cannoncocker

Below is the redacted version of the letter I received as a result of a very recent Decision Review Officer action, which leads me to 2 questions: These are my questions 1. “Your overall or combined rating remains 60% effective April 22, 2008. We do not add the individual percentages of each condition to determine your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions.” In English and standardized math how in the world did they come up with the 60 plus 20 equals 60 since they didn’t seem to pull the pyramid card out? 2. If 60 plus 20 equals 60 what would be the point of another exam, utilizing the same examiner by the way, that denied me in the first place due in no small part because of the numerous discrepancies in his original C&P Exam and the MRI/Consult/Physical Therapy/IME exam findings, which pretty much agreed? It would be relatively difficult to ignore or disagree with an MRI image it would seem to me. So why another exam for severity since 60 plus whatever equals 60? DEPARTMENT OF VETERANS AFFAIRS We made a decision on your appeal. This letter tells you about your entitlement amount and payment start date and what we decided. It includes a copy of our Rating Decision that gives the evidence used and reasons for our decision, We have also included information about additional benefits, what to do if you disagree with our decision, and who to contact if you have questions or need assistance. What We Decided Service connection for XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXis granted with an evaluation of 20 percent effective April 22, 2008. The above action is considered a full grant of this benefit sought on appeal. An examination will be scheduled at once to evaluate the severity of your service connected XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. You will receive notification regarding the date and time of your exam in a separate letter. Your overall or combined rating remains 60% effective April 22, 2008. We do not add the individual percentages of each condition to determine your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions. Your compensation payment of XXXXXXXX will continue unchanged. Any hunches would be greatly appreciated. Actually I have spoken to an Attorney and I seem to be out of my depth here.

This is for anyone that is or may be going to a DRO personal conference, it is only my experience so that is all it is, not gospel just how I experienced it so far. Having done a dust up which I really would prefer not to do but the only way to get movement I will be be getting put back on the docket to be heard. The reasoning for that to me is they gave me a zero win situation after the DAV guy in W-S Steve had told me he had it all worked out just keep it off the books and everything would be fine. Well as it turns out the under the table deal he had done with the DRO involved connecting 2 30 year old documents (ER and Follow up notes) which had no dates, no assessment, and zero radiology, to my current back problems. My IME, the VA C&P Doctor saw no Assessment no dates, nor radiolgy but I did have a statement of support from the person that drove me to the ER since I was in no condition to drive. I was a buck sgt. so what possible influence did I have over the diagnostics they pursued or any other part of my treatment? They just noted Loww Back Pain, take some motrin and leave the same way you got here. So what legitamte Doctor would sign off saying that these 2 documents were the orgin of my current back problems. My IME who is a practicing Spinal Neurologist wrote my current back problems are a result of my military Service but cannot tell or opine from those 2 documents since the Army Medical Corp did no diagnostic or radiology. Now I wonder if they realized how this would restrict the use of these documents? Anyway I figure this gives me an opportunity to question them face to face re: under the table deals implying their minds were made before I gave any testimony and how I could possibly be held accountable for the Armies lack of medical professionalism or at least intentional cover up of a service induced injury. Question is should I get the lawyer now or after the DRO? Any input.

I have to hand it to you, going against the grain and all. My claim was not submitted until April 2008 and this one portion which has never been claimed was not denied until about July 2009. So that should not interfer with hiring a lawyer. I see a trip to Columbia in my future. Anyway they still have not denied this claim but through my lack of experience I let the DAV Rep slam dunk me with no formal hearing, which for the record in my opinion is a bad move. You need to look them in the face , recorders running and nhave them tell you a Practicing Spinal Neurologist saying my back injury was service connected, but they want a Chiropractor....to say my ER and follow up notes was the direct cause. The C&P Contracter noted the ER and folllow up stated no dates and no assessment/radiology so how would any qualified reasonable doctor going to why of course that was the orgin. Heck they did palpations like it was a hernia or appendicitis. Maybe I should submit a claim for those? How can I be held accountable for their malpractice. Hilarious when you stand back, but like you I will keep coming.

