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rpowell01
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Posts posted by rpowell01
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john999 wow thanks I was just working on this same thing in my hearing letter I will be presenting during the hearing along with all my exhibits. See the VA Regional Office messed up big time because they wrote in a 2011 addendum to the C&P examiner back then that I actually have been diagnosed with DJD....You don't get healed in two years from DJD and we all know it never heals.. Also, how I am submitting evidence that shows that from Sept 2011 to around August 2012 I had three C&P exams and none of them ever showed my issues were "getting better" and actually showed my issues were getting worse.
Thanks to Carlie this reads: 38 C.F.R. § 3.344© reads “Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings, which have continued for long periods at the same level (5 years or more). They do not apply to disabilities, which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating” ...
What happened was that the Regional Office never pulled my records from James A. Haley MC so the C&P Examiner did not have those records. So, under 38 C.F.R. 4.2 (2007) establishes that it is the responsibility of the rating specialist to interpret reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability present. These provisions impose a clear requirement that VA rating reductions, as with all VA rating decisions, be based upon review of the entire history of the veterans disability. . . . Furthermore, 38 C.F.R. 4.13 (2007) provides: When any change in evaluation is to be made, the rating agency should assure itself that there has been an actual change in the conditions, for better or worse, and not merely a difference in [the] thoroughness of the examination or in use of descriptive terms.
The best investment I have gotten was the Veterans Benefit Manual somebody sold to me. If some of these VA advocates would just read this book I bet you my paycheck more and more vets would be approved for their claims. On top of this, there is no need of an attorney at the BVA level, everything is written in this book. You just have to have a legal mind.
Ever since May, one week after I receive a copy of that C&P exam, I have gather evidence and trust me there are plenty of government medical websites that gives you everything in detail. Example: the C&P Examiner stated that I had "degenerative changes" shown on an MRI but I don't have arthritis. HELLO degenerative changes is Spondylosis which is also known as Degenerative Joint Disease which are the same thing as Osteoarthritis.
The Regional Office thinks they can just change my current diagnosis and reduce my benefits but under hte 38 CFR they are NOT allowed to do this. Plus, one of my disagreements in my NOD is that my Osteoarthritis is the worse of the two DDD and Osteoarthritis and its the Osteoarthritis causing me to have radiculopathy in my arms and legs. This is why the surgeon just told me today they will NOT do surgery on me.
I have sufficient amount of evidence to disprove the C&P Examiner. This is something I haven't done on my claims and I am paying for it until my NOD hearings. I waited after the C&P exam to get diagnosis from the VA even though Dr. Bash already diagnosed me. Fool me once but never again VA.
BTW my reduction hearing is October 3rd so I pray Dr. Bash gets me those DBQ forms this week or next week. If he doesn't then you all heard it here first!!!!
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I learned a lot in the past couple of years. But what I found to be the most help is the Veterans Benefits Manual. You do not need an attorney if you read this book. It has everything there is know on filing and appealing claims.
The 60 days mark is the amount of day Dr. Bash TOLD ME to write on the letter to the RO in asking for a hearing on the Proposed Reductions. If he doesn't get me the DBQ forms then I am out of luck and I if lose at the hearing I will never forgive him. The man talked highly of doing this or that at the airport but he hasn't backed what he talked, yet. O' well if I lose then I lose but I will make sure to spread of the word about this incident.
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Be patient doctor Bash will provide what he says he will. I have used doctor Bash myself. He had you fly in and do an exam in the airport because he knows that an exam carries more weight than just an opinion review of records. (IMO). You will be getting an exam with an opinion (IME) and that will trump the VA exam, because Dr. Bash has better credentials than any of the VA examiners. Hang in there it is to your benefit, and Dr. Bash also stands behind his work, if it goes to an appeal he will win in court over a VA examiner any day of the week..- just saying :)
Actually he didn't and he has forgotten ALL about me and my DBQs. I called him last week and he told me he forgot. I know he may be busy but you don't forget like that. I mean how many physicals or DBQ exams are done in a airport? You also have to understand that I am over the 60 day mark Dr. Bash told me to write on the letter to the RO for him to submit more evidence...Understand where I am coming from?
