sixthscents

LarryJ you make a valid point. If the VA is rating a person for painful motion, does that mean painful medicated motion, or the base injury with no treatment? This is a touchy subject with varying opinions and I'd like to see how this runs.. but please lets keep it civil. Lets not call people frauds, or such... I'd just like to see everyones opinion on this subject - in an adult manner. Personally I tell my vets not to lie, but to tell the WHOLE truth. It is my impression (not fact impression) that disability compensation is for the remaining fuction of the person - reguardless of treatment..... but thats skewed when it comes to mental disorders and such.. So how about some expert raters advise here? entropent? What do you all think - believe... But lets be adults and leave name calling out of the discussion please. Another point... when does it become a lie? That is when does your options and behavior during a c&P become false or misleading? I'd really like to see a mature discussion on this point because I think it is very important that we look at where the line should probably be drawn....

Pete, as usual you are dead on, and Berta you make a very good point. I'd like to emphasize Berta's point. No person on Hadit can post that anyone should lie, or deceive the VA. Period. It's up to Tbird to decide what happens but it is a BAD thing to do... There are instances where people ask "should I take my meds, should I dress nicely.. etc." . These people are NOT saying I am going to lie to the VA. I generally tell people with these type of questions to do what they think is right... but not to minimize their injuries. Veterans as a group tend to minimize their problems to doctors. I have seen it again and again. I do not ask ANYONE to lie, but I insist they tell the WHOLE truth. If they do that, then their case is best served. No need to scream at a doctor etc., as I have seen advised (sigh).. just tell the whole truth and take the time to make sure the doctor understands what you are saying. Take your spouse or significant other with you. They will often tell the doctor better and more complete information than the veteran.

I deal with several active duty "holdover" soldier and soon to be retirees so I thought I'd comment here. The exit exam is critical... they try and give you a form and ask you to filll it out just prior to the exam listing all your problems. I reccomend saying that you need to look at your records to fill it out, reschedule and take the form home. Go over it in depth and list everything that is in your records. Yeah the VA doc is gonna get pissed when the see it all because they have to go over it.... too bad. Further, I like to tell soon to be veteran to ensure they get a copy of their service records... often things like convalescent leave are better annotated in those, as well as a great many other items you may need. May sure both your medical, and service records are complete. Make copies... several of each. Ideally, a soldier will have their claim ready prior to discharge... or soon after. Soldier CAN file for SSD even before they are discharged... I did and have watched many that I advocate do so and get paid for that time... normally no more than 3 months though. Anyway... my opinion.. sorry about the typos.. me and my new "ergonomic" keyboard are not agreeing... it's like the keys are bent to fit the hands... it just screws me up so far... joy.

I was part of a story about recuiting, but I don't think I'd like to comment on the VA medical negatively in my OWN experience. Now this is MY experience.... others differ and that I do understand but since I have been in the medical system since 2002, I have had excellent service. In a surgery that was a repeat of one done by a civilian doctor 6 years prior (pylonodial cyst) the VA did a MUCH better job of the surgery. I moved to a local clinic and I have the same doctors every time. I like my doctor, and believe it or not she returns my calls. It may take a day but she does. My physciatrist is American and speeks english... understandably! In short while I think the medical care on a one-to-one basis is less "personal" at the VA medical centers... i.e. constantly changing PCPs and Psych from India... their care is still good, to excellent IN MY EXPERIENCE. We have an outstanding group of dedicated people here in Tennessee, and I make a point of telling them that.... I guess we are lucky... the facilites are well maintained, and constantly some parts are undergoing renovation... the doctors seem competent and normally get everything right... the nurses seem compassionate and handle most f the doctor's paperwork on time... the Nasville VAMC is connected with Vanderbilt University and they have an outstanding neurology department. Now I am NOT discussing C&P's... just nortmal care, and I'll tell ya, I am really pleased so far. Sure I have spent an hour or even two waiting in the emergency room, but I've done that in the civilian world as well. In fact every negative thing I have encountered in the VA system, I have also seen in civilian care... so, I dont instantly get upset when I have to wait. Anyway... that my opinion, even tho its off topic. As for the reporters.. well speak your mind if you feel you have something they want... and you feel the need. I wouldn't worry too much about reprisals... I just dont see the VA caring that much to bother... the VARO that is..

