cannoncocker

Well aren't you thinking outside the box! I am not SC fro my back which has many problems, which no doctor denies, well they can't givent the MRI's, Neurolgy consults, epidural injection and surgery options. They just saay it wasn't SC, which i supplied ER notes/then battalion aide station notes right before I ETS'ed. But that secondary to the pes planus and post bunionectomy surgery is just plain brilliant!. I have an IMO on Wednesday and dav you better believe I will make that connection clear and add that to my claim, I guess via 21-4138 and IRIS. I have had surgery on my feet and plenty of evidence and longstanding approval for SC Podiatry problems, so that would be an excellent addition for SC evidence. Primarily they are refusing the 100%. With the condition of my back it would equal them approving 100%. Thank you so much. the IMO will get the full rendition of back problems aggravated by my body alignment re: flat feet and bunionectomies bilateral.

1. "yuku is cool" from another thread that was closed. But wasn't closed about this i don't think. What in hades is yuku? I could google it but wouldn't give me any context. 2. In my experience when yo instruct someone to get a copy of their C file, i was told they already sent it, which i never got, but must include every document active and va afterwards and wold cost a good deal of money for them to copy it. those words are their "VA". so I had to single out specifically what I wanted, say a qtc exam I didn't have. they basically told me the entire file would go in the too hard to do box. Not asking any questions just repeating what the VA put on me. Bearing in mind my original claim had: 1. Tachycardia/high blood pressure/arrythmia 2. status postbunionectomy bilateral with scar 3. high frequency hearing loss right side 0% 4. Pes Planus I requested lmbar injury consideration. it exploded from that point, but all ffor the bestt sinccee it went from 30 to 60% with heearing loss bilateral 0% but evidently that took every record I ever had. so it can be very expensive for them to copy it if for some reasson you don't or didn't receive them. this is so weird, the one thing i knew for a fact hands down, anybody would conceed the lumbar injury they nixed it flat. anyway the claim file itself can be an issue, in my experiemce.

I know all the empathy in the world doesn't change the world for you one bit, but what you just experienced I have posted, and am sure that is not lost on the VA, is that anytime they have your records they could do anything, I mean anything! Right or wrong has diddly to do with it. I frankly have a DRO review with conference requested, and a 500 buck imo scheduled for wednesday and in the back of my mind, more like right up front, they could just remove everything I have then make me take it from the top to regain it, even though they just made this new determination. I am just afraid of our government. Still weighing the cost risk ratio. So sorry if they do go dark side on you. But you can't run your life on what might hapen since you're already into it. I am actually considering dropping any reviews and go crawl in a corner like a good dog.

It is clear enough for me now and won't bother you with this any further. I'll use your post, reworded/reworked. you've done plently. Very glad it worked out for you. The va conceeded my loss of hearing bilateral at 0%. of course it cost them 0 usd from the budget, like they don't have the presses running full speed for their buddies, but that would be another story. It is just too sorry for them to conceed one that has no more merit than the other. Did I go to the er for loss of hearing, of course not. I have infinetly more evidence my lumbar injury is SC than my ears, other than the obvious. Is it not equally obvious that a kid weighing 128 lbs humping ammo that weighed 130 to 170 lbs had an impact on my back. that doesn't even desrve an answer. but no, we have to pit our wallets vs the us treasury! But this is exactly like going to vegas. I don't know her, nor do i know how she feels about vets. for all I know she, well, doesn't care for us much. Vindictive, liars.............. VA repay? That's a thought! not in my lifetime or they would have just approved this to start with. Actually they approved me for a bunch of stuff I didn't even apply for, but denied the one thing I did apply for that was dog obvious!

Berta, I am blind. just looked down and saw the getting an IMO was right there. Still the template would help too unless it is in there. I will look at your post and look for the template if not in your post.

Hi Berta, and again asking for your help. I just looked below so I just saw your post, sorry about that! is Looks like you had already answered my question: Getting an Independent Medical Opinion." could you tell me where your post : "got from him to create the Getting an IMO template I posted here' That would cap it off. I will bring my dd214 to proove my time in service. Some body had posted 400 to 1000 as a bench mark soo that is what I used. Your IMO probably required more work on their part. I'll make sure all she has to do is read, look at me. Then write basically filling in the blanks or do it her own way as long as it conforms. I want to make this as simple as possible. So that template would finish this off. Thank you for your help and hope it's not much trouble to find that template.

