gs106

Thanks, I thought I read a post from someone referring to an eBenefits estimated completion date for their C-file.

I think I already know the answer is no but I'll ask the question anyway. Is it possible that arthritis of the hand/fingers would be considered secondary to service connected fractured ulna/arthritis of the wrist?

III.v.9.B.3.i. Conducting a Hearing Prior to a Final Determination The Decision Review Officer (DRO) or designated hearing official conducts the hearing in accordance with the provisions in M21-1, Part I, 4.4. Due to the nature of the hearing, the DRO or designated hearing official must provide latitude to allow participation on behalf of, and assistance to, the beneficiary by the next of kin or any other person of the beneficiary’s choice.

From M21-1 III.v.9.B.3.a. Elements of a Notice of a Proposed Ratingof Incompetency Notice of a proposed rating of incompetency must include a copy of the proposed rating decision or a short summary of the facts and evidence of record that supports the finding of incompetency an explanation of the effect that a finding of incompetency has on the payment of VA benefits notice that a VA rating of incompetency prevents the beneficiary from purchasing firearms, according to the Brady Handgun Violence Prevention Act (Brady Act) a statement of the beneficiary’s right to submit evidence to show why the proposed action should not be taken request a personal hearing to present evidence, and have representation during the hearing, and an indication that the beneficiary has 60 days to respond to the notice. Note: If a beneficiary requests a hearing at any time before VA makes a final decision on the beneficiary’s competency, VA will postpone making the final decision until after it holds the hearing.

I have everything ready to submit the new claim...just waiting for the pending claim to close before I submit. It has been "Preparation For Decision" for a little over two weeks. Been there before but went back to Gathering Of Evidence twice. Maybe they'll make a decision this time.

It is Dot. He said he did the intent to file on 30 May 2015 so he still has about 6 weeks to complete the claim and preserve the effective date.

Thanks Dot, I have my military medical records (made two copies when I retired) except for my first three years of service. Not much from those three years except pneumonia and fractured heel (SC 0%). I also have copies of my military personnel records. I requested a copy of the C-file so I could see what they looked at on a denied claim. It appears that they didn't look at anything - not even the copies of pertinent medical records I sent with the claim. I sent the C-file request certified mail/return receipt requested but haven't received the green card. USPS tracking shows that it was delivered but not status on the return receipt. I guess I'll go to the post office and see if they can tell me why there's no status.

I also did an Intent To File on eBenefits and am waiting for a pending claim to close before I file the new claim. Just go on eBenefits and start as if you were filing a new claim. Click on "Apply" then select Compensation from the drop down list and then click on disability compensation. You should see that you have already started a claim and will ask you if you wish to continue. Click continue and it should take you to the claim you started last year and will show all your disabilities...those already rated/denied and the new ones you are going to file.

Does anyone know if a C-File request will show as a claim on eBenefits?

I talked with my VSO last week about submitting a new claim while I have a pending claim and he said it wouldn't affect the pending claim. That contradicts what it says on eBenefits so I am going to wait. I did start the claim through eBenefits to preserve the effective date. You have one year to complete the claim once you start. If the existing claim doesn't close in a year there is a serious problem and I'll submit it anyway.

Thanks Pwrslm, Did you have an EMG? The last EMG I had at VA for carpal tunnel took six months to get the appointment. According to M21 an EMG has to be done if there hasn't already been one. III.iv.4.G.4.f. EMG and Other Tests for Peripheral Nerve Conditions Electromyelogram (EMG) test results are required for evaluations of peripheral nerve disabilities unless there is a previous EMG test of record or the record contains sufficient clinical evidence to determine the extent of paralysis in the peripheral nerve. As noted in the Peripheral Nerves DBQ, EMG studies are usually rarely required to diagnose specific peripheral nerve conditions in the appropriate clinical setting and, if EMG studies are in the medical record and reflect the Veteran's current condition, repeat studies are not indicated

When I asked my civilian doctor if the headaches could be related to the cervical spondylosis she looked at me like it was a stupid question and said "of course they can".

