Type 1 Diabetes (Recieved Proposed Rating VA??)

ZANI

PEB Forum Regular Member
Registered Member
I recieved my proposed VA rating today via mail for type 1 diabetes, and the VA proposed 20%. Now i know this is fairly common but in my disposition and recommendations my endocrinologist states "must avoid strenuous and occupational and recreational activities in order to prevent hypoglycemic episodes and must restrict diet in order to help control blood glucose levels" this is exactly how it is stated..
And in the VAs explanation it says " a proposed higher evaluation of 40% is NOT warranted unless there is restriction of activties" My question is isnt that exactly what my endo put?? I feel as though i have all the criteria to recieve 40%.. I DO NOT UNDERSTAND?? Any info or opinions would be helpful
 

BC Douglas

PEB Forum Regular Member
Registered Member
I recieved my proposed VA rating today via mail for type 1 diabetes, and the VA proposed 20%. Now i know this is fairly common but in my disposition and recommendations my endocrinologist states "must avoid strenuous and occupational and recreational activities in order to prevent hypoglycemic episodes and must restrict diet in order to help control blood glucose levels" this is exactly how it is stated..
And in the VAs explanation it says " a proposed higher evaluation of 40% is NOT warranted unless there is restriction of activties" My question is isnt that exactly what my endo put?? I feel as though i have all the criteria to recieve 40%.. I DO NOT UNDERSTAND?? Any info or opinions would be helpful
You need to gather your paper work, go to your VA and request a medical release of information, if your endocrinologist said what your saying, go and refile through the DAV, or your states veterans rep. I was in the same boat as you were. I have my paper work to show you when mine went up to 40%, I will leave my email address, if you give me yours I will send you a copy of it. I have been out over 24 years, I know everything there is to know on the disability end. B.C. [email protected].
 

ZANI

PEB Forum Regular Member
Registered Member
Has anyone had a similar situation to this? Did you disagree with The VA and fight for 40%? Do I even have a case/ would it be a case to bring to a formal board?
 

Jason Perry

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The formal board will not change your ratings. You need to do a VA rating reconsideration request. You have a very strong case for a 40% rating. (It is unwise to ever count on something as guaranteed....but based on what you have written, to me it is inconceivable that you would not be rated at 40%).

Good luck!
 

ZANI

PEB Forum Regular Member
Registered Member
Jason,

So what your saying is to do a VA rating reconsideration request to get the 40% from the VA. But you dont think i'll have case to bring to a formal board from the dod's side of things. I am yet to recieve my findings from the PEB yet, but i am sure they will agree with the VA, and rate me at 20% and severance...once this happens do you think i should rebuttal??
 

Jason Perry

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Well, hold on...you aren't sure you have been found unfit for diabetes already? When you asked about taking it to a formal hearing, I assumed you already had an informal.

So, first, you have to see if the military finds you unfit for diabetes. If so, then (on that issue), there is nothing to appeal. You are found unfit. But, for the rating issue, you do your "one time" (for purposes of IDES while you are still in military...you can appeal through normal VA appeals process after you are out) VA rating reconsideration request to address the rating. It should be pretty straight forward to get the rating increased.
 

ZANI

PEB Forum Regular Member
Registered Member
OK. I understand what i need to do on the VA side of things. NOW I am still actve duty and know i will b unfit because the peblo told me. i am just waiting on the my official findings to come back. i only know what the VA has rated me because i requested my proposed ratings, and they sent them in the mail. SO do you think i will have a case to bring to a formal board? If say it comes back at unfit 20% with severance?? you get me
 

Jason Perry

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No, you don't need a formal if they found you unfit. Unless you think you have other conditions that make you unfit and they don't find you unfit for those condition. Under IDES, the PEB only decides fitness or unfitness (well, actually, they also can make other administrative findings, like combat related, etc.). So, if you are unfit for diabetes by the informal board, you have nothing to disagree with. The VA side of things is where you address the ratings.

Make sense?
 

ZANI

PEB Forum Regular Member
Registered Member
So who makes the decision if your medically retired vs separated. if i am 20% and receive severance pay, but dont agree and feel as though i should recieve 40% how do you go about doig that?
 

ZANI

PEB Forum Regular Member
Registered Member
SO all your saying i need to do is put in that VA reconsideration request? and what if i do get the 40% from the VA? pretty much what i want to know us how do i get medically retired rather than medically separated?
 

