I Got Rated For Reactive Arthritis (thank You Berta, Hoppy, And Carlie)

[hayley3]

I am so upset that I can hardly type. I already knew the claim had been approved, but was shocked with the rest of it.

I got an IMO that said the exact same thing that the VA had said, "I probably had reactive arthritis related to an in-service infection". I got my SMR's which showed sacroiliac problems in service and I felt that info clinched the in-service connection, but they made no mention of it.

However when they sent me to the C&P they didn't even care about the arthritis in my spine. They based my rating on incapacitating exacerbations of twice a year and said I don't have inflammatory arthritis, which is what reactive arthritis is. Unbelievable! They ignored the S1 radiculopathy, osteoporosis, and eyes, scoliosis, spasms, plantar fascitis, limited ROM in neck, arthritis in big toes and fatigue, etc. which are the things that keep me from working. I get an xtra $100 a month and I haven't been able to work since 2000 and that was part time.

Since the doctors would not commit, I have had such a hard time. Now this.

I'm not sure how to even go about attacking this.

Why did they leave all those things out?

This is what they said:

Upon examination your gait was normal, had right shoulder limited motion with pain and weakness, left shoulder limited motion with pain. Your right hip ROM was limited with weakness, and your left hip ROM was limited with pain. You had no loss of bone, recurrent shoulder dislocations, inflammatory arthritis, or joint ankylosis. (I have osteoporosis and significant loss of lateral flexion) You had crepitus with your bilateral knee movement. Xrays showed minimal sclerotic and cystic changes of your right hip but were otherwise negative. The VA physician noted you most likely have reactive arthritis which is most likely caused by your in-service infection. (I have an xray that shows I have moderate arthritis in my sacroiliac and I have ruptured disks in my lumbar region)

Why did they ignore these?

Thanks,

Susie

[Berta]

"Did the opinion state every disability that the doc thought was due to the reactive arthritis?

and did he/she give a full medical rationale for that?"

"No.

That's the other question I wanted to ask. If osteoporosis is common in Reactive arthritis, does the doctor have to emphatically state that the reactive arthritis caused it"

I posted a complete topic here in Getting an Independent Medical Opinion.-

the IMo doctor must state a medical rationale and support it with evidence regarding every condition claimed as service connection.

[ruby]

While I really don't have a clue on what you should do. I would probably file another claim for those conditions to be secondary to your reactive arthritis. While you would lose the time it might be worth it in the end if a DRO will take a long time

I have reactive arthritis and I just now filed a claim for it. I am waiting for the comp exam. which I normally get 9 months later.

I filed for a change in my dx from scar (infected cyst) and the reactive arthritis secondary to the infected cyst. That's it nothing more.

In your claim did you claim those specifically to be secondary to the reactive arthritis.

Inflammatory arthritis means that you have frequent to constant pain, it shows on xray's as darken area. You can have reactive arthritis and not have inflammatory episodes. Inflammation will cause you pain, redness and swelling.

If your comp exam was on a good day and you didn't limp, that's not good. They can either rate you from what I have read as individual joints or rate you on incapaciting episodes but not both. Problem with this is you have to have a doc say bedrest, like you can walk to the clinic to tell you not to walk. I am going to have my doc write in my records that he is prescribing me bedrest during each episode.

Once I am rated for the reactive I am going back to ask for ie bil heel spurs, bil achilles tendon, bil knee spurs, bil shoulder spurs, neck spurs, bil elbow spurs, costochronditis (spurs on my ribs), bil wrist spurs, bil carpal tunnel, bil hands, bilater SI's. All of this is well documentated in my VA records.

Once I get that I am then going to file for the 5 bulging disc resulting from my uneven gait that I have had for 30 years.--there is research that shows uneven gaits can cause bulging disc do to the uneven pressure on your spinal column.

I am doing it this way for the simply reason, I am afraid if I went after it all it would get ignored like yours and then I have to file an appeal.

Consider if you didn't apply for everything and each area was not addressed in the denial or approval, refile it as a new claim.

Also, make sure you rheumatolist says you can't do any repetitive motions with any part of body.

Let me say this reactive arthritis can occur as an acute episode and never occur again. While you may have reactive arthritis it may not be inflammatory. You would fight it on that, inflammatory is swollen and pain joints as indicated by comp exam, imo, your xrays. Get imo on your xrays results, thier only as good as the person who reads them. Trust some rads havent a clue but thats what they do.

Now can I ask you if you got your decision easily or did you jumped through hoops.

[hayley3]

Thanks for the idea Ruby.. I feel like I should at least challenge the non-inflammatory arthritis part because it is an inflammatory arthritis. They also said I don't have bone loss, and I have osteoporosis and that is considered bone loss. Couldn't I send a notice of disagreement and at the same time separately do another claim and ask for the other conditions to be secondary?