I am doing the claim through eBenefits and the list didn't include it so I typed in bilateral lumbar radiculopathy. I hope they can figure it out. I can't submit it yet because I have a pending claim which went to "preparation for decision" today. Third time it's gone to that status so maybe they will finally make a decision.

From M21 b. Monitoring Changes in Employability Status Changes in the employability of Veterans for whom IU is established is monitored through the · annual release of VA Form 21-4140 via the Hines Information Technology Center (ITC), and · Income Verification Match (IVM). References: For more information on · dispatch and control for the return of VA Form 21-4140, see M21-1, Part IV, Subpart ii, 2.F.5.d, and · the IVM as it relates to awards based on IU, see M21-1, Part X, 9.A.1.e. c. When Monitoring Changes in Employability Status Is Not Required Monitoring changes in employability status is not required when the Veteran · is 69 years of age or older · has an IU rating that has been in effect for 20 continuous years, or · has had an IU rating replaced with a 100-percent schedular evaluation. Reference: For more information on protection of evaluations, see 38 CFR 3.951(b).

Thanks iceturkee

I am having bilateral leg and foot pain and numbness, much worse on the left. I intend to file a claim secondary to SC spine spondylosis. I had an MRI through my civilian doctor and the report refers to nerve impingement. CFR 38 has several different nerves listed and I don't know which nerves to claim. The doctor refers to it as sciatica so I'm thinking sciatic nerve. Does the sciatic nerve have multiple roots? I am posting excerpts from the MRI report. If anyone knows the name of the nerve roots involved please let me know. Should I just file for lower extremity neauropathy and let VA sort it out? There is complete loss of disc height at L4-5 with moderately severe loss of L5-S1. At L2-3, in conjunction with retrolisthesis there is minimal broad-based disc bulge with mild effacement of the thecal sac. There is moderate narrowing of both lateral recesses with possible impingement of the descending L3 nerve root on the right as best seen on T2 axial image #8. There is mild foraminal narrowing bilaterally but no direct impingement of exiting L2 nerve roots is seen. At L4-5, anterolisthesis appears to be related to bilateral pars defects. There is uncovering of the posterior disc but no appreciable bulge or protrusion is seen. There is mild effacemdent of the thecal sac across the midline related to anterolisthesis. There is direct impingement of both exiting nerve roots due to anterolisthesis and resultant foraminal narrowing. At L5-S1, there is broad-based disc bulge without focal protrusion. There is mild to moderate effacement of the thecal sac across the midline. There is probable impingement of the descending S1 nerve root on the left within its lateral recess as best seen on T2 axial image #23 due to disc bulge and posterior element hyoertrophy. There is moderate foraminal narrowing bilaterally, with probable impingement of both exiting L5 nerve roots. This is more likely on the left, due to combination of disc bulge and facet joint hypertrophy. Tarlov cysts are present at the S2-3 level bilaterally, larger on the left.

Yes Navy4life, even a healed fracture is supposed to be SC and if you don't file a claim they "should" solicit a claim if there is evidence in your STR. I also have three fractures....two are SC @ 0 %. I haven't filed a claim for the other one but will be as soon as a pending claim is closed. i just found that information in M21 last week. VA should have solicited a claim since there are at least eight pages in my STR. There were several X-rays because it was a slow healing fracture. I am having a lot of foot pain but don't know if it's from the fractures (left heel and right 5th metatarsal). The doctor also noted on my retirement physical that I have moderate symptomatic pes planus. I have an MRI of my lower spine tomorrow to see if that is causing the foot and leg pain/numbness.

