kevin4998

As a side note, in the old forums if I remember correctly their was thread for the various Medical facilities that one could post about issues or non-issues about the particular facilities. Is it possible to re-established this thread of the various Medical facilities so we can talk about those facilities? Less of course names, but just departments. I wouldn't want Hadit to be held accountable for slander on any particular individual.

I was recently in the prosthetic department at Roudebush. I was treated rudely and when I attempted to leave the person stood in the door way to prevent me from leaving. I had to ask him three times politely (please move) to move. At the third request he finally moved out of the door frame. I went to the advocates office to explain what happened. I do have a thick shoulder, and his ruddiness I could brush off. But, him standing in the door frame and blocking me from leaving I felt needed to be addressed. As, I do have a thick skin... many would of probably lost it at his attempt to intimidate and the blocking of the door. After a few weeks I sent a message to the advocate again to see what she had found out. My complaint about my treatment was of concern, but more importantly how they addressed this issue with this person and his behavioral and what was going to be done, or had been done. A week later the advocate sent me a message and just addressed my issue with why the confrontation occurred in the first place, and not nothing about the employee. 1) Anybody else having problems with Roudebush and its employees in Prosthetics? 2) Is it typical for the VA advocates to NOT inform patients of the consequences of its employees and their bad judgment's when a complaint is filed for any certain employee? I believe they are just sweeping this under the carpet (as it appears with most complaints). At, what point can you go beyond the advocates to address a certain employee if this is his/her typical behavior? And, if it is possible to go beyond the local advocates, who would you go too? Thanks Kevin

Does that also apply to an IME, was thinking about hiring one to do just that at the end of the year.

I have spinal stenosis at l5/s1. I was not only awarded for the issue with that, but also radiculopathy down both legs which has its own rating. I did not have to submit a claim for it as the examiner noted it during the exam and RO went ahead and awarded it in connection with the spinal stenosis. And, yes mine was also based on ROM. I was also awarded somatic symptom which is a combination of pain/anxiety/depression/ptsd/gulf war syndrome not as secondary to spinal stenosis but the doctor that gave the examine said something to that affect but did not write it up that way. I am not sure exactly how he claimed/explained it, but when I was talking to him I explained that due to the pain from spinal stenosis it effect my job(s), all relationships to the extent of my wife and children and alienation because of it as I was inactive and did not participate in things with them. Eventually it led to resentment on my side for my family not sticking by my side due to my disability. The gulf war syndrome I do not even know how that played a roll, again I have not seen anything that in writing that states I actually have gws other than this this Somatic note. I was in GW, but the examiner that actually did the exam for gws said she did not see anything related too gws.. even though I was awarded for gerd and do have ibs but not service connected (tried but failed). I hope this helps, basically Radiulopthy for legs and/or maybe Somatic symptom. Maybe others that I may not be aware of. I think maybe loss of control of bowels/bladder as I have seen those related to injury/disease of the spine relationship.

I am only 30 minutes from Roudebush in Indy so choice card really isn't an option. Matter of fact I live so close I haven't bothered to file for travel, till this past month. I got like $4.60, pays for some of the gas (shrug) I do plan on filing but I do need that IMO which shouldn't be a problem, but I am also in the process of starting to buy my current home so I have to wait till that gets done and settles. Navy04 I know what your talking about with the Crohns as my mother had it for decades (1970's) till she passed away earlier this year. That is something that I am glad I do not have, at least tests are negative so far, their is always that possible chance.

A little background. I am at 80% service-connected, which means obviously I do not get dental care from the VA. I am sc for Gerd and Barrett's Disease. This sc goes back to the late 1980's, so I have Gerd in particular for years. Over the last five years I have lost 85% of my teeth and out of two dentist I can not even get them to try and fix my remaining teeth. All my teeth was repaired at one point in my life, and the following year after repairs... the started to deteriorate very fast with fillings falling out and new cavities cropping up and expanding quickly. The acid could of very well removed the protected enamel over the teeth. You can google several reference's to that fact, and leading to tooth decay and possible other problems. This morning I was reading an article about Gerd and it mention that is common for tooth loss due to Gerd. After thinking about this, it made since that their is a possible good explanation of my sudden unset of tooth loss due to Gerd. With having Barrett's Disease which is the direct result of acid flowing up my esophagus, it made since that the acid could be the cause of my tooth loose. Take in mind I am only 49 which I believe is not common for almost all my teeth to gone at such a young age. I have regurgitated acid several times over the years, and their is almost no control off it flowing up. The sphincter muscle at the bottom of esophagus barely works to control material flowing up. I can be walking and all of sudden have acid in my mouth, that quick. Anyways, I now personally believe it is possible to get a Nexus to establish a link between the two. I will probably file a claim after my current claim is finished and will keep you all informed. Just passing the info because I know many here have Gerd and maybe not have thought of the possibilities that Gerd could be linked to their teeth problems. As we know getting to the VA dentist is one of the hardest things to accomplish as you have to be 100% or service-connected. If I would of put two and two together sooner maybe I would still have some of my teeth, doubtful but who knows. I still need over 2k in repairs/fixes, so maybe if I can hold out for a bit longer I can have the VA do it. Don't know if the do implants, but considering dentures are much cheaper probably not.

