Duty To Assist Letter

[SSGmajik]

Hadit Family,

Just wanted to get recommendations on what you should put in your duty to assist letter. Should you state CFR 38 criteria according to your claim? Should you put notes from your Doctors diagnosis? I just don't want to forget or mess anything up to get denied.

Thanks,

SSGmajik

[cowgirl]

Okay, I am back for a few, been outta pocket with stuff. Reading over all this solid advice has my chin on the floor. Bet that little guy is cute as the dickens!

I am curious, what did the VCAA letter tell you ? Do they need a doctors name and address, or a form signed so the VA can request additional medical records? or social security disability records? or other employment records? Buddy statements? I cannot imagine much than other medical or employment records or ? records of what the VA would need if they are the main provider of your care.

I attend to my 'adjustment disorder' and depression in the behavorial health clinic. May may want to check that out. Overall I have found the counselors and doctors supportive.

Are you getting social security disability? and applied for VA individual unemployability? seems like very 'logical' things to do if you aren't working due to sc injuries. Let us know how it goes.

There are benefits available to help you balance out things, just ask for whats due you. And don't ever give up. Came on board here with measly 20%, and suceeded in helping my family, saving my marriage, inpatientvacation ....etc. Hadit put AM-2 out, Thank God.

Best to ya,

Cg'up2009!

If you mean the VCAA letter- this letter should tell you exactly what the VA needs from you-

it should also have a Response form with it-

watch the deadlines for any response.

You can copy and send with the VCAA response form whatever evidence they need.

Their statement as to what they need might be specific just to one disability-hard to know here- still it should contain a highlighted or underlined statement as to what they need.

Make sure you get a Proof of Mailing from the PO so you have prrof of what you send to them.

[SSGmajik]

mrsvet28,

I don't think it be "Expeditious"! My initial claim took 558 days 12/2005 - 06/2007! Then I had an increase after surgery that took 320 days and it was a no brainer! I've learned not to expect any type of "expeditious" treatment. It will get done when it gets done and I know there is nothing I can do about it. I wish you luck and hopefully your case is very close to being completed.

SSGmajik

[SSGmajik]

cowgirl,

All the VCAA letter is asking for any medical evidence I may have to support my claim other than the VA. All my treatment is at the VA, but I stii send them copies with highleted relevant notes. Is that bad to do? I was told that it helps, but please let me know if I'm wrong. I am currently employed. I struggle through each day through all the pain just to be able to put food on the table and roof over my families head. I can't afford to wait and see if I would get TDIU. My doctor thinks I shouldn't work, because it will just make things worse. We'll see what happens after this increase. Thanks for all the help and advice. Also, I'm currently 10% for adjustment disorder with depression. Always low balled the first time around!

SSGmajik

[SSGmajik]

The VA will rate the issues based on your back. Your range of motion is the big player here as they only have to rate 1 back condition, IVDS. Anything else is pyramiding.

You should ask for the max back rating of 60 percent and then add the secondaries.

The Regs are clear. If you have nerve issues like radiculpathy, it should have been considered inthe back rating as the regs clearly state to rate neurological deficits separate.

The Migraines are most likely not secondary to chronic pain but are most likely secondary to the cervical djd/ddd you have.

Getting a secondary to chronic pain is difficult but getting it for an established condition is better for you.

Have you filed for IU?

J

jbasser,

I am currently 40% for my lower back, so basically I'm maxed out for mobility. I don't meet the criteria for the 60% because of the doctor does not order bed rest just to take it easy. I will ask that my radiculapathy be rated seperate. Do you know what reg that falls under?

My doctor states that my chronic headaches diagnosed as Cervicogenic Headache caused for the DDD in the cervical spine.

I have not filed for TDIU yet, because I currently work. I fight through pain everyday to come to work and to be able to put food on the table and roof over my families head. My doctor states that it will only make things worse by working, but I have no other choice.

Thanks for the help!

SSGmajik

[broncovet]

To the VA, anything less than 10 years is "expeditious" UNLESS it involves THE VA employee's paychecks.

Then, if it is a day late, they are mad as a hornet.

.....and they wonder why Veterans are so mad..if their paycheck was delayed a year or more, they would be mad, too.

[jbasser]

jbasser,

I am currently 40% for my lower back, so basically I'm maxed out for mobility. I don't meet the criteria for the 60% because of the doctor does not order bed rest just to take it easy. I will ask that my radiculapathy be rated seperate. Do you know what reg that falls under?

My doctor states that my chronic headaches diagnosed as Cervicogenic Headache caused for the DDD in the cervical spine.

I have not filed for TDIU yet, because I currently work. I fight through pain everyday to come to work and to be able to put food on the table and roof over my families head. My doctor states that it will only make things worse by working, but I have no other choice.

Thanks for the help!

SSGmajik

Dont read too much into the bed rest. The Doc said to take it easy, did he give you any restrictions?

Bed rest is an old military term for off of your feet.

General Rating Formula for Diseases and Injuries of the Spine(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes):With or without symptoms such as pain (whther or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or diseaseUnfavorable ankylosis of the entire spine100Unfavorable ankylosis of the entire thoracolumbar spine50Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine40Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine30Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis20Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height10Note (1):Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.Note (2):(See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.Note (3):In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner's assessment that the range of motion is normal for that individual will be accepted.Note (4):Round each range of motion measurement to the nearest five degrees.Note (5):For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.Note (6):Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.