tinnitus 2ndary Conditions Denied, Va Altering Claim

[Jayg]

Hi everybody. First post here. I have tried searching but have not found much particular to my case. I am not used to this format and it's slow on rural dial up.

I am 40% overall, 10% hearing/tinnitus SC, 20% L ankle SC, Flat feet 10% SC.

I know this is going to sound trivial. Heck it does to me! :( But I'm a physical wreck now.

I sprained an ankle in service.(1974/81 US Army) While in cast we had an alert and I fell off the back of a deuce & a half. Hurt like blazes but they said it didn't hurt anything. Then had the cast off two weeks later and returned to duty. I was also diagnosed with flat feet in my second hitch.

Now both ankles, knees, hips & lower back are bad with peripheral neuropathy (I am not diabetic) thrown in. I am described in records as having "debilitating arthritis" and walk with a cane. I wear a rigid, authorized by VA, knee brace. I was a machinist but can no way work it now. Am on methadone and other "as needed for pain" meds. As noted above, I'm granted SC for feet & ankles. My records note me as having "altered gait/transferring."

But I am repeatedly denied any consideration for secondary conditions. They describe my conditions as "mild" with pain being the greatest limiting factor.

One infuriating thing is that they are rewording my claim and denying items on that basis. I claimed my bilateral knee, hip, and lower back condition with neuropathey as secondary to SC ankle & feet. But they say I claim my knees as SC (I did not) and since there's (naturally! :P ) no record of complaint in service, they're denied.

Then they say I claimed my back as secondary to my SC knee claim (not so!). Since the knees are denied, the back can't be connected! I have sent in copies of my original claim a number of times and they keep coming back to this. These claims were prepared with a well experience VSO.

VA also denied my shoulder but that's okay because I never claimed it. I expect it did add useless wait time to the process now that I think of it, however.

I've been going r'round and 'round with this since the summer of '04. I got flat feet upgraded from 0 to 10% when I sent in pictures of worn boots and got another exam. (I unfortunately wore my seldom worn dress shoes to C&P exam.)

Now I have amassed a pile of documentation, i.e., other similar cases, VA & workman's comp, granted, medical journal papers, all linking the above mentioned conditions and arthritis too, to flat feet and ankle problems. Think that will have any effect???

Sorry this is so long but this hasn't happened overnight either. I have had initial claim result, NOD denied, and am on the list for the traveling board but VA has granted the FF increase as noted above when I sent in new evidence. I am preparing another NOD including the information I mentioned.

BUT! How do I get them to straighten my claim and quit altering it?!

[Jayg]

People don't take methadone for mild pain. It is the number two drug that people OD on, oxycontin being number one I thing. Do you go to the pain clinic? I would make an appointment with the psychiatrist and tell them how depressed you are about this miserable pain you are in for the SC conditions. This could be a good claim. Being in chronic pain sure depresses the heck out of me and I am on wellbutrin and prozac.

I don't know about any pain clinic though I have discussed "pain management" with my Dr.

Depressed? darn right! In my case, I'd say there was something wrong if I wasn't! I'm a recovering alcoholic (20+ years sobriety) and these things scare the the feces out of me (or would if they weren't so constipating). By the same token, I find the thought of taking depression meds more depressing than dealing with life as is!

I just got an SSOC today.

"Entitlement to Individual unemployability remains denied."

"It is noted on the --- VAMC report severe debilitating arthritis; however, service connection for arthritis has not been established. Review of the claim file does not show that you meet the requirements for entitlement to individual unemployability as cited in 4.16."

I've read that thing with bi focals and I can argue that point, especially if you read 4.17.

But it's clear I have to connedt the arthritis to the ankle & feet. At least one of my studies does that. They all connect joint degeneration to flat feet as well as ankle or knee injuries. Again, I think I can argue that. The pain meds are for arthritis and are not worth didly if I can't connect arthur.

[rentalguy1]

OK...so you have had back problems since at least the early 80's that you feel is tied to your sc'd ankle. You also had a fall from a duece and a half in the late 70's, while on active duty that could be contributing. You did receive treatment from chiropracters in the 80's and 90's, but those doctors no longer have records of such. There is no record of treatment for back pain from 1981 until 2004. Since 2004 you've been treated for periodic back pain by the VA, who has taken x-rays that show mild degeneration of (the disc space, I'm sure). You recently received a denial on secondary service connection for your back and knees, which you believe is caused by and altered gait from your sc ankle. The RO denied because they do not believe the altered gait caused the secondary conditions (probably because a doctor did not tell them to believe such).

What you need to do right now is get a concrete diagnosis. Go to your PCP at the VAMC, and request an MRI of your back. X-rays are absolutely worthless in diagnosing back problems. The only thing they will show is narrowing of the disc space, which everyone over the age of thirty will have. You need to definatively find out what's going on in there. I'm no doctor, but I do have a spinal cord injury/disease, so I'll take a stab here. The fall from the 2 1/2T injured your spine, but it wasn't bad enough to be noticed. This injury has slowly developed arthritis on your facet joints and within the spinal canal itself. This has led to spinal stenosis, hence the horrible pain and neuropathy. This is very typical of the slow progression of spinal stenosis, and why it's former name is "creeping paralysis." When you get this diagnosis, make the doctor state what has caused it. Be sure they know your ENTIRE medical history.

There are two ways to approach this claim:

1. Go for direct service connection. This is what I would do, but it means filing a new claim and losing your EED. I would get a IMO stating that my IVDS was caused by the fall from the truck, and send it in as evidence.

2. You can file a NOD, and then obtain an IMO stating that your altered gait, which is caused by your sc ankle, has caused your back problem. The lack of this statement from a physician is why you were denied to begin with. Doing it this way will preserve your EED, but it will be very difficult to get a doctor to agree that this is what is causing your back problems. True, it can cause muscular back pain, but that would leave no cause for the neuropathy. You most likely have a few herniated discs, facet joint arthritis, and spinal stenosis, which cannot be caused by an altered gait.

I hope this helps a little.

[Jayg]

Whoa-woW! I LIKE the way you think! :P

I'm going to have to look up a couple of those abbreviations but I saw a topic hereabouts for that.

I never would have imagined falling off a truck could do all that. But I have that incident about as documented as one can be.

You're correct in that all they've done is X-ray me so far and of course no major anything reported.

I'll talk things over with my VSO considering which way to go with this as well as think it over. It seems like things are finally happening in my case now and I kind of hate to change horses in mid stream as it were. I know I can start a new claim any time but that time doesn't get paid for either. Tough call.

But that's my part.

Thanks ever so much.

[Jayg]

What you need to do right now is get a concrete diagnosis. Go to your PCP at the VAMC, and request an MRI of your back. X-rays are absolutely worthless

1. Go for direct service connection. This is what I would do, but it means filing a new claim and losing your EED. I would get a IMO stating that my IVDS was caused by the fall from the truck, and send it in as evidence.

Ohhh-K I went to the definitions page and didn't find these. A little translation please... :P

[LarryJ]

PCP = Primary Care Physician

EED = Earliest Effective Date

IMO = Independent Medical Opinion

IVDS = Uhh, ahhh, Independent Voluntary Doctor Suicide.........I haven't had my coffee yet.

[rentalguy1]

IVDS = Intervertebral Disc Syndrome (38 CFR 4.71a diagnostic code 5243), also called degenerative disc disease, herniated disc, bulging disc, etc.

Remember, whichever you choose, you need to get an MRI and a concrete diagnosis with a well thought out and explained medical opinion as to the condition's etiology. This is going to be your very fist step.