Thank you mr man, believe me when I tell you i don't give up 500 dollars for fun. I do come from the period that 500 was actually real money! I tried chiropractors= all their treatment or nothing, but I was dealing with phone desk sttaff that no doubt had zero idea of what I needed. Most MD Specialty folks, their staff's eteys rolled back in their head because they didn't have a computer code for no referral. This is an odyssey every step of the way. I did not try a walk in clinic, yet. I could still do that if they would be onboard with this. They have the two SMR's, the injury occured right before I got out so that consists of er notes and battalion aid station notes. The er saw medical claim written on my forhead so they did no diagnostic work, just palpation, looks good to me, take these motrin, remove yorself. The aid station just chaged my meds and called it low back pain, rather than "pain at waist line" like somebody would actually limp, leaning on his brother, and announce my waist line hurts! Gimme a break. Like I have said before i have had doctors laugh at that. They took lessons from the VA. Those and the fact I spent 6.5 years hunping weights with no lifting handles that weighed from 130 to 174 lbs in repetion walking a 100 yards with them on my shoulder, all unacceptable to Federal Occupatioanl Safety Equation, which I guess I'll bring, in case she isn't aware such thing exists. i don't take anything for granted. If anybody has a cheaper way ou i'd be glad to hear it. I called a couple of ambulance chasers but unless there was a payday for them. I don't think so about giving up their doctor. thinking about it, that is exactly how they make their cash, or at least part of it, having some dr's that would roll over on anything! Ok, so far it looks like I should be calling the shots, since this is my dime, as long as I have evidence to put with it. Who could not put that together: a. ER notes which when you read is for low back pain b. Aid station notes, change meds low back pain c. ligth duty till ets (my cmdr. just gave that up as a freebie) d. took all my leave to recoup e. 6.5 years of illegal occupaational lifting. f. My MRI looks like i'm 90. Can they do the math? Does the benefit of the doubt go to me? Where can I get a goog example of a letter with the different language she can use? Thank you

Hey john, thanks for your experienced considered opinion. I did fail to mention: $%%^#$^ good work if you can get it! "Get your money's worth" that is part of what I am asking, specifically, do I push for what I want, how do they expect I will be as a patient, demanding or timid? just imply it by pointing out the premium responses? Please keep in mind I have no experience with this type of exchange. It's not like getting your carb adjusted and you can walk back in the shop and say I want a/b/c, or is it since that is a fair sum of money considering I rounded up all the diagnostic material and opinions for that matter. All she has to do is read the docs, look me over and write. I find it beyond acceptable that any reasonable person could find with all those lumbar problems with active duty lumbar medical notes, that none were influenced by 6.5 years of humping jo's. Should I state that? Write that down and hand it to her? Read it to her, without being combative? No medical insurance, this is all on me. Should be titled David vs US Treasury If someone that has done this and been successful tell me how they did it, from check in, blow by blow. I know that's asking alot but by all means abbreviate to make a point.

My interests are very close to Rockhounds I started to add my experience to his thread but didn't want to hijack his thread. Here is my IME person: For Lumbar Injury which the VA denied and has now gone to the DRO and I have requested a conference. I expect zero help from anybody so I'll be toeing the mark alone. If the DAV even shows up they need, no i'll bring my own, crash cart. Her credentials: Mxxxxxx O. Bxxxxxx, M.D. 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 Cost $500.00 I gave her the following documentation: 2 MRI Disc images With Flex x-rays 2 Radiology Evaluations for the MRI 1 Neurology notes from consult Fee basis eoidural injection approcal form Surgery option by neurologist at consult. 2 VA denials, both stating different reasons. Nobody really denies my back is messed up but the VA dodged that as good as they could but those /dr's and MrI's kept interferring with that. So I have documented: 1. Sciatica from pinched S1 2. Protruded herniations 3. extruded herniations 4. degenerative disc disease multiple level 5. ventral wedging 6. osteophytes 7.kyphosis 8. annular fissure 9.facet hypertrophy etc.............. you get the idea The real issue is this SC? So how do I approach this appointment? It is next Wednesday at which point I hand them 500 bucks for who knows what. 1. Should I go bare handed and just run my mouth 2. bring an example of what the VA is looking for as in the way of form and wording/ 3. Should I and is it true point out that it does not have to be that each item idicated is SC, that one of those is possibly SCand should be noted if that is actually SC. I am open for suggestions on this. Doesn't have to be all or none right? for example 6.5 years of humping 174 lb FA projos had to play some part in the degenerative disease item. Way outside federal lifting guidlines! Seems like that or at least one of those items should be conceeded! Do I just sit there and keep my mouth shut? are try to make my point? Of course all you guys are appreciated.