From M21 a. SC for Fractures Decision makers must not automatically award SC for fracture or fracture residuals based on a mere service treatment record (STR) reference to a fracture. Where SC of a fracture or fracture residuals is claimed, SC will be established when sufficient evidence, such as x-rays, a surgical report, casting, or a physical evaluation board report, documents the fracture. If SC of a fracture has not been claimed and objective evidence such as x-ray report documents an in-service fracture, invite a claim for SC for the fracture. The following considerations apply when granting SC for a fracture: SC will be established for a healed fracture even without current residual limited motion or functional impairment of a joint. Assign a DC consistent with the location of the fracture. The fracture will be rated as noncompensable in the absence of any disabling manifestations. Reference: For more information about unclaimed chronic disabilities found in STRs, see M21-1, Part IV, Subpart ii, 2.A.1.a and f.

Thanks Vync, I am already SC for left upper extremity and have a claim pending for the right side. The headaches started during physical therapy VA arranged and are noted on the C & P DBQ done for a pending claim. They are also noted on the physical therapy report provided to VA. I have an MRI of my lumbar spine (SC) next week to determine if that is what's causing pain and numbness in my legs and feet. I also have a followup with my civilian doctor for the results of the MRI and will ask her about the headaches then.

Question - is it worthwhile to submit a claim for headaches secondary to service connected cervical spondylosis and degenerative disc disease? VA sent me to physical therapy for cervical issues and the numbness in my arms and hands/fingers and headaches are much worse since the physical therapy.

Thanks MP... I called Peggy and all he would say is "don't worry about it" over and over. Easy for him to say.

I filled a claim for TDIU on 4 August 2015 and had the C & P exam on 5 December 2015. It has gone from preparation for decision back to gathering evidence twice. I have sent them all requested information and completed all requested forms. eBenefits shows nothing needed from me and nothing needed from others. Today I received a letter from Private Medical Records Retrieval Center, Virginia Beach, Virginia listing three civilian medical providers. In the "What Should You Do" section it says: "We strongly encourage you to contact the Health Care Provider (named above) to ensure that the needed records are sent to us as soon as possible. If we do not receive the records within 15 days from the date of this letter, the VA Regional Office may make a decision on your claim without them." One of the providers listed is a physical therapy clinic where I had VA authorized and VA paid for therapy. They already have those records. Another on the list is where I had an EMG and they already have that report. The only other provider on the list is my family doctor that I have been seeing for eight years. The letter doesn't specify what records they are needing and it is not practical to obtain and send eight years worth of records. An additional problem is that the doctors office is closed on Friday afternoon and I wasn't able to get them today and I will be out of state beyond the 15 day period. Has anyone ever gotten a letter from that office? Does anyone have any suggestion as to what I should do?

Good luck with the shoulder. If only they would do the same thing with the radial, ulnar, and median nerves.

