diabetes Request For Reconsideration Letter, Please Review

[pilgrim01]

Okay. I retired in Nov 2008. I filed for disability in Aug 2008 under the Pre-discharge Program. One of my claims was for numbness and tingling of the right foot. It started in 2006. I went to the doctor and complained of numbness/tingling down the back of my leg to my right foot. The doctor concentrated on my right foot. I thought that was okay, I am not a doctor. Well, I was put on Neurontin and sent to Physical Therapy. Well, I retired Nov 2008. In Feb 2009, I went back to the doctor (A NEW DOCTOR) about the same condition. Her first response was "Let's get some x-rays and mri's of your back". Lo and behold, I have all these protrusions and nerve damage, etc. Well, on March 16, the VA made a decison on my disability. My numbness/tingling of the left foot was denied. Keep in mind they knew nothing about the x-rays and mri's because the evidence regarding this condtion was discovered through the x-rays and mri's since I retired. I was told by a DAV Rep that "since I wasn't seen about my back in service that I probably will be denied." While in service, the focus was on my right foot and not my back. That was the doctor's choice, not mine, and I am not a doctor. My new doctor is the smart one that said, Hey, let's check your back!" Do you all think I have a chance? This is not fake. You can't fake x-rays and mri's, I don't think.

Here is the letter I want to send to the VA. Please tell me what you think I should add or take out. Thanks, hadit!

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To whom it may concern,

Please accept this as my REQUEST FOR RECONSIDERATION of your decision letter dated 16 March 2009. The reason I disagree with your decision are as follows:

Issue 1: Numbness and tingling, right foot

Decision and Basis:

In the decision letter of 16 March 2009, It was stated, “Although there is a record of treatment in service for numbness and tingling, right foot, no permanent residual or chronic disability subject to service connection is shown by the service medical records or demonstrated by evidence following service.”

Background:

This condition seemed to have started during a vacation in the summer of 2006 and I had a wallet in my back pocket. I assumed the wallet had something to do with the numbness and tingling so I went to Langley Air Force Base Medical Center because the condition did not subside.

When I first complained of this condition on 14 July 2006 at Langley Air Force Base Medical Center, the numbness and tingling from my lower back, down the back of my right leg to my foot and my Primary Care Manager concentrated on the numbness and tingling in my right foot vice its origination. I was checked for diabetes. The results were negative. I was prescribed Neurontin and referred to Orthopedics.

On 26 Jul 2006, again, at Langley Air Force Base Medical Center, during my appointment at Langley Air Force Base’s Orthopedics, the doctor stated that he was referring me to Navy Medical Hospital-Portsmouth for an EMG and to Physical Therapy for four weeks.

On 6 September 2006, during a follow-up appointment in Orthopedics, the doctor stated “there was an improvement in the Neuropathy and Radiculopathy symptoms after taking the Neurontin”.

Please keep in mind, there were NO X-RAYS or MRIs COMPLETED.

On 24 Feb 2009, I went back to the doctor at Langley Air Force Base Medical Center for numbness and tingling of the right post thigh that radiated to lower leg. I explained to the doctor how this has occurred in the past and the doctor’s first response was “I need to get an X-rays and MRIs of your lower back”.

The results of the X-rays (Langley Air Force Base Medical Center) were: “Disc space narrowing is moderate and in extent at L5 – S1. Multi-level spondylosis is seen.”

The results of the MRI (Sewell’s Point Navy Medical Center-Norfolk) was: Multilevel spondylotic changes of the lower lumbar spine. Noted endplate spurrings, anteriorly, of the L3 superior and inferior endplates, L4 superior and inferior endplates and L5 superior and inferior endplates. There were subtle narrowings of the L3-4 and L4-5 disc spaces, as well as significant narrowing of the L5-S1 disc space. There was sacralization of L5. Lateral spurs of the endplates adjacent to the L3-4 disc space and the inferior endplates of L4, bilaterally. There are also noted anterior spurrings of the L3, L4 and the transitional vertebrae.

The L1-L2 level shows posterior intraspinal and left paramedian protrusion of the disk with extension of the disk protrusion into the left L1-L2 neural foramen. There is resultant impression on the intraforaminal L1 nerve root.

