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WBrennan

Second Class Petty Officers
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Everything posted by WBrennan

  1. My knee is all kinds of jacked up. 5 knee surgeries so far. :S I feel I am now currently rated appropriately.
  2. Appeal closed on 4/10/2020. That is all VA.gov is showing; however, eBenefits is showing a higher rating. Woot woot!
  3. I just had my informal conference with the VA. The senior reviewer agrees that he thinks that my knee should be rated at 30% and not 20%. He said he'll make a decision either today or early next week. I will let everybody know what the final decision is. And I think that they're rating at 30% is accurate and a very acceptable
  4. I received the BBE today. They denied my right need ACL repair and osteoarthritis. I was appealling only the osteoarthritis. What is interesting is under the: Favorable Findings in this decision they seem to hint at claiming the osteoarthritis... I called the VA and the rep was hinting at appealing for only osteoarthritis or file new claim. See attached image of denial and favorable Findings. Thoughts?
  5. While following up on my other appear(day 126 supplemental) inquired about this appeal (HLR, Day 90) no updates. Will check back in like 30-45 days....
  6. Day 126; update. Medical Records have not been sent from MACH ER. My claim had a suspense date of 3/11/2020. I was told this is when it would go back to the rater to continue with their work. I will check back in 30 days and see where it is ...
  7. My state Representative was only able to get my STR that I already had. The good news is these are a better quality than the ones the VA sent me. I will be sending a FOIA request to the facility, even though they told me that they don't have those records. I am going to hit everyone with the FOIA. I have proof I was at the base ER (Patient's Copy) but I don't have the medical and treatment records. So now I will send out a bunch of FOIA requests.
  8. I spoke to the VA on Friday and the Martin Army Community Hospital did not send them any medical records. I reached out to my state representative. They said they can assist in trying to get the medical records. I filled out their form for privacy release. I also sent them a synopsis of who have contacted regarding the visit. Also set up a copy of my patients copy of the visit. Now I'm in the waiting game for this. The claim is still in the supplemental a claim right now. I will update everybody after I hear back from either the VA or my State Representative.
  9. I too received the same email (30% SC) and thought it was weird. I also received an email from them with the following (been out since 1995): We understand that you are in the process of separating from the military and have received a DOD disability rating. You may therefore be eligible to apply to the Vocational Rehabilitation & Employment (VR&E) VetSuccess Program
  10. As of today: Status: A senior reviewer is taking a new look at your case so I will watch some paint dry and wait out the next 90 day or so ....
  11. Appeal Status: We don't know your status.... So I called.... Looks like they are requesting my Medical Records from the Base ER.... Requested it from them on 12/11 with a return date by 1/10. Going to be interesting as the BA ER medical records dept already told me that they don't have those records.... Lol. Good times.
  12. And Higher Level Review requested. Now to wait about 125 days for an answer.... Anyone have any paint I can watch dry?
  13. Looks like they bumped me to 20% and moved me from (5010-5261 10%; 5260: 0%) to (5258: 20%). I think they still owe me 10% for 5261. Time for more research....
  14. Appeal received at the VA on 11/12/2019 and was told the goal is 125 days. So hopefully by mid-March I will hear something. VA.gov also says.... We don't know the status of your appeal. That makes me chuckle....
  15. Ok BBE envelope sent on 11/14 and I received it today. I still think they owe me 10% for the range of motion. They lumped everything under the frequent swelling, locking part. (5258). Before I was rated only at 10% total for the arthritis and meniscus tear only. I wasn't rated at 10% under 5261. Weird Below you will find their reasoning. You have filed a Notice of Disagreement with the evaluation of the left knee. You expressed concern over the ranges of motion listed on the exam report. You said that the examiner told you your extension was to 11 degrees but it was reported as being 0. You also reported that your surgery dates were omitted for your knee. You asked that we use the measurement the examiner told us and we consider your surgical history. Please understand that we are aware of your multiple surgeries and your medical history has been considered. Also, your range of motion on the second exam was reported as being 10-80 degrees. Measurements are put into the system rounded to the nearest degree. A reading of 11 does not change the evaluation. A review of your August 2018 exam shows that your range of motion was reported as 0-60/0140 (normal range is completely straight knee joint to fully bent knee joint.) There was pain on motion. There was no instability. The exam results supported the separate evaluations (0% and 10%) for your knee. During your June 2019 exam said that you have had a total of 4 arthroscopies on the knee, most recently in 2017. You complained of fairly constant pain in the left knee described as aching. You take Naproxen 3-4 days per week which helps some. You also reported stiffness in the knee on first arising and after prolonged sitting. You wear a brace if you anticipate much walking. You reported You were diagnosed with left knee OA and possible meniscal tear. You said that you have pain flares unpredictably 3-4 times per week. Flares last 1-3 days. You typically take Naproxen for flares. You note decreased range of motion during flares. You must avoid running and stairs and you are limited in walking. There was tenderness of the medial joint line. There