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Found 5 results

  1. Hello, I checked ebenefits and it said I received a GRANT from the CAVC for increased rating "anklyosis of the shoulder." I had appealed for depression and anxiety as well and they were not addressed on ebenefits so I am guessing it is still on remand at the BVA level. Ebenefits also stated that my remand would take 16-24 months. I am currently 60% with 10 for tinnitus, 20 for ankle, 20 for shoulder, 20 for shoulder radicupathy, 10 for knee. What does all this mean? if I am not providing the information needed for input I am happy to do that but at this time I dont know what else to provide you guys. Thank you.
  2. Hey brothers and sisters, So I just had my C&P for my right shoulder secondary to my left shoulder injury. Since I've injured I tend to put more strain on my right shoulder to compensate for functional loss. This has caused me to have pain and limited ROM in both shoulders. This scumbag at the VA left his opinion. Even though all my tests showed limited ROM and pain on movement of right shoulder. What's next? MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Secondary Service Connection. Is the Veteran's shoulder condition right at least as likely as not (50 percent or greater probability) proximately due to or the result of rotator cuff tendonitis, left shoulder (non dominant)? b. Indicate type of exam for which opinion has been requested: RIGHT SHOULDER TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] b. The condition claimed is less likely than not (less than 50% probability) proximately due to or the result of the Veteran's service connected condition. c. Rationale: Within the concept of a pathologic entity of one specific site or joint of the human body (right shoulder in this case) it is very hypothetical to theorize or to try to conceptualize that such a pathologic process would be secondary to a SC pathological process at a separate site such as ROTATOR CUFF TENDONITIS, LEFT SHOULDER (NON DOMINANT). To ascribe a distant pathologic entity (RIGHT SHOULDER) to be secondary to the already mentioned SC condition, does not fit within the realm of a peer reviewed logical manifestation of diseases as written over centuries in the medical books. Even trying to force a connection between such SC condition and the RIGHT SHOULDER condition imperils the scientific knowledge in medicine that tries to explain disease processes and their interconnections in the most logical, reasonable and responsible ways. There is no evidence in the scientific medical literature of such connection. Therefore, the claimed condition is less likely than not proximately due to or the result of the Veteran's service connected condition. And the SC condition neither aggravates the RIGHT SHOULDER condition.
  3. I injured my left shoulder in 1979, was honorably discharged in 1981 and have been compensated, now at 40% for my left arm issues. More than 30 years after leaving the Navy I tore the bicep on my right arm lifting a computer. My right arm was in a somewhat vulnerable position because I have limited use of my left arm due to the service injury. Can my right arm bicep tear be considered service related (30 years after I left the Navy) and therefore compensated due to an injury on my left arm that was service related?
  4. Hi, I am currently rated at 20% for my shoulder. I went in for a CP exam recently and these were the results. This is a remand exam from the BVA. Am I looking at a decrease to 10 or even zero? I am not bending my shoulder so it may dislocate for any of these people or any examination and I think it may have hurt me. If you could take a look I'd appreciate it. Thanks for your time! Shoulder and Arm Conditions Disability Benefits Questionnaire Name of patient/Veteran: Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 1. Diagnosis ------------ a. List the claimed condition(s) that pertain to this DBQ: Strain with radicular sx b. Select diagnoses associated with the claimed condition(s) (check all that apply): [X] Shoulder strain Side affected: [ ] Right [X] Left [ ] Both ICD Code: S46.019A Date of diagnosis: Left UNK- S/C c. Comments, if any: No response provided d. Was an opinion requested about this condition? [ ] Yes [X] No [ ] N/A 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's shoulder or arm condition (brief summary): *** Note - Veteran was notified that this evaluation is for Compensation and Pension purposes only and he/she is to return to his/her treating clinician