The, well, more like on top of it all, life goes on, as in I am the family lacky regarding collecting rent, rental repairs, and of course in another state with my back screaming and my heart racing feeling faint most of the time. Then you have to go toe to toe with the us treasury and a va system that would make an angel cuss, toned down for public viewing. Then with the public revenues down the cops are running in packs revenueing (traffic tickets) which was 256 dollars for 15 mph over. small poor county in Florida, so they grab you by the ankles turn you upside down and shake, whatever drops out is theirs. In 54 years I never had a traffic ticket until the last 2 years. Do the math. Whining over, thanks for the help.

Thanks for the input: I went to my VAMC records dept and they said they did not have the, so by that I take it they can't bring them up on their computer, which is about a waste of money to do a physical workup with stress test that shows 30 plus 10 heart problems and my pcp doesn't have access to them but I will be at the VAMC on the 16th and give it a try. Can't hurt. Now reality sets back in, It looks like the only way to get a copy is from the VARO and to do that is IRIS/Fax them till they get tired of me bugging them and make it easier to copy a few pages and send them to me. This VA stuff is made by design to walk away from. I called them capricious, vindictive, and etc......I should have sent tissues. what was I thinking. What in our history would make me think that they cared if I woke up dead? Not a thing. Felt like telling that for some reason. Ok so ask the clerk at my pcp then when they say sure you betcha, I continue to bug the VARO. For crying out loud I will be glad to be finished with this. Thanks ps qtc did the exam at the request of the VARO for the purpose of C&P exam. As far as I know.

http://www.qtcm.com/general/contact/overview.asp Can we get our medical exam records directly from QTC or do we have to go through our miserably slow or completely non responsive VARO. Just looking for something that will get me one specific set of exam records that might actually work in my lifetime.

Of course, both were the VA, but when they use mild and mederate tey usually refer to say degenerative back disease, whic in fact covers a full 5 discs which have zero fluid left in them and are completely flat. They also use that in conjunction with extruded heneriations, protruded herinations, Osteophytes,Mild focal levocurvature centered at the L4-L5. Minimal retrolisthesis of L4 on L5,Mild ventral deformity of the L1 ventral body with asscoiated kyphosis.... You would have to read both evaluations since they cut and paste.... They do not use mild or moderate with:Alignment abnormalities, this degeneration and facet hypertrophy result in varying degrees of neural foraminal stenosis, as above. Disc material in the L5-S1 subarticular zone contacts the descending S1 Nerve Root and displaces it posteriorly towards the left facet. Which in fact is the scitica issue. All I need is one approval of one isse and the dominoes will fall. I am way beyond fair/commonsnse/reasonable preson would believe...I am just looing for the foot in the doormwith one issue and it is all over. Take degenerative disc disease (Mild degenerative disease at multiple levels) 1mm of correction on flexion views, sounds like ROM issues to me. What do you think a reasonable arbitor wold believe precipated that, or any other problem in the Lumbar area? Given they broke federal guidlines, NIOSH (Lifting Equation chart), I use that since I am a sefty andd occupational health specialist and am familiar with the things they have to adhere to, and what leads to what. that is why i want to be at the conference/hearing. I am not rich but I can verbally defend myself. Hopefully this Neurologist will throw in with me. why wouldn't they? they have a pr. that for 6.5 years lifted 174lbs projos which of course have no handles, which provide leverage, part of the equation. They also said in a denial I hade no, which we aren't schucking and joking on the street corner, range of motion problems, and the Flexion x-rays shows wedging on L1 with associated hyphosis (1mm of correction on flexion views, sounds like ROM issues to me). Sciatica diagnosed and ready for surgery and no ROM problems, please! Constant pain from degenerative disease and no ROM problems? Again, please. whichever, whatever, take an issue and tell me with a straight face, along with SMR's there is no conection, especially since i've sat for a living, so little possibillity it all happened afterwards. "mild arthritic changes and bulging disc and it hurts like hell. You know for sure that if it is affecting your legs a nerve is being compressed." at least equals: Alignment abnormalities, this degeneration and facet hypertrophy result in varying degrees of neural foraminal stenosis, as above. Disc material in the L5-S1 subarticular zone contacts the descending S1 Nerve Root and displaces it posteriorly towards the left facet. Deal is like we already said, and we all know the deal, they don't want to hand me a 100%. I will not rol over and play dead. I felt like it but on further thought, naw not quitting. Field Artillery for 6.5 years on 8' guns. Like they said with my ears=conceded!

