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

[VetDeniedSince1980s]

§4.70   Inadequate examinations.

If the report of examination is inadequate as a basis for the required consideration of service connection and evaluation, the rating agency may request a supplementary report from the examiner giving further details as to the limitations of the disabled person's ordinary activity imposed by the disease, injury, or residual condition, the prognosis for return to, or continuance of, useful work. When the best interests of the service will be advanced by personal conference with the examiner, such conference may be arranged through channels.

 

I agree with georgiapapa and the other members  He needs to get a IMO (INDEPENDENT MEDICAL OPINION)

I think a trip to a private Foot Dr (specialist ) would be very beneficial  and have Doc to read these exams and then exam your Dad and give his opinion as to the left& right leg/foot  and state in his opinion this is at least as likely as not due to his prior military service on what he finds.

And take the military medical records that you have and high lite the parts that this Specialist needs to read   let him know he don't need to read all the report but the main parts about what they said about your Dad leg/foot Back then,  so he can state he read his past military records about his LEFT &  RIGHT LEG &FOOT.

The VA will take the private foot specialist impression over a VA Regular MD.

 

I wish your Dad the Best and he gets a good decision soon!

Hang In There!

 

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

 

jmo

 

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

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TY buck!!!! Great info as always!!!! You all always have great input. Love Hadit!!! Some really wonderful people with tons of great info!!!!

we are making great progress with dads case!!! God bless u and TY again for sharing!!!

[broncovet]

The nexus wont be in your SMR's.  It will be a doc saying it, probably fairly recently, too.  Next time you go to the doc, ask him/her:

Do you think the (foot issues Im having now) have anything to do with the broken foot in the military?

 

If he responds in the affirmative, then ask him or her to please make a note in your medical records, as to this opinion.  

Have you had a C and P exam?  Did the C and P exam specify that it was at least as likely as not due to miliatary service?  

You need the SMR's, yes, and this documents a foot injury in service.  

Now you need a current diagnosis, and you need a nexus.  

Those are the big 3 without which you wont get SC. 

Edited October 22, 2015 by broncovet

[VetDeniedSince1980s]

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?

 

 

 

 

TY Berta!!! Yes he has several medical opinions stating service related even one from VA vascular specialist stating most likely happened in service. We are making great progress with this claim and I truly feel justice will prevail this go around!!! TY Berta and God Bless You and all you do and provide for all these great members!!!

[broncovet]

If your VA examiner "wont go against the SMR's" and provide your nexus because of the discrepency of "which foot", then you have 3 solid choices:

1.  Try to get the records corrected, as I posted earlier,  correcting the discrepency.  

2.  Ask ANOTHER VA doc for a nexus.  YOu can ask for another doctor, a little more Veteran friendly.  Hundreds of doctors have been sued for operating on the wrong leg.  Its a very common mistake.  When I had knee surgury, the surgeon came in, Wrote in marker, "NO", in big bold letters on my "wrong" leg, while I was awake and he could ask me "Is this the correct leg" POINTING AT IT.  Many people can not tell left from right!!!  He id not know if I knew right from left.  You see my right leg appears on the doctors LEFT side as he is facing me.  Explain to the "new" doctor that your past doctor has incorrectly opined its the wrong leg.  If your new doc agrees, this will be good, as you may not need to shell out the money for an IMO.

3.  If neither of the 2 above are productive, then you will need to spend the money for an IMO/IME.  If there is some scarring, or other supporting evidence, it should not be hard for a doctor to opine which leg it is, and the injury at least as likely as not occured from his howitzer/military injury.   Buddy letters should certainly work, provided they dont conflict with the medical evidence.  Buddy letters work when there is no evidence, but not well when there is NEGATIVE medical evidence.  There is a big difference between no evidence and negative evidence.  

a) No evidence, means records are silent on the issue.

b)  Negative evidence means the doc xrayed your foot, and the radiologist determined that your foot is "negative" for a fracture.  

The VA conflates these. Can you see why a does not equal b?  In A, records can simply be lost.  This does not mean there was no fracture, it means there was no RECORD of a fracture.  In combat, its not unusal for there to be no record.  The medic patching you up is more concerned about saving your life, and he often does not have a computer or office where he can document it, but has another man down that needs his help NOW. 

 

[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.  

Bronco we had a VA vascular specialist document in Dads file after his exam that his venous insufficiency, varicose veins, venous stasis, and his venous leg ulcer is most likely caused from his injury in Vietnam. Would that be considered a nexus?

[VetDeniedSince1980s]

§4.70   Inadequate examinations.

If the report of examination is inadequate as a basis for the required consideration of service connection and evaluation, the rating agency may request a supplementary report from the examiner giving further details as to the limitations of the disabled person's ordinary activity imposed by the disease, injury, or residual condition, the prognosis for return to, or continuance of, useful work. When the best interests of the service will be advanced by personal conference with the examiner, such conference may be arranged through channels.

 

I agree with georgiapapa and the other members  He needs to get a IMO (INDEPENDENT MEDICAL OPINION)

I think a trip to a private Foot Dr (specialist ) would be very beneficial  and have Doc to read these exams and then exam your Dad and give his opinion as to the left& right leg/foot  and state in his opinion this is at least as likely as not due to his prior military service on what he finds.

And take the military medical records that you have and high lite the parts that this Specialist needs to read   let him know he don't need to read all the report but the main parts about what they said about your Dad leg/foot Back then,  so he can state he read his past military records about his LEFT &  RIGHT LEG &FOOT.

The VA will take the private foot specialist impression over a VA Regular MD.

 

I wish your Dad the Best and he gets a good decision soon!

Hang In There!

 

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

 

jmo

 

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

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Buck we have a VA vascular specialist that documented in dads file that his current leg conditions ( venous insufficiency venous stasis varicose veins and a venous leg ulcer) is most likely caused from his injury in Vietnam. Shouldn't that help his claim especially being stated from a VA specialist???