oxygen use rating for asthma

PsychOfficer

PsychOfficer

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PEB Forum Veteran
Registered Member
I'm preparing for a possible big fight.
I have an asthma diagnosis, and an unknown diagnosis, possible pulmonitis or chronic bronchitis.
The PEB found me unfit for 2 conditions: Asthma and Shortness of breath requiring oxygen
I use the O2 daily for any exertion. I desaturate very quickly when I lose my breath.
The DBQ for respiratory asks if O2 use is 17 hours or greater. I do not.

Many of the diagnoses under respiratory state O2 use is 100%.
Asthma does not have this criteria.
After 5 weeks at BAMC, there were a number of problematic test results, but the only firm diagnosis was asthma.

Ratings are done, but I have not seen them. However, DAV looked and said they are not 100%.

I understand that there may not be a firm diagnosis, but wouldn't O2 use warrant an exception to the asthma rating? (It looks like that will be at 60%) Or does it have to be continuous use greater than 17 hours a day. (Although I don't ever remember seeing that criteria in the ratings).

I know I haven't seen the paperwork or 199 yet, but I am trying to get the ducks in a row in case I actually do have grounds for a reconsideration. Thoughts?

Thanks.,...Bob
 
Looking at the eCFR it appears as you say, asthma dies not carry an oxygen prescription rating. The conditions that do, say oxy therapy required is 100%. I suppose you would have to see what the second condition the VA rated you under. In the eCFR I don't see any requirement for 17+ hours per day. I'm very interested to hear back from you as to how this plays out for you.
 
As I look through the VASRD for respiratory conditions, the common theme is the FEV-1/FCV tests and their results. In addition to those tests the types and frequency of medications are quantifiable. I read it as an A or B situation.

Hopefully you can have the condition service connected. Quite often with the unknown types of diagnosis, they will use the rating criteria form a condition with similar symptoms.

http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_97.DOC
 
gsfowler said:
As I look through the VASRD for respiratory conditions, the common theme is the FEV-1/FCV tests and their results. In addition to those tests the types and frequency of medications are quantifiable. I read it as an A or B situation.

Hopefully you can have the condition service connected. Quite often with the unknown types of diagnosis, they will use the rating criteria form a condition with similar symptoms.

http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_97.DOC
Click to expand...

Indeed, it's referenced in 38 CFR 4.20 Analogous ratings as follows:

"When an unlisted condition is encountered it will be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. Conjectural analogies will be avoided, as will the use of analogous ratings for conditions of doubtful diagnosis, or for those not fully supported by clinical and laboratory findings. Nor will ratings assigned to organic diseases and injuries be assigned by analogy to conditions of functional origin."

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
Thanks for the posts. Its been a bit discouraging - but I am trying to be patient and wait for the actual decision - whenever things get moving again. My actual unfit diagnoses were recognized by the PEB:
1) Uncontrolled asthma (this rating to me would be clear - daily inhalers/advair and multiple courses of oral steroids over past year (60%))
and
2) dyspnea requiring oxygen.
The IMR and PEB took pains to point out there were (at least) two separate issues.

I realize there was not a concrete diagnosis, and the oxygen is treating symptoms.

I was at BAMC at San Antonio spent five weeks trying to determine an exact diagnosis, but they couldn't agree on one - possible pneumonitis, possible early copd, chronic bronchitis, and my quick desaturations (one set of stairs can drop me into low 80's) confused them. My test results were mixed, and I had bad days and not so bad days, which they also didn't understand. They found at least thee small nodules, but discounted them. The kicked me to cardiology, who looked at me pretty thoroughly, and (the doc was a little exasperated ) he said, don't they realize this is obviously a problem with your lungs?

I really don't think they understood the exposures I had = burn pits, dust storms, and a series of explosions very close from unstable Russian land mines, and while at first they questioned it, they weren't about to say I didn't need the oxygen.

OK, now I'm just starting to vent.

