Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

Vike17

HadIt.com Elder
  • Posts

    881
  • Joined

  • Last visited

Everything posted by Vike17

  1. On behalf of all VBN staff, our deepest condolences on the passing of Carlie. She will be missed but not forgotten. She has an honorary ribbon at the top of our page. She earned it many times over. Respectfully, VBN
  2. JayBrown1, This would be a question for the service department and would have nothing to do with the VA. You said he wasn't medically discharged, but then stated; "He put in 12 and 1/2 years before the let him go. Before his injury(he was an Airborne Ranger) with an excellent service record and many awards." This doesn't make any sense. If he wasn't discharged medically, how did the military "let him go?" Vike 17
  3. Johnny K, What was the reason for VA's denial?? Was it because of this; "I saw a "contract" Psychiatrist at VAMC C&P hearing for a non-combat PTSD Claim. He denied service connection but conceded my PTSD" The doctor themselves do not make an awardof service-connection, the RVSR (or DRO) does this. If the C&P examiner didn't state that your stressor was the cause of your PTSD, then the decision maker had no choice in the matter. Make sure that when you go to your hearingthat the VA is aware of your statements from your doctors. Make sure that the doctor provided a full rational as to whythey came to such a conclusion and that they reviewed your entile medical records to include your SMR's. "I have four private Doctor opinions and one VA Staff Psychiatrist opinion which support my claim, and I attend VA group meetings twice a month for PTSD" The four doctors that wrote opinions, if they weren't a psychiatrist or psychologist, then they are pretty much useless as far as mental conditions are concerned. Just make sure VA is aware of the one opinion by the "VA Staff Psychiatrist" and your treatment records. Vike 17
  4. As I've said before on this forum, the VAMC and the RO do not regularly communicate with one another except for things associated with setting up and doing C&P exams. One other instance when the two communicate with one another is when a veteran is hospitalized for a service-connected disability. There may also be instances when a veteran has a claim pending and the RO and VAMC may be continually exchanging records as to the curent condition of that claimed disability, but in order for this to happen, generally, the claimant has to tell the RO first where the treatment is taking place because the RO dosen't have that information. Vike 17
  5. Both are considered respitory conditions involving the trachea and the lungs. I suspect assigning a seperate evaluation would be pyramiding. Sinusitis, although it hinders one's breathing, is in the nose and sinuses, which is a different bodily etiology. What disabilities did you claim that were the result of Asbestoes exposure? If it was some sort of lung disease, then I suspect it will also be lumped together with your other respitory conditions. Vike 17
  6. huskerfanfl, "I also requested compensation for my upper back and neck, secondary to the cervical spine" The upper back and neck is the cervical spine. Is this a typo? "and for my left hip secondary to my right hip" Make sure you have a statement from your doctor making the nexus bewteen the two, or the claim will go no where. Vike 17
  7. "It is not about the meaning of IU, it is about the 20 year protection" Sure the IU is protected after 20 years, but for those on it that all of a sudden are able to work right after the 20 years has elapse, it sure makes one wonder about their ability to have been able to work prior to the 20 years passing. I'm not talking about the veteran that has received IU for say 25 years and is able to do some type of light or part-time work, I'm talking about that veteran that has received IU and one or two months after the rating is protected, he/she is all of a sudden able to hold down a 40 hour a week full time position! "It is not rare for the VA to send a veteran for an education higher than a doctorate. I see these request granted often. The only kicker is that the vetean must display he needed the additional education to overcome the restrictions imposed by his disability." I have also seen VocRehab approvals for post graduate studies. However, as you said, the veteran needed to show that in order to be fully "rehabilitated" for employment purposes in that particular field they choses as a career path, a Master's degree (in this case) was needed. I didn't know there was any eductation higher than a doctorate in a certain field!?!? I'm not saying the VocRehab folks don't approve some veterans for post graduate studdies, it just isn't the norm, but rather the exception. I say that it is rare because when you take the number of applicants as a whole and see just how many from them have been approved for post graduate studdies, it certainly isn't the norm. Vike 17
  8. Robert, You don't really need to go through VocRehab to "try" and work again; especially if you already have a Bachelor's Degree. You can certainly apply for VocRehab, but the chances are since you already have a BA or BS, they will deny the claim. It very rarely happens that the VocRehab people approve post graduate programs such as a Master's or Doctorate. I'm not saying that it hasn't happened before, but it's just really, really rare. On a side note, by your post I assume you're receiving IU or 100% due to a mental disability, correct? If you're IU and start working after the 20 years has past, the VA couldn't reduce the IU award regardless if you had VocRehab or not. There are veterans that receive IU and somehow get to the 20 year mark and then are miraciously able to start working again shortly afterwards. This does make one wonder sometimes. I'm not saying this is the case with you by any means. Just something to think about as far as what IU is for and what it means. Vike 17
