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Posts posted by LindaDP
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I was med boarded out in 1984 for 1. Recurrent right subclavian vein thrombosis (principal cause- combined rating w/diagnosis two-10%)
2. Right first rib resection performed 10 Apr. 84 for treatment of a possible thoracic outlet syndrome
I recently had a C&P exam for Service Connection for Thoracic Outlet Syndrome (I'll try to keep this short)
[X] In -person examination
Evidence reviewed
[X] VA e-folder(VBMS or Virtual VA)
[X] CPRS
1. Diagnosis
Does the Veteran now have or has he/she ever had a vascular disease(arterial or venous)?
[X]Yes
Diagnosis #1: Recurrent right subclavian vein thrombosis
ICD code(s):xxxx
Date of diagnosis:SC
Diagnosis #2: Thoracic outlet syndrome s/p First rib resection
ICD code(s):xxxx
Date of diagnosis:SC
2. Medical history
a. Describe the cause /onset of the Veteran's current vascular condition(s) (brief summary)
The Veteran chronically occluded right subclavian vein had multiple RUE DVT's, on Xarelto. She had upper rib resection in 1980. She c/o stable pain to RUE- constant numbness/tingling and shooting pains from armpit to hand and neck. She works as a housekeeper in the OR and reports being able to do her job w/out terrible discomfort. She also reports edema to right arm at end of the day, decreased by morning. She reports taking Tylenol for relief of pain.
UPPER EXTREMITY VENOUS DUPLEX- showing THE DISTAL SUBCLAVIAN AND PROXIMAL/MID AXILLARY VEINS WERE CHRONICALLY OCCLUDED WITH MANY COLLATERAL VESSELS
b. Type of vascular disease condition (check all that apply)
No response provided
No to all questions c-d
11.Other pertinent physical findings, complications, conditions ,signs, symptoms and scars
a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to the conditions listed in the Diagnosis Section above?
[X] No
b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above?
[X] Yes
12.Diagnostic testing
a. Has ankle/brachial index testing been performed?
[X]No
b. Are there any other significant diagnostic test findings and /or results? If yes, provide type of test or procedure, date and results (brief summary):
[X] Yes
UPPER EXTREMITY VENOUS DUPLEX (08/19/15): RIGHT INTERNAL JUGULAR VEIN : Vein is patent, Pulsatile, Phasic W/Augment
Subclavian vein: Vein not located
Proximal/Mid Axillary Vein: Vein not located
Distal Axillary Vein: Vein is patent, continuous w/augment
Brachial Vein: Vein is patent , phasic with w/augment
IMPRESSION: This study reals no evidence of DVT in the imaged veins. However, the Distal Subclavian and Proximal / Mid Axillary veins were not located with many collateral vessels imaged in this region, suggesting history of subclavian vein and Axillary vein DVT. The Distal Axillary vein was imaged with continuous waveform suggesting proximal obstruction.
The right Ulnar and Radial arteries were imaged with a high bifurcation at the mid upper arm.
13. Functional impact
Does the Veteran's vascular condition(s) impact his or her ability to work?
[X] Yes
Effect on usual occupation: Pain at the end of the day with repeated activity of the right upper extremity.
Problems with lifting and carrying, pain
Are there effects of the problem on the usual daily activities: Yes
Chores: Mild
Shopping: Mild
Exercise: Mild
Driving: Mild
MEDICAL OPINION
[X] In person examination
EVIDENCE REVIEW
Was the Veterans VA claims file reviewed? Yes
MEDICAL OPINION SUMMARY
Opinion requested: Secondary Service Connection
Is the Veteran"s claimed Thoracic Outlet Syndrome at least as likely as not (50% or greater probability) proximately due to or the result of her service connected recurrent right shoulder subclavian vein thrombosis: with right first rib resection which is currently evaluated at 10%
Type of Medical opinion provided [MEDICAL OPINION FOR DIRECT SERVICE CONNECTION]
a. The condition claimed was at least as likely as not (50% 0r greater probability) incurred in or caused by the claimed in-service injury, event or illness.
c. Rationale: The Veteran is already serviced connected to Thoracic Outlet Syndrome with first rib resection which is the treatment for that condition. The recurrent right shoulder subclavian vein thrombosis is the result of Thoracic Outlet Syndrome.
