tinnitus Balance Problems - Meniere’S Disease Or Lumbar Spine Trauma

[BasehorVet]

I am thinking about filing for Meniere's disease and would like some feedback.

Long story short; sent to MEB in 84 for chronic low back pain and they found slight high frequency hearing loss, noted on my MEB exam. IPEB found me fit for back problems, appealed to the FEB, found unfit rated back at 10% lumbar facet syndrome with pain and Rt. ear hearing loss at 0% VA Code 6297. Non-concurred with FPEB appealed to Secretary of AF and asked for additional testing. Secretary of AF agreed with FPEB and discharged me 3 weeks later. By law they could not hold me over for an upgrade of disability rating, so I served 1 week short of my enlistment, 3 years 11 months 23 days.

Prior to discharge, I had my DD214 sent to the VA from the Air Force and I applied for VA benefits for back disability and hearing loss. I was denied 3 months after discharge. Ebenefits states that "You were previously denied service connection for hearing loss. You were notified of the decision on 07/29/85. The appeal period for that decision has expired and the decision is now final. In order for us to reopen your claim, we need new and material evidence. Your claim was previously denied because service records are negative for any findings regarding hearing loss. Therefore, the evidence you submit must be new and relate to this fact. The actual denial letter from 85 reads that "We do not find in your medical records or elsewhere any evidence of the existence of a hearing loss."

The original service connection VA C&P from 85 states Pos C/O high pitch hearing loss and Rt. ear 7 m scars present and perforation. Hearing loss 4000 = 20, 6000 = 30 8000 = 25 all for the left ear. Pay attention because I went to that examination with a statutory mandated benefit entitlement to hearing loss rt. ear (FPEB Determination, SAF Appeal) but left the examination with not even a 0% rating for hearing loss in either ear.

Fast forward to VA Claim 2009 Decision - SC for bi-lateral tinnitus 10% effective 2009 granted, SC for Lt Ear hearing loss granted 0% effective 2009. SC for Rt. ear hearing loss remains denied.

The decision in part reads "Service connection for Lt. Ear hearing loss is granted because you have confirmed hearing loss based on VA examination showing a relationship between Lt. Ear hearing loss and service. And a review of your VA treatment records shows that in June of 2009, you reported ear discharge and decreased bilateral hearing. In July 2009, otoscopic examination revealed scarring on the tympanic membrane bilaterally with retraction pockets on the Rt. side.

The decision also states "Opined that any hearing loss in hearing of Rt. ear is not caused by or a result of military service since your mild hearing loss at 6000 Hz upon entrance to military service and upon your MEB improved and was within normal limits at VA examination in 85.

I brought to her a copy of my MEB showing the Rt. ear hearing loss and it states that "Hearing loss, mild, 4000hz AD; medical records unavailable for comparison" she took this to be my entrance exam.

Fast forward 2-2011, C&P examination, asked for a reconsideration of back disability and hearing in 10-2010. Rt. ear hearing loss is not caused by or a result of military service. Rationale, hearing sensitivity was within normal limits between 250-8000 Hz at his C&P exam in 85. OTHER COMMENTS - The veterans contention about disability for Rt. ear hearing loss is his 1984 MEB examination revealed his Rt. ear had a high frequency hearing loss (with his left ear within normal limits). His C&P examination in 1985 revealed his Lt. Ear had a high frequency hearing loss and Rt. ear was within normal limits, which was almost the identical to the 1984 results EXCEPT that the ear results were switched. Because his left ear is poorer, it is this examiners opinion that at his 1984 MEB evaluation either the headsets were put on backwards or the results were inadvertently recorded incorrectly because the results are almost IDENTICAL (the 1984 and 1985 hearing tests), only reversed between the ears. The evidence shows that he had hearing within normal limits in the Rt. ear in 1985 after his military service. Because of this Rt. ear hearing loss could not occurred in the service.

