Claims Advice

[TLaff]

My original claim was for my Cervical and Lumbar and when i filed the claims I didn't think to make claim for my thoracic, however I got a 20% for my cervical and a 10% for my lumbar in which I am going to file a NOD. The C/P examiner stated she was new and I believe I was her first exam and when she examined me she forcefully pushed my head to get a measurement causing pain and popping like chewing on gristle. She also eyeballed allot of it and the answers she put into her report are not my answers.

Further I am placing below my conditions and would like any suggestions, help and cold someone tell me what all I can make claims for??

I also am going to the doctor because since my cervical fusion I have headaches every day and I never use to snore and I snore really bad and gasp for air and believe the metal in my neck causes some kind of air restriction.

Dr. States;

This gentleman comes in for evaluation of his cervical, thoracic and lumbar spine. He has had a 3 level cervical fusion of his C4-5, C5-6, C6-7, cervical degenerative facet arthropathy, reversal of the cervical lordosis, apexing at C4 accompanied by right sided cervical listing, apophyseal articular degenerative alteration throughout the cervical spine.

Thoracic multisegmental mid to lower thoracic dicongenic spondylosis, T12 vertebral body compression which is likely chronic in nature, multiple thoracic intervertebral dysrelationships (subluxation).

He has schuermann’s disease in his low back involving his L1-2, 2-3 and 4-5, He has an

Annular tear at his 4-5 (spinal stenosis, ruptured disc, intervertebral disc syndrome, sciatica, radiculopathy), degenerative disc disease and arthritis degenerative throughout his entire spine.

His conditions have progressed over time and will continue to do so and I am afraid to offer him anything more surgically by virtue of the fact it’s hard to know where to stop or start.

His best treatment at this time is going to be on muscle relaxants and anti-inflammatory.

He should stay away from pain medicines if at all possible as he will simply get hooked on them, I suggest he see his primary care physician and or pain management at this point. I strongly feel it’s not in his best interest to continue carpet cleaning because of the stress it places on his entire spine.

Further Mr. Lafferty has had several incapacitating episodes in the past many resulting in

Steroid injections and bed rest. Being that he has been self employed there was no reason to write it out (whom would he have given them too?). I would be happy to see Mr. Lafferty again should the need arise.

Any advice would be greatly appreciated.

Terry

[TLaff]

Terry...These abbreviations have been posted elsewhere, but I will do it again for you:

IMO Independent Medical Opinion. This often happens when you ask for Service connected benefits, and the VA doc makes a statement such as "Veterans.....condition is most likely NOT related to military service".

Often a private doc, such as Dr. Bash, will review your medical history and give you a "nexus" such as: "In my professional medical opinion the Veterans condition is at least as likely as not due to military service".

In this instance, the IMO is probably your only chance to get service connection, because one the doc makes some kind of statement opining it is not related to military service, the only way a Veteran can "counter" that position is to have another doc say that it is related to military service.

Sometimes, the VA doc wont say either way, and you need an IMO to win benefits.

An IME (Independent Medical Exam) often carries more weight than an IMO. With an IME the doctor physically examines you, and your records, then offers an opinion. With an IMO, usualy the doc just looks at your records and does not examine you.

TDIU = Total Disability Individual Unemployability. This means you are disabled and unable to obtain "substantial Gainful employment" (SGE) It means that you are not working and cant get a job due to service connected disabilitie(s). That is, it has to be substantial, and taking a job and geting fired after a week is not SGE. Usually you need to earn more than the poverty level, that is about 10k per year for it to be considered SGE. There are specific rules the VA follows before they award TDIU. If awarded, you are paid at the 100% rate.

A "chronic" condition means it is ongoing. If you get hurt, say you break a leg in service, but have no chronic problems, you are unlikely to get benefits. However, if your broken leg is "chronic" and requires ongoing treatment...cast, physical therapy, treatment for pain, loss of use of leg, required use of wheel chair etc, over time, this becomes "chronic". Chronicity is pretty much required. They dont give you disability benefits if you get better and have no problems.

[TLaff]

Thanks for your information it is helpful, I have already been serviced connected for my cervical and lumbar 20% and 10 % so i'm sure any nexus for a secondary to my spine problems will be approved. My problem is i just don't know what all i can make separate claims for. Right now i am putting together new information from my chiropractor I've been seeing since my C/P examine and he took range of motion measurements which are way different than the C/P examiner came up with. I am hoping that the NOD request and Rater will automatically give me a better rating??

I then plan to make a new claim for my thoracic along with some others that i may have but don't quite understand.

Terry

[LarryJ]

And, again, we'll just wait to file TDIU. Right? Right!

[sawgunner]

Chronic Pain Syndrome is a medical condition all it's own and is rated by the VA as a mental health issue just like PTSD or depression. Deppresion is often a part of CPS and can be factored into the rating.

If you your back/neck pain is chronic in nature, you should go see a shirnk to see if he thinks you have Chronic Pain Syndrome.

The mental health doc should do a letter for you stating that the CPS is at least as likly as not caused by your service connected conditions.

I currently have a claim in progress for CPS secondary to DDD of the lubmar spine and left hip IT band syndrome.

The letter from my doc says that my CPS "IS" caused by my service connected issues.

Hope this helps.

[TLaff]

Chronic Pain Syndrome is a medical condition all it's own and is rated by the VA as a mental health issue just like PTSD or depression. Deppresion is often a part of CPS and can be factored into the rating.

If you your back/neck pain is chronic in nature, you should go see a shirnk to see if he thinks you have Chronic Pain Syndrome.

The mental health doc should do a letter for you stating that the CPS is at least as likly as not caused by your service connected conditions.

I currently have a claim in progress for CPS secondary to DDD of the lubmar spine and left hip IT band syndrome.

The letter from my doc says that my CPS "IS" caused by my service connected issues.

Hope this helps.

[TLaff]

Is it better for the Doc to say Chronic in Nature or just Chronic?

Terry