Andyman73

When you are doing Range Of Motion (ROM), you always MUST stop at the initial point the pain/tightness starts. That is where they are supposed to make the measurement with the Goniometer. Sorry for such a late reply. I hope you were successful with your claims for increase.

My CUE claim, filed in 2015, was for an unadjudicated claim, originally filed in '06. I had refiled for same issue in '15, and was granted a 30% rating, based on near identical C&P exam findings. After getting turned away, by a dozen law firms(including NOVA), I forged ahead on my own. I purchased the 2015 Title 38 CFR(best $189 I ever spent). And wrote my claim based on the VA's own words. About a month later I was granted my CUE claim, and was granted the 9yr, 8month earlier date. I just want to say thanks again, to all who answered my questions back then. Ms. Berta was an inspiration, and a veritable fount of knowledge.

ABSOLUTELY NOT!!!!! Firstly you aren't supposed to go past the point of pain, your disability starts where the pain starts. Secondly, if they help, then they are intentionally setting you up for a lower possible rating. Your best option would be to go to patient advocate and request a new exam with a new examiner.

File for the PTSD, so you can then file for those secondary issues. I have several that are secondary SCDs to my PTSD. And those are what brought me to 100%. Also, as I mentioned previously, if you did not use the MST specific PTSD claim form, that may well be why the VA has been able to change it. They would not be able to change a MST specific claim without opening themselves up for serious trouble. I suggest calling the MST coordinator to get that ball rolling.

When you filed, did you use the MST specific PTSD form? When I filed for it, I first called the MST coordinator, they told me which form to use, for example only, the regular/combat ptsd form is 2585, then the MST specific form is like 2585/a. Or something like that.

Hey everybody, Hope y'all had a nice Christmas. This was my first one since leaving wife. Was okay. Divorce should be finalized by end of January. I would have been back sooner, but had another death in the family. Second one in 3 months, 6th in 3 years. Now for the important stuff. Since I had Started this thread, I went through eBenefits and filed for increase for my back, and for jaw pain, secondary to my PTSD. I was on ebennies to print out a current award amount letter, for child support calculations, and decided to look at those claims. Saw they were closed and letters sent. So I went to the disabilities list option, low and behold....my back was restored to 40%. And they granted me 30% for my jaw secondary to my PTSD. Both exams were done by outside providers...LHI or something like that. The dentist was rather concerned at what he saw. And gave me full confidence this would be a win. The other, was a bit sketchy. She was too hung up on the reason the VA put for the claim....low back strain...saying that is a temporary injury. I kept trying to explain that I've been playing this game with the VA, for my back, since 1998...so...all I really needed from her was to take the ROM with the goniometer. Which she did. She told me I should look through all my VA treatment records and see what the names of ailments they used in referring to my back. Said those medical names would be the DXs and I should file claims based on them. Would that be a legitimate suggestion? Because Lumbosacral strain(the new name for my low back disability now) sure doesn't cover my SI joints. Still waiting to hear about my PTSD claim about them granting 50% based on symptoms including suicidal ideation...and that I could apply for increase based on the higher rated symptoms, to include Suicide ideation. Which is a symptom listed only in the 70 and 100% blocks. I had called the VA about that, I think before I started this thread. And they told me a decision was made and was in final authorazation/approval review...about 5-6 weeks ago. If they grant me the 70% for PTSD, that will put me to 100% for payout. And would be a welcome relief in relation to my impending alimony and child support payments. Thanks again @Buck52, @Berta and everyone else who commented.

That’s what any reasonable person would expect, right? That the treating doctor’s word would carry more weight than that of a lesser qualified individual. @Buck52 Just got done reviewing myhealthyvet to see if there was anything I could see. Saw that I was seen by my treating physician in regards to proposal to reduce. That was in April 2017. Then saw there had been a C&P for June 2017, with correlating x-ray appointment, that had been cancelled. I remember that, the C&P scheduler has called me to schedule. Then was notified some time later that they had cancelled those appointments, as no longer needed. There is nothing in my notes or records indicating resolution of proposal to reduce. Even ebenefits shows several closed appeals, around same time frame, with no identifying information about claim. So I applied for increase for my back. Been having a lot of pain lately, that wasn’t there before. And now that the VA has to consider pain as a part of the disability, maybe this will help to right this wrong.

