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  1. I have roughly one million questions but I'll try to keep it simple. This is the first time I am appealing a denied claim (though not my first denied claim - I currently have 50% combined). Almost exactly one year after my C&P exam I finally got a denial for both of my knees). I did a HLR informal conference and now my va.gov status says "The VBA is correcting an error". Here is the decision I received on Dec. 7th after the Higher Level Review (sorry I couldn't figure out how to add image) and below that are my questions. Decision: 1. A duty to assist error has been identified during the Higher Level Review of left knee pain. 2. A duty to assist error has been identified during the Higher Level Review of right knee pain. Evidence: Timeline from intent to file on 10/2/19 to HLR informal conference on 12/2/20 Reasons for Decision: 1. Higher Level Review for left knee pain The issue of left knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of patellofemoral pain syndrome. 2. Higher Level Review for right knee pain The issue of right knee pain was returned for correction of a duty to assist error in the prior decision. We failed to get other records. We will develop for lay statements and if warranted additional opinions. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.159, 38 CFR 3.2502, 38 CFR 3.2601) Favorable findings identified in the decision: A nexus or link has been established between your claimed issue and an in-service event or injury. During VA exam dated 11/7/19 the VA examiner provided a positive medical opinion linking your right knee to service. You have been diagnosed with a disability. The VA exam dated 11/7/19 showed a diagnosis of right meniscal tear, right knee instability, and patellofemoral pain syndrome. MY QUESTIONS 1. Am I just out of luck because I didn't seek treatment during Active Duty? 2. Under "favorable findings" it states that "a nexus, or link, has been established between your claimed issue and an in-service event". Isn't that the literal definition of a service connected disability?! 3. What is the error? What have you all seen as timelines and outcomes for this? Thank you to everyone who takes the time to respond and post. Reading these questions/answers over the last year has been both educational and comforting.
  2. So I went in Friday. Saw two examiners. I didn't have time to submit my Statements in Support of Claims (PTSD & knees) my wife and adult children filled out but I had them read them while I was there. I just uploaded them on Monday. The first wa a Nurse Practitioner. She checked my feet and knees. Don't know if this was the smartest idea but I didn't wear my AFO or knee brace at first, because I wanted her to see how I walk, move unassisted. I put it on after her examination and showed her how I'm still not stable on that leg no matter which apparatus I'm using. I explained my quality of life at work sucked becaue there's only one elevator, which means I walk twice as far to use it. I work upstairs and have almost fallen several times. I also told her I was concerned because the last rater wrote I was doing good with my orthotic insoles, when I 100 percent told him that I can't use the Navy issued insoles for regular shoes. My feet rating was decreased because of that. So I made it clear verbally that I was not getting better. For the Migraines increase i showed her my migraine tracker chart and she barely looked at it. It shows that I missed over 100 hours of work last year due to migraines. The second was the Psychiatrist She didn't ask me much about anything my VA psychologist wrote in her nexus letter. She skimmed over my buddy statements. She asked me about 6 questions, pretty much (yes or no) when was my last fight about my job am i taking my medications have I been arrested about my work history about my sleep It lasted about 15 minutes. So who knows what is going to happen. All I know is I left there without any confidence that the evidence nor my exams helped. We'll see.
  3. Hello, I have C&P exams all in one day in January. Any advice on what to expect? Here's a synopsis on what I'm up against/working with. - PTSD increase is based off several years of VA mental health treatment and a Nexus letter written by my mental health doctor, which named PTSD, Depression, Chronic Pain Syndrome with depression, Panic D/O with Agoraphobia and survivor's guilt as a diagnosis (last 3 are recently added to records). - Knee pain- VA issued me a big knee brace and my primary care (tricare) orthopedics specialist just put me an Ankle-Foot Orthosis (AFO) brace because she says I have drop foot and weakened ankle support which tried to compensate for my weak knee/muscle strength - Foot pain- I reviewed all of my previous C&P exams and realized my foot pain rating had dropped from 30% to 10% because the rater misquoted me (lied) on the C&P exam. I told him these insoles and stuff didn't work. that my feet hurt all the time. He wrote, I said they were not effective insoles and I have to use all kinds of feet massages equipment to get through my work days. The primary care sent me to this foot pain doctor. All she did was cortisone shots (3 times) in my feet and tried to up-sell me on her brand of insoles. - Migraines- Been at zero percent since retirement. Last year I was hospitalized twice and misdiagnosed with having TIA and strokes/CVA. My VA advocate put in a secondary claim to my service connected cervical damage. End result not service connected for CVA/TIA. However, ALL TESTS revealed that I've never had a stroke. The neurologist diagnosed me with Hemiplegic Migraines. These rare migraines an mimic strokes, causing weakness on one side of the body. They can last from a few hours or in my case,first one lasted 3 months. The neurologist provided a letter stating that all of the hospital doctors had misdiagnosed me with having CVAa. He also diagnosed me with exertional headaches. I know I'm no more special than the millions of other veterans out here, but this "deny 'til they die" tactic is wearing me down. Thanks for any advice.