What is going to TRUMP the VA examiner is all the diagnosis of VA doctors that has diagnosed me with the same issue Dr. Bash did. He did it back last year while they waited until AFTER the C&P exam...Now, I have Dr. Bash's IMO from last year along with TWO other MDs who says the same thing. Then on top of this, I just had an EMG on my legs about a week and half ago and the EMG report shows I have bilateral radiculopathy with negative neuropathy ( I am not diabetic btw). The C&P examiner stated I just had "muscle spasms" in my leg....What I find appalling is I NOW have NO feeling in both my feet from the midfoot forward and she had the nerve to say I had muscle spasms. Well, if I don't get any feeling back on them I will be upset with the medical side of the VA for waiting so long to do anything. I just had 2 epidurals last one last week and well my legs hurt worse actually and the numbness is still there in my feet. I knew they wouldn't work...And the MRI shows something different than the EMG. The MRI didn't show the pinched nerves like the EMG does...JBasser told me NOT to believe MRIs and well now I understand why he said that....
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Well as of right now I am STILL waiting on Dr. Bash to send me the DBQs he promised he would completed after giving me a physical right in the middle of the airport.
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There is a type of tens that can be implemented and what it does is stops the pain signal being sent to or from the brain.
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Attache a copy of your letter of the denial, first black out all pertinent information....Dont' let this discourage you because we have been there are are still there fighting them. The VA is a sore in the butt and please spread the word about all those fake advertisements on TV. Tell your friend and family of what the VA is doing and how they REALLY treat the veterans. Its time to FIGHT BACK!!!!!
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The VA will lowball you as much as they can on ratings. Example: I have DDD and OA. They just want to rate the DDD but I know for a fact my issues are caused by the OA which is worse. My last XRay showed multilevel progression when compared to the previous film. HELLO!!! PROGRESSION means its getting worse. I have a NOD in on the denials but I am about to amend the NOD and add that I should be rated under Osteoarthritis and NOT DDD. The DDD isn't what's causing my issues, its the OA.
I want to thank Mr. Rogers for selling me the VBM, there are tons of information in that book. If you don't have one, get one, it will help you NOT need an attorney for the BVA appeals.
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Its funny how we read that that VA has the best medical care in the U.S.A. but we also read how they are the most underfunded in the country.
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Sorry I know this is nit-picky but torn muscles are but one of the causes of osteoarthritis. However you get it, after years and years it really is a complete and total debilitating pain!
You are correct its ONE of the few reasons. Osteoarthritis happens in more 60+ of age. If you get it in your 30s and 40s then its called Traumatic Osteoarthritis which is most likely caused by a traumatic injury but not all the time. Yes there are those who have it in their 20s, 30s and 40s without it being traumatic and this is because its comes from a gene that can be detected on certain tests. I am thinking this is why the RO did a blood test on me earlier this year to see if it was genetic. I have traumatic osteoarthritis with about 6 impinged nerves throughout my spine. 4 are known and two was just found on Wednesday at L5-S1 level after waiting in pain for a year. It wasn't good news because the doc told me that since my feet are numb and has been numb that its more likely permanent. He did say there is a chance that the ESI that are being done might help but its gotten worse instead of better. Hopefully next Tuesday's injection will be at S1 and will kick it out. I know it may take two years to heal or it may never heal. Just take the pain away from my legs is what I want at the moment.
arng11 check your pm on here...
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I can tell you from my experience is that whenever you muscles in your back rips they will not heal properly and will keep ripping and other muscles will begin to rip. These rips will cause the joints in the spine to become loose and be able to move around a lot more freely. This is the cause of Osteoarthritis, where the cartilage in the joints deteriorate over time. When this happens o'boy you best be ready for the worse pain. People don't understand that whenever you lose height in your spine the nerves become impinged and actually twisted because of this. This is why surgery will not help...
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This doesn't sound correct because Spondylosis is actually Osteoarthritis. Osteoarthritis and DDD are two different medical terms but isn't rated under IVDS. I don't see how you are rated under IVDS, this is probably why you have such a low percentage. I would fight and get that changed from IVDS because IVDS is NOT based on ROM and is based on bed rest like JBasser stated.
Sounds like a low ball because degenerative spondylosis levoconvex means you have arthritis with curvature (scoliosis). I would put in a claim to have all this changed or appeal your last award if its under the 1 year mark.
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Nope I am waiting for the hearing date and I am STILL waiting on Dr. Bash's report that I was sure he would have to me by now. I flew up there on July 2nd, he conducted the physical and I flew right back home. Its been almost 60 days and I haven't heard one word from him but I have sent him a GI's report showing they have diagnosed me with Bowel Incontinence due to the spinal injury. Oh well I have been shafted from the C&P Examiner so it is what it is if he doesn't send me the reports, nothing new.
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For your back here is the ratings schedule: http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_71a.DOC
Rating for your back is based on Range of Motion. The Lumbar and Thoracic are the same segment so they will be rated as one as thoracolumbar.
