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First Class Petty Officer
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Everything posted by doc25

  1. Here is the chronological order of my evidence. 1. Entrance Exam 1998 2. In-service diagnosis by Navy Podiatrist 2006 3. Discharge C&P done by a PA 2007 4. After-service diagnosis 2016 5. 2nd C&P exam in 2017 (This one says LEFT PES PLANUS, but there's also one for RIGHT PES PLANUS that's says the same thing in CFILE) I did submit lay evidence to fill in the gap from 2007 to 2016 for continuity and chronicity of symptoms. In-serviceDxpg1.pdfIn-service Dxpg2.pdfC&Pfeetexampg1.pdfC&Pflatfeetpg2.pdfEntranceExam98.pdf2nd Flat foot C&P Exam.pdfChadburn Note9-17-16.pdf
  2. You already know what I have to say about that examiner. F-oh-S.
  3. What I found interesting is that every service members Benefits Disability Discharge C&P exam does not require a nexus of opinion. (I'll have to find where I saw that.)Which is stupid.A DBQ doesnt need to be filled out either. It just goes by what the examiner says and STRs. I'll repost everthing I have and everyone can chime in.
  4. Yes I looked at entrance exam and no notation of flat feet. Normal archs are clearly circled in my entrance exam.
  5. Yup. Working on getting the nexus by April when the claim closes. So,I'll have it in my NOD and appeal. Its a reopened claim and im expecting a denial anyway.
  6. Here is the funny part though. A Navy podiatrist and VA podiatrist made the same diagnosis of bilateral flat feet 10 years apart. The VA podiatrist was not aware of my in-service diagnosis of bilateral flat feet. So, he used his expertise to come to that diagnosis. Therefore how can a PA and Family Practice Dr conclude I had congenital flat feet? When there's already been to diagnosis made by two podiatrists? It's laughable but i know i still need a favorable nexus.
  7. I'm working on getting the nexus for my NOD and appeal. I may need two more nexus of opinions just to be on the safe side.lol. I still expect a denial after this c&p exam I had on 2-18-19.
  8. I suppose you're right so I'll complicate my question a bit more. Let's visit the definition of an event: a thing that happens, especially one of importance. There was no event of an injury and no event of illness to my feet. I won't rebut that. Nonetheless, there was a thing that happened, especially one of importance. Allow me to ask. If I was having pain in my feet did that not happen? 1. I tried treating myself for two months with Rest,Ice,Compression, Elevating my feet. Hydrating, Motrin and changing my socks everyday.I went as far as to buying new shoes during that time. Nothing worked. 2. The next step was to go to sickcall. I was then referred to a navy podiatrist that made the diagnosis of bilateral flat feet. I was provided with custom orthotics that worked for a few months. Then the pain recurred. By that time I was out of the Navy and hating life. Wouldn't it be of importance to have been seen in-service and diagnosed? My STR proves an event by definition did occur in-service. Any further feedback is appreciated.
  9. #1. Request your C-file in it's entirety first. It will take awhile (6months+) to get it which will provide you time to gather all your medical evidence. #2. File an intent to file. This will preserve your effective date for retropay purposes. #3.Gather pertinent evidence for sleep apnea. Request the VA pulmonologist provide an addendum to her note to state "CPAP Medically Necessary" or an equivalent statement. You can request this through a Patient Advocate at your local VA.The va will deny your claim if that little piece of evidence is not present. Dr.Anaise, Dr. Bash, Ellis clinic do nexus of opinions among others. I've researched VA Claims Insider and Brian markets himself and his company well. Apparently, he has a team of claims specialists, dr.s, and lawyers. But, so does comp&pen LLC out of Florida. Use your own discretion on who you want to go with. Some Dr.s nexus of opinions go for hundreds into the thousands of dollars. But that depends on the complexity of your claim. #4. Must meet Caluza factors for direct service connection. 1). Current diagnosis 2). In-service injury, event (diagnosis), illness. 3) Medical nexus stating the minimum threshold of "at least as likely as not (equal to 50% or greater probability) the claimed condition is due to or the direct result of military service. Plus, a rationale. *****This is just a recommendation other experienced forum members have been dealing with the VA for decades and have a wealth of information.*****
  10. That's a favorable nexus. You meet the occupational and social impairment criteria for a rating of 70%. Now it's up to the ratings scheduler to rate you correctly. Congrats!
