21-526

[DblTap1]

Hello again,

I have been working on my 21-526 for a few weeks now. I feel like I have ADHD! I have about 13 different issues that are going on my 21-526. Many of them I have been seen by multiple doctors and treatment dates are unclear as I am still seeing some of them.

Example: I have a hip problems that I go through my PCM to a ortho for labral surgery and pain management doctor because it is deeper than the ortho doc wants to operate(psoas/illiopsoas and pyriformis syndrome). How should it be listed?

Another example: I have been seen by VA for plantar faciitis, again in Iraq during deployment, again on demob at Ft. Lewis, and again by my PCM, and finally by a podiatrist. The podiatrist finally "officially" Dx'd me with Posterior Tibial Tendinitis, bilateral (Adult Acquired Flat Feet).

Do I list all of them?

Just for detail... VA said nothing about flat feet in '96, MTF in BFE or BFI B) '03 said flat feet, Ft. Lewis '04 said flat feet, PCM '08 said "ummm... I'll refer you", podiatrist '08 says "your dogs are just worn out from over use. Dx- Posterior Tibial Tendinitis, bilateral"

21-526

109th Treatment Information

Disability name Posterior Tibial Tendinitis, bilateral

Date disability occurred 09/2003

Treatment beginning date 09/2008

Treatment ending date

Name of doctor Dr. Neuman

Name of hospital

Address of Doctor/Hospital 123 Main St., Yourtown, USA

Thanks for reading!

[Stretch]

I also have Chronic allergic Rhinitis, sinusitis, and injury to about 10 teeth from a head trauma while in service. My claims are all service related and awaiting remand. The claims evidence is in my SMR. It has just taken time (39 years) for me to get it together.

If the claims are service related you should file. Gathering evidence that the claims are SC is another time consuming problem. Sounds to me like you were in a horrible trauma.

If all of these are service related the claims are complex. Complex claims do take a long time. You just have to hang in here with us.

[DblTap1]

39 years?? I just hope to be around in 39 years! That is absolutely nuts. I am truly sorry to hear that. My pop is a WWII vet with no records at all. I have started trying to find his stuff. It may be a lost cause.

All of the items that I previously listed that do not have "VA" behind them occured during my last tour of service. The others are from an accident while I was bicycling for PT. The plantar fasciitis had made running painful.

I am still on AD with only 26 months left before my 20 years. So I am hoping that there will not be an issue of it being service connected (entitled to base pay), as I have all of my LES's, orders, med records, etc.

The adult acquired flat feet, I may have trouble proving the start of that. Our desert boots were great because they breath, but they have no arch support. The boots and combat load were the cause of that. Prior to the tour in the desert the VA had seen me for the plantar fasciitis with no mention of flat feet. My desert DEMOB physical mentions flat feet. So I am hoping they won't deny SC. Possibly even CRSC... But that is the least of my concern.

Obvioulsy I would like to front load this as much as possible to be sure or as sure as possible that my first submission will be all that's needed. I haven't been sent to the MEB/PEB, yet. I have been avoiding it by bouncing between Army and AF for profiles as to not trigger the MEB. My goal is to reach 20 and I am sure they will bounce me at the MEB.

[DblTap1]

I met with our local TSO/DAV rep. She is suggesting that I list items in general terms. Such as "Back Condition" as opposed to "Degenerative Disk Disease" as the report states.

Does anyone have any input as to which would be better? Listing items specifically or or in general terms?

Thanks!

[carlie]

Dbl,

Listing things in general terms like "Back Condition" is NOT the way to

go -IF YOU HAVE MEDICAL EVIDENCE OF AN EXACT DIAGNOSIS.

Along with that evidence you need what's called a Nexus (medical link)

of the diagnosis to military service, from an accredited medical professional.