Test Your input is appreciated! The thing is and where I have to pick it up from now is the C&P Doc noted no date on the ER and followup notes, there was no assessment, and no diagnostic testing so what legit Doc is foing to sign off on notes with nothing of any value on them connecting them to an injury 30 years ago. How can a Sgt. make them do diagnostic work? Like I said the Neurologist said my back problems, radiculpathy, was a result of my military service. How could she go further when even the C&P stated the notes had no value. I guess I IRIS/fax the VA and my DAV rep, if that is in fact what he is doing, because they had their minds made up long before I hit the door. What is rich is some VA Claims guy came on here and said he loved to see an IME, which the CV of my IME is second to none, said it was service connected and tied it medically, yet her the DAV and VA do the underhanded thing. I will keep coming! Test, you mentioned a lawyer, when at what point can I hire a lawyer? I am ready to do that.

Test, you are absolutely correct in that they, meaning the VARO (DAV) and the DRO already have made up their minds made up and intentions cooridinated long before you walk in the door. Carlie, I don't get what good putting someyhing on the record would do? As in my case I had a Neurologist say my Left Radiculpathy was directly related to my 6.5 years of heavy repetitive lifting, which I backed up with the NIOSH Lifting Equation and copies of documentation of Civilian Army OSHA Training to give my evaluation credibility. The C&P Dr. noted there was no Assessment on my Emergency Room Notes and Follow up with zero diagnostic work done. So now of course they say they want a Medical Expert to tie the ER notes which noted Low Back Pain, but without any diagnostic work who is going to, or honestly could say they, my current back problems are connected to my back injury noted on those ER notes? The original Neurologist said that, and who could argue that. She did all she could by saying it was service related due to repetitive heavy lifting over years. The C&P Dr. said it all when who wrote there was no "assessment" on the ER notes so it makes you wonder, does the military medical corp have any professional obligation to do any diagnostic testing at all? Question is, where to go from here? Request the DRO hearing anyway, since the DRO said he would keep it open for 30 days to respond. As far as keeping this open as along as it has, I have been on their schedule, not mine. The DAV guy did know my case work, I will give him that. Whether he had my interest is questionable.

Hi Pete, hope all is good with you. That would be the worst, well bout the worst thing they could do is not be intimately acquainted with their claim! Doesn't have to be over board like I tend to go but they, at a minimum: 1. need primary documents (it is surpriing what they don't have and the dots they have not connected) 2. A general view of how your claim should be presented. Having said that, the plan will absolutely change, even when you don't see why, you just, well I just had to suck it up. 3. Wait and see if they are shooting straight with you or just jerking you around, only time will tell that story 4. Hope the DAV VSO is as on the ball as mine seems to be. I say it ain't over till it's over. I have done everything, to the letter, above what he required so now the story will be told! Hope all that go into a DRO are prepaired, have good representation, and have done their due dilegence. If posible find out who will be representing you and then discuss the plan so you can have everything ready.

I had just asked for the DRO Hearing. the real clincher for me was the fact that the DAV VSO was top notch as well as the VA DRO. I got the extra statement from the Neurologist but that is not so much the point but that the DAV was there for me when I needed him. This man knew my records about as well as I did, which is saying something. I have to revise my whole thought about the DAV and VSO's in general. I can't believe it! Thanks for the reply. also. Some curious points though: 1. they pretty much had their minds made up before any evidence was heard 2. the medical evidence didn't seem to matter whether it came from a chiropractor or a Nuerologist 3. the ER form did not have a date or assessment according to their C&P Doctor and that did not seem to mater at all. Seems to me that would make our jobs harder for both the VA and me but they did not seem to care. My IME already tied my injury to my service in erverything but Urdu but here goes 3. Yes it does I am a bit skeptical but hey, experience has made me that way. Like I said though they did suprise me by what appeared to be fair honest play. What a surprise.

