How To Word A Claim

[Geo4K]

I am working up my claim for cervical vertigo (CV) - it's my biggest, most bothersome and significant claim. I feel (and my Doc thinks it is reasonable) that my dizzy spells/CV are a result of the DDD I now have (and that the VA has acknowledged).

I have a MRI next Tuesday and a ENT appointment the week after. My new Doc is interested in helping me and has volunteered to write a Nexus letter for me. I'll be claiming CV, with headaches when my neck pain is bad - all due to the three neck injuries and resulting DDD in my C spine.

My question is how to articulate my claim for headaches, secondary to the DDD? I've seen some good advice here and have learned much from a lot of reading, but would like to hear some thoughts specifically on this. So long as my neck is in big pain, my head pounds. I eat aspirin and sleep a lot until it lets up.

Advice?

Geo

[Geo4K]

Okay, you say that the VA has acknowledged your DDD. Has the VA Service-Connected this DDD? Yes, they gave me 10% for neck pain. 20% for right shoulder pain radiating from my neck. Is Cervical Vertigo a "ratable" disorder and is it known to be caused/exerbated by the DDD? I am getting a MRI tomorrow. In a week I will meet with my doc and review. He is more than willing to write a Nexus letter on the CV, as well as the headaches being secondary, will talk to him about the left shoulder as well.

What are your doctor(s) "calling" your headaches, e.g. "tension headaches" "migraine headaches", etc.? And, do they give a nexus between the DDD and the headaches?

Can you now, considering your "eating aspirin and sleeping a lot" can you now work? I'm not sure that I could call my headaches migraines... I can and do work full time.

What effect does your DDD/CV/headaches have on your life? Your quality of life must be suffering, personal relationships, enjoyment of things you once enjoyed, ability to move about, drive a car, travel, read, do crafts/hobbies? If your life quality has suffered, then you most probably have depression and, probably, somewhat severe depression at that. I no longer play any sports or maintain my own cars. I sleep poorly due to limited "comfortable" positions. Honestly, I haven't thought about depression, but I will say that I have become, at times, ill tempered.

Do the aspirin cause stomach upset, ulcerations of the mouth or throat, gastroentestinal bleeds, cramps, pain, nausea?

Do you take NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)? Do these have any of the preceeding symptoms?

Ball's in your court!

Do we need to be turning in a claim for your DDD? Pending the MRI

Your CV? Pending the MRI

Your headaches? Pending the MRI

Total Disability due to Individual Unemployability? N/A work full time

Major Depression Disorder? Will consider, but not sure how to address to my doc?

Pain Syndrome? This, on top of all the others? They gave me a 0% SC for pain in my left shoulder (full but painfil ROM). This was confusing, as they rated my right (some limited ROM) at 20%. I am right handed. My left causes me the most discomfort.

Gastrointestinal Complications of the Aspirin/NSAIDS? None

My hypertension was rated at 0% because my lower reading was not above 100 most of the time. They only did a record review, unknown to me, as I had a series of BP readings that were above /100 while I was starting treatment with meds... I will appeal this as I was planning to take the other info with me to the exam, but did not have an oppertunity to present.

What have you done so far?

Any of the above?

If so, when?

What was the outcome? Currently at 40% (35.2): 20% right shoulder / 10% DDD (c5-c6, c6-c7) / 10% Tinnitus / 0% hypertension / 0% ;eft shoulder

How we doin' so far? Thank you Larry and all. Your insight is very helpful.

Geo

[LarryJ]

So, they have not diagnosed you with Degenerative Disk Disease, but, instead, have diagnosed you as having painful motion for neck and shoulder pain? (Please bear with me here, okay? There really IS a "method-to-my-madness".)

And, we still don't know if CV is "rate-able" per the VA, huh?

Okay, when I find time, I'll look that up for you.

You still gonna need a diagnosis of DDD or some such, before you can go much further than the "pain" diagnosis that you now have. You gonna need an actual "disease entity" to hang these other disabilities' hats' on, if you get my drift?

[pacmanx1]

Okay, you say that the VA has acknowledged your DDD. Has the VA Service-Connected this DDD? Yes, they gave me 10% for neck pain. 20% for right shoulder pain radiating from my neck. Is Cervical Vertigo a "ratable" disorder and is it known to be caused/exerbated by the DDD? I am getting a MRI tomorrow. In a week I will meet with my doc and review. He is more than willing to write a Nexus letter on the CV, as well as the headaches being secondary, will talk to him about the left shoulder as well.

What are your doctor(s) "calling" your headaches, e.g. "tension headaches" "migraine headaches", etc.? And, do they give a nexus between the DDD and the headaches?

Can you now, considering your "eating aspirin and sleeping a lot" can you now work? I'm not sure that I could call my headaches migraines... I can and do work full time.

What effect does your DDD/CV/headaches have on your life? Your quality of life must be suffering, personal relationships, enjoyment of things you once enjoyed, ability to move about, drive a car, travel, read, do crafts/hobbies? If your life quality has suffered, then you most probably have depression and, probably, somewhat severe depression at that. I no longer play any sports or maintain my own cars. I sleep poorly due to limited "comfortable" positions. Honestly, I haven't thought about depression, but I will say that I have become, at times, ill tempered.

Do the aspirin cause stomach upset, ulcerations of the mouth or throat, gastroentestinal bleeds, cramps, pain, nausea?

Do you take NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)? Do these have any of the preceeding symptoms?

Ball's in your court!