My question is how can it already be serviced connected when they clearly state POSSIBLE THORACIC OUTLET SYNDROME, also, this was an exam that was half ass at best, she looked at my arms, chest and did not want to discuss the blood clots, she didn't even know what a Drill Sgt. is. Any and all opinions and suggestions are welcomed at this point.
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I have recently put in for an increase for blood clots and have asked for Thoracic Outlet Syndrome to be added. My VA doctor says I do have Thoracic Outlet Syndrome and my VSO says to open it as a new claim, any suggestions? Here is what I am basing my claim on, it states very clearly in the report that there is an obstruction in the thoracic outlet, so how could they claim that it is a " possible " thoracic outlet syndrome. Unfortunately, at the time I got out, I had not received a copy of this, just my severance check. I always thought this was all carved into stone, little did I realize how much I had been low balled. Any ideas, thoughts or opinions are welcomed as to how I should handle my claim. Any chance I could be eligible for an EED? Thanks to all in advance. PS, tried to straighten these, but no such luck.
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In 1984 I was med boarded out of the Army after four and a half years. I was in my last week of Drill Sgt. school in Ft. McClellan Al. when I got struck down by a blood clot in the right subclavian vein. After a few more blood clots, they sent me to Walter Reed Army hospital, and there I was given a Right Rib Resection, due to them finding an obstruction at the Thoracic Outlet of the Right Subclavian vein. No thrombus, but still an obstruction.
They med boarded me for 1. 4538: Recurrent right subclavian vein thrombosis
( Principal Cause- combined rating w/ diagnosis two-10%
2. 7383: Right first rib resection performed 10Apr.84 for treatment of a possible Thoracic Outlet Syndrome
How did they come up with the term possible when they say the surgery was due to an obstructed Thoracic Outlet of the Right Subclavian vein? I have been on anticoagulants for over thirty years now, have had blood clots in the inner jugular, subclavian vein, axillary and brachiocephalic veins on the right side, while being treated at the VA for Thoracic outlet syndrome and my anti coagulants. Is this a CUE or a new case, due to my never filing on this. I just recently learned that I could ask for higher rating for the blood clots, but did not realize they did not consider the Thoracic Outlet Syndrome, when they released me. I found that after I sent for my medical records. So much for being young and dumb. Any advice on how to proceed with this is greatly appreciated.
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Here is my issue, I was med boarded out of the Army in 1984 for 1. 4538: Recurrent right subclavian vein thrombosis
( Principal cause- combined rating W/ diagnosis two-10%)
2. 7383: Right first rib resection performed 10 Apr84 for treatment of a
possible thoracic outlet syndrome
At the time I was getting out, I was so grateful for the $6000. severance package, I thought I had just ended my military career. It wasn't until I talked to another vet and learned that after being on anticoagulant meds and over 30 blood clots later, that I should ask for an increase. I sent for a copy of my medical records and then found out that they never even looked at the thoracic outlet syndrome as a real issue, gave me a right rib resection, but dropped the ball on the thoracic outlet syndrome. My current VA Dr. says that I do have Thoracic outlet syndrome and am being treated for it, as well as for the blood clots in my right arm. Any ideas on how I should approach this or what I should do with this? Will it be a new claim? Any opinions or help would be greatly appreciated, it' s the first time in over 30 years that I'm asking for an increase and have no idea what I am looking at.
Also, how cool of all of you to be there for all the Vets out there! Thanks for taking the time to help!
C&P doc claims that I am already SCd?????
in Veterans Compensation & Pension Exams
Posted
In 1983 I was in the last week of drill sgt. school, my arm swelled up and I later learned that I had a blood clot in the right subclavian vein. Ten months and five blood clots later, they sent me to Walter Reed Army hospital, after about a month there and lots of testing, they asked if I would accept a surgery to open up my ribcage for a possible thoracic outlet. I agreed and had the surgery. A few months later I had more blood clots and they med boarded me out. They had my diagnosis at the time as 1.4538 Recurrent right subclavian vein thrombosis
2.7383 Right first rib resection for treatment of a possible thoracic outlet syndrome
My VA doc says I have Paget-Schroetters disease, Factor five Leiden, Thoracic Outlet Syndrome, and I am hypercoagulable. I have been on blood thinners for the last thirty years. If nothing else, I would at least like to be compensated fairly. This cost me my job at the post office a couple of years ago because I started getting blood clots , have had over twenty five blood clots in my right shoulder, I guess time will tell. Thanks again for your help.
PS. I tried to find the code 7383 with no luck, does anyone have any info if that code means just a rib resection or what?