BC Douglas

PEB Forum Regular Member
Registered Member
I recieved my proposed VA rating today via mail for type 1 diabetes, and the VA proposed 20%. Now i know this is fairly common but in my disposition and recommendations my endocrinologist states "must avoid strenuous and occupational and recreational activities in order to prevent hypoglycemic episodes and must restrict diet in order to help control blood glucose levels" this is exactly how it is stated..
And in the VAs explanation it says " a proposed higher evaluation of 40% is NOT warranted unless there is restriction of activties" My question is isnt that exactly what my endo put?? I feel as though i have all the criteria to recieve 40%.. I DO NOT UNDERSTAND?? Any info or opinions would be helpful
One thing you need to remember is that you need to appeal every chance you get, when you become an insulin dependent diabetic, you have restriction of activities, so yes you need to appeal
 

BC Douglas

PEB Forum Regular Member
Registered Member
SO all your saying i need to do is put in that VA reconsideration request? and what if i do get the 40% from the VA? pretty much what i want to know us how do i get medically retired rather than medically separated?
I was diagnosed with Type 1 diabetes while I was in the Marines 24 years ago
, that was automatic discharge, of course that was honorable, I was out in a week, no questions asked, but it seems now that they let you stay in, I will say this, unless you are an officer, retire, get out as soon as you can, you make more from your disability. B.C. [email protected]
 

BC Douglas

PEB Forum Regular Member
Registered Member
So who makes the decision if your medically retired vs separated. if i am 20% and receive severance pay, but dont agree and feel as though i should recieve 40% how do you go about doig that?

You appeal the discision, through whatever board made the dicision. B.C. [email protected].
 

Jason Perry

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SO all your saying i need to do is put in that VA reconsideration request? and what if i do get the 40% from the VA? pretty much what i want to know us how do i get medically retired rather than medically separated?
Yes, request the reconsideration after you get the informal results back. Then, if the VA rates you at 40%, then the military will apply that as your military rating (as it is unfitting in your case).
 

ZANI

PEB Forum Regular Member
Registered Member
SO,

could someone tell me how this one time VA rating reconsideration works? how long does it take? do i stay on active duty while the reconsideration is taking place? also do i have to get additional va exams? because my problem is i feel they overlooked important documentation that was already there, and didnt rate correctly?
 

Jason Perry

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You will make your election for the reconsideration, file anything you want them to consider (cover letter, additional evidence, whatever), and they will relook your rating. This occurs while you are still on active duty. Impossible to say how quickly this might happen...I have seen very quick responses (few weeks) and I recently had a case that took many months (I think it was 6, but I have not looked at the exact timing). Additional exams? I think it is within their authority to do this, but I doubt they would in most cases.

In your case, I think you just reference what they missed (i.e., the statement about regulation of activities). Only question I would have is whether your C&P exam stated something different about regulation of activities. In that case, I think you would be best served by a memo making a legal argument about what the VA exams are required to contain, the requirements for examiners to review records, and anything else applicable to your case.
 

BC Douglas

PEB Forum Regular Member
Registered Member
SO,

could someone tell me how this one time VA rating reconsideration works? how long does it take? do i stay on active duty while the reconsideration is taking place? also do i have to get additional va exams? because my problem is i feel they overlooked important documentation that was already there, and didnt rate correctly?
You need to get any addional (sp), evidence you can get, letters from cohorts that know about your problems, ANYTHING!!. It is not a one time consideration as far as the appeal is concerned, you can appeal as many times as you want, I can't speak for being on active duty, I was put out when I became a diabetic, so for that part you will need to speak to someone else, as far as other exams, probably not. Go to your personnel and request a release of information for your medical records, high lite anything that pertains to your problems, take them to the VA.
 

Jason Perry

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You need to get any addional (sp), evidence you can get, letters from cohorts that know about your problems, ANYTHING!!. It is not a one time consideration as far as the appeal is concerned, you can appeal as many times as you want, I can't speak for being on active duty, I was put out when I became a diabetic, so for that part you will need to speak to someone else, as far as other exams, probably not.
You don't NEED additional evidence- it sounds like you have sufficient evidence already. However, additional evidence would not hurt.