  11. At this point I don't care about the $$$ that I know I'm owed. I care more about a wrongful denial that is nothing more than mere speculation to deny and delay. I just want justice for my claim and all other veterans that have to go through this.
  12. With the in-service diagnosis alone and the PA acknowledging the symptomology and orthotics I should have been awarded 10%. But,instead the PA gave only a mere speculative theory that my feet were congenital in error. The Winston-Salem ,NC RO at the time made the error of not applying the presumption of soundness to the claim. If I'm not mistaken that regional office was investigated for unjust denials such as mine a few years back. I'm more frustrated that the Houston RO just concurred with that previous denial from 2007. And made the same error of not applying presumption of soundness.
  13. My contention is that i did not enter service with congenital flat feet. The vba needs to prove that it pre-existed. The burden falls on the vba. My cfile is null for that evidence of a congenital flat feet diagnosis prior to service. What I have is acquired flat feet. That was diagnosed in service.Meaning it developed over time. Yes. I have a podiatrist and he made the same diagnosis of bilateral flat feet in 2016 and i'm still being seen every 3 months.
  14. You meet the criteria for #2. Please review the information provided. TDIU is subject to having a future exam. The key issue in a TDIU claim is the inability of the veteran to engage in "substantially gainful employment" because of his or her service-connected conditions. "Substantially gainful employment" means to hold a job that pays at least an amount equal to the annual poverty level set by the federal government. In order to qualify for TDIU benefits, a claimant must meet the following requirements: If the claimant has only one service-connected condition, that condition must be schedular rated at least 60% or more; If the claimant has two or more service-connected conditions, at least one of those conditions must be rated at 40% or more, and the veteran's combined disability rating must be 70% or more; and In either case, the veteran must be unemployable because of his or her service-connected conditions. To establish "unemployability" or "inability to substantially maintain gainful employment", the Veteran must provide: evidence of unemployment due to service-connected conditions, employment history records for example, and medical evidence that the veteran's service-connected condition renders him or her totally disabled and unemployable, generally a doctor's opinion letter. Having a paying job does not automatically disqualify a claimant from a TDIU award. If the wages are considered "marginal" (low paying) or "sheltered" (protected from usual requirements) employment are exceptions to the TDIU qualification requirements. Examples of employment that are allowed under TIDU: A job that pays substantially less than the prevailing poverty level, A job that is protected from requirements that someone else in that position would be expected to satisfy, or A job working for a friend or relative, may not be "substantially gainful employment." Although it is always better to submit a specific claim for TDIU. The VA has a duty to look for potential TDIU claims based on the evidence in the claimant's VA claims file, known as a "C-file". The VA is required to review the claims for TIDU, even if not specifically requested by the Veteran, because entitlement to TDIU is part of every claim for disability compensation. Upon reviewing the claim, the VA determines if TDIU is an appropriate award for the claim. Evidence of unemployability can be submitted after an initial decision denying TDIU, if while a claim for schedular benefits is still being processed.
  15. Nurse Practitioner. Which is why I mentioned I'll probably receive a denial, but I'll appeal it and keep appealing til my last breathe. I got my C-File today and there's a clear and unmistakable error by a PA that did my initial exam in 2007 upon my discharge. Then a FP Dr. merely concurred, BUT he clearly and unmistakably marked on my 2nd C&P the condition claimed is "at least as likely as not" (equal to 50% or greater probability) incurred in or caused by an in-service injury, event, illness (in-service diagnosis Flat Feet 5 Dec 06)
  16. 2nd C&P exam for flat feet from my C-File. 2nd Flat foot C&P Exam.pdf
  17. Hell yea. Notice the difference between the unfavorable nexus vs the favorable nexus?
  18. This article cites the article I provided in an earlier post. Reference #9 and it is mentioned in the DISCUSSION. Sleep apnea, psychopathology, and mental health care.pdf That PA-C doesn't know what he/she is talking about.
