lumbosacral What Should I File My New Cliam Under! Help

[Infantry1985]

Hey Guys ! I was wondering what I should file my new claim under. I was denied for lumbar strain multiple times. Now I have some new info so I can file again under something else. What should I put on the claim, I do not have time from work to meet with representative. Here is the stuff

from my last post. Also I will put the new info from the doctors.

If someone could point me in the right place for what to put on the claim as SC and secondary. Thank you so much for your help

PT therapist- Pt. presents with chronic back pain for 2 years. pt . with scheurmans disease. thoracic kyphosis appreciated with decreased lumber lordosis. most likely congenital and exacrerbated by heavey loads on back while in militry. pt. with weak core musculature. pt radicualr pain did not follow typical pain patterns due to radiating up leg.

Pain clinic doctor - There was ntoed to be on papatiion prominence of the L5 spinous process. palpation of this are caused the greatest amount of discomfort. motion involved in the lumbosacral spine revealed flexion to be 50 degrees, extension 10 degrees, with greatest amount of pain. right, left lateral bending 10 degrees with right lateral bending causes discomfort. reproduciable pain was noted upon palpatation of the l5- s1 spinous interspace. not erythematous changes or soft tissue swelling was appreciated. palpation and formal testing of the sacoiliac joint caused no discomfort.

Based on my exam, i am concerned that the patients pain is possibly related to the elongation of the l5 spinous process. I believe he has a kissing spine or the syndrome of baastrup. Injections will be schedualed. If injections dont work patient may be canidate for surgury.

Diagnosis - Low back pain, possibly related to baastrup syndrome.

Another follow up = tenderness in lower spinal process area found in interspinal space.

When I originally received the denial in 2006 for my lower back I seen on there that it was on there as a lumbar strain. After that Time I have spent that time going to the va off and on when my appointment came up for EMG's, x-rays, physical therapy, Pain clinic and it elapsed time of the 1 year cut off. I set in a NOD and received another denial. I was wondering what I should do. When I had my 1st C&P in 2005 I told the doctor that the pain came and went but was there 90% of the time throughout the week and got worse as time passed, So I guess they labeled it as a lumbar strain. From that time my back has gotten worse and I ache and hurt all the time with pain radiating down my left leg. My feet and left leg has also been going numb. The doctor that did my EMG told me that me a 23 year old has a back of a 60 year old and I have nerve damage. I need to know what I should do from hear? I was denied this time without another C&P, they used the one from 2005 in which my condition has gotten way worse. I was denied for Bilateral flat feet, which my PC told me I had and could be a problem. Left foot neurological damage muscle strain of the low back .Should I file again, send another NOD, Have them change the service connection from lumbar strain? Any help would be great. Im stuck. Below I am going to write my test results and attach my denial.. Please help

MRI- Schmorl's node deformities are seen in the vertebral bodies from T12 through T3. There is mild anterior wedging of the T12 verterbral body. This may be Phsiologic. There is mild biateral Facet Disease from L3 through the lumbosacral juntion. No Significant disc protrusions are identified. The Canal is widely paten. there is no significant neuroforaminal stenosis

The conus terminates at L1

Xray - There is mild anterior wedging of the T11 and T12 vertebral bodies.

EMG - The nerve condution sudies of the left leg were normal. an attempt at left medial calcaneal sensory orthodromic study was attempted buuy results wre not reproducible. Enlarged motor unit potentials without fibrillation were seen in bilateral medial gastrocnemius muscles, bilateral vastus muscles, left rectus femoris muscle, left adductor longus muscle and left biceps femoris long head muscle.

Impression

The EMG of left leg was abnormal. There is EMG evidence of Chronic bilateral lumbosacral radiculopathies involving primarily bilateral L4 and S1 Nerve roots.

[Infantry1985]

Just wanted to see if anyone had any advice on the NOD letter in the last reply. THank again

[Berta]

On the letter put Attention to and use the code and Initials in the right hand corner of the Denial and then Type Notice of Disagreement in Caps.

Then state that you disagree with their decision of ( date) and tell them exactly why.

Go over their Reasons and Bases carefully.

Tell them of any evidence you submitted that failed to be either listed as evidence in the denial, or worse yet, they listed it but never considered it in the narrative.Attach it again.

If you are obtaining IMos-they must conform to the VA's IMO criteria whoch I have posted here under topic called Getting an Independent Medical Opinion.

It is critical that the IMO doctor have your SMRs and all VA med recs and private records when they opine.

The criteria I posted here covers the other points that the opining doctor must make.

You can send them a ball park all inclusive NOD that just says you disagree with the entire decision.

But in my opinion- since the NOD is your first avenue of attack-you might as well send them some ammo- a rebuttal of what they said in the Reasons and Bases of the denial.

I have had at least 4 claims for myself, my husband, and my daughter turn on the NOD and get awarded.These were all brief NODs with the regs attached to 2 of them.

The VA actually has to carefully read the NOD to attempt to further deny the claim.

Tell them why the lumbar copde they used is wrong. Make sure your IMOs reflect the actual diagnosis.

I dont suggest sending a very lengthy NOD but on page one- in your first statements give them facts that calls their attention to the whole thing.Make sure if you do send more pages or evidence that your name, address and C file number is on them.List your enclosures as Exhibits A, B, C at the end of the letter.

Somewhere here at hadit under a search is one of the best NODS I have ever seen.

I feel a generic NOD does little to advance the claim.This is your opportunity to get the medical facts straight.Explain your MOS carefully if that is critical to your claim.

You might get an Army rater who is unfamiliar with Jarhead talk-

a MOS code on a DD 214 for an airman might be a lot different than

a similiar MOS code for a Sailor-

My husbands DD 214 MOS was Truck driver-

His job in Vietnam was fighting the enemy-USMC I Corps-

as well as driving trucks of ammo,fuel, water,and personnel dead and alive.

It pays to be a little specific on the MOS if this is critical to your claim.