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Found 307 results

  1. I submitted my supplemental claim 3 days ago for the following diagnosis with evidence: - Flat Feet (Primary) - Bilateral Plantar Fasciitis (Secondary) - Bilateral Pronation to mid and rear foot (Secondary) - Intra-articular Hip Pain (Primary) - Femoroacetabular Impingement (Secondary) - Right Adductor Groin Pain (Tertiary) - Athletic Pubalgia (Tertiary) - Osteitis Pubis (Tertiary) - Right Knee Pain - Low Back Pain - Left Tennis Elbow - Bilateral Tinnitus The VA updated va.gov 2 days ago with these pending diagnosis: - Impairment of femur - Flatfoot - Limitation of leg motion (flexion) - Lumbosacral or cervical strain - Limitation of forearm motion (flexion) - Tinnitus Through my own insurance, for all of the injuries listed in the first group of injuries above, I got doctors to diagnose me with them and they added, "More than 51% probable that the injuries occurred during military service" since the same injuries got denied in the past. I used those evidences to file my supplemental claim. I called the VA today to request for them to change what they put back to how I had it. The missing items like "Pronation", I had them annotate where to find the diagnosis on the doctors notes so that they can add it. I think they overlooked it. They also left out my right adductor pain. For the hip injury, it's not just, "Impairment of femur" as they put it. Why did they do this? Are they trying to gyp me? Why didn't they annotate the secondaries and the tertiaries like I annotated it? Instead of "Right Knee Pain" they put "Limitation of leg motion (flexion)". For "Low Back Pain" they put "Lumbosacral of Cervical Strain." For "Left Tennis Elbow" they put "Limitation of forearm motion (flexion)". Are they trying to gyp me or did I make the mistake of calling them asking them to change it back to how I had it?
  2. I have been going back and forth, including several reopens and such, with the VA since 2005 regarding a claim associated with Menieres. In 2008, I received a note that It was denied because I did not have an official diagnosis (although the symptoms: Hearing Loss, Tinnitus and Vertigo show continuously all the way back to my time in service. I spoke with my doctor at the VA and they noted that it was listed as a working diagnosis going all the way back to 2007. I requested to reopen the claim and received a notice saying there was no new and material evidence siting that the diagnosis was in fact listed on my records. I missed my deadline to respond by NOD due to a bit of moving and a new job in a new state (moved from Florida to Texas). I received a response that there was no NEW and MATERIAL evidence. I had to wait a bit until I could get another ENT apt where the VA doctor stated specifically that "it is my opinion that it is at least as likely as not that Menieres Syndrome was aggravated by military service" he also stated that the cause cannot be clearly identified - my understanding is that at least as likely as not goes to the vet unless there is some evidence to the contrary. the rep from American Legion stated that "at least as likely as not" shows less than 50% likelihood. I received a notice that it was denied (again due to lack of diagnosis?) last February, and responded with an NOD and this time I specifically highlighted my records both in service and out to show specifically issues where I had to deal with this issue. I specifically stated that I wanted to appeal there decision at the RO and I would be available when they are (I was unaware of the SSOC bit). I was told by my rep that the backlog could take over a year. A few months later, I call the VA and they say that it is closed and final and that an SSOC had been sent. after explaining that I never received one, they said it would be sent and to just wait. a few weeks later (late July of this year) I received a letter saying that an SSOC had been sent to me and to my rep. I call and email the rep and a month later I am still waiting for his response, So of course I call the VA again and they say there is an ssoc it is odd because there is no cover page or letterhead on the scanned document. Sorry about the long spiel, but I am now at a lost, what do I do next?
  3. I originally filed a claim for bilateral hearing loss for both my left and right ear, but 2 years ago was only awarded Service Connection for my Left Ear, but only at 0%. The VA said that it was at 0% due to my Right Ear being at normal hearing at the time of my hearing test. But I just now filed a claim for an increase in my Left Ear hearing loss. I went for another C&P hearing exam. I told the Hearing Doctor that now my Right Ear was getting bad too and could she test me for hearing loss in my right ear this time. When the test was all over she told me that I did have some Right Ear hearing loss this time, but it was no where near as bad as my Left Ear. So I left there thinking I would be awarded something for my Right Ear now that the Hearing Test showed Right Ear hearing loss. But on Ebenefits it still shows Not Service Connected. How can you have your left ear service connected for hearing loss and not your right ear, if you were exposed to an explosion? It doesn't make any sense. That was the whole reason they service connected my Left Ear to begin with. Now that the hearing exam shows hearing loss in my Right Ear, the VA gives the excuse that my Right Ear hearing loss isn't Service Connected, because whenever they originally tested my Ears 2 years ago for my original claim the hearing exam didn't show any Right Ear hearing loss. But everyone knows that Hearing Loss can occur many years after the fact. My Dad served in Vietnam and was exposed to explosions on a daily basis, but he didn't show any immediate signs of hearing loss for decades. It wasn't until the last few years that we've noticed his hearing getting worse, and so now he filed a VA claim and was awarded for Hearing Loss and that was from back in 1969. So Hearing Loss doesn't have to happen overnight. Just because I didn't have it 2 years ago, but I now do, doesn't mean it isn't being caused from the same explosions from whenever I was in the service and what caused my Left Ear hearing loss. Has anyone else been through anything like this before? Any suggestions as to what I might be able to do to help? Thanks.
  4. During the last 2 years or hearing exam, I have discussed "Hyperacusis" with the VA audiologist. I have a 10% service connected tinnitus award. Is there a possible claim for the Hyperacusis? Thanks for your response.
  5. I submitted a claim for Sinusitis, OSA,, and Tinnitus. My claim was denied for all 3. The tinnitus they claim was neither occurred in nor was caused by service. My job on active duty exposed me to gun fire, explosions, tanks, and tracked vehicles. I submitted the Duty Noise Exposure Spreadsheet that displayed my AFSC was rated as highly likely to be exposed to loud noise. In the first Exam they claimed I said my hearing loss was from jets flying overhead. Never said that, so they scheduled a second exam. This one they acknowledged the correct job but I was still denied. The evidence listed on the second decision dd not include the MOS Noise exposure chart I included on the first claim. I never went to sick call for ringing ears because that is just silly (had I known then) and was not something you did. I have had quiet office jobs since separating from The Air Force. What am I missing? For the OSA claim, I submitted Lay statements from my current wife and my ex-wife as well as explained to the doctor my symptoms and that when I was on Active Duty i had no idea sleep apnea was a thing. I assumed I just snored and was tired because I was working hard. I had a sleep study this past year and was deemed to have severe OSA. In my claim I listed that I believed my osa was related to my cluster headache disability. They responded Cluster headaches do not cause OSA even if there are many people with cluster headaches and also OSA. I experienced a stuffy nose during my headaches on the left side. This was completely different from the closing of my airway when I would sleep. It was just worst if both occurred at the same time. They claimed I have other risk factors such as being male, obesity, and advancing age. Something I did not include in my claim was the fact that I was on the Fat Boy program at one point on Active Duty and my SMR made a reference to obesity. Would this help support my claim. Also in the second decision they said I was a 73 year old male and I am no where near 73 so they probably mixed my records with someone else. What can I do about this? And Sinusitis, I have a couple diagnosis in my SMR's specifically listing sinusitis. I have had sinus issues since I was on Active Duty. I use a Netti Pot and have been diagnosed post active duty with sinusitis. The DBQ from the QTC Medical Doc claims I have rebound sinusitis because I mentioned using Afrin. I have always been aware of the danger of over use and in my VA records I discussed this concern whenever the VA would prescribe a nasal spray. What am I missing and how can I get this corrected. The errors on the 2 decisions make it seem as if they are not very organized and I have to suffer from their disorganization. Are they supposed to review all of the evidence from the initial claim when you submit a supplemental, or should I have resubmitted all the documents from the initial claim. Are the documents that contain research that supports your claim supposed to be on the evidence list as well? They were not on there and if they did not give those documents equal consideration what is my recourse. Any assistance would be appreciated Thanks for listening.