Thanks Buck. I know I had my treating physician evaluate me and write a statement where he went over all the treatments I had been through in the 15 months he was seeing me. He also used a goniometer to take measurements of my ROM. Which were included in his statement. To reiterate, the proposal was triggered by a crooked PA, not PhD, who was examining me for something other than my back. She used no tools or devices to take any ROM readings of my back or the part of my body she was specifically examining. She gave ROM guesstimates based on her casual observation. Since the end result was a reduction, this proves the VA took the word of their PA, who never treated me, over the word of their PhD Dr, who had been treating me for 15 months. Who also wrote a statement reviewing my treatment history with him, and the ROM measurements he took as well.

Buck, I did get a letter, to which I responded to. I recalled what others had said here in the past. I had my response back well within the 60 days. But never received the decision letter. Or anything else for that matter.

True, however I am expecting a 20% bump in my ptsd rating, which now will just bring me back to where I once was. The PA is the one who wrote that my back seems to be better, while examine me for something totally unrelated to my back. Their bases for reduction is staked to the PA’s casual observations. She took no measurements of my back at all. However my Dr, who had been treating my back for a year or more, did use a goniometer to take measurements, which keep me in the 40% rating box. There are no increases anywhere else to offset that. What other explaination is there, for them to reduce, when my PhD wrote his statement in rebuttal to the claim based on PA’s observation? And with no exam or letter, I have no clue as to what or why.

If you reread my post, you see that I wrote that I responded by seeing the VA Dr who had been treating my back. He did write a statement and I did send it in with additional exam notes from the treatments he had given/ordered in the year before hand. What I did Not get was a Decision letter stating that they overruled the treating Dr in favor of a PA, and that they chose to reduce anyway. I had no expectations of expediency, so I was not concerned when i didn’t hear back. As we all know the VA takes its own sweet time. And since there was no change to my compensation $$$ or overall rating, there was again no cause for alarm. I only noticed because I was checking on another claim that is nearly finalized. That 20% reduction in the back rating may well keep me from 100%, once the current claim is awarded.

Hello all, Been a long time since I was here. Was checking ebenefits for current status on CUE claim that is in final review/authorization stage. I noticed that my rating for low back was reduced from 40%-20% back in August. There was no exam, or notification of this. I did receive a letter stating they were going to review with possibility of reduction. I scheduled appointment with the physical rehab Dr., at the VA, that had been treating me. He wrote up a letter stating that my back had not improved. And he did use a goniometer to take measurements...the ROM kept me squarely in the 40% rating. He also went over the various treatments he had ordered, that hadn't offered any improvements....pt, chiro, and accupuncture. I sent this all off. I received no notification of the results of the review, much less an exam to overturn the treating doctor's statement. Can someone please tell me what I should do from here? I am not in a mental state of mind for handling this on my own. Thanks in advance. Semper Fi.

I will be filing my RAMP choice ASAP!!! I sure ain't waiting 7-10 years!!!

Hmmmm, good point! Wouldn’t surprise me if they did.

@Vync, The ROM thing was always in my favor, but they denied anyways because of their whole deceiving mentality of pain not being disabling. So...hopefully the IMOs/DXs will be enough to convince them otherwise. Then...then the EEDs.

@Buck52, What’s interesting is that for many types of claims involving muscoskelatal ailments, the VA fates based on ROM, but totally ignores the pain that causes you to stop moving. They hypocritically deny the very pain that causes our ROM to be limited. They accept that pain is why our ROM is reduced, just not that the pain itself is also disabling. For me, this all means I will have to get DXs from private Drs to use as N&M to re-file claims for secondary to SCDs for the painful joint ROM.

