Your Opinion Please Read!!!

[VetDeniedSince1980s]

For anyone who cares to Review and comment. Especially you Ms. Berta!!!

First document is SMR indicating my dad injured his left foot with a fracture to his 2nd metatarsal in 1969. 

Second document is an X-ray result from CP exam in 2005. Please note old nonunion fracture to RIGHT foot 5th metatarsal along with all other issues to RIGHT foot and leg. And no findings or issues whatsoever to left leg or foot. 

If you were the one conducting this exam just by reviewing both these documents what would your opinion be??? Please comment and Thank You All!!!!

Edited October 22, 2015 by VetDeniedSince1980s

[Berta]

I had eye surgery recently and cannot read the attached docs too well...but I agree that this would take a professional opinion.

The cost of an IMO has to be weighed against the fact that this might  be  rated very low, if rated over '0' %.

If this is not disabling to at least 10% ,it might not be worth the cost of an IMO.

Has your father been seen by a podiatrist  or ortho doctor  throughout the years since the inservice injury occurred?

 

 

 

 

[Buck52]

Although these have a lot of low ratings  however they can be a lot of medical that could be connected to each other  and the rating could add up in a hurry  if your Dad gets a fair examination.

 

Ms Berta I hope your eye surgery was a success.

if you had laser cat surgery   2 weeks time you should be 20/20, my mother-law had that in both eyes week apart and after two weeks she can read without her glasses  and I must say a little eazier to get along with   eh!,,,LOL

 

 

jmo

 

...........Buck

 

[VetDeniedSince1980s]

I moved your post to VA claims research because I think it will get more views there. 

TY :)

[VetDeniedSince1980s]

Based on the info in the two documents, I believe service connection will not be granted.    The most recent report indicates fracture to 5th metatarsal of right foot and the 1969 report reflects a contusion(bruise) and fracture to 2nd metatarsal of the left foot.   It is not only a question of right foot versus left foot but 5th metatarsal versus 2nd metatarsal.  This gives the VA even more ammo to deny the claim since the reports also differ on which bone was fractured. 

In my opinion,  this claim will continue to be denied without an IMO and the IMO will have to show a strong nexus between your father's current medical condition and his military service and be supported by reasonable medical rationale.  Due to the amount of time that has passed and the differences in the two reports, I think it would be difficult for an orthopedic specialist to provide a credible IMO.   I hope I am wrong.

GP

 

 

TY GP!!! Great info!!!! But wouldn't you agree that if in fact the left foot was injured it would show an old non union fracture in the left foot in the X-rays? We have many medical opinions suggesting it is most likely this condition is due to his service injury. 

Thank u for sharing I truly appreciate your input sir!! God bless!!!

[VetDeniedSince1980s]

The thing that is missing is the nexus.  A nexus statment, which may or may not be elsewhere in your records will be something close to "the Veterans (current disability diagnosis) is at least as likely as not due to a foot fracture in 1969 during military service".  

Absent a nexus, I agree that it wont fly.  Im not qualifed to differentiate between the 2d and 5th metatarsals, that is a significant discrepency and would also need some sort of resolution. 

I recommend:

1.  Review your records, and look for a nexus statement.  It need not be that doc, it can be another doc who examined you.  If you find that elusive nexus, then keep appealing and allege a "colvin" violation.  (Colvin violation means the decision maker has substituted his own unsubstantiated (medical) opinion for that of a qualified medical professional.   Or, the decision maker went "against" the favorable medical opinion and did not give a reason or bases as to why he found this examiners opinion to be unpersuasive.)

2.  If you find a nexus, keep appealing until you win.  

3.  If the nexus is missing, then try to see if it has been unincluded in your cfile for whatever reason.  If its just "gone" then resbmit the nexus and you can reopen due to N and M evidence via 38 cfr 3.156.  

4.  If there is no nexus anywhere, then an IME/IMO will be necessary for service connection UNLESS you can get the nexus statement from a VA medical professional.  

I agree Bronco TY for sharing. All these years we have searched and searched for more records. All that exist are three cover sheets from the three hospitals he was in Vietnam. All three indicate L leg and foot and were written on a typewriter. That is all the records we can find. 3 months in 3 different hospitals and that is it!!! SMH!!! It just don't make since. 

But we have great representation now and some new and material evidence. We are making progress. TY and God bless!!!!

[VetDeniedSince1980s]

My impression is useless.  I'm no radiologist and cant tell heads from tails about what the situation is without all of the fact in front of me.  That being said, was the 1st report done by a VA Radiology department?  If so, you might want to take the x rays to a non va radiologist/orthopedic specialist and get it read again. 

I had my back re-read like that and it opened up a whole new story that got my back service connected. 

TY pwr yes the report was from VA CP exam in 2005. Examiner noted she would not go against the SMR's. Wouldn't even state it was a possibility. Just seems to me if left foot and leg was really injured in service there would be an old nonunion fracture in the left. Just seems like common sense to me. 

We are making great progress now in his claim. TY for sharing and God bless!!!