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Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities. Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Tuesday & Wednesday at 7AM Central.
Take control of your medical evidence related to your benefits and visit https://podcast.prestigeveteranmctx.info/veteran/ for more information and to connect directly with us!
Hey, guys. It's Leahy here from Prestige Veteran Medical Consulting. I am a US army veteran, physician assistant, and former compensation and pension examiner. So welcome back to my channel, and today, we're gonna talk about anemia and VA disability benefits. So anemia is not as talked about as things like PTSD or sleep apnea, but it's actually more common than you think, And it can seriously impact your health and your VA claim.
Leah Bucholz:So let's break down what anemia is, how VA rates it, and what you need to know to avoid some pitfalls that can happen to veterans who get denied. So what is anemia? So anemia happens when your body doesn't have enough healthy red blood cells to carry oxygen throughout your body. Without that oxygen, you can end up feeling weak, tired, short of breath, or dizzy. There are several different types of anemia, and some of them are things like iron deficiency anemia.
Leah Bucholz:Usually, this happens when there's blood loss or poor absorption of iron, vitamin deficiency anemia caused by lack of b twelve or folate, hemolytic anemia where your body destroys red blood cells faster than it makes them, aplastic anemia is a type of anemia that, occurs when your bone marrow doesn't produce enough new cells, Sickle cell anemia is a genetic type where cells are misshaped. So this isn't just about being tired. Anemia can affect your heart, your brain, and your overall health. So let's talk about anemia in veterans. So why is anemia so common and prevalent in veterans?
Leah Bucholz:Anemia shows up very often due to things like medications. So long term use of pain meds, like anti inflammatories or NSAIDs can cause bleeding in the stomach or the intestines. That's like your Motrin and naproxen, things like that. Gastrointestinal problems like GERD, ulcers, or Crohn's disease can cause blood loss or poor absorption. Chronic illnesses like kidney disease, cancer, or autoimmune conditions can reduce blood production.
Leah Bucholz:Exposures to chemicals, radiation, or even burn pits may contribute to later blood disorders. VA health care data has shown that veterans, especially those with multiple service connected conditions, have higher rates of anemia than civilians. So let's talk about I always like to go over literature because this can sometimes be helpful to you in your claims process. So literature about anemia in veterans, It's definitely backed up by research. So a 2021 VA study found that when veterans developed anemia, many of them didn't get the proper follow-up tests like iron or b twelve checks.
Leah Bucholz:Another study showed that nearly sixty percent of older veterans admitted to hospitals already had anemia at admission. A 2024 JAMA Network study looked at over seventy one thousand veterans with iron deficiency anemia, and it found that taking iron two or more times a day improved hemoglobin faster than just once a day. So the bottom line is is that anemia is common in is very common amongst veterans, often overlooked, and it requires careful treatment. So how does VA rate anemia? So ratings are not necessarily my specialty.
Leah Bucholz:I'm not a legal professional, but I know this is important to you guys. So I try to get this data so you guys can go and look it up. So VA uses the 38 code of federal regulation, 4.117, and that's the schedule of ratings for hematic and lymphatic sim systems to evaluate anemia. Each type of anemia has its own diagnosis code. So sickle cell anemia, which, again, was that genetic disorder with misshaped cells that block blood flow.
Leah Bucholz:Aplastic anemia is that bone marrow doesn't make enough new cells. Iron deficiency anemia, often tied to chronic blood loss or poor absorption. That pernicious anemia or b twelve deficiency under code seven seven two two is the body can't absorb 12 causing nerve and blood problems. Acquired hemolytic anemia is when the body destroys red blood cells faster than it can replace them. Each of these can be rated anywhere from zero to a 100%, usually in ten percent increments.
Leah Bucholz:The VA looks at your hemoglobin levels on your on your blood test and also your symptoms, things like fatigue, dizziness, fainting, shortness of breath, or needing transfusions. The worse your labs are and the worse your symptoms are, the higher rating you may qualify for. So let's talk about primary versus secondary service connection for anemia. So when it comes to service connection for anemia, there are these two main categories. So primary service connection, this applies if the anemia was documented while you were in service or occurred while you were in service.
