Galen Rogers

Thanks for the response. What i need is an exam and report that say what my current condition is. I am challenging the rating they gave me (low ball). So I don't actually need a NEXUS letter. I already spent around $6K forn one that I submitted with my initial claim. That helped get it approved. I just need a current evaluation to help justify my request for an increased ratingand to refute the C&P nurse who examined me. All they have to do is examine me, look at the current MRI and then write what they find. Basically what they would do if I just went to them and said my knees are bothering me and want to know what is wrong. So I think I will just do that. My Tricare military clinic doctor won't do that. SO I will just go to an Ortho Dr. that I have never seen and get a second opinion.

Thanks for the info. The problem I'm having is the Ortho Doctor who has seen me in the past won't do an IME for me or even just regular exam of my knees with a written and legible report of what he sees. All I have been able to find are doctors who normally do these exams for lawyers and charge $1500 or more for each item examined. It's quite frustrating. It could be where I'm at (Northern VA). So guess I'll keep looking. If anyone knows of less expensive options that still provide good documentation please let me know.

Hi All, Has anyone used "www.valor4vet.com" for an IMO or NEXUS letter? I just ran across them and was wondering.

Thanks for the responses. From everything I have read the raters try to not follow their own rules on what is and isn't pyramiding. There are DCs for the knees that you actually can be rated for at the same time. Everything I have read is that these claims never get rated that way and you have to file a NOD, get additional medical support, and then hope the next guy up who first reviews the NOD will follow the rules. If not then on to the BVA. They figure most of us will just give up and accept what we get especially since our VSO rep is probably pushing us hard to accept it. Navy04 good luck with your knees and eventually surgery. I'm 62 and looking at that for both knees but much sooner.

My IMO for OSA provided references to medical articles that link OSA to different medical issues like sinus problems and GERD (Reflux). I also got a letter from my Sleep Doctor stating the the BIPAP machine was medically required. I also got lay statements from friends and family stating how long they have noticed my symptoms. I was lucky and the VA secondarily connected it to my GERD. If your Doctor writes a very well laid out IMO with strong medical logic backed up by medical articles why your TBI is more likely than not to have caused your OSA, you have a good shot.

Not sure what you mean by "bilateral factor rating". They did give me 10% for each knee due to the Meniscus being torn.

Thanks all for the comments. This VSO is really trying pressure me to back down. I got a second email today re-emphasizing why I should not file a NOD. Here's the email I received today. "Do you have a private doctor that you would be willing to go to to get a second opinion for the increase? Either way, applying for an increase will likely result in another exam down the road. But you should know of the risks associated with it as we are seeing many veterans applying for increase in turn being proposed to be reduced. As for the inadequacy of the exam, we can certainly make that argument, but you will need to go into greater detail as to what she did in the exam that rendered it inadequate. I see the statute you have cited, which is fine, but we need more details of your specific exam." Now I understand why so many vets get frustrated and give up.

Berta, Thanks very much for the info. I'll check these out.

I need some guidance. I want to remove my current VSO and revoke the POA I gave them. eBenefits has only allows you to change VSOs. It does not provide a way to out right remove one and not have one at all. I have read online just to fax a signed letter to the VARO revoking their POA and removing them as my VSO. I can't find any fax numbers for the regional office in Roanoke, VA. Can any one tell me how to do it?

Thanks broncovet. The hip pain is caused by a combination of the bad knees and the ruptured discs in my lower back. I'll let the VA decide what to actually tie it to. The way I understand it radiculopathy can be rated separately and it won't be considered pyramiding. But I can only get it once for my legs and once for my hands/arms or can I only get it once for all extremities combined? That is probably a more precise question.

Howdy all, I have been reading through CFR 38 diagnostic codes for my neck and lower back issues. I know I don't meet the incapacitating requirements but do have limited range of motion, painful movement, and numbness/tingling/pain in my arms and my feet. Both my lower back and neck have ruptured discs, degenerative arthritis, and stenosis to some degree. All mostly due to a fall that happened a few years back caused by my service connected knee giving out. So I know to claim both as secondary (working on those two). I believe my range of motion falls in the 20% rating range. I f I read the CFR correctly I can also claim as secondary the radiculopathy caused in my arms, hands, and feet. I also get pain in my hips when I walk due to the limp caused by my knees. So my question is: 1. Can I claim the radiculopathy as secondary as separate issues for my arms (neck), feet (lower back), and my hips (lower back)?

