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Interested
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As for your ineffectual attempt at baiting, that concept had crossed my mind but I as a charitable person ignored it - that word was brought up by another. Again, if I were not so charitable, I prolly should feel offended by such a weak attempt.
My "opinion" has little to do with anything. What do the books say? One does not have to agree with what is in the books, but one must follow the books. However, if you work hard enough - rather than complaining as another astute poster noted, you just might get things changed. Would I like whatever change comes about? Mebbe, mebbe not - but I go along with it.
While he/she didn'tclarify that aspect of the question asked, "I feel" he/she sortadanced around the CRT portion, with regard to the VA's handling of the"s" award. You feel? You feel? What is unclear in your mind about:
Posted 20September 2011 - 01:25 PM
(snip)
Once the single 100% (or 100% equivalent) is established, it is disregarded for purposes of future computations. You effectively start over with the remaining disabilities, which are combined per 38 CFR 4.26 (if appropriate) and 38 CFR 4.25.
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Although it prolly won't change the outcome, please clarify what the 20%+10%+10%+10%+10% disabilities are.
Thanks, Interested, I appreciate your efforts!! Yes, I am quite familiar w/4.25(b) and I agree this has nothing to do with the benefit of the doubt issue. I also feel that you've sort of avoided answering the question, but then, that's just me. Are you familiar w/how the VA adjudicates the SMC "s" award when the claimant is 100%+20%+10%+10%+10%+10% and, if so, how would they do it?? Once again I thank you for your time, as I'm sure you have better things to do, other than dealing w/my stupid questions.
pr
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Whatever.
I'm jumping in on pr's topic because it may apply to many - of which I might soon be one.
People were already aware of 38 CFR 4.25b of the CRT.
I question - how is the VBA able to even use the CRT for SMC/s on the additional 60 percent portion
as 3.350 (i) (1) appears to also be any exception, being that it actually spells out independently ratable and does
not state or address "combined" ?
38 CFR - 4.25
(b) Except as otherwise provided in this schedule,
the disabilities arising from a single disease entity, e.g., arthritis, multiple sclerosis, cerebrovascular accident, etc., are to be rated separately as are all other disabiling conditions, if any. All disabilities are then to be combined as described in paragraph (a) of this section. The conversion to the nearest degree divisible by 10 will be done only once per rating decision, will follow the combining of all disabilities, and will be the last procedure in determining the combined degree of disability.
38 CFR - § 3.350 Special monthly compensation ratings.
(i) Total plus 60 percent, or housebound; 38 U.S.C. 1114 ( s ). The special monthly compensation provided by 38 U.S.C. 1114(s) is payable where the veteran has a single service-connected disability rated as 100 percent and,
(1) Has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or
(2) Is permanently housebound by reason of service-connected disability or disabilities. This requirement is met when the veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime.
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Did anyone bother to read 38 CFR 4.25(b ) http://www.benefits....PART4/S4_25.DOC as I suggested? For those who didn't use the link, I'll make it real easy for y'all:
(b) Except as otherwiseprovided in this schedule, the disabilities arising from a single diseaseentity, e.g., arthritis, multiple sclerosis, cerebrovascular accident, etc.,are to be rated separately as are all other disabling conditions, if any. All disabilitiesare then to be combined as described in paragraph (a) of this section. Theconversion to the nearest degree divisible by 10 will be done only once perrating decision, will follow the combining of all disabilities, and will be thelast procedure in determining the combined degree of disability. (emphasis added).
The only exception that I am aware of is the bilateral factor from 38 CFR 4.26.
It seems pretty clear cut to me. I don't see it as a benefit of the doubt issue at all.
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I, personally, believe the VA continues to use the CRT when figuring SMC awards. I, personally, believe you are correct. However, I do not believe using the Combined Ratings Table violates the SMC "s" award criteria (or, for that matter, the criteria for award of the additional half-step of SMC for Additional independent 50 percentdisabilities. )
Once the single 100% (or 100% equivalent) is established, it is disregarded for purposes of future computations. You effectively start over with the remaining disabilities, which are combined per 38 CFR 4.26 (if appropriate) and 38 CFR 4.25. It would appears to me that 38 CFR 4.25(b) http://www.benefits....PART4/S4_25.DOC is operative here.
