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Found 12 results

  1. Happy Friday Eve Question about nexus letter. I had 2 doctors provide nexus letters to support my claim. I made sure to read the help guides and have a better understanding of what is required as in the verbiage and what nots. I read some articles and wanted to include to support my claim. My VSO said if it comes back as denied he can supply case file to support my claim. You can review past cases etc. Can I also add medical references from Pubmed or medical journals on your own to support the claim? I have 2 nexus letters and I included a reference page with medical journal information. The doctor didn’t quote medical journal but mentioned my specific issues. Will providing this help?
  2. So I have always just assumed that you find an Independent medical examiner to perform an Independent Medical Exam that renders his Independent Medical Opinion to provider a NEXUS letter; the Nexus letter being the 1.) inciting event on active duty, 2.) official diagnosis of condition and 3.) the Medical Rational/pathology linking 1 to 2 "more likely than not" . The Caluza elements is a brand new term completely but upon my very basic understanding of these elements....are they not the same 3 elements of a nexus letter? Also while reading through some of the post it kinda seems like maybe IMEs, IMOs, and Nexus reports are not all the same and so now am pretty sure I'm confused. What are the differences and what holds more value in obtaining for a successful claim? Also, is there any value in having both a Nexus letter and a DBQ performed by independent medical examiners? If a nexus letter cost $500 and a DBQ cost $500 and you only have $500..... which one would you buy or would you borrow anther $500 from a friend to get both?
  3. Can you look at this please and let me know what you think. My neurologist wrote this for me To Whom It May Concern, Mr. ________ has come to my office as a patient for his neurological and sleep condition. I am a board certified Neurologist. I am also certified and specialize in sleep medicine. Mr. ______has been diagnosed with obstructive sleep apnea (OSA). I am currently treating him for this diagnosis. Mr. _______ with confirmed OSA diagnosis treated with positive airway pressure therapy (CPAP). It is possible,or at least than not (50% or greater probability) that OSA is associated with or due to service-connected PTSD diagnosis. However, a direct casual relationship cannot be definitely ascertained. If there is any questions or concerns, please feel free to contact me in my office. Sincerely, My question is? Is this a valid nexus letter?
  4. Hello everybody I hope everyone is having a Good Friday. Almost 18 months ago I submitted through the vfw a appeal and this went to the board. After reviewing they remanded the decision back to my local VA office. There was evidence that was not included and I guess errors. In the meantime I am working with a provider that’s working a nexus letter. Should be done in the next week. with that in mind I expected the appeal to get denied and it took a while. I figured if I can get a nexus letter and send it then it could be added to the claim. Now that the appeal is back with the local va can I just send this to the intake center or upload ? I would ask my local vfw but their offices are closed up. also about my provider. He is not a doctor but I believe a MSW or CSW with 35 years of working with the dept of VA treating PTSD. I am rated with ptsd. I’m trying to get my sleep apnea rated secondary. I know this is talked about a lot however my question is will the va toss the nexus because the person is not a doctor ? I’d think 30 plus years working with the VA and working primarily with ptsd patients should count for something. He was licensed and just couldn’t prescribe meds. I like to avoid meds altogether and get to the square root of my issues. I appreciate any feedback. I’m glad the board didn’t Just deny me. I think I have a good argument and this nexus will help.
  5. I have a C&P Exam on Wednesday and I'm afraid I'll get denied. Flat feet was denied before along with Plantar Fasciitis because it's not service connected. I went back to my physician outside the VA and he typed my nexus as follows: "Bilateral flatfoot acquired possibly during time in military. When not congenital as a cause, pes planus (flatfoot) is caused due to ill fitting shoe-gear without subtalar range of motion support, which could have been a result to time in service, 51% probability.Patient presents today with bilateral heel pain, worse right foot. Patient states that the pain is 2 out of 10. Patient denies any injury. Patient states he is having pain to the plantar aspect of his right heel that has been going on for several months. Patient denies being diabetic. Patient states he received custom orthotics as a week ago and has notes slight improvement. Patient denies taking any anti-inflammatories. Patient states that he has noticed his achilles feeling tight during athletic activity. *****Physical exam: Decreased ankle dorsiflexion noted bilateral. Mild tenderness to palpation to the plantar medial aspect of the right calcaneus. No pain with lateral compression of bilateral calcaneus. No pain along posterior tibial tendon bilateral. Increased pronation to patient's mis and rear foot bilateral. (The X-rays show as normal)" It got denied due to not being service connected, so I went back and got the below nexus typed and signed. "After reviewing ******** service record at my medical opinion is his pronounced bilateral pes planus or flat feet are connected to his time in service with the Marine Corps. Plus, his flat feet are due to high impact physical activity for military training such as marching drills, drills at Corporals Course, Sergeant course, Intermediate Administration Specialist Course, and the wearing of combat boots. These have caused strain on his posterior tibial tendon resulting in painful flat feet. The diagnosis of pronounced bilateral flat feet is severe with fitted soles. He still has symptoms with a pain level ranging to 8 out of 10. Recall treatment options have been discussed but will be deferred at this time." This is good but I don't know if it will connect come to think about it. From my recollection, I only went to medical once for plantar fasciitis and it's not shown as chronic. My flat feet was marked as normal upon entry of the Marine Corps and wasn't marked at all for my final physical. There's no check in any of the boxes indicating if my feet were normal or not. The ball was lazily dropped. I did just get a service connection for my hip injury. Should I go back to this doctor again and have him add a sentence that says, "Also, it is more likely than not that his pronounced bilateral flat feet worsened following the injury to his right hip with compensating for the pain"? Or does the VA Compensation even contact the doctor to check to see if they generated it or edited it? I have 1 full day to figure this out ands submit to add to my claim for Wednesday.
