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Andyman73
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Posts posted by Andyman73
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Buck,
Thanks. I was looking through the CFR regs, but wasn't able to find one that covers my issue. Odds are it's there, but I don't know what to look for, or what wording is used for that particular reg. I will try the google search later when I have time...probably this weekend whilst it's snowing to beat the band.
Andy
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Vync and Navy4life,
First she told me that my one entry for neck pain(from when I fell down the stairs) where they couldn't find a specific injury to DX isn't good enough. Then she told me that 6 entries between medical and dental for chronic jaw pain, also no DX, isn't good enough.
Here I thought that we don't need a DX, to make the link. I fell down a flight of cement stairs, with an 80lb sea bag/duffel bag on my back. Landed knees then chest, legs flopping up behind me. Both knees bone bruised w/1 fractured knee cap, lower back was compressed, causing low back strain. Seems to me that the pain in the neck(pun intended) that resulted from same, would certainly warrant a look see.
I filed a claim for pain in the neck, secondary to my back, this past spring. No go, but x-ray did show some restructuring/calcification on C-5 and 6. That would certainly explain why my hands and arms go numb at any given time, and painful neck cramps too.
How do I convince the VARO to change her mind? Wait until I get the denial letter? I will be speaking to my PCP, during my Monday apt., about these various issues.
As for the 7 times passing on, that would leave me with 2 remaining cat lives! Yay me!
Semper Fi.
Andyman
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DirtyBulk,
For 15 years I had a 10% total for my bilateral patellafemoral pain condition. It was just this past spring after filing for increase that I was granted an additional 10% for each, due to ROM, with the original bilateral pain condition continuing unabated.
I do wish I had an experience like yours, above. Sure would make a world of difference, for me and mine.
Wish you the best with your claim.
Semper Fi.
Andyman
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DirtyBulk,
For 15 years I had a 10% total for my bilateral patellafemoral pain condition. It was just this past spring after filing for increase that I was granted an additional 10% for each, due to ROM, with the original bilateral pain condition continuing unabated.
I do wish I had an experience like yours, above. Sure would make a world of difference, for me and mine.
Wish you the best with your claim.
Semper Fi.
Andyman
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Yep, been stuck in holding, pattern is full, waiting for decision approval for 3-4 weeks now.
VARO called me over a week ago, got a slam bam exam scheduled in a day, went, but still in holding pattern.
Ready to sinch up my 'chute and step off...
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fmfdoc,
Based on your forward flexion(mine is 0-20 and I am 40%) I believe you will fall squarely in the 40% rating zone. If you post your complete redacted C&P results from same above exam, the bigger brains can give you a more clear idea.
Semper Fi
Andyman
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Navy4Life,
You have photogenic bones!
Makes me ponder my own feet. I am 30% for pes cavus(claw foot) w/plantar fasciitis, bilateral. I also have a stress fracture of the 4th metatarsal that showed up on recent x-rays, and looks to be chronic. It causes me a lot of pain, setting off a whole train of events, as far as aggravating my feet, ankles, knees and back.
What I'm pondering is this...is it secondary to my SCD feet contention or what? I've been living with it for 5+ years, whereas the SCD issue developed while still on AD in the late '90s.
I agree with green, definitely the 5283.
Andyman
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pumibel,
Can't say what they do for the PTSD C&P exam, however, keep this in mind...answer all their questions as if it was your worse day ever. Such as how are you doing today, reply, took all I had to get out of bed, hardly get any rest, trouble sleeping. Maybe even stay up late day before, and go in looking like you stayed up all night. Any thing that can give them an edge to lowball you, they will take.
Same with aches and pains, you take pain meds? So anything they ask about, you take pain meds for that. Never go beyond the initial point of pain for Range of Motion tests(ROM).
Take your notes along, to make sure you mention what ever you wrote down.
Answer the questions about the event as best as you can, if you cry, let them see it, if you get all in a rage...let them see it, any emotion you hide is one they will try to use against you.
Try to keep focus on your time in service. I had a MH exam recently, and that "person" kept trying to lead me away from my AD time.
I'll be praying for you!
Semper Fi.
Andyman
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1 hour ago, Navy4life said:
Andyman;
Regarding your fall in 1992, I have similar issues. I had several fractures and sprains to both feet/ankles and right now I sit at 10% for left ankle and that is it! I have been trying now since 2013 to get my feet/ankles S/C. I too have the SMR's to proved the AD injuries but for me I never filed for any type of disability until 2013. All that time I did however keep all SMR's and I had my outside doctor's information to back it up and I have my podiatrist at the VA backing me up with a Nexus letter.
I landed knees first, then chest, legs rebounded towards the back of my head. I ended up with bruised knees and compression injury to my lower back. The back was SC right away, the knees took nearly 2 years from EAS to be SCd. There are multiple STR entries for both. The knees took that long because my PCP at the time was trying so hard to avoid SC my knees. That was resolved a few months after she retired.
