[Ulnar Nerve Mild Paralysis]

I received my VA rating and one of the conditions was Service connection for Upper Left (20%) & Right (20%) Extremity radiculopathy.  The reasoning was Mild incomplete paralysis of minor extremity LEFT and incomplete paralysis of major extremity RIGHT. The C&P report showed all 3 radicular groups (Upper/Middle/Lower) all affected with mild paralysis.  

My question is that the Award report didn't say anything about the documented Ulnar nerve mild paralysis which, if I understand correctly, is rated separate from the Radicular groups.  Does anyone know if they Ulnar nerve paralysis should have been rated?

 

Thanks in advance.

[Got Decision]

15 minutes ago, broncovet said:

You have to wait for the envelope and not rely on ebenefits, as its unreliable.  

Thanks Broncovet. Yeah thought something wasn't right because the basic VA math didn't add up.  I am pleasantly surprised with the new VA process as my experiences with the VA in the past have been abysmal and really caused me to disconnect for over a decade.  I hope they continue to improve and become more vet friendly.

[Got Decision]

I just received my decision and was granted 80%.  I am confused as to how they calculated the numbers because what is showing on EBenefits doesn't give full details nor does it actually list 2 of conditions I filed for. Anyone ever have their decision rendered and the EBenefit list not actually include all of their claimed conditions, approved or not?

[Arthritis Rating Question]

Just now, Buck52 said:

With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations 20%

with the exception of limited motion

Hey Buck .... still confused ... does that mean that if I had both knees and both ankles (4 total major joints) then it would still only be 20% or would it be 20% for each of those joints so 20% for LKnee 20% RKnee 20% RAnkle 20% LAnkle?

 

Thanks for your input

[Arthritis Rating Question]

Hello Everyone,

I have a question about arthritis rating table below.  Is the rating applied for "EACH" major joint (or group of minor joints) affected or is it just one rating for the existence of the arthritis?  Example:  If rated in both left and right knees as well as left and right ankles ... would that be one rating of 20% for all of them or would it be 20% for each major joint?  Thank you in advance for spreading some light on this.

5003   Arthritis, degenerative (hypertrophic or osteoarthritis):
Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, rate as below:
With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations	20
With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups	10
Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion.
Note (2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive.

[C&P Exam Report Rating Question]

Any swag at what you think might be a rating that comes out of this?

[C&P Exam Report Rating Question]

1 hour ago, vetquest said:

You won the trifecta there.

Definitely hope so!

[C&P Exam Report Rating Question]

2 hours ago, broncovet said:

You aced the c and p exam.  For each condition the doc opined that it was "at least as likely as not" due to service...and with rationale.  

Thats as good as it gets.  

Thanks .... I was hoping that was the case .... fingers crossed that the VRO sees it that way.  I get confused about potential bilateral affect, when it comes to adding elements like the ulnar nerve mild paralysis etc.  I'm no sure of my calculation but if each condition got a base of 10% (7) combined with my 20% it would put me I think at 60% as a guess.

[Retroactive Pay Question]

Yes I had event(s) in service that were documented and resulted in the injuries ... was airborne and first jump landed on the side of a ditch which screwed me up in several ways but at that moment couldn't report it because would have been recycled and that isn't something you want to happen.

The C&P exam repeatedly indicated testing DBQ for Direct Service Connection to every condition that they ultimately indicated "medical nexus established" and that 50% likely that it was caused by in-service event, illness or injury.

[Retroactive Pay Question]

6 minutes ago, broncovet said:

Probably, but its more complicated than that.  

First, even "if" you were awarded SC back to 1991, you may not get the same disability percentage as you would now.  Reason:  Its likely your condition of your knees worsened since 1991.  You may meet a critieria for a lower disability percentage back to 1991 if your knees got worse in the past 28 years or so.  (likely).  

Next, you can rest assured the VA will fight you every step of the way for retro back to 1991.  However, you could likely win that, provided that you were willing to get an attorney and if VA decides to sc you but at a different effective date.  

Did this doc report you "left" the c and p exam, before he finished??  Did you read his report?  The VA "may" take that as abandoning your claim.  You would have to get your cfile and read what was reported..I have no idea.  