  6. Doctor's Letter Head Date: Subject: Medical history of Mr. Veteran Reference: C-File # and/or Social Security Number To the Department of Veterans Affairs: I am the primary care provider for Mr. Veteran. In my capacity as a primary care provider, I have cared for Mr. Veteran since 01/07/20xx. While I've provided care for Mr. Veteran, I've become familiar with his active duty medical history from 07/24/19xx to 08/07/19xx and from VA medical records from 19xx to present, past and present ailments and I've reviewed pertinent parts of his military record that document his injury, disease and clinical conditions related to the events that occurred. I am aware that Mr. Veteran was injured during his active duty military service on or about 1981 in Fort Army while (events description, time and place). A primary condition the veteran suffers is Lumbar Paravertebral Myositis (an Inflammatory Myopathy) and an L4-L5, disc desiccation and disc narrowing. MRI reports note sacralization of the L 5 representing a developmental abnormality and also that paraspinal muscle spasm is suggested. Further noted are mild thoracolumbar dextroscoliosis as well as mild spondylosis and degenerative endplate changes. Schmorl's nodes in the superior endplate of L3. L3-L4 and L4-5 degenerative disc disease are seen. There is an L4-5 small posterior disc bulge and small posterior central disc herniation and L2-3 vertebral hemangiomas. Mr. Veteran has chronic pain due to his injuries. The veteran suffers radiculopathy with pain, muscle control difficulty, tingling, numbness and weakness in the legs, likely due the sacralization of L4-L5. Mr. Veteran suffers increased fatigability because of his chronic back pain. Standing for more than 15 minutes will make him become weak and exhausted. There are multiple other clinical conditions diagnosed that are more likely than not secondary to or aggravated by the primary back condition(s). The veteran takes numerous medications for both the primary condition as well as secondary conditions that are aggravated by said primary back condition. (Medicines and secondary conditions are listed separately.) The veteran is not a likely candidate to be rehabilitated. After examining Mr. Veteran, his chart and medical records it is my opinion that Mr. Veteran is totally and permanently disabled due to the above discussed back condition. The veteran cannot hold gainful employment as a result of the injury he sustained while in the military. It is also my opinion that it is more likely than not the that the physical traumas suffered during the veteran's military service as noted in his record (description of events and dates) caused, contributed to and aggravated the totally disabling back condition(s). Respectfully, Dr. Physician, MD Diplomat of the American Board of Internal Medicine
  7. file:///C:/Users/dantr/Downloads/The Nexus Letter - An Explanation and Example.pdf
  8. I received a VA rating early last year for tinnitus and hearing loss. I recently started another claim for back pain, PES Planus(flat feet) and a ankle injury. I have proof in my service medical chart of a back injury on 2 occasion. Plus during the second visit it's document that my pain was continuous for the previous 6 months. The arch of my feet were recorded as normal during my first enlistment. When I reenlisted in the Army after being out of USMC for 4 months i recieced a entrance medical exam. In that entrance medical exam it's documented that i have flat feet. Lastly my ankle injury was documented in my service medical records. What is the opinion of getting a Nexus letter with so much proof in my service medical records. Get a Nexus, YES, or NO.