The DAV rep seemed excellent, to my surprise, that he only had a few details to clear and we should be good since he had already talked to the VA DRO and he seemed IAW this forums advice. So it all looked good, had all in binders, had every SOC and C&P Exam point answered point by point. That equals zero when the rubber meets the road. they, the DRO and the Rep already have heir agenda so I can't sy I wasted my time on the prep work because they did use aboout 2 or 3 documents but the important points, at least to me such as the C&P Dr. couldn't even find an assessment on the ER documentation...... Their main point was the IME said my injury was 50% or more likely service related, which they were on board on, but they wanted the wording to tie my injury exactly to one injury resulting in me going to the ER, even though they did zip DX work....They found it easier for the VA to get on board with a single injury than 6.5 years of repetitive injury, as defined by the Federal Government (NIOSH). So, they offered me an off the record with no swearing in and no recordings, giving me 30 days to go back and find a DR., any DR, chiropractor, CV doesn't matter here, and reword the statement IAW with exactly what they had the IME document. What does anyone make of this scenario? I don't have a clue except to go back to the Dr. for the third time.

My bad for the misunderstanding. It had been months since I logged on and had forgotten/misplaced my info, so I reregistered. In the interim I found the original login info so I continued this thread with the original username. So it is my thread, not hijacking. On my previous post I included: PS I had to use a new user ID because I couldn't find my old log in since it has been months but I ultimately found it. The thread is long but I felt it necessary to provide a full picture of this claim. Basically I am just looking for what is to be expected from this DRO Conference and given the info I provided what curve balls might I expect. As I recall a VA Rep stated they would be happy to see a claim with a clear nexus, which I believe my IME provided but then again that is what I am asking and why I am asking. Additionally do the DAV VARO have any obligation to assist in this conference or is it purely discretionary? If all this is too cumbersome please accept my appology and move on to the helping the next deserving vet.

