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Decided To Open A Claim For Old Injury

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bulldogpete

Question

Hello,

I have decided to open a VA disability claim for some old injuries I recieved while I was in the NG. I have several questions and was wanting to get some opinions about doing this.

The injuries occured while I was in training for the NG about eleven years. I was involved in a APC accident. I was pulling air guard, and the driver drove into a ditch causing me to bounce up in the air and injure my back and neck. I fell back into the APC and lost feeling to my legs for a short duration. Medics transported me to a civilian hospital, where xrays and a CT were performed. The CT and Xrays found several diffsuse bulges in my neck and back. Also, noted the faucets overlapped, Schmorl's nodes deforimites and a possible cervical fracuture (they were unsure if it was injured from the accident or a possible accident). The doctor noted Thoraic sprain and contusions.

My commander had everyone that witness the accident give a written statement of what they saw. I have a total of 4 statements, each stating I flew up in the air and hit my back and neck. Also stating I was complaining of losing feeling to my legs. I also have documentation from the reviewing officer, who stated the accident was service connected and was not any fault of my own. Also checked the box that says "injures will more than likely result in a future claim being filed."

I was out of service for about 2-4 weeks and then started drilling again. I never tried to get VA disability, because for one I was only 18-19 at the time and did not want to admit I was injured. The other reason, was unitl about 2 years ago, I did not even know NG could get VA disability.

I have had progressive pain in my back and neck since the incident. I have a history of going to the chiropractor for the last 7-8 years for back and neck pain. I recently been diagnosed with several nerve problems in my neck and back. Bulging Discs and Disk deterioration. I have also been diagnosed with Migraines (3-4 a month.)

The pain has finally progressed to the point to where I am going to file a claim. My question is, do you think I will have a problem linking my current injuries to the injuries I recieved during the accident, since such a long time has passed.

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  • HadIt.com Elder

The only way to find out is to file a claim. You want a statement from your chiropractor with a diagnosis and history of treatment. Get a copy of your service medical records. You may have to shop around for a orthopedic doctor to write you a report linking your SMR's to your current condition. What the VA might do is try and say your conditions are the result of age and natural degeneration. This is what you are going to have to beat.

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Pete,

I agree with john.

What we say isn't worth much to the VA - it's almost like talking to a wall.

They only "hear" what a medical professional says linking your current afflictions to something that happened on active duty.

This is called a "Nexus" and is key. The following info is from a previous post on the subject:

Oftentimes, the key to showing direct service connection is what is often called a nexus letter from a doctor. How and under what circumstances this letter is written is extremely important because if it is not done properly the VA may simply ignore this letter. Two of the more common reasons why these letters are not given proper weight by the VA will now be discussed.

If the doctor who wrote the letter did not review the veterans file and service medical records and state that he or she reviewed the file in his/her report than the VA will often disregard the letter. It is best if the doctor actually refers to evidence in the record. Another common reason a doctor's nexus letter would be rejected by the VA would be if the doctor when describing the nexus between the current disability and the in-service injury, disease or incident does not use the "proper" language recognized by the VA. Because the VA is supposed to give the veteran the benefit of the doubt the standard of proof is that it must be at least 50% likely that the in-service injury, disease or incident caused the present medical disability. This means that if the doctor's opinion is that it is 50% likely then the doctor should use the words "as likely as not" when describing the connection. If the doctor is more than 50% sure than he or she should use the words "more likely than not". Lastly, if the doctor is less than 50% sure of the connection then the words used by the VA is "less likely than not". In other words, if the nexus letter states either that it is "as likely as not" or states that it is "more likely than not" that the veterans present disability is connected to an in-service injury, disease or incident, than the doctor's opinion is stating the condition is service-connected.

P.S. If your private medical doctor issues an opinion of less than 50% or "less likely than not", then his report will not be helpful to your VA claim!

Original post here:

All the best, Pete, and feel free to ask more questions!

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  • HadIt.com Elder

bulldogpete:

You have a claim but it has to be developed. What you need is to file the claim today include copies of the info you have and the current dx and ask your Doc to write an IMO (Independent Medical Opinion) that links your injury to the accident you had in service.

My opinion is you have a good shot at it.

Welcome to Hadit

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Notorious - you sure stated that reply well.

My IMO criteria in the IMO forum might add a little more to what you said but you said it exactly the way it is.

I developed the IMO forum crieria from the 2 IMOs I had from Dr. Craig C Bash. He had worked for the VA before going into private practice and knew exactly how to shape his IMOs and what terms to use.

I feel awful when I see that a vet has spent a good chunk of cash on an IMO that VA rejects because it does not conform to the IMO criteria.

It is a good idea along with the SMRs and medical records to send the IMO doctor a copy of the SOC that denied the claim and copies of the actual C & P results too.

I tabbed and referred to specific medical records in my IMO request - he got everything and read everything but this way the pertinent records could easily be found.

For Another IMO I requested (which I didn't need) from a forensic cardiologist because the award came before the IMO did -the guy who channels these requests for a forensic law firm to a specific doctor with the right expertise called me up to say they had never received an IMO request like mine.

Everything was tabbed and I had prepared an outline that referred the doc to specifics in the med recs and in other enclosed documents (from my FTCA and 1151 cases) and in the Evidence list I clearly described each piece of specific tabbed evidence and why it was probative to my claim.

What surprised me when this guy called me is that this was a forensic firm that almost always does IMos for cases in a court of law.You would think lawyers requesting IMOs for criminal cases would shape their evidence in the way did so that none of it could be overlooked by anyone.

This was a lot of time consuming work as each IMO I needed involved considerable evidence and the cardio IMO had to be shaped differently than the diabetes IMO.

Neither cardiovascular disease nor diabetes appeared in the veteran's VA diagnoses so that too was time consuming to reveal all the misdagnoses etc.

My long point here is that I regret veterans and widows have to do all this work and then pay some costly IMO fees in many cases.But many IMO doctors have little or no experience with the VA claims process and they need to know what evidence the VA needs to have.Having a copy of the SOC themselves restates what the claim is for and why the VA denied it.A copy of the actual C & P exam is invaluable to an IMO doctor to pick it apart for inaccurate medical statements or highlight evidence the VA overlooked.

An IMO doctor cannot opine on what they dont have so they need all available SMRs and med recs.

And sometimes it even takes more than one IMO.

Edited by Berta
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  • HadIt.com Elder

It took me four medical opinions to get my P&T finally. I took every denial "reasons and basis" and took them back to a doctor and had them rebutt those findings. My biggest advantage was that I was already 30% so the doctors just needed to show that my condition had gotton worse. The VA did fight me every step of the way which took more appeals and more IMO's. First they granted a rating of 70% based on two medical opinions that shot down the C&P that continued the 30%. The VA denied TDIU saying my unemployability was due to NSC conditions. Another appeal and another IMO. I got the TDIU but was denied P&T. That took another appeal and another IMO. The VA seemed to look my evidence over with a microscope to find something to deny. The moral is that you want your claim to be water proof the first time around as best you can. The VA will often deny even good claims and force you into appeals. It is a game of persistence and finding evidence to continue the fight.

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