tdiu I Think I Need A Plan

[John Purser]

Hello,

I've posted here before. My details are briefly:

40% disability, service connected, parachute jump caused a back injury (herniated disk) in 1985. Surgery then a medical board out in '87 with "10% temporary" rating. Gradually increased rating as the pain rose to 40%. Today I can barely take care of myself due to back pain. Pain from the back injury keeps me in a recliner most of the day. I worked with the VFW for a couple of years before I realized they were just filing paperwork that legally couldn't be approved. Trying to fight it myself now. Can't afford a lawyer and senators all say "we'd like to help but we can't".

From the law I see that my back can only be rated at 40% under it's current classification. Since I can't get the 60% minimum I need for TDIU from the one injury I need to get other symptoms (numbness, depression, weak leg, incontinence) related to the injury and file for disability for them until I hit at least 70% even by VA math.

After reading advice on this site I asked for a copy of my "C" file a few months ago. Got a nice letter from the Seattle office telling me it would be AT LEAST next January or February before they get through the backlog and send me a copy. After my last disability exam I was given the same amount for the same thing but was denied disability for several other items, all written in medicalese, that I don't understand. I'm assuming the exam doc found categories for other issues.

Questions:

1) From what I've written does it sound like I've got the facts correct? Am I way the hell off somewhere? Deep down inside I just can't believe it "really" works this way.

2) Does my general plan (claim everything and try to get it approved as a compensable disability related to service until I qualify for TDIU) sound like the way to go? Am I missing something? I "need" 100%. Honestly I can barely shop, cook, and care for myself today and that's directly related to my military service.

3) Is there anything I can do outside of the VA that might affect the disability decision favorably? For instance, my SS lawyers suggested retraining via a State agency. If it works I can get a job and if my disability prevents it then we can take that to the judge as evidence of disability. Is there anything along those lines that might be persuasive for the VA?

4) I'm sitting here waiting months to see my C file. Any suggestions on what I can be doing now?

Thanks for the help.

John Purser

[John Purser]

I had no problem getting a doctor to write a report that I can not engage in any work and advise me not to engage in any activity that increases my levels of pain. I had a diagnosis of disc herniation with ridiculapothy and was specifically advised by my doctor to seek social security disability. I know of several other people with similar disc problems who easily won Social security disability.

At no time was I told that bed rest would cause my problem to get worse or inhibit my recovery. I told the doctors that every day of my life the only way I could control the pain was to be in the prone position 16 hours a day. On my daily activity report for SSD I wrote that I spent 16 hours a day in the prone position. I was awarded social security. The rest of the time I spent doing my shopping and light house work and preparing meals. I was in my early fifties when all this occurred.

The VA rates disabilities on their own schedule. Learn there schedule and pay particular attention to the requirement that you have a prescription by a treating physician that you required six or more weeks of bedrest in the last year. I have read BVA cases where they asked the veteran one question. Did a doctor prescibe six or more weeks of bed rest. The Veteran said no and was denied an increase over the current 40% rating. There are other neurological symptoms that can get a high rating.

The good news is that I now function much better and the pain levels have de-creased. Now all I have to worry about is the angioedema.

Hoppy I've had 5 doctors now (2 civilian, 3 VA) refuse to prescribe, recommend, or even suggest bed rest even when I told them that was the ONLY thing that reduced my pain levels to tolerable. They could document the damage to my back, couldn't come up with anything to treat it, but absolutely refused to prescribe laying down. And like you, I spend about 16 hours MINIMUM in a recliner. I can't flatten out enough to lay down in a bed. This after back surgery and decades of chronic and increasing pain. I mean I didn't just dream up "back pain" yesterday you know? And my last civilian doctor refused to write a letter or get involved in any way with SS or VA paperwork. My last SS claim was turned down because "since you can still shop for groceries you're clearly not in pain. It's just stiffness." Not kidding.

Glad your back is doing better. Life confined to a bed or chair SUCKS! My last "prescription" from my VA back specialist was "learn to tell good pain from bad pain and get more active". As a result I now have enough pain to make sleeping difficult and daily activities now start out in pain instead of building up to it. Sure hope this is "good" pain you know?

