Received New Info On A Pending Claim(mri) What Do I Do Now?

[Nathan104]

Hello all. I currently have my first claim in with the VA after exiting service via disability in Nov 05. I had all my C&P's back in January. I am still under Tricare Prime for the first six months after exiting service so I am seeing a civilian Dr. One of my claims in is for "Lower back pain with sciatic pain radiating into left leg. Well at the C&P they took an X-ray. Thats all Ive ever had. My pain has gotten worse and my civilian Dr sent me for an MRI. The Dr of radiology at the hospital said that I have the biggest herniated disc he has ever seen. The official MRI report states

"EXTREMELY Large Left Herniated Nucleus Pulposus at L5-S1 with a smaller central herniated nucleus pulposus at L4-5 which may still be subligamentous. Desiccation of the L4-5 and L5-S1 intervertabral discs is noted."

They told me that and gave me a scrip for Demerol(first thing that even touches the pain in my butt and leg)

I sent off a copy of this report certified mail today. What Im wondering is, do I need to change what my claim is in for? Or will the LBP with sciaitica cover it and the MRI will show them what the problem is? Things have gotten alot worse in the two months since my C&P's. The pain makes it where I can barely drive anymore. Im going to school full time and cant sit through class anymore. Was hoping I could get a little guidance on the best course of action. Thanks.

Edited March 13, 2006 by Nathan104

[Hoppy]

I would submitt the new report with a specific note that the doctor told you that this is the cause of the LBP and sciatica. get a SO if you do not have one to help you and keep posting to hadit to keep the SO on track.

[Guest Berta]

Nathan- welcome here and thank you for your service!

I agree with what Hoppy said-

They need to be told how this MRI ties in with your service connected problems.

You can send them a letter, in support of your claim referring to the MRI and the date you sent it, and explain a little as to what the report means.

I would mention that the pain requires demerol and that the condition is causing you problems with driving and going to school.

If you have asked the college for any accomodation at all- that too would help your claim.

Even if it is just some documentation that shows you need to take breaks during classes from a sitting position-

Veteran-it must be very hard to drive to school and then sit in classes with this condition-full time-

Have you considered on line courses?

My school is fully VA approved- most enrolled are active military-but many vets and a few civilians like me- all instruction is on line and they offer AA, BA, and Masters Degrees-

American Military University-check us out-

http://www.amu.apus.edu/index.htm

There are many other excellent schools on line-too-that accept the GI Bill, Chap 35, Voc Rehab etc-

You have excellent evidence for your claim. I just hope it doesn't take too long to get a good result from your VARO.

Berta

[Nathan104]

Berta and Hoppy, Thanks for the replies. I have not submitted a written letter with my claim yet. If I do send one in explaining the MRI and the current situation, will it matter that I do not address any of the other issues in my pending claim? And, from the replies, it looks like my original claim of LBP with sciatica will not need to be modified with the new info on the herniated discs as long as I have sent in the MRI report and the letter connecting the two? Just wanted to make sure.

As for my school. The 40 minute drive there is horrible, and my teachers are already used to me standing up throughout class. Ive talked to them about possibly finishing the semester at home somehow since we are now halfway through. Not sure thats going to work out. I may end up with an online school after this semester.

[Guest Berta]

I would focus on this MRI evidence and how it supports your LBP sciatica claim.

The other issues- are they also supported with medical evidence?

[Nathan104]

Berta, thanks again for the help. I wrote up the letter this morning explaining the MRI and my current condition. Going out today certified. As for my other conditions, they are all docemented fairly well in my SMR's. Hypertension is the only ne not really in the SMR. I was diagnosed with it a month after leaving service after the VA doc commented on it during a C&P. Im now on meds for it and I pulled out 4 or 5 pages from the SMR where my BP was high during sick call visits. Hopefully that will be enough. I am thinking I may need to write a letter for that one to and maybe get a letter from my doctor explaing my hypertension and possibly connecting it to service. Not sure on that one. Thanks for the help.

[Guest Berta]

Nathan-I sure would send them copies of those SMRs and even use a highlighter to underline the parts they should consider.

If the hypertension is documented within the month after service, I would highlight a copy of that record too.

It always help to have a doctor's statement saying the condition is "more than likely" due to your service with a brief medical explanation as to the doctor's Rationale aand reasons for that.

Even though it seems obvious that the HBP should be service connected, they breeze through our paperwork so fast, that it pays to highlight on copies-anything in our records that helps.

A local SO had problems- first the VA said the vets records were lost in the ST. Louis fire-

I suggested that the vet try to get them himself with the SF 180-

He got the whole shibang.

Then the VA denied HBP and heart disease because they said nothing was in his SMRs to support.

I carefully looked over the SMRS (with the vet's permission)and his HBP was well documented. He even needed an assigned 'buddy' at one point to escort him to his MOS job because he had been fainting and his HBP readings were quite high.

The local SO circled all this info on the SMR copies yet failed to send the VA the copy stating it was support for the claim. The vet also failed to follow through on this himself.

His claim was again denied.

They breeze through these SMRs and med recs so fast that something often has to get their attention.

I think -regardless of the fact that they have all this documentation- it pays to copy ,highlight, and send to them anything from your records that helps your claim.

Another vet this SO asked me to help- the VA denied continually because they said his SMRs were silent for inservice evidence of the disability-

no they weren't-

It took me an entire weekend to decifer the SMRs but his nexus and the evidence he needed was in them.

I blew up one record that was difficult to read and attached it to the copy of the original SMR record and explained to the VA what the record meant.

He now had the nexus but those idiots kept knocking down an excellent IMO he obtained.

He got over that---long story and lots of work there- but he finally prevailed.

His claim was 12 years old.

The SMR nexus was even stated in his BVA decision-one medical word- but no one had -in all that time- looked up the word and it's utter significance to his final success.

It is basically some RO hand holding- telling them exactly what is what-not depending on them to get it-and stating the claim

in terms that they can comprehend.

If I were an adjudicator I would appreciate having SMRs and med recs highlighted as to the specific evidence and why it is important to the claim.