for regular medical care =========================================================================== ===== Veteran served in the US Army as a Cav Scout E-5 from 1988-1996 - reports that he is s/c for L shoulder strain with radicular sx. Reports current condition includes the following sx- L shoulder Pain- intermittent Daily lasting 10 minutes to hours 3-7/10 dull to sharp depending on activity Dislocations - Last occurred was 3 years ago - has popping and clicking, sensation of weakness Reports constant L lateral 1st metatcarpal numbness Has additional numbness from axillary region to the Lateral aspect of the L 1st metacarpal- occurs 3-5 x weekly lasting 10 minutes to 2 hours Condition impacts Occupation/Recreation/Daily activities- Limits carrying, lifting, pushing, pulling and overhead work Current Tx Type Duration Response to Medications 1. Medications OTC ASA, Tylenol, Advil as directed PRN- fair results 2. Denies Physical therapy Occupation since discharge- HVAC mechanic now on SSDI since 2013 2. DOMINANT HAND: right 3. POSTURE & GAIT: straight; gait stable, smooth, symmetric b. Dominant hand: [X] Right [ ] Left [ ] Ambidextrous c. Does the Veteran report flare-ups of the shoulder or arm? [X] Yes [ ] No If yes, document the Veteran's description of the flare-ups in his or her own words: L shoulder Pain- intermittent Daily lasting 10 minutes to hours 3-7/10 dull to sharp depending on activity Dislocations - Last occurred was 3 years ago - has popping and clicking, sensation of weakness Reports constant L lateral 1st metatcarpal numbness Has additional numbness from axillary region to the Lateral aspect of the L 1st metacarpal- occurs 3-5 x weekly lasting 10 minutes to 2 hours Condition impacts Occupation/Recreation/Daily activities- Limits carrying, lifting, pushing, pulling and overhead work Pain, weakness, fatigability, or incoordination could significantly limit functional ability during flare-ups, or when the joint is used repeatedly over a period of time. Veteran would have additional limitations in ROM but unable to quantify the degree of ROM loss as it would vary due to severity of pain , weakness, fatigability and overuse. d. Does the Veteran report having any functional loss or functional impairment of the joint or extremity being evaluated on this DBQ (regardless of repetitive use)? [X] Yes [ ] No If yes, document the Veteran's description of functional loss or functional impairment in his or her own words: L shoulder Pain- intermittent Daily lasting 10 minutes to hours 3-7/10 dull to sharp depending on activity Dislocations - Last occurred was 3 years ago - has popping and clicking, sensation of weakness Reports constant L lateral 1st metatcarpal numbness Has additional numbness from axillary region to the Lateral aspect of the L 1st metacarpal- occurs 3-5 x weekly lasting 10 minutes to 2 hours Condition impacts Occupation/Recreation/Daily activities- Limits carrying, lifting, pushing, pulling and overhead work Pain, weakness, fatigability, or incoordination could significantly limit functional ability during flare-ups, or when the joint is used repeatedly over a period of time. Veteran would have additional limitations in ROM but unable to quantify the degree of ROM loss as it would vary due to severity of pain , weakness, fatigability and overuse. 3. Range of motion (ROM) and functional limitation -------------------------------------------------- a. Initial range of motion Left Shoulder ------------- [ ] All Normal [X] Abnormal or outside of normal range [ ] Unable to test (please explain) [ ] Not indicated (please explain) Flexion (0 to 180): 0 to 130 degrees Abduction (0 to 180): 0 to 150 degrees External rotation (0 to 90): 0 to 90 degrees Internal rotation (0 to 90): 0 to 90 degrees If ROM is outside of normal range, but is normal for the Veteran (for reasons other than a shoulder condition, such as age, body habitus, neurologic disease), please describe: Veteran refuses to move L shoulder beyond stated range due to fear of pain and dislocation- poor effort If abnormal, does the range of motion itself contribute to functional loss? [X] Yes (please explain) [ ] No If yes, please explain: limits ROM Description of pain (select best response): Pain noted on exam and causes functional loss If noted on exam, which ROM exhibited pain (select all that apply)? Flexion, Abduction Is there evidence of pain with weight bearing? [ ] Yes [X] No Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [ ] Yes [X] No Is there objective evidence of crepitus? [ ] Yes [X] No b. Observed repetitive use Left Shoulder ------ ------- Is the Veteran able to perform repetitive use testing with at least three repetitions? [X] Yes [ ] No Is there additional functional loss or range of motion after three repetitions? [ ] Yes [X] No c. Repeated use over time Left Shoulder ------------- Is the Veteran being examined immediately after repetitive use over time? [X] Yes [ ] No Does pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time? [ ] Yes [ ] No [X] Unable to say w/o mere speculation If unable to say w/o mere speculation, please explain: Pain, weakness, fatigability, or incoordination could significantly limit functional ability during flare-ups, or when the joint is used repeatedly over a period of time. Veteran would have additional limitations in ROM but unable to quantify the degree of ROM loss as it would vary due to severity of pain , weakness, fatigability and overuse. d. Flare-ups Left Shoulder ------------- Is the exam being conducted during a flare-up? [ ] Yes [X] No If the examination is not being conducted during a flare-up: [ ] The examination is medically consistent with the Veteran's statements describing functional loss during flare-ups. [ ] The examination is medically inconsistent with the Veteran's statements describing functional loss during flare-ups. Please explain. [X] The examination is neither medically consistent or inconsistent with the Veteran's statements describing functional loss during flare-ups. Does pain, weakness, fatigability or incoordination significantly limit functional ability with flare-ups? [ ] Yes [ ] No [X] Unable to say w/o mere speculation If unable to say w/o mere speculation, please explain: Pain, weakness, fatigability, or incoordination could significantly limit functional ability during flare-ups, or when the joint is used repeatedly over a period of time. Veteran would have additional limitations in ROM but unable to quantify the degree of ROM loss as it would vary due to severity of pain , weakness, fatigability and overuse. e. Additional factors contributing to disability Left Shoulder ------------- In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe: Less movement than normal due to ankylosis, adhesions, etc., Other (please describe) Please describe additional contributing factors of disability: Condition impacts Occupation/Recreation/Daily activities- Limits carrying, lifting, pushing, pulling and overhead work 4. Muscle strength testing -------------------------- a. Muscle strength - Rate strength according to the following scale: 0/5 No muscle movement 1/5 Palpable or visible muscle contraction, but no joint movement 2/5 Active movement with gravity eliminated 3/5 Active movement against gravity 4/5 Active movement against some resistance 5/5 Normal strength Right Shoulder: Rate Strength: Forward flexion: 5/5 Abduction: 5/5 Is there a reduction in muscle strength? [ ] Yes [X] No Left Shoulder: Rate Strength: Forward flexion: 5/5 Abduction: 5/5 Is there a reduction in muscle strength? [ ] Yes [X] No b. Does the Veteran have muscle atrophy? [ ] Yes [X] No c. Comments, if any: No response provided 5. Ankylosis ------------ Complete this section if the Veteran has ankylosis of scapulohumeral (glenohumeral) articulation (shoulder joint) (i.e., the scapula and humerus move as one piece). a. Indicate severity of ankylosis and side affected (check all that apply): Left side: [ ] Ankylosis in abduction up to 60 degrees; can reach mouth and head (Favorable ankylosis) [ ] Ankylosis in abduction between favorable and unfavorable (Intermediate ankylosis) [ ] Ankylosis in abduction at 25 degrees or less from side (Unfavorable ankylosis) [X] No ankylosis b. Comments, if any: No response provided 6. Rotator cuff conditions -------------------------- Is rotator cuff condition suspected? Right Shoulder: [ ] Yes [ ] No Left Shoulder: [X] Yes [ ] No If "Yes" complete the following: Hawkins' Impingement Test (Forward flex the arm to 90 degrees with the elbow bent to 90 degrees. Internally rotate arm. Pain on internal rotation indicates a positive test; may signify rotator cuff tendinopathy or tear.) [ ] Positive [X] Negative [ ] Unable to perform [ ] N/A Empty-can Test (Abduct arm to 90 degrees and forward flex 30 degrees. Patient turns thumbs down and resists downward force applied by the examiner. Weakness indicates a positive test; may indicate rotator cuff pathology, including supraspinatus tendinopathy or tear.) [ ] Positive [X] Negative [ ] Unable to perform [ ] N/A External Rotation/ Infraspinatus