Do we need to be turning in a claim for your DDD? Pending the MRI

Your CV? Pending the MRI

Your headaches? Pending the MRI

Total Disability due to Individual Unemployability? N/A work full time

Major Depression Disorder? Will consider, but not sure how to address to my doc?

Pain Syndrome? This, on top of all the others? They gave me a 0% SC for pain in my left shoulder (full but painfil ROM). This was confusing, as they rated my right (some limited ROM) at 20%. I am right handed. My left causes me the most discomfort.

Gastrointestinal Complications of the Aspirin/NSAIDS? None

My hypertension was rated at 0% because my lower reading was not above 100 most of the time. They only did a record review, unknown to me, as I had a series of BP readings that were above /100 while I was starting treatment with meds... I will appeal this as I was planning to take the other info with me to the exam, but did not have an oppertunity to present.

What have you done so far?

Any of the above?

If so, when?

What was the outcome? Currently at 40% (35.2): 20% right shoulder / 10% DDD (c5-c6, c6-c7) / 10% Tinnitus / 0% hypertension / 0% ;eft shoulder

How we doin' so far? Thank you Larry and all. Your insight is very helpful.

OK, how did you file your claim to get awarded 10% neck pain? Did you file a claim for neck injury, neck strain, neck sprain or what happened to your neck to cause the pain? Have you tried a sleep study to rule out sleep apnea? Are your headaches prostrating?

[Berta]

The VA does service connect vertigo and rate it but the type of vertigo has to be determined.

I found this statement in a BVA decision but this raises the issue of whether your vertigo could be due to Meniere's disease.Have you have any hearing problems in service or post service?

“The cause of his dizziness was questioned in an October 2006

VA treatment record. The physician noted that the Veteran

has significant cervical spine issues. His neck was tender

and he had very limited range of motion. The physician noted

that this tends to increase the likelihood that cervical

vertigo may also play a role in his dizziness and make it

difficult to distinguish between a Meniere's event and a

chronic neck pain.”

It almost seems they are including this vets dizziness in the chronic neck pain.

Benign paroxysmal positional vertigo (BPPV)is another cause of vertigo

and in this case ,even PTSD:

“ORDER

Secondary service connection for vertigo, on the basis of

aggravation, is granted. “

The veteran claimed vertigo as secondary to his PTSD. The BVA found that his PTSD meds caused the vertigo.

http://www4.va.gov/vetapp10/files2/1017109.txt

In any event for whatever they call it ,this will take a doctor to associate the vertigo as secondary due to an established service connected disability.

[Geo4K]

OK, how did you file your claim to get awarded 10% neck pain? Did you file a claim for neck injury, neck strain, neck sprain or what happened to your neck to cause the pain? Have you tried a sleep study to rule out sleep apnea? Are your headaches prostrating?

I filed for neck pain, resulting from 2 seperate injuries (in my SMR). They did a ROM then sent me down for xrays - the DDD was diagnosed this way and I was assigned a 10% SC for that. I claimed bouts of vertigo that was denied due to a spell I went through in 2001 that resolved and was due to a severe sinus infection. The VA zeroed in on that and looked no further, said that it resolved and was denied. Berta, your comment about wording claims correctly is dead on! That was my biggest problem with this and a few other claims, I suspect.

Interestingly, Tinnitus is often found with DDD/CV. They gave SC for that, but did not connect the dots. Another note: My ENT doc at the VA during my C&P stated (this is in my C -file as well) that my dizziness symptoms "are most consistent with cervical vertigo vs. muscle tension, and not an otological source." Again, the VA blew right past that, and my jaw hit my desk when I read that.

Larry, I was, in fact diagnosed with DDD of the c-spine (C5-C6 and C6-C7). In fact my letter back from the VA states: " Service connection for neck pain has been established as directly related to military service." I have 225 total degrees of motion. I selected my personal doc with a concentraition in Sports Medicine. He seemed interested in my case and he will write that SC nexus letter for me. SC for right shoulder pain was rated at 20% and secondary to my DDD. I just got a rating of 0% for the left side - seems like I was short changed there... Happy to bear with all of you!

George

[LarryJ]

I filed for neck pain, resulting from 2 seperate injuries (in my SMR). They did a ROM then sent me down for xrays - the DDD was diagnosed this way and I was assigned a 10% SC for that. I claimed bouts of vertigo that was denied due to a spell I went through in 2001 that resolved and was due to a severe sinus infection. The VA zeroed in on that and looked no further, said that it resolved and was denied. Berta, your comment about wording claims correctly is dead on! That was my biggest problem with this and a few other claims, I suspect.

Interestingly, Tinnitus is often found with DDD/CV. They gave SC for that, but did not connect the dots. Another note: My ENT doc at the VA during my C&P stated (this is in my C -file as well) that my dizziness symptoms "are most consistent with cervical vertigo vs. muscle tension, and not an otological source." Again, the VA blew right past that, and my jaw hit my desk when I read that.

Larry, I was, in fact diagnosed with DDD of the c-spine (C5-C6 and C6-C7). In fact my letter back from the VA states: " Service connection for neck pain has been established as directly related to military service." I have 225 total degrees of motion. I selected my personal doc with a concentraition in Sports Medicine. He seemed interested in my case and he will write that SC nexus letter for me. SC for right shoulder pain was rated at 20% and secondary to my DDD. I just got a rating of 0% for the left side - seems like I was short changed there... Happy to bear with all of you!

George

What exactly does your letter from the VA state concerning your DDD? Not your neck pain, not your shoulder pain, but your DDD? (I'm workin' for ya here, okay. I'm yer Huckleberry, temporarily!).