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Appealing My Dro


jcturpin79

Question

First off I am a 30 male weight pre-op 150lbs height 5"9 by no means was I over weight as most are with similar feet and ankle issues I received surgery on my SC left ankle 6/28/09 (triple arthrodesis fusion) This surgery requires a long period of convalescence and more so in my particular case due to my prior history of non unions ( 2 failed sub talor fusion left foot) That being said My VAMC Dr Requested a period of 1 yr for convalescence in written form this was submitted prior to the surgery as evidence for an extended convalescence. I was denied a convalescence beyond 3 months for the 6/28/09 surgery. on 11/16/09 my surgeon had to revisit the surgery site due to pin infringement ( pin was too long and needed to be retracted) and the removal of under the skin bone growth stimulator (use due to the history non unions) for this they awarded me 1 more month of convalescence for that surgery. It was awarded during my request to have a DRO to review the previous decision of only 3 months of convalescence when VAMC Dr requested 1 year. I have appealed The DRO decision and requested a hearing before VBA. Since then I have acquired 2 more medical opinions to back the need for convalescence of at least 1 years (1. civilian Dr of physical therapy that the VA out sourced me to due to the distance of my home to my nearest VAMC 2. The regional head of podiatry for the VAMC southern regions who's primary office is at my VAMC.) on top of that during my exam and evaluation given by the regional head of podiatry it was noted that a non union/ mal union of the calcaneal cubiod joint had occurred and a revision to my 6/28/09 surgery was necessary to correct this and in addition Ankle Arthrodesis Nail ( much lager than common screw used for fusion) needed to implanted to aid in a complete fusion ( zero mobility of ankle) the surgery (8/13/10) again will require an extended period of convalescence.

My issues, concern and question are many at this point

1. What kind of evidence is required to warrant a convalescence beyond 3 months( 3 medical opinion request 1 year + have been submitted)

I believe I have met the requirements of VBA 38 CFR section 4.30

2. is it possible to avoid such issues of convalescence with my future surgery of the affected limb (8/13/10)?

3. with my future surgery will zero mobility to my left ankle qualify me for SMC for loss of use per VBA 38 CFR section 4.40

4. over all what benefits should I apply for? * note that similar surgery to the right foot is also required that will also result in zero mobility to the affected limb.

This has been the worst 2 yrs of my life dealing with SC injury and being unable to walk with out crutches or a cane thus being unable to work. Not receiving the benefits due has put me in dire financial strain. My only source of income is my 20% rating payment. that being said my credit has been destroyed and if not for my father who has been paying my rent,power, water and the assistance of food stamps I would be living in the streets. I'm not trying to milk the system, I just want what I justly earned when I committed myself to the USMC. Nothing more nothing less!

Please let me thank you in advance for any constructive comments or suggestions.

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jcturpin,

Welcome to Hadit.

I don't have an answer to your specific questions at this time but just wanted to

prepare you some for the wait time for an Appeal to the BVA.

Chances are the appeal won't even get going good for at least 12 to 24 months,

even then it may still be remanded to the AMC or back to the VARO

that originally denied the issue/s.

Hang in there, other's will chime in.

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jcturpin,

Welcome to Hadit.

I don't have an answer to your specific questions at this time but just wanted to

prepare you some for the wait time for an Appeal to the BVA.

Chances are the appeal won't even get going good for at least 12 to 24 months,

even then it may still be remanded to the AMC or back to the VARO

that originally denied the issue/s.

Hang in there, other's will chime in.

Thanks for your reply

I appealed the DRO and requested the hearing before the VBA in dc back in Jan 10 so hopefully it won't be much longer. if anyone can think of some steps I might have missed or a better course of action I'm all ears at this point.

Semper Fi

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* I have also been diagnosed with RSD/CRPS in my left foot and have seeing a pain management Dr at my VAMC for which I have been receiving nerve block treatment and taking rx to aid in relief nerve associated pain.

degenerative joint disease in bilateral ankles, leg length inequality and bilateral flat footed as a result of connected to service injury. having this condition affecting both ankles has started affecting other joints such as my knees, hips, and lower back..

