kaykay

I have had MS for more than 30 years and would be happy to chat with you.

I will definitely get copies of the exams as quickly as possible. I am very fortunate to have such a great NSO.

Berta - I previously posted that my VSO went to bat for me before my last denial was promulgated (I was denied twice before this). He was apparently successful because the RO has now requested C&P exams for all of the conditions I have claimed as residuals or secondary to MS. So it looks like service connection for MS is in the bag. As a matter of fact, I am getting 7 exams done this Thursday. Once those are done I will be scheduled for an MH exam. My VSO who is very cautious about not setting vets up for a big let down had me submit claims for SAH and adapted automobile grants last week because he is pretty confident that I will qualify for these benefits. Thanks so much for the advice that you and others here have given me. I certainly attribute a great deal of my anticipated succes to this forum.

Congratulations on your rating, Tami! I also have MS which I anticipate a rating for within the next few months. When I filed my claim, I included a lot of my residuals and secondary conditions. It has been a 2-1/2 year battle getting the MS service connected, but I'm quite confident now since the RO has finally scheduled C&Ps for the residuals and secondaries. My MS is secondary progressive and I am totally disabled. I am certainly no expert on VA claims, but I would suggest that you file for all of your residual conditions as well as filing for IU. It may be possible that your residuals will get you to the 100% mark which would make IU a moot point, but if not, you will already have your IU claim in. Remember that things like depression, cognitive dysfunction, muscle weakness, spasticity and overwhelming fatigue are a few of the very common issues with MS. I wish you the best in getting an increased rating.

I am not sure, but I would guess any treatment just provides symptom relief. I don't have CFS, but have debilitating fatigue from MS. You might get an answer faster if you start a new topic with your question.

Thanks Pete, So I suppose you're saying that fatigue is rated under CFS. It looks like I fall in the 100% category as it is one of my conditions that is being treated by a doc, and I do spend most of most days in bed.

I suffer from well documented chronic fatigue due to my medical conditions. I have not been diagnosed with Chronic Fatigue Syndrome. So I'm wondering if fatigue would be rated under CFS? I have noticed a number of people have been rated for fatigue and am hoping someone will have the answer. Thanks.

In that respect I was pretty fortunate. The examiner started a little stand-offish, but really 1-1/2 hours later, she was rubbing my back and telling me to hang in there. I brought along some documents, including my specialist's opinion letter, and she was more than happy to take what she felt would help her with the report. Not only was my daughter welcomed into the exam room, but my 7 month old granddaughter was, too, and the doctor really enjoyed her. I suppose it's a real crap shoot on what to expect from these C&P doctors.

Yeah, I found that out when I didn't receive a response from the Doc. Oh well! Maybe it is a moot point now that C&Ps are being scheduled for the secondary conditions.

UPDATE: I called the 800# today and found out that the new C&P exam request is for opinions on 4 of my secondary conditions, and that no opinion has been requested for MS itself. I am very hopeful that this means MS is being granted since it would otherwise be fruitless to order the exams for the secondaries. Could I be right in my assessment?

I don't quite understand. I do have some cognitive deficits so it may be that my brain is just not working right now. If you would, please break this down a bit for me. Thanks.

Today I found out from the 800# that a new exam is being requested. I wasn't able to get any info on what type of exam. I'm wondering if the VA would request yet another opinion on service connection after recent events, or if it may be an exam for secondary conditions.

Berta, thank you so much for responding. You always have incredible insight to lend to members of this forum.

Has anyone tried contacting the C&P examiner to clarify the exam report? The reason I ask is the examiner stated to me at the time of the exam that she had no doubt as to onset of my condition during service, and specifically said that she was going to write her report in such a way as to ensure that I get what I need. Yet the report had the dreaded "mere speculation" statement. However, in the report she seemed to suggest the the RO should defer to the opinion of my VA doc who is a specialist (the examining doc is a GP or internist). Well, the VARO used the C&P exam to deny service connection. The claim has not yet been promulgated because my VSO has been successful in getting the decision reviewed before promulgation and at this time the review has not yet been completed. So I am wondering if speaking with the doc who did the exam could possibly help.

Before having the C&P, I already submitted a likely as not opinion from my neurologist.

You've got to be kidding! Your Dr.'s opinion was thrown out because it didn't agree with the C&P examiner's opinion? And they say that the claims process is non-adversarial. I wonder if the fact that my Dr. is a VA specialist will hold more weight.