I can relate to this very well, and just like you... the VA and others usually dismiss all together or say its diabetic neuropathy. I don't agree with any of these, but what do you do? I have addressed it many times to VA and Non-VA and the results are always the same. I know I am no doctor, but I do know enough and had read enough to know that this isn't normal nor is it diabetic neuropathy as I do experience this, but WHAT you and I both are experiencing is not the same as diabetic neuropathy. I wish it was, then I could rest about it. I have pain in my left foot so bad that I have to wear three pairs of socks for cushioning. At first one WOULD suspect diabetic neuropathy, but after reading allot on it a couple of dozen times I don't believe it is that. It just doesn't fit no matter how many times I have tried to see it as diabetic neuropathy. Its not a .. um cant think of how to spell it, neuroma either. They did do an examination for that (and x-ray), and I have my own "private" nurse conduct the "clicking" test for it. So, I really do not know where to go from here on out with it as it "pain" does not fit anything I have looked at. This pain is extends across all Metatarsal-phalangeal joints and feels like I have a "ball" of sorts on top of those joints (in particular at the second joint area). It is so painful, that I have to keep off that foot more and more. When not on the foot I still feel needles from all these particular joints but also out towards my big toe, with burning sensation as well. Allot of tightness when I curl my toes. I am only experiencing of this only on my left foot. Spinal Stenosis at the L5-S1 area which shoots pain in particular down my left leg sciatic nerve when I stand/walk for any particular time especially on cement or otherwise hard surface. I have had the test in my foot with the needles and electrodes and it came back negative for anything. I mention this issue (foot) to relate towards what you mention.. but I do have other pain issues as well that just can not be readily explained and knowing they can not actually find what is causing the foot pain precisely, then I do not want to even try to explain the random pains I do have.. I see no point in it. I should note, that these random pains do not fit Fibro (what ever) either as the pain is not specific to areas for which the Fibro (what ever) areas they test for.. I think 12 point test.

I was diagnosed with Spinal Stenosis which has been service connected. I have read that it is possible to get the VA to either help or pay for a new bed due to the service connection. Every bed I have ever owned breaks down rather quickly and causes more pain in my lower back, which is mostly in the morning upon waking up. So I have no doubt that my bed is causing allot of my issues by aggravating my lower back To get a quality bed that don't break down (dibs in center 6" or more) with in a few years I need to purchase a quality bed. This can be very expensive as you know, and being on SSD and VA benefits only it is more than I can really afford. I do take Hydro-Codone for pain, and because of that I have to start attending pain management class or I could forfeit my pain medications. (Just told that by my primary care this week). Who/what/where do I address this issue with and see if their is any hope in the VA helping me get a decent bed. I also have sleep apnea, but that has yet been service-connected, but working on it. Thanks beforehand.

I am sorry for your loss, I have had three in the last three months. They (VA) will unfortunately use that against you for PTSD if you mention it, unless you can relate that too loss of comrades in service and how that may brought those feelings up. jmo though and it isn't worth much.