  9. Jerry, As Carlie pointed out, a deferred rating means the VA had to put off on making a decision because there was some sort of development needed, such as obtaining additional medical records ect.., to make an accurate decision. Vike 17
  10. Don, I receieved your PM. There's no need to apologize, I was trying to explain your situation as to why the VA has done the things they have. The pursuit of the PTSD claim, as I said before, is actually a moot point for rating purposes. By claiming it, you probably put yourself through more stress then what was needed. All mental disorders are rated according to the same criteria. Maybe getting the diagnosis of PTSD was what you needed to get the right help medically, but as far as VA compensation is concerned, it doesn't matter since you are already rated for one mental disability. "There was only the visits for rating every 2 or 3 years. Was not refered to a shrink to talk about what was going on. They showed I was getting better by the reduced ratings." The C&P exams are only there to evaluate your condition as how it is doing currently. You will not receive medical treatment or referrals during these exams. The C&P is for rating puposes by the Regional Office. If you ned medical help, you need to go to the VAMC. Since you were working and weren't receiving continued therapy and treatment, this is probably why they had to reduce your evaluation. The C&P examiner didn't have anything to go from except how you were doing on that particular day of the exam. Also I never said or even hinted that you were a "fraud." Like I said, I was just trying to explain why things have transpired as they have. From tyhe looks of things you really don't have anything to be angry at the VA for. Maybe you should re-direct the fire towards your SO? Vike 17
  11. jecsb4, If you submit a new evidence and request a reconsideration on a claim within one of the denial of that claim, and your request for reconsideration is granted, your effective date will be as if the original decision wasn't made. In other words, your effective date will be the date of the original claim. As far as the new claim for your knee(s) as secondary to your feet, you need to get an IMO and submit it with your claim to support your contentions. The best senario would be for you to submit the new claim along with your request for reconsideration. If the claim for the knees is granted, then the effective date would be the date of the claim, not the date of the "pes planus" claim. Vike 17
  12. Donio, If you were discharged from the service and received subsequent ratings of 100%, 70%, and 50% right from the get go, I would venture to guess, as recruiterrick pointed out, the VA was helping you! One question I do have is, if you were already rated for a mental disorder such as "acute paranoria and nervous condition," then why would you open up a claim for PTSD? They are both rated according to the same criteria and the VA can only pay compensation for one or the other anyways, not both. By filing a claim for PTSD, you would need to be able to prove an in-service service stressor happened, obtain a clinical diagnosis of PTSD and make the connection between the two. This is much more difficult then just showing another mental disorder manifested itself whil on active duty! You wouldn't have needed to file for PTSD in 2001 to obtain a 'higher' rating. Just a simple note to the RO asking for an increase in evaluation of your already service-connected "acute paranoria and nervous condition" would have been enough! It's unclear whether the VA granted your claim for PTSD (you didn't say whether they did or not), but if they did, then they will combine the two in one rating and assign the percentage from the one that results in the higher evaluation. Furthermore, I suspect the reason why you were continully lowered in your rating percentage since your discharge (at least from 100% to 70%) was probably because you were working in some capacity. I say this because you stated "From the time I was discharged until I filed to increase my percentage I quit my job held two other jobs went back to my first job to work in a different area..." The 100% criteria is for "Total occupational and social impairment," and the 70% evaluation is for "severe occupational and social impairment." Another thing that doesn't add up is this statement; "Had I known what was really worng with me I would have ask for help. All they did was tell me I was getting better when I was really getting worse" If you were discharge from the Marines due to "acute paranoria and nervous condition" and subsequently rated by the VA for this, then you obvisouly knew something was wrong!?!? Also, if "they' were telling you that you were getting better in some capacity, then you must have been undergoing some type of treatment after your discharge?? I'm not trying to put you down or anything like that, I'm just trying to explain what and why things have probably happened as they have. Vike 17