I'm switching civilian doctors and specifically asked if this clinic would write up paperwork for SS. They will, but only after establishing a history which strikes me as ethical. Also I'm going back to the VA and hitting my primary care doc for pain treatment, back specialist for increased pain due to his last "prescription", and the psych for this depression which is just the cherry on top. And following up on a suggestion I got on this site I've applied for Voc Rehab from the VA. Not sure I'll qualify but I can ask. Either they come up with something I haven't thought of (could happen and I'd be DAMN glad to see it!) or maybe they'll admit I'm useless in this condition. I plan to see what the state offers as well.

And I'm waiting for my court date for SS. Going to have to pay a lawyer 25% plus expenses but it's better than nothing. And I'm waiting 9 months for a copy of my C file from the VA so I can see what they've got in there.

As always thank you and the rest for writing. Helps to know I'm not alone, others have made it, and I've got someone to talk to who understands this stuff.

John

[Hoppy]

John,

It is hard for me to believe that if you had disc herniation diagnosed by MRI and are post surgical that the doctors would recommend activity that resulted in an increase of pain. I have read many BVA cases whereby bed rest was prescribed by treating doctors. Most the people I know with disc herniation are given heavy pain killers and bed rest.

Like my case there are many instances wherby folks with disc herniation do recover with to some extent without surgery. There is a diagnosis called something like "failed surgery syndrome".

I had to go to an administrative law judge with SS after an initial denial. My brother won SS first time through. My brother had an impingment of the spinal cord. I had a nerve root going into my left arm that was compressed.

SS was very technical when I went through in 1993. My attorney would not take the case until I got an MRI and an EMG. She said that with these test verifying disc herniation that she could get me from being assessed by something called the GRID. The GRID is where they ask you about your activities. When I got the tests showing disc herniation and nerve injury I was not assesssed on the grid and was awarded SS due to the severe nature of the injury. I know that post surgical cases have there own requirements.

It is not uncommon for doctors to not get involved. It sounds like the new clinic that is working with you is good progress. Definately get a lawyer if you have already been denied by SS.

[John Purser]

Hoppy,

I passed through "hard to believe" about 3 years ago. Now I'm just trying to stay away from homicidal rage, suicidal depression, and just crying from frustration.

The surgery was 20 years ago in Walter Reed. I got better for about 6 months. It was a real miracle! Then one day I was going on duty and I sneezed. For the 20 years since I've experience chronic and increasing pain and for the last 5 it's been pretty much constant pain if I wasn't laying down. For the last 3 years the level of pain has hit a point where it's VERY difficult to do anything but deal with the pain. I get about a half hour of "good" time out of the chair at a time. Then about another half hour of useful but distracted by pain time where I can get stuff done but need to be able to move slowly, and sit a lot. Change positions, sit then stand, rub the back, flex it some (sometimes) and try to relieve the pain that's growing. I'm functioning but mostly working around the back. Then I need to hit the recliner. And I get one or two "long" periods like that a day normally. After that my back is pissed off and the pain comes faster. If I REALLY piss it off, take all the pain I can (say, clean the dog poop up in the small yard we have) or try to get out of the chair too many times then I'm probably gonna be down for 3 days or so with pain that doesn't even go away when I sleep.

I'm on naprocin and tramedol for the back. I'm an alcoholic. Handing me some narcotics isn't the way to go.

That's what I mean by 40% disabled in VA terms and not disabled AT ALL by SS terms.

The line I get from the doctors is "Most people, if they're going to get better, get better with exercise. Bed rest leads to deterioration." And to a certain extent they're right. Muscles atrophy and that allows worse things to happen to the back. HOWEVER I'm clearly not "most people" and I'm being forced to use bed rest anyway and since this has continued at various levels for 20 years and been utterly disabling for 3 years I think we should kinda move past the "try to stay active" prescription. I can't do anything else. So by not prescribing bed rest they cover their asses and I get the bed rest any way. Win/win for them with the unfortunate side effect of me loosing.

I've got the MRI showing damage, scar tissues, and arthritis to the back. I've got the EMG showing nerve damage. I've got the pain and numbness (can't prove those) and I've got the friends who testify that my condition has worsened drastically over last few years.

And I've got $600 a month from the VA and nothing from SS. I'm waiting 9 months for a copy of my C file and 16 months for a SS trial.

