Finally...after 5 Years, Won Bva Appeal On My Own!

[Toposurveyor]

GW1,

Congratulations on your win. It is always great to read of othersw successes here. Welcome to hadit. I am sure that others will appreciate your info and expertise.

Ed

[mobie16r]

Congrats on your win GW1 veteran.

mobie

[GW1 Veteran]

Congratulations on your win! Your case will be very usefull to me since I also suffer from FMS my case is with the BVA judge now.

Thanks for the congrats.

If I may inquire, what exactly are you appealing to the BVA with regards to your FMS?

GW1 Veteran

[ladypoetry85]

Way to go! Good for you! Wish yaa well!

Hello all!

I'm new to this forum as I've spent much of my time at the forums of American Gulf War Veterans Association helping other veterans understand similar issues as my own, and I only recently re-stumbled across this forum. So, I thought I would share the successes that I've had with the VA and the appeals I've filed over the years and won finally reaching a 100% schedular rating.

Back in the late 90s I was rated 20% for fibromyalgia (among several other conditions) instead of 40% becayse the VA based that ratings for fibromyalgia (FMS) differentiate between episodic and chronic. Well, I immediately filed a NOD which ended up as an appeal. My entire argument was based on medical facts that clearly categorize FMS as a chronic condition, i.e. there is nothing episodic about it. I provided letters from my spouse and VA primary care physician, in addition to tons of official medical resources outlining the diagnostic requirements for FMS and the medical definition of FMS. In the end, I was granted full benefits sought on appeal and ever since then I've been rated 40% for FMS. Anyone rated at 20% I recommend they appeal that rating for the 40% given the fact that the VA regulations governing the FMS rating is not only outdated but it is factually inconsistent with known medical research and definitions of what FMS is (chronic) and what it is not (episodic). That was my first appeal won on my own at the DRO de novo review level.

The next appeal I filed also concerned FMS where the VA lumps in irritable bowel syndrome (IBS) and sleep disorder (primary insomnia) into the same rating. This too is medically inaccurate, as both are coexisting but completely separate chronic conditions. The VA then tried to say my sleep disorder was associated to my depression/generalized anxiety rating, but they were wrong given the fact that my sleep disorder surpassed those conditions into a separate medical condition all its own. I was eventually denied by two different VA regional offices (over a 4+ year span) before it went to the BVA in D.C.; and it only took 3 months (which blew me away as I heard it could take years before a decision is ever reached) at the BVA for them to return a verdict agreeing with my arguments.

I provided letters from my spouse, VA primary care physician, statements from the C&P examiner, and tons of medical documentation substantiating my argument. Though it took a little more than 5 years, I won on my own. I maintained my 40% FMS rating and received a 30% rating for IBS and (sadly) 10% for the sleep disorder (apparently the VA does not have a specific diagnostic code/rating for primary insomnia since most ratings lump such a sleep disorder into other ratings - e.g. depression, etc.).

So, after 10 long years battling the VA and winning my own NOD's and appeals I finally reached 100% schedular this past year.

At present I am on vocational rehab finishing my second degree this year; then I will be back to work early next year. My first degree is an AAS in Paralegal studies and my BA I'm getting at the end of the year is in Criminology/Criminal Justice. My first goal upon graduation is applying for the VA, DVA, and other Veteran service organizations. With my own success and legal background I very much want to be an advocate for veterans filing disability claims; plan B is working either for the police or in family law helping women and children subjected to domestic violence. If plan B, I still plan on volunteering time to any veteran needing help making heads or tails of VA regulations and medical issues as they relate to the codes, laws, and regulations meeting the requirements of such in order to have a better argument towards getting their claim(s) approved. So, we'll see.

Anyhow, I just wanted to share my success story. I will take some time to read over the other threads and learn of the good news others have had in getting their claims approved.

Thanks!

GW1 Veteran

[Dorothy Kansas]

Thanks for the congrats.

If I may inquire, what exactly are you appealing to the BVA with regards to your FMS?

GW1 Veteran

I was just diagnosed with FMS it co-exist with my Sarcoid Arthritis. This is what I have at the BVA.

[GW1 Veteran]

I was just diagnosed with FMS it co-exist with my Sarcoid Arthritis. This is what I have at the BVA.

Whoah... Taking a quick glance and the information on Sarcoid Arthritis, that is going to be a tough appeal. Did you provide in your appeal a lot of medical data/literature that specified these conditions coexist and that the Sarcoid Arthritis is not a "symptom" of FMS?

I know in your response above you said 'co-exist,' is that your use of the term or the VA's? I only ask because for the VA to use it is counterproductive to their own argument. If two conditions are not the cause of the other but are often found to coexist, they are separate medical conditions. Thus, they deserve their own separate rating, which is how the appeal should be argued.

:( *sigh* I really wish you the best on this and I'd be curious to know the end result. Hopefully those at the BVA who review your case will be as intelligent and decisive as the one who reviewed and granted my appeal. Fingers crossed!

GW1 Veteran