ptsd Just Got Rating Decion...now On To Nod

[shawnb28]

Hey everyone, I'm an OEF vet and I just got my ratings decision! Thanks for all the help along the way I've found through here

here's the breakdown:

30% PTSD

10% low back

10% asthma

0% right ankle which I just had surgery on

bilateral knees - denied

40% combined rating

Here is what I want to challenge:

10% asthma

For my asthma, related to sucking in burn pit smoke from burning trash for a good portion of my deployment, I have had breathing problems and shortness of breath ever since. I was diagnosed with asthma and prescribed an albuterol bronchodialotr inhaler in March and was using it with little results the whole time. In July on a follow up appointment with my doc I was prescribed a much stronger inhaler (mometasone) which is classified as a steroidal inhaler that works as an anti-inflammatory, and am using it daily now.

According to the respiratory ratings chart a "intermittent inhalational or oral bronchodilator therapy" results in a 10% rating...while "daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication" results in a 30% rating.

Am I able to increase the 10% to 30% going all the way back to the beginning of the original date of filing the claim, or will it only be increased to 30% from here on out once I file the NOD?

bilateral knees patella femoral pain syndrome - denied

My knee problems were denied as service connected because I did not have any medical reports or doctors notes during my deployment relating to it. I was on a pretty small base and when we would go to our medics or doc for any pain issues relating to knees or back, they would just throw some ibuprofen or muscle relaxers at us and not do any paperwork. Further, on our demobilization health assessment I left off talking about my knees because we had been waiting around there all day and I was impatient in wanting to just get it over with. (screwed myself). I am hoping I can get a letter from one of our medics or the doc we had in our unit saying he treated me for knee problems while in Afghanistan and submit that as new evidence so I can at least get service connected for this.

Should that be enough to be SC? If I finally do get SC, what rating should I end up with? I wasn't able to interpret the rating schedule very well for knees. My ROM was 0-125 degrees with pain intensifying at 115 on the left and 0-130 degrees with pain intensifying at 115 degrees…crepitus (popping and snapping) at mid range with worse on the left, and no change in ROM after repetition and no instability.

0% right ankle sprain with peroneal tendon subluxation

For my ankle, I had a bad ankle sprain while overseas and was having pain and weakness and instability in the joint ever since, and my peroneal tendon was subluxing and popping over my fibula repeatedly. I was not able to stand on it for too long or do too much physical activity without it flaring up and causing me to take a breather. The VA podiatrists recommended surgery to correct. I had been using a lace up ankle brace for added support, which greatly helped with keeping it from giving way. In my C&P exam the doc found normal full range of motion (dorsiflexion 0-20 degrees and plantar flexion 0-45 degrees). Now I know according to the schedule of ratings for ankles, my ankle ROM being normal would not warrant anything other than 0%...but what about noted ankle instability in the joint. Should that warrant at least a 10% rating? I had described symptoms of instability to several docs at the VA including the C&P examiner, but when the C&P doc did his exam here is what he noted:

Findings- weakness, guarding of movement, tenderness

Ankle Instability: No

Tendon Abnormality: Yes (peroneal tendon subluxes anteriorly with eversion)

NO INTABILITY you've got to be kidding me!

His exam contradicts with my own private care foot and ankle doc through Tricare who I ended up using for the surgery. My doc did find instability, and in fact that is why during my surgery I just had, he not only fixed the tendon subluxing, but also decided to tighten up a ligament in there that was stretched out and was allowing my ankle to easily give way and be instable.

Should I challenge the 0% rating on my ankle based on the incorrect finding of the VA examiner not finding any instability during my exam?

Would I only be eligible to get a rating until the day I had my surgery, and then after that if my ankle is fully fixed and all good I no longer get that rating or only a reduced rating?

I went in to my VSO yesterday to talk about filing a NOD for these issues. The following is what she is sending to the VARO:

"Veteran wishes to file a NOD for rate date of 08/20/2009 for bilateral knee patellafemoral pain syndrom. Requesting a DRO Hearing. Veteran wishes to file for an increase for asthma, veteran submits new evidence of increased medication."

I gave her notes from my doc and the increased meds for asthma prescription list. She is waiting on the surgical report and doctor notes from my private care podiatrist. I will be trying to get a treatment report from a medic or doc I was with during my deployment for my knees.

With the way she is wording it, I am afraid it is only requesting a ratings increase from here on out with my asthma, not challenging the original 10% rating going back to the beginning of the claim as being inadequate. What do you think?

Thanks

[jbasser]

Get your OR report from the Doc or hospital and submit it with your NOD. it should tell the condition and if it does, the VA cannot deny it.

J

Edited August 26, 2009 by jbasser (see edit history)

[john999]

Did you file all these claims within one year of discharge? If you did then I think you will win eventually.

[shawnb28]

Did you file all these claims within one year of discharge? If you did then I think you will win eventually.

I did file within a year of discharge actually. Which was a nice surprise to find out that I would get backpay to the day after discharge.

Should I be filing a "Request for reconsideration" for the asthma, knees and ankle rather than a NOD if I can get additional evidence to submit?

[shawnb28]

Get your OR report from the Doc or hospital and submit it with your NOD. it should tell the condition and if it does, the VA cannot deny it.

J

Is the wording of my VSO saying "file for increase" the same thing as a request for reconsideration or different?