I preface this by saying I have made whatever gains by implementing the knowledge and experience given freely in this forum. I recognize this knowledge, successes, and failures were hard won and at times painful. Thank you for that the willingness to help as it would be very easy to keep it to yourself. New concept of the day "Relative Equipoise", which after google I get the concept. I received an increase from 30% to 60 % from a C&P dated April 2008. I received A SOC in June 2009 at which time I requested a reconsideration for radiculopathy then received another denial in August 2009. I, in consultation with my DAV Representative, requested a DRO with conference now scheduled 2 March 2010. I will attempt to leave the irrelevant personal opionions out to better allow you to apply your knowledge in an attempt to help me but that is difficult to separate. 1. Original C&P Examiner Osteopathic 14 years in Family Practice. Relevant to spine findings: The C&P Dr. in all candor did a very good examine sans the spinal portion. Claimant reports being diagnosed with spinal injury existing since 1984. The condition is not due to injury or trauma. He reports the following symptoms from the spine condition: numbness. He has no stiffness, loss of bladder or bowel control. He reports pain in the L5 Back which occurs constantly.The pain travel to the left buttocks to thye right nside.The claimant reports sharp pain. Pain can be elicited through physical activity. It is relieved through rest and medication. the treatment is PT and has not resulted in incapacitation. The pain was currently reduced due to pain medication. The bone condition has never been infected. Lifiting is completely diminished, walking, standing is very difficult. X-Ray Lumbarspine Minor lumbar spine degenerative joint Disease and disc (DJD) THORACOLUMBAR SPINE examination reveals no evidence of radiating pain. Muscle spasm is absent. No tenderness noted. There is negative straight leg raise test on right side. There is negative straight leg raise test on left side. There is no ankylosis of the lumbar spine. RANGE OF MOTION ROM DEGREE DEGREE OF PAIN FLEXION 0 TO 90 90 80 EXTENSION 0 TO 30 30 25 RIGHT LATERAL 0 TO 30 30 30 There are no signs of lumbar Intervertebral Disc Syndrome with with chronic and permanent nerve root involvement The C&P Radiology report, although just an X-ray negates and omits vital findings. The part about the SLR findings is just plant not true, so how do you counter that other than point out the fact the S1 nerve is clearly compressed as shown on 2 MRI's and Explained by two VA Radiologists not with an agenda to deny a claim. 2. New evidence: IME curriculum vitae Carolina Spine & Neurosurgery Center (current Employment) Certification: American Board of Physical Medicine & Rehabilitation Spinal Cord Injury Medicine American Board of Physical Medicine & Rehabilitation Residency: Physical Medicine, Ohio State University Hospitals Internship: Riverside Methodist Hospital, Columbus, OH Medical School: University of Maryland Medical School Findings: Reviewed SMR's Emergency Room Notes/Follow up/Impression Chronic Left Lumbar Radiculpathy/in my professional opinion it is at least as likely as not related to his heavy repetitive lifting over 6 1/2 years in the military/M110 8" 200 lbs Self-Propelled Howitzer-M109 155-mm Projectile weights 98 pounds From the VA Durham Consult the SOC (dated August 2009) stated your pain is not severe enough to undergo surgery: I have in the Doctor's writing he offered me (on his stationary that may or may not ocurred to him it would be used to counter the VA claim. 1. Surgery 2. Epidural Injections with fee basis form 3. PT which I opted for the PT. VAMC X-Ray mild degenerative disc disease at multiple levels. there is stable grade 1 retrlesthesis of L3 and L4, L4 on L5. This does not change on extension and there is 1mm of correction on flexion views at both levels. There is stable entero wedging of L1 with associated kyphosis. Small osteophytes are noted. No acute fracture. SOC does not deny the negative effect to my functioning only that it is not SC (well stating surgery was not offered which is disproven in the Neurologists handwriting on his stationary). MRI Radiology reports that refute the C&P exam: DEC 2006 MRI the L5/S1 disc shows desiccation. L1/L2, L2/3 no significant focal abnormalities identified (minimal annular buldging noted at L1/2). L4/5Mild hypertrophic narrowing of the right L4 neural foramen. L5/S1: Broad based posterior disc protrusion is noted centrally and in the left paracentral position, where an annular fissure appears to be present. Facet hypertophy appears to be minimal. The posterior protruding disc material appears to abut, and may slightly compress, the descending S1 nerve root within the lateral recess; the disc material is also associated with the L5 neural foraminal narrowing of at least a mild extent. DEC 2008 MRI FINDINGS Mild ventral wedging of the L1 vertebral body with associated kyphosis. Mild focal levocurvature centered at th L4-L5 Minimal retrolisthesis of L4-L5. No focal abnormal signal. Diffusely hypointense marrow signal pattern. L1-L2 Focal kyphosis. Anterior disc extrusion with marginal osteophysis. Minimal right paracentral disc protrusion. No significant spinal or neural foraminal stenosis. L2-L3 No significant spinal or neural forminal stenosis. L4-L5 mild circumferential buldge, small superimposed right for aminal disc extrusion and marginal osteophytes as well as miild facet hypertrophy. Mild to moderate right neural forminal stenosis. L5-S1 Annular fissure. Minimal left paracentral disc extrusion. Disc material in the left subarticular zone contacts the descending left S1 nerve root and displaces it posterioriorly towards the left facet. Impression: (Counters C&P) Alignment abnormalities, this degeneration and facet hypertrophy result in varying degress of of neural foraminal stynosis, as above. Disc material in the L5-S1 subarticular zone contacts the descending left S1 nerve root and displaces it posteriorly towards the left facet. Mild ventral deformity of the L1 ventral body with associated kyphosis. Mild local loevocurvature centered at the L4-L5. Minimal retrolisthesis of L4-L5 Diffusely hypointense marrow signal most likely due to systemic distress. This is a radiology report from the VAMC Durham which differes signficantly from the VAMC Asehville and VAMC Columbia: mild degenerative disease at multiple levels. There is stable grade 1 retrlesthesis of L3 and L4, L4 on L5. This does not change on extension and there is 1mm of correction on flexion views at both levels. There is stable entero wedging of L1 with associated kyphosis. Small osteophytes are noted. No acute fracture. Impression Grade 1 retrloisthesis at L3/L4 and L4/L5, does not change on extension, with extrension, with approxiametly 1 mm of correction on flexion views. I have a DRO conference scheduled on March 2nd and should I seek the DAV rep for help? They have been very reluctant to be of assistance. But I would ask if it might help. I must say I really don't know what tangible help they could be, even if they would condescend. I would be very greatful for any pointers. I have an IME that connected my spinal injury to my service, at least as likely as not, emergency room records and battaion aid station. The Army medical staff shoose not to treat my ijury, as in I spent 25 minutes in the ER amd was told to leave the same way I got in. PS I had to use a new user ID because I couldn't find my old log in since it has been months but I ultimately found it. Hope I'm getting closer to the end of this and I would really like to know what to expect from this DRO Conference. I forgot to add: Arrythmia30% tinnitus10% L and R feet10% hypertension10% carlie, I plan to disassmble the 2 SOC's, 1st was the initial findigs dated June 2009, which denied the spinal claim, and the 2nd SOC datd August 2009 denying the spinal injury claim again. First SOC basically denied due to lack of SC evidence. The second from what I gleaned was they foung little wrong with my spine. Through witnesses, IME, and various VA neurolgists exams and MRI's, and Radiologology reports. Example VAMC Columbia noted muscle spasms, where their C&P noted none. He was just a hired gun doing his job. Don't blame him for that. We all have to make a living. I plan to use "At least as likely as not- 50%" "The term, "at least as likely as not" etc... is used by doctor's to show a medical nexus. I consider a reasonble person would consider the cause of my spinal injury would be repetitive lifting 200 lbs from a dead ground lift with no lifting assists. NIOSH prohibits that for the express purpose to prevent injury. My post military employment was Safety and Occupational Health, Contract Administration... none of which would lead to back injuries. Crimson, If experience is an indicactor I hold little hope that the DAV VARO will be willing to assist me in this but hope springs external so I will go to their office on the day of the conference or write them a letter asking for their assistance. I have only two items outstanding, one of which has little documentation since it involved special weapons and you didn't discuss personal problems if you intended to maintain your job as chief of tactical nuclear weapons section. The rating levels were fair so I don't feel it necessary to ask for an increase. Now the spinal injury is another story, It is not my fault the Army medical apparatus choose to not treat me, as in 25 minutes from start to finish in the ER. No X-ray just leave the same way you cam. I followed up but the same bums rush. Additioanlly not every person lifting 200 lbs from a dead ground lift will end up injuried. Called individidual differences plus I had a body frame of 128 lbs. NIOSH has rules to prevent such injuries. I recognize the military does not have to adhere to the requirements but the injuries occur all the same.

