Deesulpwr

Sorry about the medical jargon, I was an EMT and have researched my symptoms and injury so much that I can talk in Dr. lingo right along with the Dr. about my case (plus my wife in a nurse and she helps me out). I have had, since 1991, bone scans/x-rays/MRI's/thermograms several times. Hoppy and Rentalguy1 seem to understand this hip thing really well. Another problem with my case is I have a VA diagnostic code that really doesn't apply to my hip problems (coded for impairment of a bone when in fact I have muscle and nerve problems). Good luck with it.

I had a long visit today with my (new)NSO@ DAV. He agreed with rental and hoppy that my claim from "denied again" thread was way too vague. He said to make sure when you file you describe each and every condition you are claiming as clearly and as plainly as you can. For example, mine said left leg condition secondary to left hip capsulitis when it should have read, left knee menisectomy/left peroneal nerve neuropathy/muscle atrophy of the left quadriceps, hamstring, calf and foot as a result of an altered gait from service connected left hip capsulitis. If you give them the way out they will jump right on it. Good luck.

Rental you asked me in an earlier post "I am just guessing here, but was your injury a broken leg, or something similiar to a lesser degree?" and I missed it. I was running in formation, my foot got caught in a pothole, when I fell forward my left leg stayed straight the rest of me twisted and then I had 3 or 4 guys tripping/falling over me and I had a pop in my left leg. You have said in earlier posts about going for SC for IVDS. I was not treated in service for back pain. I was treated by the VA for back pain about 6 - 7 mos after discharge in Jan 94. Won't I have a hard time with getting it SC'd?

OK Hoppy and Rental you guys are in the know help me with this stuff also. I appreciate all the feedback everyone has given me on this. So I just pulled out and read my copy of the C&P for my appeal, the very last line that the Dr. wrote is not on the SSOC. The very last statement that he wrote was "However, in my opinion, the left leg problem is more likely related to the problem with the injury on 1991." Everything else looks like it was copied and pasted to the SSOC. Also, if I have copies of VA med records from one Dr. stating that "he could develop back, left and right leg symptoms from a chronically altered gait" and another Dr. stating "I think it is reasonable that his chronic left hip pain may be causing pain in his right hip due to change in gait." Do you guys think this may help my cause or am I still beatin' a dead horse. I'm a stubborn a#@ and I don't want to be a pain in yours HAHAHAHA.

I was diagnosed prior to discharge as Capsulitis of left hip, my DD214 says VA codes 5003 and 5299 if that helps

Sorry for another long post but I keep coming up with more questions. So here is the million dollar question. Rental made a great point about the joint condition, if the diagnosis is for a joint condition which I received before discharge is wrong, how do I get it changed without losing the time invested since 2002 in this appeal? I have been treated for hip capsulitis (rating code 5255, impairment of the femur with slight knee or hip disability 10%) since my original injury in service in 1991, I have walked with a limp since injury and my last C&P from 2007 states "The problems in the hip and on the left side and right side all seem to be muscle and nerve in nature rather than involving the bones." So I am not sure what to do. This part bothers me a little, should it surprise me though? My wife and I both were reading the explanation section from the denial for each issue and noticed that in the section for the right leg they reference the VA examination of the left leg secondary to left hip disability AND in the left leg section they reference the VA examination of the right leg secondary to left hip disability. Here is the exact way it was written, the word in red is a completely different part of the body. The perineal nerve that the VA is referring to is in the prostate area while I am claiming the peroneal nerve which is in the calf and this is directly taken from the VA SSOC "Service connection for right leg disability is denied, as the evidence does not show that this condition either occurred in service, was caused by service, aggravated by service, or is otherwise related to service. Service connection for a right leg disability is also denied; as the evidence does not show that this condition is related to a service connected disability. Your most recent VA examination appears to note that the left perineal nerve neuropathy is thought to be secondary to lumbosacral spine disease, and not consistent with your diagnosis of left hip disability." I have treatment notes from service where I was treated for pain/strain in the right leg due to compensation for left hip and they say that I have none. How do I counter that when I have sent in a copy?