  9. I just received a letter from the Board of Veteran's Appeal notifying me that service connection for bilateral keratoconus was granted. I currently am rated at 90%. I served in the Army as a paratrooper 11B-1P from 1996 - 2000. I was diagnosed with Keratoconus in 2013 and contact lenses in both eyes are medically necessary. I had the cornea crosslinking surgery in both eyes in 2015. The decision noted the following things were positively considered in granting my appeal: 1) My medical records indicated I was exposed to asbestos and chemicals while on deployment in Kosovo (this is in reference to the report of medical history form "Standard Form 93" soldiers complete on exit of service) 2) My medical records noted I had cystic acne which required me to take medications (minocycline) that caused photosensitivity 3) I provided a nexus letter from my optometrist who opined that many of the adverse conditions I was exposed to while on deployment most likely contributed to my condition (exposure to ultra violet rays from the sun, chemicals, and unsanitary conditions 4) I submitted letters from both my parents eye doctors that stated neither of them had the disease. Two research articles I provided my optometrist were Oxidative stress in the pathogenesis of keratoconus and Fuchs endothelial corneal dystrophy by the Department of Molecular Genetics. Here is a link to another one that is useful: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449900/ I checked the E benefits VA website and although my account now indicates the condition is service connected, it shows a 0% rating. I have read conflicting info where some say the keratoconus rating is based upon your corrective vision after glasses or contacts, so if your vision is 20/20 with glasses or contacts the rating is 0. The medically necessary contact lenses I wear make my vision approximately 20/20, but I still get the halo effect a night with lights and sensitivity to light. I also read that if contacts are medically necessary a minimum of 30% is warranted. Can someone tell me which it is or provide more information? I also suffer from moderate to severe conjunctivitis which is well documented in my private medical records. I am prescribed various eye drops and get 7 allergy shot injections weekly from an allergist doctor. This of course makes it difficult to wear the medically necessary contacts to see. I have not filed a claim for the conjunctivitis, but did see it a condition that a claim could be filed for. I assume having Keratoconus service connected would increase the odds of the conjunctivitis be granted as service connected. Thoughts?
  10. Hello All, I am attaching sample nexus letters I received from my VSO. This information may have been posted before, but if it helps someone out, then so be it! Sgt. Wilky NEXUS SAMPLE.PDF NEXUS SAMPLE #2.pdf
  11. So I had a C & P appointment. I got an attorney a couple years ago after my claim was denied. My claim is for Bipolar, PTSD, and Depression. My attorney sent a NOD a little over 2 years ago and I was scheduled for a C & P appointment. The examiner that I had was the same examiner that I had on the claim I was initially denied on. He basically said "there wasn't anything wrong with me after the service". So I had my C & P appointment and the examiner pulled a note that described me mentioning taking anti-depressants prior to the military. I honestly forgot about this. I have attached the nexus letter which makes a link to the military aggravating my condition. Could someone please explain to me what can happen next? I was initially thinking award. But I'm wondering if they are going to ask for records prior to my military(teenage and young adult)... which I wouldn't be able to produce. I'm kinda freaking out because it seems like the link was made but not in the way I was expecting. Attached nexus--- 2. Current Diagnoses ------------------- a. Mental Disorder Diagnosis #1: unspecified bipolar disorder ICD code: F31.9 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): none 3. Differentiation of symptoms ----------------------------- a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes [X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------ a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [ ] No [X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ---------- Clinical Findings: ----------------- 1. Evidence Review ----------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 2. History --------- Page 26 of 139 a. Relevant Social/Marital/Family history (pre-military, military, and post-military): The Veteran has been married for approximately one year; he said lately their relationship has had problems because he feels his wife has not understood his problems. b. Relevant Occupational and Educational history (pre-military, military, and post-military): The Veteran said he had had eight jobs in the past year. He completed a bachelor's degree in psychology at UCA a year ago. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): The Veteran is followed in mental health at CAVHS. He takes lamictal, prazosin, and lithium carbonate. He also sees a private counselor. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): n/a e. Relevant Substance abuse history (pre-military, military, and post-military): The Veteran reports drinking every day, having two 30-packs over the course of a week. His last marijuana use was about two and a half years ago. f. Other, if any: n/a 3. Stressors ----------- Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: hearing a soldier getting raped Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No Is the stressor related to personal assault, e.g. military sexual trauma? [X] Yes [ ] No Page 27 of 139 4. PTSD Diagnostic Criteria -------------------------- No response provided. 5. Symptoms ---------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Inability to establish and maintain effective relationships [X] Suicidal ideation 6. Behavioral Observations ------------------------- The Veteran was cooperative. He displayed some dysphoria. 7. Other symptoms ---------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 8. Competency ------------ Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 9. Remarks, (including any testing results) if any ------------------------------------------------- The Veteran's symptoms appear to be more consistent with a mood disorder than with those of PTSD. He reported depression while still in the military, but also reported he had been treated for depression prior to the military. In today's examination the Veteran denied depression prior to the military but then conceded it was possible he had been depressed as a teenage, but could not recall details of his depression or the treatment he received. However, the same note indicated that in 2007 the Veteran reported that he had responded well to medication, suggesting that it was possible that his depression was relatively mild. Page 28 of 139 The Veteran's current bipolar disorder is severe. Therefore, it is more likely than not that any mood disorder present before the Veteran's military service was exacerbated by his time in the military. Given the Veteran's ability to complete a bachelor's degree, I did not find evidence that his bipolar disorder precluded all employment; however, it definitely makes it difficult for him to sustain employment. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's
  12. Okay so I think I have a great additional letter from my podiatrist for my upcoming DRO Review Hearing. Please let me know your thoughts! NOD doctor letter_Redacted.pdf
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