Fast forward 5-2011 VARO took claim out of decision phase after 45 days and put it back into development and scheduled me a C&P exam for hearing. Got a copy of the C&P results and now waiting on c-file to get back to VARO and go back into decision phase.

COMMENTS ON RECORDS; VARO request for current severity. Today's C&P examination revealed test/retest of C&P examination completed on 12-2009. The veteran is currently rated at 0% for hearing loss and 10% for tinnitus.

Medical history is there a current complaint of tinnitus? Yes. Date and onset of tinnitus onset; after exposure to aircraft noise. Is tinnitus constant, yes. (I was a crew chief on a C141 and stood ground 40 feet from the nose of the aircraft, tethered by a crew headset to the cockpit by a cord while engines were tested at take off required thrust, strange feeling to have the sonic blast shake your body and rattle your teeth for 10-15 minutes at a time.)

Tests: Otoscopic examination revealed excessive scarring on the Rt. tympanic membrane. Responses indicate a mild to moderately severe sensorineural hearing loss between 4000-8000 in the Rt. ear with a mild to severe sensorineural hearing loss between 4000-8000 in the Lt. Ear. A pure tone Stenger test at 8000 was negative. Tempanometry revealed excessive compliance bilaterally.

Is hearing loss present? Yes.

Diagnosis - Bilateral high frequency sensorineural hearing loss with veteran report of constant bilateral tinnitus.

Is tinnitus as likely as not a symptom associated with hearing loss? Yes.

Due to my past experience with the VA I am cautious about the this last statement, I believe they are saying I have SC tinnitus and SC bilateral hearing loss but hoping it is not someone trying to take away the 10% that I have now for tinnitus.

I called my PCP today and asked for a referral to ENT to check if balance problems are associated with possible Meniere's disease. Over the last few years I have had a problem with mobility that is getting worse. I thought that this was related to the back disability that I have also been fighting since 85 to have service connected.

There has been a lot frustration because it seems that the VA does not think that the problems I am having with my back are associated with the problems I'm having with my balance. My lumbar back MRI (2010) showed spondylosis of the entire lumbar spine, 3 bulging discs, disc dissection, degenerative facet disease, herniated disc L5-S1 with nucleolus pulpous bilaterally, the neuro surgeon stated in an earlier record that I had profound muscle atrophy of my lumbar spinal muscles. My last appointment with my PCP (March 2011) he states that "Neruo: knee jerks 2+ bilat otherwise hard to elicit (earlier 2010 EMG states Rt. ankle jerk absent), gait is broad based, can't walk on toes, or do tandem walking. PCP did a fall risk assessment and I scored a 75, I think the base for risk of a fall is 55 or higher. My legs went out recently and I was cooking so now I have a burner sized scar on the bottom of my left forearm (stated in the PCP report). I walk with a walking crutch and am constantly banging my elbow into door frames, now I have been diagnosed with tennis elbow and shoulder impingement and they gave me a shot in my shoulder joint and elbow joint that brought temporary relief.

I have an issue with balance every day, I don't feel like the room is spinning but I do feel like it is my body that is spinning and I have to reset my balance or fall. I read recently that this is a form of vertigo, anyone ever heard of this? I do take 3 VA prescribed oxycontin a day for pain and I have a VA diagnosis of chronic low back pain and MDD due to uncontrollable pain.

Last November I passed along to the VA a new document from my service department that was in the form of a Memorandum for AFBCMR dated 9 August 2010, I had asked that my dd214 be changed from the separation code JFL to JFL1 because the VA keeps denying me for compensation for the permanent disability that happened in the Line of Duty and for which I was medically separated. They state the facts as I did above in regard to the FPEB and appeal to the Secretary of the Air Force and then go onto to say; Discussion: Member is wishing to receive benefits from the Veterans Administration. Member's DD214 form correctly reflects that member was discharged by reason of a physical disability and entitled to severance pay. JFL is the correct separation code for a person who was approved for a medical separation with severance pay. It then goes on to state that they are recommending that denial of my request to change my dd214 because the preponderance of evidence reflects that no error or injustice occurred during the disability process or at the time of separation by the Air Force.

