Jump to content


Photo
- - - - -

Smitty's Gerd Claim


  • Please log in to reply
3 replies to this topic

#1 Hoppy

Hoppy

    HadIt.com Elder

  • HadIt.com Elder
  • PipPipPipPipPipPipPipPipPip
  • 1529 posts

Posted 18 May 2013 - 06:23 PM

I am still alive.  I have been battling a major lower back problem for over five months. Sitting was difficult.  The computer became an enemy. The symptoms have almost completely resolved, so I will try to get back to the board. Smitty called me yesterday and told me he won service connection for his GERD claim at the second go around at the BVA. He is mailing me the decision.  He says it is 25 pages. 25 pages and two denials for a pretty obvious (to me) valid claim.  Basically the claim was awarded without any significant new medical evidence.  Basically what it took was being persistent and connecting the dots for the raters. The trick was explaining to them that the C&P reports used as evidence against the claim on the two previous denials was based on the failure to make a diagnosis of GERD by the C&P examiners that had no legal merit and that the only significant evidence was the continuity of symptoms and diagnoses clearly established in the VAMC treatment notes and a DBQ written by the primary care doctor. On the previous denials they Gave weight to two C&P that said there was no objective evidence of GERD.  There actually were several reports based on scientific tests showing reflux.  Additionally, I found BVA cases where subjective complaints of GERD were sufficient even in the absence of scientific evidence. Smitty’s  symptoms started in the military and continued without any significant interruption or resolution.  These facts were well established in the VAMC treatment notes.

 

 



#2 qwiksting

qwiksting

    E-5 Petty Officer 2nd Class

  • Chief Petty Officers
  • PipPipPipPipPip
  • 223 posts
  • Service Connected Disability: 80%
  • Branch of Service: USA

Posted 19 May 2013 - 11:16 AM

Thank you Hoppy for connecting the dots, in a way, a first grader could follow. Thank you for helping me. I will be sending the descision letter to you.  

 

Without you, Hoppy, I would have been another disgruntled vet that the VA swept under the rug. Again sir, thank you!!



Thank you Hoppy for connecting the dots, in a way, a first grader could follow. Thank you for helping me. I will be sending the descision letter to you.  

 

Without you, Hoppy, I would have been another disgruntled vet that the VA swept under the rug. Again sir, thank you!!



#3 donh777

donh777

    E-4 Petty Officer 3rd Class

  • Second Class Petty Officers
  • PipPipPipPip
  • 87 posts
  • Service Connected Disability: 70%
  • Branch of Service: usaf

Posted 19 May 2013 - 07:33 PM

Hoppy.. Glad to see you posting again. You give excellent advice.



#4 qwiksting

qwiksting

    E-5 Petty Officer 2nd Class

  • Chief Petty Officers
  • PipPipPipPipPip
  • 223 posts
  • Service Connected Disability: 80%
  • Branch of Service: USA

Posted 30 May 2013 - 05:37 AM

Well, according to the VA, I called yesterday to get an update, I was assigned a 0 percent rating. After 5 years of denials,BVA,AMC,BVA, and finally conceded by the BVA. I am happy it was SC, however, with the treatment records, multiple endoscopy reports, and the outstanding DBQ filled out by my PCP, I will get a 0 percent rating. I wrote my congressman, Jeff Miller< to have his office look into WTF. I have looked at the CFR to get an idea of how they should have rated it. If I understand correctly, there is no code for GERD. I understand that they rate it analgalously with Hiatal Hernia because the symptoms are so close. I was denied tha Hiatal Hernia claim by the BVA, but awarded GERD, and Gastric ulcer. Looks like this is going to be another 5 year battle. I want to also thank HOPPY, for all his help,experience and input into this claim. I dont feel I would have made it through the BS without him. Although this is a bit premature, as the guy at the VA said it was in the authoization phase, I feel LOW BALLED!






0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users