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Confused on connection granted

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toomnyhats

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I served 4 years active USAF from 1986-1990.  Worked avionics...lugged heavy toolboxes and worked in cramped spaces and on flight line.  Fast forward to 2001...C5-6 disc rupture resulting in cervical myelopathy and incomplete spinal cord injury (quad with para function).  Apparently I have a very narrow spinal canal which obviously existed when I was in the AF.  The degenerative processes in my neck had already begun by that point.  

On 11/30/2015 I submitted claims for:

Spinal stenosis, cervical myelopathy, quadriplegia, neurogenic bladder (I have to cath), neurogenic bowel (I have an ileostomy), severe spasticity and muscle spasms, tinnitus.

They scheduled C&P's quickly but only for bladder and tinnitus.  Claim moved fast.  Today I was granted 60% for neurogenic bladder and 10% for tinnitus.  Everything else is listed as non service connected.  

While I'm extremely grateful for the 60% rating, I'm confused because the neurogenic bladder was caused by the spinal cord injury which they didn't service connect or even do a C&P on.  I submitted a lot of medical records from Mayo Clinic regarding the spinal cord issues so they may have used those but I don't understand how they can rate the bladder but not the spine.

Because they only rated the bladder, I assume I won't be able to pursue IU because the bladder is not what is keeping me from effective employment...it's the spinal cord injury, spasticity and pain.

Can anybody shed any light on it?

Thanks!!!

 

 

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  • HadIt.com Elder

While I'm extremely grateful for the 60% rating, I'm confused because the neurogenic bladder was caused by the spinal cord injury which they didn't service connect or even do a C&P on.  I submitted a lot of medical records from Mayo Clinic regarding the spinal cord issues so they may have used those but I don't understand how they can rate the bladder but not the spine.

file NOD and submit the Mayo Clinics records.

you will need a Dr of this speciality to opt an nexus to link the two together and get them SC. After its SC then its easier to prove and you need a Dr to state his/her impression as to the extent of the % of the disability? then you can look up the CFR's  as to what you should be rated for as do the raters do this too but a lot of help would come from a good Private IMO. following VA guidelines found here on Hadit

JMO

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

 

Edited by Buck52
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Thanks Buck52.  So if I understand correctly, I should file a NOD and get my rehab Mayo spinal cord specialist to weigh in on the spine issue - he has already expressed a willing to do so.  He can express a relationship between the spine and the other issues along with his opinion on %disabled which he feels is 100%.  I've been on SSDI for 12 years. I know the VA doesn't look at that as relevant but my physicians feel it is appropriate.  Would it be beneficial to have him fill out a DBQ?  Also, could this in anyway have a negative impact on the current rating they came up with?  One last question - which I think I know the answer to lol - is the NOD/appeal process an extremely long one?

Thanks!

 

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  • HadIt.com Elder

Just always remember once S.C.

Medical Evidence wins & a lot of it is how the Dr's word their opinion  it needs to follow VA guidelines

as for as the NOD they suppose to take them as they come in  so if they have 1000 NODs before your yes it could take some time  , and sometimes after you have a C&P they have it and decide then on a decision  every veterans case is different, but as for I know NOD is first come first serve, but it don't always work that way, there's no telling how long it would take for them to make a decision  usually the more complex the case is the longer it drags on

JMO

.........Buck

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  • HadIt.com Elder

Here is a good example of a nexus letter

!

There are certain important things in this world that we only get one shot at. Such is the Nexus letter in a veteran's service-connected disability claim with the Department of Veterans Affairs. Although only one Nexus letter is required, it is advisable to seek the overwhelming number of three individual and concurring Nexus letters if possible. The Nexus letter may require a lot of effort on the part of the veteran, but the return is indispensable.

Generally, according to the law, three elements are necessary and therefore required to obtain a favorable decision by a veteran for service-connected benefits.

#1- An event in service that could have caused or aggravated a disease or condition

#2- A present day diagnosis of the existence of the same disease or condition

#3- A medical opinion linking number 1 with number 2

The required medical opinion is called a Nexus letter. The letter must be written specifically for the individual and explicit to that individual's claim. It is important that the opinion be expressed as a degree of likelihood. The degrees of likelihood, arranged in ascending order from the lesser to the greater are as follows, "not likely", "at least as likely as not", "more than likely", "and highly likely".

In the case of "at least as likely as not", the veteran always receives the benefit of doubt and therefore the outcome is considered a favorable opinion. The doctor, or expert, does not have to use absolutes or conclusions in the statement. Opinions are gleaned by a review of the pertinent records and facts. A professional opinion can then be rendered based upon the record, the medical history, the facts, and the education and/or experience of the author of the letter.

Most denied veterans' claims failed because of the lack of a Nexus letter altogether or the lack of a properly written Nexus letter.

A proper Nexus letter must be as brief as possible while stating the facts and must include the following:

"After a review of the veterans pertinent records" - (use medical and any service records furnished by the veteran to show the event in service)

"It is my professional opinion that it is at least as likely as not" - (choose and insert the proper degree of likelihood, see above choices)

The author must offer a rationale as to the opinion in the statement - (e.g.," It is well known in medical journals")

The author must provide credentials, especially VA titles or specialties - (e.g., Oncologist, Hematologist, Orthopedic Surgeon, Environmental Clinician, etc.)

Please understand that the VA often uses credentials to assign probative value to the nexus letter.
 

Example of a Nexus Letter

DATE ____________

Reference: (Veteran's name) ____________
Edited by Buck52
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Thanks so much - I'll get to work on it and hope for the best.  Haven't received the big brown envelope yet so that might shed light on how they came to the conclusions they did.

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  • HadIt.com Elder

yes 

Read about their reason and bases of the decision. it will be included in your Award Letter.

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