Josephine, Sadly I agree with your statement that they pick and choose what they read. I have a vet that they deny limps.. who has a VA provided AFO and built-up heel. Yet he "doesnt show an antalgic gait"... when its ALL over his current and past records... so hi-ho hi-ho to BVA it goes. BUT.. eventually we will win. We went from 10% to 30% to 50% so far.... eventually he'll get 100% TDIU. Experience tells me that... the VA did schedule numerous NEW C&P exams, just not for this injury... go figure. I think they use a magic 8 ball sometimes - (sigh), but they are caught in the system just like us. Hopefully the increase in raters will help. Bob

I am that "crazy old vet", until another vet (uncle, brother, cousin) needs a claim filed... then it's Bobby or Bob... go figure. I'm getting a pool, whenever the new house gets finished ... if ever (what a nightmare) I'm putting in an indoor heated pool.. period. Yep I'll never recoup the cost out here in the sticks, but who cares anyway? Hopefully after this next surgery I'll even be able to use it. I dont use my scooter except if I have to walk a lot... but look out at Disneyworld cause I take no prisoners there.... and the thing is insanely fast... ha, I left skid marks in front of our resort room.. Somedays the only thing that keeps me sane is laughter. (according to some people that doesnt work either) As far as getting healthcare from the VA they cant deny you, but make sure they have a copy of your other insurance and if you get care elsewhere they need a copy of the medical records... take them to release opf information, dont just give a copy to your doctor and assume they will make it. Go there yourself, with a copy... also maybe do "in-person authentication" for myHealthevet at the same time huh?

HA... I didn't even consider the fact that a waiver is an admission of service connection ... otherwise why HAVE the waiver. Your dead on man... wait and see, then file. I have never seen a waiver on discharge affect a claim... and I have bumped into a couple, but it was always the Army actually trying to cover their a** if the servicemember tried to do a correction to military records and get a retirement. I dont think you will have a problem with the VA.. but darn good point on the service connection... darn good.

Dont mind at all, I'll look it over and give you a yell back tonight. Yeah, I have been out of the loop, but I am recovering from the last surgery and hopefully this next one will really help with some of the bigger problems. I am trying to get my life back on track, and stay out of bed... but I still have a babysitter (I'm 40 and have a babysitter/CNA... go figure). I gotta say it does make life easier having someone here during the day. Anyway no problem... I'll yell at ya tonight.

Absolutely, any REVEALED prior-service illness, that is waived is compensable if the service aggravated or worsened the condition. The military grants waivers all the time for slightly disqualifing factors... and they do keep track of that, but if your service worsened this condition then it is compensable and you can file a claim.... with the whole cast thing I would. The big thing here for me is you had the integrity to admit this condition prior to entry... you DESERVE compensation if it was worsened by your service, since they accepted you knowing the condition existed.

Age will be a factor, but you can win this because I have several times with other claims. I am assuming the "whisper" test is the audiology spoken word test ... where the said words and asked you to repeat them. In any case, while loss of hearing is a compensable factor... it is hard to get. You have to be clear that you have not been working in noise risk occupations, or if so you have consistently complied with OSHA regulations, (a letter from the employer if possible is a good thing).... The Va's statement that hearing was not service connected... probably meant that YOUR hearing claim was not service connected... i.e. you did not provide a "nexus" or cause for the hearing loss. I would get a new hering test done, and resubmit the claim with the new test, as new and material evidence along with details about your service history that could have caused this hearing loss. For example working on jets, or working in a shop with loud air exchangers - use of constuction equipment, operation of tanks etc.... Remember you must first 1. Provide a diagnosis of the injury or illness 2. show a service coinnection or nexus 3. file for the correct injury Also, I doubt the waiver or whatever would even come into play... I dont even think the VA would recognize such a document as having any bearing. Probably was done just so you could not seek retirement or something.