No I did not, I will be hopefully furthering my claims with Dr. Bash later this year when I have the funds. I don't believe I can further my claims by myself as it seems they refuse to raise any of my claims above 30% and I think its because they have stated in all my C&P exams that I am already unemployable and giving me 40% or above could possibly grant me 100% TDIU. I do not know if I am actually having that issue with them but it sure in the hell looks like it. IE: •You must be a Veteran (obvious I qualify) •You must have at least one service connected disability rated at least at 60%, OR (Highest I have is 30% x2) •Two or more service connected disabilities at least one disability ratable at 40 percent or more with a combined rating of 70 percent or more. (This is where I am stuck at) •You must be unable to maintain substantially gainful employment as a result of service-connected disabilities (marginal employment, such as odd jobs, is not considered substantial gainful employment for VA purposes). (C&P x2 both say I am unemployable)

I am currently rated at 80% Not none of my issues are rated above 30% that are currently service connected I have been working on getting my Sleep Apnea secondary to one of a few items that "could" be causing it. I first tried Gerd, and the claim was quickly denied. I then submitted in late Nov, 2014 it could be associated to my depression (somatic disorder) and/or meds prescribed by the VA for my multi issues that is service connected. This week E-Benefits have allot of movement in regards to this claim. Yesterday evening, I noticed the claim was finished and my notification was in the mail. Other than that, that is all I could find out last night from E-Benefit's. This morning, I checked again with no real thoughts of seeing anything as of yet. My sleep apnea last night was as follows: Sleep Apnea/50%/non-service connected This morning it showing the "arrow" to indicate now its secondary to my Somatic Disorder. BUT, it does not give the percentage nor does it say the needed "service-connected"... so now I wait for snail-mail on pin and needles to see what they actually have to say! Crossed fingers and praying. If approved I will be at least 90% service-connected. The only thing that could possibly prevent me from being TDIU now is the fact I am still on the "rolls" for my last place of work. This is only because I do not roll off the rolls till a little later this year, and till forced to come off the rolls I will not remove myself from the roll. Reason being is my children have insurance while I am on the rolls, and have no other insurance. I should qualify for the 40% (sleep apnea 50%) with above the 70% overall rule for TDIU. I have it in black in white from them in my previous claims stating that I am unemployable, but since I am still on the "rolls", that I believe will keep me from TDIU. We will see what happens one item at a time.

I really have a problem with this wording and I am sure this SOP, but most know that issues normally get worst over time so how can they "assume" things will get better and "aim" for a reduction in benefits. Not meaning to hijack the thread, just making a comment.

A little bit more information on it. http://www.portal.state.pa.us/portal/server.pt/community/persian_gulf_veterans_bonus/14433 http://www.milvet.state.pa.us/DMVA/Docs_BVA//PGVB/Digest.pdf Edit: Got curious about what other states have/had to offer. Not sure if any of these programs are defunct now but this is the list I found if anybody is curious. http://paycheck-chronicles.military.com/2010/09/09/state-veterans-bonuses/

Was not for sure where to put this as it really is not for "ILLINESS" and it does not fall under VA Compensation, so please move where it may serve the community better. Just read this, do not know much more than this. But, apparently if you served in the Gulf War theater and your home was Pennsylvania they (Pennsylvania) have a compensation program for you. Sweet deal if what I am reading is correct, but time is running out for the program. http://www.milvet.state.pa.us/DMVA/Docs_BVA//PGVB/persgulffinal.pdf

Well this is interesting and maybe a game changer for allot of people. http://www.military.com/daily-news/2015/04/03/army-seeks-to-identify-troops-veterans-exposed-to-chemical.html

AND she makes 70k a year to make light of Veterans issues.. now that's the joke. http://www.indystar.com/story/news/politics/2015/03/09/va-managers-email-mocks-veteran-suicides/24602495/

I am looking for an IMO in the state of Indiana who is familiar with the VA process and terminology needed by the VA (more than...). I am looking to secure an IMO for sleep apnea (VA sleep study completed and diagnosed with the VA) secondary due too Sonoma (multiple mental issues, and service connected) and/or medications for same. I have several other medications that are also VA service connected that "could" be a possible cause of my sleep apnea. If your aware of such a doctor in Indiana please advise. I am centrally located and will travel as necessary. Thank you for any advice

I found in my SMR's several documentation of "low back pain" where they just gave me over the counter pain meds. On that information and having a history noted by my private docs after my service time and surgery to correct but not resolving issue I filed for service connection. I stated spinal stenosis (diagnosed several years after my service time by my private physician) a claim based on the low back pain info in my SMR. That is ALL I had and I won my service connection. I believe I was either lucky or that IS all I needed. Of course everybody's chance's are different and the more "connecting dots" will most likely help than not. They also gave me radiography (spelling maybe) diagnoses with 10% in each leg. I did not file for that, but during the C&P the person noted it and they gave that to me as well. Good luck.