In May 2011 I received a record of proceedings from the AF Board for correction of military records. The board concluded that the application was not timely filed; however, it is in the interest of justice to excuse the failure to timely apply. The Board met and concluded that insufficient evidence was presented to demonstrate an error or injustice was committed by the Air Force at the time of my medical separation and that they would not change my separation code.

I am hoping that the letter from the Air Force can overcome the VA statement that my records showed no evidence of a back disability or hearing loss that was incurred or aggravated during military service.

Sorry for the long rant but it has been 26 years since my discharge and I am tired and I needed to get this out.

Does anyone have any suggestions or ideas?

[godeep]

I am thinking about filing for Meniere's disease and would like some feedback.

Long story short; sent to MEB in 84 for chronic low back pain and they found slight high frequency hearing loss, noted on my MEB exam. IPEB found me fit for back problems, appealed to the FEB, found unfit rated back at 10% lumbar facet syndrome with pain and Rt. ear hearing loss at 0% VA Code 6297. Non-concurred with FPEB appealed to Secretary of AF and asked for additional testing. Secretary of AF agreed with FPEB and discharged me 3 weeks later. By law they could not hold me over for an upgrade of disability rating, so I served 1 week short of my enlistment, 3 years 11 months 23 days.

Prior to discharge, I had my DD214 sent to the VA from the Air Force and I applied for VA benefits for back disability and hearing loss. I was denied 3 months after discharge. Ebenefits states that "You were previously denied service connection for hearing loss. You were notified of the decision on 07/29/85. The appeal period for that decision has expired and the decision is now final. In order for us to reopen your claim, we need new and material evidence. Your claim was previously denied because service records are negative for any findings regarding hearing loss. Therefore, the evidence you submit must be new and relate to this fact. The actual denial letter from 85 reads that "We do not find in your medical records or elsewhere any evidence of the existence of a hearing loss."

The original service connection VA C&P from 85 states Pos C/O high pitch hearing loss and Rt. ear 7 m scars present and perforation. Hearing loss 4000 = 20, 6000 = 30 8000 = 25 all for the left ear. Pay attention because I went to that examination with a statutory mandated benefit entitlement to hearing loss rt. ear (FPEB Determination, SAF Appeal) but left the examination with not even a 0% rating for hearing loss in either ear.

Fast forward to VA Claim 2009 Decision - SC for bi-lateral tinnitus 10% effective 2009 granted, SC for Lt Ear hearing loss granted 0% effective 2009. SC for Rt. ear hearing loss remains denied.

The decision in part reads "Service connection for Lt. Ear hearing loss is granted because you have confirmed hearing loss based on VA examination showing a relationship between Lt. Ear hearing loss and service. And a review of your VA treatment records shows that in June of 2009, you reported ear discharge and decreased bilateral hearing. In July 2009, otoscopic examination revealed scarring on the tympanic membrane bilaterally with retraction pockets on the Rt. side.

The decision also states "Opined that any hearing loss in hearing of Rt. ear is not caused by or a result of military service since your mild hearing loss at 6000 Hz upon entrance to military service and upon your MEB improved and was within normal limits at VA examination in 85.

I brought to her a copy of my MEB showing the Rt. ear hearing loss and it states that "Hearing loss, mild, 4000hz AD; medical records unavailable for comparison" she took this to be my entrance exam.

Fast forward 2-2011, C&P examination, asked for a reconsideration of back disability and hearing in 10-2010. Rt. ear hearing loss is not caused by or a result of military service. Rationale, hearing sensitivity was within normal limits between 250-8000 Hz at his C&P exam in 85. OTHER COMMENTS - The veterans contention about disability for Rt. ear hearing loss is his 1984 MEB examination revealed his Rt. ear had a high frequency hearing loss (with his left ear within normal limits). His C&P examination in 1985 revealed his Lt. Ear had a high frequency hearing loss and Rt. ear was within normal limits, which was almost the identical to the 1984 results EXCEPT that the ear results were switched. Because his left ear is poorer, it is this examiners opinion that at his 1984 MEB evaluation either the headsets were put on backwards or the results were inadvertently recorded incorrectly because the results are almost IDENTICAL (the 1984 and 1985 hearing tests), only reversed between the ears. The evidence shows that he had hearing within normal limits in the Rt. ear in 1985 after his military service. Because of this Rt. ear hearing loss could not occurred in the service.