  13. luvHIM, "I don't know if my claim has actually already been reviewed or not. The NSO stated my C-file is with an "Appeals Officer" but did not say that it had already been reviewed. I started this thread to find out if an Appeals Officer could decide the claim at this point...that's all I wanted to know). But whether the Appeals Officer has already actually reviewed my C-file was not stated...In fact, rep at the 1-800 number this morning said that from where he was reading there was a "suspense date" of 07/24/07. His guess is that some sort of action needed to happen by or on that date but he didn’t know what. He said my C-file is with an "Appeals Officer" and something about the file being “signed for” on July 19, 2007" As I said before, your claim was already reviewed by the DRO. The SOC was the review. What's probably happening now is that since you filed the Form 9 and requested a hearing with BVA (either the traveling board or vidoe conference, it doesn't matter), the recent activity at the Appeals Team is more than likely them getting ready to have your hearing. Once you have that hearing, your C-file will probably go back to the rating board so they can decide the most recent IU claim first before they ship it off to the BVA. Normally all open claims will be decided before the C-file can go to the BVA! "I have not been asked by RO to provide a "nexus" or specifically asked by RO to provide an IMO from a physician which gives a "nexus."" The VA wouldn't have needed to ask you for evidence of this in their DTA letter. You were applying for an increase. You just happened to supply them medical evidence of another disability AFTER the fact. The VA wouldn't have known there was another disability in the mix until they actually evaluated all the evidence shortly before the decision was made. Since the initial rating decision was a "cut and paste" job as you say, then at least your SO should have seen that the two disabilities needed a nexus. Remember the rating and the SOC said; "Although your BACK CONDITION is severe in nature, your problems are the result of your ankylosing spondylitis, which is not related to or caused by service. Therefore, in the absence of any evidence that your LUMBAR SPINE condition has worsened your 0 percent evaluation of CHRONIC lumbosacral strain is confirmed and continued."" I'm not really saying you are at fault here. Your SO should be trained to see this and take the needed corrective steps! "The only physician statement RO would not have been able to review before I appealed is the one from my new rheumatologist, which was sent recently certified return receipt on May 4, 2007. It was received by NSO and forwarded May 9, 2007 to Appeals Office for placement in C-File... I have three from all of my VA docs and they are scanned in my VAMR. I have one from the VA rheum (also scanned in my records... Are you suggesting I send them (under separate cover, again? All of the ones from the VAMC are in my VAMR, which RO has access to. I have provided everything to RO through my NSO, which he has verified by letter (have all of those). I received letters from the NSO stating what action was taken with anything I have provided them. Why wouldn't RO not have them? Better yet, why would they list them under EVIDENCE if they didn't really review them already." At this point it's really hard to tell if ALL of your IMO's and medical evidence were considered by the VA. At any rate, you need to make sure that during your hearing with the BVA, they are aware of and in possession of ALL of your IMO's; especially the one from your new rheumatologist, which you sent in already! Also make sure the VA has your SSA records! One thing to keep in mind is that just because you were treated at a VAMC does NOT mean the RO has those records. The RO and the VAMC are two seperate entities within the VA (the RO is part of the VBA and the VAMC is part of the VHA). The two don't routinely talk to each other other than to set up C&P exams and so forth. You need to tell the RO of these dates and treatments at any VAMC, they will then obtain them via the "Duty to Assist." You can also do this at your BVA hearing! As I said before, it looks like the VA was able to seperate the lubosacral strain and ankylosing spondylitis based on the medical information before them at the time of their decision. Like I said before, I've never seen this happen but it can be possible. Also the lower back disability in 1984 looks to be the continuation of the 1979 rating. I say this because you said you applied for an increase but did not follow through with it. In this case the VA would simply have continued the 0% evaluation. If the VA really did give you a second evaluation for your back, even if it was at 0%, in 1984 by mistake, I find it really hard to believe VA would have missed correcting this simple mistake TWICE. The first time being the application for an increase in 2003-04, and the second time by the DRO! I mean it could have happened, but easy ones like this are pretty rare! The bottom line is you need to the connection or "nexus" beteen the Lumbosacral strain and the ankylosing spondylitis. Vike 17
  14. bern381, If this transpired during your C&P exam, you need to let your RO know immediately!!! Just write them a short letter explaining what you stated here and note that the recent C&P exam is insuffient for rating purposes!! If you do not let the RO know this, then they have no way of knowing what happened. Vike 17