This time it was expected. Even as a pass through my VSO is lack luster. I originally gave them all of my claims and documentation to submit last April. My actual face to face appointment with them was last May. She waited until then to upload them into their system for their QA office to review. She did not go over them with me just uploaded them while I was there. Then their QA office (made no changes)took a month before they handed them over to the VA in Roanoke, VA. So using them as a pass through cost me 3 months. I don't plan to use them as my VSO any longer.

Howdy all. I recently received a decision letter on some of my claims. Some were positive, some negative, and some in between. After reviewing the decisions I have decided I am going to file a NOD on the decisions. SO as a courtesy I emailed my VSO to keep her informed on my intentions and provide my rough draft disagreement statements and reasoning. She immediately sent it to their legal staff. The legal staff came back with every reason why I should not submit a NOD. Their response is below. "If you are going to NOD and apply for an increase, you need to be aware of the risk that you could be reduced for the knee and/or not increased above 10% again if they do conduct another exam. Given that you just had an exam, I am not sure they would request another exam so soon after. Do you have a private doctor that you would be willing to go to to get a second opinion? Either way, applying for an increase will likely result in another exam down the road. But you should know of the risks associated with it as we are seeing many veterans applying for increase in turn being proposed to be reduced. As for the inadequacy of the exam, we can certainly make that argument, but you will need to go into greater detail as to what she did in the exam that rendered it inadequate. I see the statute you have cited, which is fine, but we need more details of your specific exam. As for your disagreement with OSA.. Your logic that the VA had a duty to assist that extended to the Rater who should have known the link between GERD and OSA does not supersede the requirement for that evidence to be submitted specific to your case and your issues. BVA decisions are not precedential, and every veteran still needs to make an argument based on their medical and military history." Now whether they are really concerned for me or just trying to dissuade me from filing a NOD, a Vet who is not a little versed in the VA Claim game would be discouraged and probably just accept the decision and not file a NOD. I know that is what i did in 2001 and then again in 2008. I won't do that now. ASKNOD just reminded me recently that the VSOs are actually chartered to assist the VA in adjudicating our claims. That means they work for the VA and not us. So as the old saying goes "Buyer beware".

Hello all. I read through many, many of the posts on IMOs/IMEs but have a question I did not see an answer to. I will be submitting a NOD on the ratings given for my knees and the denial on my lower back. Luckily there are some IME doctors within about a 100 mile radius I can drive to here in Northern VA. One of them is very close but he is a Chiropractor. He has an impressive list of certifications. My question - is it better to go to a full fledge MD or will a Chiropractor's IME and opinion carry as much weight?

Howdy all. I have a question about the actual functions that a VSO can actually do. I know supposedly they are experienced eyes that should review our claims, provide guidance on what support info we need, and then verify our claim has it and then submit it for us. I have read on here that they can atleast view our documents in the VA's system and maybe let you look at the info also. Can they provide us with copies of documents like our C & P Exam reports? The reason I ask is due to what my current VSO just recently told me about what they can't do. They are the Virginia Veterans Assistance Department. My rep there told me she could not provide a copy and could not let me view it via their system. The other statement she made was that if they don't submit the claim or NOD for me they can't represent me on that claim or NOD. Is this common among these VSOs or is this unique to my VSO?

Hello all. I need to file a NOD on my claim decision. My current VSO (Virginia Veterans Services Office) seems less than enthusiastic. She is definitely not proactive. I had to nudge every step of the way on filing my claim. I have seen articles on the internet stating I should get a very knowledgeable VSO to help me with the NOD and that it should be very detailed on what I disagree with. Then there are other articles that say not to go into the actual details of why I disagree and to just say I disagree with the decision and want to appeal. So I have two questions. 1. I'm here in Northern VA up by D.C. and need some recommendations on accredited VSO's that can and will help me fill out and file my NOD (if needed). 2. Should I go into great detail of what I disagree with or just that I disagree and want to appeal? I really don't want to sink the ship before it sails.

Good Evening. I have a question about the NOD form. It asks what percentage I feel each item should be rated at? How is the best way to handle that? I have a copy of the rating DC table but it is somewhat confusing. I read on one VA lawyer's website that you should shoot for the sky and just put down 100% and then let the VA lower it. That way you don't short change yourself. What do you all think? Secondly I figure I should get an additional IMO for my knees and lower back. Is a certified physical therapist acceptable for this or should I try and get an Ortho Surgeon for my knees and a Neurosurgeon for my back?

I did respond to her as a courtesy. I'm working on it now. I will file the NOD personally. I received some very helpful advice over at "ASKNOD.ORG". I need to get two new IMOs to counter balance the VA contracted Nurse Practitioner. She actually missed a couple medical documents that showed my lower back problem started after a fall caused by my SC right knee. She only looked at the ones 2 years later. So she disputed my original doctor IMO that linked my lower back to that fall as more likely than not. The VA sided with her.

