Denial

[ruby]

I admit I have been thinking my arthritis in all my joints are connected and recently figured out they weren't, so I wasn't really surprised at the results, what do I do now.

Lumbar was remanded in 86 with no outcome to my knowledge.

Do I go back and say I want to reopen this file or file for new SC-reactive arthritis

Or I could say that I thought my CE was for reactive arthritis.

I know this is complicated but I don't what type of appeal approach to take.

Service connection for arthritis, right hand, knees, right foot and scaroiliac.

SC may be granted for a disability which begn in military service or was caused by some event or experience in service. Service connection for arthritis in the above is denied since this condition neither occurred in nor was caused by service.

I never recieved a CE for my SI joints---can they just ignore my request for this area of my body?

SC may be granted on a presumptive basis under 38 CFR 3.309(a) for arthritis, right hand, kneeds, right foot and sacroiliac if this condition is manifested to a compensable degree ( severe enough to be evaluated at least 10 persent disabling) within a certain period after military discharge (specified under 38 CFR 3.307. As the medical evidence fails to show a diagnosis of arthritis, etc within the time period , service connection on a presumptive basis must be denied.

Again my SI was not evaluated in this last CE. I was not diagnosis with arthritis(reactive) until 83 but I was seen for leg and back pain within the timeframe.

We requested a medical opinion to determine if these claimed conditions were secondary to your service connected disability of arthritis, cervical spine.

VA examiner opines your current feet, right ankle and hands conditions are not secondary to service connected cervical arthritis, nor are these secondary to left foot injury. X rays of the bilateral feet, dated March 8 2006 was normal except bilateral calcaneal spures: xrays dated march 8 2006 of spine sacroiliac joints showed bilateral sacroiliac arthristis; xrays of bilateral hands, dated march 8 2006 were normal. VA examiner states your major pains and disability is related to sacroilitis and the lumbar spine.

Service treatment records do not provide evidence of incurrence in service of these claimed conditions.

I have the records and I sent them to the VA too that showed arthritis in the SI joints in 1977 while on active duty. They acknowledged they have those records I sent.

Consideration of reasonable doubt was given and there is no approximate balance of positive and negative evidence to give rise to substantial doubt which can be resolved in your favor (38 CFR 3.102 The rule regarding benefit of reasonable doubt does not apply because the preponderance of evidence is unfavorable.

What evidence can that be?

Based on the evidence of record, there is no compelling medical testimony or substantiated opinion that these claimed conditions were incurred in service or aggravated by a service connected condition, nor can service connection be established as presumptive condition.

I am correct that they ignored the report that said I had arthritis in my SI joints in 1977?

I really need help on what and how to disagree with the board.

Edited December 29, 2007 by ruby

[Berta]

" am correct that they ignored the report that said I had arthritis in my SI joints in 1977?"

If they did not list it as evidence in the decision or if they- but did not refer to this in the narrative- they probably ignored it.

Just go over the narrative of the decision sentence by sentence.

If you agree with a sentence go to the next one-

(It pays to have a scanner to scfan the actual statement from VA, then copy and insert it into the response)or

Quote what they said at each point and then provide your argument for each point based on the medical facts and med records.

Refer them to Exhibits if needed and then make an Exhibit list at the end.

I use colored tabs on the Exhibits - Exhibit A, B, C etc.

I wonder if they fully considered these conditions as potentially both secondary but also as direct SC too-

You should try to get a good service officer to help you with this-someone with the time to go over all of your SMRs and med recs from VA.

This bothers me:

"VA examiner states your major pains and disability is related to sacroilitis and the lumbar spine."

I wonder what medical rationale supported his point.

It reads almost as if there was no formal diagnosis of arthritis in your feet and hands etc.

A good rep could also determine what happened to the older lumbar claim since the examiner brought that up.

Edited December 29, 2007 by Berta

[ruby]

Here is a letter I sent them Oct 3, 2007 with additional evidence that they said in th evidence they used.

In response to your communication to me dated July 20, 2007 xxx/xxx/xxx/xxx,CSS xxxx and xxx/xxx/xxx/xxx, file number xxxxxx.

My interpretation of the reference letters mentioned above, I was awaiting a new compensation exam and if I had further information regarding the depression or unemployability to please submit that information. I made several calls to the VA service representative regarding when I was going to be scheduled for a new compensation exam.

