ArNG11

In any case I think I took away too much from the topic at hand. There are rules set in place and regulations for painful movement. The moment the movement becomes painful, that is the ROM measurement that should be used. Anything after that point should not be factored as true ROM ranges. The eCFR makes it quite clear, however, I read too much. Also, I am not a medical professional so, what the heck do I know. I will let you know and report back when fit hits the shan. At times I kind of get kitty thinking about a favorable outcome, I do have to keep my perspective clear though. At least try to.

Rootbeer you are correct and most likely right, to the Ellis examination, just the regional office only gave part of his exam any weight. I will make them make it right, frankly, I don't know if I can spare a few decades to make that happen, in the end though I think it will be sweet and make me smile. Ellis' opinion will have to be given weight and the effective date will come in to play. After that I have two functional capacity exams and the DBQ's to bolster my position and claims. There is also the DRO trying to play doctor and rationalizing where the sleep disturbances and fatigue/tiredness come in. I don't see M.D. in her title so I have some strong point in my claims. The kicker is going to be the effective dates and the waiver of review, I'm not going back to the regional office, I am putting it in the hands of the BVA. I have good information that I.Q. levels there are high enough that they can read and weigh evidence properly. A few years retro will make some of the heartache not be so bad, at least on principle. Your second to last statement, I agree completely, the doc from my last C&P exam I received an excellent, or lets say very favorable mental health exam, that gave my claim a very stable and strong foundation to work from. Attacks and countermeasures are going to be determining factors.

No worries, just trying to look out, last time I caught someone backtracking I wanted to give them a shot to the throat, not the best way to handle things, but would have been satisfying at the time. You're welcome, really take it slow and easy. Good hunting!

Andy I don't see how the VA raters can go against medical correlations. Also I don't see how a DRO can associate certain symptoms with specific service connected illnesses. They have no medical training yet local regional office believes this is going to fly. Im in a similar boat but my nexus was attributed with GERD and sleep apnea. I have the evidence to prove the correlations both with GERD and MDD/PTSD. I'm very interested in finding out whether the apnea will be denied at BVA level with those factors in to play. Also with my recent DRO decision service connecting sleep disturbances with the MDD, I'm very curious on how the VA comp is gonna try to counter the GERD correlation and the MDD correlation to Apnea. I will post either which way it goes when I have my turn in the hot seat at BVA.

Guys I am so mad reading about this. I thought this type of s@it was done with. I wonder if there is any way to file complaints to the heads of medical boards. I know for a fact that some of the C&P docs here in Oklahoma have private practices and do the VA comp exams to supplement income. They have to have some type of medical board to answer to? Something like an ethics committee or there has to be some type of recourse available other than a lawsuit. There has to be some type of repercussions, maybe in the form of filing charges for assault with local PD? Im taking a stab at this logically but really, there has to be something that can force consequences. Crap I guess I need to take meds getting too worked up. Hope this crap doesn't happen again. Get an unbiased medical opinion to refute the crap report that might be coming your way. Good luck.

Buck, I hate to say this, but I am sure you know, can't bite the hands that feed ya scenario. I'm curious to know her response and what she states. I wish you luck buddy. Just don't loose your temper in there, they, the VA, get a little jumpy when that happens.

retireat44, heh, do you have your SMR's, in my civilian files the had the respirator fit tests, those also included the warnings about jet fuel. You are still going to need and IMO though there is no way around that. If you find a doc that is willing to explore this let me know I'd love to talk with him. I'm waiting to see how the burn pits suit goes and really curious on the outcome. However, I don't see much in success unless I have a doctor say the magic words. Doesn't matter what studies and evidence you throw, that nexus is one of THE most important parts to substantiate your claim and keep it alive.

They changed to jp8 back in the late eighties I believe. I have to look it up, I serviced AGE equipment back then and we had JP4 running on the gas turbine generators as late as 93 that I can recall.