  19. Here is the form to fax in evidence. 2017-01-18+Claims+Intake+Fax+Coversheet-1.pdf
  20. Just as I suspected would happen. A doggone PA-C did your exam and gave you an unfavorable nexus of opinion vs a favorable nexus of opinion. Looks like a tie to me. https://www.hillandponton.com/va-benefit-of-the-doubt/ Don't be surprised if it gets denied. My secondary Sleep Apnea was denied twice. Can you post Dr. Anaise IMO, if you haven't already? Redact any personal identifying information.
  21. You can secondary connect OSA to GERD or Persistent Depressive Disorder. I'll explain GERD first. You can secondary connect OSA to 30% GERD . You will need to file an increase if your symptoms at the present day meet the criteria to rate 30% GERD. Review this BVA case to see how this veteran got sleep apnea secondary connected to 30% GERD. https://www.va.gov/vetapp14/Files7/1454144.txt Here is how GERD is rated. – Gastroesophageal reflux disease (GERD) is a condition where the acid in the stomach travels up the esophagus. It is rated under code 7346, hiatal hernia. Code 7346: A hiatal hernia is a hernia in the diaphragm that allows the organs in the abdomen to move up into the chest cavity. #1.If the hernia causes pain, vomiting, significant weight loss, blood in the vomit or feces, and anemia, or if other symptoms cause a serious overall health disability, it is rated 60%. #2.If there are regular episodes of pain in the upper abdomen, trouble swallowing, heartburn, the return of food into the back of the throat/mouth, and pain in the upper arm or shoulder, it is rated 30%. #3.If two or more of the previous symptoms are present, but are not as severe, it is rated 10%. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Since you are rated 30% PDD, a depressive disorder, have an increased probability to have developed Sleep Apnea. The insomnia combined with PDD is a sign that Sleep Apnea may have been present all along. But, I'm going to go out on a limb and say there is no evidence of an in-service sleep study(event) or diagnosis of Sleep Apnea. Review the article at the bottom of this post; that links ptsd, anxiety, depression, and other psychiatric conditions to OSA. Print out the article and see if a Sleep Specialist or another Dr, will agree to fill out a DBQ, provide a nexus of opinion with a clear and concise rationale. If you're not already being treated for PDD you may want to start building medical evidence if you believe your symptoms have worsened. You won't get a requested increase granted without being seen at the VA or a private mental health dr. proving your symptoms have worsened. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ HOW TO SECONDARY-SERVICE CONNECT #1. Current Service Connected disability. #2. Current Diagnosis for secondary condition claimed. [Sleep Apnea documentation must state the diagnosis with "medically necessary" CPAP. If "medically necessary" "medical necessity" "medically required" or equivalent is not present? The claim will be denied.] #3. Must have a Nexus of Opinion stating the minimum threshold of "at least as likely as not" the Veteran's Sleep Apnea is due to or the direct result of the veteran's service connected condition. Plus, the rationale linking #1 and #2. ****FYI, I was denied twice for Secondary Sleep Apnea because I did not meet #3.****** SecondarySleepApneaArticle.pdf
  22. Well then I'm S-O-L. Since you have the nexus then you should be good to go for a favorable decision.
  23. It looks favorable on the DBQ. It will end up getting sent back for an addendum to the examiner for a nexus of opinion and a rationale. It'll delay the decision two weeks or more depending when the examiner does the addendum and if the nexus contains the minimum threshold of "at least as likely as not" the claimed condition is due to or the result of military service. Although, sometimes the raters do use the DBQ only to make their decision. Don't be surprised if you see in ebenefits your claim go from preparation for decision to back to gathering of evidence. It's not uncommon for a claim to go back and forth, but it creates unnecessary frustration and anxiety. I'll be in the same boat and at the mercy of how the rater handles my re-opened flat foot claim. Yay! Good times.lol.
  24. Just got out of my LHI c&p exam. I was surprised that it took the examiner 1 1/2 hours. He was engaged with questions and welcomed my evidence I brought with me. He allowed me time to explain from the onset of my flat feet symptoms,in-service diagnosis, continuity of symptoms, and present diagnosis of flat feet with continued symptoms. Overall, I felt it went well. I still do expect a denial because I asked if a nexus of opinion would help my claim he mentioned the VBA only requested the DBQ and there was no instruction for his opinion. The examiner did verbally state that if it was diagnosed in-service it should have been service-connected in 2007. So, hearing that gave me hope moving forward with my NOD I have prepared should I receive a denial letter.
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