was crepitus. The examiner noted that your severity of the meniscus condition was: Meniscal tear, Frequent episodes of joint "locking," Frequent episodes of joint pain, and Frequent episodes of joint effusion. You have persistent pain, limitation of range of motion. Radiology report shows tricompartmental OA with bone spurring. There is evidence of pain when the left knee is used in non-weight bearing. Your range range of motion was reported as 10-80 with pain. Strength was normal. There was no instability or ankylosis. Neither your private treatment nor outpatient VA records provide information we need to evaluate your condition. We have discontinued the two separate conditions for your left knee (10 percent under diagnostic code 5010-5261 (limitation of extension) and 0 percent under diagnostic code 5260 (limitation of flexion)) in order to combine your symptomatology under one diagnostic code which results in a higher evaluation for you. We will now evaluate your condition under the rating criteria for semilunar cartilage, diagnostic code 5258.) Service connection for meniscectomy residuals, left knee mensical and ligament tear with osteoarthritis and limited motion and pain (previously rated under DC 5010-5261 and 5010-5260) has been established as directly related to military service. (38 CFR 3.303, 38 CFR 3.304) An evaluation of 20 percent is assigned from May 14, 2018, the date we received your Intent to File form as you formalized the claim within one year of submitting it and as preserved by the appeal process. (38 CFR 3.155 and 38 CFR 3.400) We have assigned this evaluation for the entire appeal period and resolving any doubt in your favor. We have assigned a 20 percent evaluation for your meniscectomy residuals, left knee mensical and ligament tear with osteoarthritis and limited motion and pain (previously rated under DC 5010-5261 and 5010-5260) based on. • Dislocated semilunar cartilage with frequent episodes of "locking," pain, and effusion into the joint Additional symptom(s) include: • X-ray evidence of degenerative arthritis • Limitation of extension of 10 to 14 degrees The provisions of 38 CFR *4.40 and *4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and are not warranted. This is the highest schedular evaluation allowed under the law for degenerative arthritis. (38 CFR 4.71a) Additionally, this is the highest schedular evaluation allowed under the law for dislocated semilunar cartilage of the knee. (38 CFR 4.7 la) Additionally, a higher evaluation of 30 percent is not warranted for limitation of extension of the knee unless the evidence shows: • Limitation of extension of 20 to 29 degrees. (38 CFR 4.71a)(DC 5261) (An evaluation of 0 is for extension limited to 5 degrees; an evaluation of 10 percent is assigned for extension limited to 10 degrees; and evaluation of 20 degrees is assigned for extension limited to 15 degrees.) Additionally, a higher evaluation of 30 percent is not warranted for limitation of flexion of the knee unless the evidence shows: .Limitation of flexion limited to 15 degrees. (38 CFR 4.71a)(DC 5260)
  16. I got service connected then enrolled in the VA Healthcare. I am using both my VA PCP and my other PCP for Co-treatments. If I can't get into my normal PCP, I can usually get a same day appointment at my VA PCP (Small clinic, rural area).
  17. Looks like they bumped me only 10%. Waiting on the BBE to do another appeal. The bump moves me from 20% to 30%
  18. VA said SOC Was sent out on 10/29/2019. I still haven't received it so I called them yesterday. Was told it is waiting on the narrative and rating decision. I think this might be good news... I was told if I don't have it by the 15th to call back. Fingers and toes crossed....
  19. The knee denial is: The LHI medical opinion found no link between your diagnosed medical condition and military service. The examiner state that you had no issues related to the claimed right knee prior to military service, current claims file lacks objective evidence for diagnosis or treatment for a right knee condition until post 1997 service, without abnormal gait, trauma or precipitating the right knee condition. There is no evidence to suggest your right knee condition was incurred in or caused by the left knee during service no during service. The evidence does not show that your disease developed to a compensable degree with the specified time period after release from service to qualify for the presumption of service connection. Therefore, service connection for right knee condition is denied since this condition neither occurred in nor was caused by service. So now they will receive the evidence that I was treated in service. Fingers and Toes crossed.
  20. I am not trying to service connect the Right knee as secondary to the left knee. My original claim was for bilateral knee issues. They denied the right knee due to no in-service treatment and not secondary to the left knee. I do apologise if that was not clear. I did seek treatment while in service for my right knee, but that medical record is missing from my C-file. I found the ER sheet showing where I went for treatment for both knees. I will be filing a supplemental claim today.
  21. Correct me if wrong. No matter what route I take, I will have to appeal the Effective date? Knowing this going into it helps. I think I will go through #1 to get everything started. Thoughts?
  22. I filed in May 2018 for both my knees. In my C-File I had 2 visits for left knee strain so my left knee was service connected. They denied my right knee in 9/2018. I requested my C-File and the ER visit was not in there. I requested my Med Recs for the time frame (a 2month period in 1992) and they came back saying nothing found. Today while going through a box in my garage (11/3/19) I found the ER coversheet from my visit. The chief complaint was pain in both knees. How do I appeal this? If approved, what do I do to keep the original file date since my appeal deadline was 9/2019? Thanks in advance!
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