[C&p Exam Monday]

Well I had 2 different doctors. The one that looked at my foot, knee, and back took all of 10 minutes to examine me. I offered up my medical info that I had and he said he didnt need it. Had me bend over as far as I could. Then had me lay down on the table and checked the angles of my knee and said he was done with me. He was very short with me.

The second doctor was a lot more friendly. He asked me questions about my apnea and GERD/Hiatel hernia. Showed him the related info from my SMR. Then he said my endoscopys, surgery, and sleep study were all current enough for what he needed, and I should expect my claim to be completed within 6-8 weeks.

Not sure whether to get my hopes up with that or not.

[C&p Exam Monday]

After 9 months of trying to get my C&P exam rescheduled Im finally having it Monday. They have me scheduled for 3 different appointments. Is this normal? I have a claim in for quite a few things. So Im assuming this is for different doctors to exam different things. Should I bring my medical records with me from service, as well as xrays/bone scans or should I assume that the C&P doc has all this from my submitting it to the regional office? Also Ive been treated at 3 different VA's in different states. Should I bring my treatment records from each of those as well? I know my doctors have a hard time looking at notes from different hospitals.

Anything else I should do/prepare before I go?

My claims are for my left foot condition which I was discharged from service for. Ive had surgery 4 times on it. Currently diagnosed as stage 2 Complex Regional Pain Syndrome lower left extremity. However my current diasbility rating is a general foot condition.

Also I have flat feet now which is what I thought they had rated me at which prompted to refile for a claim. So they will be looking at that as well

I also claimed lower back condition which I did sustain lower back injuries while in service. I claimed that as secondary to my lower leg issue as well. Since filing the claim I have been diagnosed with 2 herniated discs with focal annular tears at the S5/S4 and S5/S1 for which Ive been going to aquatic therapy as well as have epideral injenctions scheduled for the 1st 22nd and then will schedule for the 3rd one after that.

Also claimed sleep apnea which I dont have any "proof" it is service related however I do have documented issues with sleeping and submitted a letter from my roomate while in service stating I frequently woke up gasping, and never slept fully thru the night. Plus the medications I am on and what not I claimed that as secondary as well.

Also claimed hiatel hernia, los angelas class B esophagitus, and GERDs. Again I do not have treatment for those in service, but I do have documented heartburn, as well as was on naprozyn for a year before getting out and subsequently 6 years after. So I claimed that as service connected as well as secondary to medication. They did a surgery to fix this a couple months ago and so far so good. WIll this surgery affect my claim in any way as for getting at least a 0% rating service connected/secondary to service connections just so I have it listed for future if the surgery doesnt stick?

I have not claimed my migraines yet but will after this claim is completed. Should I mention those in my C&P exam along wiith my memory issues, or just leave it until I make a new claim?

Any thoughts/input would be greatly appreciated.

Thank you in advance.

[Question About Some Claims]

One more thing- there are only 16 claims that I found at the BVA on this condition.

If you go to http://www.index.va....ch/va/index.jsp

and then click on the link to the appeals decisions ( the VA s changing their web site around and the regular BVA links dont work) and put the intials of this disabilioty into the search feature and then click on all years and then search- more info will pop up in the 16 decisions that could possibly help you with this claim.

When I see so few similiar disability cases for your disability- it makes me all the more sure that VA docs probably don't have a clue on what it is.

Thank you very much for the help. Ill take a look at that tonight and see if I can find anything to help. I know my pain management doctor is very familiar with the disease. And Im sure he would have no qualms writing a letter to the RO about it however he has been on an emergency LOA for about a month and Im not sure when/if he is gonna return. Like I said he took really good care of me and was trying everything. I really dont like taking any drugs especially pain meds. So I suffer with the pain as best I can. His next steps were to be spinal injections and if that didnt work then a spinal stimulator. however the guy Im seeing since he left is a joke. He knew nothing about me and literally spent less than 10 minutes askign questions and listening to me. Check and saw my BP was high the passed few times I came in and prescribed BP meds and sent me on my way. Im very pissed off about that and I hope that Im able to get a different doctor next time.