  6. Berta I hope that you may provide an answer. I am presently rated 10% for tinnitus. I have some dizziness, which causes me to lose my balance. I also have feelings of fullness in my ears. I am now thinking of filing a claim for Meniere's secondary to tinnitus. I noticed that another vet's claim for Meniere's secondary to tinnitus was approved and rated at 30%. The reason for the approval was that the Meniere's was likely as not caused by the veteran's military service or SC tinnitus. I am glad that the vet got his claimed approved. I was under the impression that Meniere's was not secondary to tinnitus, however with this new information I hope to file a new claim for Meniere's. Can you provide input on what to state in my new claim? Thanks in advance for your help. 68mustang
  7. I was rated at 10% for tinnitus last year by the VA. I went to my private doctor yesterday and I described to him the problems that I have been having with my sense of balance. Any sudden movement of my head or movement while sitting in my desk chair causes me to lose my balance and become nauseous. Also when seeing TV if there are certain scenes,such as movement across or up and down the screen my balance is affected. The doctor said that what is causing the problem is Meniere's Disease. Does any know if this could be secondary to tinnitus and if it would be rated separately from the tinnitus? If I am already rated at 10% for tinnitus and I could filed for Meniere's does any one know what it might be rated at? Thanks for your help. 68mustang
  8. My husband was just denied SC for hearing loss and tinnitus. I would have expected 0% hearing loss for left ear and 10% tinnitus. I attached the C&P resultsAudiology DBQ.docx - it seems to me like the audiologist contradicts herself in her rationale - or maybe I am just confused? But overall it does seem to say he has tinnitus and its linked to service? Not sure what to think of this. Any insight would be appreciated! Thank you!
  9. I am trying to understand how I will be tested for tinnitus by the VA. I have a pending compensation claim for hearing loss and tinnitus (and a couple other things) that is in stage 5 (preparation for decision). I am now awaiting a C&P exam (I believe). I am already S/C for shoulder and lower back (20% total). How is tinnitus tested by the VA to receive the 10% rating? I served in OEF and have a Combat Action Badge (all on my DD214). I have hearing loss, but what happens if I pass as “normal” for hearing loss. I have occasional ringing in both ears from OEF (artillery/heavy machine guns/IED’s), and it has gotten worse over time. My tinnitus came later after I had separated from the US Army. I am trying to understand how I am tested for tinnitus to received the 10%, even if I get 0% for hearing loss (which I have heard is very difficult to get above 0% for hearing loss). With my claim I submitted my civilian primary care physician’s professional opinion that I could definitely have/probably do have hearing loss and tinnitus from combat. I have read/heard differing opinions, and I am just trying to find a straight answer to how tinnitus is tested for by the VA (since I see that some vets get 0% for hearing loss, but 10% for tinnitus). And what are my chances of getting the 10% for tinnitus even if I get 0% for hearing loss? Great, good, not good, etc? Please help. Thank you.
  10. Hi, Asking any vet in the Richmond, Va area for doctor recommendations. I was diagnosed by my audiologist with hearing loss and tinnitus. I'm in the process of gathering all my paperwork to file a claim. Problem is this doc doesn't want to write up a letter for me. Sorry if it sounds excessive...this would be my first VA claim I have filed. I figured if I submit as much as possible...less likely to get denied? So any help would be appreciated! Tks
  11. Facts regarding claim: Sleep Apnea secondary to insomnia Date of diagnosis: 7/18/2014 Current disabilities relevant to claim: Tinnitus – Service Connected - 6/5/2017 Insomnia – Servicee Connected - 4/13/2018 Facts regarding claim: Sleep Apnea secondary to insomnia Date of diagnosis: 7/18/2014 Current disabilities relevant to claim: Tinnitus – Service Connected - 6/5/2017 Insomnia – Servicee Connected - 4/13/2018 Status of claim: CUE submitted due to errors in claim by Rater Status of Cue: In process. Mistakes accepted as grounds for CUE Purpose of claim: Establish to VA my service connected disabilities Insomnia and tinnitus are aggravating the symptoms of my non-service connected disability sleep apnea. Sleep Apnea Symptoms: Hypersomnolence & Fatigue Service Connection Justification: Per CFE > Title 38 > Chapter I > Part 3 > Subpart A > Section 3.310: Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. Narrative: My service connected secondary insomnia and my service connected tinnitus are responsible for my sleep deprivation which is aggravating my sleep apnea symptoms: hypersomnolence and fatigue. Incident: On 27 September 2018, I went to my scheduled C&P examination expecting to answer questions about my sleep apnea symptoms (hypersomnolence and fatigue) being aggravated by the sleep deprivation I am experiencing due to my service connected tinnitus and insomnia disorder. When I got to my appointment, the C&P doctor just wanted to see my 2014 sleep study. There were no questions asked. I asked what was the reason for this C&P exam? The doctor stated he just needed dates from my sleep study. Since the VA already has this information, I was very confused as to why I was asked to attend an appointment to gather information that they already possess. I then contacted QTC who notified me of my appointment and according to the claim specialist the one question that the C&P doctor was tasked to answer was "Is the veterans sleep apnea at least likely or not proximately due to or the result of tinnitus" This question the C&P physician was tasked to answer has nothing to do with what my claim is even about. My tinnitus didn’t exist when my sleep apnea was discovered. The CUE for which was created because of a mistake made much like this one on the original claim clearly states: Because of the constant ringing in my ears that never changes in volume or goes away at any time (severe tinnitus), I am suffering chronic secondary insomnia as well as chronic migraine with tension headaches. My service connected secondary insomnia is responsible for my sleep deprivation which is aggravating my sleep apnea symptoms (hypersomnolence and fatigue). Request compensation for the aggravation of my sleep apnea symptoms (hypersomnolence and fatigue) from my service connected tinnitus and insomnia disorder. I submitted a VA Form 21-4138 and said stated: The question you tasked the C&P doctor to respond to does not at all pertain to the purpose of the claim you are evaluating. Since my sleep apnea was diagnosed in 2014, and my tinnitus was service connected 6/5/2017, how would you expect this doctor to provide a credible response to your question? My tinnitus didn’t exist in 2014. I stated: Did you not thoroughly examine the CUE (clear and un-mistakable error) and claim you are responsible re-evaluating? Are you not supposed to do this before sending someone to a C&P examination appointment for apparently nothing? Did you not check the service connection dates of my disabilities: tinnitus and insomnia along with the date of my sleep study? Doing this would have provided you vital information about my claim in that my sleep apnea was present before I was awarded my tinnitus service connection. This is a secondary service connection by aggravation claim. Please read carefully the Claim and then the CUE created because of how badly the original claim was handled. It states the circumstances leading up to my sleep deprivation I am experiencing which is causing the aggravation of my sleep apnea symptoms hypersomnolence and fatigue. I ended it with this question. How could anyone expect to get a fair claim decision if the VA representative handling their claim doesn’t bother to examine all information pertaining to the claim they are evaluating? There it is. I also put in a complaint using IRIS including everything you see on this post. I am expecting to do another CUE. My question after all of this. Is my claim valid?
