Pending Dro Hearing With New Diagnosis

[slphelan]

Good evening. I need a little help in research.

I was granted a service connection for my right ankle achille's tendonitis 10 % and Facial Scars 0%. I have 4 other items on appeal (Migraine headaches, IBS, Lumbar Strain, and Left ankle instability secondary to sprains) and I am preparing for a DRO hearing for those conditions. I have good medical opinions for these claims to provide a nexus for service connection.

In the interim I have been diagnosed with Osteoarthritis of Bilateral Hips and the Cervical Spine with radiculopathy. I will post my MRI of the Lumbar and C-spine below. Currently treated at the Tampa VAMC for all conditions and my Regional Office is at the Bay Pines VAMC.

My Lumbar Spine MRI confirmed Degenerative disc disease and degenerative joint disease Cervical Spondolysis. Left posterolateral annular fissure and small protrusion of L3-L4; L5-S1 spondylitis bulge and left paracentral protrusion that may impinge on s1 nerve. Bilateral frontal encroachment on L5 nerves, and clinical correlation suggested. Suspected Filum terminale lipoma.

C-spine MRI # 1 revealed: Moderate multilevel degenerative change with compromise of the ventral subarachnoid space and neural, and encroachment on the spinal cord. Disc osteophyte complex C3-C4, C4-C5, and C5-C6. C6-C& bony spurring and broad central protrusion.

C-Spine MRI # 2 revealed: The patient has a congenitally narrow cervical canal secondary to short pedicles throughout the cervical spine. Stable multilevel disc disease is seen from C3-4 through C6-7 as described earlier. There is evidence of canal and foraminal stenoisis without significant interval change. The MRI signal within the cervical cord is normal. There is no evidence of intradural mass lesion or cervical cord edema or myelomalacia. Intervetebral discs and motion segments: C2-3 and C3-4: The C2-3 disc level is unremarkable. At C3-4 there is a broad bulge touching but not compressing the ventral cord. There is bilateral foraminal narrowing secondary to uncovetebral joint hypertrophy. C4-5 and C5-6: At C4-5 there is a broad disc bulge with asymmetric spondylitic protrusion and osteophyte complex to the right causing indentation of the ventral portin right lateral recess stenosis. There is marked compression of the right C5 nerve root and moderate canal stenosis. At C5-6 there is a broad disc bulge indenting the ventral cord with moderate canal stenosis. C6-7 There is a broad spondylitic disc bulge and osteophyte complex causing ventral indentation of the cord and mild to moderate canal stenosis.

My questions are:

I had no service injury disease for my Cervical or the Osteoarthritis of my hips: Other than 22 years of repetitive trauma in service. I did have multiple injuries to my lumbar spine but on initial submission was denied a service connection.

1. Would I file these as secondary to my Right ankle instability for which I have a service connection?

2. Should I wait until after the DRO hearing to see if I am granted service connection for my back strain?

3. Is there any research that will show a nexus to ankle, hip, lumbar, and cervical degeneration?

4. Do the neck and back qualify for Intevetebral disc syndrome?

5. What would be the appropriate way to file for service connection since I have been granted one and have a DRO hearing pending?

[Rockhound]

However you go about it, Just like in your other claim, your still going to need a medical opinion that provides a nexus of your SC ankle to everything else or any truama you had in service. Evidence of the injury alone will not get you anywhere. IMHO

Rockhound Rider :P

[Berta]

I agree with Rockhound- it is certainly reasonable (and searching the net could find plenty of support ) to potentially service connect some if not all of these disabilities to your SC as secondary-

BUT the VA wont care a bit unless you have a strong medical nexus that holds a complete medical rationale for secondary problems.

This case shows how one SC ankle disability caused the other ankle to have secondary SC disability:

http://www.va.gov/vetapp08/files4/0833959.txt

I see a BVA case that showed how a vet had flat feet SCED-which caused not only ankle disability (probably severe pronation) but ultimately caused knee, hip and back problems which the BVA awarded TDIU on (100% comp rate)

Still- these decisions are made specifically on the claimant's medical records-

A strong medical opinion would be needed to get some if not all of these other problems service connected as secondary.

And if you get an IMO- the doc should state (if you are not working) of these conditions and any meds for them render you unable to work-

If you get a strong opinion like that (I cannot determine at all if the med recs would support TDIU)

but then you could send VA the IMO in support of the claim with a TDIU application at th same time.

"I had no service injury disease for my Cervical or the Osteoarthritis of my hips: Other than 22 years of repetitive trauma in service"

If a doctor makes this point with full medical rationale and points to your inservice MOS as definitely causing repetitive trauma- this could be a strong point in your favor for this claim.

[Berta]

Repetitive trauma-

http://www.va.gov/vetapp08/files4/0827403.txt

This is case of paratrooper who sustained repetitive injury due to his MOS.

http://www.va.gov/vetapp08/files3/0820709.txt

This vet was injured to one shoulder in service but also VA determined he had suffered bilateral repetitive trauma due to the use of the lateral driving sticks in Vietnam to control the APC he drove.

[john999]

You need a medical opinion even for secondary conditions related to a presumptive illness or injury like agent orange. I was SC'ed for DMII due to AO exposure. I have secondary conditions from the DMII. I had to get medical opinions to get secondary service connection for every and all these conditions which is a pain in the ass. Even when you state or claim the obvious secondary connection you need a medical opinion to make the nexus. I had medical opinions from the VA's own doctors and I still had a battle on some issues.

[slphelan]

Thanks for the helpful information. I will defer this claim until I have my DRO hearing at the same time obtaining and gathering a nexus to these conditions.

I am hoping to get service connected for my lumbar spine by presenting the IMO new evidence at the hearing.

Will I have a stronger case in the new nexus secondary to the lumbar strain that now has casued the lumbar spondylitis and disk bulging at L5 for IVDS? This is new eviddence since I was last denied for the lumbar strain.

[71M10]

One very simple question to ask.

When did you get out?

If the VA/VAMC has found these things within the first year it will simplify the issue of service connection.

Since arthritis is a chronic disease if it is diagnosed or you can prove conclusively that you had it within the first post year it is direct service connection not secondary.

Best regards,

Tyler