C&p Exam Results (rentalguy1)

[mags1023]

I went to the ROI office nd got a copy of my C&P exam results from 3/27. I think the cervical news is good, but not the Hiatal Hernia/GERD.

I am currently rated at 20% for my cervical spine and requested increase, my ROM for my cervical spine per this exam is forward flex 0-15, ext 0-25, R lat 0-15, L lat 0-20, It states that ROM is consistent with baseline for individual.

The way I read 38CFR, 0-15 for cervical ROM = 30% Rental is that correct??

I had an upper GI that reflects minimal sliding hiatal hernia with Schatzki B. ring. with water. Of siphon test and Valsalva manuever there was episode of reflux to the levl of the aortic arch. Impression: Small sliding hiatus area with water induced reflux. Not caused by, related to, or worsened beyond natural progression by veterans treatment for degenerative changes in the cervical spine or military service.

I have a statement from my Gastroenterologist that states the NSAIDs the VA prescribed "more likely than not" contributed to my hiatal hernia with GERD. My question is whose statement will carry the most weight? I know the VA will probably initially use their C&P doc and I'll have to NOD and appeal, right??? Just looking for anyone's thoughts on this. Thanks, Mags

[rentalguy1]

You are correct on the C-spine at 30% for a 15* or less forward flexion. On the GERD, it's going to depend. If your treating gastro doc has done a scope on you, and made his nexus based on that information, then the evidence will be in relative equipose and the benefit of the doubt rule will apply. If your treating doc did not scope you, and made his nexus based solely on the evidence on record and a minimal physical exam (no scope), then his opinion will be discounted and the C&P results would be favored because it was a more in-depth examination.

I would take this C&P information to the treating doc and see if he can refute the statement made by the C&P doc. I do not know how they can tell what caused GERD by a scope, but I am not a doc.

Edited April 11, 2009 by rentalguy1

[mags1023]

Thanks Rental. Yes, my Gastro Dr scoped me back in 2006 and diagnosed gastritis, esophageal ulcers, and hiatal hernia with GERD. That is when I put in this claim. I later got him to write the nexus with chronic NSAIDs use. The VA just did the Upper GI on me last week. I also had another scope and am awaiting the results. I am hoping it still shows GERD. I have been researching this sliding hiatal hernia with Schatzki B. ring and it looks like they don't know the exact cause, but a high percentage of people with it have GERD and gastritis. I just can't believe this guy is trying to say the NSAIDs had nothing to do with it. Hopefully, they will take the word of a Gastroenterologist over a VA Doc. I think he is a Dr. His Examining provider line states: Brett Jeffrey, DO Does that mean he is a DR???

[jbasser]

DO is aDoctor of Osteopathic medicine which is a little different than MD. A DO can and usually is a Jack of all trades doing surgury one day and delivering babies the next.

They have extra training in the Muscoskeletal system and nerves.

J

[poolguy11550]

I have a statement from my Gastroenterologist that states the NSAIDs the VA prescribed "more likely than not" contributed to my hiatal hernia with GERD. My question is whose statement will carry the most weight? I know the VA will probably initially use their C&P doc and I'll have to NOD and appeal, right??? Just looking for anyone's thoughts on this. Thanks, Mags

Mags- One problem with your doctors statement, "the NSAIDs the VA prescribed "more likely than not" *contributed* to my hiatal hernia with GERD". Secondary claims will be granted for conditions that are the approximate cause of an S/C condition. Follow Rental advice and see what opinion your doctor has as to the exact cause of your claimed condition.

[mags1023]

Mags- One problem with your doctors statement, "the NSAIDs the VA prescribed "more likely than not" *contributed* to my hiatal hernia with GERD". Secondary claims will be granted for conditions that are the approximate cause of an S/C condition. Follow Rental advice and see what opinion your doctor has as to the exact cause of your claimed condition.

Yeah, Thanks. I will have to look at the letter to see the exact wording.

[rentalguy1]

Mags..your evidence should be in equipose at this point, and the benefit of the doubt rule should apply in you favor. I would still have take the C&P results to your doc and have another opinion written. Stack the deck against the C&P quack in other words.