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VAW-126

Seaman
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Everything posted by VAW-126

  1. I currently have a claim in for herniated discs and sciatica as a secondary condition to my service connected lumbarsacral strain. My claim was in the Prep for Decision Phase a week ago but now has been kicked back to the Gathering of Evidence Phase and a C&P exam and medical opinion has been requested by the rater because of a new condition that I have that has been noticed since I filed my claim in Sept 2016. Apparently the rating saw that I have a CT Scan in my file that shows that I have Minimal levoscoliosis. No Signifcant abnormality of alignment. Vertebral body heights are preserved. Mild to moderate disk degeneration is present at C3-C4 C4-C5 and C6-C7. At most mild disc degeneration at the other cervical levels. Multilevel small disc osteophyte complex is present without significant spinal canal stenosis. Uncovertebral DJD causes neural foraminal stenosis as follows: Mild bilateral C2-C3 and left C3-C4, moderate to severe right C4-C5. The rater is requesting a medical opinion to find out if my cervical conditions can be considered to be secondary to my lower lumbar condition. I am currently receiving 20% for Lumbosacral Strain, 20% Right Lower Extremity Radiculopathy, 20% Left Lower Extremity Radiculopathy. My question is being that the rating is requesting if the cervical condition is secondary could the condition be granted without me filing a claim for it.
  2. Whats crazy about everything is that as the Nurse Practioner (C&P Examiner) was doing my exam I couldn't do any of the tasks that she asked me to do because I stated to her that It was too painful for me to attempt to do. I winced with everything she asked me to do and she was looking right in my face as I attempted to do the task.
  3. Ok so I'm 70% P/T with IU. I filed a claim in Sept 2016 for Aid/Attendance because of the difficulties that I have with daily living. My VA doctor annotated on the Aid/Attendance Exam form that I require the regular aid/attendance from my spouse. In addition to filing for the A/A I also file for increases for my service connected CAD and Lumbosacral Strain with bilateral lower extremity radiculopathy. I filed for sleep apnea and hypertension as secondary to my service connected CAD as well as I filed for Herniated Discs as secondary to my service connected Lumbosacral Strain. My VSO instructed me to file for the increases and new conditions to help with my A/A claim. I have unsteady gait and sciatica due to my lumbosacral strain and several herniated disc. My C&P exam that i had in Feb 2017 appear to be favorable for me in the that examiner noted that the new back conditions were a result of my current service connected lumbosacral strain. It is also noted in the DBQ that my ROM is abnormal/out of normal range as well as I have unsteady gait. Also the Cardiologist noted on my Heart Disease DBQ that I experience at least 3 episodes per month of having chest pain while at rest in which I use nitroglycerin tablets to help relieve. I have read that if you experience episodes or heart disease i.e. chest pain without any physical activity that It would warrant a 100% rating for the CAD. The VSO stated that it is possible that my current 70% P/T could be increased to a schedular 100% P/T and that my heart condition alone could be increased from 10% to 100%. So with this being said is it still not possible for me to be P/T with IU and schedular 100% P/T? My current TDIU is due to my service connected conditions as well as I am receiving SSDI due to my service connected conditions. My Claim is currently in the Prep for Decision phase. Wish me luck. My current conditions: Lumbosacral Strain 20%, Right Lower Extremity Radiculopathy 20%, Left Lower Extremity Radiculopathy 20%, Right Shoulder Fixation/Reduction 20%, CAD 10%.
  4. Question, on my C&P exam the examiner noted in my Thoracolumbar Spine DBQ that the examination is neither medically consistent or inconsistent with the veteran's statements describing functional impairment with repetitive use over time or functional impairment during flare-ups. Does this mean that the VA will give me the benefit of the doubt and rule in my favor in regards to my claim for functional impairment. Also the examiner noted that my range of motion and functional limitation is abnormal/outside of normal range.