  15. luvHim, I know exactly how ankylosing spondylitis is rated, I was trying to explain how you were possibly rated back in 1984 (now it appears it's 1979 as an effective date). And from the looks of it, I was correct in that assumption. If you were service-connected, now back in 1979, for lumbocaral strain, in all likelyhood the DC would have been 5295, and when you applied for an increase your DC was changed to the new rating criteria with a DC of 5237. I was also trying to explain the different senarios of why the VA assigned that DC and not combining it with either DC 5002 or 5003. As far as the letter from the VA, let me try to explain this again so you understand. Ankylosing spondylitis is a form of rheumatios arthritis, not degenerative arthritis (I mentioned DC 5003 in my prior post in the event that back in 1984 there wasn't any evidence of rheumatiod arthritis but degenerative artritis due to the lumbar strain) and would warrant either the assignement of DC 5240, or both by being hyphenated as 5002-5240. Normally you would be rated under 5240 due to the limitation of motion or DC 5002 if the rheumatiod arthritis is active, whichever rating would result in the higher evaluation. However, if the limitation of motion does not warrant a compensable evalution under 5240, meaning that there is forward flexion greater than 85 degrees, and the disease is active, then you would be given a 10% evalution under the criteria of DC 5002 because there is objective finding of limitation of motion such as muscle spasm or swelling. When the VA hyphenates a DC with another, it identifies the body system affected by the arthritis! Furthermore, you cannot be assigned a 10% or 20% rating under DC 5002 and another 10% or 20% under DC 5240 beacuase, as the letter from VA states, this would by pyramiding. Also as I noted in my prior post, as did the letter from VA, if you have ankylosing spondylitis in another bodily etiology, you can obtain service-connection for that also. "AND, I'm not sure why you think incapacitating episodes would not apply to me" If you would read my prior post, you would notice that I was reffering to the incapacitating episodes under DC 5243. If your ankylosing spondylitis is an active process, then you could be assigned a rating of 20% or higher under DC 5002 due to "incapacitating exacerbations." These are two totally different rating criteria between the two. One other thing that doesn't add up with your claim is that you said; "As of 10/03/06, HINQ shows Service Connected disability 5237-Lumbosacral or Cervical strain 0% Orig Eff Dt Jan 18, 1979. Service Connected low back disorder 0% Orig Eff Dt Apr 20, 1984. Combined %=0" You cannot have two rating for the lower back, provided that "HINQ shows Service Connected disability 5237-Lumbosacral or Cervical strain 0% Orig Eff Dt Jan 18, 1979,' means lumbocasral strain and not cervical! If this is the case, then someone at VA screwed up and enter both into the computer. Having said that, why would the VA assign a 0% evaluation for a lower back condition in 1984, which is a bit over 4 years after you were orginally service-connected. Did you apply for an increase in 1984 which prompted VA to enter something in the computer????? Are you service-connected for the cervical spine also (maybe in 1979????). "I never said the VA was asking for a nexus. I was merely being sarcastic in saying the "nexus" is in the medical evidence that is already in my C-File" Then what does this mean????? ; "the VARO is still denying me a rate increase because they state there is no nexus." "The RO DID NOT have to request my SMR's. They sent me a letter with an attached form (that showed Records could not be found). I was informed that it was not even a form VARO uses. It is one that the clinics would have used a long time ago. I think someone took it out of my SMR and copied it and then sent it to me because I had requested my SMR's...Now, I know you probably don't think that way of the VARO. But I don't put anything pass them anymore...At any rate, VARO did have my SMR's because they sent them to me. I requested my SMR's from RO, after I received the letter from NPRC in 03 stating that's who had them. I received a copy of both AF/Army SMR's in February 05, AFTER the 10/04 rating exam and AFTER the second denial (requested reconsideration in August 04 after the first decision letter denying me in June 04)." If you were service-connected and the VA requested additional records friom the the NPRC in St. Louis, then my geuss is you made some type of remark to tyhem that there mught be additional medical records that they didn't have. Even though you were already service-connected at the time and any subsequent SMR's from the DoD would actually be a moot point, the VA MUST obtain any of those brought to light by the veteran in accordance with the VCAA of 2000. After re-reading everything in these posts, I have to say that your claim is so muddled up. You aren't giving any straight answers as to what is what and you are adding things to each post such as acuisations and so forth, which actually have little to no bearing on your claim what so ever. Before I keep going on and on about this, I will say these things in my obsevations; 1) In all likely hood your problem lies within the statement from the C&P examiner in which he states; "I conclude that the cause of ankylosing spondylitis is unknown. The onset of ankylosing spondylitis beginning in 1978 is most likely but the only manifest injury was said due to strain. Her ankylosing spondylitis is not caused by or a result of her low back strain suffered in 1978." Then he contradicts himself by saying; "Her low back disorder in 1984 described in service as chronic low back pain is most likely due to the progression of her ankylosing spondylitis." 2) The VA has assigned two ratings for the lower back, which appears to be adding to the confusion. What was the reason for them to assign another rating in 1984, 4 years after the initial rating???? Did you apply for an increase back then, and if so, what were the findings from the C&P exam????? What does the actually rating decision state from 1979 AND 1984. Not just the DC's but the actaul decision. The older rating decisions probably wont have the "evidence" or "reasons and Bases" section, but rather in a format with the letters "a," "b," ect..., and they are on, I think, VA form 21-679 and 21-679b. They also may be on VA Form 21-6789 too! 3) Like I said before in my previous posts lubosacral strain and ankylosing spondylitis are two different animals and since the VA examiner in part couldn't asociate the two in his findings, this is probably where your problem lies. Having said this, as I said before, normally once you're service-conmnected for a certain bodily etiology, then any subsequent diagnosis is actually a moot point. Depeneding on what the other 3 - 5 IMO's state (I can't tell how many you have as you have contardicted yourself on this) and how thoroughthey where with their rationals, they may not have been enough to orveride the C&P examiners findings. Hell, from the looks of things, the VA didn't have these IMO's before them to consider. 