If you disagree, you prolly need to work on sumpin' that would establish ' ... what the sense of Congress was ... ' when 3.350(s) was written.
Okay, I understand how and why the CRT is the way it is. But once a claimant is rated 100% they are effectively worth zero, nothing, nada, meaning they have no value compared to a normal person. Additional disabilities should not use the CRT because the person is "0%" and has zero percent residuals left. That being said, do they continue to use the CRT or do they just add the additional disabilities together, using normal addition to come up with a total??? Once a claimant is zero they cannot become a negative. I hope I'm explaining this properly and that you understand what I'm saying. For example, a claimant rated 100+20+10+10+10+10 should be rated 100%+60%, however if they use the CRT it would combine to be 100%+50%, which violates the SMC "s" award criteria. I, personally, believe the VA continues to use the CRT when figuring SMC awards. Thank you for your time!
pr
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Before I guess at what you're really asking and provide an inadequate answer, please expand and clarify even tho it penalizes the claimant "again" for the same disabilities . As always, a specific example would be helpful.
You appear very knowledgable on VA matters, enough so that I'm guessing you're a VA employee sharing your knowledge here. Can you explain how the VA uses the Combined Ratings Table(CRT), once a claimant reaches 100%?? Also with reference to the 100%+60% "s" award?? Do they use the CRT in making that decision, even tho it penalizes the claimant "again" for the same disabilities?? Thank you for your time!
pr
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Ihd
in Agent Orange
would calcification of the abdominal aortic valve be consider IHD Not usually.
Ischemic heart disease (also referred to as coronary artery disease) usually is associated with the coronary arteries that rise from the aorta and "feed" the heart.
would calcification of the abdominal aortic valve be consider IHD
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Just some minor rambling ...
With a 10% ejection fraction, you shoulda/coulda applied for an increase for your CAD because an EF of 10% is low, really low. However, that claim for increase likely would not result in any increased compensation at this time because I presume you already are at the SMC-s level. Because you had a pacemaker installed earlier this week, there is a statutory 100% for two months, followed by a reduction to whatever's appropriate. Again, there would not appear to be increased compensation at this time. Nonetheless, although you likely would not receive any additional compensation, I encourage you to file because doing so would result in a better claims history that you might need, oh let's say, 5 years from now.
You can apply for Aid and Attendance. The criteria for A&A are at 3.352(a) http://www.benefits....ART3/S3_352.DOC . While there is no absolute prohibition AFAIK against granting A&A on a temporary basis (if your cardiac symptoms do improve), it is not all that common - usually A&A is a permanent basis. But, you can try ....
As for door widening ... at this moment, it would appear that you qualify only for the Home Improvements and Structural Alterations (HISA) http://www.prostheti...a.gov/HISA2.asp program. You apply for HISA at your local VAMC Prosthetics Department.
There are other VA home improvement programs, administered through the VARO and the Home Loan Department http://www.benefits....meloans/sah.asp . At this moment, it does not appear that you meet the criteria for either of the SAH programs.
All the programs require time, lots of it. In the short term, how about offset hinges http://www.dynamic-l...or-hinge/#clear ? These effectively "widen" a doorway by 2 inches, and may be just the amount you need. You can buy them on-line, or usually locally at a medical supply store.
Merry Christmas.
I am currently SC at 100% P&T for PTSD, 60% CAD and 10% for hypertension, in June my PCP put me on oxygen this was shortly after a massive heart attack in April, I then spent from 10 June - 28 June in ICU for Congestive Heart failure, my wife got my PCP to get us a light weight wheel chair that she could handle me easier than fighting with the huge power chair they issued me back in Sep 2003.
Should I file for the Biventricular pacemaker/defib that was put in on Wed due to my ejection fraction of being 10%, they are hoping it will increase my ejection fraction over the next few months, since my wife basically does everything for me, meds, driving, showering should I file for A&A? The doors to the bathrooms need to be widened for the wheel chairs which program covers that? I can't walk more than 50 feet any longer the docs can't or won't give me a time frame just that I am "end stage congestive heart failure" any ideas will be appreciated, so I can point my wife in the right directions.
