Appeal conditions or just add more?

Sindar27

PEB Forum Regular Member
Registered Member
Hi Jason and all,

I'm currently in the IPEB phase and was able to receive my proposed ratings from the VA. I was referred for 5 conditions for my MEB and claimed 20 conditions overall to the VA. Of those 20 conditions, 11 of them were found to be service related. My overall rating was 90% rounded down from 93% (60, 50, 30, 20, 10, 10, 10, 10, 0, 0, 0). For background, I'm over 21 years, so I have no worries about retirement.

My question is: What do you do if you believe the C&P doctor put incorrect/false information on your DBQs during an exam and you're still in the IDES process? From what I've gathered on this site, I can only ask for a VARR if the condition was a referred. I list details below, but neither of these conditions were referred.

An add on to that would be I have several conditions that I did not claim at the start of the IDES process. Instead of trying to appeal my original findings, would it be best to simply make additional claims that I forgot about and see how that plays out first?


Details on C&P exam:

1. Migraines (not a referred condition) - There are inconsistencies on the form. Question 2a says I take medication as necessary, yet question 2b is marked "no" to say my treatment plan doesn't include taking medication. The major issue I have is that I explained to the C&P doctor that I have migraines 3 to 4 times a month, yet she marked the frequency as "once every month". I feel if she had marked that box as "More frequently than once per month", my rating would have been 50% vs 30% that I received.

2. Hypertension (not a referred condition) - I'm on medication for hypertension and the C&P doctor only took my blood pressure once and noted it as 140/100. From there, we moved on to other topics. However, the DBQ shows two additional readings (143/98 and 133/88) that lowered the final average blood pressure reading down to 138/95. These other readings simply did not occur during the exam and were falsified. It seems suspicious that the diastolic threshold for 10% is at 100.

Thank you for any input.
 
Hi Jason and all,

I'm currently in the IPEB phase and was able to receive my proposed ratings from the VA. I was referred for 5 conditions for my MEB and claimed 20 conditions overall to the VA. Of those 20 conditions, 11 of them were found to be service related. My overall rating was 90% rounded down from 93% (60, 50, 30, 20, 10, 10, 10, 10, 0, 0, 0). For background, I'm over 21 years, so I have no worries about retirement.

My question is: What do you do if you believe the C&P doctor put incorrect/false information on your DBQs during an exam and you're still in the IDES process? From what I've gathered on this site, I can only ask for a VARR if the condition was a referred. I list details below, but neither of these conditions were referred.

An add on to that would be I have several conditions that I did not claim at the start of the IDES process. Instead of trying to appeal my original findings, would it be best to simply make additional claims that I forgot about and see how that plays out first?


Details on C&P exam:

1. Migraines (not a referred condition) - There are inconsistencies on the form. Question 2a says I take medication as necessary, yet question 2b is marked "no" to say my treatment plan doesn't include taking medication. The major issue I have is that I explained to the C&P doctor that I have migraines 3 to 4 times a month, yet she marked the frequency as "once every month". I feel if she had marked that box as "More frequently than once per month", my rating would have been 50% vs 30% that I received.

2. Hypertension (not a referred condition) - I'm on medication for hypertension and the C&P doctor only took my blood pressure once and noted it as 140/100. From there, we moved on to other topics. However, the DBQ shows two additional readings (143/98 and 133/88) that lowered the final average blood pressure reading down to 138/95. These other readings simply did not occur during the exam and were falsified. It seems suspicious that the diastolic threshold for 10% is at 100.

Thank you for any input.
Personally, I would appeal the IPEB and try and add new unfitting conditions between now and at the FPEB. If any conditions are added, or shifted from fitting to unfitting, those conditions could also be review by D-RAS by requesting a VARR. Given you have over 20 years, I don't see a downside if you think it is feasible getting a condition added or shifted from fitting to unfitting. But, if the C&P examiner's opinion isn't interfering with your DoD or VA rating, likely won't cause the outcome to change but will buy you more time towards retirement. Regardless of election, you should likely appeal the VA rating after you receive your VA award letter after retirement (do not need much of a bump to 100%).
 
Thank you for the input. I ended up getting impatient and decided to accept the results of the IPEB. I filed a follow up claim with my MSC for conditions that were discovered during my C&P exams. In addition to the new claims, I plan on asking the VA to split up the 60% rating...they combined Asthma, Sleep Apnea, and Sarcoidosis. I think a case could be made to split them.
 
You can filed an appeal of the VA rating through e-benefits. I found the online process easy, but not quick (on their end).
 
Top