As far as "one time reconsideration" WITHIN the IDES system, while you are still on active duty, it is a "one-time" reconsideration. That is, while still on active duty, they will only entertain an appeal once. However, if not granted, when you are out of the military (retired or separated) then you can use the normal VA appeals process. It can take some time, but if your original award is later increased, then under IDES regulations, it is supposed to be a straight forward BCMR/BCNR application to get your military rating corrected (and this should be readily granted).

You will see in various places in regulations that you must have new evidence. Regardless of what they state, you can submit additional legal argument about errors in the case and they must be considered. If they are not and they arguments are meritorious, then you should win the appeal. I get concerned when people say you have to have additional evidence and people either cannot get it or they are overwhelmed by the idea and then they give up appealing. Remember, the MEB must contain the minimum information contained in the VA disability exam worksheets (which normally cover everything needed to properly rate a condition). If the exam is deficient, that is an error.

Go to your personnel and request a release of information for your medical records, high lite anything that pertains to your problems, take them to the VA.
Submit anything you have (evidence or argument) through your PEBLO using IDES procedures. The appeal is addressed to the VA, but normally it is channeled through PEBLO or PEB office. If you just submit it to the VA directly (especially at your local Regional Office), they will likely not know what to do with it, may view it as an original claim, or take too long to get it to the correct VA office to have it considered in your IDES case.
 

dwordal

PEB Forum Regular Member
Registered Member
I just went through this exact scenario. Originally, I was found unfit by the PEB (given an overall rating of 60%) and placed on the TDRL. However, in the breakdown of my disabling conditions, my type 1 diabetes was only VA rated at 20%. I felt this was unfairly low, especially considering how restrictive and severe type 1 can be on one's lifestyle. I decided to request a one-time VA reconsideration on the diabetes alone (against the advice of my PEBLOs, Navy doctor...everyone really). I subimitted additional medical records, a personal statement, evidence of being waived from PFAs, etc. It took almost 12 weeks but this Monday I got the final paperwork back. The VA accepted my request, diabetes was bumped up to 40% and my overall disability went to 70%. However, I'm still on the TDRL and it sounds like I will have to continue this fight at my 18 mo re-evals for the next five years, potentially. If anyone wants more info regarding the details on my experience with the IDES system and type 1, please message me. I also have two questions, for anyone who might know...

1. Why does the VA (and military in general) take such an archaic attitude toward diabetes and also have no distinctions between type 1 and type 2...two totally different diseases? From my understanding, they will give 50% automatically for sleep apnea but we have to jump through all these hoops, just to get 40%?

2. Is everyone having a bad experience with their PEBLOs/med board office like I have? During this entire process, they have done nothing but discourage me at every opportunity, kept me in the dark about the status of my package, and even been openly hostile when questioned about the process and my rights. Aren't they supposed to be the patient liaisons in this IDES system?
 

scoutout13

PEB Forum Regular Member
Registered Member
Help me.. I'm trying to get my type 1 from 20% to 40%. Tell me how you did it. I have a formal hearing on Friday the 13th of September.
I just went through this exact scenario. Originally, I was found unfit by the PEB (given an overall rating of 60%) and placed on the TDRL. However, in the breakdown of my disabling conditions, my type 1 diabetes was only VA rated at 20%. I felt this was unfairly low, especially considering how restrictive and severe type 1 can be on one's lifestyle. I decided to request a one-time VA reconsideration on the diabetes alone (against the advice of my PEBLOs, Navy doctor...everyone really). I subimitted additional medical records, a personal statement, evidence of being waived from PFAs, etc. It took almost 12 weeks but this Monday I got the final paperwork back. The VA accepted my request, diabetes was bumped up to 40% and my overall disability went to 70%. However, I'm still on the TDRL and it sounds like I will have to continue this fight at my 18 mo re-evals for the next five years, potentially. If anyone wants more info regarding the details on my experience with the IDES system and type 1, please message me. I also have two questions, for anyone who might know...

1. Why does the VA (and military in general) take such an archaic attitude toward diabetes and also have no distinctions between type 1 and type 2...two totally different diseases? From my understanding, they will give 50% automatically for sleep apnea but we have to jump through all these hoops, just to get 40%?

2. Is everyone having a bad experience with their PEBLOs/med board office like I have? During this entire process, they have done nothing but discourage me at every opportunity, kept me in the dark about the status of my package, and even been openly hostile when questioned about the process and my rights. Aren't they supposed to be the patient liaisons in this IDES system?
 
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