4) The only thing that comes to mind is the VA may have had enough medical evidence to seperate the two and determined (with the medical evidence in front of them, meaning minus the IMO's) that the AS was infact causing the increased disability and not the lumbar strain. I have never seen this happen, but I suppose the VA could do this depending on the medical evidence before them. If this is the case, you need to get the IMO's to the VA that state the disabilty noted in your SMR's was in fact the early manifestation or the aggravation of AS. I say aggravation because, generally AS begins in childhood and takes year and years to maifest itself! 5) You need to read the entire SOC. There is a "reason and bases" section, which in all likely hood went into more detail as to why the claim was denied than the first rating decision did. If it is a compltete cut and paste job, which I doubt it was, of the first rating decision as you said it was, then go back and read the entire rating decision. 6) If the VA was able to seorate the two condition as I said in number 4, then the bottom line is you're missin g the nexus between the two! I'm willing to bet that there is much more to this situation that is being presented. I say this because each post by you brings to light something else. Furthermore, since your claim was also reviewed by the Appeals Team, the chances of them overlooking something as simple as you have presented it is actually pretty remote. I'm not saying it couldn't happen, but the chances aren't in your favor. I wish you the best of luch in getting this resolved. Vike 17
  16. 68mustang, Since your claim for hearing loss was previuosly denied and you didn't appeal it, you'll need "new and material' evidence to re-open that claim. This means that you need evidence that the VA was previuosly unaware of at the time of their prior decision AND evidence that bears directly on the fact of why the claim was previuosly denied. Your best bet is to get an audiologist to put in writing that your current hearing loss and tinnitus are "at least as likely as not' the result of your noise exposure while on active duty. The audiologist will need to review your complete medical records (SMR's and private treatment records since discharge) and provide a full rational as to why they have come to such a conclusion. Once you can obtain this statement/IMO, you can use it to re-open your claim for hearing loss and as evidence of a secondary condition to your hearing loss. Vike 17
  17. Josephine, "VA Regulation does not allow the R. O to state: We place out weight with a " Psychiatrist" as they are a " Psychiatrist". VA Regulations - C&P by a Psychologist, Nurse, etc are equal. Credentials do not come into play only the rationale of the decision. Am I not correct?" Actually, no, that's not correct. The decision maker's job within the VA is to deteremine the weight to be afforded to certain evidence as it applies to disability compensation claims. I have seen claims where the RVSR or DRO has gone against a C&P examiners opinion in which they stated some medical issue wasn't related to a veteran's service and placed more weight on an IMO provided by an outside doctor and subsequently award the claim based on that outside IMO. Actually credentials by doctors play a large role in the weight that their IMO's/statments are afforded by the decision maker. Granted, the rational also plays a large role, but for example, if there are two doctors wrangling over how an MRI is read and one of those doctors is a radiologist and the other is say just a general practioner, then the VA will most certainly place more weight with that radiologist's opinion. Vike 17
  18. Hoppy is correct, this regulation only pertains to the VA and how they need to go about authorization of getting a IMO. In all the years I've been doing claims, I have never seen the VA do this. Generally, if they need an opinion, they'll just ask the C&P doctor to opine. The veteran can obtain an IMO at any time they wish without any authorization from VA! Vike 17
  19. luvHIM, There are a couple of things with your claim that don't really add up and I'll try to address both of them in terms that you can understand. First of all, you said you are already service-connected for a "back injury" since 1984 at 0%. I'm assuming this is for the lumbar spine. If this is the case, you were rated under the old rating criteria (prior to Sept. 2002) and from the looks of things you were probably assigned DC 5295 Lumbosacral strain, which in all likelyhood was correct because, generally, Ankylosing Spondylitis takes time to develope and probably wouldn't have shown up on an x-ray back then (even your doctors stated this). This in turn maybe would warrant the VA to assign DC 5289 Ankylosis of the LUmbar Spine. At any rate the rating criteria for a 0% evaluation under DC 5295 calls for "With slight subjective symptoms only." Depending on what the C&P examiner stated back in 1984-85 and what the x-rays showed as far as degenerative arthritis, the VA could have also assigned a 10% rating under DC 5003 (your disability would then be hyphenated and would be 5003-5295). The X-rays would have needed to show arthritis involving "2 