While there "may" be CUE, a difference of opinion between you and the c and p examiner is not CUE.  And, VA basing a denial on this c and p exam, is also unlikely CUE.  Remember Cue has to be "undebatable", and it sounds like "at least one" person would dispute that..your c and p examiner!!  

Its a virtual certainty that, to get retro back to 1991, you will need an attorney, or, perhaps a non attorney practioner like Alex Graham.  You see, GS9's, regardless of what they tell you are "not" authorized to "ok" a six figure check sent to you for 28 years of retro.  That's probably gonna require a judge at the BVA or above.  That is just the way it is.  

My suggestion is to wait until you get a decision , then decide if you want to fight va for your effecitve date.  I would.  Or I should say I AM, because I am at the cavc as we speak, fighting va for an earlier effective date, represented by attorney Chris Attig.  

Thanks so much for the reply and info.  When I left I never got the C&P report, exam  info or anything ... I have submitted document request to try and get my hands on all of the documentation, including the original C&P report from 1991.  Right now I'm trying to educate myself on everything that is out there and then I can make an informed decision on the path forward (and definitely would be getting attorney for this if I go that route).  My latest C&P from Jan '19 found 50% or greater possibility for service connection with medical nexus for both knees as well ad degenerative disk disease along with other issues so I'm hopeful for a positive rating on those conditions.  I posted summary in C&P forum of the C&P report.

Good luck with your fight and keep me posted as to how you make out!

[Retroactive Pay Question]

I have a question that I hope someone can clarify for me.

I got out of the service and was rated 20% for chronic lombar sacral strain but denied for related knee conditions in 1991.  Through the years I have gone to private and VA doctors with documented issues for chronic knee and back issues with knees, including 3 scope surgeries, 2 left knee and 1 right knee.  I tried to open a claim in 2009 and went to my C&P exam in downtown Boston and literally the moment I came into the exam room, the doctor sitting at the desk turned around with a scowl on his face, looked at me and said there's nothing wrong with you, get out.  I was so pissed, aggravated, frustrated and dumbfounded I left, disgusted and basically disconnected from the VA for a decade.  I actually considered myself fortunate because I had a good job as a chief technology officer, with great benefits and great insurance for me and my family.  Since then, I left the corporate world and started my own business and was encouraged to re-engage with the VA last year.  Once I did, I was told that I should resubmit my claims for conditions since the VA had undergone such dramatic changes and that my conditions were well documented, so I did and am currently waiting for a decision, including being rated for both knees. 

My question is this, is if I do finally get direct service connection for my knees, would I be on solid ground to seek retroactive status back to my 1991 original claims?  Perhaps form the perspective of Clear and Unmistakeable Error (CUE)?

Sorry for the lengthy post and thanks for any thoughts.

[C&P Exam Report Rating Question]

Hello Everyone,

I'm new to the forum and wanted to see if anyone could shed a little light or thoughts on what they think the rating would be from this C&P exam report.  I have been out since '91, current disability is 20% for Chronic Lumbosacral Strain and they originally denied some of these incorrectly.  I'm also a bit confused on conditions that are potentially Bilateral (Ankle, Knee and Shoulders ... potentially rediculapathy?)  Lastly there is also Ulnar nerve mild paralysis on right side along with meniscus issues in both knees.  Any thoughts would be greatly appreciated.

Condition 1:  Ankle Condition Left
TAB A B C D E, (veteran is claiming 2nd to knee but not SC for knee at this time and STRs have complaints of left ankle) also complaints of Achilles tendon. Veteran also has a parachute badge, please consider this as well.   

b. Indicate type of exam for which opinion has been requested: ankle 

TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ]

a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness.       
c. Rationale: The left ankle x-ray today does show degenerative bone in possible old injury areas of the ankle. The veteran was in the service, jumped and marched and no injury outside of the service, only rolling of the ankles from time to time. The initial trauma to this joint more than likely as not was while on AD from repetition with marching and jumping. Medical nexus is established. 