No I didn't ask that they be rated secondary although I did submit them. I was too worried about getting the reactive arthritis approved.

My rheumatologist is biased against veterans who get compensation claims for arthritis, so he fixed it where he would only give me a dx of a spondyloarthritis and never went any further, even though the infection was known. But he did write I probably had reactive arthritis, so I had to go and get an IMO to state the same thing. I also don't have alot of swelling and my pain comes and goes. But even when I was in severe pain in my sacroiliac at his office, he just said I didn't have any inflammation going on. B) So that is going to work against me.

They rated me on incapacitating episodes and I read somewhere that they should do both, because you will have residuals and since it is a chronic process you will have incapacitating episodes also. I read it on the spondylitis.org military forum.

At the C&P exam my left sacroiliac was really bothering me so I couldn't sit because I was in pain and so had to lean on the exam table. It didn't matter because that wasn't mentioned. They didn't even bother checking my spine or neck. They checked my hips, arms and knees and that was it.

I made copies of my SMR's where it showed I was seen for sacroiliac pain and gave it to the C&P examiner and I think that was a good thing to do. It saved her some work.

I was already service connected for the infection. I started my claim in 2003 and because I was sick and though I thought I got my evidence in on the last day, the claim was closed last August.

They never in 4 years sent me for a C&P exam. That's when I came here and Berta and Hoppy drilled it into my brain to get an IMO. So I only got 7 months of retro. Amazing how they work fast sometimes, and other times it's years of waiting.

I've been looking for evidence to show that my herniated disks are connected to the reactive arthritis, because it seems to be very common among us.

Susie

[ruby]

I don't know the legal in's and out's, I would think you could do a NOD. I would get the IMO fine tuned and submit it, don't be late on the time frame.

You need to get the doc to state specifically that each and every symptom you have is due to inflammatory reactive arthritis.

This type of arthirits over time will cause bone spurs throughout your body. I think thier called enthospaties (sp) which are tiny spurs. I have them on my ribs its called costochondirits (sp) --really bad speller tonight. At times I can't take a breath without severe pain.

There are articles out that say uneven gaits cause bulging disc, you need to get that in an imo from an neurosurgeon or ortho doc I would personally wait until I got the rest of this granted. You have to much to fight right now.

There are articles that say osteo is common with people who have reactive arthritis. People who are double jointed are more incline to develop arthritis in those joints.

You have to understand the difference in reactive and inflammatory.

reactive is a general term used to describe some forms of arthritis. They are inflammatory in nature but you may never have more than a one time acute attack which may or may not have caused damage. You can also have intermittent attacks.

there are no definite test for each type, they are usually dx by your symptoms. If your going to fight this you need to show how your symptoms are the hallmark of inflammatory reactive arthritis. Get you IMO doc to state each and every symptom is related to the inflammartory arthritis.

I have what use to be called reiter's arthritis, if your not familiar with that then start googling it and you will see if you have reiters that is now known to be reactive arthritis which is 100% inflammatory.

One of the major ss of reiters is uveitis/iritis, cystitis, vaginitis and bilateral SI involvement. My arthritis is severe.

basically the inflammatory arthritis are reacting to a gene you carry and when exposed to the right agent you develop a form of arthritis. Most but not all inflammatory arthritis pt are positive for HLB-27 gene, this is what more than likely caused the reaction to the infection. You also have an abnormal or high normal sedimentation rate which indicates you have an active infective process.

If your doc won't do it voluntairly then back door him with your symptoms, so he has to write it in his notes. What I mean by this you need to tell him what your symptoms are each time you go in, but be specific and limit your problems, when you tell them a bunch of stuff they write the easiest and quickest.

Have you had a bone scan, if not ask for one. I have normal bone mass so they say. I have minimal to no osteo. my arthritis is all inflammatory reactive.

When you are bedridden due to the flare up make them document those facts, I had to go to bed for a week due to the sciatia pain in my right leg the pain was 8/10 and nothing worked that I take to eliminate the pain. If they tell you to rest when this occurs tell them they need to write it in thier notes.

If you SI hurts get a cane to help you walk as your gait is unsteady due to the pain. Ask for physical therapy to help you with your mobility.

Most important if they ask you to bend over stop when the pain starts. I can bend all the way over, I am very flexible but I am in pain when I do it. I am telling you this as the PT people will use a gonimeter to measure your ability to bend. Stop when the pain starts thats what they want to know when you start to have pain. I can lift my leg straight up but it hurts about l ft off the ground. I can cross my legs but they go numb and I have shooting pain down my leg to my ankle.

I have a high tolerance for pain and a low to non existent ability to take drugs to help me. Its a bear for me when my pain is severe.

PM me with you causative agent and I will guide you where to look for help in proving its inflammatory arthritis.

Are you in Florida, I didn't look, I would also suggest that your IMO doc specializes in reative arthritis.