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brokensoldier244th
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Posts posted by brokensoldier244th
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They may have to rate you, but their criteria and VA's criteria are totally different. Im 'Rated' by the Army at 0% for a traumatic back injury that made me undeployable in my MOS, but my VA rating for it and residuals is 50%.
John
I thought I read under the new rules that the military had to rate you for all condtions makeing a service member undeployable. I just trying to find that law its been a change recently.
Thanks,
JIM
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Service rating and VA rating are two different animals. I was was discharged 0% for my degenerative disc/trauma, but VA granted 40%. *shrug*
Good luck!
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Thanks John999
So, the reason for the Decision in the Decision letter is not what I use to fashion my NOD? I have one done up, but based on the Decision Letter. Im tipping my hand then?
i feel they overlooked propensity of evidence from various providers going back to 2001-2002 with notes/etc from when I was still on active duty up to now with my own doctors examination of me vs. the C&P exaiminer PA saying there is not enough for her to make an opinion, and 1 EMG that shows my left extremities don't have nerve damage-but my rt extremities are rated 10% with no EMG with the same symptoms (mild incomplete paralysis/Radiculopathy depending on which part of the decision you read). Everything I have to support the NOD is stuff they already have.
When you send in the NOD the VA is supposed to send you a statement of the case. This is the VA's case regarding how and why they have reached their decision. Now you shape your appeal on the SOC. They have to tell you why they did not give you the maximum benefit requested. You can then go out and get more evidence to rebutt the SOC. The VA gives you the path to overcome their decision.
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Ive had one. It said I didn't have any abnormality in my left leg.
My right leg never had an EMG either, yet the physical diagnosis of decreased sensation of the right great toe was enough for 10% for incomplete paralysis.
They symptoms persist in my left toes, and have for years. My contention is that they call my right leg radiculopathy in one part, yet in the same decision then call it 'incomplete paralysis', and then deny the left leg for the same symptoms as the right-when those symptoms are noted by the C&P during her physical examination. Im taking neurotnin 1200 MG a day for the tingling and what not-It helps, but I can't make an EMG show nerve impingement if the drugs im taking help with it. I suppose I could stop taking them and go get another one. *shrug*.
Thanks for weighing in, Jbasser! :-)
Clinically diagnosed would mean that you need to get an EMG and Nerve conduction study.
I would get that done before the NOD and ask for reconsideration.
J
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Okay, here we go-high points first;
Denied for Left Leg radiculopathy; I guess now they are calling it 'incomplete paralysis'. my Rt leg is already service connected for 10% but it was called radiculopathy, though no EMG was ever done. The C&P from that time never used the word 'radiculopathy' in it, anywhere, nor did my treatment notes from service (bilateral dysesthesias is in there, once, but the rest of my notes from various exams use generic terms such as "pins and needles", "bilateral radiculopathy" or "radiating pain and numbness". )
I feel that I should be rated 10% for radiculopathy, left leg-but what do I call it? Bilateral dysesthesias? Incomplete Paralysis?
Is it separate claim, i.e. do i refile and call it something else using the same evidence that I have now (past and present), or do I do an appeal of the same claim pointing out the inconsistency?
Denial for Erectile Dysfunction-in the list of what was considered, my 'statement of support' (clinical visit notes) are listed for my Dr. but I sent in a nexus letter that specifically says "erectile dysfunction" but it is not listed on the decision letter. Maybe its listed as 'statement in support of claim', but ive attached it below and it seems pretty straightforward to me. The Decision letter also states that the examiner found no evidence of ED, but she never examined me for ED at all-she asked a few questions and spent the rest of the time on my PN tests.
I feel that with my letter from my doctor, her clinical notes, and a 2003 complaint of erectile problems to a VAMC PCP where he states " also have a VAMC report from my PCP in 2003 where he states " Genetalia-he admits to some problems with his erections, which again is secondary to his back injury.....".', and prescription for gabapentin, that I should have met the criteria. I submitted both of these, though the doctor's letter was after the claim had been sitting for a bit. I'm figuring the VAMC report from 2003 may have gotten buried. It happens.
