VA CLAIMS 
SECONDARY TO DIABETES 

CORONARY ARTERY DISEASE In this chronic disease, atherosclerosis narrows the coronary arteries, the arteries supplying blood to the heart muscle. As the coronary arteries narrow, the chest pain called angina may be triggered. And the risk of a heart attack (myocardial infarction), which occurs when a coronary artery is blocked completely, is increased. Coronary artery disease currently affects 11 million people in the United States.

RIGHT  UPPER EXTREMITY DIABETIC NEUROPATHY
LEFT UPPER EXTREMITY DIABETIC NEUROPATHY 
RIGHT LOWER EXTREMITY DIABETIC NEUROPATHY 
LEFT LOWER EXTREMITY DIABETIC NEUROPATHY

Examinations for diabetic neuropathy assess muscle strength, deep tendon reflexes, and sense of touch (temperature, pinprick or pressure sensation, vibratory sensation, position sense). Different functions are affected in different individuals, and symptoms may be out of proportion to the findings on examination. Diagnostic criteria are based on some combination of symptoms, focused neurologic examination, nerve conduction studies, and special quantitative sensory tests, but some tests are difficult and time consuming, and not all are ordinarily done.

RIGHT FOOT ONYCHOMYCOSIS  What are the skin complications? In addition to infections (for example, Candida, dermatophytes, and bacterial infections) and ulcers, there are several specific conditions that may affect diabetics. Onychomycosis due to Epidermophyton floccosum (Toenail Fungus)

ERECTILE DYSFUNCTION  The examiner reviewed the medical records, examined the veteran, and provided the diagnosis of: Diabetes Mellitus. The examiner noted conditions as being secondary to the diabetes: Erectile dysfunction, hypertension, and neuropathy. The veteran reported to the examiner that attempts to alleviate the erectile dysfunction with medication had failed.
ANALYSIS: Entitlement to special monthly compensation is warranted in this case because criteria regarding loss of use of a creative organ were met from 
This case has been reviewed pursuant to the class action Nehmer v. United States Veterans Administration, Civil Action No. C86-6 160 TEll (N.D.). An effective date of 04-30-0 1 has been assigned. This is the date on which the VA received the claim that resulted in the grant of compensation. The rule stated in 38 USC 5110(g) and 38 CFR 3.114 that an award based on liberalizing law may not be effective earlier than the effective date of the new law does not apply to Nehmer cases.

RENAL DISEASE You need to have your doctor request regular 24 hour urine protein tests. They give you a plastic jug and you take it home, follow the directions and fill it up over 24 hours and then return it to the lab. They should also do a creatine test. The lab report will tell you the amount of microalbumin present. Creatin tests will also give an indication of the amount of renal damage and the efficiency of your kidneys. In order to be valid or acceptable to the VA there needs to be several 24 hour tests over a period.

DIABETIC RETINOPATHY  impairment or loss of vision due to damage to the blood vessels of the retina.

CATARACT clouding or opaqueness of the lens of the eye.

GLAUCOMA  Increased fluid pressure in the eye. Causes loss of visual fields due to optic nerve damage.

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