When you fell what was the result of it? Fracture or Sprain? Was that your only issue while on AD for that contention? What was the ER's results?
The ER DXd me with contusions(bruises) on my knees and low back strain. I went to sick call for treatment 3-4 times a year over my 6 yr enlistment. They wrote up my problem list which shows complaint of pain in those areas and my neck. Their check didn't show a specific injury to my neck, just difuse neck pain. An x-ray in 2000 showed an old fracture of one of my knee caps, which was right before I was granted SC for my knees.
If all you have is the ONE ER visit while on AD that is going to be an uphill battle regarding linking your neck injury. Secondly, you state you completely forgot about your neck pain? Have you not had any treatment to your neck? If so, I would supply that information. If not, again, it's going to be tough to connect the neck contention.
I had an ER visit for chest pain/angina, but that was a few years later. I only forgot my neck pain due to the amount of NSAIDs I was taking, which was enough to leave only more painful body parts clamoring for my attention. I had so much trouble sleeping that I resorted to OTC sleep aids and booze. I've been taking VA prescribed NSAIDs since day one. I mentioned my neck bothering me and the cervical radiculapathy to my PCP sometime ago.
As far as the jaw issues, do you suffer from TMJ? If so can you prove it is s/c while on AD? You have to have the connections in order to get the award of S/C. How long have you been seeing your current dentist? Will he/she provide a DBQ on your behalf?
I was never DXd with TMJ, or bruxism, but went to sick call, and after several visits was then referred to dental for further eval. I was prescribed muscle relaxers to help alleviate the pain. Current dentist...3-4 years or so. He was the main force pushing me to get evaluated for SA. He said that many people who snore and have excessive wear on their teeth tend to also have SA. I do, he saved my life. I did mention to his hygenist about the faint seam or ridge along my cheeks, she said that is due to long term clenching my teeth. As for DBQ, I will call and ask them.
I will ask my PCP about the neck issue, as a starting point, since I will be seeing him this coming Monday. Same for jaw.
Thanks, Navy and pwrslm.
Semper Fi
Andyman
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I recently spoke with the VARO in regards to my current claims. I wonder how much evidence do I need to make a connection?
When I fell down a flight of stairs, during boot camp in November 1992, I was given the full once over by the ER staff. At the time my neck was hurting, as was many other body parts. But when they checked me over, they found no specific injury. VARO told me that this in itself is not enough to quantify scheduling a C&P exam. I had a an exam for my neck with x-rays, which showed some recalcification of C-5 and C-6. And I have radiculapathy symptoms in both arms. The only difference being the first claim was filed as secondary to my back. I had completely forgotten about my neck hurting after that fall. And pretty much ever since then I've been on pain meds of varying degrees and flavors. The current claim was filed as a primary SC claim.
Next I have a claim for painful jaw condition. I have about 6 entries in my STR from both medical and dental visits. I was having intense pain in my jaw muscles, from clenching my teeth. I don't recall ever being DXd with anything, and they weren't able to pinpoint the cause. Of course they weren't even considering stress as the cause. Now my teeth are quite worn, my dentist has noted for years that my teeth look like I've been using sand paper as chewing gum. My jaw aches all the time, even though the intense muscle pain occurs infrequently, it still happens.
I'm going to my PCP on Monday, do I need to address these issues with him?
Andyman
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Berta,
You do your husbands proud! Bet if you were the first female president, we as a nation, would be whipped into the best shape ever!
Semper Fi.
Andyman
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I will be seeing my PCP this coming Monday, and will be bringing up my chronic sleep issues, and my acid reflux/heart burn returned. Hopefully that will get some attention from him, to get a flanking maneuver in the works.
Interesting that one of the effects of SA is memory loss, I've been dealing with that for ages, even to the point of not remembering a conversation even took place, much less forgetting what was talked about. I told my MH doc about this on Friday when I was in for therapy. He seemed quite concerned at is requesting/scheduling a neurological exam for me. Gonna see why I can't recall what it is that I don't even remember forgetting!
Semper Fi
Andyman
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Sleep apnea is most likely going to be the next big VA scandal, as far as denying benefits goes.
- Vync and HorizontalMike
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Gastone,
I would post, however, I haven't yet received the decision letter from the VA on this claim. Also the MH examiner did not follow a DBQ for depression or any other MH issue. I had posted his whole exam via Blue Button download, previously, and it was very jumbled and hard to read.
As mentioned the other day, I did speak to my therapist about this. He said he is not allowed to write a letter in my behalf, directly. However, he is allowed to conduct any exams as he deems neccessary in the process of my treatment. So on my next session he will administer the DBQ for depression, etc; himself and write his notes accordingly. He said it is the only ethical and legal way that he can help me.
