Billy woke up one morning to find
himself, a Disabled American Veteran, trapped in a web of technicalities
created by the VA Disability system. The VA only gave his condition a 0% VA Disability Rating, but he lived every day in pain from his disability. What
could he possibly do to get the proxper compensation his condition deserved?
While Billy was serving on active
duty, he began to develop serious skin infections that caused large, painful boils
all over his body, including his head, torso, buttocks, groin, arms, legs, and
feet. His physicians treated his symptoms by lancing the boils and giving him
antibiotics. With this treatment, his infections would clear up, only to recur
again in the future. He was officially diagnosed with “recurring abscesses”.
During this time, Billy also noticed
patches of dry, irritated skin, but they were basically ignored since the
infected areas were much more problematic. He noted, “These dry skin conditions
could have been eczema/dermatitis for all I know, but no one bothered to call
it that in my medical record. That was the unfortunate part, because this
oversight still haunts me to this day.”
The only condition mentioned in his
medical records, and thus the only condition eligible to receive Military Disability, was skin infections.
Billy’s first C&P Exam after
leaving the military unfortunately occurred at a time when he had no obvious
skin infections. He had recently been treated, the sores had all been cleared
up by the antibiotics, and they had not yet come back. Because of this, the VA
gave him a rating of 0% for Infections of the Skin, code 7820.
Code 7820 is one of the conditions in
the VASRD, the law that determines how conditions are rated, that is rated analogously
as something else. In Billy’s case, the VA decided to rate his condition
analogously with Dermatitis/Eczema, code 7806. So his final rating was
Infections of the Skin rated as Dermatitis/Eczema, code 7820-7806.
Years passed. Billy’s skin
infections continued coming back, and they were getting worse over time. He saw
numerous doctors for treatment. One physician officially diagnosed him with
dermatitis, and reported that his infections could be spreading across his body
because of scratching the patches of dermatitis while sleeping. Dermatitis was
now his main diagnosis.
After years of skin problems, Billy
also began to develop painful and unstable scars, meaning that the scars also
became infected regularly.
With his condition continually
getting worse, Billy’s ability to function normally in his day-to-day life also
worsened. He now definitely needed VA Disability Benefits, so he decided to
contact his local VA about having his rating increased.
He contacted his local VA and filed
a claim, but it was denied. The only official diagnosis he had at the time was
Dermatitis, and there was no proof in his military medical records that he had had
dermatitis while he was in the military. If a condition is not recorded while
in the military, it is not considered service-connected and thus not ratable.
The only other way Billy could prove
his dermatitis was service-connected was by providing definite proof that the
dermatitis was caused by the skin infections. Unfortunately, his type of skin
infections doesn’t necessarily cause dermatitis, and vice versa. Could it have,
though? Absolutely, but there is no definitive proof. The VA’s loophole.
Billy tried to file VA Appeals numerous
times to have his rating increased, but was always denied.
Now it may seem very clear to you
and I (and I hope the majority of people) that all Billy’s skin conditions are
very closely related, even to the point of being basically inseparable, regardless
of what they are called. Yet, based on the laws in place, the VA denials are
technically justified. Would another person reviewing his case decide that he
does indeed qualify for a higher rating? It is quite possible. There are rules
that the VA raters are required to follow, but there is still quite a lot left
up to interpretation. Another rater may look at everything, see it as we do,
and decide that he does qualify. Billy is literally being harmed by a mere
technicality.
So, what can he do?
First, he should go back to his
current physician and try to get him to change the diagnosis back to skin
infections. They couldn’t argue with the same diagnosis that is
service-connected.
If the physician decides that his
current condition is better defined as dermatitis than skin infections, then Billy
should at least try to get his physician to change the diagnosis to dermatitis caused
by skin infections, or something to that effect. What Billy needs to do is
make it harder on the VA to say no than yes. The skin infections are
service-connected, so having his doctor claim that his current condition was
caused by those skin infections could be enough to sway the VA rater.
Another tool that could help
influence the VA rater would be to submit images of his skin conditions with
his claim. Each image should be clearly dated. If an image of his skin
infections while he was in the military looks pretty close to the current
images, they might agree that they are basically the same condition.
Another option would be for him to
stop trying to get a better rating for his dermatitis/infections and instead
focus on getting a rating for his scars. Since his scars are pretty extensive,
painful, and unstable, he could get a pretty high rating for them alone. Again,
though, the key to this is to have the physician claim that the scars were
caused by his skin infections, not his dermatitis. Everything must link back to
his skin infections in order for the VA to rate them.
All in all, Billy is in a really
tough and unfortunate spot. The VA isn’t technically doing anything wrong, but
Billy is definitely not receiving the disability compensation he deserves for a
legit condition.
The main lesson to learn from this
is to guarantee that every single condition you have, no matter how small, is
properly recorded while in the military.
Service-connection is the key.
While this may not seem fair, it is
actually a very good law that protects the system from being abused by the
users out there. Why should taxpayers’ money go to pay for conditions that had
absolutely nothing to do with military service? Military disability should be
given for military disabilities.
It’s a good law overall, but it can
unfortunately backfire on the honest veterans who unquestionably deserve the
proper compensation.
Sadly, it may be too late for the
majority of you to have their conditions properly recorded while in the
military. If you are not fully separated from the military yet, though, make
sure to get this done. You will definitely not regret it, and it may make all
the difference in the future.
For all those stuck in the web of
technicalities right along with Billy, know that you need to carefully choose
your battles. There are some battles that may be easily won, but if you cannot
find a way to prove service-connection, you will only be fighting a loosing
battle.
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