deltaj, the courses you took in: anatomy and physiology, medical transcription, and medical terminology, were of great service to me and right on the money from the bits a pieces I gathered from the net already. I took human anatomy and physiology about the time the ice age ended so it helpd but the med terminology and probably transction both nailed it for me. I pretty much have a handle on the MRI(they were abbreviatted from 2-they cut and pasted what they decided to use. But here is where you get it or got it. A negative SLR was stated in a denial (I am guessing from a QTC C&P Exam Physician DO, but don't know for sure since they will not release the records till i use a crow bar). that is such nonsense. Google SLR and you have the responses required for a positive minus some reflex actions/but that varies from the nerve root invovled. a sixth graded could derive that. Not to mention the fact that the MRI states "Disc material in the L5-S1 subarticular zone contacts the descending S1 Nerve Root and displaces it posteriorly towards the left facet."Can you say Sciatica ? Evidently the VA Neurologists were on board with that or they would not have approved injection or surgery. In your opinion do you believe the above indicates a positive SLR? This is only a small point, the big one is the nexues that is in the works as we speak. Thank you so much for sharing your knowledge. I hope you do well at your studies! Thank you also pool guy for your input.

no to 1 they offered surgery for pinched S1 which is more than mild or moderare. Protruded/extruded discs. and epidural injections. Degenerative disease is mild to moderate, so they say. Degenerative disease MRI shows normal aging or at least some normal aging, depending which eval you look at. Wonder if carrying the projos far in excess of the NIOSH Lifting Equation played any part in this? Make a reasonable person consider that. whether physician agrees is up to them i guess. Denied after 6.5 years of field artillery lifting projos weighing 174 lbs across 100 yard repetitively. The W-S VARO came to the conclusion which approximate= over my dead body. Thanks though. DRO Hearing upcoming. no to 2 (left only) but on slr move on rigt produces pain in left.

Berta you spoke to me and I undestood it. Maybe you should label your posts "postgraduated degree required/Law degree optional/layman approved)", just kidding. I again probably put the horse before the wagon. I have a request through IRIS, acknowledged, for the only QTC C & P exam that would be pertinent, but my concern is that will be in the year 2525 when they get to making that available to me. I have and assembled all other documents assembled and gave to the nurse. She was very focused on having the MRI discs and radiology evals., which I did give her. the only thing out of the picture is that qtc exam you reference. the chiropractors (only 2) wanted me to sign on for the full program (not gonna happen) and the Nerologists wanted referrals. This nurse wanted to know if the VA would refer me and I told her this was an adverserial relationship and a referral could possiblly be out of the range of authority of my VA PCP and possibly put the VA in a position of financial responsibility. I explained that wasn't gonna happen as the point of this game is to pit you, an individual vet, vs the US Treasury. She took me under her wing and said she knew what needed to be done. I suppose she will have to review the package, put it together in a manner they are accusstomed to. Then run it by the Neurologist. No numbers have been discussed so that remains looming out there too. If this doesn't work out I will hopefully have the qtc notes and X-ray images. I have a request in requiring time to develope the rebuttal due to physical challenges and financial requirements since my income on paper would make you laugh. The call from the VA I mentioned, the person said to just mention that and there should not be a problem. Extra time and the VA should not be an issue. I will continue to hammer on the VA for the QTC exam, failing that I will drive to the W-S VARO in person reqiring them stating and in hand my months old request for the QTC C&P Exam Notes. Not that they will start crying over their miserable failures but they will have to play slaughter ball in person with me. Thank you Berta PS I did mention I sent all the stuff to Bash minus the discs and the one C&P requesting a review indicating costs etc...I'll wait on that too to see if this is viable. PS: in writing the VA stated a soc will be made and supplied after the DRO. I did attach the lumbar denial sections from the award letter that will have to serve as an SOC until they feel it is appropriate to provide one.

Let me guess, you either lay around the pool a bunch or maintaina pool, which I think number 1 would be my first choice. Thanks pool, for the reply, and i see you still get up early too. can't help it. I am up on the acronym slr = Straight Leg Raise. more interested in the real world meanings in the findings and to what extent, if any, they hedged their interpretations. Thanks Friend!