  12. Hello, I've had positional vertigo problems in the past ever since a hand grenade exploded close to my position four years ago. One week ago I had an appointment at the V.A. and I noticed that the building was moving, I asked my case manager if she felt the movement of the building and she said no, I was about to exit the building when this happened. I drove home and woke up the next morning feeling like my house was moving but ignored it since I have had episodes of vertigo before. I got to the building where I volunteer at (voc rehab) and felt the same way so I figured that it was positional vertigo kicking in for sure, for one week straight I've felt this way and is not going away. I went to the E.R. at the V.A. and I was prescribed meclizine and it is not working. The doctor told me it might be a viral infection and I do not know what to say or do other than taking the meds because I feel so weak and confused while I'm at home this is so annoying that I cannot take it anymore. The tinnitus in my ears became stronger and sometimes I hear drums beating inside my right ear. I like to have a few beers especially when others buy it to be honest, family members brought a few bottles of wine and beers for the holidays and I haven't had a sip of it due to my dizziness, that's how bad it its. Has anyone had this before?? I would like to put this to an end and if I'm gonna be like this for the rest of my life I'll put it in my claim, like I said I've had this feeling before, but not so many days in a row and with this intensity, any inputs thanks tiredmRONW0331
  13. I have seen a bunch of conversations about tinnitus lately, but was curious if anyone has had any luck getting tinnitus SC as secondary to TMJ. The military yanked my 3rd molars and now I am SC for TMJ. In December, I had a really bad time with my TMJ. The VA oral surgeon treated me and my records indicate bilateral TMJ exacerbation. Since this occurred, I hear this constant high-pitched in both ears. When there is not a lot of background noise, it is significantly pronounced. Should I go back and see my VA oral surgeon or an audiologist? Any thoughts? Is there anything that can be done to get rid of the ringing sound?
  14. I was awarded 10% for Tinnitus but turned down for hearing loss. How can that be?
  15. Back in1961 I was pushed backwards and fell on the frozen ground. Records showed "concussion", Infirmary and Hospitalized with loss of consciousness. Had C&P and got 40% for TBI and 30% for chronic headaches. My neck has been acting up for years. Can I ask for an MRI or Xray to find out what it is? If it's osteoarthritis neck or some other thing can I claim it as secondary to the TBI? Also have 10% for tinnitus for a total of their math at 60%.
  16. I'm working on preparing my brief to the CAVC on my appeal having received the Record Before the Agency (RBA). Searching for the initial EENT consult in the RBA now. Have it in a CD sent to me by the VA Records Management Center earlier. Does anyone know the date of "liberalization" of tinnitus allowing the rating of 10% for noise induced loss instead of only as secondary to a TBI? Is there a reference? Docket 17-2990 The following is in the RBA. 1) RBA Pages 4255 & 4254; The Rating Decision of 2-25-76, RO did not do investigation of injuries medically, only for “in line of duty” determination. a) CUE: RBA page 4365 dated 4/5/65; 4/4/65. “Patient took exam to operate a forklift and was noted to have a moderate hearing deficit. Please see and evaluate.” 4/5/65, “tinnitus ® ear & vertigo.” (tinnitus subsequent to exposure to 5” naval gunnery practice in the battle dressing station under the gun mount during the USS Sperry AS-12 gunnery practice during my tour on that ship aggravating a pre service mild hearing deficit with an incident of losing most of hearing for a period of 3 days not recorded or complained about on the record as an HN E3 when told it would come back.) b) RBA page 4309, Audiogram at Guam Memorial Hospital dated 7/31/75 noting “poor speech discrimination both ears.” But without noting the claim of tinnitus which is at least partially contributing to that. And the AOJ, given the EENT consult of 4/5/65 above and the other earlier Audiograms failed to send the examination back for a clarification on whether the tinnitus had subsided or was omitted from the report. c) RBA page 476, Audiology consult dated June 18, 2013. Please include the audiology report and notes on tinnitus and word discrimination. d) RBA page 3106, Rating Decision date 1/22/92: i) “F. Service medical records show complaints of recurrent tinnitus in April 1965 and January 1968. The audiometrics done on current VA examination show average pure tone thresholds as 48 in the right ear and 63 in the left ear, with speech recognition as 88 percent and 76 percent respectively. Also shown is periodic bilateral tinnitus.” ii) D. Service connection is warranted for a separate diagnosis Of tinnitus at a compensable level with application of 38 CFR 3.114 (A). iii) 2016 38 CFR 3.114(a) “…or a liberalizing VA issue approved by the Secretary or by the Secretary's direction, the effective date of such award or increase shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the act or administrative issue.” iv) 1974 38 CFR § 3.114 Change of law or Veterans Administration issue. (1) (a) Effective date of awards. Where pension, compensation, or dependency and indemnity compensation is awarded or increased pursuant to a liberalizing law or a liberalizing Veterans Administration issue, approved by the Administrator or by his direction, the effective date of such award or increase shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the act or administrative Issue. v) 1974 38 CFR 4.84(b) 6260 Tinnitus ---------------------- 0 (See diagnostic codes 8045 and 8046.) vi) 1974 38 CFR 4.124(a) 8045 Brain disease due to trauma Purely neurological disabilities, such as hemiplegia, epileptiform seizures, facial' nerve paralysis, etc., following trauma to the brain, will be rated under the diagnostic codes specifically dealing with such disabilities, with citation of a hyphenated diagnostic code (e.g., 8045-8207). Purely subjective complaints, such as headache, dizziness, insomnia, tinnitus, etc., recognized as symptomatic of brain trauma, will be rated 10 percent and no more under diagnostic code 9304. This 10 percent rating will not be combined with any other rating for a disability due to brain trauma. Ratings in excess of 10 percent for brain disease due to trauma under diagnostic code 9304 are not assignable in the absence of a diagnosis of chronic