Vync, I will try and find a link again - I think I just did a search for M21-1 on VA.gov. I downloaded it....this is the part I was referring to. Change Date January 11, 2016February 1, 2016 a. Considering Separate Evaluations for Disabilities of the Shoulder and Arm Separate evaluations may be given for disabilities of the shoulder and arm under 38 CFR 4.71a DCs 5201, 5202, or 5203 if the manifestations represent separate and distinct symptomatology that are neither duplicative nor overlapping. Reference: For additional information concerning separate and distinct symptomatology, refer to · 38 CFR 4.14, and · Esteban v. Brown, 6 Vet.App. 259 (1994). b. Example of Separate Evaluations for Disabilities of the Shoulder and Arm Situation: A Veteran was involved in an automobile accident that resulted in multiple injuries to the upper extremities. The Veteran sustained the following injuries · a humeral fracture resulting in restriction of arm motion at shoulder level, and · a clavicular fracture resulting in malunion of the clavicle. Result: · assign a 20-percent evaluation for the impairment of the humerus under 38 CFR 4.71a, DC 5202-5201, and · assign a separate 10-percent evaluation for malunion of the clavicle under 38 CFR 4.71a, DC 5203. Notes: · The hyphenated evaluation DC is assigned under 38 CFR 4.71a, DC 5202-5201 because the humerus impairment affects ROM. · The separate evaluation for the clavicle disability is warranted because this disability does not affect ROM. Exception: Multiple evaluations cannot be assigned under 38 CFR 4.71a, DC 5201 for limited flexion and abduction of the shoulder. Reference: For additional information on evaluating shoulder conditions, see Yonek v. Shinseki, 22 F.3d 1355 (Fed. Cir. 2013). c. Assigning Separate Evaluations for Disabilities of the Elbow, Forearm, and Wrist Impairments of the elbow, forearm, and wrist will be assigned separate disability evaluations. The motions of these joints are all viewed as clinically separate and distinct. Assign separate evaluations for impairment under the following DCs. · elbow flexion under 38 CFR 4.71a, DC 5206 · elbow extension under 38 CFR 4.71a, DC 5207 · forearm supination and pronation under 38 CFR 4.71a, DC 5213, and · wrist flexion or ankylosis under 38 CFR 4.71a, DC 5214 or 38 CFR 4.71a, DC 5215. Reference: For additional information on assigning separate evaluations for elbow motion, see M21-1, Part III, Subpart iv. 4.A.1.a. d. Example of Separate Evaluations for Disabilities of the Elbow, Forearm, and Wrist Situation: A Veteran sustained multiple injuries to the right upper extremity in a vehicle rollover accident. The following impairments are due to the service-connected (SC) injuries · elbow flexion limited to 90 degrees · elbow extension limited to 45 degrees · full ROM on supination and pronation with painful supination, and · full ROM of the wrist with pain on dorsiflexion. Result: Assign the following disability evaluations · 20 percent for limited elbow flexion under 38 CFR 4.71a, DC 5206 · 10 percent for limited elbow extension under 38 CFR 4.71a, DC 5207 · 10 percent for painful forearm supination under 38 CFR 4.71a, DC 5213, and · 10 percent for painful wrist motion under 38 CFR 4.71a, DC 5215. Explanation: · Compensable LOM of elbow flexion and extension is present. Separate evaluations are warranted for elbow flexion and extension. · Motion of the forearm is separate and distinct from elbow motion. Therefore, a separate evaluation is warranted for painful supination. · Motion of the wrist is separate and distinct from forearm motion. Therefore, a separate evaluation is warranted for painful motion of the wrist. Note: If elbow flexion is limited to 100 degrees and elbow extension is limited to 45 degrees, assign a single 20-percent disability evaluation under 38 CFR 4.71a, DC 5208. References: For more information on · separate evaluations for motion of a single joint, see - VAOPGCPREC 9-2004, and - M21-1, Part III, Subpart iv, 4.A.1.a · separate evaluations for the elbow, forearm, and wrist, see M21-1, Part III, Subpart iv, 4.A.2.c · evaluating painful motion of a joint, see - 38 CFR 4.59, and - M21-1, Part III, Subpart iv, 4.A.1.c, and · considering impairment of supination and pronation of the forearm, see M21-1, Part III, Subpart iv, 4.A.2.e. e. Considering Impairment of Supination and Pronation of the Forearm When preparing rating decisions involving impairment of supination and pronation of the forearm, consider the following facts: · Full pronation is the position of the hand flat on a table. · Full supination is the position of the hand palm up. · When examining limitation of pronation, the - arc is from full supination to full pronation, and - middle of the arc is the position of the hand, palm vertical to the table. Assign the lowest, 20-percent evaluation when pronation cannot be accomplished through more than the first three-quarters of the arc from full supination. Do not assign a compensable evaluation for both limitation of pronation and limitation of supination of the same extremity. Reference: For more information on painful motion, see · 38 CFR 4.59, and · M21-1, Part III, Subpart iv, 4.A.1.c.

There is another change to M21-1 that actually benefits some veterans. I posted it in VA Claims and Benefits Research