The night they did it Wed I was in quite a bit of pain my wife told them the percocet wasn't touching this pain, the nurse came in with demorol it wasn't but a few seconds later I was totally loopy and talking all kinds of BS Dori, my brother and the nurse were all cracking up, I slept like a baby. The rep from Medtronic came by about 8 and waved a device over my chest and down loaded the data it has collected since the insertion just to see that it was firing on all cylinders, they told me that they did not do the big test where they stop your heart to see if the defib works right or not but that the pacemaker function was doing it right but stopping my heart and hoping it would restart just didn't make a lot of sense to anyone, works for me with my luck it wouldn't have restarted.
My wife said the doctor told her I can't swim or take a bath to get the incision soaking wet and not to over use my left arm for the next few weeks 2-3 so the leads will have a chance to start having tissue grow around them to hold them in place. Now I can't even carry in the bread lol life is rough and I have a wife that I don't deserve she treats me so well and I know I am a pain in the azz
Hopefully now with this new gizmo I will be able to offer my 2 cents here for years to come a few months ago I wouldn't have bet any amount of money I would live to Xmas, now I am wiling to make that bet
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Good info but 3.309 must be read with 38 CFR 3.307 http://www.benefits....ART3/S3_307.DOC . The veteran must understand that there are time limits for most of these presumptives. These time limits refer to actual diagnosis of the presumptive condition, or objective records during the presumptive period that show symptoms of the condition. That is, a claim does not have to be filed within these periods, but that the condition was diagnosed or manifested during that period.
Another presumptive is ALS, mentioned in 38 CFR 3.318 http://www.benefits....ART3/S3_318.DOC . While not exactly a presumptive, but close, may be cardiac disease following one or more LE amputations , ref: http://www.benefits....RT3/S3_310.DOC. There may be other gems hidden here and there.
http://ecfr.gpoacces....1.1.4.1.66.117
I can never seem to find the regs on the Chronic presumptives here.I know they ARE here, I just can never seem to find them.
It pays to mention them again.
(snip)
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Well, a VA examination is not absolutely required if the medical evidence accompanying the claim is adequate for ratingpurposes per 38 CFR 3.326(a) http://www.benefits....ART3/S3_326.DOC . However, I have seen few claims that did not need a CP&E. Without knowing specifically what the claim is for, that is, the claimed disability and what medical evidence was provided, it's difficult to say whether a CP&E would be helpful.
On the negative side, why would I waste a CP&E slot if there was no way that I could grant the claim? The classic example is when a troop makes an AO related claim but there is no record that the troop was ever in Vietnam; there was no evidence that the troop was otherwise exposed to one of the listed herbicides; there was no evidence that I could grant on a direct basis; and, there was no evidence that I could grant based on the 'normal' presumptive basis. So, if I wouldn't be able to grant, why waste an exam slot?
Finally, I wouldn't necessarily take as gospel everything I read on eBenefits. Just sayin' ...
Hello,
This q is for a friend, He has no computer or computer skills.
He filled a cliam in march this year, it just went from development stage to decision. So after 6 months hes happy its moving foward, The problem is he has not had a c and p exam yet? And is worried about this. Is this bad news?
Thanks
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1. Yes.
2. Yes.
Got a question....Just had to give up my job due to my inability to understand people on the phone and also absolutely cannot understand asian or latins. Anyway I am currently rated 10% for tinitus and 0% for hearing loss. I know you cannot collect NSC and SC comp together. My question is... Are you still covered for any medical issues related to the SC conditions as in my case hearing aids? I can collect more from the NSC side than the SC side. Also, if down the road you get SC'd for a larger amount do they automaticly stop one and restart the other. I am over 65 so I qualify for the NSC pension.
