I Am Not Just Angry

[rdnkjeeper]

I am pissed. (Sorry, but I am)

I got my award letter today. They said that everything has stayed the same so they are leaving me at 20% for "low back strain". For those that missed it I have 4 herniated discs, 5 bulging discs and a bunch of other stuff according to my MRI. I can hardly do my job, I can barely live day to day. But the dang doctor I saw lied his butt off. Said no pain, no sciadia (sp?), and a bunch of other stuff, but I do have that stuff. So I am going to get a report from the neuroligist and a few other people and send down a NOD, but I am actually thinking about filing a CUE. My chiropractor is pretty POed when he reviewed all my medical records and said why didn't they treat you for the numbness in you butt and stuff. I said I don't know. There is also a note in my medical records suggesting an MRI, when I saw a Doctor at my local clinic, she said it is just a "Mechanical Back".

Any advice? I have to wait until after the Neuro appointments before I do anything. I am actually thinking about hiring an attorney.

[john999]

I would go ahead and hire the lawyer if he is an expert in VA law. He gets 20% of your retro, but probably will know doctors who understand what is needed to get a higher rating and how to get it.

[poolguy11550]

I am pissed. (Sorry, but I am)

I got my award letter today. They said that everything has stayed the same so they are leaving me at 20% for "low back strain". For those that missed it I have 4 herniated discs, 5 bulging discs and a bunch of other stuff according to my MRI. I can hardly do my job, I can barely live day to day. But the dang doctor I saw lied his butt off. Said no pain, no sciadia (sp?), and a bunch of other stuff, but I do have that stuff. So I am going to get a report from the neuroligist and a few other people and send down a NOD, but I am actually thinking about filing a CUE. My chiropractor is pretty POed when he reviewed all my medical records and said why didn't they treat you for the numbness in you butt and stuff. I said I don't know. There is also a note in my medical records suggesting an MRI, when I saw a Doctor at my local clinic, she said it is just a "Mechanical Back".

Any advice? I have to wait until after the Neuro appointments before I do anything. I am actually thinking about hiring an attorney.

It really sounds to me like the rating was fair with regards to the evidence that you presented. If you feel that a higher rating is warranted you will need a rebuttal C&P exam (IMO) preformed by your own medical doctor. Your doctor should change the diagnoses to IVDS if that is the case. Start documenting your back pain episodes and get a prescription for bed rest when the occurrence arises. If you do have sciatica pain that shoots past the knee then claim that separate as secondary to your back issues- if its bilateral claim as such. Reliance on your chiropractor for the IMO or any statements will be given minimum weight by the R/O.

[sharon]

Once you have your medical documentation, you can ask for reconsideration based on the medical evidence. This will send you case directly back to the rating board. It usually takes about three to four months for a reconsideration. In order to ask for a reconsideration you need to include medical evidence, otherwise they just reopen your claim. "REQUEST RECONSIDERATION FOR _______________BASED ON THE ATTACHED MEDICAL EVIDENCE".

[BMCS00]

38 CFR 4.71A similar thing happened to me last year. Part of degenerative disk disease C&P addressed radiculopathy. I described my symptoms, which was quite clear that I had. The doctors report said that I had no signs or symptoms of radiculopathy. So, I went down to my DAV rep and discussed it with him, followed some advice here on hadit.com, and filed a request for reconsideration. The VA scheduled another C&P with the same doc. He said he had no recollections of our discussion about the radiculopathy symptoms, so he did a test or two ... weeks later I got a new decision for 10% for bilateral radiculopathy for both lower extremities.

I didn't need to go see a separate independent doc. In my request for reconsideration, I described my symptoms as I had with the doctor.

The ratings are described in the link below. Depending on your diagnostic code, there may be a certain condition or symptom required to get a higher rating. I encourage you to take a look here and see what it says.

38 CFR 4.B.471a

Keep in mind I think you have to do the request for reconsideration within the 60 window as of the date on the rating decision letter. After that I think you have up to a year to file a NOD (notice of disagreement). I also think that a request for reconsideration only addresses that issue, and won't open any others up that you may have had on your claim or that you have already been rated for.

The system does work sometimes ... but sometimes it needs another look. Best of luck,

--Jim

Life is good! B)

Edited January 27, 2009 by BMCS00

[rentalguy1]

You can get the dx changes to IVDS by a nexus statement from your PCP, but there is not really a need because most spine ratings are based upon ROM. If your ROM's measured in the C&P exam match up with the rating criteria for 20%, then I would not even appeal this. You would get the same result. Also, without a clear diagnosis of sciatica and a clear nexus relating the sciatica to the back troubles, they cannot sc it on a secondary basis.

My advice; get PCP or Neuro doc to write a nexus statement stating that your "current diagnoses of IVDS (herniated discs-same thing) and sciatica, as exposed on the recent MRI and in recent physical examinations, is at least as likely as not related to your service connected back condition. Common medical knowledge dictates that the patient's current diagnosis represents normal, degenerative progression of this type of injury. Then file a new claim for increase. While waiting for a new C&P, study the exam worksheet and the rating criteria for spine conditions and sciatica so you will better know what to expect.

[rdnkjeeper]

The thing is when he did the ROM test he said tell me where there is pain. Told him, that is no where in the report or anywhere else. He said force yourself to go as far as you can. I told him that it is painful, but he said do it anyway. Most of this was done before I found Hadit.com. According to the spine exam, he didn't even do half of it. My PCP won't give me a diagnosis, I don't know why. I asked him point blank if I had IVDS or what I have....He said you probably do have it.....

So this is what I am going to do. I am going to get a write up from both neuros and my PCP, plus my Chiro. I know the Chiro won't do much but I am going to include it anyway. And send it down for a reeval.....make sure I don't take any pills the day before and have a copy of the exam with me to make sure it is done properly this time.

The part that makes me so angry is they didn't even look at my med records.....everything was just off of the C&P that the guy didn't do.

Hope that makes sense.