Fast forward 5-2011 VARO took claim out of decision phase after 45 days and put it back into development and scheduled me a C&P exam for hearing. Got a copy of the C&P results and now waiting on c-file to get back to VARO and go back into decision phase.

COMMENTS ON RECORDS; VARO request for current severity. Today's C&P examination revealed test/retest of C&P examination completed on 12-2009. The veteran is currently rated at 0% for hearing loss and 10% for tinnitus.

Medical history is there a current complaint of tinnitus? Yes. Date and onset of tinnitus onset; after exposure to aircraft noise. Is tinnitus constant, yes. (I was a crew chief on a C141 and stood ground 40 feet from the nose of the aircraft, tethered by a crew headset to the cockpit by a cord while engines were tested at take off required thrust, strange feeling to have the sonic blast shake your body and rattle your teeth for 10-15 minutes at a time.)

Tests: Otoscopic examination revealed excessive scarring on the Rt. tympanic membrane. Responses indicate a mild to moderately severe sensorineural hearing loss between 4000-8000 in the Rt. ear with a mild to severe sensorineural hearing loss between 4000-8000 in the Lt. Ear. A pure tone Stenger test at 8000 was negative. Tempanometry revealed excessive compliance bilaterally.

Is hearing loss present? Yes.

Diagnosis - Bilateral high frequency sensorineural hearing loss with veteran report of constant bilateral tinnitus.

Is tinnitus as likely as not a symptom associated with hearing loss? Yes.

Due to my past experience with the VA I am cautious about the this last statement, I believe they are saying I have SC tinnitus and SC bilateral hearing loss but hoping it is not someone trying to take away the 10% that I have now for tinnitus.

I called my PCP today and asked for a referral to ENT to check if balance problems are associated with possible Meniere's disease. Over the last few years I have had a problem with mobility that is getting worse. I thought that this was related to the back disability that I have also been fighting since 85 to have service connected.

There has been a lot frustration because it seems that the VA does not think that the problems I am having with my back are associated with the problems I'm having with my balance. My lumbar back MRI (2010) showed spondylosis of the entire lumbar spine, 3 bulging discs, disc dissection, degenerative facet disease, herniated disc L5-S1 with nucleolus pulpous bilaterally, the neuro surgeon stated in an earlier record that I had profound muscle atrophy of my lumbar spinal muscles. My last appointment with my PCP (March 2011) he states that "Neruo: knee jerks 2+ bilat otherwise hard to elicit (earlier 2010 EMG states Rt. ankle jerk absent), gait is broad based, can't walk on toes, or do tandem walking. PCP did a fall risk assessment and I scored a 75, I think the base for risk of a fall is 55 or higher. My legs went out recently and I was cooking so now I have a burner sized scar on the bottom of my left forearm (stated in the PCP report). I walk with a walking crutch and am constantly banging my elbow into door frames, now I have been diagnosed with tennis elbow and shoulder impingement and they gave me a shot in my shoulder joint and elbow joint that brought temporary relief.

I have an issue with balance every day, I don't feel like the room is spinning but I do feel like it is my body that is spinning and I have to reset my balance or fall. I read recently that this is a form of vertigo, anyone ever heard of this? I do take 3 VA prescribed oxycontin a day for pain and I have a VA diagnosis of chronic low back pain and MDD due to uncontrollable pain.