He went over the notes from the C&P exam and thought it was quite odd that the examiner noted I started drinking to help cope with the pain( yet opined that he couldn't see how a "minor" leg injury could lead to depression). And further along in his notes he wrote the drinking was connected to the sleep issues, during my service. But wrote that my depression is more likely due to other factors, but didn't say whether or not the drinking and sleep issues contributed to the depression either.
Sure seems that he was bound and determined to find no SC at all. And all this despite the alcohol related incident and subsequent NJP(article 15), and substance abuse treatment(3 weeks outpatient).
Semper Fi.
Andyman
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I've been getting prescription NSAIDs from the VA since day one, for my pain issues. My PCP is well aware of my pain issues. I have mentioned it to my MH clinician, and even asked him if he thought pain can and often does lead to depression...to which he replied oh yes, it's well documented and accepted in the MH community.
The VARO told me that she can't go against what the examiner wrote. But said that my MH doc can write an opinion that will trump the examiner's.
No special accommodations made in my behalf. I am loathe to say anything for fear of jeopardizing my job.
Semper Fi.
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Navy4Life,
I would have gotten to you sooner, but it's frowned upon, in my house, for me to spend much time on line. So I use break time at work.
Was your L ankle SC before the 06/15 surgery? If so, you might have an increase claim for that.
I know what you mean about the VA system! If my VA MH dr can't or won't write me a favorable opinion in regards to my depression, I will be up the creek with out a paddle for sure! I had an exam and the hominid wrote he can't see how a minor leg injury can lead to depression, completely ignoring all the pain related entries in my STR for my knees, back and feet. And ignoring that 3 of my SCDs were granted the day I left the Marines.
Andyman
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broncovet,
Should I then contact the sleep lab that did my sleep study and see if the dr will give me an IME and how much they charge? I'm facing a possible denial on my depression secondary to chronic pain claim, and want to see what I can do to convince them to grant my claim.
I have a therapy session tomorrow with my VA MH dr and will be speaking of this with him, as far as if he will write a favorable opinion in regards to my claim. He told me before I filed the claim the pain, especially chronic pain can and does lead to depression.
Thanks.
Semper Fi.
Andyman
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On 1/12/2016 at 11:34 AM, Navy4life said:On 1/12/2016 at 11:34 AM, Navy4life said:
Hi there!
I had the surgery and I saw my doctor this morning for my first Post-Op appointment. He gave me the attached letter to use for my appeal on my right foot.
Here are my questions:
1. Can you tell me if the letter is good enough (SEE ATTACHED)? If not, I would love your feedback because my doctor is willing to tweak it.
2. Should I file for Temporary Convalescence leave? Doctor indicates I can't drive for 2 months.
3. Should I file for an increase for the left ankle since it is the reason for my right foot injury?
4. Since i have an appeal in at NOD level (Dec 2014) - should i file to re-open the right foot/ankle or add all my documentation to the current NOD?
Thank You
Ok, here's my 2 cents worth,
I see that the required phrase is there, but not worded exactly, so not sure if it is good enough. At least it is written by a VA dr. More likely equals 75% in your favor.
Yes, file for the temp con 100%. All they can say is no...but they might say yes, too!
Not sure about the increase on the L since it hasn't gotten worse. And if so, file, but not just because of the R being SC secondary. At the bare minimum you should get 10% for the R ankle.
Not sure how that works, for the NOD, but if you have N&M evidence, and you do, file to reopen for the R ankle.
If anyone knows better or different please step up, I only have tiny crumbs of knowledge.
Hope this gives you a starting point.
Semper Fi.
Andyman
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1 hour ago, Gastone said:
Your 80% looking for a 30%+ rating that would bump you to 90%, right?
That's pretty much it, the granted issue is R ankle secondary to feet. She told me that most likely will be a 10%, unless the ROM is limited enough to warrant a higher rate. But the radiculapathy secondary to low back involves my legs and hips. Not sure if ROM comes into play for that, but the ROM is pretty limited for hip ROM. She was able to authorize an exam for that due to the hips, since I was receiving PT via VA for that, just recently. Thank the Good Lord for that, otherwise she would have continued the denial on the sciatica claim. Hopefully it gets 20% or higher, it should retro to 04/15.
Then, there is the Scheduler IU claim. If you meet the Earned Income Limitations, and due solely to your SC conditions, are unable to do even Sedentary work that would provide a level of income at or above the current SGI cut of $12,400 under 65. Do you meet these requirements.
No, I am able to keep my current employment. I take measures to limit the effects of my SCDs during my work day. I got kids and mortgage and need the benefits my job provides.
As to your Evidence of the in-service injury, everything backing up your claimed injury needs to be provided, right. Appears you didn't file an FDC, if that's the case, you probably won't get a C & P anytime in the near future.