Evaluation of the L2-L3 levels shows a broad posterior intraspinal protrusion of the L2-L3 disk with extension of the protrusion into the inferior recesses of the neural foramina bilaterally with impression on the bilateral intraforaminal nerve roots-worse on the left than the right. The left side has findings compatible with a left lateral herniation in addition to the intraspinal protrusion of the L2-L3 disk.

Evaluation of the L3-L4 level shows broad posterior intraspinal protrusion of the disk with extension of the disk protrusions into the inferior recesses of the neural foramina bilaterally with significant impressions on the intraforaminal nerve roots and with worst impressions on the left than the right. The broad posterior protrusion combines with bilateral ligamentum flavum and facet enlargements to produce significant narrowing of the spinal canal with bunching together of the caudal equine nerve roots at this L3-L4 level.

Evaluation of the L4 transitional level shows broad posterior intraspinal protrusion of the disk with extension of the protrusion into the bilateral inferior recesses of the spinal canal with impressions on the bilateral intraforaminal L4 nerve roots. Impression on the right nerve root is worse than on the left at this L4-L5 level.

I was diagnosed with Radiculopathy due to my current back conditions. I am currently on medications Celebrex and Neurontin. I have been referred to Pain Management and Physical Therapy.

Conclusion:

I find it reasonable to expect a favorable grant of the benefits sought in this Reconsideration for both Radiculopathy for the nerve damage(s) and my current back protrusions, disk damage and narrowing of the disc spaces.

All of the statements contained herein are true and correct to the best of my knowledge. There is no further evidence in existence at this time in regards to this Reconsideration.

Thank you for your timely attention to this delicate matter.

Sincerely,

Pilgrim01

[Berta]

Okay. I have an appt with my doctor in the morning. Correct me if I am wrong, I need her to explain how the initial visit (mis-diagnosis during active duty) relates to my current condtion in which they didn't even check my back, only my foot, because I said the pain went down my leg to my foot. I also need the doc to expalin the conditions even though the MRIs and X-rays explain them in detail? Thanks.

Yes-she needs to establish your current problems due to inservice problems in your SMRs (even if not diagnosed properly there)

I helped a vet do this in an intricate claim and once I decifered the SMRs thoroughly ( it took me days) the IMO doc knew what to write as to the nexus. He also had been misdiagnosed in the mil.We had to make that point clear to the VA by using his documented symptoms.

Your doc if willing-should make a nexus statement as to 'at least as likely or not' or 'more than likely' that your present cpnditions are related to whatever she sees in the SMRS regarding them.

Edited April 6, 2009 by Berta

[pilgrim01]

I really don't understand when you say "nexus statement". B) How do I get a copy of an IMO?

Edited April 6, 2009 by pilgrim01

[poolguy11550]

pilgrim- your letter needs to be shorten up, anyone reading it stop after the first paragraph. Also do not use the word disagree unless you are filing a notice of disagreement. Go to web MD or other medical web cites and print out medical literature that applies to your condition. Write a strong statement in support of your claim also. PM me if need further help.

April 6 2008

Your veterans NAME

#1 Appeals Way

Any town, USA 00000

CSS: 000000000

Dear Sir/Madame;

I ask that the VA to reconsider my claim with new evidence for the following condition:

1. Lumbar condition with radiculopathy.

Since filing the original claim my current doctors have discovered via x-ray and MRI that I have a lumbar condition. I am providing the following medical literature that shows that the general medical community is well aware that the symptoms and complaints I had while in-service could highly be related.

Attached are my doctors treatment notes, medical literature, and lay statements from myself.

Respectfully,

Signed your Veteran

Edited April 6, 2009 by poolguy11550

[pilgrim01]

Oh my! B) You guys are great! :D I truly appreciate the draft letter! Wow! Thanks!

Do you all suggest I continue to use AMVETS or do this myself? Would one have more leverage than the other?

[poolguy11550]

Oh my! B) You guys are great! :D I truly appreciate the draft letter! Wow! Thanks!

Do you all suggest I continue to use AMVETS or do this myself? Would one have more leverage than the other?

Its up to you, but I'll say this- its your claim and nobody will care about your claim as much as you do.

[pilgrim01]

Thanks, poolguy. Have you done this yourself or anyone else that is reading?