Hey @Buck52, how ya been? Guess I’m gonna have to go back to the drawing board with my secondary claims. They have all been denied based on the ‘pain itself is not disabling’ premise, or no in service dx. I never could understand how the VA had been treating me for a handful of various physical ailments that they would not dx. Now I know. I had asked the dr treating me for me back, the past few years, what was wrong with me. All he would ever give me was a runaround answer how it could be this thing or that thing. Now I know why, same for neck too. On a good note, since leaving wife, she can’t prevent me from go to dr/specialists to get dx and MOs. Just have lay out money is all. Earlier this week I discovered a shiv in my back, figuratively, from the VA. Was looking at eBenefits to add my adopted daughter as a dependent. I saw they had reduced my back from 40% to 20%, the “shiv”. Almost lost my temper!!! I don’t remember if I had mentioned it here, that I got a letter stating they wanted to. Based on erroneous data given by a PA while being seen for something not related to my back. Buck, right after that I scheduled an appointment with the VA dr who had been treating my back. I explained it all to him. So he gave me a once over, and used a goniometer to get measurements, which were solidly in the 40% rating range. I sent off a copy of his report highlighting his measurements along with a statement. But it seems that without even looking at me, they chose the PA’s opinion over the PhD MD who had been seeing me regularly. While my compensation rate didn’t drop, it can’t be too far from that. Just when I finally got to a place where I could start moving forward, I run into yet another obstacle from the VA.

@Broken Cat, been a few weeks since I was here. I do hope you’ve heard some by now. With all your evidentiary matter it should be real easy for the RO to grant your claim .

Excellent post Bronco!

Buck, I was denied secondary SC for MDD due to chronic back pain, because the examiner felt my depression was due to other factors just as much. Even though those other factors he cited were years after the back injury occurred. One such issue was marital problems, however, I was injured in November 1992, married April 1999. And marital issues didn't begin to effect me until mid2000s. But the back pain was there, constantly since 11/21/1992. Not that this matters now, since I have a lowball 50% for PTSD anyway. How do I go about filing or refiling claims that were wrongly denied due to the VA's illegal stance of pain not being disabling? All of those claims are well past the 1 year NOD time frame. Is this now a good time to revisit the lawyer issue? Now that this ruling has come down, there is potential for 5 figure retro compensation. Honestly I do feel some level of vindication. Only in the sense of me knowing the VA was wrong on this, from day one. Yet, I also feel taken advantage of and dismissed by the VA as well. Because now it's been legally determined that the VA was illegally denying millions of Vets their SCDs on the false premise of pain not being disabling. Andy

Stay safe Berta! We got same advisory here in South Eastern PA. I do hope this does in fact, open the door for SC for pain and include clear pathways for EED as well.

Berta, I get Ben’s e-letter, which is where I saw this. According to what he said, based upon the Fed circuit, I could possibly refile over a dozen claims that were Denied due to no DX, but noted and treated in my SMR. I’m really hoping that I am understanding this correctly. Andy

How does this new ruling from the fed circuit court effect claims denied because pain was ignored or dismisssed?

@VN-Vet I’m so sorry that happened to you. Happened to me too. For PTSD due to personal trauma(MST), you need not have any proof whatsoever. They can use why they call “markers” which are changes in behavior that would have been noted by others at that time. The MST May be easier to get SC for, as you don’t have to have documentation for it. The VA does recognize that many of us never report for fear of reprisal or worse. Never mind the overwhelming shame and self blame factors. The VA also uses outside contracted forensic psychologists to conduct the exam. I was terrified that I was going to be railroaded, but was quite surprised that the examiner not only believed me but was rather compassionate about the whole thing too. If you wish to discuss more personally feel free to pm me. Semper Fi, Andy

I used the female MST rep for my area. She was kind and compassionate. And basically just helped me get the ball rolling as far as sending me the correct forms to fill it and such. My claim was decided in 89 days from date filed.