or more major joints or 2 or more minor joint groups. For VA purposes each disk segement is considered a minor joint and multiple disk segements are considered a minor joint group. But since Spondylitis takes time to actually develope on x-rays, there probably wasn't sufficient evidence back then to assign the 10% evalutaion under DC 5003. Also since there wasn't sufficient evidence back then to warrant a diagnosis of Spondylitis, that means any rating under DC 5002 wasn't warranted, such as 10% due to limited range of motion when there is a non-compensable rating of motion under any other DC concerning that particular joint affected. So now if you are already service-connected for your lower back, then normally any subsequent diagnosis made regarding it is actually a moot point in the eys of the VA. And since you applied for an increase in 2003, your back would be rated either under the old criteria or the new criteria (post 2002) with DC's 5235 through 5242, whichever results in the higher evaluation. Under the new criteria it's all about range of motion (DC 5243 Intervertebral Disc Syndrome also entails incapacitating episode, which do not apply to you), meaning how far you can bend your back without pain. Taking into account pain, fatigue, and weakness is called the DeLuca Criteria which stemmed from the Court case you cited in your prior post. Your assumption that; "The chronicity factor for low back condition should have awarded 10%, if nothing else" is not correct. The 10 evalution under the old criteria is "with characteristic pain on motion," and under the new criteria it is "Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees." Having said all of this, I come to the second part of my analysis. After reading through your posts, I am to wonder if you are even service-connected for your lumbar spine at all. I say this because you keep referring to; "although adjudicated for ankylosing spondylitis, resulted in a denial and medical description for lumboscaral strain, chronic. VA rating examiner noted consistent treatment of chronic lower back pain from SMR's. I received a permanent physical profile that listed lumbosacral facet syndrome as the diagnoses, with permanent restrictions of NO PROLONGED STANDING, SITTING OR WALKING; NO HEAVY LIFTING (MORE THAN 10LBS), NO BENDING, TWISTING, OR EXCESSIVE REACHING. This profile was given to me AFTER several times of being treated for lumbar strain by a military Orthopedic DR" If you are already service-connected for your lumbar spine anything in your service-medical records are irrelevant in regards to a claim for an increase! It's all about how your back is currently doing and any medical evidence since your last C&P exam and rating! "VARO even went so far as to send me a letter stating that they requested my Army SMR from NPR and had been notified that my records were lost and nowhere to be found. They sent this letter, unaware that I had also requested my Army SMR and had received a letter almost 2 months prior from NPR stating that my "...Army SMR has been loaned to the local VARO in your area. You may contact the local VARO in your area to obtain a copy." Well, I had already done that and the records were probably in route while they were typing up the falsified letter they sent me" Also, if the RO had to request your SMR's then that leads me to believe that there is more to this claim than whats being presented. If you were already service-connected back in 1984, the RO would have already requested those records and they would already be in your C-file. They wouldn't have needed to request them for a claim for an increase, unless you told them about some clinical (impatient) records that aren't a part of your SMR's! "Vike17, I would also like to make clear that I was already service connected. I didn't need to establish that... You are almost coming across like the VARO. I'm not trying to prove I had a low back condition. That was already established before I got of the military. I was asked to show how my condition had worsened...I DID NOT PRESENT ANYTHING NEW TO THE VARO. THE VARO SIMPLY DECIDED TO DISMISS WHAT THE VA PHYSICIANS WERE ESTABLISHING AS MY WORSENED "BACK CONDITION", which is how it appeared in my records until the VARO gave it a description. I DIDN'T KNOW ANYTHING ABOUT LUMBOSACRAL STRAIN, CHRONIC UNTIL MY CLAIM WAS DENIED AND THIS WAS THE MEDICAL CONDITION VARO HAD OUTLINED IN THERE REASON FOR DENIAL" Furthermore, just because something is in your SMR's doesn't mean it is automatically servic-connected by the VA. Did you actually file a claim in 1984 and did you receive a actual rating decision from VA stating that your lower back was determinded to be service-connected with a 0% evaluation being assigned??? Another thing that struck me was the fact that the VA was asking for a nexus between your lumbosacaral strain and your current Spondylitis. If your SMR's showed low back pain and lumbar strain and you aren't service-connected for that, and you have Spondylitis now, these are two complete different conditions and would need a nexus from a doctor. You also said that have 5 IMO's from three different doctors. Well, if those doctors didn't review your medical records and didn't give a full rational for why they came to such a conclusion, then the VA will assign little to no weight to them when deciding an issue, regardless if it a VA doctor doing a C&P exam or a private doctors. Having said this, if what you said as far as; "the etiology from in-service supports the diagnosis of Ankylosing Spondylitis. Every IMO has meticulously addressed how they can be certain this condition began in service and connect the dots. I have two IMO's (one recent) from outside rheumatologists...None of the IMO's that had been submitted