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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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johnc515

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I have a few questions but thought I provide background to assist in answering. I submitted my service connected claim on March 16, 2007 for Psoriatic Arthritis (PSA) and Psoriasis. I was active duty in the Navy for ten years (1980-1990), I started having skin problems in 1982 and it intensified during my last three years in the Navy. The Squadron Flight surgeon repeatedly sent me to the Pensacola Navy Hospital Dermatology clinic for evaluation (At least ten visits in my medical record), at first they claimed I had exzema but later changed the diagnoses to Psoriasis and my discharge physical has "Chronic Psoriasis" noted. I was even sent to Balboa Naval Hospital three times when the squadron was in El Centro or the San Diego area; those docs also diagnosed me with Psoriasis. I got out in 1990 and controlled the Psoriasis for a few years until I started seeing my private primary care Doc and after a few times of treating me with various creams he referred me to a Dermatologist who also diagnosed me with Psoriasis. I never filed a claim due to ignorance of my eligibility and I never thought of myself as a disabled vet. In 1996 I started have joint pains and swelling, I was referred to a Rheumatologist and after a few visits I was told I had PSA. I was treated with various anti inflammatory medicines until a last year when I started having servere pain in my left wrist and since than have lost almost all Range of Movement, after numerous miss-diagnosed by my primary care and Neurologist I was sent to see a Orthopedic Doc that looked at my x-rays of my left hand/wrist and told me the wrist was dislocated and my only option is fusion of the wrist. He also x-rays the right wrist and stated it was about 50% degraded in ROM and would I would face the same fate "fusion". (I have seen two other Orthopedics doctors and both concur with the fisrt doc) They said that the PSA was attacking the joints and I needed to see my Rheumatologist to get on some drugs to prevent any further damage. I am now on an immune suppressing drug (methrotrextate) and almost all of my major joints have damage.

I didn't use a VSO on my claim but I submitted all of my private medical records and my Navy records in my claim, my Rheumatologist tells me the records state everything and I do not need her to write any statement for a nexus. She told me that Psoriatic arthritis is an inflammatory condition that affects the joints of children and adults with psoriasis and that most people develop the skin signs of psoriasis first and are later diagnosed with psoriatic arthritis (up to twenty years later in some cases). All major medical type websites that I have researched state the same, and my doc stated any medical background person know they are linked. I looked a few BVA decisions and it seems lin most cases that a veteran that has documented proof of psoriasis, than his claim of PSA is linked.

My questions are:

1. Are the copies of the medical records enough?

2. Or should I try to have another Rheumatologist review my records and write a nexus?

3. Should I see a VSO or wait until I get my rating? (Whenever that may be)

4. Will I get rejected because I waited too long even though the chronic psoriasis problems are documented in my medical records?

5. Do the raters have a medical background to know PSA is linked to psoriasis?

I thank you all for helping me and all of our veterans

John.

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John, Welcome Home.

My claim that I filed about 4 years ago, went back to something that happened in 1964, so, no, I think that you're fine, time wise.

You have to have something that occurred during service.

You must still have that something affecting you today.

You must have your nexus between the something that occurred in service and the something that you still have today.

And, there are a couple other "things" that you need, but my oldtimers is kicking in.......

I would go to MedLine or one of the other internet medical sites and find the "All major medical type websites that I have researched state the same, and my doc stated any medical background person know they are linked. I looked a few BVA decisions and it seems lin most cases that a veteran that has documented proof of psoriasis, than his claim of PSA is linked." And send that to your VA Regional Office with your name and social # on it.

I have no advice to offer vis a vis a SO. I can only offer my experience. Don't.

I can recommend one of our hadit board members for your consideration, for without him I'd still be scratching my arse.

Alex Humphreys

But I don't think that he gets involved initially, but, instead, he works BVA and Veterans Court appeals. But, keep him in mind. He helped me in conjunction with the VVA.