Thanks again - I am formulating strategy based upon what I think (my wife is used to me having plan A,B,C,D, and E, with E being to make more plans), while waiting patiently to actually know something. I will pass on more information when I get it.
Bob
 
PsychOfficer said:
Thanks for the posts. Its been a bit discouraging - but I am trying to be patient and wait for the actual decision - whenever things get moving again. My actual unfit diagnoses were recognized by the PEB:
1) Uncontrolled asthma (this rating to me would be clear - daily inhalers/advair and multiple courses of oral steroids over past year (60%))
and
2) dyspnea requiring oxygen.
The IMR and PEB took pains to point out there were (at least) two separate issues.

I realize there was not a concrete diagnosis, and the oxygen is treating symptoms.

I was at BAMC at San Antonio spent five weeks trying to determine an exact diagnosis, but they couldn't agree on one - possible pneumonitis, possible early copd, chronic bronchitis, and my quick desaturations (one set of stairs can drop me into low 80's) confused them. My test results were mixed, and I had bad days and not so bad days, which they also didn't understand. They found at least thee small nodules, but discounted them. The kicked me to cardiology, who looked at me pretty thoroughly, and (the doc was a little exasperated ) he said, don't they realize this is obviously a problem with your lungs?

I really don't think they understood the exposures I had = burn pits, dust storms, and a series of explosions very close from unstable Russian land mines, and while at first they questioned it, they weren't about to say I didn't need the oxygen.

OK, now I'm just starting to vent.

Thanks again - I am formulating strategy based upon what I think (my wife is used to me having plan A,B,C,D, and E, with E being to make more plans), while waiting patiently to actually know something. I will pass on more information when I get it.
Bob
Click to expand...

Indeed, an occasional venting session is just fine since it helps to clear the mind in my opinion.

To that extent, you have a solid contingency planning process in progress; keep up the good work! ;)

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
PsychOfficer said:
.

... my quick desaturations (one set of stairs can drop me into low 80's) confused them. My test results were mixed, and I had bad days and not so bad days, which they also didn't understand... The kicked me to cardiology, who looked at me pretty thoroughly, and (the doc was a little exasperated ) he said, don't they realize this is obviously a problem with your lungs?


Bob
Click to expand...

I'm in a similar position. My pulmo says emphysema but kicked me to cardio too. I have the same quick desats. Hopefully they get your rating sorted out, but more importantly I hope they figure out the real cause of your condition.
 
... said:
I'm in a similar position. My pulmo says emphysema but kicked me to cardio too. I have the same quick desats. Hopefully they get your rating sorted out, but more importantly I hope they figure out the real cause of your condition.
Click to expand...
Did you have the same situation being near burn pits or anything of the like?
 
Mine is from other documented chemical exposures. Not burn pits.
 
Update:

Saw PEBLO today and he said that he had seen my ratings - he couldn't "tell me" but when I guessed correctly he did the wink wink nudge nudge.

60% for the asthma (DOD), (90% for all rated conditions) the VA did not apparently rate the Oxygen use.

There may be a possible bit of good news - the PEB has kicked it back to the VA for questions and verification, but of what I do not know. I am way too cynical to hope they caught it, but one can dream.

Still no intel on time frame.

Thanks...Bob
 
PsychOfficer said:
Update:

Saw PEBLO today and he said that he had seen my ratings - he couldn't "tell me" but when I guessed correctly he did the wink wink nudge nudge.

60% for the asthma (DOD), (90% for all rated conditions) the VA did not apparently rate the Oxygen use.

There may be a possible bit of good news - the PEB has kicked it back to the VA for questions and verification, but of what I do not know. I am way too cynical to hope they caught it, but one can dream.

Still no intel on time frame.

Thanks...Bob
Click to expand...
Good for you, just make sure that you are rated correctly on the 199 in your claims!!!
 
PsychOfficer said:
Update:

Saw PEBLO today and he said that he had seen my ratings - he couldn't "tell me" but when I guessed correctly he did the wink wink nudge nudge.

60% for the asthma (DOD), (90% for all rated conditions) the VA did not apparently rate the Oxygen use.

There may be a possible bit of good news - the PEB has kicked it back to the VA for questions and verification, but of what I do not know. I am way too cynical to hope they caught it, but one can dream.

Still no intel on time frame.

Thanks...Bob
Click to expand...

Indeed, good deal! At least you are "unofficially" aware of your DoVA proposed ratings at this point in time.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
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