Condition 2:  Ankle Condition Right
TAB A B C D E, (veteran is claiming 2nd to knee but not SC for knee at this time) also complaints of achilles tendon. Veteran also has a parachute badge.  

b. Indicate type of exam for which opinion has been requested: ankle
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ]

a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness.
c. Rationale: The veteran's right ankle also has signs of previous repetitive trauma in the ankle joint via radiograph. The veteran did not have any other ankle injuries post-AD. He continues to have rolling and instability of both ankles after AD and since injuring the ankles while in service. More than likely as not, the veteran's initial trauma to the right ankle was in the    service from jumping and marching so much. The ankle is a weight bearing joint and excessive weight with repetition can cause long lasting effects and damage to the joint.

Condition 3:  Knee Condition Right
TAB A B C D E, there is also a direct complaint about R knee in STrs. 

b. Indicate type of exam for which opinion has been requested: knee    
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION]

a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. 
c. Rationale: The veteran's right and left knee were injured while in the service. There are noted injury of "MCL" strain of right knee in 1990.  Veteran did not have a very physical job outside of AD. Veteran did do jumps and marching while in the service which would affect the weight bearing joint on AD. Surgery done on the right knee for meniscal tear in 1997, more than likely than not began with initial injury in 1990. Medical nexus is established.

Condition 4:  Knee Condition Left
TAB A B C D E, there is also a direct complaint about R knee in STrs.  

b. Indicate type of exam for which opinion has been requested: knee    
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ].

a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness.       
c. Rationale: Left knee was injured prior to AD, as per veteran, while playing football. The veteran was not seen for this injury. Veteran had an asymptomatic knee on entrance exam into the service. While in the service, he states that he injured the knee- silent STR's for this. Veteran eventually did have surgery on the left knee in 1996. Unclear of the etiology of the knee surgery for a meniscal tear. May have been due to high school injury. Without records to bridge the gap from AD to 1996 and no record of left knee issues in the service, it's hard to connect the left knee to AD. But, more than likely, the veteran reinjured an already weak left knee while doing parachute jumps and marching while on AD. No injury to the left knee after AD. The veteran's PCP wrote a letter stating (3/10/2009) that the veteran's joint and back issues were related to service. The knees are a weight bearing joint, my point is that the veteran would worsen an old injury or easily create a new injury due to the wear and tear of the service. Medical nexus is established.

Condition 5:  Neck Condition
Additional remarks for the examiner: veteran was previously denied, claiming 2nd to back which veteran is SC for, but also has a parachute badge, please consider.

TAB A B C D E    
b. Indicate type of exam for which opinion has been requested: neck    
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] .

a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness.     
c. Rationale: The current neck diagnosis at C4-5 is suspected to be an old injury as per neurosurgeon’s note from 1/18/2019. The veteran did have an abnormal MRI of the cervical spine in 2009 as well. Veteran is having surgery in a few weeks due to the issues with his spine. Veteran has probable cause to have damage to his neck after doing 5 jumps and marching with a heavy pack on his back. There is no STR documentation of a neck issue, but this type of injury is due to wear and tear or a direct fall onto the neck such as    landing from a jump. Medical nexus is established as there was no other trauma to the neck other than the service.

Condition 6:  Shoulder Condition Bilateral
TAB A B C D E, veteran is also claiming degenerative disc disease cervical spine with radiation to right shoulder and arm which he was previously denied, but if there is a positive opinion due to the parachute badge, may need to assess with a PN DBQ as well.
    
b. Indicate type of exam for which opinion has been requested: shoulder    
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ]  
  
a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. 
c. Rationale: there is no medical documentation in the STR's for a shoulder condition, veteran jumped and rolled several times which can eventually cause an impingement type picture with the clavicle. The right side is his dominant side. No other right shoulder injuries since service, more than likely as not, the right shoulder issue is due to the jumping on AD

Condition 7:  Shoulder Condition Bilateral
TAB A B C D E, veteran is also claiming degenerative disc disease cervical spine with radiation to right shoulder and arm which he was previously denied, but if there is a positive opinion due to the parachute badge, may need to assess with a PN DBQ as well.

b. Indicate type of exam for which opinion has been requested: PN    
TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] 

a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. 
c. Rationale: The veteran's cervical radiculopathy more than likely as not is due to (secondary to) the degeneration of the cervical spine. The veteran is having surgery on the spine due to this discomfort. Medical nexus is established. Cervical stenosis is a narrowing of the spine due to arthritis causing tightness of the spinal cord and pinching which can cause pain into the upper extremities.