lt4ds

Thanks pete for the advice. On the last claim, in the narrative, the DVA rep noted my intention to file TDIU, not an offical notification using the forms, but on form 21-4138. I have not idea if that will matter, so I am filing the required form next week when I visit with the DVA rep.

Thanks for the advice Berta, I have an appointment scheduled with the local DAV office to fill out and return some required information for 1 of the deferred claims, I got a letter seeking additional information the day after I received the award notification letter. I am planning on sending in the form to request TDIU as well. I have some claims that were deferred in 2008 that I waited until Dec 2010 for the VA to do something, and finally requested an appeal on them. I am just concerned they will never get around to taking action on the claims, even though they have addressed the particular problems in subsequent C & P exams for other issues, but still no action. I wish there was some way to prod them in the right dorection at times, but afraid that will cause them to take longer. SSDI and the VA both agree I am disabled for the same problems but both seem to be just wasting time making me run around in circles over and over.

I am currently rated 70% overall, 40% for traumatic arthritis lumbar spine secondary to surgery for lumbar disc disease 20% paralysis, incomplete, moderate, right sciatic nerve 10% tinnitis left easr 10% right knee DJD/patellafemoral pain syndrome 10% left knee DJD/patellafemoral pain syndrome 10% Irritable bowel syndrome 10% migraines claims currently under appeal Right hip (related to the cause of traumatic arthritis in lumbar spine) I think a high chance this will be rated 20% left shoulder I think a high chance this will be rated 10% right foot deferred claims scars aches/pains neuropathy upper and lower extremities bilateral diabetes skin disorder/acne I am unable to work as a result of my disabilities, am currently working through the SSDI circus (step 3 of the process), haven't worked since march 2010. Should I apply for TDIU? Is there a chance it will slow down more the existing appeal that the VA seems to have stuck in a drawer somewhere? Will it be decided cuncurrent with the existing appeal, or how will that work? What are the odds that I am approved for TDIU? Just wondering what y'all think. Thanks.

Well, I recieved a decision, or at least a partial decision on this claim. I did recieve 2 ratings, 1 expected just lower than expected, and 1 that was not expected. Still quite a few that were either denied or deferred. Also several things that are part of an appeal that were covered in the C & P. The VA can be so frustrating. They rated me as follows: 10% Irritable Bowel Syndrome as a presumptive illness from service in Southwest Asia. I thought with my symptoms it would rate as 30% but am happy with this, it can be appealed later. Symptoms as stated by the rating officer: Soft to loose stool with every episode of of food intake. eating reliably followed by fecal urgency with abdominal cramps. I am not sure I understand the difference, the explaniation of the rating decisions follows. States an evaluation of 10 % is granted if the record shows frequent episodes of bowel disturbance with abdominal distress. A higher evaluation of 30 % is not warranted unless there are symptoms of diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress. 10 % Miagraines (claimed as headaches) This was a surprise. Went through the "Gulf War Syndrome" exam, of which headaches are part of, and I do have headaches. I also was diaginosed with migraines during my service time. not unhappy about this at all. Deferred on the following: increase for scar, left nose aches/pains (associated with Gulf War Service) Neuropathy bilateral upper and lower extremities Skin disorder/acne diabetes several others that were denied. I guess I am going to have to let the deferred claims work themselves out, but from my experience I will have to file an NOD and then an appeal. I have a pending appeal for several items that were covered during the C & P, that have set for over a year and have not moved from the local office of jurisdiction. I am sure it's because I had another claim in process, hopefully they will begin working on the appeal since everything in the appeal was addressed in the original claim filed in 2008, and were identifed in the last C & P exam. Right hip, included in original C & P and denied, NOD'd, and then appealed Hip Active Range on Motion for each type of motion of this joint : Flexion: to 80 degrees extension: to 0 degrees adductions: to 25 degrees abduction: to 45 degrees internal rotation: to 40 degrees external rotation: to 60 degrees Note: pain is caused with active excursion and is due to back condition and not due to intrinsic hip joint disease: passive excursion is tolerated with normal flexion to 90 degrees. Is there objective evidence of pain on active motion: yes Is there pain on motion after at least 3 repetitions of ROM: unable to test Additional limitations: no reason unable to test: baseline pain with active excursion and baseline impairment makes testing an undue burden Right foot part of original C & P denied, NOD'd, appealed Foot exam right/left Abnormal findings: weakness, circulatory disturbance dscription of abnormal findings: unable to abduct, normally plantat flex toes at MTP joints very cool to touch absent ankle jerk knee jerk hyperactive Sensory exam: sciatic nerve right/left lower vibration: absent pain/pinprick: decreased location: entire limb, more severe anterior thigh, medial calf, and foot light touch: decreased dysesthesias: yes burning pain anterior thigh description of other motorimpairment: unable to abduct, plantar flex toes either foot, marked weakness of right EHL; increased tone in both calves; mild atrophy distal quadriceps effectson usual occupation and resulting work problems: leg symptoms due to SC degenerative disc disease limit walking, standing, sitting and similar activities of the lower extremities. hypertonicity of bilateral plantar flexor muscle groups with overuse related to pain; etiology is likely as not disuse due to severity o SC back and sciatic nerve conditions. Left Shoulder part of original C & P, denied, NOD'd, appealed Left shoulder ROM forward flexion: 90 degrees abduction: to 90 degrees internal and external rotation: to 50 degrees extention: to 30 degrees objective evidence of pain on active motion: yes pain on active motion after at least 3 repetitions of ROM: yes

