Please Review An Comment

[ruby]

I have been holding on to this claim due to the current NOD I have at St Pete. Its been a year and I haven't heard anything, I filed another NOD a vouple of months ago for at least another year so I have decided to finally file my radiculopathy claim so I don't lose my effective date. I have shorten it immensley please review I am planning on submitting this on Monday.

Thanks

Ruby

STATEMENT IN SUPPORT OF CLAIM

October 20, 2009

By this document I am filing a claim for entitlement to service connection for:

A. Bilateral cervical radiculopathy secondary to my service connected cervical arthritis

B. Migraine headaches dx code 8100 secondary to service connected cervical arthritis

C. I am requesting that the diagnostic code of 5237 be changed to a more analogous diagnostic code of 5243.

D. Bilateral shoulder impingement disorder due to service connected cervical arthritis.

1. Migraine Headaches- See Dr. Ricca’s notes date 11/20/2008 and 02/06/2009. I have frequent headaches 4-5 times a week. The medication that I currently take for my sc conditions cause drowsiness, impaired memory lightheaded ness and somulence. ( SOMA, Percocet, Ambien and Prozasin)

2. Bilateral Cervical Radiculopathy - I have constant tingling and numbness in both hands along with weakness and pain in my arms and hands. As indicated in the MRI dated June 19, 2008 there is minimal cord compression seen at C4/5 level with bilateral mild to moderate foraminal narrrowing. Moderate to severe left neural foramen narrowing is seen at C5/6 level..

The EMG performed on November 8, 2008 showed bilateral muscle membrane instability in the C6, C7 myotomes.

3. Cervical IVDS (dx code 5243) is described as neck pain with pain radiating down the arm (brachialgia) and it may be referred pain in the middle of the back. This dx code is more analogous to my symptoms of cervical arthritis dx code 5237.

4. I am requesting an effective date no later than November 2008.

5. Enclosed are pertinent medical records to support this claim.

A. Dr. Ricca’s notes dated August 20, 2008, October 31, 2008, February 6, 2009.

B. Dr. Lombardi’s notes dated November 20, 2008

C. MRI C-Spine report dated June 19, 2008

D. Dr. Humayun’s Nerve Conduction Report dated November 21, 2008

E. Dr. Yussef’s notes dated February 23, 2009.

F. Dr. Lehman’s noted dated February 2009

Thank you for your time and consideration to my claim.

Respectfully submitted,

[Berta]

Ruby-are you still able to work? If not have you formally applied for TDIU and SSA?

What type of claims were the NODs filed on?

Did the docs you mentioned make a full nexus statement in their notes as to the association of this to your established SC disabilities?

Would any of them be able to provide a complete Independent Medical Opinion for you or are they all VA docs?

Have you considered getting an IMO that ties all this in with your SC disabilities? AN IMO can be expensive but then again it is an investment if it helps support a claim for a higher rating.

[ruby]

Berta, the claims on nod are for reactive arthritis, IU and change in dx code, no I can't work and I get SSD for reactive arthritis. I am SC for traumatic cervical arthritis. One of the doctors made a a nexus statment kind of--he said prostrating headaches see MRI results.

What I have seen with my claims and others it doesn't matter what's written in your SMR's or VAMR--its the opinion of the C&P person and even if they say at least as likely as not, if the RO wants to say no they do and your in a appeal stat

Ruby-are you still able to work? If not have you formally applied for TDIU and SSA?

What type of claims were the NODs filed on?

Did the docs you mentioned make a full nexus statement in their notes as to the association of this to your established SC disabilities?

Would any of them be able to provide a complete Independent Medical Opinion for you or are they all VA docs?

Have you considered getting an IMO that ties all this in with your SC disabilities? AN IMO can be expensive but then again it is an investment if it helps support a claim for a higher rating.

