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carliecash wrote:

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dittybopper wrote:

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It would do me good to get this off my chest by explaining in great detail to the DRO just how wrong the denial(s) were and how much I think I have proven that with my new and material evidence. 
DB

DB,

What was the exact reason/s for the prior denial.

What does your additional evidence you have since then state ?

XXXXXXXXXXXXXXXXXXXXXXX

Start with "Frequent urgent urinary condition" every 30-45 minutes.  I witheld fluids all morning because of a 124 mile drive and I didn't know where I was going.  Still went 5 times between 5AM and 9AM.  Explained I had witheld fluids and why.  My C&P exam lasted about 40 minutes and I did not void while in the exam.  Immediately before and after but not in the exam.  My exam was scheduled for 2.5 hours.  I wasn't in the VAMC more than an hour and 10 minutes.  Check in, exam, sign in at lab desk, give blood and urine, take 6 xrays, go void, file for travel pay and get travel pay.  All before 10:10.  Increase in urinary condition was denied because I didn't void during my 2.5 hour exam???????????????  During my 40 minute exam she left the room 4 times.  twice so I could change into and out of my yellow paper gown, but she was gone over 5 minutes both times.  The other two times she left for about 5 minutes without explanation.

She told me I looked like Robert Duvall.  I replied that lots of people said I looked like Dale Earnthart.  Her respones was...."WHO".  I knew I was in trouble right then.


Migraines were denied because she left out the meat of our conversataion.  ie what i had to do when I got one.  She said if veteran can catch the headache in time with tylenol migraine............What she failed to put in her report was the conversation about having to get in the  bed for several hours in a curled up position, lights out, and the imitrex I had to take.

I've had 7 surgeries on my right ankle...last one a fusion, at that time 6 surgeries on left knee and 4 on right.  Both scheduled for TKR.  Because of her "spotty" recollection of our conversations and vague Xrays  (xrays from my ortho guy a week prior and after the exam showed arthritis abounded and much more) that said knees looked fine.  Lost claim for even a 10% increase.  Knees have not gotten worse since 1989?????

Had five letters from 2 ortho surgeons, 2 from pain managemente doctors and my PCM stating my low back pain was severely aggrvated my my very antalgic gait.  She only saw me walk about 20 feet and I definely has a bad limp because I had been sittin in a low chair for 10minutes.  She said I had a normal gait.  No back exam at all.

Denied SMC-K.  Because I was 56 years old.  I smoked 23 years ago, dyslipidemia (been under control for 11 years) and had testosterone level in the low 300's.  Failed to mention that I had explained to her depression, depression medication, 4-5 loritab 10's a day, HBP medication, 2 different "flow" medications.  Also lab results were "skewed" because I was dehydrated????????????

I'll get the nod on the first 4 denials this time, but the SMC-K is very subjective, so probably not, even though that's not the way I see it.

DB

Bilateral knees,
R ankle,
R shoulder (dominant)
LBP,
Migraines,
Frequent Urgent Urinary Condition
Loss of hearing,
Tinnitus
MMD
Hypertension
Bursitis
Bilateral loss of motion, wrists

Carlie, I know my last post was scattered, so let me try to explain it better.

I am 20% for urinary condition.  Filed for increase as day time voiding is now as frequent as 30-45 minutes, nocturia is 4-5 times per night.  Either one of those symptoms is rateable at 40%.  I had letters from my PCM, urologist and nephrologist stating the above condition with the above symptoms in my C-file at the time fo the denial.  The PA that did the exam said that during her 2.5 hour examination that I voided once so therefore my average urination was 2.5 hours.  However, I wasn't even in the VAMC more than an hour and fifteen minutes and I did not void during her examination.  She covered her time sheet/activiy report with the statement that my exam lasted 2.5 hours.  Yes I explained in great detail that the only fluit I had consumed since about 10 PM the night before was just enough water to take my morning meds.  I also told her that I stoped at every rest stop (about 30 mile average) b etween my home and the VAMC.  And that I voided immediately upon entering the building.  So between 4 AM and 9:30 I voided at least 6 times.  Several years worth of medication trials, cystoscopies and other modalities went right down the drain at the word of a PA that barely spoke enough English for me to comprehend her questions. 