I had a couple of exposures to JP4, one was and Open Skies Recon KC 135, and the other was the tanker for an SR-71. One had pods and still had the water injection system operable. I have the evidence but not a medical opinion so I'm dead in the water. Seriously not even the paid IMO specialist want to touch this one. Much worse than trying to find an attorney to fight for my 11 hand surgery federal workers comp claim. I have evidence and 4 IMO's and still being denied, even at DC. I cannot conceive in my mind how this crap is allowed to go on. It's blatant BS. I knew a guy at Tinker AFB, that had severe reactions to hydraulic fluid, red and purple stuff, they moved him out to a different section and he is under the impression that all is hunkie dory, for his sake I hope he doesn't come down with anything. That is nasty stuff. As bad as Skydrol and 7808. Cancer galore.

Wish you luck man. I'm stuck myself. With two exposure routes I can't seem to find an attorney to go after this. Fuel exposure from kc 135 fuel tanks as a fuels mechanic or exposure from the pits for a year in Bucca. The suit against KBR is still alive but that's been going on for a few years now. At least it is at the jurisdictional hearing phase. Being part of the Class action law suit gives some peace of mind. I hope you get some good news bubba. Keep us posted. Take care.

congrats. way to fight.

Old Joe I would say Veterans are fine as long as the "benefit of doubt" does not go out the window. Most folks resort to an IME/IMO because the VA is scandalous, the VA breaks the law and goes against clear, crystal clear, regulations. It is only with an IME/IMO that you can blow their hired docs BS out of the water. The system is a completely adversarial nightmare, even though the law states differently. That is the way it is. I don't agree with it, and I don't put up with that crap, just like most of us, Veterans and dependents, who fight for benefits and win, not because the VA finally gave in, but because the VA can't keep dodging the law. As long as we, Veterans alike, keep fighting,we will be victorious, because the regulations and laws state when we are in the right.

The Knee and Leg Rating 5256 Knee, ankylosis of: Extremely unfavorable, in flexion at an angle of 45° or more 60 In flexion between 20° and 45° 50 In flexion between 10° and 20° 40 Favorable angle in full extension, or in slight flexion between 0° and 10° 30 5257 Knee, other impairment of: Recurrent subluxation or lateral instability: Severe 30 Moderate 20 Slight 10 5258 Cartilage, semilunar, dislocated, with frequent episodes of “locking,” pain, and effusion into the joint 20 5259 Cartilage, semilunar, removal of, symptomatic 10 5260 Leg, limitation of flexion of: Flexion limited to 15° 30 Flexion limited to 30° 20 Flexion limited to 45° 10 Flexion limited to 60° 0 5261 Leg, limitation of extension of: Extension limited to 45° 50 Extension limited to 30° 40 Extension limited to 20° 30 Extension limited to 15° 20 Extension limited to 10° 10 Extension limited to 5° 0 5262 Tibia and fibula, impairment of: Nonunion of, with loose motion, requiring brace 40 Malunion of: With marked knee or ankle disability 30 With moderate knee or ankle disability 20 With slight knee or ankle disability 10 5263 Genu recurvatum (acquired, traumatic, with weakness and insecurity in weight-bearing objectively demonstrated) 10