ok, I wasn't sure. It's hard to figure what they will do with limited experience dealing with them. I would assume the C & P notes will make a decent place to start for filing a claim for those things moving forward, although I am sure there will be some type of contention and a follow up C & P, even though they are noted in the notes. Thanks for the input John.

What about things (not currently rated) in the C & P exam that are stated as resulting from SC issues? Hip Active Range on Motion for each type of motion of this joint : Flexion: to 80 degrees extension: to 0 degrees adductions: to 25 degrees abduction: to 45 degrees internal rotation: to 40 degrees external rotation: to 60 degrees Note: pain is caused with active excursion and is due to back condition and not due to intrinsic hip joint disease: passive excursion is tolerated with normal flexion to 90 degrees. Is there objective evidence of pain on active motion: yes Is there pain on motion after at least 3 repetitions of ROM: unable to test Additional limitations: no reason unable to test: baseline pain with active excursion and baseline impairment makes testing an undue burden Thoraco-lumbar spine ROM active motion: Flexion: 0 to 20 degrees extension: 0 to 0 degrees left lateral flexion: 0 to 10 degrees left lateral rotation: 0 to 10 degrees right lateral flexion: 0 to 10 degrees right lateral rotation: 0 to 10 degrees Objective evidence of pain: yes additional limitations after 3 reps: unable to test reason unable to test: baseline pain and impairment Foot exam right/left Abnormal findings: weakness, circulatory disturbance dscription of abnormal findings: unable to abduct, normally plantat flex toes at MTP joints very cool to touch absent ankle jerk knee jerk hyperactive Sensory exam: sciatic nerve right/left lower vibration: absent pain/pinprick: decreased location: entire limb, more severe anterior thigh, medial calf, and foot light touch: decreased dysesthesias: yes burning pain anterior thigh description of other motorimpairment: unable to abduct, plantar flex toes either foot, marked weakness of right EHL; increased tone in both calves; mild atrophy distal quadriceps effectson usual occupation and resulting work problems: leg symptoms due to SC degenerative disc disease limit walking, standing, sitting and similar activities of the lower extremities. hypertonicity of bilateral plantar flexor muscle groups with overuse related to pain; etiology is likely as not disuse due to severity o SC back and sciatic nerve conditions.

Thanks for the info, it confirms what I thought, my ROM measurement fall outside the normal range. I was just unsure about the secondary rating, but I should hear something within the next 4 weeks or so, I recieved the "Still working on your claim" letter last week, so I am expecting some answer soon. By the way, I have an uncle named Cooter, funny, that's his real name.

Thanks for the advice, I am pretty sure I should hear something in regards to the current claim within the next 4 weeks, so I should be able to make a decision concerning further action. As far as TDIU I have not filed, but have thought seriously about it in the last few months. I am currently semi-retired. I had to have a break from work because of increasing problems with my lumbar spine. I actually started the form yesterday to begin the process, although I have some concerns about the amount of medical evidence. I have always been reluctant to seek medical advice for aliments, raised with the "rub some dirt" attitude, and it has carried over from childhood. I usually only visit a doctor when it's a cut it off or cut it out situation, which I know in this case doesn't help. I guess it will be a learning opportunity on TDIU as well.

