New Member With Questions About Reopening Claim (sorry, Long)

[sleepyjenn]

Hello, I've been a member for a while here, but I've never posted. I would really love some input from you all about the best way to go about reopening my claim with the VA. As of right now I am rated at 40% total, which breaks down to: 30% for Insomnia, 20% for cervical radiculopathy and strain with left upper extremity weakness, and 0% for mild left sacroiliitis. The 30% for Insomnia was based on a sleep study that showed disturbed nightime sleep. No MSLT (daytime sleep study) was done at that time. The 20% for cervical radiculopathy was for left shoulder pain that I had been seen continuously throughout my military service for, but had never gotten a firm diagnosis. Now, here is where I have questions.

Since being discharged in May 2005, my primary care doc (I am lucky that I am married to someone who is still active duty, so I still receive care in the base clinic) ordered an overnight sleep study with MSLT based on my continuing complaint of being constantly exhausted. Sleep issues/fatigue were well documented in my service records. The sleep study and MSLT found pathologic daytime sleepiness. My doc gave me the diagnosis of Idiopathic Hypersomnia. This is the first issue.

Second, doc ordered a cervical MRI to try and establish a firm diagnosis, based on the VA opinion that I have cervical radiculopathy. The MRI findings were:

Findings: There is a slight straightening of the normal cervical lordosis. The signal of the spinal cord is normal. There is no evidence of tonsillar herniation. All cervical vertebral bodies are normal in height and contour.

C2-C3 and C3-C4 show no significant disc bulge or disc herniation. The central canal and neural foramina are patent.

C4-C5 shows minimal disc/osteophyte complex posterocentrally. This is better visualized on the axial images. No significant central canal or neural foraminal narrowing is identified. There is left uncovertebral hypertrophy.

C5-C6 shows bilateral uncovertebral hypertrophy, which is more prominent on the left. There is superimposed bulge. No significant central canal or neural foraminal narrowing is seen.

C6-C7 and C7-T1 normal

Impression: Minimal Spondylitic disc disease of the cervical spine, predominantly at the level of C5-C6 and C4-C5.

My symptoms are neck/left shoulder/shoulder blade/left arm pain, numbness, tingling, burning. Weakness and shakes in the left arm at times. I am 28 years old, and these symptoms began when I was 23. It is well documented in my service records, just no diagnosis. I have an appointment with a neurologist in a week. This is issue #2.

Third, my primary care doc just diagnosed me with Rosacea. I have an appointment with a dermatologist on Monday.

Okay, the questions are: How do I go about submitting this information? One of the conditions is completely new (rosacea), but since I've been out for less than a year there will be a presumptive service connection, correct? When I go to the dermatologist and neurologist what information should I get from them to submit? Keep in mind these are not C&P exams, so the drs. will not be going by VA protocol. Do I ask them to write some sort of statement of their diagnosis? Any thoughts on what the heck my MRI findings mean? Has anyone had any experience with "spondylitic disc disease" (whatever that means--is that DDD, DJD, IDD, arthritis???), "Idiopathic Hypersomnia" or any similar sleep disorders, or "Rosacea?" If so, what ratings did you get or what ratings would you expect me to get? Increase of current rating, decrease? I think that's all my questions. Like there weren't enough of them, right? B)

Any who read/respond, thank you, thank you, thank you. I know I just wrote a lot of information to wade through but I wanted to try to give all the pertinent facts. If anyone needs more information to answer any of my questions, please let me know.

Thank you,

[Pete53]

Welcome to Hadit Jenn and good luck on your claim. You are proceeding in a way that should help but I don't know enough to post on technical merits of your claim.