  4. I have 4 C&P exams this Friday. All for increases. (Migraine, PTSD/depression/anxiety/chronic pain/agoraphobia, bilateral foot pain and knee pain increase [including VA issued knee brace and civilian issued AFO foot brace]). Should I have my wife ad adult kids who both witness and suffer from my mood swings, depression, anxiety and antisocial like living on a daily basis? They can also talk about my constant leg pain and migraines. I also want my supervisor to do one regarding my migraines that have me leaving work early, alot. But that is a touchy subject, because I don't want me asking him to affect my employment. Also I hide a lot from them, to keep my job, like just suffer with headaches and migraines at work. Or fake my way through the day, pretending to want to be around people.
  5. Hello everyone! I would like your thoughts and opinions on my claims. Sorry that this is long. This issue spans back to 1997. I hope someone can provide insight to what I am doing wrong and can assist me. I have highlighted my specific questions. I have been denied 3 times since 2005 for patellafemoral / chondromalacia, rheumatoid arthritis. All of the results of my claims come back not service connected - which confuses me. I was in the Army from 1995-1999. During my 5th week of basic training I have a documented diagnosis of metatarsalgia, retropatellar pain syndrome, constant bilateral knee pain, patellar tendonitis, ITB syndrome and a "possible connective tissue disorder". Other symptoms and diagnoses were: tenderness to palpitations on peripatellar region, poor tracking of knee, positive heel strike, locking and giving way many times, aggravated by marching, running, walking, straightening, no prior history of knee pain, ipsilateral knee pain, barely noticeable limp, pain on the lateral tibial region, pain on subpatellar and peripatellar region, knee pain on extension and hip flexion, increase in pain while approaching terminal knee extension, with a mild 99.0 fever at each visit. My xrays showed within normal limits. No MRIs, ultrasounds or blood work was performed - except pregnancy tests each time I went to sick call. This was over a period of 3 clinic visits (3 weeks) and 3-4 physical therapy visits. I was prescribed shoe orthotics, Naproxen and Ecotrin. The last entry during basic training states no sign of improvement, bilateral knee pain. In basic training, I denied a 7-day profile, 2 times, because I was threatened with being recycled, and at each clinic visit with malingering and being discharged if I continued to complain of knee issues. When I returned to duty after sick-call, I was forced to do exercises as punishment for missing training and PT that consisted of squats, mule kicks, running multiple laps around the building, doing high-knees while jogging, side to side ice-skaters, deep lunges, running in place and performing one-leg squat stands for close to 1 hour. If I complained, cried or cried out in pain, more punishment was added: planks, jumping jacks and holding a dummy rifle outstretched in my hands, while in a deep squat. I didn't go back to sick call again because each time I asked, I was either denied outright or only allowed to go after PT. When I did go, I was punished which brought more knee pain and stress upon myself. When I got to AIT, I went back to sick call for the same knee issues and to get more medication - here is where it gets interesting. There is only 1 record of any of my visits while in AIT. I have requested records 3 times since 2005 and there is only 1 record. This record does not describe any treatments, no diagnosis, only the profile which states no running, jumping, marching for 7 days, "discussed sick call policy", 0 major medical problems and a notation of LSC Nov 30, 1995 C protected, accused of malingering again, with a plan of return to training. If discussed sick call policy was an issue - wouldn't that be reason to assume to VA rater that I went more than 1 time? I know I went several times. Why wouldn't there be any examination records? After AIT, I did not go to sick call for my knees again because I didn't want to be discharged. I self-medicated with Motrin, ice packs, heating pads for the rest of my service to Germany and 2 tours to Bosnia and Hungary. Motrin and prescribed anti-inflammatories use caused diagnosed vision issues starting in 1997. I just filed a claim 2 days ago. I chaptered out of service in 1999 due to pregnancy. I was not given a medical, dental or vision exit examination and no counseling on VA benefits. I was out-processed fast. I was told since I would be a dependant of a soldier, that my continuity of care would continue at his base and not to worry about anything. I didn't know any better at the time. Now, I know that not having an exit medical exam has apparently screwed me from any disability claims and receiving any ratings. In 1999, 2000 and 2001, for 3 pregnancies at 3 different bases, I complained to my military OB Drs about all-over joint and knee pain, continued mild fevers and fatigue. They blew me off and said it was normal with pregnancy, that I was gaining weight which put stress on my tendons and ligaments and causing them to stretch and that I was going to be tired. I accepted that and trusted the Drs. I have 0 medical records regarding my pregnancy, hospitalizations, hemorrhages after each pregnancy and subsequent D+Cs. They are missing. No records requests have produced them. After my last pregnancy in 2001, I was still having the same issues with joint pain. I finally got blood work done. They found that I had Rheumatoid Arthritis and other potential connective tissue disorders. I had no previous auto-immune issues prior to service. I have no family history of auto-immune issues. I continued on with care as a dependent until 2004 when my husband ETSd from Ft Knox to Phoenix, AZ. When he ETSd, he received a VA briefing and an exit medical. He found out about VA benefits. Of course we were stumped on why this didn't happen for me or I would have filed in 1999. I applied at VA for health care. I was denied treatment at VA hospital in Phoenix, AZ because I did not have any current disability ratings, we made too much money and already had private health insurance. With the help of a VSO, I submitted a