis if there is one to be had.

Next here is how the VA checks for sinusitis.

After your C&P exam, the VA has to determine if you qualify for disability compensation. Diagnostic Code 6510 correlates to sinusitis, para sinusitis, and chronic sinusitis. The general rating formula states:

• A 0% rating is awarded if sinusitis is detected by X-ray alone
• A 10% rating is awarded if sinusitis is manifested in one or two incapacitating episodes annually and requires prolonged (four to six weeks) antibiotic treatment. A 10% rating is also used when a person has three to six non-incapacitating episodes annually with symptoms of purulent discharge, crusting, pain, and headaches.
• A 30% disability rating is awarded if there are three or more incapacitating episodes annually that require long-term antibiotics of four to six weeks. A 30% rating may also be used for cases of six or more non-incapacitating episodes with symptoms of purulent discharge, crusting, pain, and headaches.
• A 50% disability rating is awarded for those requiring radical surgery for sinusitis with chronic osteomyelitis. A 50% rating may also be given to those with near-constant sinusitis that continues to cause symptoms following repeated surgeries.

Under the Diagnostic Code 6522, a 10% rating is used for vasomotor or allergic rhinitis without polyps but 50% or greater blockage of the nasal passages on both sides. It may also be used if one side is completely obstructed. If polyps (growths) are present, this rises to a 30% rating.

Incapacitating episodes occur when a vet is ordered by a doctor to remain on bed rest.

Is any of the above information in your records?

If so then you should fight it for sure.

The other part to think about here is pyramiding.  I am not sure here, but if someone could jump in.  Will the VA pay for Sinusitis and Allergic Rhinitis?  Or do they just pay the higher of the two?

[Wico1337]

Hey Shrek, I completely understand the rating schedule. I am already SC and Rated for Rhinitus at 0% but plan to appeal as they never evaluated if I have pollups or obstruction.

 

My problem is that while I have clear symptoms and I am 100% sure I have sinusitis and would easily be rated 30% for it. Nexus being Burn Pits. My problem is that I have never been officially diagnosed by a doctor for Sinusitis. I am seeing what the best path to getting a "confirmed" diagnosis of Sinusitis would be. The VA doctor refuse to give me a diagnosis for it while everywhere I have read points to it being Sinusitis. Even nurses I know that I have spoken to says its sinusitis. I am asking if people know of the easiest route to get an "offocial" diagnosis on record for a diagnosis of Sinutisis. Again, the symptoms have existed for years. I take the medication to prevent sinusitis. But they never gave me the actual "diagnosis". The anti-allergy medicine for my sinus issues were given with the exuse by the doctor that my sinus issues are Rhinitus.

 

[ShrekTheTank]

https://cck-law.com/video/allergic-rhinitis-sinusitis-va-disability-ratings/

It does look like they are rated seperatly.  I was worried it was stack and they would just deny it.

https://www.va.gov/vetapp17/Files8/1744951.txt

Here is a remand

So for my Dercum's disease I could not get a doctor to give me an actual diagnosiss.  I took my fight to the BVA and they told the VRO they needed to do a duty to assist to get a diagnosis.  They finally did it correctly and gave me the diagnosis.  But this cost me a lot of years and a lot of fighting.

 

I would suggest to find a doctor who will give an IMO.  I know they can be found by asking around as that is how I found mine for my PTSD.