If someone that has experience with SLR findings could interpret this for me would be great and save a lot of digging and extrapolating: Exam: SLR - + on L at 75 degrees; + contralateral at 75 degrees with pain to 1 leg. LE DTR's - 2+ throughout LE Motor: 4.5 5 1 Plantar Flex: otherwise 5/5 throughtout LE Sens. - sl. decreased PP L lateral foot and left post. leg babinski - down going toes bilat. No ankle clonus Toe Walk Mild weakness on L Heel walk - nl MRI 1. Alignment abnormalities, this degeneration and facet hypertrophy result in varying degrees of neural foraminal stenosis, as above. Disc material in the L5-S1 subarticular zone contacts the descending S1 Nerve Root and displaces it posteriorly towards the left facet. 2. Mild ventral deformity of the L1 ventral body with asscoiated kyphosis. 3. Mild focal levocurvature centered at the L4-L5. Minimal retrolisthesis of L4 on L5 4. diffusely hypointense marrow signal pattern most likely due to systemic stress. lateral neural, flexion, and extension views of the lumbosacral spine are provided. Mild degenerative disease at multiple levels. there is stable grade 1 retrolisthesis at l3 on L4, and L4 on L5. this does not change on extension and there is approx. 1mm of correction on flexion views. at both levels. There is stable minimal antero-wedging on L1 with associated hyphosis. Smaill Osteophytes are again noted. No acute fracture. Impression Grade 1 retrolesthesis at L3/L4 and L4/L5, does not change on extension, with approx. 1 mm correction on flexion views. It has a bunch more history but this is the crux. Bilateral thigh numbness whic hot one has been able to isolate the orgin, but we are talking numb, not hurt, so I just roll with that, whatever the orgin. They noted my options from meds to pt to epidural injections to surgery. Any deciphering would be appreciated. I have some med. knowledge but this is pretty inside baseball for me.

I don't really know that i am looking for an answer since there isn't a cut and dried answer. this is more on the order of putting my experience out there and others can compare and contrast with their own experiences and maybe figure what's coming down the pike for them if and when the time comes. I called numerous Chiropractors and they wanted to do the full treatment or kiss off with the documentation and write a letter in the proper form. afte numerous calls, i found a nurse at Carolina Spine and Nuerology in Asheville that was kind enough to have me gather the MRI discs, SMR's..... and said she would take care of it. I printed a page from the Bash site to give them an idea for form. I didn't feel right telling them the word for word on how to phrase it, but this is soooooo "what a reasonable person would believe/construe as SC I just don't phathom how it could take a word for word. For Example, I got a copy of my Durham VAMC and flex x-ray blew their denial to knigdom come. Fur crying out loud what more could it take. It clearly stated the degree I was SLR positive, when they said I was negative! It just goes on, restricted flex.......which they said there was none. Lying, cheating............. I just can't say it in mixed company. I almost had a heart attach this am when the VAS honestly called me wanting to know exactly what I wanted to appeal, which was 1 thing, the lumbar denial. Worst than the Army/PO/both on LSD. Just for thought. I also sent some info to Bash just to see what was up with that. Hi everybody.

It has been years but during a clinical in nursess tng. I watched a Hiatal Herniorophy (spelling), and after they open the rib cage to get to the esophogeal flap, if that is the cause, it is not something you would do voluntarily. Do something about that. The alternatives are not pretty.. Best wishes Berta. i

Yes , I do know exactly yhe way you sre looing at this. they put on my claim "residual effects of Flu". Now what on planet earth does that mean? I insisted they remove that. My VSO became angry at me because i was interfering with the process, and in laymans terms just plaim bothering hime. If I had it to do it over again I would have left it and minded my own business. Your honorable intentions sadly play no part in this that I can discern. Or reality for that matter. They did in 1978 line us up and say here is a new thing called a flu shot. I have never been so sick in my life, but I lived and that was the end of that. what that meant nobody I have talked to knows. Just let it go is all I can say. Negative side= nothing. Positive side would be they award you something or whatever they write down may help reagarding your UI. Wish you luck on the UI. Sounds like you deserve it . Stay strong and honorable and things will go your way.