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Did you apply for TDIU? You say you asked for a hearing in front of the BVA? I had a hearing 7 months ago. I waited about 6 months for the hearing after a DRO with my lawyer present. If you are going to be disabled for at least one year I would apply for SSDI. Is your file still at the VARO. If it is I would ask for a personal hearing. You sure sound like you are a lot more disabled than 20%. Have you considered getting a lawyer? I would be asking for permanent disability. All the King's horese and all the King's men can't put old Humpty back together again. What the heck kind of work are you going to be able to do after all these surgeries even if they are successful?

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"Since then I have acquired 2 more medical opinions to back the need for convalescence of at least 1 years (1. civilian Dr of physical therapy that the VA out sourced me etc"

Does the VA have those opinions? Have they acknowledged them at all yet?

I wonder if a Reconsideration Request would get the opinions the attention they deserve-but maybe not-

do you have a vet rep?

Have you formally claimed all this yet?

*" I have also been diagnosed with RSD/CRPS in my left foot and have seeing a pain management Dr at my VAMC for which I have been receiving nerve block treatment and taking rx to aid in relief nerve associated pain.

degenerative joint disease in bilateral ankles, leg length inequality and bilateral flat footed as a result of connected to service injury. having this condition affecting both ankles has started affecting other joints such as my knees, hips, and lower back.."

John ,as always, has given some very good advise-

the TDIU form might well draw them out to consider those IMOs you have.

Check Yes to # 18 and then under # 25 Remarks refer them to separate page with your name, address, C file number and tell them how this SC disability prevents you from working, Mention again the IMos and any other disabilities that are secondary to this, tell them of any side affects of the meds that prevent you from working, and anything else they should consider.

And tell them this too:

"the surgery (8/13/10) again will require an extended period of convalescence."

Under the Remarks info ask them to also consider you for Special Monthly Compensation:

"with my future surgery will zero mobility to my left ankle qualify me for SMC for loss of use per VBA 38 CFR section 4.40

4. over all what benefits should I apply for? * note that similar surgery to the right foot is also required that will also result in zero mobility to the affected limb"

In my opinion sometimes a TDIU clam can alter the whole picture.It requires the VA to look at the disabling conditions in a new light.

Also this is a way to possibly prevent that long trek at the BVA.You do have probative new evidence so this TDIU claim might draw out the VARO to either award the TDIU or extend the convalescence period.

TDIU 21-8940.pdf

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Berta and John

s

Thanks you so much for your input. To answer some of your question.

1. yes I have been submitting all evidence to my regional VA office ( Roanoke Virginia) in addition I have been having my congressman help ( Congressman Tom Perrillo, D - congressional board veterans affairs)

as far as if they have acknowledged the evidence yet I'm not sure, I know the first Dr. opinion was but the other 2 opinions were submitted after my appeal of the DRO decision so I have no up to date list of accepted evidence. but it should have been allowed with out issue.

2. other than having the help the help of my congressman, I have pretty much handled this on my own for the past 2 yrs, I have gone to my local VA claims rep but IMHO the lady that runs it is rude and clueless to top it off.

I have been looking for a lawyer to rep. me. I have just found it difficult to find a lawyer in my area (central Virginia) that deals with VA Law. If someone could point me in the right direction in finding a lawyer it would be much appreciated.

3. With inquiring about TDIU I have not taking that path yet. I was planning on doing so after my 8/13/10 surgery.

4. As for SSDI I was unaware I would qualify I will start the ball rolling on that as soon as possible because at this point I need an help I can get. Lord knows I'm putting my Father in a bad situation by not being able to work and having him support me until the VA does the right thing and awards me what my Dr say I am justly due.

If there are any questions I missed or new ones that arise please feel free to ask and once again I would like to thank you both! It's refreshing to know there are people that care and are willing to help when The VA doesn't seem to care.

SEMPER FI

JC TURPIN

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