In regards to the migraines.  I am SC'd at 0%.  I filed for an increase as the headaches have become worse and more frequent since my retirement in 1995.  I explained the symptoms of the headaches and that I could tell in advance when I was going to have one.  I did tell her that "if I could catch it" in time to head it off with Excedrin Migraine and laying perfectly still for an hour I could avoid it.  BUT if I was not somewhere that I could get to my medicine and lie down that I would have a full blown headache and have to take Imitrex and go to bed as soon as I could get to one.  Her exam notes said "Veteran states that if he can catch it in time he can prevent it with Excedrin.  PERIOD ! ! !  Denied   NOD exam by a different PA in August says 4-6 tyimes per month, completely prostrating for 4-6 hours per headache, prescribed medication is Relpax.  Should be rated at 30% when appeal is decided.

Bilateral knees.  At the time of the exam I had been operated on 4 times for the right knee and 5 on the left.  I was rated at 10% for each.  Years (since 1989) of surgical reports by orthopedic surgeons, MRI reports, Xray reports doctor's notes.  Especially in the 18 months prior to the exam,  doctor's notes said things like chronic tendonitis, Grade IV chondromalacia, severe degenerative arthritis, crepitus, bone spurs, meniscus(es) almost non-existant, sinovitus, subluxation, instability, weakness and fatigue.  I had taken a series of bilateral knee xrays just about 10 days prior to the C&P exam.  The three xrays of each knee taken by the VA said joint lines were clean and no arthritis was noted.  Less than two weeks after the exam a second ortho surgeon took the same set of bilateral xrays as the first ortho surgeon and completely agreed with those xrays.  Both knees were not worth saving and both recommended bilateral TKRs.  My ROM was withing the aceptable range of the VA so my claims for increase(s) were denied.  Since the exam I have had a TKR on the left knee and will have the right TKR done within 2 months.

SMC-K.  Yes, am SC'd and diagnosed with MMD.  Rated at 30%, take meds for it.  SC'd for hypertension and take meds for it.  Chronic pain in ankle, knees and right shoulder: SC'd and take a hand full on pain meds a day.  Take 3 max dosage pills a day for voiding disorder.  Each bad for SMC-K. Letters from PCM, Urologist and Nephrologist gave legitimate reasons for the SMC-K. Denied because of natural aging, dislipedemia, low testosterone and smoking.  I was only 56 at the time of the decision.  My dislipedemia has been well under control for 11 years, I take testosterone replacement meds and I hadn't smoked in 23 years.

In regards to the LBP;  Yes, all 5 doctors either said my low back pain was caused by or severely aggrevated by my antalgic gait, which was a result of my service connected knee conditions.  She definitely saw me limp and walk all hunched over in the back.  Denied

I have no reason to be mad at the DRO, unless he argues the evidence I have provided to support my claim.  I'll be a gentleman and keep a cool head.  My VSO will be there to smack me in the back of the head when I start to get out of line. :-)

DB

carliecash wrote:

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Well, sounds like your OK with the game plan you have.
I hope your evidence is strong enough to sway the DRO to either agree or
at least find the evidence to be in relative equipoise, for application of the BOD.

I sending good thoughts your way.
JMHO

carliecash wrote:

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dittybopper wrote:

I know we didn't get off on the right foot at our first meeting, but as you can see, I have learned to "shut up and listen".
  

I don't remember any difficulties.

I can use all the help I can get.

I've been making mental notes in my head about the decions, what the outcome of my C&P exam was and the evidence I presented before and after the decision.  I'll put it on paper soon and start making copies of all the new and material evidence I have given them since I filed the NOD in Nov 2010.  I was a Master Instructor for 7 years.  I will have my "speach" ready come March 8th.

 

Thanks to all,

DB

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pper,
I do wish you well in your hearing. Use my site to organize and assemble your thoughts if you think it will help.

I don't know if this suggestion would help or not since I have never had to appear in one (with hubby) but maybe if

1. Write out the disability decision stuff, the areas that are incorrect and then your proofs

2. Make copies of the above

3. Submit these copies to your VSO and the DRO so as you read off it, they can follow. It might help you and them stay focussed on the facts.

It might help you stay on track where you don't lose it from frustration.

It is just a thought to help you. Again, I am not an expert here since I've never been involved in one.

fanaticbooks

p.s. Do you have written comments from family members you could submit describing their observations for this stuff? That might also help. Here's a link to that kind of stuff if it would help. JMO

http://vets.yuku.com/topic/70992

me again

gulfie wrote:

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diittybopper,

Finished up what you started and get this hearing over with. I my self just had my hearing last week and found the rater very helpful with my intensions and any evidences presented. NEW SETS OF EYES are better that the previous ones, go straight to the point on WHAT IT IS and WHY YOU requested for an hearing as long as you  can support any SC increase you've been requested, you will get all the considerations you are expecting. Goodluck....Gulfie