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John:

Welcome to Hadit. It is hard to answer your questions cause you may get someone who rates you well and you will be happy with the decision. Its sort of a waiting game when you first file the claim cause if you don't agree with the decision they are supposed to say why they did what they did and how you can cure it.

You can probably expect that as the VA gaters information that you will have some pretty significant waing time probably months and than they might ask you to go to your local VA for a Comp & Pen Exam and than the ball will start rolling.

If you have medical records that support your claim you should make sure to send them.

Good Luck on your claim and welcome to Hadit.

Pete

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johnc515,

"All major medical type websites that I have researched state the same, and my doc stated any medical background person know they are linked. I looked a few BVA decisions and it seems lin most cases that a veteran that has documented proof of psoriasis, than his claim of PSA is linked."

One thing to keep in mind is that the RVSR (the rater) is not a doctor and has no medical training. It may be common knowledge that Psoriatic arthritis and psoriasis are somehow linked together, but the VA will most likely need a nexus statement from one of your doctors stating that YOUR psoriasis, which was diagnosed while on active duty, is the cause of YOUR Psoriatic arthritis.

"Are the copies of the medical records enough...Or should I try to have another Rheumatologist review my records and write a nexus?

?"

To establish service-connection for psoriasis, they proabably are since they show a chronic condition while in service and was actually diagnosed while on active duty. However to establish secondary service-connection for Psoriatic arthritis, you'll probably need an IMO from your doctor.

"Should I see a VSO or wait until I get my rating? (Whenever that may be)"

Why would you want to wait until you may have been denied because you didn't have the needed medical nexus to rectify the situation. You really don't need an SO to do this. Just submit the claim with your SMR's (if you have them), a copy of your private treatment records since discharge, and an IMO connecting the psoriasis and the Psoriatic arthritis to one another.

"Will I get rejected because I waited too long even though the chronic psoriasis problems are documented in my medical records?"

It doesn't matter how long it has been. As long as you have medical records to substantiate what you're claiming, the VA will award service-connection.

"Do the raters have a medical background to know PSA is linked to psoriasis?"

See the first paragraph I posted in this post.

I hope this helps!

Vike 17

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". Or should I try to have another Rheumatologist review my records and write a nexus?"

The VA will reject an IMO without a strong nexus statement-

please see my topic under the search feature at top of page-"Getting an Independent Medical Opinion."

The opining doctor has to state they reviewed your SMRs and all current clinical medical records and in their opinion the disability is more than like,(75 %), at least as likely as not (50%) or not likely (zilch)

related to your service-

The %s I used are not regarding comp ratings- just the value of the weight to VA of how they are stated-

"as likely as not" meaning 50 % one way or the other- under the evidentiary regs in 38 CFR means the veteran has succeeded in establishing the nexus factor.(Benefit of Doubt regs)

Please all -correct me if the 75% more than likely is wrong-

The doctor also has to add a full medical rationale for this-

meaning it could be that they refer directly to evidence in yur SMRs- that documents the inservice condition or in my case-

I have 2 strong opinions from Dr. BAsh with considerable medical points supporting his opinion " his (my husband's) demise due to cardiovascular disease and infarcts (multiple brain lesions and damages areas) was caused by his Agent Orange induced diabetes."

He gave 14 points in 2 IMos that cover his medical rationale.

It also helps that he provided a lengthy 9-10 page Curriculum Vitae as he is Neuroradiologist and could opine on the veterans autopsy ,MRIs, and ECHOs s, etc

and he diplomatically reminded VA that they admitted to malpractice already on the CAD and CVAs.

If you need to find an additional rheumatologist you might consider Medopinions -they know VA regs and can provide, for a fee, the type of opinion you might need.

Edited by Berta

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Berta,

The actual phrases mean the following;

"is due to" = 100%

"is more than likely than not" = 51% to 99%

"is at least as likely as not" = 50%/50%

"is less likely than not" = 1% to 49%

"is not due to" = 0%

Vike 17

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