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Resubmit or not

This is a discussion on Resubmit or not within the Diabetes forums, part of the Medical Forums category; Hello, I retired from the Air Force in Jan 03. I’m 45. Just would like to know if I should ...

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Old 07-31-2007, 10:31 PM
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Default Resubmit or not

Hello, I retired from the Air Force in Jan 03. I’m 45. Just would like to know if I should resubmit a DMII and Hypertension claim I did in 04 and was denied. The claims were submitted within the 1 year time frame. My glucose was 129 before I retired and the doctor said the standard for DM was 126 but I don't think he put it in my records as a confirmed diagnosis. In May 07 I went to a doctor and he stated I do have DMII, my glucose was 169 and my A1C was 139. I was put on medication that I have to take twice a day. Also the doctor said I have hypertension and was put on medication for that to. I looked at my medical records ten years back and blood pressure readings are mostly in the low to high 140s. Now it’s in the high 150s but has dropped down since I started to take medication. Would it be advisable to resubmit on both of these issues? Also in 03 I got 10% for arthritis of my lower back. I have gone back to the doctor on many occasions due to back problems. In 06 a doctor mailed me my medical report and it stated my entire spine top-down was arthritic. Should I or can I resubmit for an increase for my entire spine. I also have arthritis in both shoulders and both hips
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Old 08-01-2007, 09:19 AM
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I can't tell you if you should resubmit or not. Only you can decide that but I can help you understand the statutes and regs as well as how the VA currently handles various conditions. In order to be successful with a claim, you will need to show it manifested either during your service or for certain chronic conditions, during the one, three or seven year presumptive periods. All of the conditions you mention seem to meet the one year presumptive period as defined in 38CFR3.309.

You don't actually require a diagnosis by the end of the presumptive period but you will need to show it existed by that time. You will also need to show a current diagnosis. That diagnosis can come from your physician or from a VA C&P examiner. I couldn't say if your glucose level of 129 before discharge is sufficient to show it manifested or not. Is your blood glucose documented in your Service Medical Records? Look in the Reasons and Bases Section of your decision papers and tell us why the VA denied SC for DMII at that time.

OK, now the arthritis. You say you have a current SC at 10% for lower back and wonder if you should resubmit. OK, why? Understand, this condition will generally be evaluated based on range of motion. Pain, in and of it self, is irrelevant unless it limits range of motion and specious claims of "back problems" won't be persuasive. as far as seeking an award for SC arthritis in other joints goes, that's going to be a hard sell unless you can show that joint manifested by the end of the presumptive period. An award for one joint isn't a guarantee to an award of every other joint in your body as each joint is evaluated separately. Sounds like a genetic problem.

Wrt your hypertension: I'd suspect a doctor's diagnosis will get you a service connection at 0% as it doesn't seem to rise to a level sufficient for a 10% award which should be a minimum of 160mm diastolic or 100mm systolic. Of course a C&P examiner might disagree. A single reading is generally insufficient and hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days.

FWIW, you don't need to go this alone. Every Veterans Service Organization (VSO) and some States and Counties have VA certified Service Officers (SO's) that will assist veterans and their spouses with presenting their claims. Call The Veterans of Foreign Wars (VFW), the American Legion (AL), the American Red Cross (ARC), the Disabled American Veterans (DAV) Military Order of the Purple Heart (MoPH) or any of the other hundreds of organizations and ask for help filing a claim. It's free and you don't have to be a member.

One thing to remember is that all SO's are not cut from the same cloth. Choosing one is pretty much a crap shoot unless you get personal recommendations in your area from other vets. SO's can be both good and bad depending on the individual SO. Talk to several, find out which ones return your calls and are available when you call them. Most of the major Veterans Service Organizations have training programs but not all require it. In the end, find someone you can work with.
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TinCanMan
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