VA says.. 100% to 40% for my Psychomotor seizures because of whatever new evidence.
I am not sure why but all of a sudden after 2 years they want to drop me on my %. I am 100%VA 100%Army and I have a Caregiver (my wife). Both 100's are for the seizures.
The original 100% is because I have had SO many seizures a week/month/ a year etc while I was in before the med board took place for seizures "with an automatic state"
100%= 1 major seizure a month. +
Major seizures:
Psychomotor seizures will be rated as major seizures under the general
rating formula when characterized by automatic states and/or
generalized convulsions with unconsciousness
What is the best way of approaching an appeal? I am looking for any input on this
For the record.. It doesn't matter if i got better or not because that just means I went from 25/30 seizures to 1-10 a month. So in the last 7 years the numbers just dropped that's it, I still have em and there is still no Aura and they are still pretty scary.
VA says.. 100% to 40% for my Psychomotor seizures because of whatever new evidence.
I am not sure why but all of a sudden after 2 years they want to drop me on my %. I am 100%VA 100%Army and I have a Caregiver (my wife). Both 100's are for the seizures.
The original 100% is because I have had SO many seizures a week/month/ a year etc while I was in before the med board took place for seizures "with an automatic state"
100%= 1 major seizure a month. +
Major seizures:
Psychomotor seizures will be rated as major seizures under the general
rating formula when characterized by automatic states and/or
generalized convulsions with unconsciousness
What is the best way of approaching an appeal? I am looking for any input on this
For the record.. It doesn't matter if i got better or not because that just means I went from 25/30 seizures to 1-10 a month. So in the last 7 years the numbers just dropped that's it, I still have em and there is still no Aura and they are still pretty scary.
There was no evidence listed in the packet, just two past appointment dates. So I am going to assume that someone made a mistake or had a misunderstanding.
There was no evidence listed in the packet, just two past appointment dates. So I am going to assume that someone made a mistake or had a misunderstanding.
Okay, indeed, that may be the case albeit if you actually attended the "two past" appointments then I would strongly suggest that you obtain a copy of each Veterans Health Administration (VHA) appointment's progress notes via the DoVA's MyHealtheVet website; it's the quickest route of acquisition at this point. Otherwise, an in-person visit to your treating VA Medical Center's (VAMC) record section would be the next applicable choice.
As such, the aforementioned VHA appointment's progress notes may yield additional information as to why the VBA is recommending to lower your current medical condition's VA rating. Hmm, maybe your assigned VA Primary Care Provider (PCP) or the VA clinician on duty at the appointment annotated some information which doesn't accurately describe your medical condition!
To that extent, you can establish a direct course of action to counteract the BVA's supposed rating decision with other medical evidence and/or medical documentation in support of your forthcoming submission of a VA Notice of Disagreement (NOD) via the Board of Veterans' Appeals (BVA) in my opinion.
Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."
Can you go to the nearest VA clinic and request copies of your records? That way you can see everything the docs wrote about your case recently. You can do this while still in active duty.... It's how I found the following facts of my case (which this allows me to better argue my case):
1. CP examiner concurred with new diagnosis of myasthenia Gravis and ordered pulmonary function test and then failed to opine on PFT, which compared me to someone with "severe restrictive lung disease" so due to failure of CP examiner opinion, there is an accompanying failure of the VA to rate me on pulmonary at all...
2. CP examiner opined on bilateral feet parathesias which got me rated at 21 percent including bilateral factor for MG
3. CP examiner failed to opine on bilateral leg weakness at all for MG
4. CP examiner optometrist concurred with new diagnosis. Of myasthenia Gravis, but rater rated me at zero percent for Ptosis and diplopia...
I will request them. Do you think they can fax them to me if I call? Yes I went to all my appointments!! The confusing part is there can't be any data saying anything to lower my % below 100. It would be like saying " Well we cured his TBI and brain after this long 12+ yr journey"... I just find it so fxcked up. My meds alone cost 1500 a month. :-/ (for humana @least)
I will request them. Do you think they can fax them to me if I call? Yes I went to all my appointments!! The confusing part is there can't be any data saying anything to lower my % below 100. It would be like saying " Well we cured his TBI and brain after this long 12+ yr journey"... I just find it so fxcked up. My meds alone cost 1500 a month. :-/ (for humana @least)
From my experiences with physically requesting medical records at my treating VAMC, there exist a requirement to validate the identity of the military disabled veteran; either via the VA medical ID card and/or signature on the applicable VA request for medical records form.
Indeed, I would suggest that you verbally contact the treating VAMC and make your request of receiving VA medical records via facsimile; worst case scenario is the receipt of a no response due to the HIPPA Privacy & Security Rules requirement. Take care!
Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."
You can go to the nearest VA facility and request your records, whether it happens to be the facility that did your CP exams or not. I had CP exams done in Omaha NE and requested and got my copies of those exams from a VA clinic I Grand Island Ne five weeks later
It appears the VA considered your initial rating temporary. This caused them to schedule reexams to determine if a disability rating change is needed. These exams were scheduled by them, not you, and it appears you missed them. Usually this happens because the little postcards they send out are thrown away without being viewed (I tend to do this, I already know what my appointments are). This caused the rater to not receive the information s/he needs to make a rating determination and for them to propose a rating drop to 0%.
Its important to realize that the VHA and the VBA are different and don't talk to each other very well. While this can be annoying, its largely due to HIPAA concerns. Don't assume because your doctors, who work for the VHA, know facts about your condition, that the raters, who work for the VBA, also know these same facts.
Likely the best COA is to inform the rater that you did not receive scheduling information about the reexams and to provide them some data about the frequency and severity of your seizures. Either the information you send is enough for them to determine you are still 100% or they will reschedule a new exam.
While getting your rating lowered to a 0% would suck, its worth noting that you are still eligible for VA health care for the condition at a 0% rating, so the cost of meds should not become an issue.
They were going to lower my rating to 70%. As of now I called the VA and they are going to mail me a letter with the info for a hearing time & location (which will probably be the VA Nashville) to appeal the reduction of my rating. In regards to the missing appointment, the VA listed the examination as part of the evidence but I went to that appointment and have it listed on my iPhone calendar(so I know I went). Funny thing is all they do is ask a few questions, do height and weight, and tell you to have a nice day ( o and the VA lady told me I should of gotten a WAY higher % for my TBI since I was in a coma and they screwed me out of my % even with my 30+ days in a VA hospital because of my coma in MN recovering and residual brain damage
Sometimes the problem can happen due to you reporting a change of address to the VHA but not the VBA. Some report the VA just never notifies them (lost in mail?).
The 40% for seizures is a little strange, probably the most the rater felt comfortable lowering it, but without any evidence, lowering it is the rule. Indeed with still having 1-10 a month you should be able to establish that 100% is still appropriate. Establishing how often they happen should be pretty straight forward, how often you refill meds, bring in doc's notes, letter from someone who witnesses/responds to them, things like that. I'm fairly certain with that many you have to have some means of documenting them as it'd be pretty scary to just silently suffer through them alone.
Think of it like the training room clerk not knowing the details of your profile. He knows you have a profile, but beyond that, the doc has no reason to communicate to them everything, and really, you'd have good reason to be upset if the doc was spreading your info everywhere. Then the training room guy says hey, where's your PT test with alternative events? All you need to do is show him how your profile says you can't take one.
