gousto64

Thank you both for your input i will let the doctor know.

Is their anything that can be added to my letter I am gousto64 Nexus Letter 　 　 Dr. smith-Orthopedic Surgeon Address To Whom it may concern, I am a Board Certified in Sports Medicine Board Certified in Orthopedic Surgery Licensed in Louisiana, with 17 years experience in my field of medicine . I’ve been treating Patient: smucktelley for (2 years) and I've been asked to provide an Independent Medical Opinion as to the patients condition as well as to providing a nexus to the patients Left shoulder and arm conditions. I've reviewed the patients civilian as well as Military medical records and deem it in my medical opinion, that Patients Left Shoulder and Arm problems are due to over use and is secondary to his service connected Right Shoulder injury patient suffered in 1988 following a rollover auto accident. Patient injured right shoulder or a Grade 3 shoulder separation With impingement . Patient has developed problems with his left shoulder and arm due to repetitive use, symptoms have been constant and have worsened over the past years. Patient suffered from the following symptoms at least 3 or more times a week with pain and numbness. In conclusion, it is in my medical and professional opinion, that the patients left shoulder and arm problems was caused by or the result of his right service connected shoulder injury (100% Medical certainty) and the conditions and symptoms have worsened and should be considered as secondary to his injury from May 1988. Please feel free to contact my office should you have any questions regarding this medical opinion or need any other assistance from my office. Regards, Dr. smith 9 November 2012 　

The loan officer that the va guieded me Requested her information before they would complete the loan app And would not go any further without it

Today I was denied a home loan because My wife has bad credit.The loan officer Said that alone I qualifiy for 150000 dollars but Because we live I acommunity property state State together we don,t quailify What can we do?

today i recieved information from the loan office that i qualify for a 150,000 dollars loan but with a wife i gualify for nothing. community property state. what can we do.

I,M 30% FOR RIGHT SHOULDER,I'VE JUST COMPLETED MAJOR SURGERY ON MY LEFT SHOULDER DUE TO OVERUSE. HOW WOULD THE BILATERAL FACTOR APPLY TO ME?

FIRST THANKS FOR YOUR TIMELY REPLIES I'M RECEVING 30% FOR MY RIGHT SHOULDER AND I,VE BEEN TRYING TO GET THE VA TO DO SOMETHING TO EAS MY PAIN THEY SAID WE WILL SUPPLY YOU WITH MEDS AND EXRAYS MRI,S BUT THATS IT .IF DID,NT HAVE HEALTH INSURANCE TO HIRE A DOCTOR WHO WAS WILLING TO TREAT ME AS IF I WAS,NT A 5150 SECTION 8 AND BELIVE WHEN I SAID THAT THE PAIN IN MY SHOULDER AND ARM WAS REAL, THE OPERATION PROVED THAT THERE WAS MORE DAMAGE THAN THEY WERE WILLING TO ADMIT . KNOWN I HAVE 3 MONTHS AWAY FROM WORK ON SHORT TERM DISABILITY AND LOSS OF INCOME. BUT I ALSO WANT TO REPORT THAT MY DOCTOR IS WILLING TO GIVE A IMO WE WEIGHTING ON A COMPLETE SMR,S .TO SEE IF WE CAN FIND A NEXUS BETWEEN THE RIGHT SHOULDER DISABILITY AND THE LEFT SHOULDER THAT I CLAIM AS OVERUSE .MY QUESTION IS IF WE ARE SUCESSFUL WHOULD THE 4.26 BILATERAL FACTOR APPLY.

I JUST HAD SURGERY ON MY LEFT SHOULDER AND ARM AND IT READS OPERATIVE PROCEDURES PERFORMED: 1. LEFT SHOULDER ARTHRISCOPIC BICEPS TENODESIS. 2. LEFT SHOULDER ARTHRISCOPIC SUBACROMIAL DECOMPRESSION AND BURSECTOMY. 3. LEFT SHOULDER ARTHROSCOPIC ROTATOR CUFF AND LABRAL DEBRIDEMENT. 4. LEFT SHOULDER PLATELET RICH PLASMA ARTHROCENTESIS. MY QUESTION IS THIS, IF I FILED A CLAIM WHOULD THIS BE CONSIDERED ONE INJURY OR FOUR.

And another thing the only law listed for their decision is the 38 cfr cowards nothing to challenge.

I have the first C&P exam from the NP for the month of Feb ,but no one at the VA hospital or the C&P exam unit has any record of a second C&P exam for the month of March.

correction it was the NP opinion that thrown out because they fell that the DR. has more education.

The Board may appropriately favor the opinion of one competent medical authority over another. See Owens v. Brown, 7 Vet. App. 429, 433 (1995); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Is their any way to win my claim after the VA uses Owens V. Brown against me?

I do not recall seeing anyone other than a NP . The VA gave only one official C&P exam in Feb and they say that in March i was given a second unofficial C&P exam because I was'nt aware of a second C&P Exam .

