Received Partial Decision

[cannoncocker]

2 Questions not knowing whereelse to post them and they are in a general nature

1. The decision document stated:

Dated June 23, 2009

Claim submitted April 22, 2008

In the decision paper it stated:

We have deferred a decision on the following issues because we need additional information or evidence:

1. Chronic Anxiety

2. High Frequency hearing loss

We have requested a medical examination. You will be notified of the time, and place to report.

In a box on the same page number 2, it states you should have already received a letter about our request. If not please contact our office.

The only examination or documentation I have received was regarding number 2 which was QTC Examination Audiology 31 March 2009

KAY MARIE ARADO M.A.,CCC-A,FAAA

Speech, Language and Hearing Service Providers Audiologist

80 DOCTORS DR HENDERSONVILLE, NC 28792-7290 US

Tel: 828-684-8501

Which I completed. I have no other exams scheduled.

Do I just wait for the VA to act or can I fulcrum the system to schedule the exams by their own document states I should already have?

2. Chronic anxiety. This is tied to question 1 since no exams have been scheduled. I experience panic attacks chronic anxiety but I was a special weapons chief so it was not the sort os thing you would discuss if you choose to keep your job. i have document the orgin with the VA psychologist but does anyone have any suggestions they would putsue in this situation other than what I have done, ie maintain my VA psychologist appointments?

Last and only issue I have is I was denied Lumbar Spine injury with radiating pain. i was in the field artillery for 6.5 year in 155mm qnd 8 inch ronds with a smal frame 5'6" weight 130 lbs. I have an Emergency Room copy of my progress notes, but they naturally saw medical discharge written all over me since I was going to ets in about 2 months, but they did no x=-rays etc, described chief complaint as pain at waist level. Who could dodge an issue better than that? Who would walk in an emergency room for the first time in their life and tell the doctor I have pain at my waist line? That doesn't pass the laugh test. If you can move then do so towards the door. They precribed motrin and said hit the bricks. I went back later to my company medic for a change of medicine, which he gave me anothe nsaid type thing, after I took annual leave to recoup, which I had planned on cashing out.

I have 2 current MRI's which show one screwed uo lumbar with a pinch S1 Root Nerve which i take hydrocodone for. Various buldges, protrusions, extrusion, and degenerative disease.

Any suggestions to pursue a dissagrement with that decision?

If I should break this up and post elswhere please tell me.

Thank you for any help.

[Berta]

Also- a NOD certainly is what they use to prepare the SOC-

Statement of the Case.

It is well worth to take the time to state why their decision is wrong and to refer to specific evidence that should have been used to support a favorable decision.

It is the initial way to question if they did not list all of your evidence or listed it but never referred to it in the decision.

It is also the time to send to them a copy of their own regs regarding the decision if they have erred on interpretation of the regs.

You should have received a VCAA letter and election notice prior to any denials.

These letter should be prepared for each specific claim, with a highlighted area where the VA states exactly what evidence they need.

If you complied with the VCAA request and sent back the signed election form-they might have missed important evidence you already sent when they made the decision.

[Pete53]

The Service Organizations for the most part have better people embedded with the VARO's. I think that it is only prudent to retain a Service Organization even if you are working your own claim.

[cannoncocker]

Pete53/Berta/Sharon, I am sorry it took so long to get back but I rent/buy/repair houses in one state and live in another so I stay jumping from one place to another. So excuses aside here are my reponses and I'll start by thanking all of you for caring. These responses have been very beneficial in my current Request for Reconsideration (denial of Lumbar Spine Injury)while waiting for deferred items(2 Chronic Anxiety and High Frequency Hearing Loss). I will start a separate thread for the chronic anxiety but I only have a couple of specific questions regarding that.

Pete53: I could not agree more that you need someone on the inside of the VARO, I just happen to be unlucky in that regard. I could blame them, they could blame me. All irrelevant. I will say this, I found a DAV rep located at out local VAMC that I could talk to face to face. That to me was the key. He actually called me re my case. I basically am running my own case but I do need his help on many things and all I have to do is get in the car and go to his office. When I was dealing with the DAV at the VARO I was their poster child for villain. They called me one time. that was to tell me to stop sending them paper and stop responding to the VA. Yes that was their command to me. Not advise, but order. All is great now that I have someone I can meet with when necessary. I hope others better luck and if you can find a person or person with liaison to the VARO that was most beneficial to me.

I have also found you can get multiple ideas on any given question so you are ultimately responsible for your claim, hence I am here asking question. No such thing as to much knowledge.

Hi Berta, yes this is a request for reconsideration. I asked my DAV Rep that precise question and that was the answer. I did Briefly state my Request for Reconsideration while with the DAV rep. but once I got home I read the decision specifically the lowe lumbar denial and narrowed down to the gist. I responded to point by point. Where they claim no pain, I attached the MRI evaluation and Neurology statement in writing stating pinched S1 Nerve Root/bulging/protruding/extruded/degenerative disease on and on. Items such as ER notes that I complained pain at waist level. They later at my battalion aid station changed it to lower back pack pain and changed meds from motrin to some other NSAID. I pointed out that no diagnostic work was done at all. No x-rays, blood work, nothing. Additionally I pointed out that I did not go to the ER for the first time in my life and tell them I had pain at the waist line. What is that? Who would complain of that? Front? Back? Side? Left/Right? Would it not be prudent to x-ray and lab work? I told the staff I could barley move, to which I was met with you got in here you can leave the same way. You know, a Sargent getting ready to ets, all they saw was cha ching, that I was looking for a c&p or who knows what but since it has been 30 years and I have just lived with it and not filed anything for it so a claim was not on my mind at all.

