Filed to increase diabetes rating - now I need evidence of severity?

Discussion in 'Diabetes' started by Tom130, Feb 4, 2009.

  1. Tom130

    Tom130 New Member

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    I am currently rated at 20% for DMII. A few months ago, my private doctor replaced my oral meds with insulin - Humalog and Lantus. He signed a form 4138 statement describing this change; it included a sentence which I believe clearly states that I have a "regulation" of activities.
    I just got a letter from the VA regional office in which the following appeared:
    "As we consider your claim, you may submit evidence showing that your service-connected diabetes mellitus type II have increased in severity."
    Considering what I've read, this is news to me. I thought it was straight forward that changing from oral meds to insulin along with regulation of activities would be enough to increase my rating from 20 to 40%. Perhaps I should write a letter to them describing the rational for changing to insulin but I am worried that it will not be what they want, whatever that is.
    Any thought on this?
  2. TinCanMan

    TinCanMan Active Member

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    This is probably just a form of the required VCAA letter asking if you have additional info to submit. If you have it, send it in otherwise tell them to move on with the claim. FWIW, a change to insulin isn't required for 40% but regulation of activities is. A physician saying you have regulation will probably be insufficient. They are going to want to know kust what activities are being regulated. Statemrnts like should exercise more or modify diet are generally insufficient. What they want to see is something on the order of must not exercise or similar. It is a very small window.
  3. Tom130

    Tom130 New Member

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    Thanks TinCanMan,
    Here is the part of the statement dealing with regulation of activities:
    . "I advised the patient to avoid strenuous occupational and recreational activities to prevent any increase in the severity or frequency of hypoglycemic episodes. Activities should be limited and regulated to light and moderate levels with blood glucose management measures in accordance with ADA guidelines."
    . If you think this is insufficient, I'll get another more descriptive one put together. You're right about the letter they sent. It's the 30 day waiver one. I'm tempted to add a letter to my reply, but I'm also concerned that I might make things more complicated than need be. Towards the end of their letter, they mentioned that they had set up a medical appointment for me. That's probably a C&P so maybe it might be better to wait and discuss things face to face with their doctor.
    TB
  4. TinCanMan

    TinCanMan Active Member

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    Make sure you respond to that letter and any others like it or they will wait the required 30 or 60 days before proceeding. Send any info you want in and tell them you have no additional evidence and to get on with it.

    Their C&P examiner probably doesn't care what your doctor says. That info needs to go to the decision maker at the RO.

    I'd think your doctors statement should work. Please let us know how it turns out.
  5. abc160561b1

    abc160561b1 Member

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