brain syndrome associated with brain trauma. vii) RBA page 844, Periods of steady tone were greater in Japan because of the constant additional background noise but still the 20 per day of the steady high-pitched tone seems a bit exaggerated. Probably something lost in the translation to the Audiologist. However, even with the translation, this is the clearest and best history of my tinnitus reported in the record. viii) RBA pages 3149 & 3150, Audiogram dated 8/21/91, recording tinnitus but inaccurately. My tinnitus has been constant with the bird chirping, with an intermittent steady high-pitched tone that more grossly interferes with hearing especially in a circumstance like an audiogram, since it first appeared in late 1964 during my tour on the USS Sperry AS-12 following gunnery practice and a temporary hearing deficit of everyone sounding like they were down in a well which off the record, after the practice, by a physician I was told would go away in a day or two. As an HN E-3, at the time, all I was concerned about was getting my hearing back which I did except for the tinnitus interference which wasn’t too severe except when trying to intently listen to soft sounds when it becomes a high pitched steady tone. So, it is intermittent in nature of interference. Otherwise it is like a soft background noise unless competing with soft sounds. This is the way I always describe it, but it has never been recorded in the long version except on RBA 844. ix) RBA page 3202, Claim on my behalf by representative with no mention of tinnitus. Given that it was granted on the review of the record under 38 CFR 3.114(a) it should have been dated from Mar 18, 1976 per the 1976 38 CFR 4.85b and the cited, in the 1/22/92 Rating Decision, 38 CFR 3.114(a). x) RBA pages 3484 & 3485 Audiological Case History, dated 5/24/88, recording tinnitus but with errors. Not “since taking Elavil” as the record shows. Worse since taking Elavil. And not intermittent as stated above except for the difference in tone. It is there when I wake up and when I go to sleep and probably keeps me from dreaming most of the time. And it has been like that since the 1963 or 1964 USS Sperry AS-12 gunnery practice. xi) RBA pages 3955 & 3956, Audiology Case History dated 5/14/85, also reporting tinnitus but erroneously. Is the reporting of “intermittent” because that is the usual? Where did the “2 episodes come from” Perhaps 2 episodes of the change in tone to a high-pitched tone. Should be mild constant with intermittent severe. xii) RBA pages 3965 & 3966, Audiology Case History dated 7/14/83 recording tinnitus moderate with errors as above. xiii) RBA pages 3987 & 3988. Audiology Case History dated 12/13/83, tinnitus reported, correctly as not in ears, incorrectly as periodic and just in morning (louder when first awakening). Appears to include both high pitched and “birds” (high pitched; “birds.”) xiv) RBA pages 4328 & 4329, Audiogram dated 22 Jan 67, Audiologist did not fill out history on back. Similar Beltone reports back was not copied. xv) RBA page 4462, Rating Decision dated June 25, 2015; “We determined that the following condition was not related to your military service, so service connection couldn't be granted: Medical Description Tinnitus” This goes to the authenticity of the June 25, 2015 Rating Decision and its sloppiness. e) Several audiograms listing tinnitus in boxes provided on VA and Military audiogram report forms are not included in the record. Some but not all are on the CD provided to me dated 02/15/2017.
  17. Thank You in advance! (First question after reviewing this book I wrote here should probably be, do i need to separate all of these questions into the different subject forums or is this OK ?) I've been procrastinating now for almost 10 years (mainly because of denial, I volunteered, tough guy, I know guys that seen/did worse and horror stories with the VA) and have just this year decided to attack this VA Claims Process. Putting it off for too long and ready to get the information needed to hopefully (fingers crossed) have a smooth process. I have not filed for anything, have no medical records or injuries documented while active or since (I have just requested my military records from the right place after all these years, because I assumed the VA would have them and keep them safe, so I didn't need a copy. MISTAKE #1, Naive I know) and have not been to see a private doctor for anything. I medicate with over the counter and always have, but have never been officially diagnosed with anything. Just last month I made an appointment with advice from an amazing local veteran group with a psychologist outside of the VA and she diagnosed me with PTSD. It was extremely hard to even talk to her, I've never talked to anyone about it just denied it or pushed it back. (I know I'll still need a VA exam). I was also seen by an outside, but VA referred hearing specialist and was diagnosed with tinnitus in the 3k range and hearing loss. 6 months after release from active duty in 2007 I was seen at the local VA for hemorrhoids and treated. I have had issues with roids, constipation, diarrhea etc ever since. This is also the only thing I have ever been seen for at the VA. My wife has also complained for years about sleep apnea and me startling her in the middle of the night when I sleep, should I get an evaluation for sleep apnea. She doesn't remember ifI did it when active or not, but does that matter for service connection ? I have already made the intent to file as of last month and am wondering how I should proceed from the above mentioned. I have not been seen for IBS, by any professional but it reads like that is a high possibility, so do I need a diagnosis from outside of the VA or should I get one prior to filing? Should I file IBS, if diagnosed under "presumptive illness" (BALAD IRAQ 2005-2006) ? Should I get on the Burn Pit or Gulf War Registry (Is there anything I should know prior to going to these registry appts) ? Should I file for PTSD with just an outside evaluation (How are stressors confirmed, all mine are personal accounts and encounters) ? Should I file for hearing loss or tinnitus or both I served as a firefighter and have read that as being on some list hearing related jobs ? And finally, Should I file for all of these now at one time or should I wait and do them individually ? My main concern is going into this and not being fully prepared, if there is anything you believe would aid in the above filings please let me know. I know there is a long road ahead, but I don't see any point in going alone and appreciate you all. Thanks again!
