SPO

I asked the doc to add a nexus statement with rationale and reference to medical literature. She has been very agreeable so far to the weird requests for VA stuff. I have a copy of her profile from the hospital website that details her education, board certifications, clinical expertise, and a list/links to studies and medical publications she has been involved in, specific to my condition. Would this cover the CV part?

I just got what is basically an IMO from my doctor for my appeal. Wanted to get some opinions. The only thing I really notes is that she didn’t directly address the link between psoriasis and psoriatic arthritis, but I have 2 other opinions in my file that do. As a note I was denied for specifically for no diagnosis on everything but my back, hip, and right ankle.

So the DAV rep I'm assigned to is making nervous that he will not properly represent me. He is telling me I can submit any additional evidence I have before the hearing so the judge will have it the day of, or I can wait. When I look at the BVA website, it says specifically do not submit ahead of time. On top of that I can't get him to actually answer my questions about what arguments to make. He did say that I can't argue anything in the C&P exam. The only argument to make is that my doc is more qualified to diagnose. I'm pretty sure he won't he even look at my file before going to the hearing. Also he said that office doesn't usually handle to hearings at the board. I'm not sure what to do, I don' know if I have time to change representation or anything since my hearing is just under a month from now. Any ideas what I can do at this point?

I know I ask a lot of questions, but DAV and VA never want to give any answers. I have a virtual appeal hearing next month and I have 2 questions not related to each other. 1. If my claims are granted will the VARO use the existing C&P to implement the decision, or are new C&P's likely? for reference, when the hearing occurs it will be less than 1 year since the last exam. 2. Has anyone had recent experience in the timeframe after the hearing to get a decision?

In my case she listed the records she reviewed stating “dermatology” associates. She never opined about what my doctor said, just provided her own diagnosis or lack there of. They weren’t lacking X-ray evidence as in it didn’t exist. Lacking x-ray evidence as in it didn’t show on X-ray. Inflammatory arthritis doesn’t always effect the bones right away, mostly soft tissue.

All of my current disabilities are listed static and the section about future exams says “none”. I believe the ones on appeal will be listed static as well since the joints on my last claim that were granted are static. the appeal is for the rest of joints that were denied (arthritis claim) so it’s the same condition. I have used the calculator multiple times based off the info in my last c&p exams and it puts me well over 100% if they overturn the denials.

I just reviews my disability ratings in my C-file. Everything is rated as “static”. I also have a pending appeal that could push me to 100%. If the items on appeal are also rated as static, would this translate to getting 100% p&t?

Interesting. I also noticed that she kept listing the evidences reviewed as “dermatology associates” not rheumatology. Wondering if she thought the other doc wasn’t the right specialty. So many what if’s and maybes. I found at least one decision on BVA that a person was granted even though the va nurse practitioner didn’t agree with the diagnosis, but their private rheumatologist did. They were also lacking X-ray evidence in some joints.

Just got off the phone with DAV, and they are telling not to argue about how if the x-ray is or isn't necessary to substantiate a diagnosis. They said don't try to talk about orders, rules, and regulations to the judge. The only thing they want to point out is that my doctor who is a specialist diagnosed me and their examiner who is a nurse practitioner said i don't have a diagnosis, so the specialist should have overruled. So frustrating, I have now idea what I'm supposed to do when the hearing comes.

@VyncI think part of my denial problem stems from an xray issue. I was granted a few joint that showed X-ray evidence and denied on the ones that don’t. my reading shows my arthritis (psoriatic arthritis) can be rated analogous to rheumatoid (dc code 5002) or degenerative (dc code 5003). I’m wondering if the examiner said no diagnosis because there was no X-ray evidence, but the m21 says rheumatoid doesn’t require x-ray evidence to substantiate a diagnosis. I have an appeal hearing and wondering if I can use that as an argument? Hopefully this link works. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000014195/M21-1,-Part-III,-Subpart-iv,-Chapter-4,-Section-B---Musculoskeletal-Diseases-and-Muscle-Injuries#1

Love the inconsistency. 4.59 says objective evidence of painful motion should be rated at the minimum compensable level. Digging deeper into m.21 (sorry I don’t remember the exact reference) once X-ray evidence is confirmed, subjective evidence of painful motion such as lay statements are acceptable. I know the rules vary between inflammatory arthritis and degenerative. My case is inflammatory. I think degenerative must be confirmed by X-ray while inflammatory can be granted by objective painful motion alone due to the fact the don’t always show in xrays. Wonder if this was part of your issue hamslice.