I don't know the answer either, and don't want to risk confusing anyone: I like the way you think already. got my IMO with SMR's refrence etc and the correct diagnosis and is at least as likel due to military service so i'll fight this till the cows come home. I don't worry about watching what I say. I wouldn't ever say anything here i wouldn't tell the VA administrator. I welcome all advise, I'll just be more circumspect on what i act on. Like I said I have family problems so I was preoccupied so it was nobodies fault. i should have been more focused, that's all. the neurologist, qualified neurologist, didn't even do the slr test because she said it wasn't really relevant or more outdated. but the C&P GP said I was negative when he didn't even think about doing one. Now modern neurologists use MRI's and pin pricks, looking for numbness in certain locations which tells them exactly what nerve roots are involved, tuning fork type instruments. That dude sucks and I can assure you after this is won, qtc and the va will know. the neurologist from the same area never heard of him so it's not like he's a mogule in the nerology industry! PS Rental is over my head/and this ain't my thread, Larry is a ok with the doubt should go to the vet, we'll check the validty of that since i have them nailed to the wall on that. No wiggle room. Either that is right or not.

You know it had not ocurred to me the va was monitoring this board, but tell me that doesn't make sense. now we have to monitor our words here too? That is sick! Pete, your'e a good guy and glad you are here! My younger brother just had a double anuerism, money or insurance isn't an issue but mortality is so I'm not really hitting on all eight cylinders, or I guess 4 now, but I am just over reacting, but blieve that I don't want to play any part in someones misery or poor reaction to it. sounds like he's got a handle on it and took it like it was meant. Just trying to lighten things up.

It never even ocurred to me that you were serious about the violence bit. i just thought it was a joke, but it is true you can't tell how someone else might react. i will play it say from now on and bow out to be sure I don't do any harm. the VA is good enough at that with no help from me. I got the neurologist to add the smr's stff on my IMO but they have already made their decision so it's all moot. 2 or 3 appeals down the roaqd it may help but the DRO has his rubber stamp out already. You can bet on it. I have the C&P guy on paper in writing lying and there is zip that can be done but accept it and appeal. better luck than I have had to everybody, I hope!

