USAFvet13

I'll have to look later tonight at the notes to see if he mentioned the IMOs. One key thing he is saying against my claim in his conclusion was that if the back pain was caused by knee issues then recent xrays of the knees prior would show abnormalities. He refers to xrays from 2009 which I have no idea what he is talking about. BUT, he fails to mention just this year in 2010 I had ANOTHER C&P for a knee increase and that C&P doc found degen arthritis and slight subluxation and my knees were given another 10%. NOt to mention the recent orho doc this month did xrays and found patella tilt in both knees (this is the doc that wrote my IMO). I included all this information with my appeal.

Finished my C&P and got a copy. Not looking good. Doctor states "less likely as not" back pain secondary to knees..... I did submit 2 chiro IMOs that say otherwise, and 2 other IMOs one from a physical therapist and one from an Ortho that says "as likely as not" or "is due to" so I'm not sure what to think at this point.... I don't think it's looking good though.

What about getting an eduction in landscaping or something similar? Then you can use it to get into landscaping / lawn care and/or start your own business. Those guys have limited contact with customers and seem to work 99% of the time by themselves. Seems really relaxing and stress free. Or maybe web design and then you can work from home....

Sorry to hear about your suffering. I know how difficult it is living with back problems... I'm going on 5 years now with back pain and just recently submitted a claim for it also. I don't have any advice for the back claim. But on another note if you haven't already, ask your primary care doc for an appointment with mental health. Reading through your post and reading about your difficulties due to your service connected disablity its pretty obvious it is causing you depression. You need to be diagnosed from the mental health clinic and then gather those notes and file for depression secondary to your service connected disabilities.

wow, I did ask for a referal to the pain clinic a few months back and my PCP told me basically I didn't meet the requirements. Thanks for the comments and suggestions guys, I would have never known. I'm calling right now to ask for a referal again and if they say no again I will ask for a new PCP. Thanks!

I have had chronic bilateral knee pain for almost 6 years now, both of which are service connected. Also have degenerative arthritis. My PCP at the VA has been giving me NSAIDS for my knees and they dont' seem to help at all with the pain. I told her this and all she has done is changed to a different brand 3 times. My PCP tells me that for chrodromalacia patella syndrome NSAIDS is the only thing they can give me... is this true? It does nothing for my knee pain. The pain keeps me up at night and gives me trouble sleeping.

At least you received notice in advance.. I had a C&P scheduled for last month and the day of my appointment, one hour before I was going to head out, I received a phone call for a reschedule. The Doctor was sick in my case so I had to be rescheduled.

I wouldn't leave it be if you feel you deserve a higher rating. I have a similar gait claim going currently. I filed for a back condition secondary to my service connected knees and was first denied because of lack of evidence of an altered gait. So I filed a NOD but didn't get my information to them intime and so they denied me again. So then I filed an appeal. I have since gathered 4 IMOs stating my gait and knees are the cause of my back problems. I would file a NOD and then go to your doctors and ask them to put it in writing about you gait and get them to write you up an IMO stating something about you having more "cerebellar gait".

Thanks Berta. I also just got a IMO and treatment records from a physical therapist I have been seeing. I know it's not weighted the same as a doctor's IMO but hopefully this will help. I have another question..... 1. Thanks to jameshadit's post about "A Good Start For Va Claims\development" I've decided to write up a narrative / letter that will refer to my evidence I have sumbitted with a time line linking everything together. What is the proper format for this? I've tried looking for examples but couldn't find anything. If I remember correctly just put my name and social on the top and address it To whom it may concern? Is anything else needed to make it official or a specific format to follow?

Yes I will be bringing this IMO with me to the C and P exam along with my other IMO and hopefully an additional one concerning being treated for an altered gait. On my letter for the exam it did say to bring any medical records with me, which I found odd since I already sumbitted everything. But I want to have these IMOs on hand since it's possile the examing doc will have missed something. So is there a possibility I will not have to go to the appeal video conference? Assuming the C and P exam goes in my favor, will I still need to do the video conference? What worries me is that my altered gait is slightly noticiable during the first min or so of walking, but as my walk continues my knees start hurting worse and then my gait becomes worse. Also some days are better than others so my gait can be really bad one day and not so bad another. Going up or down stairs I have to hold onto a rail because sometimes they go out. And I can't walk up normally because it hurts so I have to compensate on how I walk up and down the stairs. None of this has ever been tested in any of my C and P exams so that's why I believe no mention of an altered gait has ever been said by the examing doctors.....