Strength Test (Patient holds arms at side with elbow flexed 90 degrees. Patient externally rotates against resistance. Weakness indicates a positive test; may be associated with infraspinatus tendinopathy or tear.) [ ] Positive [X] Negative [ ] Unable to perform [ ] N/A Lift-off Subscapularis Test (Patient internally rotates arm behind lower back, pushes against examiner's hand. Weakness indicates a positive test; may indicate subscapularis tendinopathy or tear.) [X] Positive [ ] Negative [ ] Unable to perform [ ] N/A 7. Shoulder instability, dislocation or labral pathology -------------------------------------------------------- a. Is shoulder instability, dislocation or labral pathology suspected? [X] Yes [ ] No If yes, complete questions 7b - 7d below: b. Is there a history of mechanical symptoms (clicking, catching, etc.)? [X] Yes [ ] No If yes, indicate side affected: [ ] Right [X] Left [ ] Both c. Is there a history of recurrent dislocation (subluxation) of the glenohumeral (scapulohumeral) joint? [X] Yes [ ] No If yes, indicate frequency, severity and side affected (check all that apply): [X] Infrequent episodes [ ] Right [X] Left [ ] Both [X] Guarding of movement only at [ ] Right [X] Left [ ] Both shoulder level d. Crank apprehension and relocation test (with patient supine, abduct patient's arm to 90 degrees and flex elbow 90 degrees. Pain and sense of instability with further external rotation may indicate shoulder instability.) [ ] Positive [X] Negative [ ] Unable to perform [ ] N/A 8. Clavicle, scapula, acromioclavicular (AC) joint and sternoclavicular joint conditions ------------------------------------------------------------------------------ a. Is a clavicle, scapula, acromioclavicular (AC) joint or sternoclavicular joint condition suspected? [X] Yes [ ] No If yes, complete questions 8b, 8d and 8e below: b. Does the Veteran have an AC joint condition or any other impairment of the clavicle or scapula? [ ] Yes [X] No c. Does the clavicle or scapula condition affect range of motion of the shoulder (glenohumeral) joint? No response provided d. Is there tenderness on palpation of the AC joint? [ ] Yes [X] No e. Cross-body adduction test (Passively adduct arm across the patient's body toward the contralateral shoulder. Pain may indicate acromioclavicular joint pathology.) [ ] Positive [X] Negative [ ] Unable to perform [ ] N/A 9. Conditions or impairments of the humerus ------------------------------------------- a. Does the Veteran have loss of head (flail shoulder), nonunion (false flail shoulder), or fibrous union of the humerus? [ ] Yes [X] No b. Does the Veteran have malunion of the humerus with moderate or marked deformity? [ ] Yes [X] No c. Does the humerus condition affect range of motion of the shoulder (glenohumeral) joint? No response provided d. Comments, if any: No response provided 10. Surgical procedures ----------------------- No response provided 11. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ------------------------------------------------------------------------ a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? [ ] Yes [X] No b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No c. Comments, if any: No response provided 12. Assistive devices --------------------- a. Does the Veteran use any assistive devices? [ ] Yes [X] No b. If the Veteran uses any assistive devices, specify the condition and identify the assistive device used for each condition: No response provided 13. Remaining effective function of the extremities --------------------------------------------------- Due to the Veteran's shoulder and/or arm conditions, is there functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis? (Functions of the upper extremity include grasping, manipulation, etc., while functions for the lower extremity include balance and propulsion, etc.) [ ] Yes, functioning is so diminished that amputation with prosthesis would equally serve the Veteran. [X] No 14. Diagnostic testing ---------------------- a. Have imaging studies of the shoulder been performed and are the results available? [X] Yes [ ] No If yes, is degenerative or traumatic arthritis documented? [ ] Yes [X] No b. Are there any other significant diagnostic test findings or results? [ ] Yes [X] No c. If any test results are other than normal, indicate relationship of abnormal findings to diagnosed conditions: No response provided 15. Functional impact --------------------- Regardless of the Veteran's current employment status, do the condition(s) listed in the Diagnosis Section impact his or her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)? [X] Yes [ ] No If yes, describe the impact of each of the Veteran's shoulder conditions providing one or more examples: Condition impacts Occupation/Recreation/Daily activities- Limits carrying, lifting, pushing, pulling and overhead work 16. Remarks, if any: -------------------- Impression- 1. L shoulder strain with residuals of radicular sx as noted- Veteran refused to move L shoulder beyond stated range due to fear of pain and dislocation