  18. Noise and Military Service; Implications for Hearing Loss and Tinnitus (2006) is the Institute of Medicines findings and presentation to the VA Secretary which deals with a lot of history throughout the DOD, addressing such things as "whisper exams" that fail to register the upper frequency ranges or loss thereof which is what Bilateral SNHL is all about. Lack of documentation, and a wealth of other information. Did you know that prior to 1978 a bonafide DOD Hearing Conservation Program to safeguard hearing loss did not exist. One exception the USAF did in fact conduct audiograms on select personnel from the late 50s forward. Do not be surprised in your VA Denial letters to find those serving prior to 1978 to have had an audiogram during their induction physical, but a whisper exam upon separation. The VA C&P examiners frequently refer to your hearing being normal upon separation, therefore the military did not cause your hearing loss. The VARO will concede your traumatic acoustic events and further noise environments, but will side with the medical evidence (by law) each and every time. Solution? Private Audiology Medical Opinions, the doctor will review all information in your VA Claims folder, and list the items they reviewed on their office letterhead, with the statement they have reviewed, then have the doctor remark as to "as least as likely as not" (equal to or greater than 50%) or "more likely than not" (greater than 50%) due to traumatic acoustic events endured during his/her military service, followed by medical reasoning as to why. The doctor will date and sign their letter and insert their credentials behind their name. (You may want to request copies of your military treatment records if you don't already have copies in order to challenge the VARO decision) Today I get the private medical opinions before submitting the claims. That way if the VA C&P Examiner determines the military didn't cause your hearing loss (negative opinion), I have the Private Medical Opinion (positive) and they cancel each other out. Then the RVSR within VARO is left with reviewing the remaining positive evidence in your claims folder, if available, and provide the veteran the benefit of doubt. 38 U.S. Code § 5107 - Claimant responsibility; benefit of the doubt Hearing protection devices; there are various designs, based on noise levels in your work environment; that have what are referred to as Noise Reduction Ratings to preclude hearing loss. These did not exist, in my case prior to 1979. Years ago, while in the Navy, I noticed engineers would wear what we called Mickey Mouse ears, to help attenuate the noise in their work space. These items were shared, gaskets wore out after extensive use and personnel continued wearing them without a proper seal. Their workspace would require at least a double flange and ideally a triple flange hearing protection device along with the ear muffs to preclude hearing loss. Problem being, they had to be removed in order to communicate, receive orders in conventional engineering spaces due to noise levels. News flash! There is no test for Tinnitus. VA will attempt to state otherwise, but the American Tinnitus Association and their very own DOVA JRRD Vol 46, number 5, 2009 pages 619-632 states "Special audiological tests are effective in detecting deliberate exaggeration of hearing loss, but no documented test exists that is capable of detecting the presence or absence of tinnitus." Furthermore, you are authorized to diagnose Tinnitus; for this very reason. Define the traumatic acoustic event you were exposed to that caused your Tinnitus since military service. 105mm Howitzers 185dB, M-16 156dB, flight deck on aircraft carriers 136dB are but just a few areas of impulse noise levels that exceed OSHA 90dB exposure in an eight hour period. Here is a further recommendation by Veterans Law Blog: Draft a Sworn Declaration – do not use VA Form 21-4138 – with the following information: (I've used the 21-4138 with success) List each and every incident of significant noise exposure you can remember – and give enough detail to show that the exposure was significant and credible Grenade blasts, artillery rounds, simulators, constant machine-gun fire, years around loud jet or tank engines, you get the idea. Don’t OVERDO it…1-3 sentences should suffice, but identify if you can the approximate month and year of the noise exposure. State approximately when you remember the tinnitus starting. If it started in service, explain why you didn’t seek medical treatment in service (for most Veterans, explaining the reality of military service to bureaucrats will suffice: no soldier, sailor, or airmen is going to stop a mission or training to seek treatment for a condition that everybody has and that there is no cure for. True Story). Identify the chronicity of your tinnitus – has it been continuous since exposure to the noise? If yes, explain that you have had this ringing since the exposure to noise. Identify the frequency of your tinnitus – how often do you have ringing in the ears? Every day? Twice a week? 4 times a month? Identify the severity of your tinnitus. I think you need only do this if your tinnitus is so severe that it is debilitating, prevents you from working, or in very rare cases, is “objective tinnitus”, meaning it can be heard by other people standing next to you. In these cases, you might be able to seek an extra-schedular rating for the tinnitus in excess of the 10% limit in the Schedule of Impairment Ratings.
  19. First post... I read some posts recommending Dr. Nash to do an opinion letter. For just a medical opinion letter for hearing loss/tinnitus appeal... any other recommendations on who to contact. THANKS.
  20. Hello, Army OIF/OEF vet here. In 10/2015 I initially filed for claims with little/no evidence. Most were of course denied. Through appeals I am now at 40% SC for IBS and tinnitus. I appealed my anxiety denial and was given a C&P exam in 06/2016, fast forward to 01/2017 and the VA sends me an SOC along with the VA form 9. I hired Vet Comp and Pen to help me gather supporting documents. (I think they did an excellent job) and submitted my VA for 9 along with new documents (02/2017) and waived my hearing before the BVA to help expedite things. Much to my surprise I was told I should still expect to wait about a year or so for the BVA's decision. In the meantime I have been developing a FDC for sleep apnea. Should I go ahead and file it even though the BVA currently has my anxiety claim or should I wait until it is decided? Thanks, and hopefully my post wasn't too lengthy.
  21. Hello, Background information: 35 Years old, 70% SC for Anxiety and Depression as well as 10% for tinnitus, no other medical issues. Living in Japan. I have recently been diagnosed with chronic prostatitis. I did not have the problem when I was in, it is a recent development with a high anxiety/stress load. The doctor told me it was likely caused by stress. I asked for a written diagnosis but the Doctor would not opine as to the cause, only diagnosis what was wrong. This is not unusual in Japan I think it has to do with insurance laws, because I experienced the same thing a few years ago with a another matter for the Foreign Medical Program. If I understand the process right I need to get a diagnosis that says something to the effect of likely being caused by stress and anxiety. I have a couple of options I can talk to my primary care physician who consults for Veteran Evaluation Services (CnP exam for those who dont live near a VA), and he might provide me with the diagnosis since he is familiar with my anxiety. Option two I could see if the Navy Hospital has a urologist and try to get a diagnosis there but I do not like going there. Or should I just file the claim with the diagnosis I have, along with statements from my wife and people who know me and hope? Since the Chronic Prostatitis I have erectile dysfunction or rather a painful climax which is common from this. How do I incorporate this into my claim?