It sounds like the BVA didn't get the whole C-File... otherwise how could they have missed the rating decisions from the VARO? I'd request another copy of my C-File (since it now should be at the VARO - again) and see whats in there. I just cant see the BVA making a mistake like this... how could they miss a rating decision if it was in the file? Or, if you can go and view your C-File with your copies of everything and compare them... Man carlie thats a hard one... if the C-Files do not match I would resubmit to the BVA with the reasoning that they had an incomplete evidence issue... does that sound right, I mean it's almost a CUE, if the records were in fact in the C-File I think it would be... if they were incomplete then I think not... entropent... you got any ideas?

Oh Ricky I did have a spinal chord stimulator implanted, and it does work for mild to moderate pain... it lets me have more "good" days. I can reccomend them without reservation.

Why sure its sixthscents@hotmail.com, or sixthscents@twlakes.net. Please feel free to email me anytime.

Josephine if I may ask were the psych records complete or were they summaries. I havent been able to get a single complete psych record from any Army psychiatrists for any claim... all they will provide is a summary. While it tends to be sufficient I wondered if they kept the whole records somewhere other than St. Louis. I know this is a bit off topic, but I had to ask since I am working a couple claims that pertain to this... Thanks.

Congrats Cowgirl!... can I borrow some money? Ha... good for you! I dont need any money though, I'd just spend it on tools...

Wow... I knew that they played the numbers game, I had been told about it before, but having it confirmed by another ex-rater is scary. Do they do this often? I mean honestly, how often do you think this occurs? Maybe you cant answer this because it's too involved but I think it is pertinent to the question at hand, and other claims as well. I have seen claims where this is what I thought happened, or something similar... so I'd like to know an estimate if possible. Sorry if it puts you on the spot. Don't answer if your not comfortable in doing so.

Wow Ricky I wasn't aware that was your case. I severed the mylan sheath in the sciatic nerve, therfore losing my anterior tibialis and common peroneal nerve as well as having the pain, but not as bad as yours appears to be. I take 2900mg of neurontin.. and it seems to do ok for the muscle spasms and leg cramps... narcotics do almost nothing but dull my perception, they do not eliminate the pain. I found it interesting that the paper I posted the link to says Opiates like morphine etc. will not really affect the pain because of how they work... They did say a scan could be done of the thalamus to determine activity etc. Have you had that? Bob

Army physical standards are covered in AR 40-501... enlistment standards are covered in AR 601-210. I am addressing this because there was a question about enlistment policies concerning Ritalin. Initially, as far back as 1995, if you had taken Ritalin and were diagnosed with ADD you could not enlist without a waiver, and the waiver was almost impossible to get. This policy changed in 2001 (imagine that!), and an enlistee was allowed to have taken Ritalin but could not have taken it for 6 months prior to the physical. They could have a diagnosis of ADD, but that required a waiver... but the waiver was automatic if the applicant had not taken Ritalin for 6 months and was released from doctors care. There was discussion of changing the time frame to 6 WEEKS prior but I dont think that was approved. Thats was and is still the current policy on enlistment into the US Army with Ritalin, and ADD to my best knowlege. However I encourage anyone to look into 40-501 but please make sure you check the amendments... thats where all the changes will be. The same applies to 601-210... they havent changed the reg since 98 or so, they just keep amending it... maybe by now they have actually issued a completely updated reg. The end answer being that the Army will allow enlistment of a person with a prior diagnosis of ADD. I have no idea about the standards for the other services and they very well may be VERY different. This answer is posted in response to a request by tssnave, made on Sept 27... Is there some regulation that says you can't be or have been on Ritalin and join the service? I find that interesting since the last stats I read on Ritalin (and other ADHD drugs for kids) was that 10% of our boys today are on Riatalin or like drugs. I did some research on ADHD drugs when they wanted to put one of our grandchildren on it and thankfully the parents decided against it when the docs said a 6 year old had to get a "base line EKG" before going on Ritalin because it can affect a child's heart.

Heck my bad too... sorry Windy, I got caught up in that aspect... I'll post comments related to the thalamus in Rickys new thread.... Here however, I think you are straight... have you filed the claim?