[Question About Some Claims]

There is info on the net on your condition and this article struck me:

"Complex Regional Pain Syndrome Type I (RSD)

CRPS development does not appear to depend on the magnitude of the injury. The sympathetic nervous system seems to assume an abnormal function after an injury.

Since there is no single laboratory test to diagnose CRPS, the physician must assess and document both subjective complaints (medical history) and, if present, objective findings (physical examination)."

http://www.rsds.org/...crps/index.html

It is saying that documented symptoms would have to be considered along with any objective findings.

I was also surprised at the bone scan. I had a bone scan and it revealed I didn't have osteoporosis-I saw the print outs of the scan and I don't know how a bone scan would reveal a neurological condition?

I dont think these VA doctors had a clue as to what your condition really is.

"Ive also requested a consult with my PCP to see a neuro doc." That in my opinion is an excellent idea.If the secondaries you claim are diagfnosed and current, then the neuro doctor would be the one to opine as to whether there is any secondary SC potential here if they grant the prime disability as SC.

"What is the best way to get a VA doctor to write a nexus? Do I just request a referral from my PCP for a specialist in that area specifically to be examined for the possibility of service connection? For example I have Sleep Apnea with documented sleep troubles while in service and a buddy statement saying I snored and occasionally woke up gasping. I am also on meds that are known to exacerbate OSA. So do I just request to be seen by the sleep lab people again and ask them to review my case or do I actually need to find a doc outside of the VA?"

You have evidence there that they need to consider but in my opinion- only a real doctor, and in this case an outside Neuro would be great-can really explain this to VA as to how your condition is from service -and as it appears to be directly related to the 30% SC you get now.That s my opinion as to the nexus to the 30% but a real doctor might agree)

Or it could be aggravated by the SC condition.Then they would have to service connect the 'aggravation'It sounds like the surgery in the military damaged a major nerve in your foot. Do you have the surgical notes in your SMRs?

There is an IMO criteria that any independent IMO doctor has to follow and it is in the IMO forum here.

Has the VA ever prescribed NSAIDs to you and if so do you also have GERD?

Yeah the VA did an MRI to get the CRPS diagnosis so Im not sure why he said R/O because of the bone scan. I mean in phase 3 bone density does decrease, but I highly doubt that would happen within 6- 8 months in order to show up on a bone scan. But I did have a bone scan as well at the VA and I do have some kind of porisis ending thing in my foot bones.

Ill have to look around for a neurologist to do an IMO then. Hopefully they will take payments as Im currently living off of my 376 a month disaility and 547 from voc rehab.

As for NSAIDS.. I was on 500mg of Naporsyn for 6 years because of my foot. and I had heartburn from about a year before discharge until May 16th this year. I was on omeprozole for 7 years then switched to prevacid and given an endoscopy. Which showed i had barrets esophagitus a hiatel hernia and 3 erosions on my throat and 2 in my stomach and severe GERDs. After that endoscopy and 3 months on prevacid they had me outsourced to University Hospitals for a second endoscopy to have a Bravo PH monitor implanted in my throat. That tested acid levels while I was still taking prevacid. It showed that I had well above severe acid levels while still on the medication. So they doubled the maxium dose so I was taking 60mg of prevacid 3 times a day still with not relief. So in May they did a Nissen Fundoplication and so far I havent had any reflux. I go in on the 8th to see the chief of surgery and then he is schedulig me for another endoscopy.

[Question About Some Claims]

It sounds like you were a victim of Shreddergate- then again the VA doesn't shred much I hope- because they usually lose it first.

I can sure relate to your frustrations in sending and resending what they lost or misplaced.I had to do that myself MANY times.

Do you have a copy of the entire Bethesda Report?

"as I was discharged due to the navy doc screwing up my surgery on my foot"

Do you mean you were PEBed or MEBed out? If so are you sure VA has that information?

Were you given any rating by the Navy?

It would be good to get a copy of your C file too as it concerns me that the VA is reconstructing your file.

