Automobile Allowance Denied

[Michellee]

Well big yellow envelope came in today. WHERE DO I GO FROM HERE? WHAT MORE EVIDENCE ARE THEY LOOKING FOR? I DON"T UNDERSTAND> OK the reason for decision says that imo dr xxxxxxxx noted that i suffered a cervical spine injury which resulted in left foot drop with one hundred percent loss of use of the leg and cervical radiculopathy with seventy five percent loss of use of the right arm> Then they have medical physical statement filled out by VA doc where he states I have left foot drop. Then they dont mention my DDD and claim there is no evidence that I have loss of use of the left lower extremity. ?????? Then they don't mention the MRI that shows the spinal stenosis or cord injury and they also report that they obtained outpation treatment reports from the VA medical center that showed I just enrolle in the primary care clinic in March 2010. I am confused on that one I have been enrolled since Jan 98. I was medically boarded out from active duty for a Left foot Lisfranc Injury gone bad and from incorrect casting of the left foot. They immediately caught my spinal problems after I reported to the VA as soon as I got home. I fell in a 15 foot hole during the Gulf war. So that is how I sustained all those traumatic injuries. Getting back to letter they noted an error that Physical therapy had said I was able to ambulate 30 feet with use of rolling walker which was an error that I had to take up with PT and they said they would fix they meant 3 feet and not 30 feet and some how regional got the incorrect info and not the correction that PT made. They also note that I have descrepancies with the lenght of my extremeties. I guess one of my legs have become shorter which is a result of the continuos incorrect casting while on active duty which threw my hip out and today I have severe pain in my hip and lumbar. They keep citing that I dont meet the requirement of 38 CFR 3.808. When I do have loss of use my left foot. Also have loss of function of my left leg and have no effective functioning ability to ambulate with it. Maybe I can get my outside neuro doc to explain to them and do a nexus. Do you think that will help. Perhaps its not tied together because I have so many different things going on with my back and my left foot. I can ambulate without a wheelchair if I did I would be dragging it while using a cane and could only do it for about 3 feet. I find things stuck in it and don't even realize it was there, tacks, paperclips, little rocks under my foot sometimes. My left leg is ice cold when my right leg is nice and warm. They don't even mention my MRI that I submitted as evidence. Should I drive down to Regional its about 3 hours away. What should I do now? This is the second refile for this claim. I am getting tired.

[Michellee]

It doesn't appear to me that the VA examiner was asked the question if there was loss of use of the foot. I would need a copy of the C&P exam and the 2507 exam request to be sure, but that's how it looks. I'm guessing that what happened was that somebody was either lazy or poorly trained or having a bad day, and instead of asking the correct question, they just checked the box that results in an standard examination to evaluate the leg, and no opinion was even requested. What aggravates me is that you HAVE an opinion by a private doctor that says there is loss of use! And the VA examiner may not have said in so many words that there was loss of use, but he sure as heck didn't say there WASN'T! Do you have a POA? The fastest way to get this fixed is to turn right around and ask for a reconsideration, that you feel that either your private doctor's opinion was ignored, or that the VA doctor was not asked whether there was loss of use according to the VA definition. Before you do THAT though, request the 2507 exam request and a copy of the C&P examination to see what the VA doctor was actually asked and what his actual reply was. Also, if you're going to a private doctor anyway, print out the definition I gave you for "loss of use" and ask for a medical opinion as to whether your condition meets the criteria, and include that with your request for reconsideration.

REPLY

I did not have a CP exam for loss of use. I did not initially have loss of use when I was being medically boarded out from active duty to the VA I was still in the middle of treatment at that. I became progressively worse and continue too over the years. Handed me a wheelchair and some drugs. Told me that there was nothing else that PT could do for me and had OT set me up with some equipment around the house. The end. VA doctor says its not loss of use even I can't use it and have marked difficulty with ambulation, he notes that there are discrepancies in the lenght of my lower extremities as a result of the trauma but he re quotes that "that the VA has a special definition for Loss of use as "existing when no effective function remains other than that which would be equally well serve by an amputation stump at the site of election below elbow or knee with use of a sutiable prosthetic appliance. He says that I have extreme marked impairment of use but not loss of use as defined by the VA. So I believe that this is probally why I did not get it. My initial CP was for the sciatica, DDD, etc the other ratings that I listed earlier. Perhaps, secondary due to progression or even caused by the spinal stenosis. I'm not a doctor so I really don't know whats causing this progression. My VA doctor even stated I have left foot drop. READ THIS NEW ATTACHMENT THAT WAS ALSO SENT WITH THE REQUEST for this claim. I had the primary care VA doctor fill out a medical statement form that I had printed off of the Social security website when I was applying for social security, which I don't recieve as yet. I sent VARO a copy of what the VA physician reported to SSA in regards to my disability and they can see the foot drop I have and the other affects as well. So do I need to volunteer for an amputation????? I totally agree with you btw. This was a reconsideration. I originally applied in Aug of 09 got denied so I asked for reconsideration in May 2010 and sent in the MRI and additional info and they treated like it was brand new and it was actually a reconsideration as recommended by the folks here on Hadit. That's what I rolled with and then they came back like it was initial claim and didn't even mention the MRI in the evidence they listed. Can you have FOOT DROP WITHOUT LOSS OF USE?????? Never heard of that. Well I asked couple of Doctors at the Army medical Center and they say no. So how could they have ignored the statement by my primary Care doctor who noted it on the medical statement I presented them??

Edited August 5, 2010 by Michellee

[Pete53]

Michelle:

I think that using the advice of James and LarryJ you will get your grant. I want to thank both as I think this thread has been very helpful to many Members.

Good Luck

[JamesBreckenridge]

Wait, so you weren't seen at all for an examination and medical opinion?

WHat about the first time you filed the claim, surely you were seen for a VA exam THEN... are you sure that it was the DOCTOR that said you didn't have loss of use, or was that the rating specialist's words? Look at your previous denial, and previous C&P/exam request.

You need to continuously prosecute this claim, so call in and say you're asking for another reconsideration. You can keep on doing that, and it saves your original effective date. Then write in a 4138 saying that they ignored the MRI and disregarded the Social Security Administration evidence showing you had loss of use.

DO YOU HAVE A POA????? If not, get one.

[Michellee]

My POA is American Legion. They are very busy. I went by there a couple months ago and the room was filled and eventually had to leave. Plus I couldn't continue to sit that long. I will file a 4138 as you suggested and call tomorrow to ask for second reconsideration. What about a DRO review. When I filed my reconsideration they did not allow me to keep my original date. The claim was now noted as filing in May 10. The original claim was filed Aug 09. To this day I was never sent for a C&P or any medical exam other than what I went out on my own to pursue and pay for in reference to filing for loss of use and the vehicle allowance/adaptation. Any vehicle I own I have to adapt to carry around my power chair. Well thanks for your support these suggestions keep me on track and I hope it does help others encourage them to keep fighting for what they deserve. Thanks all.

[JamesBreckenridge]

Ask for them to either accept your doctors statement regarding loss of use or send you for an exam with opinion by a VA doc. Also ask for your original effective date when it's granted because you have continuously prosecuted your claim.

[JamesBreckenridge]

Your date of claim will chnge with each request for reconsideration. But your effective date should be saved if you continously prosecute.

Reconsideration should be faster than a dro