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Rating criteria for back conditions are at 38 CFR 4.71a http://www.benefits....ART4/S4_71a.DOC . Diagnostic Codes (DC) 5237 or 5243 may be appropriate. Review General Rating Formula for Diseases and Injuries of the Spine and Formula for Rating Intervertebral DiscSyndrome Based on Incapacitating Episodes . You can be evaluated under one, not both, sets of criteria.
At my C&P I was diagnosed with Thoraco-lumbar sprain with mild thoraco-lumbar DJD: Problems associated with the Diagnosis: Lumbar spine condition/Thoracic lumbar spine condition w. bulging discs. Any indication if this is rated? I think they go of of mobility and if it affects day to day.
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See, this is what I get for guessing that your stressor was combat related.
In your case, more information is required. While others have made good suggestions, there are other sources to validate your stressor. You have to show evidence that you were involved in the event, not just that you were on-base. If you received a medal for your actions, what does the Citation To Accompany the Award of __________" say? During claims development, it is routine to request your 201/personnel file ... do any or your proficiency or performance reports comment on the event? Additionally, there are unit daily reports and your name perhaps may be mentioned in the reports; give the VARO the date of the event and ask them to request the daily unit reports.
And finally, do you have proof of a current disability? That is, are you receiving treatment for a psychiatric disorder, and have you actually been diagnosed with a psychiatric disorder?
Hello everyone,
I filled my cliam, Q is will the va find my stressers in my military records IE medels and write ups, Or do i have to tell them where to look? I looked at my records and the stressers are there? Does the va really read ev ererything? I just dont want them to miss this info!!
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What was the rationale on the Rating Decision for assigning the 10%? What was your historical ejection fraction or METs in 2002? Have you had treatments for a heart condition from 2002 to whenever the 48% EF was determined? Did those treatment records report any EF or METs? Did you have actual or chemical stress tests through the years and what were the results? Did you have any echocardiograms? Did the echos report hypertrophy?
Received a decision on my Nehmir claim last week.
It was infered back to the year 2000. The paid retro at 10% which I am filing a NOD, due that my injection fraction was 48%. Send decision to NVLSP for there review.
They granted 100% for IHD from 01-2011
They granted SMC from 01-2011
Has taken 12 years.
Great to see that Vietnam Vet are being taken care of.
RDT
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If no one cares to ask what those situations are, it can hardly be called a controversy, now can it?
As for bait and bs is that something that doesn't follow the party line?
This is kinda like the Republican pre-election 'debate' last Monday ... when any of the contestants dared make a comment that wasn't in line with the talking points of the "sponsors", they were booed by the Peanut Gallery.
Interested,
You are welcome to come here and provide help or even vent
BUT
do not start throwing in bait and bs - to get arguments going.
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will the va find my stressers If the stressor is associated with one of the magic medals, the answer is yes. If one of the designated medals is recorded in your DD Form 214, that generally suffices. In the case of a claim for post-traumatic stress disorder, it's part of the development to request your personnel file, the '201 file' from the Records Center; all medal awards should be recorded in the 201 file.
If the stressor is not associated with one of the designated medals, some report or mention of it is - hopefully - in your Service Medical Records, if you had treatment associated with the stressor.
Or do i have to tell them where to look? You could, if it makes you feel better.
Does the va really read ev ererything? I'd say yes.
I just dont want them to miss this info!! I doubt that anything gets missed. However, how much credence or validity is given, ...?
Hello everyone,
I filled my cliam, Q is will the va find my stressers in my military records IE medels and write ups, Or do i have to tell them where to look? I looked at my records and the stressers are there? Does the va really read ev ererything? I just dont want them to miss this info!!
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As for your question, the two conditions are rated separately.
As for your comment about raters most of the ones I have had ignore what surgeons and Doctors say and I believe that they (raters) will decide based on their opinion not my Doctors , it's about as valid as saying that most veterans are lying about their claims.
FWIW, it's sometimes appropriate to ignore or disregard a doctor's opinion. (there, that should stir up some controversy).