So-my questions are:
-Do I refile for "What, exactly?" for my left leg service connection, or appeal/reconsider? If the pain and numbness, and sensory loss in my toes isn't radiculopathy, then what do I call it? Incomplete Parlysis (since those are the words that they used)? My right leg original decision from 2003 has the same symptoms listed by the C&P examiner and is called "radiculopathy", and no EMG was done that time.
-Do I appeal with my letter from my Doctor for ED since it wasn't included in the list of evidence considered, or just ask them to reconsider, with the letter?
Reasons for Decisions are attached.
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Here is my NOD letter for a decision for ED and SC for left leg radiculopathy-Thoughts?
NOD Notice of Disagreement
Department of Veterans Affairs
I received a rating decision dated10/05/2010. Consider this letter to be an official “Notice of (NOD) regarding thefollowing denied disability claims: Service connection Left extremities forradiculopathy, and service connection for Erectile Dysfunction/Sexualdysfunction. I disagree with both findings for the reasons noted below.
1) Service Connection for Left leg Radiculopathy denied due tolack of evidence per C&P examiner.
After reviewing the decision of the VA for
my claims of service connection of my left extremities, I feel that the rater overlooked substantive evidence and history of a bilateral condition(tingling/numbness in lower extremities) since my time on active duty, and that the VA rater failed to address that my right service connected extremity wasrated as 10% Radiculopathy (mild incomplete paralysis continued) with the samesymptoms as what my left extremity as had since 2003. Within the same rating decision my service right extremity is called both radiculopathy and “incomplete paralysis”, yet my claim for service connection for my left foot was denied with the same symptoms present.
I have noted below what I feel is
conclusive evidence for service connection for radiculopathy/incomplete paralysis below the knee, based on findings that Left Lower extremity radiculopathy was clinically diagnosed during military service, and was caused by a rated service connected condition (Intervertebral disc syndrome). Thesediagnoses occurred while still on Active Duty, and were a direct result of theinitial back injury, and thus I feel they fulfill the required evidence forservice connection.
Rating Decision
2010
“Service connection for Radiculopathy of the left lowerextremity, claimed as secondary to your service connected intervertebral discsyndrome, lumbar spine, is denied because there is no evidence showing thatleft lower extremity Radiculopathy has been clinically diagnosed, as well as noevidence indicating that the claimed condition otherwise began during or was caused by military service....” [1]
Reasons for Disagreement:
-11JUL2001 Battalion Aid, Ft.
Lee, VA clinic screening notes " that all 10 toes felt numb"and acute lower back pain [2]
-12JUL2001 Dr. so and so Army
notes "b/L parasesthesias" in his exam notes, also lower back pain [3]
-08AUG2001 MRI findings/neurological
narrative notes (my history of Bilateral Radiculopathy was the reason for the MRI in the first place) [4]
-Medical board proceedings were for
back pain/degenerative disc disease/bilateral dysesthesias (NarrativeSummary 1OCT2001)[5]
-VA Exam 17JAN2003 indicates
decreased reflexes bilaterally [6]
-2003 VA Ratings decision grants
service connection for Radiculopathy 10% right leg based on decreased sensationof right great toe, but not left leg, yet same symptoms are present in bothlegs. Treatment medication at that time included 800 mg ibuprofen 4x’s daily,Ultram, and Flexaril.
-Dr. notes both right and
left leg symptoms in her examination notes 6AUG2010. She did SLR’s, sensory,reflexes, and physical manipulation at that time.
“Strength is slightly diminished on the right leg
compared to the left. He is able to toe and heel walk although he does thiswith some difficulty. He has limited amount of toe raises that he can do rightfoot and left foot but can’t initially do them. The patients gait is antalgic” [7]
-C&P Examiner notes “decreased vibratory sense, left great toe” during 2010 exam. 1
These are symptoms that have beenpresent in my left leg (radiating pain, numbness, decreased sensory) sincebefore I discharged from the Army. I used the terminology “radiculopathy” basedon the VA’s usage of that description for my right extremity, but regardless of whether it’s called “radiculopathy”, “pins and needles”, “bilateral dysesthesias”, it is the same thing. I’m simply using VA’s own description ofthe condition as my basis for calling it radiculopathy. Since my right leg is rated 10% for Radiculopathy (or “incomplete paralysis, Mild”) based onmy lower back condition, I feel that my left leg should be granted 10% and bilateral, on thepresentation of the same symptoms (note current C&P finding of “decreased vibratory sense, left great toe” )1
This itself is consistent with a 10% rating for “mild incomplete paralysis” as used by the VA for my 10% rating in my Right lower extremity. The Examiner notes a lack of clinical evidence. I feel I haveprovided more than enough over a long period of time (since active duty) to indicate chronic pain and numbness is due to my back injury.