Nope, last time I used FDC, they all went straight into the denial bin.
Are you currently receiving VA treatment for DX'd physical issues Secondary to your in-service injury? Your discussion with your VA HM Clinician is documented and appears on your VMC MHV Clinician notes, right?
This past May, I had an FDC C &P for an Increase due to a Secondary issue. C & P Dr was extremely uninformed regarding my VMC Med File and very negative in regards to my request for an increased rating. This was the 1st time a C & P Dr ever discussed the VA Rating Schedule with me, during an exam.
That's how my MH exam went, examiner totally ignored the evidence proving my chronic pain.
I thought it was a very negative exam, and that was confirmed when I receive a Secondary SC 0% Award Letter 08/15. I was in the process of NODing the Decision early 12, just hadn't hit the Send Button on E-Ben. 01/03/16 went into copy E-Ben IU letter for Tax Exemptions, New Rating of 100% SMC (S-1) from 07/15 Decision. Retro's in the bank, still haven't received the Award Letter.
What caused them to change it?
The Rater had to make his Decision based strictly on Medical Evidence of Record in my C-File and my VMC Medical File, that negative C & P DBQ could not have been a positive factor.
No doubt. My mh exam was for depression secondary to chronic pain, yet the chronic pain and causes of it seemed to be the only thing he didn't want to speak about...the basis for the claim to begin with! And my sciatica claim originally denied as a FDC, was recently reopened with N&M evidence, being the MRI from my back increase claim. The MRI shows severe narrowing of neural formamins and bulging disc. But not good enough, since the examiner for my back marked no for the questions regarding radiculapathy. But I had told her of the symptoms during the back exam, and she kept telling me that that needs to be a separate claim!!! RO told me yesterday that the back DBQ and exam is one and same for radiculapathy!!! I ask, why then did the examiner keep telling me that it needs to be a separate claim!?!?!?!!! Was sounding like the RO didn't want to evaluate the evidence and form her own opinion. The examiner did write in the comment section that I suffered from various radiculapathy symptoms!
Semper Fi
Gastone,
I hope and pray I won't have to go after IMOs or a lawyer, my wife won't support me if I have to go that route, even though she would benefit from it.
I'm going to lay it on heavy with my VA MH therapist tomorrow. All we've been talking about is how I feel about what ever. Now we need to talk about why I have problems sleeping and how my chronic pain is woven through out all of my life and daily routine. And why the examiner felt that those issues and drinking during the service, and since then, aren't enough to grant SC.
Semper Fi.
Andyman
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Just wanted to give a quick update on this claim. I took a phone call from the VARO, yesterday afternoon. Was on the line with her for over 2 hours. She wanted to talk about most of the claims I currently have in progress.
Several of them are going to be denied because the evidence is not strong enough, such as only marking the yes box on a health questionaire. 2 are being deferred, 1 is being granted and 1 going to sent to scheduling for a C&P exam.
One of the deferred is the depression secondary to chronic pain. She told me that despite the evidence I submitted from my STR and VA TRs, she can't go against what the mh examiner said, that he doesn't feel that my chronic pain, from a minor leg injury, is enough to cause my depression. I said that the medical proof of my chronic pain is worthless, then?
While her response wasn't exactly yes, she pretty much told me that I will have to get an IMO in order for her to grant it. I asked if my VA MH dr can write it, and then she acted surprised, as if she didn't know I was first DXd by the VA. for MDD. She said yes, if he writes a favorable opinion, she will grant, since he has been treating me since July, and the examiner saw me only 1 time.
Also if he opines that my jaw pain is a result of clenching and grinding in response to stress, she can combine that with the depression claim, otherwise, despite half a dozen STR entries, she will deny the jaw pain contention.
Guess my fate hangs in the balance of what my MH doc will say. Good news is that I see him tomorrow. If he won't help me, then I see no point of continuing to see him.
However a tiny bit of good news is that my radiculapathy claim that was going to be denied is saved, it's the one she is sending to scheduling. My PT sessions regarding my hip pain, the PT therapist noted radicular symptoms moderate to severe in nature caused him to cease PT and recommend further eval by a physiatrist.
So that's where I stand.
Andyman
Successful Sleep Apnea Secondary to PTSD
in Success Stories
Posted
OEF 21B,
Got me wondering how this will play out for me, since I've been DXd for over 2 years now, by my private Dr.
I recently had a MH C&P and one of the things the Dr did DX me with was chronic sleep issues/disturbances. Maybe that will work for me? I'm kinda in my own little world, mostly inside my head.
Eh, sure do wish I hadn't kept all my stuff locked up inside...
Congratulations on your successful climb up the high peak to SCD of sleep apnea!
Semper Fi.
Andyman