Thanks for passing on your story. It helps to hear from someone with much the same condition who got what I'm asking for. Sometimes I actually wind up questioning myself over whether or not I'm being reasonable since "everyone agrees" that I don't have anything coming.

John

John,

It is hard for me to believe that if you had disc herniation diagnosed by MRI and are post surgical that the doctors would recommend activity that resulted in an increase of pain. I have read many BVA cases whereby bed rest was prescribed by treating doctors. Most the people I know with disc herniation are given heavy pain killers and bed rest.

Like my case there are many instances wherby folks with disc herniation do recover with to some extent without surgery. There is a diagnosis called something like "failed surgery syndrome".

I had to go to an administrative law judge with SS after an initial denial. My brother won SS first time through. My brother had an impingment of the spinal cord. I had a nerve root going into my left arm that was compressed.

SS was very technical when I went through in 1993. My attorney would not take the case until I got an MRI and an EMG. She said that with these test verifying disc herniation that she could get me from being assessed by something called the GRID. The GRID is where they ask you about your activities. When I got the tests showing disc herniation and nerve injury I was not assesssed on the grid and was awarded SS due to the severe nature of the injury. I know that post surgical cases have there own requirements.

It is not uncommon for doctors to not get involved. It sounds like the new clinic that is working with you is good progress. Definately get a lawyer if you have already been denied by SS.

[william n]

Though are circumstances are somewhat similar, my alcoholism has been in remission for sometime. However, i do receive for my pain Hydocodone, Methocarbamol,Prendisone,, and Ambien for Sleep. All prescribed by the VA with no Med. contract. My pain is somewhat tolerable, though i have had some incapcitating periods,over the past couple years. Funny thing is when i met my new PCP, he put in his notes that i like vanilla ice cream but never mentioned the incapacitating episodes that Ive had where family was flown in to take care of me, which i told him about. Sooo, you may be on too what i always believed to be, that VA Dr.s are not assisting with the claims process. Just my experience. You can tell the VA dr.'s anything u want but unless u have ER visits,Physical Therapy Sessions, Psych ward visits(depression from the pain), Independent Medical Opinions, Mri's, and etc,.Its alot tougher for them too award based on "your version" of lifestyle and events. Just this Vets experience. Peace, William

Edited September 9, 2008 by william n (see edit history)

[John Purser]

William,

First, didn't mean to say that alcoholism automatically means I CAN'T take stronger meds or that doing so is against the AA program. I'm just really careful about them. The only time in my life I got stupid with pills was when I was in the Army shortly after the back surgery blew out. I was taking 8 times the prescribed dose of Codeine and mixing it with lots of Alcohol and prescription sleeping pills so I could sleep at night. I stayed in a stoned fog until the Codeine ran out. Told my Army doc what I was doing and he said "That's not good" and wrote me another prescription for Codeine. I went home and flushed the pills. Haven't taken much stronger than aspirin since until I got the Tramedol for my back a year or so ago.

I'm scared of how I handle most pain or sleeping pills now. That's not program, that's personal experience and I'd be a fool to forget it.

I do take a flexeril once in a while when the pain just won't shut up. It doesn't directly affect the pain I think but it does make me pass out for a while. However it also makes me slow and stupid for at least 24 hours after I wake so I lose a couple of days whenever I take one. Not a good trade IMHO.

Agreed on the doctors notes. I told one civilian doctor that my back was the single biggest medical issue I had and that it was destroying my life by confining me to a recliner. I went to him repeatedly and complained about the back every time and we agreed there was nothing he could do about it. 2 years later I moved and when my new doc got my last docs notes there was almost no mention of my back at all. Just one note saying he referred me to another doc for a consult. On paper, my back was just fine for those two years.

Today I HAVE the MRI, the EMG (electronic nerve damage test. May have the acronym wrong), and the X-rays all showing back and nerve damage. But you can't "show" someone pain.

I've been to the VA for depression. Going back again. No good for the depression and no use for the boards. I've tried the emergency room visits for pain but the last two times I had to leave before I was seen. I REALLY can't sit up that long. Just driving to the emergency room hurts and after an hour or so of waiting I have to leave. I've been seen about half the times I've gone to VA ER.

