Result Of C&p "less Likely Than Not"

[Quint7]

Hi All,

I went and got the copy of my C&P for knee and back that was done 10 days ago. The results are unusual. I will start by saying that I claimed an increase for my 0% knee, a claim for my back being secondary to my knee and a reopening that my back alone is SC.

My measurements were:

Knee 0-90 degrees out of 140 degrees.

Back 0-20 degrees forward out of 90 degrees, 0-5 degrees extention out of 30 degrees, 0-20 degrees right lateral flextion out of 30 degrees, left and right rotation is 0-30 degrees out of 30 degrees.

The PA that examined me mentions that I have had therapy for both problems. She also mentions that I had a MRI and that it shows DDD and Stenisis along with disc buldge.

She then states that the "spine condition is less likely as not secondary to his right knee condition. The vet has a lot of other contributing factors to his back condition, including his occupation as a firefighter. The vet's gait was normal on exam today. The MRI findings do not support spinous condition as secondary from the right knee. It is more likely from other causes."

OK, a few things:

I had the actual MRI films with me and I asked the PA to look at them, to which she said "I don't need to, I have the report here".

I have been a firefighter for 11 years. I filed originally for my back upon my end of enlistment in 1994. I also saw a chiropractor in 1998 or 99 (XRays from then show some disc damage already) which is only 1 or 2 years into my firefighting career. She made no mention of this in person or her report yet it claims she reviewed my file.

She claims there are "a lot of other contributing factors" yet other than my job, she does not mention any.

As I posted before, she had 2 huge folders that were my file with her. My exam lasted 20 minutes at most.

Any comments or suggestions?

She states that no further tests are needed.

As I see it, she did not fully review my folder, did not ask my history, automatically took my current career over my explanation that I have had this problem since I was in the service. She did mention that I have had the pain since 1992.

thanks!

jason

I can post any other info from the paperwork I received that might be relavent if I am missing something.

[john999]

You need a high class IMO to try and get this thing right. What you lack is contiunual treatment for this problem since discharge. That is how the VA has been able to find all these alternative diagnostic reasons for your problems. If you told them about all these other accidents over the years they will latch onto those accidents as alternative sources for your problems. A good IMO may be able to trace the problem back to your service and account for your increased problems now. This would be the best investment you could make. You need to have your IMO review all your SMR's and other medical records.

[Quint7]

I agree that if I am denied by the rating board I will have to go the IMO way.

I actually went though my service records and the "Lumbar Strain" that I was denied SC for originally (again for failure to appear), mentions tenderness around the L4-L5 area and raditing pain down the right leg, 3 days after the incident. Also the XRays from 2000 (the car wreck was in 1998, not immediately before the XRays and chiropractor visits as I thought), show mild degeneration already.

I have also read that there are all kinds of different diagnostic codes...... my back is 5295, lum./sac. strain and as I said, was denied SC in 1995. Should I just consider filing for a deifferent code (DDD/IVD?) and claim that going back to 1993 when the injury is documented, or maybe try to get my code changed? I've seen a few posts on this but as with all of this, I am not too sure what any of it means.

[rentalguy1]

You have medically documentes DDD, which is another name for IVDS. You most certainly need to file for IVDS. Lumbosacral strain is the VA's way to make it look like you have a temporary injury that will eventually heal in time. It is muscular in nature. You have degenerative changes in the bone and connective tissues of your spine. Consider the problems you are having with your back right now, then magnify them times 100, because that's where you're headed. You are officially a "spiney." Welcome to the club! Let's just hope you don't join the diaper club becuase of it, like myself and so many other have done.

IVDS will open up many more doors becuase it is now medically known what degenerative changes in the spine will do to the nerve roots in your lumbosacral area. The VA won't have as much wiggle room to get out of rating your secondary conditions once they have rated you for IVDS. They will try to fight it, but you have the evidence on your side. Now all you need is a definative nexus. Good Luck!

[Quint7]

Rentalguy, thanks for the upbeat message! I will say that there might be one or two other clubs that I would rather be a member of..... although, I wouldn't join any club that would willingly have me! LOL

Seriously though, I can tell you that the minute the back doc turned the light on on my MRI slides my heart skipped a beat. I have been an EMT for 14 years and it was SO obvious to ME that two of the discs were shot that I pointed at them and said this isn't good,eh? The doc just kinda nodded and said "yeah....".

Anyway, since the C&P confirmed DDD and says that it is due to many factors, if I file a new claim and the VA accepts my nexus to allow SC dhould I have to have another C&P before they can rate me or??????

As for nexus, I can think of a million things that have been bad for my back. Besides running and going on "humps", as we were falling back from an Iraqi tank unit in Kuwait, I backed my Amtrak (tank) into a bunker. We dropped about 10 feet and ended up verticle. Then myself and two other crew members had to break the tank track and repair it while under fire and wearing chemical suits. Just one of the tons of things that I know beat the hell outta me.

Unfortunately, the only thing that is definately back related in my medical record is that injury from playing basketball.

Is there any type of "militarty job related" or "combat waiver" allowance for making that connection to allow SC?

I'm hoping that the diapers never happenbut if they do, let me quote a saying from an old fireman who was known for doing more than his part to keep the firehouse smelling "fresh":

"You'll never be a good farter if you're scared of shittin yourself!"

Thanks again for all of the replies so far!

Jason

[rentalguy1]

I would wait and see what comes out of this round prior to forming a game plan for the future. You need to get a copy of the C&P, and see if it clearly says that it was a exam for IVDS. It is usually posed as a question with the examiner marking a yes or no answer. If they answered no, then when this rating decision is made, you need to start thinking about filing a new claim for IVDS. This will be difficult, because the VARO is going to want to reopen the claim that was denied (if it actually gets denied). Don't get too worked up about, though, just be thinking about new and material evidence. That would mean trying to get at least one good IMO sometime in the next few months. Two would be much better; one from an ortho doc and one from a neurosurgeon.

Don't worry about the diaper club. If you start having a loss of bowel control, then you have a huge problem. For bladder incontinence, though, the VA docs don't seem to want to do much about it. That could be that it's too late in my case. I was too embarrased to say anything for the first year or so, so the damage that has been done is irreversible. If you start dribbling, get to the doctor.

[Quint7]

Ya know, I NEVER even thought of this...... but even without a documented visit to medical, could photographic evidence of a situation that caused trauma be used to help link a condition to service?

I ask because of the attatchment Im including. It is me (with the glasses) after hitting a ship.... yes a ship.... at 30mph with a 26ton Amtrak (tank). I was driving and seated right above where the damage is. This was in 1989. My nickname for the rest of my enlistment was "McCrash" (my last name is McGrath)...........

Just wondering........