Hogfan1978

Will do - thanks.

Thanks again!

Ok thanks. If you get the increase do they retroactively pay back to the intent to file?

Hi, I was active duty from 2001 to 2008. I was given a SC of 0% for sinusitis back in 2016 based sinusitis being detected by x-ray only. I did not appeal the decision. This past year, I decided to start going to the doctor when my sinuses got bad instead of just toughing it out, in order to document the issues. I’m getting over a sinus infection now and was prescribed meds and antibiotics by my PCP last week. My med record from last week calls it “acute sinusitis”. My plan is to document the occurrences over the next year with my primary care physician. Once I have those medical records documented of three or more non-incapacitating episodes, I can submit a claim for an increase….right? Am I missing anything? Any other advice from fellow vets?

Hi all, good site and good information. So I was diagnosed by my VA doc with obstructive sleep apnea last year. They gave me a CPAP machine as a result of the sleep study. Earlier this year I was given a 0% service connection for sinusitis. About a month ago, I put in a claim for sleep apnea secondary to my 0% sinusitis disability. There's no sleep apnea in my service records. I'm assuming that I had sleep apnea while in the service because nothing had changed and the wife tells me I snore the same... Today, I was scheduled for 2 C&P exams at the Houston VA Center. Any idea why there are two exams? Any idea what the exams will entail? I want to be prepared for the exam. Thanks!

usmcgirl, Thanks. That makes sense. I might try to go see a VA doc at the clinic prior to going to my C&P exam. I've not yet been to a VA doc, so that will be a new experience...

I'm scheduled for a C&P exam in November due to my lower back condition worsening. They want to examine me for an increase in my existing SC disability. Do I need to show that I've been to my doctor recently for the worsening condition, or do I just show up for the C&P exam? I haven't been back to the doctor since I was awarded 10% disability a few months ago, but my back definitely hurts worse and my ROM seems to have decreased since then. Just wondering if I should go to my private doc about it prior to going to the C&P exam? Thanks.

Broken, My cervical spine injury is NOT service connected...yet...waiting to get a nexus letter from neurologist (hopefully). However, when they retest my ROM for my increase in my lumbar spine (current 10%) in this next appointment, they should see much less ROM in my cervical spine. I am basing this on what my lumbar spine decision report stated would have to happen for me to get 20%: forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees. Am I correct in this? Or is that JUST for cervical spine injuries, even though it says that in my lumbar decision report....? And yes, I currently have deadening in my left tricep, the back of my forearm, and my index and middle finger...I will look in to filing a claim for that too... Thanks.

Wait, I just realized something in my current decision rating... In my current lumbar decision report, it says to "receive an increase to 20%" there must be.... Forward flexion of the thoracolumbar spine greater than 30 degrees but notgreater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis The part that I bolded above talks to the ROM my cervical spine....so even though my current SC injury is in my lumbar spine, I should see an increased rating when they examine me nest month since my current cervical spine injury prohibits my forward flexion from going barely 15 degrees... ...RIGHT????

Howdy, I received a call today from the VA notifying me of a C&P exam...and I'm not sure why.... I currently have a SC lumbar spine disability of 10%, which was decided on 2 months ago. Around the beginning of this month, I experienced an upper spine injury (herniated discs). I called the VA and they reopened the lumbar spine claim and added notes about the new cervical spine injury. According to the VA, the lumbar spine strain claim says "new/reopened/increase in rating" and the notes mention my cervical spine injury. Apparently, the "new" part is the cervical spine injury, and the "reopened" part is the fact that the lumbar sprain claim was closed and now reopened, and the "increase in rating" is because ??????? I never asked for any increase in rating. The VA guy I just talked to on the phone said he really didn't know why they scheduled me for this new appointment. He just said that the appointment was listed as a "thoracolumbar spine" appointment and the appointment didn't mention ANYTHING about my cervical spine injury, but the cervical part was listed on the claim. Based on the fact that it's listed as a "thoracolumbar appointment", doesn't it look like they are not looking at my new cervical injury, but at my existing lumbar spine SC injury?? Questions: 1. If that is so and that the only reason for my appointment is to re-look at my existing thoracolumbar injury.......my existing thoracolumbar spine injury has not really changed....why the heck are they calling me back to re-look at my thoracolumbar spine injury when I never told them that it has changed?? 2. Do ya'll think that they might be taking a look at my new cervical injury? Even though I haven't given them ANY evidence of the cervical injury (haven't sent them the MRI pics, and NO service records mention cervical injuries or problems) Thanks.