I see what you are saying rental and agree. Believe it or not I have questioned the VA about my rating code 5255, I have repeatedly complained that there is nothing wrong with the femur. That the majority of my problems are muscle and nerve related. The only response I get is "that's the closest rating to your symptoms". A friend of a family member says don't let it go and he agrees that the rom's played a huge part into the denial. He suggests IMO's and additional lay statements may help when it gets back to the board. I guess what I was hoping for was that they would rate for the left peroneal nerve being completely gone, residuals of left knee menisectomy (that I paid for), the abscence of the EDB muscle on my left foot and the numbness in both legs

I appreciate you being straight up rental, I really believe that this is all connected though. My hip is 10% SC'd since discharge in '93. The part that confuses me is that they didn't refer to any of the SMR copies, VA treatment notes, lay statements or cover all of the symptoms that I am claiming. Walking with a limp (altered gait) due to the pain in my hip for almost 17 years now has done damage to both of my legs and my back. Plus I have SMR’s where I was treated for pain in my right leg and knee that was “a result of altered gait compensating for left hip pain”. It is as clear as mud, right hahaha. That is the one reason I am hesitant to let this appeal go, this claimed was originally filed in 2002. I did file for my back in 2004 (denied) and not sure what happened or why but I didn’t appeal, stupidity I guess. it was the opinion of the examiner that your hip and leg disabilities seem to date to your injury in 1991, and subsequently. According to the examiner, it was as likely as not that your left leg disability is the result of the injury in 1991 Can anyone explain why these statements mean denial? It covers what I am claiming as left leg secondary to the left hip capsulitis doesn’t it?

Hey Quint I know how you feel, 6'3" and 280 medically discharged USMC and medically retired firefighter here. These docs assume we don't have the problems because of our size and stature, I have heard this myself about 1,000 times. Good luck

Sorry for the length but this is from the AMC received on a Friday (way to ruin a weekend). They do not mention the muscle atrophy or the bilateral leg numbness from the original claim in this decision. I have 60 days before this goes to BVA again. HELP!!!!!! What do I do now? I am trying to connect the left and the right legs secondary to my left hip due to altered gait, now it looks like they are trying to make this a result of my back, I was going to go after the back secondary to the hip due to altered gait after this one is done. I have walked with a limp since my injury in service in 1991. I do have pain constantly and was medically retired from the fire service in 2003 because of this injury. Decision: Entitlement to service connection for right leg disability, to include as secondary to service connected left hip capsulitis, is denied. Entitlement to service connection for left leg disability, to include as secondary to service connected left hip capsulitis, is denied. [*]Entitlement to an increased evaluation for left hip capsulitis, currently evaluated as 10 percent disabling, is denied. Reasons and Bases: In accordance with the BVA remand instructions, we scheduled you for a comprehensive VA medical examination to determine the etiology of your claimed disabilities and to determine the current severity of your service connected left hip capsulitis. Examination findings show that hips were normal in appearance. You complained of some tenderness to palpitation in the left hip and the left sciatic notch areas. You do not have this on the right side. You were able to flex the hips on the torso to 115 degrees bilaterally. You complained of discomfort as you do this. You have more pain on the left side seemingly than the right. You were able to extend the back about 20 degrees, complaining of pain. Pain was more on the right side than on the left side. You can abduct either leg to 45 degrees. You complained of pain the final 10 degrees of the abduction and stops at that point because of the pain. You can adduct 30 degrees, again complaining of pain through the final about 15 degrees of adduction and stopping at that point because of the pain. Internal and external rotation was equally painful. You can externally rotate 60 degrees and internally rotate about 40 degrees, again complaining of pain bilaterally, equally and symmetrically. Motor and sensory examination revealed that you have a 1+ left knee jerk. You have an equivocal knee jerk on the right. You have equivocal ankle jerks bilaterally. On motor examination, you have decreased strength in the left leg when compared to the right leg. Your strength on the left at the knee, the hip and the ankle are approximately 3/5 when compared to that on the right. The extensor hallucis longus power was also rated as being decreased. The sensory examination was essentially normal , equal, and symmetrical except for a band laterally down the lateral aspect of the left lower extremity, from the knee down to the top of the left foot, where you complained of decreased perception of light touch. You have normal perception of light touch across the plantar surface of the foot. You complained of pain with any movement of either hip. Imaging studies showed degenerative changes in the spine. The magnetic resonance imaging scan of the hip and pelvis have shown no evidence of any bony disease in the hip. There was no evidence of malunion of the hip. The problems in the hip and on the left side and right side all seem to be muscle and nerve in nature rather than involving the bones. The magnetic resonance imaging scan has shown changes which initially were interpreted as being the result of avulsion injuries to the muscles, but now are thought to be more consistent with chronic inflammation of the hamstring muscles. An electromyelogram and peripheral nerve conduction study done several years ago indicated the absence of a response in the left perineal nerve, which is thought to be secondary to lumbrosacral spine disease, and not consistent with his diagnosis of left hip disability. The examiner's diagnoses were causalgia of the left and right hips, with residuals, also called capsulitis of the left hip and left perineal neuropathy, with residuals. There was no evidence of malunion of the hip. According to the examiner, your disability appears to involve just the muscles and the nerves, not really the joint. Based on a review of your claims file and examination findings, it was the opinion of the examiner that your hip and leg disabilities seem to date to your injury in 1991, and subsequently. According to the examiner, it was as likely as not that your left leg disability is the result of the injury in 1991. the examiner further noted that he could not state whether the right leg problems have been aggravated by the left leg problem without resorting to speculation.