If any of the experts would be so kind as to comment on this, I would really appreciate hearing what impact this exam could have on my claim. Does it seem that this examiner who is a GP is simply deferring to the opinion supplied by my neurologist? How much of an impact might this exam have on my claim for service connection? Despite the C&P examiner telling me there was no doubt as to onset in service, here is how her opinion is worded: PERTINENT EVIDENCE: Note from Dr. _____, specialist, stating it is his opinion that the initial headaches in services were the onsetting symptoms of MS. He said that patient was recommended for discharge due to the headaches, and that the current literature clearly support that headaches are a clinical feature and can be the onsetting symptom of multiple sclerosis. "I cannot resolve this issue without resort to mere speculation if it is continuation of headaches in service RATIONALE FOR OPINION GIVEN: This is a very difficult case, being Multiple Sclerosis is a reslapsing/remitting disease with a variable and impredictable course which behaves differently in different patients. In Ms. ______ case, based on the evidence, I would say it could be that the severe headaches that motivated the discharge of this veteran were the onset symptom of the MS. She continued having symptoms of MS on/off, over years, and finally in 2006 diagnosis was made, and this could be the case of a patient with MS. According to the expert opinion of the specialist, and the evidence of the literature (see below), headache alone, although unusual, can be the primary manifestation of MS, even in the preclinical patient. Unfortunately, we do not have medical information on this patient for a long period of time, which could be due to the same nature o fthe disease, remitting/relapsing, but leave to speculation any objective opinion. OTHER COMMENT: Neurol Sci (2009) (remainder of citation omitted): Headache and multiple sclerosis. Clinical and therapeutic correlations. "....Headaches has been also described as "unusal primary manifestation...in 20 out of 30 preclinical MS patients ..."

Sorry for the extra post. I don't know what happened, but I was still working on my message. Effect on Daily Activities Chores: Prevents Shopping: Severe Exercise: Prevents Sports: Prevents Recreation: Severe Traveling: Severe Feeding: Moderate Bathing: Moderate Dressing: Moderate Toileting: Moderate Grooming: Moderate Additional comments: Daughter helps with majority of ADL Any ideas on how this would be rated? I'm pretty sure it should be SMC, but at what level?

Physical Exam -Functional Motor Impairment - lower legs, from hip down, all muscle groups 3/5, except flexor in both feet 0/5 (drop foot bilaterally); upper extremeties muscle 4/5; face & neck 5/5 -Abnormal Gait -Abnormal Balance - can not walk without cane, walker (uses scooter outside of house) -Ataxia, incoordination or spasticity - yes, cannot walk without cane -Bowel Impairment - yes -Bladder Impairment - yes -Other significant findings - patient does not have limitations of ROM of major joints, but has severe pain with movements Effect on Usual Daily Activities - yes

Thanks guys! I will definitely work on getting a copy of the report. I had the exam at a VA OPC a couple of hours away. Do you know if I can get a copy of it from my local VAMC? I'd hate to have to get someone to drive me that far again, especially since I may have to go for more exams for the secondary conditions if the RO makes a grant.

I had my C&P exam yesterday and I'm left feeling very hopeful. My exam lasted about 1-1/2 hours. The doctor said she had no doubt that the onset of my MS occurred in service. She told me that she would get her report to the RO the same day so I could get what I need. I am very pleased with the outcome. Now to see what the RO does. Thanks so much for all of the advice.

Quite honestly folks, I am majorly confused now. I have quite a bit of cognitive dysfunction so it may take me a minute to process all of your very helpful responses. I will try to find out from my VSO or the VA whether my claim was reopened or is in the appeals process. Please know that I am overwhelmed with the outpouring of support I am receiving here. Thanks.

Thanks Bob. My best wishes to you, too, on your claim. I'll be keeping an eye out for your update.

We are working on this as a direct service connection because my SMRs have a record of my most prevalent initial symptom. As a matter of fact, I was discharged for it. My neuro's IMO specifically addresses this presenting symptom, and he also provided several pieces of medical literature to support it his opinion.

Carlie, After the Jan '09 denial, the VSO suggested that I get an updated IMO from my VA neurologist so we could send it in with a request to reopen. He said it would take less time, which it did. That was when I was denied again in Jun '09. I had my concerns about how he was assisting with my claim so I asked to be switched to have his supervisor as my VSO. So after then Jun 09 denial, I was feeling too defeated to continue so it wasn't until Nov 09 that I had it reopened. The new VSO worked with me to pull together exactly what the VA said was missing. My doctor then wrote a much stronger IMO and the claim was reopened again. I know it is better to file an NOD, but I was hoping not to have to wait more than a year to get my claim worked on.