2) Service Connection Erectile Dysfunction denied due to lackof evidence from Examiner. I disagree.
“Service connection for erectile dysfunction (also
claimed as sexual dysfunction) , claimed as secondary to your service connectedintervertebral disc syndrome, lumbar spine, is denied because there is noevidence showing that any erectile dysfunction has been diagnosed, as well asno evidence that the claimed condition otherwise began during or was caused bymilitary service….” [8]
Reasons for disagreement:
-17JAN2003 difficulty with erectionsnoted by VAMC PA, progress notes
“Genitourinary-he reports urinary urgency sometimes has to sit tourinate since back injury. Genitalia-he admits to some problems with erections,which again is secondary to his back injury.”6
-Diagnosis/prescription Paxil for
premature ejaculation noted in letter as secondary to my lower back injury, Dr.so and so
“I have reviewed Mr. X service medical record
pertaining to his back injury that he sustained while in the service in 2002. Isaw him on August 6th and we went through the history and currentissues involved with his low back pain and radiculopathy. At that time he told me that he has had issues with erections and premature ejaculation since that injury was sustained. Therefore it is my opinion that his current symptoms appear to coincide with the injury in the service. We have started him on Paxilas that does tend to help delay ejaculation and hopefully improve hissymptoms.” [9]
-No C&P was scheduled for
erectile dysfunction, no examination given for this condition. Why would aC&P for peripheral nerves be addressing sexual dysfunction? My own doctorhas examined my service records in their entirety, and examined me independently of those records. She has diagnosed premature ejaculation/sexualdysfunction being secondary to my service connected injury, and prescribedmedication for it.
I believe this clearly supports that there is erectile difficulty that is a direct result of my lower
back injury and that a 0% rating (for deformity) with SMC-K should have been granted. I have no priorhistory of sexual dysfunction before my injury during military service. Dr.so and so reviewed with me my entire service medical file and my C-file, inaddition to making her own assessment of my genital issues, and prescribed medical treatment for it, that is ongoing and under continual review. The VAMCvisit on 17JAN2003 where erectile problems were noted was also within one yearof my leaving the military (26FEB2002) and determined at that time by the VAmedical personnel to be secondary to my back injury that is service connected.The C&P Examiner notes no 'clinical' evidence of ED, yet complaints persist from 2003, and further clinical evidence of erectile difficulty was provided in 2010.<
am requesting a “De Novo Review”by a new Decision Review Officer.
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So, after filing a letter saying that In NOD-ing, is there something that happens after that that acknowledges their acceptance of the NOD, or do I just send it on in with my evidence?
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Here is what I have so far for my NOD letter....
NOD Notice of Disagreement
Dear Sir or Madame,
I received a rating decision dated 10/05/2010.Consider this letter to be an official "Notice of Disagreement" (NOD) regarding the followingdenied disability claims:
1) Service Connection for Left leg Radiculopathydenied due to lack of evidence per C&P examiner. I disagree-
Below I have noted what I feel is conclusiveevidence for service connection for radiculopathy/incomplete paralysis belowthe knee, based on findings that Left Lower extremity radiculopathy wasclinically diagnosed during military service, and was caused by a rated serviceconnected condition (Intervertebral disc syndrome). These diagnoses occurredwhile still on Active Duty, and were a direct result of the initial backinjury, and thus I feel they fulfill the required evidence for serviceconnection.
Rating Decision 2010
"Service connectionfor Radiculopathy of the left lower extremity, claimed as secondary to yourservice connected intervertebral disc syndrome, lumbar spine, is denied becausethere is no evidence showing that left lower extremity Radiculopathy has beenclinically diagnosed, as well as no evidence indicating that the claimecondition otherwise began during or was caused by military service...."