[carlie]

ruby,

A. Dr. Ricca’s notes dated August 20, 2008, October 31, 2008, February 6, 2009.

B. Dr. Lombardi’s notes dated November 20, 2008

C. MRI C-Spine report dated June 19, 2008

D. Dr. Humayun’s Nerve Conduction Report dated November 21, 2008

E. Dr. Yussef’s notes dated February 23, 2009.

F. Dr. Lehman’s noted dated February 2009

Can you post some blips of the most pertinent parts of the evidence above, that shows support and connection from the cervical radiculopathy to the

cervical arthritis ?

carlie

[ruby]

I don't know how to do that so I will type what they said. After reading I see no direct link to cervical arthritis, except thats what all the osteophytes are indicative of.---except the osteophytes depending on there location is a symptom of spondlyarthopathy-(arthritis) specifically ReA in my case- I am SC for traumatic arthritis-how can you distinquish which one is the culprit.

I figure it will be 2-3 years before I get a DRO hearing on the NOD, no sense in losing 2-3 years effective date. It will take them 2 years to get to this one by that time I will have all the connections.

Dr. Ricca-rheum

spondylitis

cervical disc disease, she is having increasing and prostating pain in the neck at frequent intervals-see mri

shoulder pain-may well have rotator cuff tennonitis. had ia injection in the past on the right with some benefit has more pain in the left shoulder has to use her right arem to raise the left shoulder

also has a trigger finger on the rt hand in the thumb which has been injected in the past has no patholoic reflexes

Oct 31 2008

spondyloarthropathy-has sacro ilitis has a history of hidradenitis is sc for same this most like is an associated, if not a precipitating factor.

rotator cuff tear-by mri has orth eval pending

cervical disc disease at last visit I ordered a collar with some limited benefit. she is havin more numbness in the hads has some weakness-mri showed some core compression has an intermitten grasp reflexs on the right has what she describes as "massive neck pain

sypmptoms of calcneal spur had minimal relief with heel cup will get podiatry consult

Oct 14, 2009

spondyloarthropathy this lady clearly has spondyloarthropathy based on enthesopathy of the patellae, enthesopathy of the calacanel bone bilaterally and obliteration of the si joints on x ray noted by myself and dr. vasey in the past. This may well be a reactive arthritis assocaited with her sc hidrandenits (this and another one I wanted to send in for the NOD on ReA)

Anesthisa pain

pt's neck pain causes daily heaaches, as well as the pt experiencing bilateral hand numbess. pts neck pain awakens her at night-describes pain procedure

emg

bilateral C6,7 radiculopathy with normal nerve conductions and muscle membrane instability in C6,7 myotomes

mri

C2-3 an irregular disc osteophyte

C3-4 a diffuse disc bulge indents the thecal sac, with mild canal narrowing without significant cord copression

C4-5 a diffuse disc osteophte complex indents the thecal sac, touching and slightly compressing the ventral spinal cord with resultant moderate spinal canal and bilateral mild to moderate neural foramen narrowingC5-6 an asymmetric (left side prominent) disc osteophyte complex indents the ventral spinal cord and results in mild spinal canal and moderate to severe left newural foramen narrowing

C6-7 an osteopphyte complex indents the thecal sac with mild spinal canal and bilateral nerural foramen narrowing

Neurosurgeon:

has very abnormal mri of the c spine, she has weakness and pathologic reflexes in the upper extremeities she has nerve conductions suggesting a radiculopathy

A/P cervical spondylosis without myelopathy

Patient does not want surgery unless her condition is worse to the point of functional loss. Continue conservative treatment

thanks for your help

ruby,

A. Dr. Ricca's notes dated August 20, 2008, October 31, 2008, February 6, 2009.

B. Dr. Lombardi's notes dated November 20, 2008

C. MRI C-Spine report dated June 19, 2008

D. Dr. Humayun's Nerve Conduction Report dated November 21, 2008

E. Dr. Yussef's notes dated February 23, 2009.

F. Dr. Lehman's noted dated February 2009

Can you post some blips of the most pertinent parts of the evidence above, that shows support and connection from the cervical radiculopathy to the

cervical arthritis ?

carlie

[Pete53]

Ruby:

Maybe not take so long. Good Luck to you.

[ruby]

Ruby:

Maybe not take so long. Good Luck to you.

Thanks Pete but the last one took almost 2 yrs for a reopen and its been a year and I haven't heard a thing about my NOD.