service connection

malibupx30
Registered: 11/24/08
Posts: 6

	02/03/09	#1

Good morning to all.Back in Feb 2006 I filed a claim for Hep B&C with liver cirrhosis, and quite naturally I was denied.I filed a NOD with new evidence and requested a DRO hearing but was told I had to wait to file for I had not received a soc.After receiving soc(9 months later) refiled a nod and requested a VBA hearing. December of 2008 I received a call from the VA asking me if I still wanted a local DRO hearing and I said yes. On Jan 7th 2009 went to my DRO hearing.Jan 10 Th 2009 recieved my all important letter from the VA stating, We have decided your claim is “Service Connected” for Hep B&C with liver cirrhosis at 20% disability for Hep c but 0% for liver cirrhosis. They also included the wording you may get better so things may change. I only have 6 more weeks of shots (treatment Peg&Rib)Finally here are my questions(lol).Should I file a NOD on the cirrhosis(0%) rating before or after I finish my treatment.How did they determine my symptoms were Hep C related and not cirrhosis symptoms for both basically has the same symptoms. What is your opinion on all of this? Thanks for any and all assistance you may give. Julian
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NOD

Manager
Registered: 11/22/08
Posts: 654

	02/03/09	#2

Julian. This is how it works. If you look at the bottom of 38 CFR part 4, 4.114 Digestive ratings to DC 7354, it says you cannot rate Vet with DC7354 AND DC 7312(Cirrhosis).The reason being is that symptoms described in 7312 correspond with symptoms in 7354 and that would constitute pyramiding of ratings. Pyramiding is strictly prohibited in 4.14.Now, what is interesting to us is how you got SC for B(DC7345) AND C(DC7354), rather than just C. HBV, unless it is the chronic persistent version, is usually an acute disease(i.e. a disease you suffered, but subsequently recovered from). Recovery from an acute HBV infection imparts immunity and protects you from future infections. HBV is rated under DC 7345, which is almost identical to 7354. However, 7345 specifically excludes cirrhosis. If you are not currently infected and sick from the HBV, VA usually will not grant SC for it. As for the C, your most current symptoms will be what VA examiner rates you on for 2 years (usually, unless your symptoms get worse and you report it.)Chances are you will get a letter telling you you have a VA exam scheduled for Jan. 10, 2012 (in 22 months). So, if you file a NOD on the cirrhosis(7312), what extra-schedular argument will you use to defend a higher rating that does not pyramid on the Hepatitis C(7354)? You have to give a reason for your request and it has to hold H20. Cirrhosis, by medical definition, is Stage 4 or a decompensated liver. Doing IFN TX when you are S4 is a new one on me. It would kill most of us. What we have seen VA do is change your rating from 7354 to 7312 when you reach that cirrhotic state. They may start to get away from that as more and more of us are hitting that P&T point with the HCV. Once you get P&T, they don’t bother you anymore or insist you get out of the coffin and come down for an exam- in case you “got better”. You are being rated @ 20% now. So that means you are suffering symptoms for more than 2 weeks, but less than 4 weeks during the past 12 months. That is the only true yardstick of the rating for VA’s purposes. If you are now (currently)finding that you are losing more than 4 but less than 6 weeks per 12 months, then you need to file the NOD on the DC7354(hep C)and ask for 40%. If you are currently doing IFN TX I suspect you are in denial and doing the typical male macho thing I did until I couldn’t wake up one morning until 11AM. After 3 months of sailing the bed around the known universe, I acknowledged that maybe I was pushing the 100% envelope. Be honest about your illness to yourself. If you are entitled to it, claim it Julian.
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malibupx30
Registered: 11/24/08
Posts: 6

	02/04/09	#3

Hi thank you for your fast reply.Safetydanh from the Deli forum suggested I write you. Here is the exact wording from my SC papers,”service connection is granted for Hep C (also claimed as Hep B) with a history of cirrhosis as of Jan 10TH 2009 with a 20% rating”. So, my records do show I tested positive for Hep B antigen.I guess that means I had it and didn’t know it. My records show( after a bunch of test) I am Geno Type 1 and stage f3 to f4. Just a little back ground. In December of 2005 I started getting dizzy getting up and down and went to my family doctor.After a bunch of test I was told I have enlarged lymph nodes,liver,and spleen.Further test reviled Hep C and cirrhosis of the liver.Always felt tired,itching,pain on right side,lack of sleep.In April 2008 started treatment(peg&rib) which made symptoms worse.I figured after my treatment(6 more weeks) and I still feel the same or worse then maybe I should ask for a increase.Right now I am thankful I got service connected. I understand what you are saying and I don’t want anything I am not in titled to.You made a lot of sense and hopefully I will not feel worse.Thanks for your reply and assistance. Julian.
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NOD

Manager
Registered: 11/22/08
Posts: 654

	04/17/10	#4

Hey, Julian. Just checking up on you and wondering about your health. We worry if we don’t hear from you frequently. I see some of your posts on Delphi but you keep your cards pretty close to your chest, Cowboy! Hope all is well and you are keeping close tabs on your rating %. I’ve been in the hospital for most of last year (May to November) and just went thru another couple of operations to fix what they messed up last year. This time it was only 3 weeks , not 9 months. Anyway, let us all know you’re okay. You’re one of our Poster children- you won!
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stilwellrick
Registered: 02/17/09
Posts: 8

	04/26/10	#5

manager, name here is Rick. Need to ask some questions,but when I click on Ask Nod questions I get a message saying that whay I am looking for cant be found. Feel certain its on this end but I need help. Thanks. Rick
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AZeeJensMom
Moderator
Registered: 01/05/09
Posts: 94

	04/27/10	#6

Rick, I sent you a private message with instructions on how to post a new thread…..Hope it helps.
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shplimp1111
Registered: 03/11/10
Posts: 2

	04/29/10	#7

shplimp here..new to the site but very gratefull for all of the great info..I am waiting for my initial decision for hepc..just got the 30 day notice..keeping my fingers crossed..Thanks to you guys and 18 months of homework I feel I submited the best package I could..thanks for everything
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NOD

Manager
Registered: 11/22/08
Posts: 654

	05/01/10	#8

Dear Sir,Thank you for letting us know we are providing something useful for Vets. Most of us here have been through the VA hamburger machine a couple of times and that gives us some insight as to what you will be encountering. If your case has a solid foundation with nothing queer in there then you’ll win. Remember that the “VA examiners” who do your initial rating are young punk kids that have never been near gunpowder. I guess there are a few Vets who have been hired who may be raters, but I believe the number is insignificant. They usually twist the facts around to make you look far worse morally than you really are. Be prepared for that. Also, be prepared for a denial at the VARO level. This is very common and almost to be expected. If you truly prepared for this as you said, then you may very well succeed. I started in 94, gave up. and then started again in 2007 and won at the RO level after 2 nexus and an Independent Medical Opinion (IMO). The IMO backfired on the VA and I won. 17 months– and without my VSO who told me I was going to lose. There is no reason you can’t win unless you simply don’t have a doctor, a nexus from him and are presently infected with the disease. If it (the disease) has gotten progressively worse since you got out, then they can date its onset to within a year or so of when you contracted it or started exhibiting symptoms. I had high ALT (SGPT) readings in the mid 100s for 20 years before I came down with PCT. By then it was a no brainer. Good luck with your claim sir and remember we’re here if you need anything. Thank you also for your service to our Country.