Pain Disorder has been removed off of the e-CFR Old version had it at code 9422 http://www.law.cornell.edu/cfr/text/38/4.130 while the new version has 9422 with "Other specified somatic symptom and related disorder" You have to look at DSM-5 which is new this year. http://dsm.psychiatryonline.org/book.aspx?bookid=556 I pulled up a site that reflects what notable changes was made from DSM-4 too DSM-5 http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf This is what I see: Somatic Symptom and Related Disorders In DSM-5, somatoform disorders are now referred to as somatic symptom and related disorders. In DSM-IV, there was significant overlap across the somatoform disorders and a lack of clarity about their boundaries. These disorders are primarily seen in medical settings, and nonpsychiatric physicians found the DSM-IV somatoform diagnoses problematic to use. The DSM-5 classification reduces the number of these disorders and subcategories to avoid problematic overlap. Diagnoses of somatization disorder, hypochondriasis, pain disorder, and undifferentiated somatoform disorder have been removed. Somatic Symptom Disorder DSM-5 better recognizes the complexity of the interface between psychiatry and medicine. Individuals with somatic symptoms plus abnormal thoughts, feelings, and behaviors may or may not have a diagnosed medical condition. The relationship between somatic symptoms and psychopathology exists along a spectrum, and the arbitrarily high symptom count required for DSM-IV somatization disorder did not accommodate this spectrum. The diagnosis of somatization disorder was essentially based on a long and complex symptom count of medically unexplained symptoms. Individuals previously diagnosed with somatization disorder will usually meet DSM-5 criteria for somatic symptom disorder, but only if they have the maladaptive thoughts, feelings, and behaviors that define the disorder, in addition to their somatic symptoms. In DSM-IV, the diagnosis undifferentiated somatoform disorder had been created in recognition that somatization disorder would only describe a small minority of "somatizing" individuals, but this disorder did not prove to be a useful clinical diagnosis. Because the distinction between somatization disorder and undifferentiated somatoform disorder was arbitrary, they are merged in DSM-5 under somatic symptom disorder, and no specific number of somatic symptoms is required. Pain Disorder DSM-5 takes a different approach to the important clinical realm of individuals with pain. In DSM-IV, the pain disorder diagnoses assume that some pains are associated solely with psychological factors, some with medical diseases or injuries, and some with both. There is a lack of evidence that such distinctions can be made with reliability and validity, and a large body of research has demonstrated that psychological factors influence all forms of pain. Most individuals with chronic pain attribute their pain to a combination of factors, including somatic, psychological, and environmental influences. In DSM-5, some individuals with chronic pain would be appropriately diagnosed as having somatic symptom disorder, with predominant pain. For others, psychological factors affecting other medical conditions or an adjustment disorder would be more appropriate. My question is why doesn't the updated e-CFR not reflect more accurately too DMS-5? Why wouldn't it reflect more accurately should be the question, is their a reason why they don't want it too?

I have reviewed the notes that is available to me, but have not seen that diagnoses... but who really knows what is actually in our records behind the wall? Yea, that is pretty much what I was told, if I was to have surgery again than it would probably just make it worst. When the VA even offered for that particular surgery I told them, only if I was unable to walk at all will I would even consider that surgery again. Yes the first, well second, surgery did help but only to the point I can move with the help of medication, but I am unable to lift or do anything that would stress my lower back at all. That issue was called low back pain in the my smr's, but never fully diagnosed. Only after I had gotten out and years later became almost totally unable to walk with out sever pain did my private physician diagnose me with spinal stenosis. Then I had surgery and I was able to walk for awhile with out hardly any issues, but now my pain is back to an 8-9 with out meds, meds puts it down too 6 till I over do it with what little I do. I lost my job because of it, and that lead to depression as I no longer could take care of myself let alone a family. So major depression was secondary to the spinal stenosis. I did not even know I could claim my issues.. got out in 97, pain got bad in 2005, surgery in 2006, good till 2011, that's when things got bad, but also the same time I was told to look in to my smr and see if had a possible claim. Had never even heard of that possibility. But luckily that issue and a few others was in my smr's. I have been slowly getting better since, even though the pain is still there, at least I am being taking care of for the most part. But, I fully believe my diabetes, sleep apnea and weight issues are related to my spinal stenosis, because I didn't have these problems a few years ago till I was not able to basically have a life... people that know of these issues, know that your life drastically changes when you just can do the normal things in life that you once did which includes keeping in shape. Cant work out with this or I would be in tears, even with meds. I would love to work out to some extent, something that would help with my diabetes and weight, but so far I have not found a thing I could do to help with them. Light works out is not going to do it.