During my last conversation I was informed the Board was awaiting my response to the letters prior to scheduling a new compensation examination. I was also informed that the Board does not review your ongoing medical records and if I had further information regarding any treatment or statements that I need to submit those for consideration. I thought this information would be reviewed and submitted at the new compensation exam. I am enclosing additional information for the Boards review.

I have not responded to the communication regarding the unemployability or depression since I do not feel that I qualify for either according to the guidelines. This communication stated that if I believe I qualify that I needed to complete, sign and return the enclosed VA form 21-8940.

My depression is related to the arthritis and the pain associated with the arthritis, the fact that I am unable to work full time to support myself and that I cannot enjoy my personal life. As I have stated in my previous communications, I am depressed due to the pain and the physical limitations it presents.

While I don’t seem to understand the process I thought my original compensation exam in December of 2006 I was being evaluated for arthritis and for all residual effects of the arthritis and the subsequent damage it has caused such as the bilateral carpal tunnel, bilateral heel spurs, bilateral achilles tendon and the generalized exacerbation of the disease process.

During my compensation exam I was informed this was not true and that I had to resubmit for residuals, which I immediately applied for.

Dr. xxxx, Head of the Rheumatology Department at the VA in xxx, Florida has stated in my medical records that he feels due to the severity of my arthritis I am “completely physically disabled” (see attachment). Radiological evidence that shows the severity of the arthritis is located at xxxVA in , Florida. It is visually obvious of the arthritis due to the swelling that is present in my hands, feet and knees.

My active duty records clearly demonstrate that I showed arthritic changes in my SI joints while on active duty in 1977 (see attachment). I would believe this evidence would clearly establish the arthritis in the SI joints is service connected and not residual. I am not aware of what documentation the Board has in regards to my arthritis. Therefore, I have obtained a copy of my service records and I am submitting the medical records and statement (enclosed) for the Boards review to expedite this matter and any questions the Board may have.

All the evidence I may have to show that I am depressed is in your possession. I have not sought any medical treatment for this condition.

I am not sure what is required from me in regards to what actions are necessary on my part to expedite this matter. I have been waiting to receive a new compensation exam date.

Please notify me of what actions are necessary on my part to obtain the new compensation exam or any further documentation that is required for the Board to reach a decision.

“I hereby certify that the information I have given is true to the best of my knowledge and belief.”

Sincerely,

[ruby]

Here's the evidence they said they used:

Rating decision date july 13, 2007 and the evidence therein

our letter dated July 24, 2007, sent to you explaining VA's Duty to Assist and information & evidence is needed to establish entitlement to benefits claimed

Your statment, dated October 3 2007, (recieved October 22, 2007) with copies of your service treatment records (STRs and grogress notes from xxx Va Medical center

STR's from the period Sep 24, 1975 to Dep 22, 1978

VA exam dated Nove 28, conducted through VAMC

VAMC treatment records dated Feb 10, 2006 through November 19, 2007.

[ruby]

Thats whats in my denial, they said they looked at service connected but they apparently didn't as it clearly shows the arthritis in its earliest form.

Thanks for the response, I am looking for a new service rep that is good. Someone approached me at the VA when he saw my look on my rating. I guess he is some biggie in a service org and said he would call me.

Who knows if he will, he put my name and number on a newspaper, I just hope he doesn't throw it away.

Anyone know of someone in Florida, I am willing to travel if they know what thier doing, as it is evident I don't.

[ruby]

They said in the denial "service connection for arthritis, right hand, knees, right foot and sacroiliac is denied since this condition neither occurred in nor was caused by the serive"

By this statement they are denying the medical report that says there was evidence of arthritis in 1977? Am I understanding this correctly and this is how I attack thier denial. Especially when I never recieved a comp exam on my SI's

I was never asked in the comp exam how I got this just what type of arthritis did I have.

They are not denying I have arthritis, just that it isn't service connected.

[rdawg]

if you had arthritis in service and still (duh, it doesn't go away) then it is service connected. Find the regs on chronic condition in service, I think it states something to the effect - if it's chronic in service and manifests post service then it is service connected unless clearly attributable to an intercurrent cause(injury).