Reasons for Disagreement:
-11JUL2001 Battalion Aid, Ft. Lee, VA
clinic screening notes " that all 10 toes felt numb" and acutelower back pain
-12JUL2001 Dr. notes "b/L
parasesthesias" in his exam notes, also lower back pain
-08AUG2001 MRI findings/neurological narrativenotes,(my history of Bilateral Radiculopathy was the reason for theMRI in the first place)
-Medical board proceedings were for back
pain/degenerative disc disease/bilateral dysesthesias (Narrative Summary1OCT2001)
-VA Exam 17JAN2003 indicates decreased reflexes bilaterally
-2003 VA Ratings decision grants service
connection for Radiculopathy 10% right leg based on decreased sensation of
right great toe, but not left leg, yet same symptoms are present in bothlegs. Treatment medication at that time included 800 mg ibuprofen 4x's daily,
Ultram, and Flexaril.
-Dr. notes both right and left leg
symptoms in her examination notes 6AUG2010. She did SLR's, sensory, reflexes, andphysical manipulation at that time.
"Strength is slightly diminished on the right leg compared to the left.
He is able to toe and heel walk although he does this with some difficulty. Hehas limited amount of toe raises that he can do right foot and left foot butcan't initially do them. The patients gait is antalgic"
-C&P Examiner notes "decreased vibratory sense, left great toe" during 2010 exam.
These symptoms that have been, present in myleft leg (radiating pain, numbness, decreased sensory) since before Idischarged from the Army. I used the terminology "radiculopathy" based on theVA's usage of that description, but regardless of whether its called"radiculopathy", "pins and needles", "bilateral dysesthesias", it is the samething. I'm simply using VA's own assessment of the condition as my basis forcalling it radiculopathy. Since my right leg is rated 10% for Radiculopathybased on my lower back condition, I feel that my left leg should have beengranted the same based on the presentation of the same symptoms (note currentC&P finding of "decreased vibratorysense, left great toe" This itself is consistent with a 10% rating for "mildincomplete paralysis" as used by the VA for my 10% rating in my Right lowerextremity. The Examiner notes a lack of clinical evidence. I feel I have providedmore than enough over a long period of time to indicate chronic pain andnumbness is due to my back injury.
2) Service Connection Erectile Dysfunctiondenied due to lack of evidence from Examiner. I disagree.
"Service connection for erectile dysfunction (also claimed as sexual
dysfunction), claimed as secondary to your service connected intervertebraldisc syndrome, lumbar spine, is denied because there is no evidence showingthat any erectile dysfunction has been diagnosed, as well as no evidence thatthe claimed condition otherwise began during or was caused by militaryservice…."
Reasons for disagreement:
-17JAN2003 difficulty with erections noted byVAMC PA , progress notes
"Genitourinary-hereports urinary urgency, sometimes has to sit to urinate since back injury.Genitalia-he admits to some problems with erections, which again is secondaryto his back injury."
-Diagnosis/prescription Paxil for premature
ejaculation noted in letter as secondary to my lower back injury, Dr. so and so
"I have reviewed Mr. Satterfield's service medical record pertaining to his back injury that he sustained while in the service in 2002. I saw him onAugust 6th and we went through the history and current issuesinvolved with his low back pain and radiculopathy. At that time he told me thathe has had issues with erections and premature ejaculation since that injurywas sustained. Therefore it is my opinion that his current symptoms appear tocoincide with the injury in the service. We have started him on Paxil as thatdoes tend to help delay ejaculation and hopefully improve his symptoms."
-No C&P was scheduled for erectile
dysfunction, and other than noting I had it listed the Examiner during myC&P did no physical exam, did not ask about frequency of sexual encounter,or difficulties with sex with my wife, or acknowledge that I had already complained about it in 2003 to a VA practitioner who opined that it was indeedconnected to my back injury.
I feel this clearly states that there iserectile difficulty that is a direct result of my lower back injury. Dr.so and soreviewed with me my entire service medical file, in addition to making her ownassessment of erectile problems, and prescribed medical treatment for it, thatis ongoing. The VAMC visit on 17JAN2003 where erectile problems were noted waswithin one year of my leaving the military (26FEB2002). The Examiner notes no'clinical' evidence of ED, yet complaints persist from 2003, and furtherclinical evidence of erectile difficulty was provided in 2010.
