Proving In Service Connection

[hayley3]

They say in the denial that I failed to relate the arthritis condition to the service connected condition.

How can I show them that it is connected? What concrete evidence are they looking for? It almost seems like they didn't read anything I said.

This is what I typed up:

Timeline of disease history:

Cervicitis (treated in service) Symptom of reactive arthritis

Hemorrhagic Cystitis (treated in service) Symptom of reactive arthritis

Salpingitis infection (PID) resulting from the cervicitis/cystitis: Symptom of reactive arthritis (treated in service and service connected)

Acute knee pain (treated in service) Symptom of reactive arthritis

Back pain (sacroiliac arthritis) Result of reactive arthritis or inflammatory bowel disease.

I don't have the symptoms of inflammatory bowel disease (IBD) nor did I have an intestinal infection prior to the arthritis which is what causes IBD.

But like I said, my Dr was a jerk. The resident said it was reactive arthritis but the Attending? said it could be either Reactive or (IBD). I had a colonoscopy which should have ruled out the inflammatory bowel disease(IBD) because they found nothing but a polyp.

Anyway, I just thought I'd pass this by someone who may have some ideas. I think they didn't do their job.

[hayley3]

Thanks everyone and an update

Thanks Larry! I will request the records. I really should have got the doctor in trouble in the beginning when he said it. I'm afraid I waited too late.

Thanks Pete and John! I went back and looked at the VA outpatient records and in 3 different visits after the xrays, he says I probably have reactive arthritis. He says it could be reactive arthritis in another visit. And then in another visit, the resident says it's probably reactive arthritis and the attending agrees with him. Why is that not good enough????? What happened to that "benefit of the doubt"?

Also, I have decided that I would attempt to see a rheumatologist I had seen in the past, at my expense. (Now remember I have no money) I called them up and she said I could get an appt, (which is a miracle for a rheumatologist without waiting 3 to 6 months) The appt is scheduled for June 18. So I was excited and she says it will be about $300. I can handle that, until she tells me they only accept cash!!!!!!!!

I was going to use my credit card. If you get cash off your credit card the interest rate jumps to $25%. But I guess I'll do it, because August is my cutoff date for submitting new information. I have only asked the Rheumy for a second opinion visit. I am gathering all of my bloodwork and outpatient appts that are relevant including xrays and mri reports. If he won't give me a definite diagnosis, (which I doubt on only one visit) and will only suggest a mri for further evaluation, would that be enough to submit to the VARO to extend my date?

Thanks for any help!

[Vike17]

hayley3,

"I went back and looked at the VA outpatient records and in 3 different visits after the xrays, he says I probably have reactive arthritis. He says it could be reactive arthritis in another visit. And then in another visit, the resident says it's probably reactive arthritis and the attending agrees with him. Why is that not good enough????? What happened to that "benefit of the doubt"

Let me try to explain this for you. First, the "benefit of the doubt" is afforded to the veteran when all the evidence for the claim is weighed by the decision maker and that weight given to the evidence by that decision maker results in an equal balance of evidence for the claimant and against the claimant. When this happens the "tie goes to the runner" or the "benefit of the doubt goes to the veteran. So now this is where thoses phrases of "proabably, and "could be," comes into play. Well, actually they don't come into play. According to the CAVA,, not VA, they have determined that legally there should be the words "at least as likely as not," which means 50/50 possiblity, written when reasonable doubt comes into question. With this phrase the VA can legally resolve the benefit of the doubt in the claimants favor.

Vike 17

[spike]

Just my two cents when I have an IMO done. I ask them to state that it is more likely than not due to service connected injuries. Especially if state the reason. I.E. For my back, it was more likely than not that my lumbar disc disease (L4 and L5) are related to the injury occured in the U.S. Corps in April 2000. I usually bring a copy of the records for them to review....(treatments). My IU claim indicated the physician has reviewed my medical records and has been treating me since ( ) and it is more likely than not that I will not be able to obtain or sustain gainful employment due to my service connected disabilities (list them here).

When I have other vets ask me, I usually recommend a few physicians. Tell them to get a few treatments, then I hand them a prewritten form (basically what the CFR states for the rating schedule), have them bring the records from the VA (a free copy of your treatments can be obtained through correspondence...claiming freedom of information act), bring a COPY to the physican and have him review and make the statement on his or her official letterhead. I submit that with or after we make a claim. It usually helps speed the process along. What are your thoughts.

[hayley3]

Thanks Vike! Well, I think that's retarded, because probably technically means the same as "at least as likely as not". Only the VA..........

What is CAVA?

Let me try to explain this for you. First, the "benefit of the doubt" is afforded to the veteran when all the evidence for the claim is weighed by the decision maker and that weight given to the evidence by that decision maker results in an equal balance of evidence for the claimant and against the claimant. When this happens the "tie goes to the runner" or the "benefit of the doubt goes to the veteran. So now this is where thoses phrases of "proabably, and "could be," comes into play. Well, actually they don't come into play. According to the CAVA,, not VA, they have determined that legally there should be the words "at least as likely as not," which means 50/50 possiblity, written when reasonable doubt comes into question. With this phrase the VA can legally resolve the benefit of the doubt in the claimants favor.

Vike 17

[hayley3]

Ok Spike, are you saying you tell the doctor what to say and they do it?

I have never had any doctor agree with me. Maybe this could be the first.

Rheumatology is more art than science, so we'll see. And my arthritis has no specific, lab tests and fits more into a category. Hard to explain, which is why it's taken me so long to even get an xray.

Thanks for the ideas though. I need every idea I can get.

What do you mean about claiming information of freedom act? I'm getting ready to ask for my records, is there something else I need to include before I mail it to speed up the process?

Just my two cents when I have an IMO done. I ask them to state that it is more likely than not due to service connected injuries. Especially if state the reason. I.E. For my back, it was more likely than not that my lumbar disc disease (L4 and L5) are related to the injury occured in the U.S. Corps in April 2000. I usually bring a copy of the records for them to review....(treatments). My IU claim indicated the physician has reviewed my medical records and has been treating me since ( ) and it is more likely than not that I will not be able to obtain or sustain gainful employment due to my service connected disabilities (list them here).

When I have other vets ask me, I usually recommend a few physicians. Tell them to get a few treatments, then I hand them a prewritten form (basically what the CFR states for the rating schedule), have them bring the records from the VA (a free copy of your treatments can be obtained through correspondence...claiming freedom of information act), bring a COPY to the physican and have him review and make the statement on his or her official letterhead. I submit that with or after we make a claim. It usually helps speed the process along. What are your thoughts.

[Pete53]

Ok time out.

You are asking the Doc to use the language of the VA. The Doc's opinion is still their own. Its tough but its worse when you wait a couple of years and get denied and have to go back and do it again.

Good Luck

I would just say Doc the VA is anal and they have to have this phrase. Would you mind working it into the opinion letter it would really help me out. Thank you.