§4.40 Functional loss. Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. It is essential that the examination on which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to all these elements. The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part which becomes painful on use must be regarded as seriously disabled. A little used part of the musculoskeletal system may be expected to show evidence of disuse, either through atrophy, the condition of the skin, absence of normal callosity or the like. §4.45 The joints. As regards the joints the factors of disability reside in reductions of their normal excursion of movements in different planes. Inquiry will be directed to these considerations: (a) Less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-up, contracted scars, etc.). (b) More movement than normal (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c) Weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc.). (d) Excess fatigability. (e) Incoordination, impaired ability to execute skilled movements smoothly. (f) Pain on movement, swelling, deformity or atrophy of disuse. Instability of station, disturbance of locomotion, interference with sitting, standing and weight-bearing are related considerations. For the purpose of rating disability from arthritis, the shoulder, elbow, wrist, hip, knee, and ankle are considered major joints; multiple involvements of the interphalangeal, metacarpal and carpal joints of the upper extremities, the interphalangeal, metatarsal and tarsal joints of the lower extremities, the cervical vertebrae, the dorsal vertebrae, and the lumbar vertebrae, are considered groups of minor joints, ratable on a parity with major joints. The lumbosacral articulation and both sacroiliac joints are considered to be a group of minor joints, ratable on disturbance of lumbar spine functions. §4.59 Painful motion. With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. Muscle spasm will greatly assist the identification. Sciatic neuritis is not uncommonly caused by arthritis of the spine. The intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. Crepitation either in the soft tissues such as the tendons or ligaments, or crepitation within the joint structures should be noted carefully as points of contact which are diseased. Flexion elicits such manifestations. The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. These are some of the references

I actually was referencing the CFR but that is a good find.

To me it reads like your in line for an increase, however, I am not a rater and it is purely JMO. I started with 0 on both knees and appealed to get to 10% bilateral, I am still in appeals to go for a 20% on the right knee because of the laxity and crepitus of that joint. I am going for this rating because I have an independent medical opinion to substantiate such rating. Without an objective medical examination it will be difficult to go much higher. Read the ratings criteria in the eCFRs under the knee joint and you will have a clearer picture of what is needed. I stress you must have the medical evidence to warrant the higher rating.

Yes that is a possibility, there is no sense worrying about it though. The foremost concern is getting the injury service connected, once that is done then you can appeal the rest that you may be entitled to with medical evidence,IME/IMO, ect.... This sounds cold, however, no sense worrying about it until you receive the decision, from there you can decide which avenue you will pursue as well what attack to utilize.

It must be considered as part of the claim, as it could effect the rating percentage, but rarely is this done in the first examination. At least from 6 exams I have had. You usually have to fight for the secondary issues caused by a service connected injury. JMO.

You will have a fight on your hands no doubt, but with your medical opinions and wife/buddy statements, personally I would pursue the claim. JMO I am stubborn, however, I fight for what I can prove by medical evidence and medical rationale. If I didn't I'd still be stuck at 30%. Just facts, if you file for something, pursue it until the end, otherwise why put a claim in to begin with. Principle is why I keep going.

This is exactly why you file even if you are a 100%. Just like you and others pointed out DIC. If you bite the bullet due to a service connected issue, or you bite it because of another not service connected issue, YES it is completely relevant to your spouse and survivors, as far as possible benefits. JMO I don't believe in that horse manure of not rocking the boat, if you have the evidence, if it can be supported by independent medical opinions and exams, then yes file. More times than not, the Veterans Administration is in the wrong and denies due benefits; hence all the appeals, hence all the claims that get approved down the road.

Coincidence, hmm, makes a person think for a bit. Results is how success is measured, time will tell.

This is usually the process. Most examiners under rate your disability to begin with. What you must be concerned at this point is service connection, that is the goal. You have appeal options after you are rated, if you disagree with the rating. If there was a way to have C&P's evaluated, the hired doctors would fail miserably. The process is rigged in the VA favor. Unfortunately the waiting process starts, however, this is great because it gives you time to get medical evidence/IMO,IME/ect., to tip the scales in your favor and accurately assess your disability. JMO

Its ArNG11 but thats okay, I'll accept the thanks. Heh as others have posted, look into your specific states benefits as they differ quite a bit depending on your state of residency. There are some great tax benefits and perks. Good luck and congrats again.

Congrats Coastie. Always good to read good news. Look in to all your benefits. Good luck and take care.

I haven't been on here for a bit, but when did the mandate of 20 business days from the date of request change? From above it almost sounds like a two year wait?