Leah Bucholz:For example, your service medical records might show low hemoglobin, repeated fatigue, or hospitalizations for blood loss while you are on active duty. Secondary service connection is gonna refer to the anemia being related to another service connected disability, and this is usually gonna be more common. It means that that anemia developed because of another condition like gastrointestinal bleeding from GERD or ulcers, chronic kidney disease, things like cancer treatments, for example, chemotherapy or radiation can cause anemia, side effects of medications for PTSD or chronic pain, autoimmune conditions such as lupus, and the list just goes on and on. So either way, you need to show that medical connection between your service and your anemia. So common reasons anemia VA claims get denied.
Leah Bucholz:So why does VA deny so many anemia claims? Here are some typical reasons that you could consider. You don't have a current diagnosis. You need lab work proving that you have low hemoglobin. Just symptoms alone is not gonna cut it.
Leah Bucholz:K? So no service connection. Even with a diagnosis, the VA is not gonna just grant benefits without a link to your service or another rated condition. So a lot of veterans get this confused. They think just because VA diagnoses them with a condition, that means it should be they should be compensated for it.
Leah Bucholz:No. They're just providing you health care. You still have to show how that's related to your service. So weak or missing nexus. So a doctor, whether that's the CMP examiner, your private doctor, or or another, you know, medical professional that you're seeing, must state that your anemia is at least as likely as not related to your service or another service connected condition so that adjudicators can review that and link it to your service if the evidence aligns.
Leah Bucholz:So C and P exam issues. Sometimes the VA examiner blames anemia on diet, lifestyle, aging instead of recognizing the service related cause. Again, the C and P examiner does not I've said this before in multiple videos. The C and P examiner doesn't make the decision. They just give a medical opinion.
Leah Bucholz:And then the adjudicators, whether it's the rater or whoever, the judge, rater, makes that determination based on the totality of evidence. So poor symptom documentation is another reason. If your fatigue, fainting, or shortness of breath aren't clearly documented, you might get underrated, or we could have your claim denied. So how do veterans support their claim? If you're filing an appeal, or if you're just filing a new claim, there are lots of great resources out there for you.
Leah Bucholz:Va.gov has a lot of health documents that can help you with the filing process. You can talk with a a VSO. You can talk with an accredited claims agent or an accredited VA attorney. They can also help you with it. So recent blood work or rep medical records showing your current hemo hemoglobin levels and your diagnosis.
Leah Bucholz:You can ask your own treating doctor for a nexus opinion if they're willing to provide you one linking it to your service. That's not required, but you can do that. Maybe they're they will help you. Doc you can document your symptoms and medical visits. You can write a journal and keep a journal.
Leah Bucholz:You can get buddy statements from your family or friends who have observed how that anemia affects your daily life. You can, you know, again, you can ask your doctor, and if they're willing, that's great. But if they're not, you know, that C and P examiner certainly can provide a positive opinion for you. So the stronger and clearer your evidence is, you know, you would hope, the more more likely your chances of approval are. So to wrap up, anemia is a real health issue for veterans, and the VA does recognize it under several different diagnostic codes, but claims are often denied because of missing lab work, weak nexus statements, or poor documentation.
Leah Bucholz:The good news is is you can fix those gaps with the right evidence. Anemia claims can be one. So if you found this video helpful, make sure to hit that like button, subscribe, and share it with another veteran who might be dealing with anemia and the VA system, and let me know in the comments if you've dealt with this before. What challenges did you face? What great experiences did you have?
Leah Bucholz:Maybe some of you had great experiences with your C and P exams and getting it connected. So until the time. Take care of yourself. And as always, thank you for your service, and thank you for watching. Alright.
Leah Bucholz:Bye, guys.