It wasn't a VA doc, it was my private general practitioner letter.

So, I used the below nexus letter format, wrote a "sample" letter, and scheduled an appointment with my General Practitioner. I gave my doc the choice to write "as likely as not" if she thought it was 50/50 chance of service connection, or "more likely than not" if she thought it could be more than 50/50 chance that my current herniated disc was caused by my ATV accident back in 2002. She said, and I quote, "I can't really say either way, so I can't sign the letter". I told her that she didn't have to be 100% on her decision. I told her that if she thought it was just a 50/50 chance, then she could say "as least likely as not" on the letter....she still wouldn't sign the nexus, and apparently no explanation of mine would change her mind. I thought that it was kinda strange that back during my first doctor visit after this herniated disc started causing problems, her exact words were "have you had an accident in the past? If so, that accident could have caused it...." HOW THE HECK DO YOU GET THE DOC TO SIGN A NEXUS?!! Maybe it just wasn't meant to be. I have yet to ask my neurologist to sign a nexus, afraid he might reject me like my general practitioner did... Any ideas before the neuro says the same thing she said???

I have been watching other posts on here and reading them. However, due to my limited exposure to the VA (sent my first claim in May of this year), I don't know how to answer most questions. I'll keep reading posts and as I gain experience, I will add my $0.02 when I am able! Thanks for all the help that all of you experienced folks have given me! I promise to give back when I can!!

Okay, so I found the "Dr. Quack/John Doe" sample nexus letter that has circulated around this site. I basically pasted that sample letter into a Word document and inserted my info and several notes for my general practitioner to put her own words in it. In a nutshell, it's got the following items in it: -the fact that she has reviewed my service medical records and the medical records that she has on me since I separated (which is not much) -her diagnosis of my problems -specific references to pertinent medical records (the ones that complain about back problem (although they are all complaints about my lower back) and the record of my ATV accident) -the fact that I have not had any traumatic injuries since my ATV accident that would have caused or worsened my accident -medical terminology that links my ATV injury to my current condition -I gave her a choice that if she feels that there's a 50/50 chance that my ATV injury is linked to my current condition to say that "it is as least as likely as not" and if she feels that the chance is greater than 50% that they are linked, to say, "it is more likely than not" that they are linked. I gave her the sample and explained that all of the above info must be in the letter or the VA would disregard it. I also gave her copies of any service records about my back and the ATV accident. I also included the neurologist's diagnosis that my C6-7 showed an "impressive herniation". Once I have my general practitioner's nexus letter (assuming she does write it), I will include her letter in a similar package to my neurologist to get a nexus letter from him. The reason I'm doing this is because my neurologist's nurse told me that he would probably be glad to sign such a letter, but it would be advantageous if my general practitioner signed one first and he could follow up with a similar letter.... So, what do you think about how my nexus letter will be written? My only concern is that I wasn't able to give the nexus letter request package (as described above) directly to the doc. In fact, I had to give it to the receptionist who looked like she was about 18....so we'll see what happens.....*fingers crossed*

Berta, So I can chase this as a new claim submitted and also try the route of secondary to my lumbar SC disability? If so, can you step by step the process of getting a secondary claim? I will also search the forums, but you seem to know a lot about it. Thanks Ryan

