Claim Denied

[michael09070]

After 2 years the Chicago RO denied my claim for multiple sclerosis. I had the medical nexus,buddie letters,solid medical evidence and a written time line of events. my claim was in Chicago since June 2011and around feb. 2013 they outsourced my claim to the Des. Moines Iowa RO. And within a couple of weeks my claim started to move but in the wrong direction. Talking to them it was oblivious they just pushed my claim through without weighing all my evidence. I have zero faith in the Chicago RO or any for that matter. Now I was told the appeals will take 3-5 years to even be seen by a human again. Way to go government, taking care of those who afforded you the job you have..

[Bevo]

Yep, ROs deny for all sorts of nonsense. Often it's contrary to every law and regulation. Post the wording of the denial and let everyone dog in.

Hooters has free food Monday too.

[michael09070]

Not sure what to look at but, I will start here.

Reasons for decision: On multiple sclerosis verbatim

1: service connection for multiple sclerosis.

The claim for service connection for multiple sclerosis is considered reopened. However, the evidence continues to show this condition was not incurred in or aggravated by military service.

The va examiner stated that records from 11/01/1996 were received and reviewed. They support the diagnosis of acute labyrinth it's and otitis media not multiple sclerosis.

2: service connection for 3 lesions in brain as secondary to multiple sclerosis.

The claim for service connection for 3 lesions in brain as secondary to multiple sclerosis is considered reopened because the evidence received is considered new and material. However, the evidence continues to show that multiple sclerosis is not related to service. Further, there is still no evidence that 3 lesions was incurred in or caused by service or within any applicable presumptive period,

My original nexus stated he was highly suspicious my first clinical delimitation event happened in November 1, 1996. I ets'ed December 30 1991 well within the 7year window. I have since gotten my diagnosing dr to word it correctly. More likely than not.. But it was too late to stop the appeals process. I have not requested my c-file yet my claim was denied June 1 2013. Thank everyone for the words of support. I had several secondary issues to that we're all denied of course. I also had tinnitus as a claim that for some reason they tied it to my ms as well as an ankle injury that was in my Smrs. I never said it was connected to my ms but that is how they rated it. All my claims were denied and I know they didn't look at my Smrs at all. If I knew how to scan this I would.

[michael09070]

Also the otitis media and labyrinth were from the er in 1996 and it was not a dx just the er opinion at the time but, a couple days later I went to the ears,nose, and throat dr and he found no ear issues. The er dr told me if it didn't get better in a few days then go to my regular dr. He sent me to get hearing test and nothing was found and then I got better and let it go. I was out of work for sometime due to debilitating vertigo and then one day I got up and could walk and preform my work duties so I let it go as instructed by my dr. Then in 2002 my left side went completely numb and I went to the dr and he though maybe I had hurt my back but it got better in a couple of weeks roughly. All this is in medical records, I even made a timeline of events to connect all dr visits. The emergency rooms job is to stabilize a patient not diagnosis. I did as instructed. Thanks again..

[michael09070]

My denial letter didn't really say much to me. Basically they just disregarded the systemic evidence that goes with ms. Their was like 6 years in between my episodes so I never put 2 & 2 together.but if you look at the timeline of events after the fact (high insight) my ms is apparent to my dr.my first nexus was from an ms specialist (his word was highly suspicious) so now I have my dx'ing dr.'s nexus that states it exactly the way the va wants it, I was unaware of just how much they could chew up my ms specialist letter just because they didn't word it exactly to va request. This is really dumb to me, stalling tactics for sure. I don't want to bad mouth the taters because they have a tough job but when they have the evidence I would hope they would do what's right but I guess not.

[Berta]

“They support the diagnosis of acute labyrinth it's and otitis media not multiple sclerosis. “

Vertigo and symptoms similar to labyrinthitis are consistent with early symptoms of MS:

Did the IMO doctor make that point and support it with a good medical printout such as:

http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/dizziness--vertigo/index.aspx

Was he fully aware of the many warning signs of MS that might have appeared in your SMRs?

http://www.healthline.com/health-slideshow/multiple-sclerosis#6

“3 lesions in brain as secondary to multiple sclerosis “

Did he give a strong medical rationale that, but for the MS, there is no other etiology for the lesions in your brain and support that with a good medical abstract such as :

http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/diagnosing-ms/index.aspx

“I have since gotten my diagnosing dr to word it correctly. More likely than not.. But it was too late to stop the appeals process. “

Did you mean that the VA did not have that IMO before they made the decision?

Did the doctor fully adhere to the IMO format here at hadit?

What type of a doctor made this opinion?

