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2 Weeks And Still No Cnp Report

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Aquabear

Question

I did a TDIU CnP (at PM&R) on March 14 2011 and still no report in the system from ROI when I called them. I am confused/anxious/second guessing everything- as to the reaosns why the report is still not done. I had a General Medical exam on Sat 3/22 and the report was in the system that Monday and I got the print from ROI.

I know I probably am trying to read into it too much but is it taking so long becasue I just had a VA contractor install handles in the shower, provide and hook up toilet handles, and brought and put together the shower seat? Does the CnP doc need to see that these were installed to put on the report? About 99% of the time I have a VA doc's report from ROI within 24/48 hours BUT my CnP Doc REALLY went out of his way and broke the normal protocol and got me medical assit living services- ie new cane, shower handles, toilet handles and much much more. Do you think (I know anything could happen) he had to wait to type the report til after the home install stuff.

I am trying to be positive and remember how much the doc helped me out that day. Even the General Medical doc Cnp from Saturday March 12 2011-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 for your help, the last 2 weeks not knowing sucked AND of couse after he's done the report I'll have to wait for VA toprocess/RATE the claim UUUUUGGGGHHHHHHH!!!!!!!!!!!!!

Sincerely ,

Aquabear

Edited by Aquabear
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  • HadIt.com Elder

Based on the general medical C&P I think you should get TDIU. What is your percentage rating right now? Two weeks to wait for C&P copy is not a long time. I think you have rounded third base and headed for home.

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  • HadIt.com Elder

I guess according to 4.16b bear should get TDIU, but if percentage is only 20% then it might be a fight unless he gets more. When VA C&P doctor says you can't work due to SC condition that should do it for TDIU, but who knows for sure?

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Thnks all. I knew from the beginning that I am taking a crao shoot a this but now that I understand the system and howit works I am bettter prepared for the CnP.I'll call the VAMC tomorrow and see if the Doc finished it yet. I want to get a copy of it! Then pray and do the waiting game ooops-I mean learn how to knit a sweater patiently :))

I hope the rating goes faster than waiting for the report.

Thank you all again for the vote of being patient-namaste

Aquabear

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I got the report in the mail today!!!:biggrin:

ROI kept their word and mailed the CnP Report when it was finally completed! What a great lady they have working there!

The report is LONG 11 pages to be exact! Holy cow! I almost don't know where to start BUT I think it's great news for my case of TDIU and an increase from 20%. Below is An example of whats witten, the second to last page states(page 10, apge 11 is the EMG report):

E: Diagnoses

2.The chronic lower back pain, the veteran complains of difficulty with his activities of daily living. He states that he needs assistance with dressing. He claims difficulty driving especially with distance. This would impact on sedentary employment in that he is unable to sit for prolonged periods of timea(i.e.: greater than 15 minutes) without experiencing pain, according to the veteran. As for physical employmen the veteran reports that he is only able to ambulage about 50 feet before he has to rest. The service connected of chronic lower back syndrome would render him unable to secure or maintain substantially gainful employment.

3. For more information regarding chronic lower back syndrome and limitation of flexion of the thigh please refer to the spine and joint compensation and pension examination.

4. The veteran is not working as he is on Social Security disability.

Below is from page 4 of the report part of the subjective complaints:

In terms of ADL's he is using a walking stick for mobility. He is currently dependent on is wife, who is present at the examination; for his bathing, dressing, grooming and toileting. He is having difficulty getting to his university and performing well on his studies.

In terms of Deluca criteria for his low back pain he reports 10-12 incapacitating episodes in the past year that has caused him to have rest for 7 days at home causing him to miss school time. He reports flare ups daily that occur every hour with prolonged sitting, prolnged ambulation and cold weather. He treats there flare ups that occur every hour that he reports are 10-10 on the pain scale with rest from 30-60 minutes. He uses pain MEDS as well as ice to relieve some of the pain. On repetitive motion of the lumbar spine he reports increased pain, weakness and endurance.

Physical Examination (Objective findings)

There is tenderness to palpitation throughout the lumbar paraspinals and the gluteus maximus as well as the quadratus lumborum. Using a goniometer passive and active motions of the thoracolumbar spine . There was limited range of motion due to pain. Forward flexion was 0-30 degrees. Extension was 0-5 degrees. He was unable to perform bilateral lateral flexion and bilateral lateral rotation because of pain. Pain was elicited upon range of motion in any of the above directions of the lumbar spine. In terms of muscle strength testing, there was poor effort due to his low back pain. Difficult to assess muscle strength testing of his lower extremeties. DTR were +2 throughout all 4 extremeties. Sensation was intact of all 4 extremeties. On straight leg raise he was positive bilaterally at 30 dgrees. FABER test was positive bilaterally.

Deluca criteria; No additional limitation of range of motion, there is pain, fatigue, weakness, lack of endurance or any incoordination following repetitive use.

Diagnostic and Clinical tests: MRI of the lumbar soine from February 2009 shows L2-L3 small central disk herniation with annular tear indenting the thecal sac. At L5-S1 there is broad based central disk herniation with annular tear abutting the thecal sac. Facet Hypertrophy is demonstrated.

An EMG from August 2010 performed at the VA showed a chronic right S1 radiculopathy.

E. Diagnosis: Chronic low back pain syndrome of second lumbar- third lumbar, fifth lumbar first sacral disk herniation.

Veteran is currently on disability and unable to be employed due to his chronic low back pain. Unable to perform his activities of daily living and having difficulty performing his activiittes at school at this time.

EDIT: My wife pointed this statement out and I wanted to put this in I think its VERY IMPORTANT- this is to establish my claim for right hip pain that has been denied from the beginning, my initial claim I put in in 2/1998 and was denied so I hope the below statement gets me approved with backpay-

" As per Regional Office request to render an opinion as to claim for Chronic Right thigh pain as secondary to Lumbar sacral strain"

"Based on review of recent Spine C&P examination and above EMG report. It is less likely than not that the chronic Right thigh pain is secondary to the lumbar-sacral strain in service.

"END OF EDIT"

SO the above is a part of whats in the report, what do you think my chances are of an increase and of TDIU.

I am currently at 10% chronic low back pain syndrome and 10% left hip/thigh pain syndrome. I know I have to wait AGAIN for the rating board to review this so more patience.

Thanks for reading,

Aquabear

Edited by Aquabear
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