Berta, thanks for the response. My responses to your comments/questions are in BOLD: In your past reply to JBasser: "No sir, this recent c-spine injury is the first problem I've had from my neck/upper back. However, my civilian doc attributes it to my on duty vehicular accident." Did this doctor document that statement? No, she didn't. This was my general practitioner. She has stated that she will write a letter though. I will try to write it for her with all the correct verbiage and see if she'll sign it. Does the VA have that info? No, it just happened on 1 Oct. The only thing that the VA knows about is the 10%SC lower lumbar spine injury. "looked at the name of the radiologist on the report and said, "I'm not sure what she was thinking, she normally does a better job at the reports." Anyway, I asked the neurologist if I should have them correct the report and he said, "no, it will all be correct in my report and notes." Was the MRI radiologist report done by a VA doctor? NO Is the Neuro a VA doctor? No Was the MRI report favorable to your claim? Not as written, that's why I want it corrected. If correct, it would support my claim. I, myself, can look at the MRI pic and see the herniated discs... If so why change it? Personal experience- often Neuros compete with Radiologists to be 'right'.And vice versa. "About the nexus letter, I am going to ask the neurologist. I'm so nervous that he won't agree to sign it." If not it is time to consider an independent medical opinion. Unless this neuro is a non VA doctor- but one also has to consider he would need to understand how your SC disabilty is relevant to this claim. I will bring him my pertinent service records. The IMO criteria is here in our IMO forum. His statements here wont help you: "Anyway, after clearing that up, I asked him what would have caused this problem (earlier in the appointment he had asked me if I had ever had any trauma or anything like that). He said it could have been anything. He also said that sometimes these things can just happen to people." Yeah, I know. Nothing like this will be sent to the VA. I have prepared cover letters and evidence for 4 separate IMOs I obtained for my last claim. Even though 2 of them came from Dr. Bash (Neuro-Radiologist) and former VA doctor who knows exactly what an IMO should contain, in any event I laid out the probative evidence they needed to consider in the cover letter and why and then gave them all medical and legal records available to support my position . My point here is you have a SC disability that this could be found as secondary to. But an IMO doc needs to access the SMRs and/or the past VA SC decision as to the nature of the back injury as to being relevant to causing you this additional disability. I was under the impression that it would be best to claim this new c-spine injury as a new claim, independent of the lumbar spine strain 10% that I've got. That's why I wanted to get this nexus letter, to link the upper spine injury to the ATV accident (not to the lower back injury). If this is a bad idea, or I just don't know what I'm talking about, please, let me know.... I had an experience years ago with a VA cardio and two VA Neuros who all thought they were stating the word of God to me and that I would buy what they were selling. It was funny in a way because they all wanted me to think they each were in charge of the situation.Which meant they wanted to be in charge of a cluster XXXX.In my opinion. Unbelievable situation. This was on the heels of a CT scan as well as MRI. The VA doctor who read the CT scan was wrong and I challenged her. I had past experience of a Neuro nature and knew her interpretation of the scan was wrong and I got her to call a Neuro at another VA to read it, and his interpretation was correct and exactly my 'diagnosis' too. When I read this it hit me that this neuro seems pretty pompous. I don't know him well, but other trusted doctors have recommended him to me. My original statements about him may have been written incorrectly, I think he's good. Just when I asked "what could've caused this?" he basically said "anything really" BUT he might be a great doctor and give you a strong IMO. IMOs can be expensive but a private doc might do one for free or low cost. Did the radiologist's MRI narrative refer to the SC back injury at all? NO, I have never seen, not talked to, this radiologist. It probably didn't but if it did-what did the narrative say as to that?