  5. 1989-I was medically discharged for eczema and rated at 10% service connected. 1999 and 2000-The VA rated my ankle (5271-Moderate Ankle Limited Motion) at 10% and shoulder (5202-Dislocations) at 20% service connected. Total rating: 40%. Oct 2012-I filed for reevaluation and increase for all three service connected disabilities. Mar 2013-C & P Exam. Examiner stated that x-rays will be order. I was never contacted or afforded the opportunity to have x-rays done according to the examiner. Aug 2013-Received VA Decision. No change in the three ratings, but received an increase of 10% for limited motion of the shoulder. Total rating: 40%. Feb 2014-Seeked private medical appointment (overseas) and was referred for Ankle x-rays and shoulder MRI. Right ANKLE FINDINGS: Frontal, lateral and oblique views of the right ankle show no fracture or dislocation. Two screws are present in the distal right fibular metaphysis without evidence of loosening or fracture. The ankle mortise and other imaged joint spaces are maintained. Mild osseous sclerotic changes are present in the medial and lateral malleoli. Plantar enthesophyte is noted. There is no significant soft tissue swelling. IMPRESSION: 1. No acute osseous abnormality. 2. Two screws in the distal right fibula without evidence of complication. 3. Mild degenerative changes in the ankle. Right SHOULDER FINDINGS: SUPRASPINATUS: The tendon is intact. There is heterogeneous fluid signal and thickening, consistent with tendinosis. INFRASPINATUS: Chronic articular sided partial thickness tear with a large segment of scarring, measuring 1.5 ern, Some fibers remain intact, as the tendon does not appear retracted, TERES MINOR: Intact. SUBSCAPULARIS: Intact. There is heterogeneous fluid signal and thickening, consistent with tendinosis. LONG HEAD OF THE BICEPS TENDON: Normal. MUSCLE VOLUME: Normal in signal and bulk. ROTATOR CUFF INTERVAL: Unremarkable. AXILLARY POUCH: Evaluation is limited given the relative absence of fluid in the glenohumeral joint space. No large bone fragments. LABRUM: There is near complete circumferential degenerative tearing of the labrum. A small amount of anterior labrum maintained. Multiple para-labral cyst involving both the anterior inferior and posterior inferior labrum. ACROMIOCLAVICULAR JOINT: Abnormal with hypertrophy of the capsule and fluid within the joint space. No widening of the joint space. Subchondral cystic and sclerotic changes. ACROMION TYPE: II, small enthesophyte at the deltoid insertion. Undersurface osteophyte at the acromioclavicular joint. No downsloping. BONES: There is extensive amount of subchondral sclerosis and cystic changes of the glenoid. Ring osteophyte of the humeral head. SUBACROMIAL/SUBDELTOID BURSA: Small amount of fluid in the bursa. OTHER: Unremarkable. IMPRESSION: 1. EXTENSIVE OSTEOARTHRITIC CHANGES OF THE GLENOHUMERAL JOINT. 2. PRIOR HIGH-GRADE PARTIAL-THICKNESS ARTICULAR SIDED TEAR OF THE INFRASPINATUS TENDON. 3. SUBSCAPULARIS AND SUPRASPINATUS TENDINOSIS. 4. ACROMIOCLAVICULAR JOINT ARTHROSIS. Used this radiology report with NOD as medical evidence. June 2014-Filed NOD for insufficient C&P Exam and noted that Right Ankle should be rated under (5262- Fibula Impairment with Moderate Ankle Disability) at 20% secondary to (5003- Painful Motion) at 10% vice the current (5271-Moderate Ankle Limited Motion) at 10% and Right Shoulder (5201-Arm Limitation and Painful Motion) at 20% secondary to my existing (5202-shoulder dislocation) at 20%.. July 2014-Seeked private medical appointment with Ortho Doc (stateside) for ankle and shoulder pain. Additional x-rays taken of ankle and shoulder. Prescribed ankle support brace and recommended brace fitting for shoulder. Ortho Doc also suggested in report for ankle a well-defined lucent lesion in the distal fibula and plantar calcaneal enthesophyte/spur. Also submitted this report as supporting medical evidence. Your opinion and thoughts are appreciated. Thank you.
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