were addressed" ...the VA may not have received those IMO's for a number od reasons, especially if they aren't even listed as evidence in a rating decision or SOC! You may need to check to see if they even had them to consider. "Secondly, lumbar strain does not cause Ankylosing Spondylitis. BUT Ankylosing Spondylitis does cause lumbar strain. And, for the record, Ankylosing Spondylitis does not just attack the spine. It is medically proven to be a systemic disease, especially when left untreated. And the prescribed treatment for Ankylosing Spondylitis is MOST DEFINITELY NOT bed rest" Like I said before, this would have to have been addressed by a doctor in an IMO. It may be common knowledge within the medical community, but the VA needs something in writing from a doctor saying YOUR Spondylitis has caused some other medical condition! The RVSR and DRO cannot make that determinatiion. "I even have documentation of how other VARO's adjudicate claims like mine. How the VARO should adjudicate a veteran's claim when they are treated for lumbosacral strain in service and the veteran discovers years later he/she actually has Ankylosing Spondylitis" It doesn't matter what anyone elses claim shows. Each claim is unique to that individual person as far as medical records, the nexus, and symptoms are concerned. If you're arguing the merits of your claim based on what and how someone elses was decided, you're going to be one frustrated veteran!!! The VA will decided your claim on your evidence ect..., not how they may have decided someone elses claim. One thing I also noticed was that you said you have 'severe osteoarthritis at C3-C4." did you claim your cervical spine also?? If you did, the cervical spine is generally rated seperately from the lumbar spine and you would need an IMO from a doctor stating that your lumbar spine condition (either the lumbar strain or the Spondylitis has some how caused your cervical spine disability. I could go on and on about the inconsistancies of how you presented your claim. The bottom line is if you're already service-connected for your lumbar spine, which I'm having serious doubts of, then any other subsequent diagnosis is irrelavent. And if you're already service-connected for the lumbar spine and you claimed the cervical spine as secondary to your lumbar spine, or any other condition for that matter, as I said before, you'll need an IMO to make the connection. If you are not service-connected for your lumbar spine, you'll need an IMO making the connection between your inservice lumbosacral strain and your current Ankylosing Spondylitis. Vike 17
  20. Any of the three would suffice. If all three of them would write an IMO, then that would even be better. Just make sure that the doctor states he reviewed your entire SMR's and any private treatment records, and provides a full rational as to how and why they have come to a certain conclusion. Vike 17
  21. Arch, According to you prior post, you filed you claim(s) on or about July 8th. It's only been about two and a half weeks! Give it some time. I wouldn't expect a VCAA letter for another 2-4 weeks. Having said that, you stated that the VA told you your claim for cirrhosis of the liver is already "at the Rater." If this is the case it looks like the VA is trying to expedite your claim because it is somehow related to your "end stage liver disease" (assuming you provided the medical nexus from a doctor). Just as a side note, I hope you provided the VA medical evidence of a relationship of your conditions to your military service to avoid of the problems you may have had in the past! Vike 17
  22. hj232, Jbasser is correct, you'll need an IMO from a doctor stating that your Sleep Apnea is somehow related to your service. The doctor might want to reference, if this is applicable, that you had symptoms of sleep apnea while in the service too, which may make the argument of service-connection more concrete. The doctor must review your complete SMR's in order to carry any weight! Vike 17
  23. Kris, It appears that you filed a claim for PTSD?? If you're already service-connected for a menatl condition at 50%, filing a claim for another menatal condition won't get you anything finacially. If you did file another claim for PTSD, the RO must work that claim regardless of what you are already service-connected for, hence the request for a stressor letter. What the VA will try to do now is determine which mental condition is the worse of the two and if PTSD can be granted service-connection, they'll assign the evaluation with the higher percentage. Berta, When a veteran has post cuncussion syndrome and only has subjective complaints, then they're rated under DC 9304 for Dementia, which is the "menatal residuals" so to speak of physical brain trauma. So if a veteran has also PTSD, then of course the VA would assign the higher of the ratings since they both are mental disabilities (DC 9304 and 9411). Does this make sense?? I've tried to explain this to Rocky many, many times. The only time a veteran can receive both a mental evaluation along with post concussion syndrom is if there is evidence of a neurological disabilty such as hemiplegia, epileptiform seizures, or facial nerve paralysis. Since these are neurological disabilities, the VA can award seperate evaluations without pyramiding; "8045 Brain disease due to trauma: Purely neurological disabilities, such as hemiplegia, epileptiform seizures, facial nerve paralysis, etc., following trauma to the brain, will be rated under the diagnostic codes specifically dealing with such disabilities, with citation of a hyphenated diagnostic code (e.g., 8045–8207). Purely subjective complaints such as headache, dizziness, insomnia, etc., recognized as symptomatic of brain trauma, will be rated 10 percent and no more under diagnostic code 9304. This 10 percent rating will not be combined with any other rating for a disability due to brain trauma. Ratings in excess of 10 percent for brain disease due to trauma under diagnostic code 9304 are not assignable in the absence of a diagnosis of multi-infarct dementia associated with brain trauma" Vike 17
