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Cue Or Not To Cue

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Michellee

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If anyone see's Berta please send her my way. I know she will direct me in the right direction. Well here is the deal. I was medically boarded off of active duty for an accident that was well documented actually I was even transfered not quit cleared and sent to the VA for evaluation and treatment. Within my presumptive period after the medical board/disharge I filed numerous claims all at once for numerous symptoms/injuries. Most was given o% or denied and few were given very low percentages like for my foot/hip/uterus/pelvic etc. That was then back in 98. The thing that bothers me to this day is that I think a mistake was really made on the neck and back claim. Today I have pretty good ratings for my lower/back/sciatica etc and was eventually service connected. My neck progressively has gotten worse and worse and still not service connected. The rating the decision they gave me right after the accident for my neck makes no sense. They didn't even do a MRI back then even though I begged. As a result today my MRI's have shown I have spinal cord injury from the cervical area and all sorts of spurs from previous fractures in the neck area. I have stenosis, Ankylosing spondylitis of the cervical spine, myelopathy of the cervical spine, bulging disk etc. So when I filed for neck and back pain I was trying to call their attention to address my injury to my neck and they denied it. Here is what the rating decision in 98 stated for my neck during the presumptive period (after falling in a 15 foot hole which they had the accident report evidence).

The law provides that a person who submits a claim for VA benefits must submit evidence sufficent to justify a belief that the claim is well grounded. A well grounded claim is plausible claim, one which has merit on its own or is capable of substantiation. Such a claim need not be conclusive, but it must be accompanied by evidence which shows that claimed condition exist and is possibly related to service.

Compensation is payable for a disease or injury which causes a disabling physical or mental limitation. The evidence regarding neck and back pains fails to show a disability for which compensation be be established. It is therefore not a well grounded claim which can be resolved. In order to establish a well grounded claim, it is necessary to provide evidence which demonstrates an actually disabling condition. (this is the part that makes me wonder whose records were they looking at) Services records contain no evidence of an injury to the neck or back and no indication of a chronic disease process relative to neck or back. Xrays of the cervical and lumbusacral spine on Va examination were normal.

Now they did not assist me in addressing my symptons. Today they have changed their tune about my back (lower) and of course I lost the initial dates. I just accepted it. Back then I really didn't know much about claims or the Va and would have have believed if they told me the sky was purple. The thing is through out the years since the initial claim I kept complaining and seeking answers about my cervical neck pain and finally about 2006 they started doing MRI's and other tools to look at it. That's when I started pulling my records and finding all the results of the MRI and progression of my back and neck injury. I didnt even think to pull records until another veteran taught me the process. I just didn't know. I always played by the rules and I thought they did. I am still suffering today. I finally after my doctor told me blantantly that this injury to my neck was a direct result of the accident because of how young I am and how the MRI's look. Today I do recieved treatment for my neck but it was never service connected no matter what my doctor told me. I had to make a decision and so not really understanding about CUE's I thought it may be best to just reopen my claim from 1998 for my neck pain (cervical) and file for all the newly diagnose cervical results from my doc and MRI. After reading so much on Hadit and another Vet site I am wondering If I really did the right thing. Did I just let them off the hook. I have read multiple post on this site about what makes a claim, Browskoski test etc., and I am wondering I made the right move. It appears that I didn't I keep asking should I have Cued or Not. They were well aware of my accident during the first claim and had the accident report so it was well grounded. Sure it may not have been conclusive because there was no official diagnoses made but I was seeking medical answers and care based on my symptoms to which I kept being told maybe I pulled a muscle in my neck. They had the after action report from my commander which showed evidence, they had my medical out paperwork where I checked the box for back and neck pain. Sure the pain then wasn't as bad as it is now but it did cause me pain and spasm that I expressed to them in my claim as neck and back pain. I didn't know then how to write it up any different than that and they didnt bother to C & P all they did was an xray which they claim was normal. Funny thing is couple of years later I continue to complain and the next set of xrays shows spurs and other things in the same area. Obviously, the pain that I was feeling then in my neck and back during the presumptive period was the injury that I am still suffering from and proven by recent MRI's today. I would like to hear various takes on this. Cue or not to Cue?

Edited by Michellee
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"Well I hope I win because I wonder if that could prompt them to come after our children with social service."

No , I dont think you should ever worry about that at all.And you have some great evidence to get this proposed issue overturned.

VA Incompetency is solely a VA issue about compensation.

Real incompetency has to be declared by a court of law and with A LOT of evidence.

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But it is ok. I just want to make sure I get these things accurately rated, evaluated and treated.

I am not worried about filing claims as I am TDIU and not under the 20 year rule.

Mic,

Is your current rating already covered by the 20 year protection rule ?

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I vaguely remember the C&P doc asking who handles the bills and I thought she was asking as in do I have a good support system and

I may expressed that my husband does the bills does the majority of the bills.

Mic,

I'll bet that the underlined above is why they have proposed incompetency.

If the MH C&P was done at your VAMC - get a copy of it and look it over real good.

See if the MH C&P examiner stated competent or incompetent to handle VA funds.

Ask for the hearing.

BTW - did this new rating decision state P&T OR No Future Exams OR Chapter35 benefits ?

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Mic,

Is your current rating already covered by the 20 year protection rule ?

No I don't think so. It's funny that now when I read that old award letter and how they referred to my claim for my back and neck when I was medically boarded from active duty for my lower back and foot from my accident. Then turned around, corrected themselves and gave it to me. That's why you shouldn't give up. Sometimes it's how we initially present it. I guess....

Edited by Michellee
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I need some advice/direction. I am 50% connected and one of the reasons is because of my back (they only rated my back 10%). Blew it out and had to have surgery for L5,S1 hurniated disc that causes pain down my left leg. OK, Last August I re-injured it.....went to the VA and after MRI surgeon said i rehurniated the disc and needed another surgery. I said ok, because i was in unbelievable pain. After I woke up, the doctor said i didnt have a hurniated disc but i did have a ton of scar tissue that he removed. Now my calf does not work....its dead...doc says he dont know why and that he didnt do anything to affect my calf!. Also the pain has returned with a vengence....Went for 6 week follow up and doc says post MRI shows guess what?? A hurniated disc at L5.S1!!!! I asked him, wasnt that the disc he was SUPPOSE TO TAKE CARE OF IN SURGERY...he shrugged his shoulders and said i dont know....then asked if i wanted another surgery!!!! I said no. Went to patient advocate and they said if i wanted another surgery (which i will have to have due to this pain that morphine wont touch) that I would have to go to Houston for a second opinion and then go back to Houston for the surgery at the VA there.

My question is what do I do? What should I file for? increase in disability? new disability because of dead calf muscle? CUE? I have no clue. Thanks

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I respnded to your question as posted in our FTCA forum here.

Th is not a CUE issue.

CUE claims are explained in our CUE forum.

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