Yes I have a copy of the bethesda report. I was medically discharged from the Marines for "Hallux Vulgus" which is a fancy name for a bunion. However I injured my foot and they did surgery and screwed it up. It was not a bunion. I tore the tendons and ligaments in the foot and it healed wrong as they diagnosed me with a strain and I had to run around on it for 3 weeks before the XO made me go to a podiatrist. I was given 10% at discharge. And Im fairly certain the VA has that info though there is no way for me to tell as they lost my file twice. Actually three times however I saved the letter they sent me after my 3rd submission so they honored that date.

[Question About Some Claims]

I have a question for you. This is a little fishing expedition.

Was your father a in country Viet Nam Vet.

J

My father was not in the military. However my step father was in the army in vietnam

[Question About Some Claims]

I assume you do have copies of your SMRs.

In this case you certainly need to consider that only an independent medical opinion might be what is needed to connect the inservice documented symptoms to the actual diagnosis that you have now.

VA doesnt connect the dots- we usually have to do that or get an outside doctor to do it.

Perhaps a C & P doctor would connect the medical dots but that is often not the case at all.

These IMOs can be costly but if there is a nexus between the SMR documentation and your current conditions ( the IMO could also opine on any claimed secondaries) that a doctor with expertise in the field can opine on with a full medical rationale- then service connection can be established.

I assume you received the VCAA letter asking for evidence.Did they mention the CRPS and RSD in that letter?

Have you responded to the VCAA letter? Have you told them your VA medical records should be used to adjudicate the claim? DO you have any private medical records? They will need to obtain those or you could submit them.

The VA will not grant any secondary disability as SC until it grants the initial disability as SC and then they will need medical evidence that the prime SC condition has medically caused the additional disabilties.

There are cases for your claimed disability at the BVA web site.Many some of those cases would reveal some help as to what evidence they need.

But if the SMRs only reveal documented symptoms then it will take a doctor to assess the SMRs and your post service Medical records to opine on and establish the nexus-the linkage of the current diagnosis to your service.

Yes I have 1 copy remaining of my SMR. I have already submitted 3 copies to the regional office as they have lost them twice.

Yes the VCAA letter states I need to provide evidence of a diagnosis of CRPS/RSD and also submit documents that it is service connected. Which I have in my SMR the symptoms, and it shouldnt be too hard to connect the dots as I was discharged due to the navy doc screwing up my surgery on my foot. I have letters from a private doctor back then stating what the navy doc did and what he should have done, along with letters from my CO and XO when I was trying to fight my medical discharge stating that they only agreed to it because the navy doc said it was not a repairable condition and they wanted me examined by someone else. Which they then sent me to Bethesda for an exam and the doc there again sited the symptoms of CRPS in his notes and stated "R/O RSD(Which Im not sure if this RSD actually means Reflex Sympathetic Dystrophy or not I was never explained anything about this I just saw it in my SMR long after I was already diagnosed with it) and scheduled me for a bone scan. Which after the bone scan came back they said there was nothing they could do for me.

I have not responded to this letter other than to do the online inquiry asking whether or not they had my file or if it was lost, as I was told 3 months ago they were working off of a rebuilt file. And I asked that if it was yet again lost whether or not I needed to resubmit my SMR or not. I do not have any private medical records other than the consult from when I was in service which I submitted initially with my claim.

Thanks again for the help and answering my questions. I have time next week Im going to go to the RO and ask to speak to someone about my file to see exactly what paperwork I need. Ive also requested a consult with my PCP to see a neuro doc. I already have an appointment for Physical Medicine as PT says Im too jacked up to benefit from therapy. My Pain Mgt doc has been on a LOA and the last guy I saw took 5 minutes to see me gave me blood pressure meds that supposedly help neuro conditions and sent me on my way with an RTC for 3 months out, so I had my PCP try and get me a different interim pain doc and cancel the stupid meds.

[Video Conference/hearings]

Okay thanks. I wasnt sure if this was something to request prior to getting my rating or denial. So as I understand it now that if I get denied or dont agree with their rating I can and should request the hearing.