The key words are:

Medical statements regarding possible Service Connection:

Is due to- 100%

More likely than not- Greater than 50%

At least as likely as not- 50% (Benefit of doubt goes to Vet)

Not at least as likely as not- Less than 50%

Is not due to- 0%

Hope this helps a vet.

jmho,

carlie

[rentalguy1]

She's nuts! Absolutely list them on the 526 as the are DIAGNOSED. The VA understands diagnoses, and will rip "general terms" to shreds. You have 26 months until you retire. That is plenty of time to learn the VA's entire system prior to filing your claims. I wouldn't even be bothering with the 526 at the moment, because you can tack on several conditions before you get out. You need to file for every ache and pain that you've ever had, because you never know what these guys are going to deny. You also need to spend the next few months getting up to date copies of every medical record that Uncle Sam has on you. Especially your entrance physical. When you get out, DO NOT let them skate through your exit physical, and demand to see what was entered into the record and a physical copy of that record. That is the number one document that VA uses to deny our claims.

You need to take a lot of time between now and filing to read and learn 38 CFR 3, 38 CFR 4, M21-1, and M21-1MR. All of our claims are decided based on these regs and manuals.

Now, for the conditions that you already have to file on:

Posterior Tibial Tendinitis, bilateral (Adult Acquired Flat Feet) - Local DPM

Planter Faciitis -VA

They cannot rate both of these seperately. That would be pyramiding and is against the regs. File for both, but you want them to rate the bilateral flat feet. They both are supposed to be rated under the same diagnostic code, but this one is bilateral, so the bilateral factor will apply giving you a higher rating. I would not expect more than 20% for this condition.

Illiopsoas tendinitis - Loma Linda Med Ctr Ortho

Hip Labral tear - Loma Linda Med Ctr Ortho

Again, file for both, but pyramiding will apply. Most likely these would be rated based on range of motion. You can find the rating criteria for this in 38 CFR 4.71a. You may expect another 10%-20% out of this.

Pyriformis Syndrome - Loma Linda Med Ctr Ortho

I don't know the dx code on this one, but I would say a service connection of 0%-10%.

Muscle and nerve damage to thigh - PCM

I would think no more than 10% on this.

Hypertension >160/100 >3x per week - VA & PCM

I'm not up to speed on the heart stuff, but I think I have read that this would be a 0% rating. Somone with more knowledge will chime in.

Biceps tear - Local MTF & ortho

Again, I would say not more than 10%.

Elbow tendinitis - Local MTF & ortho

Probably based on ROM, again 10%

Allergic Rhinitis - VA & PCM

Sinusitis - VA & PCM

This would be another pyramiding case. There are several factors that the rating will depend on, but maybe 0%-10%.

DDD - Loma Linda Med Ctr Ortho

This will be your biggie. So many things can hinge off of this in the future that it'snto even funny. It will be rated under dx code 5243, Intervertabral Disc Syndrome, and it will be rated under either incapacitating episodes (doctor prescribed bed rest) or on ROM. Since you are on active duty, I would think it is safe to say yours will be on ROM. If you are able to bend over and touch the floor, you'll get a 10% rating at best. The thing to know, though, is that this condition will do nothing but deteriorate over time. If the affected area of your spine is in the lumbar region, watch for symptoms of pain/weakness in the legs and urinary/fecal incontinence. These are the typical types of progression for this disease. High ratings can come from this in the future. Please click the link to the spine claim repository in my signature line for a ton of info on back claims.

Wrist fracture, Plate in, Plate out, Arthroscopic reformation of carpal bones/tendons, neurectomy - Loma Linda Ortho

This one will also be based on ROM. You can find this in 38 CFR 4.71a, also. Might be another 10% rating.

Some others that come to mind are Tinnitus (ringing in the ears), hearing loss, runners knees, and either PTSD, or a mood disorder due to a general medical condtion (you get pissed off too easliy due to all the pain you are constantly in). Try to get diagnoses of these things prior to your retirement (if they are actually bothering you) and be sure you mention all of them in your exit physical.

[MRRRR5]

She's nuts! Absolutely list them on the 526 as the are DIAGNOSED. The VA understands diagnoses, and will rip "general terms" to shreds. You have 26 months until you retire. That is plenty of time to learn the VA's entire system prior to filing your claims. I wouldn't even be bothering with the 526 at the moment, because you can tack on several conditions before you get out. You need to file for every ache and pain that you've ever had, because you never know what these guys are going to deny. You also need to spend the next few months getting up to date copies of every medical record that Uncle Sam has on you. Especially your entrance physical. When you get out, DO NOT let them skate through your exit physical, and demand to see what was entered into the record and a physical copy of that record. That is the number one document that VA uses to deny our claims.