Sticher, have you tried asking any of the specialists or doctors you see to provide you with an IMO? Maybe I lucked out, but my private health care doctor gave me one free of charge for my knee. And I had two chiropractors write IMOs free of charge to support my back secondary to my knees. One chiropractor told me he would do it but it would cost 500$ or more depeding on the time involved so I didn't use him. The key for me was I made an example IMO letter and explained how important the format was to follow. I also brought in my service records incase they wanted to review them. Six years is a long time to be working on a claim. I wish you the best in getting a good IMO and hope you reach a conclusion to your claims sometime soon.

Here is my most recent IMO, I think he described the connection clearly enough but I could be wrong....

Quick update to my appeal, I had a CP exam scheduled this month but the doctor became sick and cancled on me so it's been rescheduled for Sept 20th. I had a second chiropractor write me another IMO and he also said it was as least likely as not my SC knees were the cause of my back problems. This Chiro also stated a few facts about how an altered gait will eventually lead to compensation of other muscles and eventually lead to muscle imbalances and pain / problems in other areas of the body. He also attached two sheets of all his medical training. After reading over my previous denial for back secondary to knees, it seems the probelm is the lack of documentaion of an altered gait. But I have seen a muscle activation therapist for a few months in hope of getting my knees to work a little better so this therapist is supposed to be writing me another IMO stating he saw me for an altered gait. Hopefully with all this my appeal will go through in my favor.

I'll scan what I have and post it here this evening. The IMO was listed as evidence. I don't have it in front of me now, but I think it was said although my Chiro's IMO stated my back condition is due to my altered gait from my s/c knees it also stated that other than this one time my chiro never said anything about an altered gait during all my chiro visits I submitted. I'm pretty sure he followed the format, he said that he reviewed my SMRs and he said my back condition "is due to" my altered gait from my s/c knees.

Hello all, unfortuantely my first post must be one asking for help as I do not know what to do from here. I have service connections for the following: Right knee degen joint disease w/ slight subluxation 10% Right knee patellofemoral syndrome with chondromalacia 10% Left knee patellofemoral syndrome with chondromalacia 10% My knee symptoms and pain started during my service in the USAF. I have a lot of medical records to prove this so getting s/c for my knees wasn't extremely difficult. My knee s/c disablities began in 2004. I had surgery on my right knee with a private doctor in 2005 and since then I have had back pain and problems. I have continuous medical records from different chiropractors to show my back problems. Problem is I never had any of them connect my knee problems to developing a back problem until I decided to try to get s/c back secondary to knees. I was able to get an IMO recently from one chiro saying "........ I have reviewed xxxx SMR's and it is my professional opinion that his altered gait due to his bilateral knee complaints has contributed to his low-back pain." Here is where the difficulty began. I failed to get all my chiro records and this letter to the VA before they made a decision on back secondary to my knees. So I was denied. I filed a NOD and during this time my chiro records and my IMO made it to the VA. Well, they denied me again. This time they are saying there is significant documentation in support of a back problem, but I am lacking evidence of an altered gait with the exception of one VA note, and the IMO I submitted. So I have now requested a board of vet appeal video conference hearing. I just today came from an appointment with the physical therapy / rehab doc at the VA in hopes that she would back up the altered gait developing a back problem, but she wouldn't write me an IMO and didn't agree with me that its a possiblity my knee conditions contributed to my back condition... WTF? She said she has plenty of patients with knee/ankle problems that do not develope back conditions... So now I'm not sure what to do. The DAV is helping me, and he even said it's common medical knowledge that if you ankle or knee get messed up it will have a chain reaction and eventually mess up your back. Sorry for the long rant, I look forward to hearing some advice on what to do. Hopefully I have enough time to figure something out before my appeal.