  5. BACK DBQ PG 1.pdf BACK DBQ PG 2.pdf BACK DBQ PG 3.pdf BACK DBQ PG 4.pdf BACK DBQ PG 5.pdf BACK DBQ PG 6.pdf BACK DBQ PG 7.pdf BACK DBQ PG 8.pdf AHI.pdf
  6. Can anyone tell me if Obstructive Sleep Apnea and Hypertension be secondary to CAD. Also the C&P examiner copied and pasted into my Heart Condition DBQ the following statements from my last cardiology exam. . CC: 1st visit today. Pt w/ h/o chronic, stable angina - reported CP in service in 9/1990 - had NL MPI. Has undergone heart CATHs (1993, 2008), which were NL except as noted below - advised he likely his microvascular disease, or microspasm, or (cardiac) syndrome X (decreased blood flow in LAD). Info in scanned records. Pt has noted intermittent CP >25 years - avg 3x per month - occurs at rest or during sleep or w/ activity - pausing/resting typically relieves - uses one SL Nitro tab on avg of 1x per month to relieve CP. The C&P examiner used the above cardiology exam as a Interview-based METs test because the limitation in METs level is due to multiple medical conditions including the heart condition, it is not possible to accurately estimate the percent of METs limitation attributable to each medical condition. Based on the above statements from the Cardiologist could my SC heart condition be increased from 10% to 100%. i. was also hospitalized in Dec 2016 for my heart condition in which a ECHO and Nuclear Stress Test was performed. My stress test showed I have a EF of 60%. But my ECHO revealed that I have the following: Left Ventricular Basal Septal Hypertrophy, Left Ventricular Diastolic function abnormality with Mild (grade 1) showing impaired relaxation and Trace Mitral and Valve Regurgitation. I also have a history of a past Myocardial Infarction when I was on active duty.
  7. Hi I had a C&P exam in Feb 2017 the examiner wrote the following: The examination is neither medically consistent or inconsistent with the Veteran's statements describing functional loss with repetitive use over time and the examination is neither medically consistent or inconsistent with the Veteran's statements describing functional loss during flare-ups. Can you tell me what does this mean?
  8. Yes thats me. I had different drafts and was just trying to get a feel and feedback to see if anyone else out there has been in similar situation and their outcome. My claims are current in the Prep for Decision phase.
  9. Hello al,l need your help. I am currently rated at 70% P/T with IU. I have a current claim in for increase of my S/C 10% Coronary Artery Disease. In regards to the METs for the heart condition, on my Feb 11, 2017 C&P exam the examiner noted the following on the DBQ. Interview-based METs test on 2/11/2017 Symptoms during activity: The METs level checked below reflected the lowest activity level at which the Veteran reports any of the following symptoms attributable to a cardiac condition: FATIGUE Results of interview-based METs test METs level on most recent interview-based METs test: 7-10 METs; This METs level has been found to be consistent with activities such as climbing stairs quickly, moderate bicycling, sawing wood, jogging (6 mph). Has the Veteran had both an exercise stress test and an interview-based METs test? Examiner answered: YES The questioned was asked "What is the estimated METs level due solely to the cardiac condition(s) listed above? (If this is different than METs reported above because of co-morbid conditions, provide METs level and Rationale below.) The examiner's answer was "The limitations in METs level is due to multiple medical conditions including the heart condition(s). it is not possible to accurately estimated the percent of METs limitation attributable to each medical condition." Now the C&P Examiner copy and pasted the following into the DBQ (Heart Condition) * * * ATLANTA VA HOSPITAL CARDIOLOGY CONSULT * * * 10/16/2016 PT IS A 51 YR OLD MALE HERE FOR CARDIOLOGY CC: 1st visit today: Veteran w/ h/o chronic, stable angina - reported CP in service on Sept 6, 1990 in which Veteran was told he had a Myocardial Infarction- had NL MPI. Veteran has undergone heart Caths in 1992 and 2008, which were NL except as noted below - advised he likely has microvascular disease or microspasm or cardiac syndrome X (decreased blood flow in left ventricle). Veteran has noted intermittent CP for more than 25yrs - averages CP 3 times per month at it occurs at rest and during sleep and with or without activity. pausing/resting typically relieves the pain but uses one 1 nitro tablet to help relieve the CP. Veteran uses on average 1 nitro table per month. Veteran also has Obstructive Sleep Apnea with use of CPAP nightly. My last hospital admission for CP was 12-7-2016 to 12-8-2016 at which I had a Nuclear Stress Test and ECHOCARDIGRAPHY done. The Tests revealed the following: The Left Ventricular Cavity size is normal. There is Left Ventricular Basal Septal Hypertrophy The Left Ventricular Systolic Function is normal, Ejection Fraction is 60-65%. The Left Ventricular Diastolic function is ABNORMAL. Mild (grade I) showing impair.red relaxation The Right Ventricular Cavity size and systolic function is/are normal. The Mitral Valve Leaflets are mildly thickened There is Trace Mitral and Valve regurgitation present. Pulmonary artery pressure is normal. My question is being that a Exercise METs level cant be determined should my CAD be rated at 100% based on my last Cardiologist exam that is noted above. The last and only time that I had a Exercise Stress Test was in December 1990. I feel that the examiner didn't have a clue as to what she was doing and this may cost me the rating that I deserve. I am also receiving Social Security Disability Compensation for my S/C Heart and Back Conditions. The examiner also noted that my Heart and Back Conditions DO NOT prevent me from working. The Social Security Disability paperwork is in my VA file not to mention I gave her a copy at my C&P Exam.