My bad for sure, I never thought he was serious. violence will never fix any of our problems. At best it would make our situations much worse! Probably much much worse! I can see I am not seeing things clearly so I better leave for awhile. Good luck with your va problems and believe me I did not mean for that to be taken seriously! what could violence posssibly gain anyone? I thought it was so ridiculous it was funny. what I said about the VA C&P eaminers I stand by. My IMO said the exact same thig, and I quote the neurologist " the va hires them for just this reason" refering to his findings on my lumbar.

Jayg: The paid VA C&P Assasins have told me I a. have no unusual shoe wear b. no shoe orthotic/inserts. Both lies The only thing they couldn't duck with mine was about 40 pages of SMR's (or whatever they call them now) for pes planus, and bilateral surgery for bunionectomy (Mitchell Procedure), while in service. I don't know your MOS but you can try to tie it to that but you know the bottom line is you will have to have an IMO, and not just an IMO that is willing to Nexus it for you but will write that she has reviewed your SMR's specifically, regardless of how obvious that is, and tie it to your complaint in writing. Evidently a nexus must contain that statement that she has reviewed your SMR's . I just grabbed an IMO off the site that did not have that statement in it so just to save you the trouble of going back to the dr. and no doubt paying more money, be sure that statement is in there. I agree that resorting to violence should be part of the VA review steps. A place in the CFR's. I'm thinkning about going to a walk in clinic to add to the IMO I already have just to see if they will play ball. PS it can't just say "at least as/diagnosis/injury or event". Must say reviewed SMR's and those are the result of the SMR's reviewed. Jayg good luck and hang in there. I felt the pressure to just say to heck with it, take it as is or not, but don't let them win by default!

First thing I would like to mention if I haven't. i live in the NC mountains and have to use satellite internet, and I will be the first to tell you it sucks. better than dial-up but not by much so if there are like 2 hour lags between reply-response that's it! What did Hillary say when they had Bill's back against the wall with the Monica saga? Stand back, take a deep breath... I got it. Whatever works to remove the emotion from the equation. Rule 2. You are responsible for you. you can get excellent advise and direction here but when it is all said and done, you are responsible for you and the actions you take. you are getting exactly a. advise b. experience But ultimately you are responsible for the decisions you make. I lost sight of that and that is on me. I appreciate you putting this in perspective and will follow that. I am still holding on to that concept that Federal Health and Occupational Health Standards (beings as how the Army trained me in exactly that) plays a part in my claim. I will let you know how that in particular works out. All of that is in the CFR's. No emotion. Rules enacted to protect us. Much more importantly is my upcoming interaction with the DRO. I have no experience with that so I would have probaly come out ready to fight when that would evidently been 180 degrees out from what I should do! Please understand that all my contacts with VSO's and the VA have been either negative/confrontational/lies/no return of calls etc... so I just naturally expected the DRO would be the same. It is very important that I know now that I am trying to win him over rather than beat him down and basically fight using suprise or any weapon at my disposale. Those are 2 completely different battle plans. If I want to win him over I will get the data together and send it to him with a rationale to make it clear what my intentions are. If it were a battle of the kind i am accustomed to I would gather my data and arrive with it in my hand then begin my presentation. Naturally I would by nature prefer to have a civil discourse with no suprises. But What I really want is to win. I will try not to directly dispute Dr. King (VA Hit Man) but will try to indrectly dispute his finds with Dr. Burke's (IMO) findings by enumerating her findings in the exact order he enumerated his. We could go on and on. I got the idea and will follow it, get my dr. to be specific with dates and references to SMR's in her findings or add to the sheet she already signed. Thanks for all the help! Will try to win the DRO over not make an advesary!