[Guest Berta]

Presumptive diseases- there are 5 types-

Presumption for Tropical disease : 38 CFR 3.307 (a) (4) (2005)

Presumption for Radiogenic diseases: 38 CFR 3.309 (d) 2005

Presumption for former POWs : 38 CFR 38 CFR 3.307 (a) (5) (2005)

Gulf war chronicity as defined in:

7-IV-6

February 5, 2004 M21-1, Part VI

Change 110

7.22 COMPENSATION FOR DISABILITIES ASSOCIATED WITH GULF WAR SERVICE

Also presumptions defined in the Agent Orange disease list

And Presumption for chronic disease-38 CFR 3.309 (a) (2005)---this is the one that fits most veterans with a presumtive claim-

Those diseases (chronic presumptive ones)must be manifested to a degree if at least 10% within one year of service and are listed within:

38 USCS 1101 (3) and 38 CFR 3.3.09 (a) 2005-

You might have a disability somehow falling into that criteria---

I hope this legalise hasn't turned you off! Welcome aboard veteran and thank you for your service-

I think you might have misunderstood the presumptive regs-

If a veteran files a claim within one year after discharge and the claim is awarded -the retro date for comp goes back to the day after discharge-

Rosecea- here is a rosecea claim granted at the BVA-

http://www.va.gov/vetapp95/files3/9513458.txt

It might help you-

I guess my point is unless you fit into the Chronic presumptive list at 38 CFR 3.309 (a)-or any other presumptive category- then you would need medical linkage to your service.

This claim might be better- it has the rosecea ratings and how they determine them;

http://www.va.gov/vetapp95/files3/9513458.txt

[wallyg]

Sleepy,

Since the Idiopathic Hypersomnia and the Rosacea are newly diagnosed conditions, get the specialists to do a good write up on them, you might want to download/print the C&P examinations for these, to show the doctors. Then file new claims, ASAP.

For the spinal report, you MIGHT be able to get a 0% SC, which will be good, because it will likely get worse, as you age. The symptomalogy that you describe, suggests a neuropathy.

[sleepyjenn]

I guess I'm confused about why you think the Idiopathic Hypersomnia is a new condition? It's not. The sleep issues have been ongoing for years, as documented in my service records. There just wasn't a good diagnosis of it yet, so the VA rated it as "Insomnia" at the time of my initial claim. They knew that a second sleep study was going to be done. There is some mention of that in my initial award. So really, I would just be submitting new information about the same issue I already had. Since IH is somewhat more severe than Insomnia, I was wondering if anyone had any thoughts about how they might rate it. It is sometimes called by doctors "Non-REM Narcolepsy."

Also, why would a degenerative spinal condition only be a 0% SC? As above, this is only new information about a condition that I already had. They already knew I had neck/shoulder issues, they just didn't know that it was rooted in a disc disease. Can you please clarify your reasoning on this? Are you saying it would be a separate rating from the cervical radiculopathy rating?

The rosacea thing, I admit I don't have a clue about how that would work. I spoke to someone at the VA yesterday, and he told me that yes, there was a one year period when any new conditions diagnosed were presumed to be service connected. I've only been out for 8 months. Maybe I misunderstood this...I'll do some more research.

Thank you for your replies, and I'm sorry if I come across as ignorant. I'm trying to learn as I go. I have never had any problems with the VA to this point, and it only took them about 3 months to approve my initial claim. So maybe my problem is that I haven't lost faith in them yet. B)

[sleepyjenn]

PS, I do think that Rosacea would fit the category of a chronic disease, so I'll look into that. I know it's definitely manifested at least 10% because it affects not only my facial skin, but my eyes.

Thanks again.

[Guest jstacy]

Did you have a c and p exam for your cervical spine or did the VA use infomation listed in the SMR.

You have Degenerative disk and Joint disease. You should file it as the same and get an c and p exam.

The C and P exam will measure the limitation of motion on your neck and the extent of the severity of the range of motion is how the VA rates IVDS. You are already service connected for cervical Radioculpathy.

I am a little confused because usually DJD / DDD caused disk herniations andpress ont he nerve roots that cause Radioculpathy.