I don't have anything in my service medical records that I can recall that involved a head or neck injury other than migraine headaches. I did have several incidents involving my left shoulder, which I have an ongoing claim for. I eventually had surgery after service. As you said, I thought I would have to have a medical statement connecting the cervical spine to the lumbar, but wasn't sure after the C & P and the examiner's question, and the resulting appointments specifically for the cervical spine. Since Mid July, I have had an appointment with my normal VA doctor for my cervical spine, an MRI, an appointment with Neurosurgery, and today I have a EMG/NCV scheduled. Just amazed at how quickly the appointments have been scheduled, and how short a time period between each 1 has been. If there was no possiblity of the cervical spine being rated as secondary to the lumbar spine, would the VA run all these tests? It seems to me that the VA is trying to establish the extent of problems as a function of rating the cervical spine, where if it was not related (secondary), they wouldn't invest the time and money into establishing the extent of disablility.

The first C & P specifically cited "no noted abnormalities of cervical or Thoracic spine". The 2nd C & P was as follows: Diagnosis: Traumatic arthritis lumbar spine secondary to surgery for lumbar disc disease Paralysis, incomplete, moderate, right sciatic nerve, as likely as not secondary to service connected lumbar spine condition. impacts: decreased mobility, problems with lifting and carrying, pain prevents: exercise, sports, recreation severe: chores moderate: shopping, traveling, bathing, dressing, mild: toileting, grooming none: feeding The 3rd C & P has resulted in a diagnosis of HNP c5-c6 broad left posterolateral disk/spur complex effacing the left ventrolateral CSF space along the left c6 root exit zone and causing severe left c6 foraminal impingement, lesser posterior and right posterolaterl disk/spur complexes causing mild narrowing od the cental AP canal diminsions to just under 9 mm and moderate right foraminal stenosis , DDD, Osteophytes, mild to moderate arthrosis in all joints, pain through neck and shoulders, neuritis. The examiner asked questions about guarding and using my upper body to avoid using my lower back, they seemes to think I was avoiding activity that ivolved my lower back and used my arms and shoulders to do things normally done with my lower back, lifting my body weight. Abnormalties of spinal muscles, guarding, spasm, tenderness: yes Description of abnormalities: tenderness ans spasms in cervical and lumbar paraspinous muscles Evidence of spinal ankylosis: yes location and position of ankylosis: lumbar spine ( neutral) Cervical ROM Active motion Flexion: 0 to 30 degrees extention: 0 to 30 degrees left lateral flexion: 0 to 20 degrees left lateral rotation: 0 to 30 degrees right lateral flexion: 0 to 20 degrees right lateral rotation: 0 to 60 degrees objective evidence of pain on active ROM: yes objective pain following repetitive motion: yes additional limitations after 3 repetitions of ROM: unable to test due to pain Right shoulder ROM foward flexion: 120 degrees abduction: to 120 degrees internal and external rotation: to 80 degrees extention: to 30 degrees objective evidence of pain on avtice motion: yes pain on motion after at least 3 repetitions of ROM: yes additional limitations: no Left shoulder ROM forward flexion: 90 degrees abduction: to 90 degrees internal and external rotation: to 50 degrees extention: to 30 degrees objective evidence of pain on active motion: yes pain on active motion after at least 3 repetitions of ROM: yes

Ok, that leads to another question, can it be rated since it was found during a C & P exam, or will I have to get the medical statement stating it is related? Just not clear on that