Good to go. I'll just give her till say tomorrow afternoon, go by her office to get a copy of her findigs, then over the weekend i'll match it up to the statement above and be sure the statement above is included, have her write it in or write the data in myself and have here resign a new doc, then just hold it till the hearing. I was just using the wrong language when I referred to sucker punching. Please excuse the over zealous nature of my emotion on this but please realize they have straight fabricated, just as the doctor pointed out, and attempted to do me harm for payment by the us treasury. Somehow I tend to take that personal. that is pointless! the facts maam, nothing but the fact in the language of the realm. Just irritated that I have to pit my bill fold against them when we all know why they are doing this. they do not want, will not allow me 100% disability without a knockdown dragout fight. So be it. thanks for pointing the flaws out. but I am not depending on fed law as such, or any bit of folk law, but that did get what i wanted from the Dr, being in the front door and engaged in a conversation with the goal of winning a claim with the VA, and how bad could that be? thanks, for all the help BTW I got that form off this site at the direction of another member so I thought that would be sufficient. i see that is not the case. I should have done more research before I handed it to her rather than now reapproach her with additional requests. My bad as they say but got a handle on it now.

This is more than a humble opinion. i feel you have loads more experience with this than i do hence i come to you seeking wisdom. I read the federal lifting limits do not apply to the military or they could not do half the things they do, having sais that, it does not, according to me and the dr change the fact it has the same negative impact on your body, therefore if you suffer as a result of this allowed activity, you should be allowed compensation, or no vet would be allowed any comp for any reason. If action a leads to negative result b, whether the feds decided to allow it or not the disease/injury is the same . Do you think I should get this corrected and mail it in to the appeals section? I am looking for your experience and want to follow it to the extent my circumstances will allow. You are right of course that if every fed reg were violated were to be compensated we'd all be filing C&P's, the point is I have a medical doctor saying At least as likely as not for sciatica, which is the key, I suffer a disease/injury from my duty, not the fact they did not adhere to fed requirements, but the requiremnets were implemented for a scientific medical reason. In this case to prevent sciatica.

Oh yea, I relalize of course the "what a resonable person would believe" statement would be totally irrelevant to the VA, but the point is this was one human being talking to another human being and without winning her over the game would be over before we event started the game since she had said earlier that it would be hard to prove a nexus from such a long period of time. That small statement put me back in the game, since it is one of those obvious, undeniable things, as opposed to what? Saying yes it's been a long time might as well give up. Actually she said all the things that Carlie mentioned, minus the dates. It is possible for me to have her add those in, with her own writing, and just hand her the dates to add. Her husband was a Vietnam Vet so she was not totally unfamiliar with the VA and was not a vet hater type. Actully she was pretty hard nose been very reasonable. I will see what her notes look like, by going up there and get a copy in person and see what needs to be adjusted. I can't really tell her to fix a b and c when I have no idea what her write up says. I am with carlie 100% when it comes to requesting a different finding since it is not really necessary since at least in theory the benefit goes to the vet. But for now I need to know the rest of her findings, other than the fact she found: a. At least as likely as not related to b. an injury , disease, or event dring the vets military service.(Chronic Left Lumbar Radiopathy(spelling?)i believe Sciatica. c. Injury or event ocurring during service (as described by veteran or found in other records provided by the vet): Repetitive Lifting (which ties directly into the niosh lifting equation) which the rounds for the howitzer were far in excess of the Federal limits! They cannot deny the 6.5 years of breaking the federal lifting limits! I just don't know if I should sucker punch them with this, with any additional corrections or not, as required, or send this in before the DRO Hearing with the requested conference. If I went to the conference, slapped this info on the table in rebuttal and say your turn, what? PS she didn't write that down that it would be hard to prove a nexus from a long time ago, that was her and me figuring a way into this successfully. She signed the doc i handed her and she said she would mail her findings which would be:Chronic Left Lumbar Radiopathy(spelling?)i believe Sciatica.

I will print that off and hand it to the receptionist and see how she feels about that. since that is all true i don't see any problem with that. Thanks

