Menieres Disease C&P Exam Help!

Globe2280

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So I had my general C&P exams done by a QTC General Practice Doc. I went in, he started as expected and went down the list of conditions while asking me questions about them. Here is where it becomes odd. After finishing the Muscle Skeletal exam (ROM) he ended the exam without talking about my boardable condition which is Menieres Disease. Not a single question was asked. While exiting I asked him about it and he said that he will look at the treatment records. Fast forward 5 days, I call QTC's front desk and ask about the results and voiced my concerns. The lady pulled up the DBQ and as I had and told me hat the doc selected VERTIGO, HEARING IMPAIRMENT, TINNITUS, STAGGERING. Unfortunately he did NOT select hearing impairent associated with vertigo and CEREBELLAR GAIT, which is essential for a rating above 30%. So I faxed then my private ENT Doc's memo that states that I have ATAXIC GAIT during episodes. The next they the lady spoke with the Doc and he told her that the file had already been submitted. The DBQ does mention staggering and gait issues, but he did not select Cerebellar gait. Does anyone have advice in what I could do at this point to prove the CEREBELLAR GAIT? Any advice is much appreciated !
 

oddpedestrian

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You can submit additional evidence or appeal and add it later if you don't like the findings. The doc can add an addendum as well but may be refusing.
 

Globe2280

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Thanks for the reply. Do you think getting my private ENT to fill out the DBQ and maybe a letter stating that I have cerebellar gait would be enough? Is there any other evidence I can get that you could think of? I could probably upload any evidendce I get directly through Ebenefits website?
 

oddpedestrian

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Getting the private DBQ would be the best option.
 

LCDR Greg

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Do the private DBQ and submit any progress notes, diagnosis, etc from your private MD. They will read it all.
 

FormerMedic

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Hey there. You are fine, but you should get an independent audiologist to write your diagnosis of menieres disease, that it's more likely than not that your exposure in service either caused or exacerbated it, and a reasonable logical argument which refers to your exposures and peer reviewed medical literature. Get it done and on file NOW. Here's why; not all QTC C&P examiners operate on an admirable ethical or intellectual level. These people are not providing you medical care so their state boards frankly do not care whether or not they provide you a competent exam. At least my state board didn't. BUT, if you have a professional with a cogent argument whose degrees are as specialized, or of equal or greater merit than that of their examiner - tie goes to the veteran.

With regard to the disease itself. Worry not. The rating criteria are based upon how many episodes a month you have of extreme dizziness, loss of low tone hearing, feeling fullness in the ears, and vestibular symptoms, etc. THE KEY HERE IS THAT THESE SYMPTOMS ARE TRANSIENT. Even VA's rating criteria acknowledge that they are of a temporary nature, passing after 20 min to an hour. Eventually you will lose low tone hearing and suffer the further debilitating effects of menieres - no you didn't ask for it - who did?

At any given day, at any given time, the probability that you are not having an episode is greater than that of you having one. Get good documentation that you do have them and make sure VA has that on file. Next time you have one, if you have a driver available, go to your closest physician so they can document it. Barring that, if you have a trigger (some people trigger like migranes to seafood, sweets, caffiene, etc.) - ask yourself if it's worth it to suffer once unnecessarily so that your next VA medical appointment can document how bad it is - AND that you have menieres.

But remember - you need three things: 1) an injury or precipitating event on AD, 2) a present disability, and 3) a nexus or sound proof that 1 caused or made worse 2.

All 3.

Without that you stand no chance at all. I really hope this helps you and am sorry you suffer from it. As an afterthought I will post the appropriate section from 38CFR. That Note is very important too. If you get 30% for menieres, tinnitus will be 0 - so they don't rate the same issue twice.

Note: Evaluate Meniere's syndrome either under these criteria or by separately evaluating vertigo (as a peripheral vestibular disorder), hearing impairment, and tinnitus, whichever method results in a higher overall evaluation. But do not combine an evaluation for hearing impairment, tinnitus, or vertigo with an evaluation under diagnostic code 6205.
6205 Meniere's syndrome (endolymphatic hydrops):
Hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus100
Hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus60
Hearing impairment with vertigo less than once a month, with or without tinnitus30
 

Globe2280

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First off, thanks to all of you for the great advice. I did receive 100% rating! At this time it is a proposed. The military has not officially found me fit or unfit. I am kind of stressing out though about the proposed portion though. From your experiences, do they change?
 

dposey717

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First off, thanks to all of you for the great advice. I did receive 100% rating! At this time it is a proposed. The military has not officially found me fit or unfit. I am kind of stressing out though about the proposed portion though. From your experiences, do they change?
hey there! did you have to get more opinions or did they accept staggering?
 

Globe2280

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They did accept staggering from the C&p exam doc, but I had my ENT fill out the exact same DBQ and he checked almost all of the symptoms including vertigo/cerebellar gait more than once weekly. I believe that is what pushed it over the edge. I would not solely rely on the C&p doc, simply because they just aren’t specialized enough and have never treated you before. Please let me know if you have any other questions.
 
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