You can't pyramid, so I think even though you have scoliosis you can only be rated for one thing on your back but the one that rated should be the higher rating. You have to watch this one because the RO will try to low ball you.
For the damaged nerves here is the ratings schedule: http://www.benefits.va.gov/WARMS/docs/regs/38cfr/bookc/part4/s4_124a.doc
This is self explanatory and you can see what your should be rated at based on the degree of paralysis of the nerve.
If you want to know the ins and out of the VA, how to file claims and what is needed and how to challenge the VA with your NODs then purchase the Veterans Benefit Manual from lexisnexis.com or some other website that carries it. This is what attorneys use and they charge us an arm and leg.
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But those of use stuck in limbo can get any help for our dependents!!!! I can't wait for 2016....
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TENS work on some and not on others. I have one and it's only good as long as I am using it and as soon as I take it off it all comes back.
I finally had one epidural very low in my back yesterday and I will say that today my right leg is in more pain. I guess this is normal one day after the injection?
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The thing about the TSpine is your ribs will hold up the vertebrae so the spacing will not change much. But this will put pressure on your sternum and cause your chest muscles to hurt or have spasms/trigger points....
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I am finding out some things that is causing a lot more issues than it's helping. I am prescribed 3200mg of Gabapentin and believe me its very sedating and causing me to sleep 8-10 hours per day. I get up and it takes me 2-3 hours to get out of bed. So, I have had enough that crap and decided to only take half of that and now I can get up after 6 hours. Yes it takes the normal 30 minutes to get up out of bed but I don't hurt as much in the mornings. Laying in bed too long is bad for us with arthritis in the back.
Finally, the VA has fee based me to a Orthopedic Doc who is going to do 2 ESIs in my Lumbar and 2 in my Cervical. He told me that I have some serious issues because I can't bend backwards whatsoever so after he completes the VA fee base request he said he will get approval from the VA to work on that issue. He said he can't believe how many veterans come into his office and has a different mindset than the civilian population. He said the Veterans want to get fixed while the civilians just want the opioids. I told him I don't take opiods even though I wish there were days I had it. I have taken opiods for shingles so I know what they do to a person but again after long term use people get use to it because I take Tramadol.
Anyway, I am hoping and praying that this Doctor can fix me enough where I can go back to college and then be able to go back to work. I hate sitting around the house, this is worse than the pain.
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john999 as long as my family is taken care of then that's what is the most important thing with me right now.
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Anytime you put in for an increase you can be subjected to someone thinking your condition has changed for the better, they can propose to sever or reduce your rating. If you receive a letter stating so, make sure you reply before the 30 day time limit. Even if you get a letter with a date on it of 2 weeks earlier, remember 30 days from the date of the letter. You need to follow through with your notice of disagreement asap. That will hold them off from this action at this time. Then get all of your info as to why they propose to do this action. Get verification your condition has NOT improved and send all info certified/registered to them. Sometime an idiot assumes they read something different in your c-file or changes the meaning of the documentation to fit "what they perceive. Wrong! Fight it with valid evidence. If you wait your compensation gets severed and it could take years to retrieve it. I know 1st hand. It happened to me some years back. The ending was the VARO cued themselves for the error and granted me a higher %. I know of a few others who have had this happen to them and as long as they acted on it fast, they were able to receive their benefits without a stoppage or decrease. BTW they were determined to warrant a higher % too in the end. Hopefully but not realistically it happens less of the time but I highly doubt it!
That right there doesn't make one sense whatsoever. If a person places an increase then why would anybody think their condition got better. With me my condition actually got worse, so bad that I had to file TDIU. They denied everything but it was kind of my fault because the Regional Offices seem to believe a C&P Examiner over an independent medical opinion for some reason, even when the IMO/IME is a specialist and the C&P Examiner is just a Geriatrics Doctor. Yep the examiner is just a Geriatrics Doctor but she knew everything there is to know even to say I don't have arthritis in my spine when every report there is known to man says I have DJD/OA in my whole spine.
I already filed the letter and awaiting for schedule. Hopefully somebody will send me the new DBQs and rebuttal to the C&P exam report soon that I am still waiting on.
rpowell01 said-: rater didn't go by the OVERALL Medical History?
Reply:
Once the determination is made to service connect a condition, the rater really is no longer concerned about your overall medical "history".
Once you are determined to be service connected, they wan to know your "current Condition or current status of functional abilities and inabilities".
They don't give a hoot on how it used to be, they only care about how it is NOW.