claim for my knee issues and Rheumatoid arthritis in 2005. I had a C&P exam in 2005. The examiner determined that I had bi-lateral knee pain consistent with non-inflammatory arthralgia, pain and grinding on both knees, subpatellar tenderness, had a range of motion to 140 degrees but pain at 120. I should be sent to Rheumatology because I mentioned a diagnosis in 2001 (didn't happen). It said that although there are treatments in active service notated, yet subsequent records were negative for any follow up care or treatment for any knee condition. A condition has to be considered "chronic" before service connection can be granted. Wouldn't 4 documented times going to sick call, being threatened with malingering/discharge, being prescribed medication, orthotic insoles with physical therapy, a profile and no improvement be considered "chronic"? Any other civilian records provided for the claim were dismissed stating "were too remote from service to be related to service". No permanent or residual or chronic disability subject to service connection is shown by the service records or demonstrated by evidence following service. Furthermore, pain in itself, without an underlying disease process is not ratable condition subject to service connection. Therefore, the current diagnosis of bilateral knee pain is denied. Bilateral patella tendon laxity/patellafemoral syndrome is also denied. No NOD or appeal was filed at the suggestion of VSO. I filed again in 2006 with more knee evidence and treatments. VSO said to file claim under 38 USC 1151. I was denied. No NOD or appeal was filed at the suggestion of VSO. I filed again in 2014 for painful joints, bilateral inflammatory arthralgia, bilateral patella tendon laxity/patella femoral syndrome, degenerative arthritis, orthopedic condition, right knee condition, left knee condition. I was not provided an examination. I was denied. No NOD or appeal was filed. I have a chain of records spanning since 1997-present showing knee issues and joint pain. I had a knee replacement in 2017 and a revision surgery in 2018. I have been diagnosed with 2 additional auto-immune issues since 2007. I have submitted buddy statements, my own statement of claim and a million medical records. None of my Drs except an allergy and eye dr will write a nexus letter or do a DBQ. I am not sure what else to do. Do I need a lawyer? My previous VSO did not want me to appeal anything or do a NOD upon receiving a denial. Can I do anything with these old claims? They just recently said to reopen the 2005 claim with a new form of supplemental evidence showing the issue progressed to needing a knee replacement. If I didn't appeal it back then, how can I reopen it? If it wasn't service connected, then would the new patellafemoral and pain "Saunders" case help me for reopening a claim from 2005 or should I just file a new claim? in 2017, I filed for personal trauma, depression and anxiety relating to pain. That claim was denied with no service connection and because of no currently disabilities. I did not have a mental health or C&P exam. I received a phone call from VA asking me about sexual trauma. The claim denial said no stressor was found to cause mental health issues and that I had no current diagnosis. The VSO wants me to get a mental health evaluation regarding chronic pain over the past 20+ years causing depression and anxiety when going to the Drs, having issues reporting pain or medical conditions and "sucking it up" until I cause more damage to myself. I see all these veterans on here with ratings for patellafemoral and other issues. I am frustrated that I cannot get another examination or get any service-connection at all - when there are obviously issues reported while in service. Any claim that I file (regardless of the issue filed) - they reference the 2005 C&P exam that was only for my knees and I am denied. I am sitting down with DAV, the new VSO in October to go over everything previously submitted regarding my knees. If none of my civilian Drs over the past 20 years wont provide a nexus letter or DBQ, (although I have a current diagnosis) how can I correlate rheumatoid arthritis to the knee pain, all over joint pain and low-grade fevers? How can I win the patellafemoral that is still present in my right knee? If my left knee is now replaced, but it had patellafemoral and arthritis prior to the replacement, would that even be rateable now? If anyone would like to provide assistance, I would greatly appreciate it.
  6. I didn't go through what most of you real military went through. But, I am going through alot physically now at the age of 32. I been out of the military since Aug of 2014. I only did about 3 years before getting medically separated. I just filed my first claim increase for both knees, major depression, both wrist, headaches, lower back, and left foot for several conditions. Im sooo nervous. Im soooo paranoid. I keep thinking that everything and anything will be used against me. There are days where I can't leave bed...I feel like that will be used against me. "Ohhhh...so you just want to get a check? We're taking away your benifts." There are days where I refuse to let my depression and accompanying ailments beat me and I try to work somehow to ease the financial burden on my wife. "Oh....you're working...let me take away your benifits. Im not looking for a free ride. Im just trying to be wise. I hear the stories from many veterans about how bad their condition gets in 10 years. Then they are left high and dry and can't work, and can't improve themselves, and people end up leaving their life cause of the burden. I have a Va rep filing for an increase in my conditions. My C&P is not dated yet...but Im sooo anxious and paranoid thinking that everything will be used against me to take the little I do make a month to contribute towards my wife paying bills. Please share some, or direct me to some experiences of people filing their first claim increase stories...and leading to c&p . Please help me understand this process better. My va rep says I have a shot at 100 percent. Im so worried. I have red and met people who have been screwed. I can't take yet another thing going bad. I think i'll kill myself if it does.
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