The VA sent you (I assume ) a Statement of the case and you have 60 days I think ( need to check that or someone else will correct me here) to rebutt their denial and ask for a DRO hearing.

If the IMO conforms to the IMO format here in our IMO forum, or the IMO doc has time to correct it, make sure you send it to the VA as a response to the denial and get proof of mailing. Others will opine here too but I think you should request a DRO hearing.

Also do you have a copy the C & P results? It is often the actual wording of a C & P negative opinion that makes an IMO rebuttal have much weight with the VA. C & P results are invaluable to IMO doctors.

My husband presented very similar symptoms to the VA long ago and the VA gave MS as one diagnosis along with many more VA diagnoses that followed and that were all wrong.

After multiple ER visits for TIAs which VA said were due to a hole in his eardrum (not true)he had been diagnosed with acute labyrhinitis as well, and could hardly move, and spent 3 weeks at the VAMC before VA ( at my insistence) gave him an MRI. The diagnosis was stroke.

“The va examiner stated that records from 11/01/1996 were received and reviewed. They support the diagnosis of acute labyrinth it's and otitis media not multiple sclerosis. “

That record is critical and I sure hope the IMO doc you had recognized this as a major symptom of your MS that gets you right into that 7 year window ,and that the doc expounded on this fact in his IMO.

Also what kind of a doctor did the actual C & P exam?

Was it even a real doctor?

A veterans can overcome a negative C & P exam with an IMO from a doctor whose credentials and areas of expertise outweigh that of the VA's opining C & P “doctor.”

I hope your opinion came from a Neurologist.

I had a brief email from a former VA Neuro who had treated my husband at the VA before he went into private practice.It took me months to find him and then many more months to get a clean copy of the critical blood chem report that he needed from VA. Every copy they had sent me was cut off in a way that the chem results could not be matched up with the actual blood work abbreviations.

In any event my IMO doc, Dr. Bash called him up,when I got his last email , and had him type the email onto his private Neuro practice letter head.

The BVA gave that brief Neuro opinion.....it was only three sentences … as much weight as the opinions from Dr Bash, a NeuroRadiologist, because it corroborated them.

VA had denied with 2 endocrinologist opinions ( at least this was a Real VA doctor but I knocked her credentials down with a www.healthgrade printout and Dr Bash had no problem rebutting her two C & P opinions either.

When the brain is involved, the is nothing better than a Neurologist or Neuroradiologist to opine on

brain trauma due to a specific disability.

You are definitely in that 7 year window in my opinion.

Have you yourself gone over your SMRs carefully? Look for anything that could be a symptom of MS.....there are many MS sites on the net.....

were you ever so fatigued you could not go to your duty station?

did you ever complain inservice of the vertigo and/or have problems with your balance?

Were you hospitalized for what they thought was the acute labyrhinitis? If not can you get lay statements,if needed, from significant others who can verify your vertigo symptoms?

I however hope the IMO will turn the tide for you here.

As long as it complies to our IMO criteria here at hadit and the doc who wrote it has more expertise or medical rationale (supported by good medical literature), this should become an award for service connection,in my opinion.

BTW do you get SSDI for MS?.

[michael09070]

Berta thanks for your time. I will try and answer some things you mentioned; I never had a C&P exam the va in Des Moines just looked at my file and made this decision. In 1996 I had sever vertigo and had to be taken from work to the emergency room. They just gave me an iv and let me go after about 4 hours. My er report said they though it could be an ear infection but to go see my regular dr if it doesn't get better. Well it didn't so I went to my doctor and he sent me to an ear nose and throat specialist. They found nothing wrong with my ears or anything else.(all in file I sent theVA) my first nexus I sent to the VA was from a ms dr, but in his statement he used the term highly suspect not more likely than not. My POA said for me to call that ms dr and ask him to reword his letter but my dr said that was dumb and what he stated means the same thing. Now after my denial letter I went to my treating neurologist who dx'ed me with ms and I gave him the hadit format along with the ms specialist report and all my medical records to include my Smrs. I was never hospitalized in 1996 just went to the er. Also Berta there is possible evidence in my Smrs that my neurologist said was as likely as not the first delaminating event. If I could figure out how to scan this letter I would but I'm not that tech savvy..lol I had a lay statement from my supervisor who came in and took me to the er in 1996. Yes I am on SSDI for ms. Can't tell you how much I appreciate your advice. As you know this will take its toll on a person. When my claim was outsourced it was done in about a week, my gut says they didn't look at all my evidence after they seen the er report from 1996 saying possible ear infection.that was their out to hurry up and close me out of backlog.