You need to take a lot of time between now and filing to read and learn 38 CFR 3, 38 CFR 4, M21-1, and M21-1MR. All of our claims are decided based on these regs and manuals.

Now, for the conditions that you already have to file on:

Posterior Tibial Tendinitis, bilateral (Adult Acquired Flat Feet) - Local DPM

Planter Faciitis -VA

They cannot rate both of these seperately. That would be pyramiding and is against the regs. File for both, but you want them to rate the bilateral flat feet. They both are supposed to be rated under the same diagnostic code, but this one is bilateral, so the bilateral factor will apply giving you a higher rating. I would not expect more than 20% for this condition.

Illiopsoas tendinitis - Loma Linda Med Ctr Ortho

Hip Labral tear - Loma Linda Med Ctr Ortho

Again, file for both, but pyramiding will apply. Most likely these would be rated based on range of motion. You can find the rating criteria for this in 38 CFR 4.71a. You may expect another 10%-20% out of this.

Pyriformis Syndrome - Loma Linda Med Ctr Ortho

I don't know the dx code on this one, but I would say a service connection of 0%-10%.

Muscle and nerve damage to thigh - PCM

I would think no more than 10% on this.

Hypertension >160/100 >3x per week - VA & PCM

I'm not up to speed on the heart stuff, but I think I have read that this would be a 0% rating. Somone with more knowledge will chime in.

Biceps tear - Local MTF & ortho

Again, I would say not more than 10%.

Elbow tendinitis - Local MTF & ortho

Probably based on ROM, again 10%

Allergic Rhinitis - VA & PCM

Sinusitis - VA & PCM

This would be another pyramiding case. There are several factors that the rating will depend on, but maybe 0%-10%.

DDD - Loma Linda Med Ctr Ortho

This will be your biggie. So many things can hinge off of this in the future that it'snto even funny. It will be rated under dx code 5243, Intervertabral Disc Syndrome, and it will be rated under either incapacitating episodes (doctor prescribed bed rest) or on ROM. Since you are on active duty, I would think it is safe to say yours will be on ROM. If you are able to bend over and touch the floor, you'll get a 10% rating at best. The thing to know, though, is that this condition will do nothing but deteriorate over time. If the affected area of your spine is in the lumbar region, watch for symptoms of pain/weakness in the legs and urinary/fecal incontinence. These are the typical types of progression for this disease. High ratings can come from this in the future. Please click the link to the spine claim repository in my signature line for a ton of info on back claims.

Wrist fracture, Plate in, Plate out, Arthroscopic reformation of carpal bones/tendons, neurectomy - Loma Linda Ortho

This one will also be based on ROM. You can find this in 38 CFR 4.71a, also. Might be another 10% rating.

Some others that come to mind are Tinnitus (ringing in the ears), hearing loss, runners knees, and either PTSD, or a mood disorder due to a general medical condtion (you get pissed off too easliy due to all the pain you are constantly in). Try to get diagnoses of these things prior to your retirement (if they are actually bothering you) and be sure you mention all of them in your exit physical.

Dbltap1,

good advice from all here, especially Carlie and Rentalguy.

The advice that Rental gave you is pretty much verbatim that i got from a great NCO who retired 12 months before me and warn me of what he did not do because he did not know what to expect from the VA. :P

I can't stress how important that separation/retirement physical will be; you must and I stress, you must list any all all ailments that you want to claim during your separation/retirement physical; if you don't, believe me the VA will use it against you later on when you are least expected. Watch out for the ole' oke-doke from the VA! :o

One bit of advice I was given before I had my retirement physical; go by the clinic and pick up the paperwork that they want you to complete at least a week in advance and also have a copy of your medical records.

I did this and completed the 21-526 over the weekend before my retirement physical and I was glad I did.

Other Soldiers in there were trying to complete the forms but were "rushed" because the doc would call their names so fast and they could not remember what they wanted to claim. :P