Hey I was wondering I just had a C/P for depression secondary to my SC back which I claimed a chronic pain issue are they all rated together or seperate? I am waiting to see what the raters will do. I am leary of the raters as most of the ones I have had ignore what surgeons and Doctors say and I believe that they (raters) will decide based on their opinion not my Doctors. Anyone got an idea? I just got off the phone with the VARO telling them that I was going out of state to find a place to live and I would not have acess to my PO Box should they send anything in the next two weeks. I have tried sending messages to VA within the system IRIS but I can never get one through. I am also writing a letter to them as well and asking for a signature upon receipt. I have heard way too many times a veteran gets the shaft when he never recivied the letter or hearing notice.I got my C/P results back and the Mental health Doc put my GAF score at 50 but stated I had the ability to handle my own money. I do not know what the GAF score means I looked it up and again it is based on the raters. I am going ahead and move before the cold weather gets here this fall. It looks like Arizona or Texas just not sure yet.
Thanks have a good day
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I am not aware of any specific regulation or policy that requires Service Medical Records to be reviewed by the examiner for all veterans' claims. It may be thought of as nice to do so, but I am torn about the actual utility to do this on a routine basis.
The only time review of the medical records is required is when I ask for a medical opinion, that is, " ... is this event dated ______ less likely/as likely/more likely related to this ____ current condition?"
Veterans Health Information Systems and Technology Architecture (VistA, from the repository of all internet knowledge: http://en.wikipedia.org/wiki/VistA ) is the VA health information management system. Some agencies have full access to entering data, whereas some agencies have only viewing privileges. At present, VistA does not incorporate Service Medical Records, however it appears that a goal is to create some sort of Electronic Health Record (EHR) exchange.
Ok. I have spent over an hour searching all the FAQ's and a regular search and have had no luck finding something I believe I have read before but have forgot what it said. So I will ask again for I am tired of searching.
What exactly is the requirement of the C&P Examiner having access and review of the C-File or SMR's?
Also I looked up what Vista Records are. Is looking at the Vista Records considered the same thing?
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My estimate was not based at all on TBI (claimed as spinning), PTSD, or any of the other items that you had not specifically claimed. For purposes of the estimation I gave, I assigned the percentages that I was absolutely sure of. So, the 60% range was good. It's probably better to under promise and over deliver though.
WRT any evaluation for TBI, I'd defer this issue for further development; that statement does not mean that I would not grant service connection, just that some information needs clarification. As I recall from the audiology exam, the audiologist provided a diagnosis of TBI and this type of diagnosis is not usually made by an audiologist. I'd defer the issue of TBI for another CP&E by a neurologist to confirm that diagnosis.
As for PTSD, I would defer this also for the above clarification. I recall that the symptoms attributed to the TBI in the audiology exam duplicated many of the symptoms mentioned in the psychiatric examination. Because using the same set of symptoms/findings to support two different evaluations is called "pyramiding", I would want a better feel of the overall situation before I finalized.
While you may believe that your other, specifically not claimed items will be dealt with automatically .... mebbe, mebbe not. A specific claim is prolly best.
An earlier poster mentioned It looks like your hearing is totally shot in both ears. Rather than guess, I took the time to run the numbers through 38 CFR 4.85, Tables VI and VII and I find a 0% evaluation.
Of course, whoever rates your claim may simply choose to ignore everything and just slap on ratings.
But I was asking about the PTSD and the TBI you said "exclusive of TBI and PTSD and the solicited items if you choose to formally claim them" what are you meaning by this? are you saying not including this just with what I have for the rest of the medical problems you would say about 60% or am I just reading it wrong?
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Unfortunately, although there is a required certification for veterans service officers, there is a wide variability in capabilities from office to office, year to year (as staff moves), and from region to region.
However, in my observation, the state veterans offices seem to be well run and knowledgeable. Of course, YMMV.
First off I would like to tell everyone this site is great help!!
My first q is, I heard that if your out within 1 yr from service you can link your disibility to your service, Is this one yr from active duty or 1 yr from end of obligated service? This q is for a friend.
second q, Is there a site to see what vro is the fastest or witch one has the most cliams?
Thanks
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Thank you for the update, that the IU issue is for historical rating purposes.
am a bit confused so please bear with me ...
