Matthew: Hello and welcome to the Hill & Ponton’s Veterans Video Blog. I’m Matthew Hill.
Carol: I’m Carol Ponton.
Matthew: Today we want to talk to you about the importance of secondary service connection with two specific areas. Those are the back and diabetes.
We see a lot of times where veterans are incredibly disabled. They can barely get around with diabetes and the back, but the core service connected disability itself is always low.
For instance, for diabetes. If you are diagnosed with diabetes and just taking insulin, it’s a 20% rating. We’ll see a veteran who is almost completely disabled at that rating, but it’s not because of the diabetes diagnosis itself; it’s because of the secondary problems.
Carol: Peripheral neuropathy, the tingling, the numbness, the inability to feel or use your hands or your feet for walking – they are significant additional ratings that you deserve if you have diabetes, and most diabetes ends up causing these kinds of problems.
If you have a 20% rating for your diabetes, you could have a 40% rating for one hand, a 50% for another and you could have the same thing, 40% each for your feet. Sometimes the diabetes becomes so bad that you can’t feel your feet at all. Sometimes your rating is far higher for the secondary problems than it is for the main problem – the diabetes diagnosis itself.
Matthew: We’ll see, a lot of times, where a veteran will even be 100%. The directly service connected disability is the diabetes, but it’s because of all of the secondary problems from the diabetes that they get that higher rating.
Carol: Before we finish, DBQs are what the VA uses when they’re evaluating a problem. The DBQs will ask questions about problems that diabetes commonly causes. Along with the peripheral neuropathy, it could cause incontinence and it could cause kidney problems.
There are lots of things that diabetes can cause. You need to know your own diagnosis – what problems am I having and are they related – so that you can bring this to the VA’s attention.
Matthew: The DBQ is the Disability Benefits Questionnaire. One that is not on there but is very common is depression. A lot of times the more severe a disability gets, the more likely the veteran cannot do what he used to do, cannot interact like he used to interact, and there is a severe depression that sets in.
The other one we were talking about is back disabilities. Again, we’ll see veterans with a back disability that is rated at 20%. It is really hard to get a rating higher than 20% just for the back. However, it also causes severe secondary disabilities.
Peripheral neuropathy is the tingling and numbness that is caused by diabetes. There is a very similar sensation in lumbar disc problems called radiculopathy. It can cause weakness, tingling, frankly, loss of muscle strength in your legs as well. We’ll see veterans who have a back problem, but the main problem is the radiculopathy that goes up and down.
Carol: They can get to the point because of the loss of muscle power and the loss of feeling that they have foot drop and they can’t pick up their foot to move. That is a significant rating all on its own which comes with other benefits as well. You need to think about all of the problems, whatever your service connected disability is, that it would cause.
For instance, a neck problem. A neck problem, you may have it rated at 20% or 30%, but the serious problem you have from that comes from your inability to use your hands, inability to raise your arms – cervical radiculopathy.
Matthew: We’re not doctors; we just play one on video blogs. Again, that is another important place where a veteran could be extremely disabled and the rating for the actual neck, just like the back or the diabetes, is very difficult to get in proportion to the extent of the disability. But it’s the secondary problems that allow the veterans to get that rating higher to what they deserve.
Carol: I really worry about veterans who are not using the VA for their medical treatment in this regard because if your medical records are not in your claim file, they are not going to know that you have all these problems necessarily.
It is up to you to get those records in. The VA tells you they will write for them, and they do, but they don’t pay for them so a lot of facilities are not going to send them. You think the records are in the file; they are not in the file.
It’s very important that you get all the records that you think are important, especially to these secondary problems, and get them in the record. When you go to a C&P exam, make sure that that doctor who is evaluating you knows about these problems.
Matthew: As in you tell them, give them the records if you have them there, but also tell them. We’ve spoken about C&P exams in the past, and we would recommend you take somebody with you who knows your conditions – your spouse, children, or parents – because it’s important to make sure the VA knows all of the disabilities and that it might have started with the diabetes, but the neuropathy has gotten horrible and the diabetes is what caused that.
Carol: If you’re the veteran, like most people, when you’re there that day for the exam, you are going to be thinking about what is it that is hurting me most today which may not be what hurts you tomorrow.
It’s important to have someone who sees the big picture with you and say, “Yes, but yesterday, you couldn’t walk because of your foot; it was so totally numb,” or “remember you tripped? Look at all the bruises you have on you because you couldn’t feel.” “You came home with no shoe on. You didn’t even know you had walked out of your shoe because your foot is so totally numb.”
These are all instances of what has happened to my veterans that I’ve been told by their spouse or family members, not by them.
Matthew: That does it again for this edition to the video blog. Thank you for watching. This is Matthew Hill and Carol Ponton. We hope to see you next time.