  22. so my claim was submitted on 12/12/2016. I submitted for bipolar/depression (reopen) and tinnitus (new). I sent it in as an FDC with all my evidence. I checked ebenefits on 12/21/2016 and the status is already showing preparation for decision. Is this normal? I haven't even gone to a c&p exam, I haven't recieved any correspondences or anything. For the bipolar depression it is a reopen because when i first filed in 2011, I missed my appointment. After I missed my appointment, the VA sent me papers (back in 2011) saying that they see that i was treated for depression during active duty. but since i failed to show up to the appointment, it was denied. So now i've sent a ton of new evidence that supports my claim and they've reopened the case. But does the speed with which this is progressing means that i am being denied? As noted below, ebennies is showing that the va rep has already made a decision, in less than two weeks. With no exams or anything... What does this mean... Is this normal? have i been denied? Is there a phone number i can call?? im freaking out. Here's what ebenefits show: Estimated Completion: 01/24/2017 - 03/04/2017 STATUS: Preparation For Decision The Veterans Service Representative has recommended a decision, and is preparing required documents detailing that decision. If more evidence is required, the claim will be sent back in the process for more information or evidence
  23. Sorry all. I previously started a thread but couldnt edit it to include my C&Ps. This claim was for an increase on my Left Knee and Back and Right Knee secondary to my left knee. Anyone care to give a guess at percentages? Im already at 10% for tinnitus and 0% for left knee. Provide description and/or etiology: Pain is the functional limitation impacting the veteran's abilities during flare-ups. The exam today WAS NOT DURING A FLARE-UP and the veteran was able to perform repetitive range of motion maneuvers. In summary, it is not practical or feasible to express additional limitation in terms of additional ROM loss as this cannot be objectively quantified. Pain is the functional limitation impacting the veteran's abilities during flare-ups. The exam today WAS NOT DURING A FLARE-UP and the veteran was able to perform repetitive range of motion maneuvers. In summary, it is not practical or feasible to express additional limitation in terms of additional ROM loss as this cannot be objectively quantified. Loss of normal lordotic curve Guarding: [ ] None [ ] Resulting in abnormal gait or abnormal spinal contour [X] Not resulting in abnormal gait or abnormal spinal contour [ ] Unable to evaluate, describe below: Provide description and/or etiology: Loss of normal lordotic curve f. Additional factors contributing to disability In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe: Disturbance of locomotion, Interference with sitting, Interference with standing 4. Muscle strength testing -------------------------- a. 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 Hip flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Page 30 of 109 Knee extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle plantar flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle dorsiflexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Great toe extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 b. Does the Veteran have muscle atrophy? [ ] Yes [X] No 5. Reflex exam -------------- Rate deep tendon reflexes (DTRs) according to the following scale: 0 Absent 1+ Hypoactive 2+ Normal 3+ Hyperactive without clonus 4+ Hyperactive with clonus Knee: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Ankle: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ 6. Sensory exam --------------- Provide results for sensation to light touch (dermatome) testing: Upper anterior thigh (L2): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Thigh/knee (L3/4): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Lower leg/ankle (L4/L5/S1): Right: [X] Normal [ ] Decreased [ ] Absent Page 31 of 109 Left: [X] Normal [ ] Decreased [ ] Absent Foot/toes (L5): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent 7. Straight leg raising test ---------------------------- Provide straight leg raising test results: Right: [X] Negative [ ] Positive [ ] Unable to perform Left: [X] Negative [ ] Positive [ ] Unable to perform 8. Radiculopathy ---------------- Does the Veteran have radicular pain or any other signs or symptoms due to radiculopathy? [X] Yes [ ] No a. Indicate symptoms' location and severity (check all that apply): Constant pain (may be excruciating at times) Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Intermittent pain (usually dull) Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Paresthesias and/or dysesthesias Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Numbness Right lower extremity: [ ] None [X] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe b. Does the Veteran have any other signs or symptoms of radiculopathy? [ ] Yes [X] No c. Indicate nerve roots involved: (check all that apply) [X] Involvement of L2/L3L/L4 nerve roots (femoral nerve) d. Indicate severity of radiculopathy and side affected: Right: [ ] Not affected [X] Mild [ ] Moderate [ ] Severe Left: [X] Not affected [ ] Mild [ ] Moderate [ ] Severe 9. Ankylosis Page 32 of 109 ------------ Is there ankylosis of the spine? [ ] Yes [X] No 10. Other neurologic abnormalities ---------------------------------- Does the Veteran have any other neurologic abnormalities or findings related to a thoracolumbar spine (back) condition (such as bowel or bladder problems/pathologic reflexes)? [ ] Yes [X] No 11. Intervertebral disc syndrome (IVDS) and episodes requiring bed rest ----------------------------------------------------------------------- a. Does the Veteran have IVDS of the thoracolumbar spine? [ ] Yes [X] No 12. Assistive devices --------------------- a. Does the Veteran use any assistive device(s) as a normal mode of locomotion, although occasional locomotion by other methods may be possible? [X] Yes [ ] No If yes, identify assistive device(s) used (check all that apply and indicate frequency): Assistive Device: Frequency of use: ----------------- ----------------- [X] Cane(s) [X] Occasional [ ] Regular [ ] Constant b. If the Veteran uses any assistive devices, specify the condition and identify the assistive device used for each condition: Cane is used for both knee pain and low back pain 13. Remaining effective function of the extremities --------------------------------------------------- Due to a thoracolumbar spine (back) condition, 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.; functions of the lower extremity include balance and propulsion, etc.) [X] No 14. 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? Page 33 of 109 [ ] 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 15. Diagnostic testing ---------------------- a. Have imaging studies of the thoracolumbar spine been performed and are the results available? [X] Yes [ ] No If yes, is arthritis documented? [X] Yes [ ] No b. Does the Veteran have a thoracic vertebral fracture with loss of 50 percent or more of height? [ ] Yes [X] No c. Are there any other significant diagnostic test findings and/or results? [X] Yes [ ] No 16. Functional impact --------------------- Does the Veteran's thoracolumbar spine (back) condition impact on his or her ability to work? [X] Yes [ ] No If yes describe the impact of each of the Veteran's thoracolumbar spine (back) conditions providing one or more examples: The veteran states the pain in both his RIGHT and LEFT knees creates a functional limitation of inability to complete his recurrent PT testing that may cause the veteran to lose his employed postion as a police officer at DSCC. 17. Remarks, if any: -------------------- The veteran's claim file was reviewed in VBMS, CPRS, Vista Web, and Vista Imaging. Previous C&P history and physical exam records from 9-21-2016 were reviewed. The veteran served active duty United States Army from 2008 - 2014. The veteran earned a combat badge while serving on active duty. In January 2010 Knee and Lower Leg 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: RIGHT KNEE CONDITION SECONDARY TO LEFT KNEE STATUS POST LEFT MEDIAL MENISCECTOMY AND CHONDROPLASTY, LEFT PATELLOFEMORAL JOINT b. Select diagnoses associated with the claimed condition(s) (Check all that apply): [X] Knee meniscal tear Side affected: [ ] Right [X] Left [ ] Both ICD Code: M23 Date of diagnosis: Left SC [X] Patellofemoral pain syndrome Side affected: [ ] Right [X] Left [ ] Both ICD Code: M22 Date of diagnosis: Left SC c. Comments (if any): Page 36 of 109 No response provided d. Was an opinion requested about this condition (internal VA only)? [X] Yes [ ] No [ ] N/A 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's knee and/or lower leg condition (brief summary): The veteran's claim file was reviewed in VBMS, CPRS, Vista Web, and Vista Imaging. Previous C&P history and physical exam records from 9-21-2016 were reviewed and it was noted that the range of motion testing for the veteran's LEFT knee could not be completed during that C&P exam. The veteran served active duty United States Army from 2008 - 2014. The veteran earned a combat badge while serving on active duty. In January 2010 the veteran sustained an injury to his LEFT KNEE while taking mortar fire during combat while serving in Iraq and this injury is documented in the veteran's STRS as well as prior C&P exams. Ultimately, the veteran was placed on light duty while still serving on active duty several times due to LEFT knee pain and instability. The veteran eventually underwent a second LEFT knee surgery to correct a meniscus tear and also repair arthritic changes (the first LEFT knee surgery occurred prior to the veteran's active duty service). b. Does the Veteran report flare-ups of the knee and/or lower leg? [X] Yes [ ] No If yes, document the Veteran's description of the flare-ups in his or her own words: The veteran states he has continued to have pain since the LEFT KNEE injury on active duty occurred. The veteran states he has at least DAILY flare-ups of pain in his LEFT knee which he describes as a "sharp pain" that severely limits his range of motion. The veteran ALSO states he has at least WEEKLY flare-ups of pain in his RIGHT knee which he describes as a "sharp and throbbing pain in two different spots" that limits his range of motion. c. Does the Veteran report having any functional loss or functional impairment of the joint or extremity being evaluated on this DBQ, including but not Page 37 of 109 limited to repeated use over time? [X] Yes [ ] No If yes, document the Veteran's description of functional loss or functional impairment in his or her own words: The veteran states the flare-ups in both his RIGHT and LEFT knee make it difficult to stand for long periods and walking for long distances becomes difficult. 3. Range of motion (ROM) and functional limitation -------------------------------------------------- a. Initial range of motion Right Knee ---------- [ ] All normal [X] Abnormal or outside of normal range [ ] Unable to test (please explain) [ ] Not indicated (please explain) Flexion (0 to 140): 0 to 130 degrees Extension (140 to 0): 130 to 0 degrees If abnormal, does the range of motion itself contribute to functional loss? [X] Yes (please explain) [ ] No If yes, please explain: Limited ROM as described above 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, Extension Is there evidence of pain with weight bearing? [X] Yes [ ] No Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [X] Yes [ ] No If yes, describe including location, severity and relationship to condition(s): Mild soft tissue tenderness to palpation diffusely over knee joint but no redness or warmth Is there objective evidence of crepitus? [X] Yes [ ] No Left Knee --------- [ ] All normal Page 38 of 109 [X] Abnormal or outside of normal range [ ] Unable to test (please explain) [ ] Not indicated (please explain) Flexion (0 to 140): 15 to 110 degrees Extension (140 to 0): 110 to 15 degrees If abnormal, does the range of motion itself contribute to functional loss? [X] Yes (please explain) [ ] No If yes, please explain: Limited ROM as described above 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, Extension Is there evidence of pain with weight bearing? [X] Yes [ ] No Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [X] Yes [ ] No If yes, describe including location, severity and relationship to condition(s): Mild soft tissue tenderness to palpation diffusely over knee joint but no redness or warmth Is there objective evidence of crepitus? [X] Yes [ ] No b. Observed repetitive use Right Knee ---------- 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 Left Knee --------- 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 Right Knee ---------- Is the Veteran being examined immediately after repetitive use over time? Page 39 of 109 [ ] Yes [X] No If the examination is not being conducted immediately after repetitive use over time: [ ] The examination is medically consistent with the Veteran's statements describing functional loss with repetitive use over time. [ ] The examination is medically inconsistent with the Veteran's statements describing functional loss with repetitive use over time. Please explain. [X] The examination is neither medically consistent or inconsistent with the Veteran's statements describing functional loss with repetitive use over time. 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 is the functional limitation impacting the veteran's abilities during flare-ups. The exam today WAS NOT DURING A FLARE-UP and the veteran was able to perform repetitive range of motion maneuvers. In summary, it is not practical or feasible to express additional limitation in terms of additional ROM loss during repeated use over time as this cannot be objectively quantified. Left Knee --------- Is the Veteran being examined immediately after repetitive use over time? [ ] Yes [X] No If the examination is not being conducted immediately after repetitive use over time: [ ] The examination is medically consistent with the Veteran's statements describing functional loss with repetitive use over time. [ ] The examination is medically inconsistent with the Veteran's statements describing functional loss with repetitive use over time. Please explain. [X] The examination is neither medically consistent or inconsistent Page 40 of 109 with the Veteran's statements describing functional loss with repetitive use over time. 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 is the functional limitation impacting the veteran's abilities during flare-ups. The exam today WAS NOT DURING A FLARE-UP and the veteran was able to perform repetitive range of motion maneuvers. In summary, it is not practical or feasible to express additional limitation in terms of additional ROM loss during repeated use over time as this cannot be objectively quantified. d. Flare-ups Right Knee ---------- 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 is the functional limitation impacting the veteran's abilities during flare-ups. The exam today WAS NOT DURING A FLARE-UP and the veteran was able to perform repetitive range of motion maneuvers. In summary, it is not practical or feasible to express additional Page 41 of 109 limitation in terms of additional ROM loss as this cannot be objectively quantified. Left Knee --------- 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 is the functional limitation impacting the veteran's abilities during flare-ups. The exam today WAS NOT DURING A FLARE-UP and the veteran was able to perform repetitive range of motion maneuvers. In summary, it is not practical or feasible to express additional limitation in terms of additional ROM loss as this cannot be objectively quantified. e. Additional factors contributing to disability Right Knee ---------- In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe: Disturbance of locomotion, Interference with sitting, Interference with standing Left Knee --------- In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe: Page 42 of 109 Disturbance of locomotion, Interference with sitting, Interference with standing 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 Knee: Rate Strength: Flexion: 5/5 Extension: 5/5 Is there a reduction in muscle strength? [ ] Yes [X] No Left Knee: Rate Strength: Flexion: 5/5 Extension: 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 the knee and/or lower leg. a. Indicate severity of ankylosis and side affected (check all that apply): Right Side: [ ] Favorable angle in full extension or in slight flexion between 0 and 10 degrees [ ] In flexion between 10 and 20 degrees [ ] In flexion between 20 and 45 degrees [ ] Extremely unfavorable, in flexion at an angle of 45 degrees or more [X] No ankylosis Left Side: [ ] Favorable angle in full extension or in slight flexion between 0 and 10 degrees [ ] In flexion between 10 and 20 degrees [ ] In flexion between 20 and 45 degrees [ ] Extremely unfavorable, in flexion at an angle of 45 degrees or more [X] No ankylosis b. Indicate angle of ankylosis in degrees: No response provided c. Comments, if any: No response provided 6. Joint stability tests ------------------------ a. Is there a history of recurrent subluxation? Right: [X] None [ ] Slight [ ] Moderate [ ] Severe Left: [X] None [ ] Slight [ ] Moderate [ ] Severe b. Is there a history of lateral instability? Right: [ ] None [X] Slight [ ] Moderate [ ] Severe Left: [ ] None [ ] Slight [X] Moderate [ ] Severe c. Is there a history of recurrent effusion? [ ] Yes [X] No d. Performance of joint stability testing Right Knee: Was joint stability testing performed? [X] Yes [ ] No [ ] Not indicated [ ] Indicated, but not able to perform If joint stability testing was performed is there joint instability? [ ] Yes [X] No If yes (joint stability testing was performed), complete the section below: - Anterior instability (Lachman test) [X] Normal [ ] 1+ (0-5 millimeters) [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) - Posterior instability (Posterior drawer test) [X] Normal [ ] 1+ (0-5 millimeters) Page 44 of 109 [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) - Medial instability (Apply valgus pressure to knee in extension and with 30 degrees of flexion) [X] Normal [ ] 1+ (0-5 millimeters) [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) - Lateral instability (Apply varus pressure to knee in extension and with 30 degrees of flexion) [X] Normal [ ] 1+ (0-5 millimeters) [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) Left Knee: Was joint stability testing performed? [X] Yes [ ] No [ ] Not indicated [ ] Indicated, but not able to perform If joint stability testing was performed is there joint instability? [ ] Yes [X] No If yes (joint stability testing was performed), complete the section below: - Anterior instability (Lachman test) [X] Normal [ ] 1+ (0-5 millimeters) [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) - Posterior instability (Posterior drawer test) [X] Normal [ ] 1+ (0-5 millimeters) [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) - Medial instability (Apply valgus pressure to knee in extension and with 30 degrees of flexion) [X] Normal [ ] 1+ (0-5 millimeters) [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) - Lateral instability (Apply varus pressure to knee in extension and with 30 degrees of flexion) [X] Normal [ ] 1+ (0-5 millimeters) [ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters) Page 45 of 109 e. Comments, if any: No response provided 7. Additional conditions ------------------------ a. Does the Veteran now have or has he or she ever had recurrent patellar dislocation, "shin splints" (medial tibial stress syndrome), stress fractures, chronic exertional compartment syndrome or any other tibial and/or fibular impairment? [ ] Yes [X] No b. Comments, if any: No response provided 8. Meniscal conditions ---------------------- a. Does the Veteran now have or has he or she ever had a meniscus (semilunar cartilage) condition? [X] Yes [ ] No If yes, indicate severity and frequency of symptoms, and side affected: Left Side: [X] Meniscal tear b. For all checked boxes above, describe: Surgery x 3 for left knee meniscus tears 9. Surgical procedures ---------------------- Indicate any surgical procedures that the Veteran has had performed and provide the additional information as requested (check all that apply): Left Side: [X] Meniscectomy, arthroscopic or other knee surgery not described above Type of surgery: MENISCUS REPAIR Date of surgery: 2011 [X] Residual signs or symptoms due to meniscectomy, arthroscopic or other knee surgery not described above: Describe residuals: Chronic pain with daily flare ups and limitied range of motion 10. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ------------------------------------------------------------------------ a. Does the Veteran have any other pertinent physical findings, complications, Page 46 of 109 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? [X] Yes [ ] No If yes, is there objective evidence that any of these scars are painful, unstable, have a total area equal to or greater than 39 square cm (6 square inches) or are located on the head, face or neck? (An "unstable scar" is one where, for any reason, there is frequent loss of covering of the skin over the scar.) [ ] Yes [X] No If no, provide location and measurements of scar in centimeters. Location: LEFT KNEE POST OP X 3 Measurements: length 1cm X width 0.5cm c. Comments, if any: No response provided 11. Assistive devices --------------------- a. Does the Veteran use any assistive device(s) as a normal mode of locomotion, although occasional locomotion by other methods may be possible? [X] Yes [ ] No If yes, identify assistive device(s) used (check all that apply and indicate frequency): Assistive Device: Frequency of use: ----------------- ----------------- [X] Brace(s) [ ] Occasional [X] Regular [ ] Constant [X] Cane(s) [X] Occasional [ ] Regular [ ] Constant b. If the Veteran uses any assistive devices, specify the condition and identify the assistive device used for each condition: Brace and cane are both used for chronic and pain and flare ups in the veteran's RIGHT and LEFT knee. 12. Remaining effective function of the extremities --------------------------------------------------- Due to the Veteran's knee and/or lower leg condition(s), 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? Page 47 of 109 (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 sorry for the length i couldnt figure out how to shorten it without removing information. Any and all help or guidance is appreciated. Thanks!
  24. Opened an FDC for tinnitus and hearing loss today. 28 years of EOD, Boatswain's Mate, Engineman and deep sea diving with multiple ear squeezes should account for my messed up hearing...right?
  25. OMG, I just spent an hour plus typing this up and it vanished. Guess I should have copied it to a Word doc before trying to post. What a pisser… In 2011 I was given a SC rating of 50% for occupational and social impairment with reduced reliability and productivity…. It was tied to a SC disability of degenerative spine disease of C5-C7. Since that time my neck has gotten worse and with more pain. My mood has turned pretty dark as I find my thoughts drifting off to being dead and therefore out of pain, now on a daily basis. So far the only thing that has kept me from doing anything drastic has been the stigma it would attach to my family. I fear my temper has deteriorated as well and I basically lost my last real friend a month or two ago. I was last seen (medically) at the VA in 2011 as well. Now that I want to return for counseling, they tell me that since greater than 2 years have gone by I need to reestablish myself and go through cattle call again…. That’s in mid-November. They also gave me a 0% SC for muscle tensions headaches. Looks like their biggest beef with my claim is that I did not use the term Prostrating Episode. I did however describe my 2-3 severe headaches a month that requited me to take Imitrex, NorCal, and lay down in a quiet dark room for 2-3 hours… was that not enough for a 30% rating here? Seems to me that I described a “prostrating episode”, but you tell me please. My headaches have increased in frequency to up to 5 a month – despite the occipital injections, and Botox shots (30+ per visit). Botox injections were so bad that I tensed up during the procedure and ended up with shooting neck pain. I quit the Botox after 2 tries. They weren’t very effective either. Other than sleeping them off in a quiet dark room for 2-3 hours, nothing helps much. In order to quell the neck pain, I have tried facet injections (helped some but lasted no more than a week) and on 30 June I had radio frequency nerve ablation in the C-spine. That hurt me so bad…. I had no idea how much pain I would be in as the nerves “died” until I read on why I was hurting so bad 2 weeks post procedure – turns out it’s real common. Pain went away after 7 whole weeks. See, though I have tried just about everything thrown I me. Now I am just tired of trying. BTW: I was rated at 20% for my neck issues… The crux of everything else I have, except Tinnitus. Something I have not, until now, wondered about is my sleep issues. I have been on sleeping meds for 5 years. Got off the Ambien to something less harsh. But I have trouble sleeping due to the pain I am in. Either falling asleep or staying asleep – or both. Is this something the VA would look at? All this had added up to me fearing for my job. I am a federal employee with 10 years in (post retirement from the USAF. I recently had to drop down 2 grades as previously a Contracting Officer (GS-1102) to something less in the critical thinking arena. Still, I have missed a ton of work over the past several years. I stayed up typing this as the sharp pain in my neck makes it impossible to sleep right now and I am on track to missing one more day of work. I fear I will lose my job due to absenteeism. The whole point of this post is my asking you all for “what you think” – I feel I may have left somethings on the table. It took me 5 years after I retired from the Air Force to file and that got me 80%. Another 5 has gone my and I feel much worse for the wear. I would appreciate to hear from you all. I have laid it all out there for you to see. My candor has never been an issue. Gratefully, Geo
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