Nexus From Neurosurgen

[81150 CAFB]

I received a nexus letter from my neurosurgen today in the mail. He is very nice and the first surgery I had with this group was with a different doctor who said he does not do disabilty and how should he know if they are related(1989 surgery and his surgery in august 2009) and would not even think of writing a nexus for me. So happens my next surgery, about three months later (all at L4-L5), was with this other doctor who is younger and the only one in their neurosurgical group that does fusions. I am very thankful for this letter.

Please let me know what you think. Keep in mind I might not get him to change much. I feel he has done so much for me. Please look at the big picture as a nexus and let me know if you think it will fly.

81150 Carswell AFB

"To whom it may concern:

Mr. Hurt Back is a 40 year old gentlemen and patient of mine who recently underwent a redo L4-5 laminotimy, medial facetectomy, and foraminotomy with transforaminal lumbar interbody fusion. He asked me to personally review his miltary service records in regards to his history of back and leg pain, as well as mutiple surgeries at the L4-5 level.

When reviewing his military service medical records, I noted he had a right-sided L4-5 laminotimy and diskectomy performed in November of 1989 during his military service. This was done for right sided sciatic nerve pain. The patient did well after surgery but re-herniated his disk in 2009. He then underwent a redo left L4-5 laminotimy and diskectomy performed by one of my partners, Dr. Grouch, in August of 2009. The patient initially did well after after this surgery, though he developed new back pain and left leg sciatic nerve pain later in the year.

He then underwent CT myleogram, which showed a left posterolateral disk herniation effacing the left L5 nerve root and causing severe degenerative disk disease at the L4-5 level. This resulted in left leg sciatic pain and low back pain. He then subsequently underwent the previously mentioned decompression and fusion at the L4-5 level.

Based on my experience, it is likely that his mutiple problems at L4-5 are related to his initial injury and surgery in the late 1980's. This led to progression of his degenerative disk at this level, ultimately for him to have spinal fusion. I am hopeful that now with spinal fusion and decompression of both sides, he will have good long-term success, but he will never be completely pain free.

It has been my pleasure to take care of Mr. Hurt back and please call me with questions.

Sincerely,

Neurosurgen"

I know he didn't use more likely then not etc... but do you think his connection is solid? My other concern is sciatica that I still have that is probably permanent-can I claim it even though he doesn't diagnose in this letter?

All help/comments are appreciated.

Thanks!

[*Bergie*]

I received a nexus letter from my neurosurgen today in the mail. He is very nice and the first surgery I had with this group was with a different doctor who said he does not do disabilty and how should he know if they are related(1989 surgery and his surgery in august 2009) and would not even think of writing a nexus for me. So happens my next surgery, about three months later (all at L4-L5), was with this other doctor who is younger and the only one in their neurosurgical group that does fusions. I am very thankful for this letter.

Please let me know what you think. Keep in mind I might not get him to change much. I feel he has done so much for me. Please look at the big picture as a nexus and let me know if you think it will fly.

81150 Carswell AFB

"To whom it may concern:

Mr. Hurt Back is a 40 year old gentlemen and patient of mine who recently underwent a redo L4-5 laminotimy, medial facetectomy, and foraminotomy with transforaminal lumbar interbody fusion. He asked me to personally review his miltary service records in regards to his history of back and leg pain, as well as mutiple surgeries at the L4-5 level.

When reviewing his military service medical records, I noted he had a right-sided L4-5 laminotimy and diskectomy performed in November of 1989 during his military service. This was done for right sided sciatic nerve pain. The patient did well after surgery but re-herniated his disk in 2009. He then underwent a redo left L4-5 laminotimy and diskectomy performed by one of my partners, Dr. Grouch, in August of 2009. The patient initially did well after after this surgery, though he developed new back pain and left leg sciatic nerve pain later in the year.

He then underwent CT myleogram, which showed a left posterolateral disk herniation effacing the left L5 nerve root and causing severe degenerative disk disease at the L4-5 level. This resulted in left leg sciatic pain and low back pain. He then subsequently underwent the previously mentioned decompression and fusion at the L4-5 level.

Based on my experience, it is likely that his mutiple problems at L4-5 are related to his initial injury and surgery in the late 1980's. This led to progression of his degenerative disk at this level, ultimately for him to have spinal fusion. I am hopeful that now with spinal fusion and decompression of both sides, he will have good long-term success, but he will never be completely pain free.

It has been my pleasure to take care of Mr. Hurt back and please call me with questions.

Sincerely,

Neurosurgen"

I know he didn't use more likely then not etc... but do you think his connection is solid? My other concern is sciatica that I still have that is probably permanent-can I claim it even though he doesn't diagnose in this letter?

All help/comments are appreciated.

Thanks!

This letter is excellent and will work great. I also have a neurologist who helps me and from my experience your letter is very good.

Bergie

[81150 CAFB]

I'm on Lexapro 10mg

Doctor just upped me to 20mg..I used to take wellbutrin and was having anxiety attacks but haven't had any since Lexapro

I am on 20mg and it is the best med I have ever been on. You only need to wait 2-4 weeks+ for it to kick in. I feel very lucky to get the right prescription the first time...I understand some people try all different ones to see which finally works. I have only recently (post-op) had some anexity attacks. I just started taking clonazapam 2 times a day instead of 1. No attacks since.

[81150 CAFB]

This letter is excellent and will work great. I also have a neurologist who helps me and from my experience your letter is very good.

Bergie

Do you think I will have any problems claiming sciatica...I know I have some permanent damage(mild-moderate bilateral) even though he doesn't mention? Or will the VA assume that I have and allow me to claim and determine severity based on C&P?

Thanks for the response regarding the letter. He is a very good neurosurgen.

81150

[Stretch]

Don't understand why you weren't service connected with the first operation.

[81150 CAFB]

Don't understand why you weren't service connected with the first operation.

I was stupid/young and never filed when I seperated in 1991. My doc who did the surgery back in the Air Force told me that I would eventually have more problems in this area. I don't even remember meeting with anyone when I seperated-VA. I guess you heal pretty easy when you are young and don't really think about the future.

81150

[*Bergie*]

Do you think I will have any problems claiming sciatica...I know I have some permanent damage(mild-moderate bilateral) even though he doesn't mention? Or will the VA assume that I have and allow me to claim and determine severity based on C&P?

Thanks for the response regarding the letter. He is a very good neurosurgen.

81150

As I said, I think your neurosurgon wrote an excellent letter for you. It pretty much covers all bases and reads well. Wait and see what they say, good or bad you can always file NOD if they don't grant sciatica. However, I suspect they will have no alternative but to grant due to the thoroughness of the letter.

Regards,

Bergie