I'm being seen by the local VA back clinic. They've told me to learn to tell "good pain" from "bad pain" and start enjoying "more pain". That's not working out so well. Going back to them soon but don't expect much better results. Last time they said they were going to order me a corsett which would in fact DAMAGE my back so I could only wear it for 15 minutes at a time. No one believes me when I tell these stories.

Physical therapy made a HUGE difference when I first got out 20 years ago. But over the years it started causing more pain and finally got to the point where just trying those exercises put me down for days.

Thanks for sharing your experience. I'm looking for anything that works that I haven't tried and hearing about someone else's experience really helps.

John

Though are circumstances are somewhat similar, my alcoholism has been in remission for sometime. However, i do receive for my pain Hydocodone, Methocarbamol,Prendisone,, and Ambien for Sleep. All prescribed by the VA with no Med. contract. My pain is somewhat tolerable, though i have had some incapcitating periods,over the past couple years. Funny thing is when i met my new PCP, he put in his notes that i like vanilla ice cream but never mentioned the incapacitating episodes that Ive had where family was flown in to take care of me, which i told him about. Sooo, you may be on too what i always believed to be, that VA Dr.s are not assisting with the claims process. Just my experience. You can tell the VA dr.'s anything u want but unless u have ER visits,Physical Therapy Sessions, Psych ward visits(depression from the pain), Independent Medical Opinions, Mri's, and etc,.Its alot tougher for them too award based on "your version" of lifestyle and events. Just this Vets experience. Peace, William

[cowgirl]

John, I glanced over your posts here and feel for you. Glad to see you at Hadit and keep yer chin up.

Are you currently SC for depression?

My story, on a visit to VA php (flu shot time), intake interview asked 'are your or have you been depressed', a standard question. Stunned me somehow, said 'uh,,yes', got immediate consult.

After a few visits, VA psych diagnosed years of depression re military service events. The diagnosis resulted in psych notes in VA med records. Hadit family helped w/stressors, what, when, and how to 'clearly' present for a much needed claim. A while later, % compensation and continued va care. (THANKS Hadit!).

When va php, psych or any doc asks, my truthful response is Yes. Now its occasional counseling, some meds and continued compensation for chronic Major Depressive Disorder (MDD). Hard work but a good difference in being here for my family.

Best to ya,

cg (sc lumbar, d3, veins, etc..)

Edited September 9, 2008 by cowgirl (see edit history)

[John Purser]

My Depression isn't officially service connected yet. Not sure how to proceed to get it connected. I asked about whether or not my 20 years of increasing pain, becoming a shut in, self treating pain with alcohol leading to alcoholism, etc. would in any way be related to my Depression. The answer I got was that since not EVERYBODY winds up with depression after a back injury there's nothing to link my depression to my service.

This doesn't sound right to me.

But in regards to depression right now my main concern is just getting some better treatments or coping skills. The VA doc had me on Prozac but I didn't really notice much of a difference. Then she put me on some additional meds that tore my stomach up without really changing anything else so I quit those too. Exercise helps the depression a lot but tears up the back of course. Tried therapy. Gave me some interesting life tools but nothing really directly applicable to Depression.

Just feeling my way along here. I'm not constantly suffering. At least twice a month, sometimes as often as weekly, I crash big time. I've learned to feel it coming on, warn the girl friend, and then shut the hell up until I'm mostly over it. Usually just takes a day or to for the worst of it to pass. At least I limit the damage to me that way.

John, I glanced over your posts here and feel for you. Glad to see you at Hadit and keep yer chin up.

Are you currently SC for depression?

My story, on a visit to VA php (flu shot time), intake interview asked 'are your or have you been depressed', a standard question. Stunned me somehow, said 'uh,,yes', got immediate consult.

After a few visits, VA psych diagnosed years of depression re military service events. The diagnosis resulted in psych notes in VA med records. Hadit family helped w/stressors, what, when, and how to 'clearly' present for a much needed claim. A while later, % compensation and continued va care. (THANKS Hadit!).

When va php, psych or any doc asks, my truthful response is Yes. Now its occasional counseling, some meds and continued compensation for chronic Major Depressive Disorder (MDD). Hard work but a good difference in being here for my family.

Best to ya,

cg (sc lumbar, d3, veins, etc..)

[william n]

Hey John, Cg said what i wanted to say.... Thanks Cg Peace, William