Thank you Pete for making me feel welcome here! I say that I am a nobody here not just to be self-effacing but when you read some of the posts, and in particular members like Bertha, and God knows we need her here, and I'm sure she has won many case for members, and I do not want her to speak in the vernacular, but it is reminiscent of picking the mind of a research astro physicist while peaking on two hits of window pane. Point is I am not the one to be giving much advise when it comes to someones ability to provide food and shelter for themselves an their families. This is very serious stuff. Encouragement is equally as important as the procedural law since if you don't follow through it is meaningless. It was just last week and I was ready to toss in the towel but I read on and saw the successes and found the motivation to continue so we need, I need, it all. I try to restrict my comments to the things I have experience with. Not just shoot from the hip. This is far too important to interject my ego into. You guys provide a very valuable service and I want the person I am speaking to know I am not the final authority but will not lie to them either. I think billy2 should follow his VSO's lead since I don't anymore about the case than I do. It may not make sense to him now but look at the down side. You have nothing to lose and the VSO is probably basing their recommendation on experience, law, and his records, I hope, and if the C&P examiner is claiming a nexus between his current condition and his service then that sounds like a winner to me. If the C&P examiner says you have flat feet and for instance you have been employed at a desk for the majority of your working years, and depending on your service medical records, I don't think you are wasting anybodies time. That/This is exactly what the VA was established for. They are getting paid well for their efforts. IMHO if you answered the call and were willing to do as you were told then this is the price of doing business. They know that. Some at the VA and VSO's think we are all dead beats. You gonna let what someone thinks about you stop you from receiving what they are legally required to provide? You are not wasting anybodies time. Do it! PS: you are good at that.

Papa is again on the mark. If taking anti deppresion medication disaqualified folks from federal employment dc would look like a ghost town. Some clerance checks are just run the license and look for any current warrants and if you had done time. I got one for working at Blue Cross Blue Shield and it was nothing, just a fed. requirement. As a nuclear weapons chief they went deeper and the form was extensive, but they never really followed it to the end. The rest of my fed jobs just wanted to know if I was currently wanted by the fuzz. On the other hand my brother, in Germany worked for the Frankfurt Milcom and he put down that he had never done time. During the pot witch hunts of 1970 vintage, That was not quite true. But still time, so out the door he went. Moral: tell the truth because they can look on a computer in seconds to see the obvious. They can't tell what you did in the basement with a few buddies. Still it depends what the clearance is for. My advise, tell the truth and apply. If you have a problem it is better to know now than have to pack your bags later. My brother now makes 75,000 a year working from home, With a home office allowance, so their ......

Think of it this way, which I read here and took to heart: when you entered the service by the fact they accepted you, they acknowledged you were in prime physical and mental condition. They had you performing tasks the civilian world would not even consider, such as in field artillery they couldn't legally run one without breaking federal lifting equation guidlines, much less stand in front of people that were intent on doing you harm. So you see where I am going with this. I and many other vets are rightfully receiving benefits due to the actions you performed to defend our country. Your varicous veins for example could well have been aggravated by or originated by your service. Same goes for all very long list of other health issues that a good VSO will review your records and submit the items that appear to have been caused or worsened by your service, even if it took many years to present itself. Go with it. You would be very superised by how the system works and how they determine the illness nad the connection to your service. I am a nobody on this forum and am only telling you what I personally have experienced and what I know to be true and fair. Mainly the VA will toss you a bone but withold the real debilitating issues. Others on this board such as Bertha, John999, Pete....... are much better equppied to go into detail with you. They know the law! Ultimately the law and evidence is what matters but if a VSO says claim it then claim it. I do not believe your age is such a major factor. give this some thought. I have among other things degenerative disc disease, herniated discs, and pinch S1 nerve. I was in FA for 6.5 years lifting 176 lbs over my head for years with in service med records. where do you think thos injuries came from and have just gotten worse over the years till now it is screaming. I am 54 years old, but that doesn't change the fact my service set my lumbar up for these problems. Others will help you here since I know zero about copd, Agent Orange and PTSD. flat feet, or acquired flat feet since they would never accept you with flat feet could well have been caused or at least been the prime source for you developing acqired flat feet. Others know more and will be glad to help you.

I have been put in for issues that never occured to me as service connected but they were approved at the RO level, no appealing involved. So I don't see the down side to this. i will say this regarding hyper-hypothyroidism unless they detonated a nuclear device in close proximity to you it will be denied. Still no sweat off your brow. I worked as a tactical nuclear weapons chief for years, open box etc. but unless it was detonated /i can hear the wheels spining. I have zero info on the rest of your issues. You are very honorable and I respect you for that, not wanting to take something you are not sure you have coming. the people you are dealing with are not, IMHO. So my advise for the little it is worth, thank your rep for caring, since most don't, then say by all means apply.