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What Is The Best Approach For Claim?


kent76

Question

While on active duty in the late 80's, I had 2 injuries, one a back injury with severe muscle spasms in which the doctor precribed 5 days of bed rest. This problem was flared up several times while on active duty. I haven't seen my SMR since the 80's so I really don't know what's in them! Also, I fractured my right ankle but it was treated as a sprain and for 8 months I walked and ran(including 2 PT runs) around with pain until it was discovered and properly treated with a leg cast for several weeks. I started having severe pain in my knees just before getting out of the service and noted it in my exist physical exam along with my back. Two months after getting out of the service, I filed a claim for my knees only because they were so weak that I had to hold onto railings just to keep from falling while walking down stairs. I went to the VA and the said that my knees had degenerative changes but I was denied my claim in 1990. I never challenged it and have yet to file since for compensation.

I pretty much have lived with back and knee pain for the last 17 years and only over the past 3 years began seeking treatment for my back pain and hypertension. My knees improved slightly because I totally stopped all my physical activities that made it almost impossible for me to sleep most nights. I believe that my hypertension became noticable when I began getting headaches at work that would last for several days. I believe that there might be something in my SMR related to the this but I am not sure since it's been so long. I recently requested copies of my medical records but I getting conflicting stories as to their location. I sent a request to St. Louis and the sent me a letter stating that they were in the possession of the VA while the VA told me just the opposite, who knows where they are!

Ok, here's the deal on my back:

From VA treatment reports since 2005:

LUMBISACRAL SPINE: The lumbar spine demonstrates normal curvature. The vertebral bodies, pedicles, transverse and spinous processes demonstrate no abnormality. There is moderated degenerative disease at the L5-S1 disc.

Impression: Moderate degenerative changes noted at the L5-S1 disc.

Primary Diagnostic code: Minor Abnormality

Also:

Diagnosis: Chronic back pain djd

After being involved in a minor traffic accident with some co-workers, my back pain really became worse.

After having an MRI done, this is what they found:

IMPRESSION:

1. T10-11 mild left posterolateral to lateral disc bulging contributes to mild left foraminal narrowing.

2. L3-4 mild shallow diffuse disc bulging seen slightly greatest in the right posterolateral to lateral region in conjuction with mild right facet anthropathy contributes to mild bilateral foraminal narrowing, right greater than left.

3. L4-5 mild posterior vertebral ridging and a mild shallow diffuse disc protrusion contributes to mild bilateral recess stenosis and mild to moderate bilateral foraminal stenosis.

4. L5-S1 mild posterior vertebral ridging and a superimposed mild disc protrusion in conjunction with mild left facet arthropathy contributes to mild bilateral foraminal narrowing.

5. There is mild diminished stature of the L5 veterbral body, particularly posteriorly, and suggests a mild remote compression fracture deformity. No acute or traumatic osseous abnormalities are presently seen.

I am currently on workman's compensation and have been since May 21st of this year. I am still going through therapy but this is not really helping much. My knees are bothering me alot lately and I am thinking about having them checked out. They actually lock up on me and pops alot. My physical therapist tells me that I should have an MRI done on them also because of the pain because it sounds like some muscle and hamstring problems.

I have a doctor's appointment on monday to discuss future treatment plans. He suggested earlier, steroid shots to the back and surgery as a last option.

I honestly believe that my problem is service connected because my back has been hurting for the past 17 years and that remote fracture could have been the culprit! I need to locate my SMR's before putting in another claim.

Questions: Will this be reopening an old claim since I filed for my knees and was denied? Also, since I had both back and ankle injuries in the service, what would be the best approach in your opinion to pursue this claim for compensation?

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"Will this be reopening an old claim since I filed for my knees and was denied? Also, since I had both back and ankle injuries in the service, what would be the best approach in your opinion to pursue this claim for compensation? "

Yes- the claim if it succeeds will get the EED of the date you file the claim to re-open-

the VA will need "new and material" evidence to re-open a previously denied claim.

The SMRs will be needed to prove the "nexus" or link to your service-

You will need to show chronic treatment records and also that the disability was established to a ratable degree prior to the NSC accident.

You will most surely need a strong Independent medical opinion to associate whatever part of the disability you have now is attributable to your service.

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"Will this be reopening an old claim since I filed for my knees and was denied? Also, since I had both back and ankle injuries in the service, what would be the best approach in your opinion to pursue this claim for compensation? "

Yes- the claim if it succeeds will get the EED of the date you file the claim to re-open-

the VA will need "new and material" evidence to re-open a previously denied claim.

The SMRs will be needed to prove the "nexus" or link to your service-

You will need to show chronic treatment records and also that the disability was established to a ratable degree prior to the NSC accident.