Anyway I amended my response on a 4138 with attachements via certified mail to the local DAV and VARO and documented these actions in total with the exceptions of the attachements on their IRIS system to creat a documented paper trail with usps certified numbers.

The original 4138 specified Request for Reconsideration.

I did virtually as you said after the initial DAV 4138 Reconsideration I went line by line of the Decision Paper and responded to them with medical note attachments.

A question I do have is there are statements which, for instance, claim no pain on Straight Leg Test. I actually get sharp shooting pain in the left leg when left leg is raised and pain in left leg when right leg is raised. So what can I do when I am comfronted with an untrue statement? Let my MRI , Neurology consult in writing L1S1 herniated disc/S1 pinched nerve/leg... pain do my talking? I am not sure which exam to which they are referring. The decision paper just makes this statement as a standalone without linking it to any particular exam. Could be QTC, which I don't have the exam results. But what do you do with a blatant untruth?

"Is the exact service nexus (link) established for this-meaning if this was due to your MOS -did they clearly seem to comprehend what your MOS involved?"

Absolutely I pointed out that I was in Field Artilerry for 6.5 years and attached the NIOSH lifting equation:

[Field Artillery]203mm [in 8] How He , m106 Description 198.42 lbs 90 kg

[Field Artillery]155mm HE & ERFB-BB Specifications 94.799 lbs

http://www.emcins.com/lc/niosh.htm

That for my body size and type that was way beyond acceptable standards. Which is what I believe set me up for lower back injury/degenerative disease/protrusions/extrusions etc. it was physical training incident that ust set the pain off, pinched the S1 Nerve. This sent me to the Ft. Polk ER and battalion aid station

"Did they specifically refer to your SMRs at all?" None it reads like this:

On VA examination you gave history of back pain since 1984. This condition is not due to injury or trauma."

No Lab work. No Scans. No Mri's. No X-rays that support that statement.

Since they did no definitive examination at the Ft. Polk ER other than look ate me, zero diagnostic testing how can I prove or disprove that statement?

The only proof is my current condition/My ER noted,my battalion aid station notes/30 day annual leave to recoup when anybody else would have cashed them in. I was put on light duty by my btry commander. 6.5 years of lifting and carrying weight well beyond US national standards.

All circumstantial at Ft Polk since they did not do a minimum of testing. If this were civilian they would be sued for malpractice. They had no idea what was wrong with me and could not care less.

Hi Sharon thank you for helping me. I think the deffered items are covered because they cover 2 items:

1. chronic anxiety= QTC examination appoitment already issued.

2. High Frequency Hearing Loss= They stated additional information is needed from the QTC Audiologist. I have no idea what that is code for or if I should do anything about that?

It should go without saying how much help you provide to us by doing all the hard work to gather the body of knowledge to contend with the C&P Claim process and providing it with us.

Thank you all!

[john999]

The easiest way to rebut a bad C&P exam is to get your own medical opinion to refute each and every mistake or lie in your exam.

[12R3G]

CC

"Could be QTC, which I don't have the exam results. But what do you do with a blatant untruth?"

An IME to go along with the MRI/Neurology reports confirming pain in the legs would be a tremendous help. but, so would a statement from you attached to the reports that refutes the statement and accurately describes your symptoms. If you didn't already, you can ask for a new C&P.

[Gulfvet]

2 Questions not knowing whereelse to post them and they are in a general nature

1. The decision document stated:

Dated June 23, 2009

Claim submitted April 22, 2008

In the decision paper it stated:

We have deferred a decision on the following issues because we need additional information or evidence:

1. Chronic Anxiety

2. High Frequency hearing loss

We have requested a medical examination. You will be notified of the time, and place to report.

In a box on the same page number 2, it states you should have already received a letter about our request. If not please contact our office.

The only examination or documentation I have received was regarding number 2 which was QTC Examination Audiology 31 March 2009

KAY MARIE ARADO M.A.,CCC-A,FAAA

Speech, Language and Hearing Service Providers Audiologist

80 DOCTORS DR HENDERSONVILLE, NC 28792-7290 US

Tel: 828-684-8501

Which I completed. I have no other exams scheduled.

Do I just wait for the VA to act or can I fulcrum the system to schedule the exams by their own document states I should already have?

2. Chronic anxiety. This is tied to question 1 since no exams have been scheduled. I experience panic attacks chronic anxiety but I was a special weapons chief so it was not the sort os thing you would discuss if you choose to keep your job. i have document the orgin with the VA psychologist but does anyone have any suggestions they would putsue in this situation other than what I have done, ie maintain my VA psychologist appointments?

Last and only issue I have is I was denied Lumbar Spine injury with radiating pain. i was in the field artillery for 6.5 year in 155mm qnd 8 inch ronds with a smal frame 5'6" weight 130 lbs. I have an Emergency Room copy of my progress notes, but they naturally saw medical discharge written all over me since I was going to ets in about 2 months, but they did no x=-rays etc, described chief complaint as pain at waist level. Who could dodge an issue better than that? Who would walk in an emergency room for the first time in their life and tell the doctor I have pain at my waist line? That doesn't pass the laugh test. If you can move then do so towards the door. They precribed motrin and said hit the bricks. I went back later to my company medic for a change of medicine, which he gave me anothe nsaid type thing, after I took annual leave to recoup, which I had planned on cashing out.

I have 2 current MRI's which show one screwed uo lumbar with a pinch S1 Root Nerve which i take hydrocodone for. Various buldges, protrusions, extrusion, and degenerative disease.

Any suggestions to pursue a dissagrement with that decision?

If I should break this up and post elswhere please tell me.

Thank you for any help.

What was the partial decision? Did they grant 1 of your claims?