DECISION Service connection for hiatal hernia with gastroesophagal reflux disease (claimed as stomach problems and acid reflux secondary to medication for right shoulder separation with impingment and degenerative joint disease) as secondary to the medication used for the service-connection disability of right shoulder disability is denied REASONS FOR DECISION We have denied entitlement to service connection for hiatial hernia and gastro esophageal reflux disease as this condition did not occur in service nor is shown to be secondary to the medication used for your service connection right shoulder condition. Service treatment record are negative for complaints, findings or treatment for Haitian hernia or gerd while in military service. Private treatment records were reviewed and show complaints of dyspepsia and gerd. A relationship between this condition and your right shoulder condition is not shown. VA outpatient treatment reports show complaints and treatment for your right shoulder condition, for which you are on diclofenac and methocarbol for pain and muscle symptoms. Complaints of reflux systems are also shown, however, a relationship between these two condition is not of record. VA examination of Date was reviewed . The Nurse Practitioner indicated that your claim file and medical records were reviewed. For the examination. You Reported taking ranitidine for stoma problems, acid reflux,and heartburn. You Reported symptoms of epigastria pain, nausea, vomiting, and indigestion. Physical examination found no signs of significant weight loss or malnutrition. There were no signs of anemia. Upper GI series revealed a fixed Haitian hernia with associated GERD . In a medical opinion, the examiner stated is as least likely as not that your current complaints of stomach problems and acid reflux are related to the medication prescribed for your service connected shoulder disability. The rational is that the methocarbamol is used as a skeletal muscle relaxant , with side effects of nausea, vomiting, and dyspepsia. Diclofenac is a NSAID that has antipyretic, analgesic, and anti-inflammatory properties. It’s side effects include Dyspepsia, peptic ulcer disease, and bleeding. Ranitidine is a histamine H2 antagonist that is used to treat heartburn, acid indigestion, and sour stomach, which could prevent Systems and damage to the gastro esophageal tract caused by stomach acid or infection. THE NURSE Practitioner stated that a review of the existing data revealed that you developed gastro esophageal problems following taking the prescriptions of diclofenac And methocarbamol. You were eventually placed on ranitidine to control gastrointestinal effects. And here’s the bad part known after reading this you will say why did you take another C&P exam answer I didn’t. On March another VA examination was performed by a staff physician. The Physician noted that your claims file and medical records were reviewed for the examination. Symptoms reported included daily heartburn, regurgitation, and esophageal Distress. Physical examination found your overall general health to be fair There were no signs of anemia or significant weight loss/malnutrition. The physician diagnosed you with hiatal hernia with Gerd. The examiner provided an opinion that it was not likely that your current muscle relaxer(mwthocarbamol) and /or pain medication(diclofenac) Caused the hialat hernia or GERD . He noted that this is based on the fact that the lexi- Comp online (medication information) shows gastrointestinal adverse effects of methocarbol are nausea,vomiting,metallic taste and dyspepsia. It shows adverse Gastrointestinal effects of diclofenac are abdominal pain, nausea, and vomiting. The examiner indicated that the statements by the nurse Practitioner are incorrect. A request was made for the physician to clarify his statement from March > The Physician responded on June and indicated that he thinks there are two different things. The “stomach problems” such as burning pain, nausea, etc. He agreed that it is at least as likely as not that these symptoms are related to the muscle relawer and pain medications. That opinions based on the face that those things are listed as possible adverse effects of both medications. gastro esophageal junction. Frequently GERD is found in association with a hiatal hernia. There in nothing in the medical Literature that supports a claim of pain medications Causing a hiatal hernia. Therefore, it is the Physicians contention that your hiatal hernia And sddociated gastro esophageal reflux is not caused by the muscle rexlaxer and/ or pain medications. The evidence of record shows two competing opinions from a nurse Practitioner and a staff physician. Probative weight must be assigned for each opinion. The Nurse Practitioner gave a 50/50 Probability that your current complaints of stomach problems and acid reflux are related to the medications used for your right shoulder, based on published side effects listed for those medications . However, the staff physician indicated that you have a hiatal hernia with associated gerd. He indicated that this is a structural problem/ abnormality and there is nothing in the medical literature that shows muscle relaxants or pain medication causing a hiatal hernia. He state that your hiatal hernia and associated Gerd is not caused by medications for the right shoulder. The physician’s opinion is given greater weight based on the educational background of the examiner and the rational provided regarding the etiology of your hiatal hernia and associated reflux. The available evidence does not show that a hiatal hernia with GERD was treated for or Diagnosed in service. Additionally, no evidence was submitted to show that hiatal hernia With GERD is the result of military service or the result of medication used for your Service connected right shoulder condition. The benefit of the doubt rule does not apply because the preponderance of evidence is unfavorable. Therefore, entitlement to service connection is denied. Service connection may be granted for a disease or injury which result from a service connected disability or was aggravated thereby. The evidence does not show that hiatal Hernia with gastro esophageal reflux disease (claimed as stomach problems and acid reflux secondary to medication for right shoulder separation with impingement ) is related to the medications used for the service-connected condition of right shoulder injury nor is there any evidence of this disability during military service. I NEED HELP WHAT SHOULD I DO NEXT?

The year 2000 i filed a claim for a grade 3 shoulder separation and was denied i appealed and was granted 10% . I appealed for a higher rating and was given 20% than i filed a claim for an increase in 2009 and was given 30%. My question is can request retro all the way back to 2000?