Grant Changed Effective Date

[cannoncocker]

This is derived from my DAV rep.

The original claim filing date was April 2008 which included: From VA DRO appeall. DAV lay statement for "Low Back Pain" was the initial claim submittal.

Service connection for lumbar strain with radiating pain through buttocks and down legs is granted with an evaluation of 20 percent effective April 22. 2008. Note radiating pain down both legs.

Dated MAR 22 2010

Severity QTC Exam at once was scheduled for 19 April 2010

DAV sent the following 5/6/2010:

This letter is not intended to serve as your official notification from the Department of Veterans Affairs (VA), You will receive an official decision from the VA upon completion of necessary administrative procedures. The VA reserves the right to modify the decision prior to your official notification. The VAfs letter will inform you of the current monetary monthly and retroactive benefits to which you are entitled.

The Disabled American Veterans (DAV) has reviewed the most recent VA decision concerning your claim for benefits. A combined evaluation of 70 percent has been assigned as a result of the following action(s):

Service connection for Radicular pain pattern left leg; sensory is granted with an evaluation of 10% effective April 19, 2010.

Evaluation of Lumbar Strain with L5-S1 herniated disc and IVDS involving sciatic nerve; previously claimed as lumbar strain with radiating pain through buttocks and down legs, which is currently 20% disabling, is continued.

So this leaves me questioning the backpay

1. Service connection for lumbar strain with radiating pain through buttocks and down legs is granted with an evaluation of 20 percent effective April 22. 2008

2.

Service connection for Radicular pain pattern left leg; sensory is granted with an evaluation of 10% effective April 19, 2010.

I would appreciate any input on whether there will be any backpay associated with this as 20% ( Evaluation of Lumbar Strain with L5-S1 herniated disc and IVDS involving sciatic nerve; previously claimed as lumbar strain with radiating pain through buttocks and down legs, which is currently 20% disabling, is continued) was effective April 2008 but the Radicular pain was granted April 19, 2010 which was enough according to VA Math to put me at 70%.

Other part of the question is how did the VA came up with the effective date from the same QTC Doctor that found nothing wrong with my back to start with and effective date of April 19, 2010. They couldn't possibly claim I did not use the proper medical terminology. Do you need a medical degree to file now? DAV lay statement for "Low Back Pain" is pretty inclusive and since the DAV worded thhe claim and I have no special knowledge of filing claimsmsom wouldn't the benefit of the doubt go to the vet since radiating pain is granted. So whey the different date other than avoid back pay?

Any help would be great.

PS wonders never cease in this looking glass world of the VA. Now we are in a semantics war. How in the world could they split radiating pain at 20% to 10% Radicular pain = A Radicular Pain Syndrome is a spinal condition that results in symptoms of ... In the lower extremity the term "sciatica" with sensory=numbness which has been documented and is frequently part of Sciatica. Is there no end the gate keepers will go to?

I hope I am wrong and that there is a reasonable explanation but I can't see anything but a clear brick wall without much thought going into the rebuttal, just a fight.

Edited May 9, 2010 by cannoncocker

[cannoncocker]

I thought I would bump this to see if the tumbleweeds were still collecting.

[pacmanx1]

This is derived from my DAV rep.

The original claim filing date was April 2008 which included: From VA DRO appeall. DAV lay statement for "Low Back Pain" was the initial claim submittal.

Service connection for lumbar strain with radiating pain through buttocks and down legs is granted with an evaluation of 20 percent effective April 22. 2008. Note radiating pain down both legs.

Dated MAR 22 2010 </SPAN>

I understand that this is not the answer you want to hear but, the only thing I can offer is to wait for the official letter from VA. Since you've been in the system for a while you should know that anything can change. VA has some really weird ways of making their decisions, make sure that you read the reason for decision several times to understand it and you can remove all the personal information and post it here and maybe someone can explain it to you. Sometimes post are not answered because it may be very difficult to know what is really going on. Since the information came from your DAV rep. and not the VARO it is hard to say. As I said, I know that this is not what you are looking for but maybe someone else will chime in

As Always Hope the Best

[cannoncocker]

This is a quite a pleasant surprise and from pete no less. I'll put the the thank you first. Actually what I want to hear is whatever the truth is, whether that's in my favor or not. I had already determined that waiting for the official ltr to come since nothing is official until that happens. Having said that I am kind of a proactive type which is why I posted this, to get opinions if there ar any proactive steps I could take before the VA has committed to a particular outcome.