Howdy All. I recently received a decision letter from the VA that approved some of my claims, denied one, and then deferred the remaining ones. So after I reviewed the decisions and rating percentage I have decided to file NODs on the rating percentage on my knees, denial of my lower back claim, and effective date of my OSA. So out of courtesy I emailed my VSO Rep and told her what I planned to do. Rather than saying "OK" and I'm here to help she just said on what and why. She didn't even mention any support for what i did win. I am honestly surprised by here less than positive and supportive response. So my impression is she is preparing to try and shoot me down or try to dissuade me from challenging any of my approvals. Have any of the rest of you had a similar experience with your VSO Reps?

Howdy all. I have a question regarding my rating approved for both of my knees. Originally the VA granted service connection for my right knee torn meniscus and subsequent repair (10% - DC 5259). My current claim requested an increased rating for my right knee due to increased problems with it. I also requested secondary connection of my left knee due to a fall caused by my right knee giving out. They granted the left knee request at 10% and they left the right knee at 10%. I read on one of the VA law blogs that the BVA has ruled that we can get rated for multiple DCs for our knees if the meet the requirements of each one. I'm planning on submitting a NOD to disagree with the 10% for a single DC. I plan to state the right knee should be rated 10% under DC 5259 for the original medial meniscus tear repair, and 20% under DC 5258 for additional tears to both the medial and lateral meniscus caused by numerous falls by my knee giving out. I have the 2001 original MRI and the current one showing the increased damage. I also plan to state that I disagree with only the 10% for the left knee due to pain and reduced motion. Not sure which DC they actually used for that one. I will state that I should be given that 10% and also an additional and separate 20% under DC 5258 for the various tears in the left knee meniscus. Both knees currently have effusion into the joint, have frequent episodes of locking, and painful motion. Finally the decision letter actually confirms I have "degenerative arthritis" in both knees and then states I am not entitled to the higher 20% rating for it so I will also challenge that. Should I also add that I should get the additional and separate 20% for the degenerative arthritis und DC 5003? VA Claim Decision Ltr 08 Nov 2018.PDF Redacted Right knee New & Old MRI Details.docx

I was awarded service connection and 10% for GERD and service connection with 0% for my allergic rhinitis on my original claim in 2000 directly after I retired. The denied my claim for sinusitis. I had headaches listed on every physical for many years and fatigue a few times. The VA rater stated originally that my SMR evidence was not probative. My constant sinus problems was well documented in my SMRs and I basically lived on Pseudophed that sick bay handed out without requiring a prescription. (cold packs) ASKNOD originally advised me that I can't claim CUE on opinion of probativeness if they looked at everything. I think the real issue is that in 2008 the medical world was just starting to realize the links of different issues to OSA. I appreciate your advice and now I have to think about it and what step to take next.

all of them were coordinated by the contractor LHI and I saw providers at outside locations. None of them were done at a VA clinic. So guess I just have to wait.

I submitted Dr. Bash's NEXUS Letter with my claim. I also referenced it in my sworn statement. So I will try the NOD and if approved I'm good. That would back date the effective date to the original claim. If the NOD does not work then I will appeal up the chain and get an updated NEXUS from another reputable medical professional. Attached is Dr Bash's IMO. Dr Bash VAE OSA NEXUS OPINION ICO Galen Rogers 2018.docx

Howdy All. I just recently went through 4 separate C&P Exams and have a couple more I think. I asked the provider for copies of the reports but they said they could not give them to me. So I contacted the VA and they said fax in the request. I did and apparently that is a FOIA request. Estimated completion Feb 2019. Is this the only way to get copies?

Dr Bash based the CUE on the fact that I was service connected for GERD and Allergic Rhinitis (AR). There are various medical articles that link OSA to GERD and AR. There ared even a few VA appeal results that approved OSA due to these links and articles. All of this evidence was available prior to my claim. The VA had the appeal results in their possession prior to my claim. With that being said, ASKNOD recommended I reopen my claim and then do a NOD on the effective date if approved. Hi opinion was that a CUE was a very slippery slope in most cases that are somewhat vague like this one. I'll attach the VA decision letter I just received yesterday for you to look at. Also one of the VA Citations that approved someones OSA based partially on GERD is Citation Nr. 0721743 Decision Date: 07/19/07. VA Claim Decision Ltr 08 Nov 2018.PDF