Man tell me about it. If I knew that it would not hurt my case I would "fire" them as my rep and go at it alone. The receptionist gave me the name of my new SO when I called monday, I referenced it on the SO phone list at DAV.org and I now have a NSO Trainee. And the hits just keep on coming. This dude has yet to return my call (from Monday 1/14) and 1/10 of an inch of ice and slush in NC shuts down offices.

Does anyone know how to contact the the DAV rep at the AMC? If the DAV is my POA I should be able to talk to them and discuss the results that they are looking at on my file, correct? I want to know that they are acting in my best interest. I have asked this question to my SO a month ago and he said I would know something before they would but that didn't sit well with me. Yesterday I find out that my SO has changed again (5th time) and he has yet to return my call, so I turn to the information hounds on Hadit for advice. How would you handle this situation? Thanks Dean

I smoked for 15 yrs, used Chantix (not VA prescribed) I only took it for one month, had one smoke on the 8th day and put them down. Jan 23 will be one year smoke free. Guys, if you aren't ready to quit and have your mind set to quit you will fail, plain and simple. I tried three times before I was really ready and took control. You can do it, while taking Chantix if you need a smoke after your quit day try only half, then reduce it from there, tailor it to fit you. Have heard that works for some. If you REALLY want to quit you will. Good luck

Thanks Paul, Betty, Berta and all the other people on these boards for their advice too. James has helped me a few times. I'm not complaining too much (YET) HAHAHA. My claim has a decision in under one year. My understanding from the DAV is that they have an attorney at the AMC that reviews the decisions they have POA for. My local SO told me that I would know something before he did (I have never met this guy, my SO has changed four times since I started this journey in 2002). My main concern with what James said was that my POA may want to take a look at it. Leads me to believe that it is not in my favor. Thanks again, Dean

Ok so I talk to James at AMC today and he says that a decision hass been made on my claim and it has been sent to post and determination (not assigned yet though). He then says that my POA (the DAV) will probably want to review it but that was all I could get from him. So a couple of hours later I called back and talked to Gwen. She then tells me that this process will take "A WHILE". I asked her what her definition of "a while" was and I couldn't tell if she said month or months. Anyone got ideas on how long this could take and what POA may want to look over this could mean? I have a bad feeling about that last part.