See that is what is really confusing, they say the Pain disorder in the first exam is associated with my spinal stenosis. Which IS service connected and well documented and I have had two some what failed surgeries for it. So I am not for sure what they are talking about, because their IS a documented cause for the pain.

My first C&P (2013) read: "2. Service connection for Pain disorder (claimed as depression, anxiety, post-traumatic stress disorder and gulf war syndrome) as secondary to the service-connected disability of Spinal stenosis. We have assigned a 30 percent evaluation for your based on: o Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal) o Chronic sleep impairment Your Global Assessment of Function (GAP) score is 61. A range of 61-70 indicates some mild symptoms; or some difficulty in social, occupational, or school functioning, but generally functioning pretty well, has some meaningful interpersonal relationships. The overall evidentiary record shows that the severity of your disability most closely approximates the criteria for a 30 percent disability evaluation. A higher evaluation of 50 percent is not warranted unless there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: Flattened affect; circumstantial, circumlocutory, or stereotyped speech; Panic attacks more than once a week; Difficulty in understanding complex commands; Impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks);"... My second C&P (2014) exam read the following which they(VA) now use Somatic instead of Pain Disorder as noted in the copied text below. "1. Evaluation for somatic symptom disorder (previously rated as Pain disorder, claimed as depression, anxiety, post-traumatic stress disorder and gulf war syndrome). Evaluation for somatic symptom disorder (previously rated as Pain disorder (claimed as depression, anxiety, post-traumatic stress disorder and gulf war syndrome) currently rated as 30 percent disabling, is continued. An evaluation of 30 percent is continued. We have continued a 30 percent evaluation for your somatic system disorder (previously coded as Pain disorder, claimed as depression, anxiety, post-traumatic stress disorder and gulf war syndrome) based on: Difficulty in establishing and maintaining effective work and social relationships Anxiety Depressed mood Symptoms controlled by continuous medication Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress. No Global Assessment of Function (GAF) score was reported. (The paper work I received, stated they don't use GAF anymore) The overall evidentiary record shows that the severity of your disability most closely approximates the criteria for a 30 percent disability evaluation."... 1) Has anyone else "Pain Disorder" been changed too Somatic Disorder that you know of? 2) Why was this change made to the cfr if that is what has happened? (speculation) I tried during this bout (2014 C&P) with the VA to connect sleep apnea secondary too Gerd, but if I would of done my research better I would of realized that I would of been better off going with my mental disabilities. But now, with the way this last exam was worded and the change to somatic... I am wondering if that "is" even a possibility now. To me they threw every mental disability I have into a pot and took out the reasoning which was spinal stenosis. I am not sure what to make out of the changes and what it means too me. I have been diagnosed with sleep apnea, through the VA. They have that documentation in their files. I am also diabetic and from the research I have done sleep apnea and diabetes type 2 can be linked to each other. (question will it be the chicken or the egg first) But, for now I need to get sleep apnea secondary to my major depression. Any thoughts on this would be greatly appreciated.

Update, got the 80% and moving on :)

Prior Navy myself, and I admit my story pretty much reflects yours in regards to why should I when so many other warriors deserve it much more than me. But, when I basically came to a wall and not able to actually work at all I did the only thing I could do. I filed for SC and SSDI at the same time. While I waited and my finances fell thru the floor I never felt more guilty and useless to the point of that it started coming out wrong in so many ways. I did win SC, but it should be higher than 60% and I believe I will get it too where it should be and that's at 80%. Now that the VA is taking care of me (which I actually didn't even know was available to me), including to major depression and anxiety issues I have come to realize that I did my part and now its time for me to take it easy a little. I still have issues from time to time, but I work thru it. I recently even got my own emotional support dog, not a trained one.. just a pet.. but he does bring my spirits up allot. He is my little boy, not that he is little.. at 11 months he weights in at close to 120 pds. Yes I am Navy, but his name is Sarge... and I don't know what I do with out him. I hope some how this helps you in some way in knowing your not alone in how you feel. Good luck and congratz!

At the following site, it will do the math for you. I "believe" to be pretty accurate, but then again I do not do math very well. Others more intelligent then me will chim in on this if the math is correct or not I am sure. For the above it came up with 64% zero'd down to 60% as noted from the above previous posters. http://www.vvaarizona.org/combined_disability.php After you find the percentage, you can click on the link to the right of the result and do the math for actual compensation. "The rounded number would be 70% disability. Use this figure in the disability compensation calculator."