Sorry, conditions can improve and the government does not want to pay more for a disbility it the Veteran has improved function and is not as disabled as he once was because his condition has improved or healed with time.
At the same time, if the condition has worsened then the government wants to know so they can increase the disablity payment for the wosening condition. they order examinations because that is the only objective evidence they have to grant a condition or grant an increase.
Thats why on a couple of other posts I have made recently, I was very upset when I heard the VA was making rating decisions without exams. That worries me as they are basing their rating decisions on the evidence of record which may not really reflect the Veterans current physical or mental status. That is worrisome.
So I guess this is wrong: 38 C.F.R. 3.344(a) requires that "all the evidence of record" support the conclusion that sustained improvement in the disability has occurred, the VA cannot view the single examination upon which the reduction is proposed "in isolation from the rest of the record."
Nowhere in my treatment records does it show improvement. Only one C&P examiner, who basically lied with every effort she had, said I had FULL ROM. Luckily my wife was in the room and also has written a sworn statement one week after the exam, two months before the decision was ever made. I wrote a SOC statement that the examination report was not accurate and sent that info to the RO and respectfully requested a new exam. They didn't even bother sending a reply back. That shows me that the railroad tracks was being laid down because I filed for TDIU at the request of a MEDICAL SPECIALIST. Funny thing is two important things the Specialist diagnosed me with and the C&P denying, two VA GI doctors diagnosed me with the samething after the decision was made. So, now I have wait for the NOD which will be 2 years. Such BS and they know it. Also the examiner stated in all her history evaluation that I had Spondylosis and degenernative changes on all my MRIs and Xrays. Every one of them since 2007 showed this. But in her "opinion" she stated I didn't have "arthritis"..This is what happens when you get a Contract Examiner who is only a Geriatrics MD. After doing my homework in reading MEDICAL LITERATURE, Spondylosis and "degernative changes" is in fact DJD/Osteoarthritis. See where I am going with this?
Its all good though hopefully I will prevail at the BVA. These two issues alone will put me over 100%.
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harley my SMRs has been with the VA since 1996. The RO is the one who ordered the blood samples because the Nurse told me there was a request.
Why would they do this? No explanation.
So you are telling me that ONE C&P exam can trigger a proposed to reduce ratings and the rater didn't go by the OVERALL Medical History? Hope you understand where I am going with this.
I love the CFR and the Veteran's Benefit Manual. A lot of information in them to include the M21...
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I am just wondering about something. How many people here are currently going through this?
Somebody told me in a PM that he was at the DAV and there were 8 vets that came in complaining of being proposed to reduce. Is this something the VA does every so often? Or is this something that is coming from the top?
I wonder, are vets now being targeted like what happened with the IRS issue? Kind of makes you think...
Also, why would the RO need samples of my blood from my biyearly blood tests I get and then send the blood samples to me stating they have no way to store that type of evidence? I didn't send them no samples. This doesn't make any sense IMO because they don't never explain anything.
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I all good. I have enough overwhelming evidence and found out I have a possible failure in "Duty to Assist"....
You are right tonio this is not about any money but about the principle and about my wife and kids.
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Well I dont' have any...I thought I did but I don't. They closed the Proposed Reduction but the close them on eBenefits after 30 days. Its a standard red tape thing they do, you know. Still have to have the hearing in the next couple of months. So, no good news yet...
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vet2010 on my experience there are very little VSOs, if you are going to use them for this, that know more than a person who doesn't. I can seriously say that after talking with two VSO with the State of Florida, one about 2 months ago and one just today on the phone, they don't know a lot. They go by a standard pretemplate on writing up claims, they really don't study the Fed Code and CFR. They might have a copy of the M21 on their desk but that is about it. Example: I asked the first one, two months ago, about the 5 year protection on VA ratings, his reply was "There is no 5 year protection only a 10 and 20." I come home and find there is a 5 year protection. I knew then that it was best for me to learn this stuff instead of relying on other people.
Its really not hard and all the answers are on the internet and the Veteran's Benefit Manual. Not the one the VA sends you each year but the Legal VBM which can be purchased on from lexisnexus or even amazon...
Pain Management In-House...
in Entitlement - Veterans Compensation Benefits Claims
Posted
The Tampa VA has a in-house pain management program they want to go to and I decided to go in January 2014. As anybody here attended this program before and if so what should I expect. The surgeon told me today that because I have Osteoarthritis he doesn't feel that surgery will help and he thinks this program will help me deal with the pain. Basically what he is saying is that unless I totally screw up my spine after today that I will have to live with this pain for the rest of my life....
Just wondering about it...