You will most surely need a strong Independent medical opinion to associate whatever part of the disability you have now is attributable to your service.

Berta, the doctor I am seeing Monday gave me some advise since he works with the VA "all the time".

He suggested that I wait until the workman's comp ordeal is over before filing a VA claim for disability.

I am pretty sure that he will give me a positive medical opinion once I get my service medical records.

Wouldn't both the VA report and MRI report qualify as new evidence since I have never filed for back?

I understand the need to establish a nexum but I must wait to see what's in my service records then review them with a doctor.

Do you think that because I haven't sought treatment for my knees since the denial will hurt my chances there? I will have to get archived records from the VA to show the degenerative changes diagnosis back in 1990 because the records I have only go back several years. Thanks for your help!

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Hi, Kent, I have a coiple of questions to ask.

1: When the VA denied your knee claim, did they have the Service Medical records or were they unavailable.

if the denial was frivilous and it is well documented in the record,You may have another avenue to pursue.

2: What did the denial letter say about your knee.

3: Do you have all records including MRI films and Xrays.

If you have all of your information you should get an opinion like Dr Bash if you can afford it.

You need a Doc who can relate the compression fracture to the in service incident. I recommend dr Craig Bash.

Your claim is right down his ally. (He is a Neuroradiologist)

He is expensive but have you ever heard the term you get what you pay for.

results.

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Kent

Don't intermigle your workers compensation case with your VA claim. Usually, if you get one you will lose the other. If the workers compensation people realize you have a service connected injury to the same body part they will start trying to push you off onto the VA. Just keep them in the dark until you get 100% compensation from the VA because you will probably have to make a choice between comp and VA benefits. The VA if they realize you have a work related injury will blame all your increase in disability on you job accident.

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Hi, Kent, I have a coiple of questions to ask.

1: When the VA denied your knee claim, did they have the Service Medical records or were they unavailable.

if the denial was frivilous and it is well documented in the record,You may have another avenue to pursue.

2: What did the denial letter say about your knee.

3: Do you have all records including MRI films and Xrays.

If you have all of your information you should get an opinion like Dr Bash if you can afford it.

You need a Doc who can relate the compression fracture to the in service incident. I recommend dr Craig Bash.

Your claim is right down his ally. (He is a Neuroradiologist)

He is expensive but have you ever heard the term you get what you pay for.

results.

I honestly don't know really! I didn't know much about the process then but I know that I never had an exam done and it was a very quick denial. Is it possible for me to get the results of that decision 17 years later?

I honestly don't remember anything about the letter! I know it sounds crazy but I figured that I must have been ok since the VA couldn't find anything wrong with me. I remember having an appointment scheduled something like 5 months later at the VA hospital and that's when the doctor noted that I had degenerative changes in my knees. I was scheduled for therapy but quit going because I had job that made it difficult.

I have all my treatment records since 2005 which includes the VA x-rays and MRI reports.

I agree with you as for as getting what you pay for! The doctor seeing me now says that the fracture is consistant with an old injury and was possibly occurred in the service. Also he said, the accident probably aggrevated the back and caused the disc problems and stenosis. The VA noted degenerative conditions in the back and gave me medication for back pain.

I know that I never had any knee treatments in the service but I did complain about them and it was noted in my exit physical!

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Kent

Don't intermigle your workers compensation case with your VA claim. Usually, if you get one you will lose the other. If the workers compensation people realize you have a service connected injury to the same body part they will start trying to push you off onto the VA. Just keep them in the dark until you get 100% compensation from the VA because you will probably have to make a choice between comp and VA benefits. The VA if they realize you have a work related injury will blame all your increase in disability on you job accident.

Yeah, I don't want to screw this up! I only know that my back and knees has serious problems and I am almost 50 years old!

I am not rushing into this even though I had to quit my secondary job as a manager in a store because my back won't allow me any heavy lifting.

Honestly, my back pain now is not too much different than before the accident! The day after the accident was slightly worst than normal and I know that nothing happen during the accident to cause a fracture. One of my co-workers wasn't wearing his seatbelt and when we were t-boned by another vehicle, he fell into me causing bruising on my shoulder and a slight discomfort to my back. It's possible that some disc problems occurred but my back pain has been chronic since I got out of the military in 1990. I have never had an MRI done prior to the accident however!

The doctor treating me said that the accident aggravated these conditions but since it was work-related, he put me on light-duty and my supervisor and benefits coordinator thought that it would be best that I not take a chance with this injury and since they had no other position available for me, they put me out of work on total temp disability. It has been since May 21st and my physical therapist is talking a minimum of another 6 months of treatment! It's depressing really because I am only making about 40 percent of my previous salaries. But I can't go back to work because I would lose my WC and could not get back on if I were to get worse.

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