About 15 years ago, when the IDES had been underway for a year or more, a prospective client came to me to appeal his TDRL findings. He had originally been placed on the TDRL through the IDES for a conversion disorder at a 30% disability rating, and the IPEB had reduced his findings to 10% disability severance upon reevaluation. For those of you unfamiliar with the term "conversion disorder", the simple explanation is that it is a term used to describe when a person suffers from a mental health issue that disrupts how their brain works. It can cause very real physical symptoms that are beyond your control, such as seizure-like attacks, muscle weakness, or reduced senses. Nowadays, it would be called a functional neurological disorder.
However, in this case, the IPEB had adopted this diagnosis based on an assessment by a military neurologist who said that my client had psychogenic seizures, but who never conducted any EEG studies to validate his diagnosis. Compounding this error, the VA C&P examiner never considered ordering an EEG study or sending the case back for further development. I found these errors to be very troubling and had his post-service Tricare provider refer him to another neurologist. He underwent extensive testing and was found to have a focal point seizure disorder.
Based on this testing, I filed an FPEB brief requesting that the panel overturn his previous findings and award him a 60% PDRL finding for his seizure disorder. The FPEB members gave us an on-the-record decision overturning his original diagnosis and awarding the 60% PDRL rating that we requested. We then went back to the VA and successfully appealed the errors made on the VA side as well.
What did I learn from this case? Simple- I always first review the previous case file in TDRL cases for diagnostic errors, tests that were never performed, errors in previous VA exams, and records from outside treating providers that were not given due consideration when the case was initially evaluated.
However, in this case, the IPEB had adopted this diagnosis based on an assessment by a military neurologist who said that my client had psychogenic seizures, but who never conducted any EEG studies to validate his diagnosis. Compounding this error, the VA C&P examiner never considered ordering an EEG study or sending the case back for further development. I found these errors to be very troubling and had his post-service Tricare provider refer him to another neurologist. He underwent extensive testing and was found to have a focal point seizure disorder.
Based on this testing, I filed an FPEB brief requesting that the panel overturn his previous findings and award him a 60% PDRL finding for his seizure disorder. The FPEB members gave us an on-the-record decision overturning his original diagnosis and awarding the 60% PDRL rating that we requested. We then went back to the VA and successfully appealed the errors made on the VA side as well.
What did I learn from this case? Simple- I always first review the previous case file in TDRL cases for diagnostic errors, tests that were never performed, errors in previous VA exams, and records from outside treating providers that were not given due consideration when the case was initially evaluated.