  24. luvHIM, "If that is the same as the "duty to assist" letter, then I did receive them. However, I always addressed these letters with my SO (at initial filing in May it was Arizona Department of Veterans Services). But my rep always said "don't worry about them because they are system generated and VARO can review your VA medical records." I merely took her at her word on the matter. I did, however, provide her with a list of all medical treating facilities w/addresses. She even returned that to me saying it wasn't necessary." The VCAA letter is specific to your claim. What your rep probably meant was that certain portions of the letter are computer generated. For example, The VCAA letter probably listed each condition you claimed and then listed what specific evidence what was needed by VA to grant that claim. That portion of the letter stating the specific evidence you needed sometimes comes from pre-programed sentences that are then put in the letter, such as "Pharmacy prescription records" ect... One must keep in mind that there isn't a VSR at your RO actually typing every single word of that letter for each and every claim. However, the VSR that produces the VCAA letters do go through each claim to see what evidence would be needed for that particular claim and then list it mostly from pre-programmed sentences and paragraphs. "Now hear I have sat for almost two years, since the filing of the form 9, waiting on a hearing before the BVA. I have never received a SSOC. I have never had a hearing or meeting with the DRO and my vet rep. Nothing. When I inquire about the process, I get a bunch of rhetoric that makes no sense." You won't receive a SSOC from the RO if you requested a BVA hearing. However, if you requested a hearing through the DRO review you should have had a hearing and either been issued a SOC/SSOC. If I'm not mistaken, your claims folder will remain at the RO until your BVA hearing is held (either the traveling board or the video conference), and once that BVA hearing is conducted, then your C-file is sent to Washington. "I have never received anything on the actual results of the de novo review, other than the SOC I mentioned dated September 2005. It was merely a "copy and paste" of the decision letter" If you received a SOC from the DRO, then that was the resultes of the DRO review. Also, I'm willing to bet the SOC wasn't a "cut and paste" job, but rather a more in depth analysis of the prior denial. Also if it seemes like a "cut and paste" job, then It looks like the DRO decided pretty much the same thing as the RVSR did, meaning in the DRO's eyes the prior decision was correct! "According to LTC P, they acknowledged my medical evidence when the rated me for Ankylosing Spondylitis, instead of the lumbosacral strain...I applied for rate increase for the worsening of my sc medical condition and the VARO rated my claim on residual Ankylosing Spondylitis. Totally wrong and incorrect adjudication...In the SOC it reads, "Although your BACK CONDITION is severe in nature, your problems are the result of your ankylosing spondylitis, which is not related to or caused by service. Therefore, in the absence of any evidence that your LUMBAR SPINE condition has worsened your 0 percent evaluation of CHRONIC lumbosacral strain is confirmed and continued."...NOW CORRECT ME IF I'M WRONG BUT THE LUMBAR SPINE/LUMBOSACRAL REGION IS YOUR BACK. HOW CAN ONE PROBLEM EXIST WITHOUT THE OTHER BEING A PROBLEM? ANKYLOSING SPONDYLITIS (AS) AFFECTS ON THE LUMBOSACRAL SPINE IS A CLASSIC SYMPTOM. IN FACT, A PERSON WOULDN'T EVEN GET AN AS DX IF IT WEREN'T FOR THE RADIOGRAHIC EVIDENCE OF FUSION OF THE SACROILIAC JOINTS W/EVIDENCE OF LUMBAR DEGENERATION (WHICH ARE BOTH MEDICALLY DOCUMENTED ALONG WITH RADIOGRAPHIC PROOF IN MY VAMR). IN ADDITION, BECAUSE THE SI JOINTS ARE WEIGHT BEARING JOINTS IT CAUSES EXCESSIVE STRAIN TO THE LUMBAR SPINE. I JUST UNDERWENT A HYSTERECTOMY ON JUNE 5, 2007 HOPING TO RELIEVE SOME OF THE PELVIC/GROIN PAIN IT WAS SO BAD. MY RHEUMS ARE SO AMAZED BY WHAT THE VARO IS OVERLOOKING HERE, IT IS ALMOST LAUGHABLE. IT IS ABSOLUTELY CRAZY. I TELL YOU, IT MAKES NO DARN SENSE TO ANYONE BUT THE PHX VARO" From the looks of it, you sent VA medical records of a complete different diagnosis that affected an additional body etiology. In short, you are rated for a lumbar condition and you sent them medical evidence that showed a disability that affected the entire spine! The RVSR and the DRO's are not medical personnel and cannot by law make a medical determination. It may be common knowledge in the medical community that the two are related, but not to just an average lay person. You'll need a medical statement or an IMO from a doctor that states your Lumbar strain at least as likely as not cuased the "ankylosing spondylitis." As a side note, the spine is rated based on range of motion (how far you can bend over) or incapacitating episodes (number of weeks of bed rest prescribed by a doctor over the past 12 months), whichever results in the higher evaluation. I hate to say it, but it looks like the RO has done everything it was suppose to do so far. If you are able to get that medical statement or IMO, you'll more than likely prevail in your claim. The bottom line is you're missing the nexus between the lumbosacral strain and ankylosing spondylitis. Vike 17
×
×
  • Create New...

Important Information

Guidelines and Terms of Use