What I’m trying to clarify is if that statement from my exam is grounds enough to give me the 10% (the minimum rating) under CFR 4.59 painful motion. Does that equal objective evidence of painful motion. Some of the joints do not have range of motion reduced enough to get the rating based on that but the do hurt through range of motion

I'm looking at a copy of my last c&p exams for arthritis. I was denied for no diagnosis, which is an issue I am appealing because I have more than one. However, the examiner checked the block "Pain noted on exam but does not result in / cause functional loss" for many of my joints with varying Ranges of motions( such as flexion or exetension). Would this qualify as the objective evidence of pain for the painful motion rule?

I’m working on a claim/appeal with inflammatory arthritis effecting my feet. The symptoms are both plantar faciitis and pain in the toes (I have x ray evidence of arthritis in the toes). Would these be rated separately or considered pyramiding? I have a diagnosis and documentation for both. I claimed it as arthritis of the feet in general.

Hey folks, just wanted to share some info. I was waiting for a hearing and got some info from DAV. If you want a virtual hearing you must call your representative and ask for it, if va.gov says video conference it won’t be scheduled until the DAV/va offices re-open. I called and my DAV rep contacted the hearing coordinator and within a couple hours I was scheduled for a hearing in May. I sent my NOD in August 2020. I don’t know of this applies to legacy appeals.

Just for clarification she said physiologic, not psychologic.

I have had hand tremors for a few years now (i don't remember exactly when they started). I was recently told by a doctor to see a neurologist, which I did last month. I was told that she believes they are physiologic tremor. With no known history tremors in my family and no abnormalities in my blood work, I am curious if this is a condition that I could apply for as presumptive to service in the gulf war? I did 3 deployments to Iraq (2005,2006, 2007), I am also already presumptively service for IBS from gulf war service. Has anyone had experience with this?

So I got a response to my email. He added a not that said his comments were not meant to minimize my symptoms. But it looks like he didn’t actually remove the comments I asked about

The last copy of my c-file stated all my conditions are static. Would the secure email be the best way to ask him about this since it will be kept in my records that I disagreed? Should I him his wording is concerning because it could result in a reduction?

I am mildly worried about the VA wanting to reduce my IBS rating at some point in the future, which is currently at 30% . I went to see my VA PCP and he noted that I had "dramatic improvement" when he asked me how it was. This is not what I told him. I said it was a little better at the moment, but it is absolutely not dramatic. I want use these records, which contain information on another condition, when I submit for another claim, but I don't want the VA to think this issue is getting better, I just happen to be on a short stretch where it wasn't at its worst. Should I avoid submitting these records now, or just send a message and/or get another appointment when it flares back up? Other than some poor wording choices, this doc is very helpful. He basically wrote a nexus statement in my records for my sciatic issues.

I have not gotten an appeal decision yet. I was just confused how the issue would be handled. By that I mean if the board were to grant service connection or a remand. This is my first appeal to the board.

I realized that I didn't specifically say on the NOD that I think the exam was inadequate, and the rating % will likely be inaccurate because of that if service connection is granted. I just said denial of service connection was the issue. Is there a point when they need that specific information as to what I disagree with, or can I bring all that up in the hearing and they will adjust their decision to match? Also, if sc is granted, does it go back to the RO with instructions that I need a new exam? I know this is a lot of what if.

I’m wondering if the time is as long under AMA? The board appeals metrics say 346 days from NOD and 299 days average from board intake for hearing to appeal to be completed. I’ve been assigned a docket number so I’m guessing the board has completed intake on my appeAl. Any idea if I’m reading this right? Here is a link if anyone wants to look for themselves. https://www.bva.va.gov/Appeals_Metrics.asp

In this case it’s board of appeals hearing with a law judge not a DRO. That why I’m concerned about the time since I’ve always heard these appeal will take years

While my hearing isn’t what it used to be I can physically get by in the hearing. My issue is if I can convey they information necessary in writing without having to wait years to say it to a judge, will I have as good of chance of winging.