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Cnp Tomorrow- Here We Go


Here we go again on the merry go round but this time I feel better going in with the documents I have.

Tomorrow, Saturday March 12 2011, I'll have my CnP exam at Central Intake then I have another CnP on Tuesday for PM&R. I don't think Ihave EVERY had 2 CnP exams!? Whats the deal?

I am bringing some papers, myself and my wife- she will drive me and assist me with the exam. She remembers MUCH MUCH more than I ever could recall theses days about all that I am going thru and she reminds me to put my pride aside and talk about how I really feel :((((((:sad: .

Papers wise, I am bringing:

1. My HOLY GRAIL (but no Monty Python) of Papers SSSID "Notice of Decision- Favorable" about 7 pages, which states everything the VA wants to hear per the reqs to be rated for or increased,


A. I have not engaged in substantial gainful activity since 11/23/2009

B. The claimant has the following severe im[airments: degenerative and herniated lumbar discs

C. has mild restriction in activities of daily living

D. Mild difficulties in maintaining concentration, persistence or pace and no episodes of decompensation, each of extended duration

E. The patient has the residual functual capacity to perform sedentary work as defined in 20CFR 404.1567 (a) EXCEPT can only sit two hours in an 8 hour day.

Claimaint has progressive worsening back pain. He testified that the back pain is so bad that he needs help to groom, dress himself, do laundry, cook and clean and that medication help BUT then limit his ability to focus. Xrays showed degenerative changes at L1-L2 and L5-S1. An MRI scan disclosed herniation at L2-L3 with and annular tear indenting the thecal sac and a herniation at L5-S1 with an annular tear, facet hypertrophy and mild stenosis

Clinical exams were noted for loss of motion, tenderness, occasionalspasm and positive straight leg raising signs, despite several medications, facet blocks, chiropractic therapy and physical therapy. This evidence amply supports the treating doctor's recent opinion that the claimant could sit, stand, walktwo hours in an eight hour day and occasionally life and carry ten pounds since Nov 23 2009. The undersigned(the Judge) accords this uncontroverted opinion considerable weight.

After consideringthe evidence of record, the undersigned finds that the claimant's medically determinable impairments could reasonably be expected to produce the alleged symptoms, and the claimants statements concerning the intensity, persistency and limiting effects of these symptoms are generally credible.

- The claimant is unable to perform any past relevant work 20 CFR 404.1565 and his skills cannot transfer to other occupations within residual functional capacity.AND there are no jobs that exist that the claimant can perform considering his age,education, work experience and residual function.

11. The claimant has been under a disability as defined in the social Security Act sinceNovember 23 2009.


Based on the application for a period of disability and disability insurance benefits filed on March 13 2009 the claimant has been disabled under sections 216(i) and 223(d) of the Social Security Act since Nov 23 2009.


2.A note from my doc to my college explaining that I am under his care for pain mangmt, had a radiofrequency ablation and is still experiencing pain which increases when sitting or standing for an extended period of time.

3. D Pain mgnt doc typed letter stating I am under his carestill March 11 2011 for Pain Management treatment of the lumbar spondylosis. Patient suffering from continued pain which is severe and sharp and more diffuse. Topamax caused altered mental status, which has been weaned down. I suggested starting Cymbalta daily for his myofascial and neuropathic symptoms. He will stop percocet and start Norico 10/325. Robaxin will be continued for spasm. He will remain of flector and lidoderm patches. Patient still reports mental clouding. At this time length of treatment is undetermined.

4. Also bringing in my EMG/EEG results done at VAMC Northport. DOC wrote: EMG " there is marked disparity in the amplitudes of the psoterior tibial nerves with the right side response being approx ONE THIRD that of the left side. the right H reflex is absent, the left is normal. EMG study does not show scute signs of denervation but there are CHRONIC changes consistet with prior loss of motor axons from the posterior tibial nerve. IMPRESSION: Chronic right S1


I already sent in with the IU form my SSDI favorable decision (item A) but I want to bring and show the examiners. I think the SSDI papers I sent in are what triggered the wholy SHYT at the RO and why they on their own reopened my case for Bilateral pain in legs/hips/knees- I didnt askto reopen but sure as hell WANT IT, NEED IT!

Thanks al for reading

Ok any comments...................................................................


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4 answers to this question

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Like you I had a C&P for my service connected lower back injury from being blown up in Vietnam by a rocket. The doc did not use any kind of measuring device but probably didn't need to since the most I could bend was 20% in any direction.I had applied for IU prior to this exam. Two weeks later I was ordered to have a repeat ROM C&P exam. The same doc need it again with the same results. Maybe they didn't believe the first test or the first test was related to my claim for an increase in my disability rating on my back and the second on was for my IU claim?:

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Thanks Captain Soggy for the reply.

I wanted to write about my CnP exam experience today.

Today I had part 2 to my CnP exam, the ROM for spine n joints, I am SC for low back, left hip pain and the exam was for TDIU which means they look to increase SC conditions and maybe add some more in. I had my wife along with me and I know she brought about a nice change. The CnP was not the evil day appointment it usually is. It was at 9:15am and I expected it to be about an hour but I didn’t leave the VAMC until almost 3pm.

The CnP doc went thru entire history of my conditions and my wife and I gave him our complaints of my condition. The exam sucked, he tried to do ROM, which was very little, I screamed in pain because I was told that’s how the VA doc’s respond to someone who’s in pain. Told him of my Humvee rollover, the MRI herniated discs, the EMG that noted severe nerve impingement/neuropathy, a good thing I gave him my report of my Pain Management Doc which also states severe pain, can’t sit for 15 minutes without pain etc and he knew him, he even trained there and says they are the best Docs there. Long story short the Doc turned the IME/CnP into a help the vet appointment. He brought in a senior doc to help and they both went (I feel) above and beyond a CnP exam. They made some calls and got me walk in appointments that day to get a custom cane on order, a wooden cane for that day to use and keep, get a new large ice pack THEN had me go to Rehab/Ortho and get and it a long shoe horn, a sponge on a stick to wash my back, a long grabber, a sock puller and some sort of sock put on thing, handles for my shower at home that they will pay to have installed, toilet handles to help rise/sit and much more! NO WAY would I have thought my CnP would have gone this way, I never heard of a CnP doc actually helping a patient!

I can only hope that the exam he type’s will help with my TDIU/SC increase. I heard him and the senior doc talking in how to write this and it sounded as they wanted to help even asking how to type in the report no ROM and 10-12 debilitating episodes per year. Now the only thing I can only is the waiting game for the rating people(ROI said they will mail me a copy of the CnP when it is finished maybe in a day or two).

NOTE: One really good thing from the General CnP exam from this past Saturday the Doc wrote in Diagnosis a lot of helpful things to my case but one that I really hope helps that “The service connected disability of chronic lower back syndrome would render him unable to secure or maintain substantially gainful employment.”

Thanks all.

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You probably could not ask for a better C&P exam results. And, contrary to what we all want to believe, there ARE some VA docs that really do care and will go the extra mile for a veteran.

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LarryJ totally agree. This doc's actions were shocking and my wife and I were so thankful to him and everyone who helped us today. Thanks for your comments and have a great night!

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