OK, I think this is the best... description of how the thalamus works with the neurons/axons etc. Its a long and technical article but it seems comprehensive from a skimming. I am going to read it in depth. http://www.painonline.org/NerveCells.htm You try and read it too Ricky and maybe we can help each other with the big words... (joking) really though please try to read it so we can sort out HOW this stuff works... I thought I knew, but after skimming this article I only grasped the basics.

Wait I made the assumption that with the thalamus, you might not see EMG problems but would still see loss of deep tendon reflexes, and inccordination or inability to plantar/dorsi flex foot, or diminished capacity too. I would assume this to be true, for there even to be a claim. Yet I am not 100% certain. It's simply something I have not run into. I can investigate it if you would like Ricky... I mean the physical effects have to be present so one would assume dep tendon and others would be affected. I am just uncertain as to how an EMG wouldnt see some of this... but again I'm going to read up on it, because all I can say now honestly is I'm not sure.

Ok that makes sense... thanks.

Well, I will admit that in EVERY single claim that I have helped where the applicant was awarded loss of use, an EMG did reveal abnormal nerve function - specifically with the anterior tiibialis, and/or common peroneal as evidenced by loss of ability to dorsal and/or plantar flex the foot. I do ALWAYS reccomend that a veteran get an EMG done prior to submission of the claim because a C&P will be done anyway... and it is objective evidence that there is clear and demonstratable injury.. it doesn't get much more objective. Sure a Doc can misread one, but I never have seen that happen. However, there always is a for instance and the newest post points it out. If its in the thalamus and cannot be seen, then I would think that if the objective evidence showed a loss of ability to push off, with a LONG and ANNOTATED history of lost or diminished deep tendon reflex, well I think a good case could be made based upon just the deep tendon reflexes... but this would have to be over a long period since each doctor evaluates this subjectivly - unless they are completely absent and not just dimninished. I spoke with Windy months ago before I got sick, and then I bailed out and kinda stopped online advocacy...looking over my notes, I think he has a GOOD case... but they are kinda sketchy since I was progressivly feeling worse and annotating less and less. I am feeling a bit better now, so I am trying to work back up, but my personal local advocacy is still on hold. Something I do reccomend for advocates is to keep a daily journal, I just use notepad and date each entry. You can review older cases that pop back up. You would be suprised how easy it is to forget facts... You make good points buddy... and you are right in that I do always say that an EMG is a GOOD thing to have. Hope to see you around for a long time. We... let me say I... value an ex-raters opinion because it gives us a tremendous insight into how the VA looks at a claim, and what evidence a rater would normally require etc. This is an incredible advantage because we can properly prepare a claim and get all the testing done if possible prior to submission. If you let me I'll be picking your brain now from time to time... however I will accept the answer you give even if its not what I want to hear.

Way to go carlie, I looked for this repeatedly and couldn't find it. Yet, a category one does not jive with all the combat related injuries he has listed... I bet someone made a mistake and entered a one. What's your opinion there? I mean the combat related designations must mean the injuries so listed were combat related dont they?

I decided to post the reference... 4.63 Loss of use of hand or foot. Loss of use of a hand or a foot, for the purpose of special monthly compensation, will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function of the hand or foot, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance and propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis. (a) Extremely unfavorable complete ankylosis of the knee, or complete ankylosis of 2 major joints of an extremity, or shortening of the lower extremity of 3-1/2 inches (8.9 cms.) or more, will be taken as loss of use of the hand or foot involved. (B) Complete paralysis of the external popliteal nerve (common peroneal) and consequent, footdrop, accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of this nerve, will be taken as loss of use of the foot PLEASE NOTE: (a) and (B) are guidelines for certain situations, however the definition in the main paragraph is equally impotant since it is the general guideline. An EMG is highly recommended for a loss of use claim, but not exactly necessary. It will make the claim much more "clear" for the rater. I advise all people who are seeking this rating to get an EMG performed. Entropent is certainly correct in that. It is a great help in proving the claim.