Well it was a very interesting afternoon, First, I went to the hospital where I had the MRI done and got a copy of the written results from the radiologist. I also wanted to get the actual MRI pictures to show the neurologist, so I made a visit to x-ray and they burned me a cd with the pics. Then it was off to the neurologist appointment. I gave the written MRI results to the neurologist. He looked at them and said, "I'm not impressed with this". He then gave me a physical exam, part of which was poking my fingers with a needle. I could NOT feel a thing. Looking surprised, he took the CD into his office to look at the pics, came back in about 5 minutes and said "follow me". In he office, he showed me pics of 2 herniated discs - between C5 and C7. He then told me that the written MRI report was not worth the paper it was printed on. He looked at the name of the radiologist on the report and said, "I'm not sure what she was thinking, she normally does a better job at the reports." Anyway, I asked the neurologist if I should have them correct the report and he said, "no, it will all be correct in my report and notes." Anyway, after clearing that up, I asked him what would have caused this problem (earlier in the appointment he had asked me if I had ever had any trauma or anything like that). He said it could have been anything. He also said that sometimes these things can just happen to people. Bottom line, I didn't feel like today was the day to ask about any nexus letter or anything. I did, however, bring it to his attention that I have a VA disability with my lower back. In conclusion, he gave me another prescription for hydrocodone and he also had me get this water-bag neck-stretcher contraption to use over the weekend. He said to call him Monday to give him an update on how I was feeling and we'd go to the next step of steroid shots at that point. What do ya'll think (spoken like a true southern gentleman)? Should I go ahead and have the radiologist correct the MRI report? Seems like that would be the smart thing to do, otherwise I won't send it to the VA written incorrectly. About the nexus letter, I am going to ask the neurologist. I'm so nervous that he won't agree to sign it....

Thanks, great advice. I'll play it by ear on asking for the letter. I want to do this right, and I don't want to give the neurologist the impression that I'm just seeing him to get this letter. First and foremost, I want him to fix me....the letter is secondary. I'm doing better this morning, still nerve tinglings up and down my arm into my fingers, but it's better. Thanks, Ryan

cool b, That's pretty messed up. Luckily, it's only been 4 years since my separation date and I haven't had any traumatic accidents, so they won't be able to blame anything else.... Again, what's the protocol about when to ask for the nexus letter? I've never seen this neurologist before, tomorrow's appointment will be the first. Not sure I want to just go bustin' up in there and say, "gimme a letter!" LOL.

Thanks for the well wishes. Feelin' much better today....by the grace of God. I've got an appointment tomorrow afternoon with a neurologist. I'm guessing that the best way to approach him about a nexus letter is not to ask him on the first visit. To me that would seem a little forward, but I wouldn't know.... Any thoughts?

71M, Yes! My lumbar back injury has affected my posture. I've noticed recently (within the last 2 months) how when I stand straight (or what feels like should be straight), my torso looks ever-so-slightly lop-sided, or crooked. I'm assuming you're talking about my military medical records....there's no proof of that misalignment in my service records. All that's in my service records are lower back sprain, spasms, and backaches. Nothing about specific misalignment, but like I said, it's it present. I can see it when I look in the mirror. John999, I have been on doc prescribed meds since 1 Oct because of this mess. I'm on valuum, vicadin, lyrica, and a 5 day dose of prednisone. The only thing that makes the pain go away is when I take 2 vicadin (hydrocondone). I've been on them for 12 days now. Thanks for helping a fellow veteran.

Thanks for the encouragement. I just got back from the physical therapist. I'm currently in a LOT of pain. Mostly the nerve pain down my right arm is what's bothering me. Been on narcodics, etc since 1 Oct. This really sucks. Nothing seems to help except a couple of hydrocondone. Anyway, I've tried to get a neurologist appointment and was told that the soonest was 26 Oct - no way I can last that long in this condition. They put me on "standby" in case someone else cancels......still waiting on that to happen..... What if I go to a VA neurologist for this pain? Will they be "on my side" in getting a service connection? At this point, I would give up all my current disability payments to get rid of this pain.....

Jbasser, No sir, this recent c-spine injury is the first problem I've had from my neck/upper back. However, my civilian doc attributes it to my on duty vehicular accident. Having said that, I'm pretty discouraged. I don't see how it can be service connected since I didn't complain of my "upper" back or neck while in service. My lower back is all I complained about while in service and there was one appointment when I complained of just backaches and they prescribed me a back brace...but no upper back. I just don't see how the Nexus can be obtained. Can neck injuries easily be caused by back injuries? How?

Gotcha. Doing a quick scan of my service records, I found 3 records pertaining to my back. 2 were specified as lower back pain, and 1 was just backache. Non of them were specifically upper back in the cervical area. Looks like I will have to go with the lumbar spine sprain connection. Is this hard to prove? I'm a little nervous that I'll mess up and screw my chances of getting my C-spine injury service connected.... Thanks.