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gerd persistent recurrence

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#1 casaderussell

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Posted 23 May 2012 - 02:16 AM

I'm working on my NOD (Notice of Disagreement) and am having trouble figuring out how the VA defines "persistently recurrent." Does anyone know how they define this subjective term?

My biggest disagreement is with my 0% rating of GERD. Based on my readings here, the VA uses 7346 Hernia hiatal to determine a rating.

Based on what I know and am finding in my medical record, I should be rated at 30%.

My first "attack" was on 11 May 2010 and I went to the ER. Reported pain at 7/10 and one episode of regurgitation. Pain radiated through my back and down my arm. I thought I was having a heart attack.
I had a follow up with my primary care provider on 12 May 2010 where I was diagnosed with Esophageal reflux and told to continue daily doses of 20mg Nexium.
I went to the ER again 28 Oct 2010. I reported similar episodes of acid reflux in the past. This occasion lasted longer and pain was rated at 10/10. Same symptoms of pain.
Followed up with PCP 29 Oct 2010. Nexium dosage was increased to 40mg. Report indicated a loss of 15 lbs.
Another ER visit on 26 Jan 2011 for chest pain that was diagnosed at "atypical chest pain"
Follow up with PCP 27 Jan 2011 agreed with "atypical chest pain"
Then i retired from the Navy.
I have since had additional attacks and appointments with my civilian doctor.
27 Apr 2011 for recent GERD attack
16 Sep 2011 regular follow up for GERD.
I have the documentation of these visits and the symptoms and diagnosis are documented on the reports.

I did not go to the doctor for all GERD attacks because I knew what it was. When then happen I can't do anything. I've even had to leave work because of some attacks. I've kept track of my GERD attacks. Dates are:
May 2010
Aug 2010
October 2010
April 2011
July 2011
October 2011
May 2012

Does that sound like a persistent recurrence?

Is there other details I'm leaving out?

Here is what I found for the rating guide:
7346 Hernia hiatal:

Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health 60
Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health 30
With two or more of the symptoms for the 30 percent evaluation of less severity 10

#2 cooter

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Posted 24 May 2012 - 01:07 AM

It means it is chronic in VA terminology


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#3 casaderussell

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Posted 24 May 2012 - 02:02 AM

O.K. so what is Chronic? lasting 6 months, 1 year, 2 years...forever? 1 episode 4 times a year?
Or does my medical record have to say "chronic?"

#4 casaderussell

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Posted 24 May 2012 - 02:04 AM

So how is chronic defined?
Certain number of occurrences over a certain period of time (i.e. 4 episodes in 1 year)?
Or does my medical record have to say, "chronic?"

#5 carlie

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Posted 24 May 2012 - 01:59 PM

http://www.va.gov/ve...es1/1105617.txt

http://www.va.gov/ve...es4/1134260.txt

http://www.va.gov/ve...es1/1107582.txt

http://www.va.gov/ve...es1/1106280.txt

http://www.va.gov/ve...es1/1102809.txt

#6 cooter

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Posted 25 May 2012 - 02:51 AM

Without hunting for the exact phrase, chronic means having a medical issue lasting 3 months and longer. If it was me, I would have my Dr write it in his notes, letter, IMO or whatever he's doing. As far as it being mentioned in your medical records I wouldn't worry about it cause any Dr reading it will see it would be chronic if the issue has been a problem 3 months and longer.


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#7 casaderussell

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Posted 25 May 2012 - 03:34 AM

Thanks Coot. and everyone else.

last question. The letter says to mail my NOD. Can I take a copy to my local VA office so I get a date stamped receipt? I'm close to the deadline.

#8 Stretch

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Posted 25 May 2012 - 10:50 AM

If you are going to do a Notice of Disagreement, then get it done now. WE all put off things. This is not something to put off. Get it done.

#9 cooter

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Posted 25 May 2012 - 07:14 PM

Yes by all means, and make sure they give you a copy AFTER their stamped. Good Luck!


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