I understand that you are being compensated at the SMC L 1/2 level, correct?
If so, why is Individual Unemployabilty an issue? If you are at 100% for another condition Meniere's Disease?), the issue of IU is moot (unless there is something of a historical nature that I'm unaware of).
On what basis are you applying for an additional 100%? You seem to have a good handle on SMC so you probably already know this: an additional, independent 100% grants a step increase in SMC, or perhaps in your case to SMC S 1/2 (if you aren't pursuing an increase for PTSD) from 38 CFR 3.350(f)(4) http://www.benefits....ART3/S3_350.DOC
As I said before my case is a bit confusing:
The BVA Judge service connected Meniere's and sent it back to the RO to rate. Due to the c&p exam, they assigned me 100% back dated to the date I filed, which was the middle of 2007.
She also remand several issues Including left knee which was granted, Also IU. The ask a specific question. ( Was this Veteran unable to work prior to 2007) I had three c&p's on the same day. One for hearing which the c&P DR. said my hearing alone made me iu,. This is insignificant as it only took me back to the same date I was granted P&T. I'll skip to the PTSD The Shrink who did this C&P stated I was iu due solely on ptsd and gave me a gaf of 40. He also made reference to another C&P I had in 2005 for ptsd where that Dr said I was unable to work due solely to ptsd. ( the RO low balled me and gave me 50% at that time). This claim was filed in 2004 which if granted the VA would have to pay me the difference of 50% to 100% from 2004 to 2007 when they gave me 100% for meniere's, but more important to me it would reset the 10 year clock back to 2004 for DIC purposes.
Just for the record the third Md also said I was IU prior to 2007 for all the medical conditions conbinded.
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As for time frame .... if the VA Regional Office with your claims file intends for you to have a re-examination, actions to schedule them usually begin about 3 1/2 - 4 years after service connection or evaluation award.
Others have made good suggestions about continuing treatment. However, AND I DO NOT RECOMMEND THIS, you may choose to do nothing. Interesting question isn't it, cure or comp?
If you do have a reexamination, make sure that the VARO knows where you've had treatments, whether at a VAMC, a Military Treatment Facility or from a civilian practitioner.
Following is some general (and brief) information about future examinations, preservation of service connection, and preservation of evaluations.
There are three time frames of importance:
1. Five years of service connection and/or award of a particular evaluation. Before the five year point, I may propose to reduce an evaluation based on only one reexamination. However, after 5 years of service connection or a particular evaluation, a disability is generally considered static and I generally must have another re-examination to propose to reduce. Note: I can even propose to sever service connection up to the 10 year point.
2. Ten years of service connection. After ten years of service connection, service connection cannot be withdrawn (subject to fraud, etc). However, I can propose a reduction based on medical evidence or reexamination.
3. Twenty years after award of a particular evaluation. After 20 years, a particular rating evaluation becomes "set", that is, if you have had a 30% for a particular disability for 20 years, the evaluation cannot be reduced lower than 30%. However, if you had that 30% rating for twenty years and get an increase to 50% at the 20 year point, the 50% would not be protected for another 20 years. However, the 30% level is protected. Simple, isn't it?
Please don't obsess. No matter what anyone says, it really is time-consuming and moderately to very difficult to reduce an evaluation and particularly to sever service connection.
I am worried about two ratings that were awarded to me and you're exactly right it states " as this condition may improve, a future examination has been ordered ". I retired 31 Oct 2010 and I cannot work however I don't want VA to reduce my claim for any reason. The two I am worried about is, a) Depression, and b) Prostatis, both of these conditions have worsened since my retirment and I was never prescribed meds for either condition while on active duty. Since retireing I am now prescribed Zoloft for depression and a host of other meds for my Prostate. What should I expect, how soon and basically what do yall think?
thanks
vet2010
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I try not to get into these message board mictuation contests but ...
broncovet, you wrote: This is very close to CUE. Rating specialists can not substitute their own unsubstantiated medical opinion for that of a qualifed medical professional. I would "nail" them on this.