I have been trying to contact my DAV Rep which is like getting an appointment with the President, since he wrote the letter that got this ball rolling so he should be in a position to be on the inside of this situation. The DAV written layperson claim Low Back Pain, Which is about as catchall as you can devise, but this is early on when I had little experience with this process. They granted on MAR 22 2010 An examination will be scheduled at once to evaluate the severity of your service connected 1. lumbar strain with radiating pain through buttocks and down legs (document 1 Attached). After the severity exam I received Document 2 (attached) from the DAV, which changed the effective date and diagnosis, in particular:

1. Service connection for Radicular pain pattern left leg; sensory is granted with an evaluation of 10% effective April 19, 2010.

2. Evaluation of Lumbar Strain with L5-S1 herniated disc and IVDS involving sciatic nerve; previously claimed as lumbar strain with radiating pain through buttocks and down legs, which is currently 20% disabling, is continued, effective April 22. 2008.

Does a severity exam change diagnosis and effective date? Let there be no mistake, this is about money, and specifically back pay. Frankly I got everything I wanted out of this exercise: the correct diagnosis and SC grant. The part that has my back up is I know they are wrong by changing the effective date for item 1 since Sensory loss has been documented from 2006 multiple times from VA Neurology Consult/Ide[endent Opinion/PT in addition to radiating pain as demonstrated from Neurology Consults and Explicit MRI pinching S1 from 2006 on.

It just does not ever seem to stop. Now the DAV rep is not answering his calls but I hav had some luck with the politicals which I don't like playing that card but what choice do I have?

How would you handle this?

PS ABBY Fine Reader is not exactly perfect.

Department_of_Veterans_Affairs_Document1.doc

Disabled_American_Veteran1_Document_2.doc

Edited May 9, 2010 by cannoncocker

[john999]

If you are already 70% and have this low back pain radiating down your legs that probably means disc problems. How can you work under such conditions? Have you put in for IU. When does lumbar strain become herniated disc? What sort of surgery are they proposing or just nerve blocks? I know you can't sit or stand without pain. How can you work?

[cannoncocker]

John it is helpful to know I can count on you for a thoughtful option. You are always helpful and appreciated.

The problem is the VA has nothing to do all day and frequently years of experience in thwarting claimants regardless of the merits of the case. In addition to that they know your alternatives often require years so the smart money is on the claimant just take whatever they feel like handing out.

Case in point: The VA has manipulated this case to where no particular disability reaches 40%, which as I understand it is a requirement for unemployablity. They rated my sinus tachycardia at 30%. After tooth and nail fight they granted 20% for lumbar strain. Now they changed the diagnosis and split it to 20% and 10% whih in effect gave me a rating increase from 60 to 70 % without the backpay. They just never stop but neither do I. Fotunately I was there for my brother early on so he is here for me now, which is clearly more than I can say for uncle sam.

This is clearly the definition of not willing to grant the full amount that, by their own admission is legally owed to me. Since when does a severity exam change diagnosis? Although the new diagnosis is more accurate and better for the long term, but denial of the backpay is going into a fight.

So no unemployability at this point since they have blocked that.

[Berta]

"The VA has manipulated this case to where no particular disability reaches 40%, which as I understand it is a requirement for unemployablity. "

No=the only requirement for TDIU is being unemployed and that a SC or many SCs prevent you from gaining and sustaining substantial employment.

This is why a vet should always apply for SSA disability as well as TDIU if their SC prevents them from working.

If SSA awards solely due to SC conditions -then the VA should too (Washington V Derwinski)

SSA also is faster then VA in many cases.

and vice versa-a TDIU award could be instrumental in a SSA decision.

Many many years ago I had a NSC vet who had never been to the VA who had considerable private psychiatric records for PTSD.

I looked over the TDIU form carefully and there was nothing there that prohibited him from filing for TDIU.

The vet rep mantra of "you have to be 70% " was missing too from the form. I helped him fill it out and told him what evidence to attach to it.

If VA awards 70 then VA will consider TDIU.

He got TDIU in 4 months.He had an established nexus for his PTSD ,a current diagnosis and treatement for it from his private doc and also received SSA for PTSD.

I always use my husband's case to make this point-too- I know I repeat this a lot here- but every time it reaches and helps a vet, my husband knows I have honored his service and death to keep reminding vets of how TDIU is determined.

He was

1984 30 % PTSD

1992 applied for higher rating and then sent in TDIU form (they never acknowledged it)

1993 SSA for PTSD retro to 1991.

1997 posthumous 100% SC for PTSD award from VA back to 1991.

I guess they didnt call it TDIU or use his 8940 form on the award letter because by then he was not only TDIU-he was dead.

The medical evidence warranted his retro to 1991 for 100%.

Some of that evidence came from an unusual source as well as his new VA shrink.His past VA shrtink was the employee psychologist and never documented anything. The new shrink had been an in field Vietnam Psychiatrist.

Edited May 9, 2010 by Berta