Lower Back Claim

[Vync]

Hello everyone,

I am new here, so I am asking folks to please review and offer your opinions. Any assistance is greatly appreciated.

While I was on active duty from 1990-1995, I was injured numerous times during military training. I originally filed a claim back regarding my back in 1995, but it was denied. I am currently 40% SC, thanks for SC approval for several unrelated problems. While on active duty, the military took x-rays and diagnosed me with lumbar or muscular strain and prescribed medication, exepted me from physical activity, and also sent to physical therapy.

In early 2006, I suffered an injury to my L4-L5 and L5-S1 and was given an MRI, I was diagnosed with lower lumbar spondylosis (moderate narrowing of the disc cavities), degenerative disc disease, herniated vertebrae discs contacting the nerve roots, muscle spasms and strains, reversal of the lordotic curve, and and even advised to seriously consider surgery. I was given more loads strong medication, an epidural pain block, and eventually sought help from physical therapy and even a chiropractor.

In 2008, I filed another claim regarding my back, but it was denied. I spent time gathering copies of my service medical records and civilian medical records and re-filed again in August of 2008, providing counters to each reason the RO claimed was a basis for my denial. I also got a written statement from my ex-wife, who described her observations of my back problems. I just received a letter asking me to fill out medical release forms or provide medical evidence, even thought I sent the medical records already.

It seems very obvious that my back injuries during military service were the root cause for my current problems. I now have a sedentary desk job with an ergonomic chair and a wonderfully supportive girlfriend. Over time have had to re-train myself how to avoid reinjuring my back while performing normal daily duties. Quite often, I can control the pain and problems with medication, but when I simply sneeze or cough, I always worry about having to take another unplanned visit to the emergency room.

Questions

1. Given the nature of my injuries, what type of percentage would I qualify for?

2. With respect to my overall 40% SC rating, could I potentially see this increase or will they just embed it and leave me with the same rating?

3. Since I did not 'keep alive' the back injury portion of my original claim in 1996, if my back claim is approved, what could I expect as an effective date?

4. If I kept records of my out of pocket expenses for doctor and medication co-pays, if my back claim is approved, will the VA allow me to file for some sort of reimbursement?

Thanks,

Vync

[Berta]

Welcome here.

1. if this gets service connected they will use the Schedule of Ratings available here in the Claims Reference area-they might do funny VA math for the overall percentages- hard to say

2. if these are distinctly separate from what you the 40% for -they will rate the back problems and then possible do funny VA math again-

I am serious about the funny math part-others will chime in-you didnt say what the 40% is for-

3. The date you file the claim would be the EED.

You could have potential basis for a CUE claim- hard to say yet- to recover the date of the original claim.I wouldnt even consider that at this point.Cues usually depend on established evidence of what is now and should have been in prior decision -service connection.

4. You probably could recover any co pays for anything SCed once it is SCed.

"In early 2006, I suffered an injury to my L4-L5 and L5-S1 and was given an MRI, I was diagnosed with lower lumb" etc

They will attempt to use this NSC injury to say it is cause of your present back problems.

I advise that you collect copies of all available medical records and try to get an independent medical opinion- Make sure the IMO doc follows the IMO criteria here at hadit.

Can you prove your condition was continuous and chronic from service to present?

It sounds like you can connect the dots but the VA isn't good at that.

They will not pay comp for a NSC injury unless somehow it can be shown as being "aggravated" by a SC disability.

The inservice nexus is what you need.

Did they list and refer to all evidence yopu sent to them?

What did they say as to your SMRs and this condition?

[Pete53]

Welcome to Hadit

[john999]

Does the VA know about your 2006 back injury?

[Papa]

Hello everyone,

I am new here, so I am asking folks to please review and offer your opinions. Any assistance is greatly appreciated.

While I was on active duty from 1990-1995, I was injured numerous times during military training. I originally filed a claim back regarding my back in 1995, but it was denied. I am currently 40% SC, thanks for SC approval for several unrelated problems. While on active duty, the military took x-rays and diagnosed me with lumbar or muscular strain and prescribed medication, exepted me from physical activity, and also sent to physical therapy.

In early 2006, I suffered an injury to my L4-L5 and L5-S1 and was given an MRI, I was diagnosed with lower lumbar spondylosis (moderate narrowing of the disc cavities), degenerative disc disease, herniated vertebrae discs contacting the nerve roots, muscle spasms and strains, reversal of the lordotic curve, and and even advised to seriously consider surgery. I was given more loads strong medication, an epidural pain block, and eventually sought help from physical therapy and even a chiropractor.