I am requesting a "De Novo Review" by a newDecision Review Officer.
I will be awaiting your reply.
Sincerely,
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So I should probably just appeal, request DRO, and pick it apart and submit the nexus letter for ED? I also have a VAMC report from my PCP in 2003 where he states " Genetalia-he admits to some problems with his erections, which again is secondary to his back injury.....".That was already submitted, though-it may have been buried.
What can I do about the SC for the Left Leg radiculopathy? My Rt leg was rated for it, though no EMG was ever done-it was based on my complaints and MRI, etc. I have service records/sick call notes that note bilateral radiculopathy and bilateral dysesthesias. I don't know why they denied it. Should I appeal, or refile a claim and call it 'incomplete paralysis' since that is the wording they used?
Thanks for replying, Carlie!
1) Does the act of submitting a NOD and requesting DRO review require me to have a lawyer or court or is it more like submitting more things for 'discovery'?
2) Is 'reconsideration' basically the same thing as a NOD-
They both reconsider, but what are the more subtle differences between the two processes?
broken,
1) No - you are never required to have a lawyer.
2) There are not subtle differences between a NOD and a request for reconsideration.
A NOD has to be filed within one year of the Rating Decision in question.
NOD = Notice of Disagreement - and you present your argument as to why you disagree
with XXX in the Rating Decision.
A Request for Reconsideration = yes - I agree with the Rating Decision but I feel
if the issues are reconsidered with this additional information/evidence, then
the Rating Decision would either grant SC - a higher percentage - a different
effective date, etc... what ever the case may be.
Although one can submit a request for reconsideration - there is no reg to support
that it will be answered quickly or in a timely manner - and while you are waiting
for a response on your request for reconsideration - your NOD clock is still ticking.
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Okay, here we go-high points first;
I feel that I should be rated 10% for radiculopathy, left leg-but what do I call it? Bilateral dysthesis? Partial Paralysis?
Is it separate claim, i.e. do i refile and call it something else using the same evidence that I have now (past and present), or do I do an appeal of the same claim pointing out the inconsistency?
Denial for Erectile Dysfunction-in the list of what was considered, my 'statement of support' (clinical visit notes) are listed for my Dr. but I sent in a nexus letter that specifically says "erectile dysfunction" but it is not listed on the decision letter. Decision letter also states that the examiner found no evidence of ED, but she never examined me for ED at all-she asked a few questions and spent the rest of the time on my PN tests.
So-my questions are:
-Do I refile for "What, exactly?" for my left leg service connection? If the pain and numbness, and sensory loss in my toes isn't radiculopathy, then what do I call it? Partial paralysis? My right leg original decision from 2003 has the same symptoms listed by the C&P examiner, and no EMG was done that time.
-Do I appeal with my letter from my Doctor for ED, or just ask them to reconsider?
Reasons for Decisions:
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Got my unofficial 'white' letter today from DAV.Rt lower extremity radiculopathy continuedService Connection for left lower extremity deniedservice connection for ED is denied. My EMG for left leg came back negative, though id been taking meloxicam and neurotnin as newer medications, that seemed to help with the pain and numbness. No EMG, no radiculopathy, I guess-though I never had one for my right leg-I don't know if they went off the MRI's or what.
The ED was based on my report of it at a VA appt. in 2003 during a C&P, my Dr.'s statement of such in 2010, and her prescribing Paxil for PME, plus issues ive noticed with getting a firm erection after starting neurotnin. I haven't seen her for that yet, though.
The C&P doc wrote up a statement that said there was not enough evidence of either for her to make a decision one way or the other.
Ill get the statement of case and decide if I want to pursue it further or not. I really don't have any other evidence to throw at it right now. Is the list of things submitted via VonApp and Ebenefits the same list of things they evaluated, e.g. is there going to be a list of every thing they considered in the SOC when I get it?Does the act of submitting a NOD and requesting DRO review require me to have a lawyer or court or is it more like submitting more things for 'discovery'? Is 'reconsideration' basically the same thing as a NOD-They both reconsider, but what are the more subtle differences between the two processes?