  10. Hello I have a claim in for increase of my SC Heart Condition (CAD) which is currently rated at 10%. My military records show that I had a Myocardial Infarction in Sept 1990 while deployed on the USS John F Kennedy. I had a C&P exam on Feb 11, 2017 and the examiner did note on the DBQ that I had the MI in Sept 1990. It also appears that the examiner cut/pasted into the DBQ my last appt with my VA Cardiologist (Oct 2016). It says " CC: 1st visit today. Pt w/ h/o chronic, stable angina - reported chest pain in service in Sept 1990 - Had NL MPI. Has undergone Heart CATHS in 1993 and 2008 which were NL except as noted below - advised he likely has microvascular disease or microspasm or cardiac syndrome X (small vessel disease which causes decreased blood flow in my LAD which in turns cause chest pain). Pt has noted intermittent chest pain for over 25 years with a average of 3 episodes of chest pain per month and the chest pain occurs at rest and during sleep and or with activity and that he uses 1 nitro tab to relieve the pain. I was just hospitalized in Dec 2016 for chest pain which was prior to me filing this increase claim. My question is due to the fact that it is noted that I experience my chest pain at rest and or while sleeping should I be rated at 100% for my heart condition. I also have cardiac arrhythmia and a mitral valve condition and cardiac hypertrophy. My last nuclear stress test show my ejection fraction to be 60-65% but the Medical Expert (A Doctor for the Social Security Administration) testified that even though my ejection fraction is 60-65% it looks good for me but is certainly not a perfect condition for my type of cardiac diagnoses. However, the C&P examiner noted that a true METS can't be established because of me not being able to do the stress test on a treadmill because of my SC heart and back conditions. So will the rater look at the fact that it is documented that my chest pain occurs at rest and grant me the 100% rating? Also the Social Security Administration found me to be disable due to my SC Heart and Back Conditions.
  11. The examiner is Sandra Reid, DNP, FNP-BC Nurse Practitioner
  12. The VA has those private records, one to hospital stay was when I was transported by ambulance from a VA clinics and the last o e was from my home. The examiner had both of those Hospital discharge summaries in front of her and I brought copies with me to the exam just in case the VA mysteriously didn't have them in my file.
  13. Hi Ms. Berta, yes I was employed and that time and my rating was 30% but due to my condition they increased my rating to 70%' P/T and because I was terminated from my employer because of missing too much time off from work due to my condition. The VA told me in my decision letter to apply for the IU and within 2 months I was awarded the IU.
  14. Can anyone tell me if Obstructive Sleep Apnea or Hypertension can be linked to Coronary Artery Disease? I have filed a claim for both of these conditions as secondary to my SC Coronary Artery Disease.
  15. The examiner also noted in my DBQ that my back and heart conditions DO NOT prevent me from working when in fact the reason I am receiving IU from the VA is because of those same conditions so why would the examiner say otherwise. Also she was looking at my Disability FAVORABLE Decision from the Social Security Administration that referenced that my SC conditions caused my disability. I just hope that the rater will take a MUCH closer look at all of my evidence because it appears that the EXAMINER is against me.
  16. Tks and I hope there are other vets out there that can help me out with this.
  17. I looked at the DBQ but when the examiner says the exam is neither medically consistent or inconsistent with the veterans statement is that good for the veteran?
  18. I am looking at one of my DBQ for Back (Thoracolumbar Spine) Conditions for which i have file for a increase evaluation for my S/C Lumbosacral Strain. The following is what the C&P Examiner wrote verbatim "The examination is neither medically consistent or inconsistent with the Veteran's statements describing functional loss with repetitive use over time". What does the mean. I am currently rated at 70% P/T with IU. The Social Security Administration has found me disabled as well because of my service connected back and cardiac conditions. A Medical Expert testified at my social security disability hearing as to the extent and severity of my service connected conditions which ultimately resulted in my being granted social security disability. My heart condition is currently rated at 10% but based on the research that i have been doing it appears that my heart condition should be rated at 100% because of the fact that i take medications to help control my stable angina and that I have been hospitalized twice in the past 12 months prior to my C&P exam for my heart condition. Please help clarify if possible. Service Connected: Lumbosacral Strain 20%, Right Lower Extremity Radiculopathy 20%, Left Lower Extremity Radiculopathy 20%, Right Acromial Fracture 20%, Coronoary Artery Disease 10% Current Claim filed for: Herniated Discs secondary to SC Lumbosacral Strain, High Blood Pressure secondary to SC Coronary Artery Disease, Coronary Artery DIsease (Increase), Obstructive Sleep Apnea with use of CPAP secondary to SC Coronary Artery Disease, Lumbosacral Strain (Increase), Aid and Attendance.
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