In 2008, I filed another claim regarding my back, but it was denied. I spent time gathering copies of my service medical records and civilian medical records and re-filed again in August of 2008, providing counters to each reason the RO claimed was a basis for my denial. I also got a written statement from my ex-wife, who described her observations of my back problems. I just received a letter asking me to fill out medical release forms or provide medical evidence, even thought I sent the medical records already.

It seems very obvious that my back injuries during military service were the root cause for my current problems. I now have a sedentary desk job with an ergonomic chair and a wonderfully supportive girlfriend. Over time have had to re-train myself how to avoid reinjuring my back while performing normal daily duties. Quite often, I can control the pain and problems with medication, but when I simply sneeze or cough, I always worry about having to take another unplanned visit to the emergency room.

Questions

1. Given the nature of my injuries, what type of percentage would I qualify for?

2. With respect to my overall 40% SC rating, could I potentially see this increase or will they just embed it and leave me with the same rating?

3. Since I did not 'keep alive' the back injury portion of my original claim in 1996, if my back claim is approved, what could I expect as an effective date?

4. If I kept records of my out of pocket expenses for doctor and medication co-pays, if my back claim is approved, will the VA allow me to file for some sort of reimbursement?

Thanks,

Vync

Vync, I'm very impressed that the military doctors did all that for you. Do not give up the fight like I did. The VA denied me saying that I never hurt my back in the service. I like a bonehead let it go without a fight. I can now prove my injury and it is documented that the doctor requested no xrays, no PT, no pain meds nada. Oh! I'm sorry the doctor told me to sleep on the floor. I have had back problems ever since. BTW, Welcome. People on Hadit are just great.

Papa

[Vync]

Hey Berta,

I'll post the way they calculated my original 40% and text from the denial letter I received recently, but will need to dig out my original SC award letter. I have a couple of questions about the original calculation too. I looked over the calculations used in the fuzzy math and now know why it is referred to as fuzzy.

What is an EED? I looked on the commonly used definitions page, but EED is not there.

When I got out of the military, muscle spasms continued periodically, a couple of times a year until the major episode in 2006, which changed everything for me. The pain is now chronic and I am lucky if I go a couple of days without having some sort of problem.

Here is how I connect the dots:

1. Multiple injuries during military service

2. Injuries continue intermittently between 1995 and 2006.

3. Major episode occurred in 2006

4. Major problems and treatment through end of 2008, but been kinda lucky in 2009.

I have all service medical records and all private medical records from 2006 forward. I tried to gather medical records prior to 2006, but the medical provider claims they lost them.

Hey John999,

Oh yes, the VA definitely knows about my 2006 back injury, because my private records are well documented. I must say that the MRI looks really neat, kind of like someone stepped on a jelly donut and the jelly is oozing all out. The side view is also pretty neat too. You see all of these nice thick solid white discs running down my spine, but L4-L5 and L5-S1 are really dark and almost nonexistent. I didn't realize how bad off I was until I looked at the spine model and realized that the two discs that were supposed to be the largest were toasted.

Hey Papa,

When I was injured in the military, they usually gave me motrin and flexeril. They exempted me from physical activity for a few weeks and sent me to physical therapy just once. I got the records to prove to the VA that it actually happened. If they deny SC by saying I never hurt my back while in the service, I'll definitely look into filing a CUE. Since my problems in 2006, my civilian doctors have rolled out the red carpet of treatment, but it hasn't been cheap.

Hey Pete53,

Thanks! I am glad I found these forums.

It's great to meet everyone! Thank you very much for the feedback.

[Vync]

Here is the breakdown of my 40% SC rating:

1. 10% asthma bronchiole (claimed as asthma)

2. 30% allergic rhinitis/sinusitis (reduced by 10% because the VA says I had a 10% pre-service disability)

3. 10% chronic allergic conjunctivitis, bilateral

4. 10% internal derangement of the right temporomandibular joint

I posted on another topic about the pre-service disability rating and asking about getting it 'corrected'.

Here is the meaty text from my back problem SC denial letter. As always, any feedback is greatly appreciated.

We determined that the following condition(s) was/were not related to your military service, so service connection remains denied: back disability 0%.

Decision

The previous denial of service connection for back disability (also claimed as upper and lower back condition) is confirmed and continued.

Evidence (I am paraphrasing)

- Service treatment records

- ER treatment records

- Orthopedic treatment records

- MRI report

- Epidural pain block treatment records

- Neurologist treatment records

Reasons for Decision

The claim for service connection for back disability (also claimed as upper and lower back condition) is considered reopened. However, the evidence continues to show this condition was not incurred in or aggravated by military service.

The service treatment records were considered in deciding your claim. Private medical records show you have been diagnosed with degenerative disc disease and chronic low back pain with lumbar disc displacement. You have received lumbar epidural steroid injections.

Based on this information, can anyone please offer opinions on where I went wrong?