VA CASE STUDY

WHAT WE WILL COVER

• Service Dates

• History of Veteran

• Claims Filed

• VA Decisions

SERVICE DATES

• Active Duty Dates:

• July 16, 2008 to March 3, 2009

• September 20, 2011 to November 6, 2012

• May 1, 2013 to October 31, 2013

• SD National Guard:

• January 30, 2008 to August 16, 2016

CLAIMS FILED IN 2016

• Skin Condition (Acquired in Afghanistan)

• Sleep Condition

• Sinusitis

• Stomach Condition

• Tinnitus

• Hearing Loss

Medical records such as post deployment physicals, and private treatment records describing

itchy skin, allergy and related symptoms were submitted with claim.

VA Rating Decision on Initial Claim

Granted

o 7825 Urticaria (Claimed as Skin Condition) 10%

Denied

o 6100 Bilateral Hearing Loss

o 6260 Tinnitus

o 6513 Sinusitis

o 7399-7346 Stomach Condition

o 9499-9411 Acquired Mental Health Condition (Claimed as Sleep Condition)

Treatment Purposes Only

o 9499-9440 A Mental Health Condition

CLAIMS FILED IN OCTOBER 2016

• Hodgkin’s Lymphoma

Veteran wrote a statement that he/she was diagnosed with this cancer (Diagnosed at VA in

September 2016) and submitted articles in support of service connected condition being a

symptom.

VA RATING DECISION

Denied

o 7709 Hodgkin’s Lymphoma

Reasoning: VA treatment and service treatment records were used to make the

determination that the veteran only suffered from a skin rash and no other symptoms of

Hodgkin’s Lymphoma were present or reported during service.

CLAIMS FILED IN NOVEMBER 2016

• Hodgkin’s Lymphoma (Reconsideration)

Veteran submitted another statement outlining history of symptoms, private treatment

records, and research articles.

VA RATING DECISION

Denied

o 7709 Hodgkin’s Lymphoma

Reasoning: Same reasoning as before: VA treatment and service treatment records were

used to make the determination that the veteran only suffered from a skin rash and no

other symptoms of Hodgkin’s Lymphoma were present or reported. A DBQ medical

opinion was requested by VA and the examiner opined that her condition was not service

connected as the additional symptoms of Hodgkin’s Lymphoma, increased lymph node size

and night seats, were not noted until 2016.

NOD FILED IN JANUARY 2017

• Hodgkin’s Lymphoma

Veteran submitted a statement with NOD which basically stated that the VA, Mayo, and

private physician all agreed that the initial complaint of itchy skin in 2012 was an early

symptom of the lymphoma.

VA RATING DECISION

Granted

• 7709 Hodgkin’s Lymphoma 100% (Back to original date of denial)

Rationale: A review of the evidence of record shows there are two negative opinions by a

VA examiner and a positive opinion by a doctor at the Rapid City Medical Center which

have compelling rationale for their conflicting opinions. Since both opinions are considered

credible the benefit of the doubt applies in this case. Considering the doctrine of benefit of

the doubt, the evidence of record provides an approximate balance of negative and positive

evidence on the merits. Therefore, a reasonable basis for a grant of the benefit is identified

at this time.

Updated VA Rating Decision Granted

o 8513 Peripheral Neuropathy, Right Upper Extremity Associated with Hodgkin’s Lymphoma 40%

o 8513 Peripheral Neuropathy, Left Upper Extremity Associated with Hodgkin’s Lymphoma 30%

o 8521 Peripheral Neuropathy, Right Lower Extremity Associated with Hodgkin’s Lymphoma 20%

o 8521 Peripheral Neuropathy, Left Lower Extremity Associated with Hodgkin’s Lymphoma 20%

o 7825 Urticaria 10%

o 6260 Tinnitus 10%

o 8100 Headache Associated with Hodgkin’s Lymphoma 0%

o 7709 Hodgkin’s Lymphoma 0%

QUESTIONS?