I have a question about service connected and secondary claims I have had 2 previous C & P exams for my back, knees and shoulder I am currently rated: 40% for Traumatic arthritis lumbar spine secondary to surgery for lumbar disc disease 20% Paralysis, incomplete, moderate, right sciatic nerve 10% tinnitis left ear 10% bilaterally knees for DJD I have an appealable claim for left shoulder residuals from surgery post service for symptoms that manifested during service. I recently had a 3rd C & P for a few other claims seemingly unrelated to any of the above listed claims. The examiner asked if I used my shoulders and arms more when lifting, sitting, raising from a sitting position, and other activities, and if I had headaches or tingling numbness in my hands. This C & P has resulted in numerous appointments, including an MRI for cervical spine that had a diagnosis of HNP (severe impingement) c5-c6, osteophytes(9mm), neuritis, and carpal tunnel. The MRI was listed as "STAT" on the appointment letter. I have an EMG/NVC scheduled for Upper Extremities. All of these have happened at a much faster pace than I have normally experienced with the VA. I have a question about the cervical spine being considered secondary to the lumbar spine. The original C & P specifically cited "no noted abnormalities of cervical or Thoracic spine". The second C & P was dramtically different Diagnosis: Traumatic arthritis lumbar spine secondary to surgery for lumbar disc disease Paralysis, incomplete, moderate, right sciatic nerve, as likely as not secondary to service connected lumbar spine condition. impacts: decreased mobility, problems with lifting and carrying, pain prevents: exercise, sports, recreation severe: chores moderate: shopping, traveling, bathing, dressing, mild: toileting, grooming none: feeding My activities are severely limited as a result of the problems with my back, so my question is: 1. Likeliness of a rating for the cervical spine as secondary to lumbar spine, even if the C & P was not for my cervical spine. 2. If I do not recieve a rating for the problems with my cervical spine, should I start a claim. I have assumed the back pain was natural with the arthritis and DDD so my cervical spine has never been a specific complaint to a doctor. It seems apparent that I have progressive issues with my spine over the previous 3 years Note: All appointments for my lumbar problems and cervical spine have been with VA doctors. Thanks for any and all responses.

Thank you for the responses, I understand what you are saying about the symptoms and the actual condition. I am still allergic to all histamine blockers, so I would need to address each of the symptoms, hives, irratic heart rate, irratic blood pressure, labored breathing, swelling of the tongue. Of course, I avoid anything that will cause a repeat of the Anaphylactic shock, meaning I avoid histamine blockers at all cost, so the documentation consists mostly of of the drug allergy listed in medical records, and not active reactions to anything. I also understand your point of not focusing on the "cause", but in this case I think it is pertinent to the subject matter. the The out gasing of the incinerator resulted in personal on-going physical side effects (typical of exposure to specific toxins released and documented by the DOD at NAF Atsugi, including Dioxins, Furans and heavy metals). Some of the symptoms were immeditate including the allergy, facial rash, and others have been gradual, diabetes, neuropathy, unusual liver and thyroid functions, and other problems. The out gassing and the resulting medical conditions in personnel stationed there have been the subject of congressional hearings and a bill (Senate bill S.3378 ) passed to address the issue. Recently the VA issued a training letter (VA training letter 10-03 Enviromental Hazards in Iraq, Afghanistan, and Other Military Installations) that includes NAF Atsugi personnel and the fact sheets concerning the exposure. Thanks guys for the responses, it will help knowing that I will have to find each of the symptoms and address them individually.

I was stationed at NAF Atsugi in Japan for 3 years (1993-1996), during which time the (SIC) Shinkampo Incinerator Complex was in full operation, spewing a variety of toxins in the air on base. During my tour there, I developed allergies to Bynadryl and other histamine blockers. I had a a very serious incident at 1 point, about 14 hours in the ER at Camp Zama, and 3 weeks SIQ for the reaction to Bynadryl. I also developed other physical problems, including a persistent rash on my face and over the years since my assigment there, I have experienced other health issues that I am filing claims for. the question I have concerns the allergies to Bynadryl and histamine blockers. I have searched through the e-cfr site trying to find the applicable codes for allergies to medicines. I haven't been able to locate anything that would apply and need some help. I know there are people on this site that are very knowledgable about the codes and hope someone can offer some help. Thanks in advance for any help, if this isn't the correct forum please tell me which 1 I should post in.

I posted yesterday about my ongoing claims including a condition that the VA can't seem to identify. I think it is a form of Polymorphous Light Eruption (PMLE). I have always thought it was due to some type of exposure during Desert Shield/Desert Storm, but while looking around today for other vets who have had claims for PMLE I came across this article several times, and other related information about Atsugi. I have strange symptoms similar to the list provided, and was stationed at Atsugi for a little over 3 years, from 1992 through 1996, and was exposed to the incinirator constantly during that time. my wife and I have a daughter who suffers from TB and other upper respritory issues still to this day. Over the past 2 1/2 years of dealing with the VA and researching this ailments, I am still amazed when I find things like this. If anyone was stationed at Atsugi I would suggest you go to http://www.atsugi-incinerator-group.com/ and check out the articles and list of toxic substances you were exposed to. It sheds new light on possible causes for illnesses for anyone stationed there.