Thanks again all =)

[Question About Some Claims]

"It is clearly documented that my foot condition is CRPS/RSD in my VA treatment records. And I have statements in my SMR that clearly indicate RSD back then."

Do you mean a formal medical diagnosis of CRPS and RSD ?

What did the VCAA letter they sent to yo on this specifc claim say that you needed as evidence?

Yes I have a formal medical diagnosis in my VA medical records for CRPS/RSD. However I do not have a formal diagnosis in my SMR. I do however have in my SMR being treated for many of the symptoms of it.

What the VA sent me says

"We need evidence showing that the following conditions exsisted from military service to the present time:"

And then it lists everything I am claiming "esophagitus with hiatal hernia, sleep apnea, left knee condition, low back condition........ And then continues saying I need to show proof the issues I claimed as secondary to service connection existed in service. Which I dont understand that part. Im not claiming those were SC Im claiming they are secondary to SC. And then it goes on to say I need to submit current medical records stating the conditions exist. Which again I dont understand as I thought if I was treated at the VA then I didnt need to submit anything. So does this mean I need to go to the VA and get copies of all my treatments and submit them?

And thank you in advance for your help.

[Video Conference/hearings]

What exactly takes place with a video conference or a hearing? Ive seen the option before but never understood what the purpose was. When is a good time to recommend one of these?

[Victory In Alabama]

Just got a call from a friend of mine that lives in Huntsvilla, Alabama. He received a nice retro check and is SC for Pancreatic Cancer. His service officer says the claim for IHD has to wiat till the legislation clears in Washington DC.

He says he is going to drive up to Michigan and buy me a "big ol steak".

I love it when a veteran gets the benifits thay have earned. Terry

Anyway you have your friend message me with how he got the SC for pancreatic cancer? My best friend died from it last year, and if there is something in his records taht state it could be the cause Im sure it would help his widow immensly with her school if nothing else.

[Question About Some Claims]

Okay Ill try and keep this short so people with experience dont have to read a book to respond. The long of the short is that it took about 9 years for my to get my disability approved. Im currently rated at 30%. I was told and was under the impression this was for flat feet. My original claim was for left foot condition that at the time was not diagnosed properly. I was discharged medically due to "Hallux Vulgus" yet that was not the underlying condition. At any rate after 9 years they finally came back with the flat foot rating because I didnt have flat feet going in but do now. I actually have RSD in my foot/lower left calf. So I filed for an increase after talking to my pain managment doctor. All of my treatment is done at the VA

It is clearly documented that my foot condition is CRPS/RSD in my VA treatment records. And I have statements in my SMR that clearly indicate RSD back then.

1.) With my claim for the CRPS (granting they approve it) will they back date it to when I filed my original claim as I applied for the increase within 1 year of receiving my 30% decision?

2.) To prove something is service connected do I need the stated issue sited in my SMR or is having multiple "general" treatment for conditions good enough? For example I had an MRI in 2006 of my back that states " There is an apparent left pars defect of L5 suggestive of unilateral spondylolysis. Incidental note of Spina bifida Occult of L5. Sagittal images shows posterior disc bulge at T11-T12 which narrows the spinal canal at thsi level. Conus medullaris is displaced posteriorly. At l4-l5 there is hypertrophy of both facet joints causing mild bilateral beural foraminal narrowing. And in my SMR I have multiple low back strains as well as documented contusions in the T5 and T9 areas. However I never had an MRI when I was in the service.

3.) What is the best way to get a VA doctor to write a nexus? Do I just request a referral from my PCP for a specialist in that area specifically to be examined for the possibility of service connection? For example I have Sleep Apnea with documented sleep troubles while in service and a buddy statement saying I snored and occasionally woke up gasping. I am also on meds that are known to exacerbate OSA. So do I just request to be seen by the sleep lab people again and ask them to review my case or do I actually need to find a doc outside of the VA?

I have more but those are my main concerns for now. Its been over a year since my initial request for increase and due to logistical issues I still havent had my C&P exam so Im trying to get all my ducks in a row prior to going to the regional office.