I thought I had a solid claim. I submitted supporting copies of my own SMR's from 2002 that show both L and R leg radiculopathy, but my C&P then for my initial rating only noted the R leg. I was trying to correct that. My new x rays from a few months ago show decreasing disc spacing in more levels than in 2002, and Im on stronger drugs for pain than I was before.
The ED was noted by my doctor, and I complained of it in 2003 to a VA doctor and in a C &P then as well. I finally went to my Dr to be treated for PME, and we started with Paxil to try to help with that (2 months ago) but now I have trouble getting erect at all (and I take gabapentin for my lower back). She wrote a letter for me that stated based on her evaluation of both me and my service records that my erectile issues were caused by my back. I also had a letter from my wife (RE: Pain and ED issues) and co worker (pain issues, mobility). All in all between my old evidence (for SC of left leg contension) and ED, plus xrays and narratives, etc was some 20 pages. I got copies of it all, typed up a cover sheet noting pages and paragraphs) and sent it off.
One of the hurdles that I have is that my EMG said I was fine, and since I started on these new drugs (mobic and gabapentin) my symptoms in my Rt leg that is already rated are better then they are without. Since the drugs help with both legs, I can't really see how I can show what's going on short of them (or me) getting a new MRI, probably on my own. That may be my next step.
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Is there supposed to be an attachment?
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Good question. Im in decision now, too.
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is this for a hearing? If for a regular claim I would just type up the highlights like a termpaper cover sheet and cite various places/dates/forms. You can't really 'do' a PPT or a videography to the RO, and the C&P docs probably don't have time (though they should make time), though I would think it to be immensely helpful during a C&P for some conditions like mental health or ambulatory.
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If they are P and T, I thought you could work, it was just if you were IU where you were penalized for working?
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'Remanded'-means it goes back to somewhere-the RO?
Watching.....
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If you are rated over 30% you go to the Travel office and they punch in your mileage and pay you 41.5 cents per.
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It depends. If there is the chance of a widow, or of going downrange from one of your non-SC conditions, Id get the worst of them on the list, even at 0%.
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THey have to notify you first, then prove it and give you the opportunity to appeal, during which your benefits remain as they are.
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Thats the downer of Ebenefits-it's tied to the RO's. You can see plainly that it's information, for good or ill, probably mirrors the Monday Morning reports.
Its a great resource if you live near an RO that is not overwhelmed, but if you live near one of the more used ones in the country, well, *shrug*. I don't really know what to say-short of thin-clienting the entire RO system to one Cray sized computer farm (or a RAID network of cheap Dell optiplex's set up to mirror each other) there really is no solution to the disparity of information available. I think they should contract with Google and get a search server or 5 installed. Our State Legislature has one in the basement, and once the documents are digitized they are instantly accesible via Google search algorithms on the server. Its maintained by Google, too, so there is little overhead. It's pretty slick.
I have access to Ebenefits and have found it to be lacking current information. It seems that the Houston RO has not updated my info on claims since April of this year. I check it every day and have contacted the VA by phone and IRIS inquiring what is going with a deferred claim. I just get the response from them that they are working on it.
68mustang
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Thats the same source-all they did was copy the blurb from cq.com
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The linked article is a blog/journal that you have to pay for. *shrug*
cq.com
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I have a claim in for an increase, a claim for SC on a related issue to my already rated back, and a claim for ED.
I put in the first 2 on the 22nd of July, and the ED on the 29th. I had my C&P two weeks ago for the radiculopathy/Service Connection claim, and this morning they called me about dependents that they should already know I have. Along the way was 1 PCP appt, 1 private doctor appointment for a nexus for ED, and an EMG.
I'm not sure what the Ebenefits screen is saying to me, other than I don't need to send anything else in on my side and they have copies of everything already. The old dependency was the birth of my daughter.
maybe I am reading it wrong but I see where it says the dependents issue was closed on 22 Sep so you should be getting your deposit any day now but above it also shows a open compensation claim any idea what that is about?
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The catch 22 is that if they moved faster and missed something along the way that affected a Veterans rating they would get sued, so they wait for paperwork just in case something shows up. I make copies of all my own stuff and carry it in there ( i live in the same town as my RO, though) but certified mail or VONAPP work, too.
Bva Decisions
in VA Disability Claims Research
Posted
What is the link to the site you are using?