Hi Mike, looks like there is a lot of that going on at the VA. That Dr King that tried to slam dunk me is a disgrace tothe prfession. The neurologist (IMO) I just got finished seeing didn't even do a SLR who said I was negative and the VA said I was positive, she said they weren't even relevant to what we are dealing with or pretty much outdated. eithe way he said my back was fine. First, the IMO said it's gonna be tough to prove casation after the length of time I had been out. She also said it was a mistake not to get an exit exam. I told her the truth, that why would I since I thought you got out, left, and good luck. Never heard of a VA in 6.5 years. Never asked me to be a genius to cock a cannon! Anyway I gave her the old law statement or tenant being what would a reasonable person believe. Since I had led a sedentary work life what do you think caused my back problems. she looked at the junk King, won't even call him a dr anymore, he doesn't derserve that, pushed out for the VA and she said they hire people just like him to do this. So I showed he this: Medical statements regarding possible Service Connection: Is due to- 100% *** More likely than not- Greater than 50% *** At least as likely as not- 50% (Benefit of doubt goes to Vet) Not at least as likely as not- Less than 50% Is not due to- 0% then gave her the attached form which differed from this a little but she gave me: At least as likely as not Should I go back and shot for the More likely than not since that wasn't an option on the sheet I gave her or just roll with what I got. Shoots down king saying nothing wrong with back. for 340 bucks it keeps the hope alive. She said she would mail here notes to mee. I have a DRO with conference request in currently for the lumbar denial. What do I do from here?

Papa is again exactly right!. Don't let all your hopes ride on one job. It is clear you have alot invested in this and god know if you don't deserve this one who does, and I'd pretty much say something like that if it gets to an interview. but the game is play by quantity. that may not be reasonable, make sense, etc. but that is just how it is. I got a job in Germany with the govvernment and I was behind dependents, so believe when i tell you I know what you are feeling. You can win this battle, hopefully this particular one, but somewhere, somehow it will be your turn. the combination of things will come together and bang you are in. we already told you the formula to win. the rest is on you. You may not like that formula but whe don't make the rules! Everybody is rooting for a guy like you, well qualified, wants to work.... Good luck on this one. PS It is like going to Vegas and say "I am going to get rich" but i will only roll the dice one time and if that doesn't do it I will just go home and never try agsin.

Tell you what! copy/paste print place right behind the cover letter. if that don't get it it can't be got. Thank you for making this bone simple. I look at it this way. She may or may not be a loving caring person but you don't want to bet the farm on it so make it so undeniable and simple it would be harder for them to deny than roll with you, that would be with the VA or IME. Oh yes, somebody mentioned tabbing the compilation.Just did that. the only lingering thing I have is they have both my mri images, i have a copy of the 2008, but i worry that they will lose the 2006, and this didn't come from left field, they originally lost my records then found them, so you better believe i don't take anything, no atter how silly, for granted! at least tomorrow this chapter will be over!!!!!!

I would be hurting if it wasn't for your help. She has: a. SMrs and all clinical records b. I put in the cover ltr, and will make it clear my rationale for my postion that my lumbar diseases and injuries were either caused directly by my field artillery activities and diseases aggravated and secondary due to my SC approved Podiatry (need to add that wording) problems. c. cite any medical text or abstract: I will verbally make the distinction from say Dr. kings findings and every other doctors finds, which indicate all the problems that would natrally result from hauling around 194 lbs with a 128 lbs body. d. "more than likely" or " as likely as Not : I added two sheets that explain the language aand give examples. e. I provided cover letters too for my IMOs.: we are on exactly the same sheet, jusst wanted your eys on this, already found the podiatry wording needs adding so she won't have yo guess. f. You sold me on what you have-I think it was good idea to use the buddy statement and the occupational regulations as to weights in this cover letter. : the buddy ltr was no problem, and i. was an army trained safety and occupational health specialist so I have plenty of ammo there. I could litterly destroy them with my knowledge on that. Actually, anyone with a bad back, can prove it has a case due to federal requirements. All that is in the CFR's j. Did I put on the cover letter you are my hero? Hey carlie, back again but this should do and will let you guys know how it goes: Is this what you are preparing to give your new doctor (private doctor you go to) for an IMO ? Just a cover ltr. to pull it together, rather than handing her a stack of records. what I have attached is my cover ltr. don't know how to make it shorter. Thanks to all! Now back to podiatry

If anyone could put a second set of eyes and experience on these 3 pages it would be greatly appreciated. They, along with the noted attachments, and a couple of sheets indicating the VA language and meanings will go to my IME. Any questions, problems, doubts, or difficulties with how I worded this. I tried to keep everything short as I could but still cover the the possible loop holes. Thank you for anyone willing to take the time. This should be the end of this portion of the saga!