What is available for review does not appear to support the above statement. Would it be more likely that the rater merely quoted the examiner's statement from the VAE? Instead of fabricating some great conspiracy, why don't you apply Occam's Razor (from the repository of all internet knowledge http://en.wikipedia....Occam%27s_Razor )?
Also, I'm appalled that you didn't choose to criticize this: Although there is a record of treatment in service for pes cavus claimed as right foot condition, no permanent residual or chronic disability subject to service connection is shown by the service medical records or demonstrated by evidence following service.
Getting Old Posted: My comments are underlined:
The x-ray was normal.
Xrays dont show everything, for example, they dont show damage to tissues, only things like fractures.
Your separation examination noted a "normal" spine and there were not complaints voiced by you at the time concerning your back and/or spine.....
....... Lying down will help this.
What? This is the rating specialist telling you that "lying down will help this"? Makes no sense and suggest rating specialist is recommending treatment. This is very close to CUE. Rating specialists can not substitute their own unsubstantiated medical opinion for that of a qualifed medical professional. I would "nail" them on this.
You saw a private provider and was scheduled to get therapy before trying back injections. You have numbness in the right leg to the foot that would occur with the back pain flare ups but currently you denied any numbness.
Contradiction. This is a very very bad decision. You also start limping during a flare-up. The pain is located across the lumbosacral area and does not radiate. You are able to walk normally without any assistive device. This condition has no effect on your usual occupation. You are able to perform all activities of daily living. Range of motion of the lumbar spine: forward flexion: 0 to 90 degrees without objective evidence of pain; extension: 0- 30 degrees without evidence of pain; right lateral flexion: 0-30 without objective evidence of pain; left lateral rotation: 0-30 degrees without objective evidence of pain. There was no additional limitation of motion following 3 repetitions.
Who says? The rating specialist or the examiner? Again, the rating specialist can not insert his unsubstantianed medical opinion. The examiner stated that on exam today, there was no objective evidence of painful motion, spasm, weakness, or tenderness. You denied any incapacitating episodes in the past 12 month period. Strength was 5/5 in all muscle groups of the upper and lower extremities. Straight leg raise negative bilaterally,. Sensation to light touch was intact in the upper and lower extremities. DTR's: 2+ bilaterally, babinski negative. MRI of the lumbar spine dated June 29, 2010 noted mild bulging of the annulus at L4/L5 may abut but does not displace the exiting right L4 nerve root. The diagnosis provided by the examiner is lumbar degenerative disc disease. The examiner opined Now we are talking. The examiner can opine, but the rating specialists medical opinion on your health is irrelevant. that this condition is less likely as not caused by or related to veterans service. You need to read the C and P exam..this looks like an obfuscation of the facts if the examiner said your condition was "at least as likely as not due to military service". The rating specialist "twisted" what the examiner said and made it sound like it was "less likely". There was no evidence found of periodic treatment more obfuscation. There needs to be chronicity of symptoms, not chronicity of treatment. You see, the doc can change the treatment, try different drugs, different therapies, etc. But you still have chronic symptoms. for low back condition continuing from service. No low back condition was noted on exit exam from the service.
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I'm not about to wade through your C&P records again, so I'll let you do it ...
As I recall, at the end of the general C&P (I believe it was by QTC) there is a fairly lengthy Remarks section about your feet (and perhaps other things too). Also as I recall, there were some radiological reports for your feet.
It's not totally clear to me whether you had claimed a foot problem or whether this came up during the exam. If you claimed it, sorry for getting you hot and bothered. If you had not claimed a foot problem, you likely should.
What other conditions are you thinking I am lost when it comes to this stuff, and just so you know when I put these in here I put them in order I am not ssure how they got all jumbled around but thank you very much for your help.
Loss Of Creative Organ
in SMC Special Monthly Compensation
Posted
You can't get two K awards To be technically precise, this is incorrect.
As you noted, a veteran cannot receive two awards of SMC-k for Loss of Use of a Creative Organ. However, a veteran may receive SMC-k for other reasons. It's all right here in 38 CFR 3.350(a)(1) through (6) http://www.benefits....ART3/S3_350.DOC .