Opinion On Reopen Claim Letter

[ruby]

Re: Reopen Claim

I am requesting to reopen my claim for reactive arthritis (ReA) in all joints secondary to cyst (rated as scar 0% sc).

As evidenced by the following it is my belief the ReA was the direct cause of an infected recurring cyst that developed while on active duty.

In support of my claim I have included copies of pertinent service medical records and veteran medical records along with letters from those with knowledge of these frequent recurring cyst.

18 Dec 1975: 1 in tender node R med thigh hard.

19 Dec 1975: c/o of swollen lymph node in inner aspect of L thigh leg x yesterday-very painful- states she applied hot soaks to leg last PM with no relief

I was leaving the base for leave on 20 Dec 1975, I was instructed to stop at any hospital should it become necessary for me to seek further medical attention for this infected cyst. The military facility refused to do anything further due to my leave.

I was forced to stop and have the cyst lanced upon arriving in Tampa, I was to sick to drive to my home, I parked at a doctors office and waited for him. He lanced the cyst and instructed me to keep hot towels on it for it to continue to stay open and drain, he also started me on antibiotics. Within a few days later I developed a rash and I went to MacDill AFB, for medical attention.

Undated note - This occurred within a week of December 20, 1975. MacDill Hospital. Infected sub cysts groin -no treatment ordered (saw private md couple of days before)-rash Scabies probably acquired in boot camp.

25 Jan 76 Staph infection-was treated by civilian doctor for staph infection (subcutaneous cyst in groin area without success pt c/o discomfort and fatigue.

26 Jan 1976: Staph and Scabies

From January 1976 until Nov 1978, I used hot packs to treat any further cyst that occurred during this time.

Nov 22 1978 at1035 am (2 mos post discharge from USMC) Fever 2-3 days large swollen area near perineum and top of L thigh:

22 Nov 1978 at 6:40 pm additional note due to allergic reaction- DX acute lymphadenitis infection

Nov 29 78- Pt returns for follow up of cellulitis- resolution of celluitis (a cyst deleveoped and resolved during this time period).

5/21/84: Cyst medial infected R thigh.

During a Comp Exam dated 5-1- 85 it was noted; cyst was still present 2-3mm very small.

During all my encounters with the medical professionals regarding this matter, whether they realized it or not they always made me feel like I was dirty and unclean. I primarily didn’t seek medical attention for this problem, since they never did anything for them I applied hot soaks and attempted to get them to open. After I became a registered nurse with 20 years of critical care experience I felt comfortable lancing them using aseptic technique. As a registered nurse, I was able to obtain antibiotics from a physician if the need arose.

There were frequent times that I was unable to accept work when I was working agency due to a severe flare up with numerous foul smelling cyst both in my groin and axillar.

On xxx I informed my primary xxxx ARNP that I had been avoiding seeing the GYN physician due to frequent cyst and blackheads in my perinum/ groin area.

On December 28, 2007, I was questioned by my rheumatoligst Dr.xxx, Chief of Rheumatology if I ever had any cyst in my groin area or under my arms. At that time I was having a severe flare up as noted in his notes.

At that time Dr xxxx, Chief of Rheumatology reviewed portions of my service medical records and in his opinion the 0% SC for this cyst has been missed diagnosed and the correct diagnosis is hidradenitis suppurtiva and the reactive arthritis is secondary to this condition.

On January 15, 2007, Dr. xxxx, Chief of Rheumatology again reviewed a portion of my medical records relating to these cyst and stated a second time "57 yr old WF with reactive arthritis secondary to hydradinitis suppurtiva.

Enclosed are additional statements from close friends and family that are aware of the continuous problem I have had related to the frequent and recurring cyst.

I hereby certify that th information I have given is true to thebest of my knowledge, memory and belief.

Suggestion anyone, if not I sending it.

[ruby]

I apparently don't know hwaat I am doing can someone please help me.

I have a 0% SC for cyst rated as scar- I am asking to reopen this SC for ReA secondary to the cyst.

What have I done wrong. What do I ask for and how

[hurryupnwait]

I apparently don't know hwaat I am doing can someone please help me.

I have a 0% SC for cyst rated as scar- I am asking to reopen this SC for ReA secondary to the cyst.

What have I done wrong. What do I ask for and how

Am I correct, you are service connected for a cyst rated as a scar and you are asking for an increase in that rating and you have a doctor's statement that the condition is worst.

Or are you asking for them to change the diagnostic code to something else.

What is ReA?

Paul

[rentalguy1]

When and why were you previously denied for the ReA? This is important, because if you are reopening a claim you need to have evidence that is both new (wasn't seen in the previous denial) and material (makes a nexus between the SC'd condition and the current condition). Are you also seeking an increase in the SC'd cyst? Need more info here...

Also, do you have copies of all of the medical records where you were treated? What is the exact language that Dr. XXX, Chief of Rheumatology used in the progress notes? It's very important that this, or another doctor makes an undisputable nexus.

[ruby]

hurry and rental

I don't know what I am asking for.

I am asking I think for Reactive Arthritis (ReA) secondary to cyst.

I am service connected for cyst o% (rated as scar)

The cyst(s) are now dx as a disease and not just random cyst.

"57 yo WF nurse with ReA since 1977"

"Now she reports hydradinitis in groin for 30 yrs. Now has axillary pustules as well."

IMP: reactive arthritis (suspected due to hidradenitis supportiva (spondyolarthopathy)

I see problems, I didn't say I had hidradenitis, he said it. He said " I am sure in the past 30 years we ask you this, have you ever had any cyst in the groin or axillar area." I said yes and then showed him my axillar.

[rentalguy1]

So, as I read this, you have NOT been denied for ReA in the past. That makes this much easier.

1. Go to THIS THREAD and fill out and print 2 copies of the form. One should state that the hidradenitis suppurtiva is "most likely caused by the SC'd cyst." The other should state that the ReA is "at least as likely as not related to the SC'd cyst." This will make the nexus between your service connected condition and the ReA.

2. Go to your doctor and ask him if he agrees with this diagnosis, to which he will say yes (since he's already said it). Then get him to sign the forms you printed.

3. Gather ALL medical records, service, VA, and civillian, that pertain to these conditions.

4. Fill out a VA Form 21-526 stating "I am requesting an increase in my service connected cyst. I am also requesting that service connected compensation be granted for hidradentis suppurtiva as secondary to my service connected cyst. I am also requesting that service connected compensation be granted for reactive arthritis as secondary to my service connected cyst. Thank you for your timely attention to this matter."

5. Fill out a VA Form 21-4138 stating "Please accept the following evidence in support of my claim increase in service connected compensation for a cyst, and my new claims for service connected compensation for hidradentis suppurtiva and reactive arthritis, both secondary to my service connected cyst. I have also included signed release forms for Dr. XXX, Dr XXX, and Dr. XXX, so that VA may acquire all records that are pertinent to these claims. These records are all of the evidence that I have in my possession at the current time, and it is my wish that you take whatever actions necessary to adjudicate my claims. Please schedule any required C&P exams at XXXX VAMC in a timely fashion. Thank you for your attention to this matter.

6. Fill out a VA Form 21-4142 for each doctor that has treated you for these conditions.

7. Put all of these forms and medical records together in the order listed above and number each page 1 of XX, 2 of XX, etc.

8. Send it to the VARO, via certified mail, return receipt requested.

9. Wait for a C&P to be scheduled.

Hope this helps.

[ruby]

Yes, It did, I took stupid pills today, yesterday, day before etc. I just am not getting this VA stuff.

Give me civilian medicine or law any day of the week.

Thank you