Last November I passed along to the VA a new document from my service department that was in the form of a Memorandum for AFBCMR dated 9 August 2010, I had asked that my dd214 be changed from the separation code JFL to JFL1 because the VA keeps denying me for compensation for the permanent disability that happened in the Line of Duty and for which I was medically separated. They state the facts as I did above in regard to the FPEB and appeal to the Secretary of the Air Force and then go onto to say; Discussion: Member is wishing to receive benefits from the Veterans Administration. Member's DD214 form correctly reflects that member was discharged by reason of a physical disability and entitled to severance pay. JFL is the correct separation code for a person who was approved for a medical separation with severance pay. It then goes on to state that they are recommending that denial of my request to change my dd214 because the preponderance of evidence reflects that no error or injustice occurred during the disability process or at the time of separation by the Air Force.

In May 2011 I received a record of proceedings from the AF Board for correction of military records. The board concluded that the application was not timely filed; however, it is in the interest of justice to excuse the failure to timely apply. The Board met and concluded that insufficient evidence was presented to demonstrate an error or injustice was committed by the Air Force at the time of my medical separation and that they would not change my separation code.

I am hoping that the letter from the Air Force can overcome the VA statement that my records showed no evidence of a back disability or hearing loss that was incurred or aggravated during military service.

Sorry for the long rant but it has been 26 years since my discharge and I am tired and I needed to get this out.

Does anyone have any suggestions or ideas?

Wow, that's a lot of stuff to respond to!

First of all, the evidence is that the sensorineural hearing loss in your right ear is mild and uncompensatable both then and now. The hearing loss in your left ear is conductive and is a result of an incomplete tympanum, hence the drainage. That is in your service record. I suggest that you see an ENT physician and talk to him about Meniere's Syndrome. Endolymphatic hydrops is nothing to mess around with, and it's symptoms are vertigo, nausea, fluctuant hearing loss and tinitus, all usually of significant severity.

I'd say off the top that it's unlikely that you'll get that diagnosis based on what you've provided here, but that doesn't mean that you shouldn't pursue a medical opinion.

Hope this helps!

Edited May 24, 2011 by godeep

[Berta]

"I am hoping that the letter from the Air Force can overcome the VA statement that my records showed no evidence of a back disability or hearing loss that was incurred or aggravated during military service."

Do you have your SMRs?

Is there evidence if a back problem in them?

If not have you attempted to get buddy statements as eye witness accounts that you injured your back in service?

How will you prove this has been a chronic and continuous disability since service, even if you get buddy statements to verify what happened in service to your back?

The VCAA letter you got when you filed these claims should have specifically told you what evidence the VA needed.

Edited May 24, 2011 by Berta

[BasehorVet]

I have most of my SMR's from when I copied them from my file when still on active duty 26 years ago.

I asked on IRIS a while back "why did they sever my direct service connection in the 85 ruling and was told that "The Air Force and VA are separate organizations. The Air Force granted service connection, but the VA didn't. The Air Force still considers those conditions to be service connected. Service connection was never severed by the VA, because it was never established by the VA."

I sent in a buddy letter from the guy I joined the military with under the buddy system, he states that I never had a back problem as a kid and that I was injured in the line of duty and that this injury caused me to be medically discharged for the resulting disability. We enlisted together with the promise that we would go through basic training together, we then got orders to the same tech school and then orders to the same AFB in New Jersey, we were room mates in the barracks for most of our time together in service. He stayed in and retired as a Master Sargent.

My claim is in the administrative review stage, per eBenefits, this happened because I saw in my original C&P examination that the doctor never mentioned my disabilities that I had just been medically discharged for but instead said I had spondylosis L1, I went to the walk in clinic in Wichita and tried to file for the facet syndrome for which I was discharged for. The VA adjudicator that I met with looked over my Line of Duty determination, my dd214 which states discharged due to disability and entitled to severance pay and the statement from the formal physical evaluation board that stated I had a hearing disability and back disability. He asked me why I had not filed for this before and was shocked when I told him that I did in 85 right after getting out and that it had been denied and again denied in 90 and in 2009. I also pointed out that the last denial came on the same day that my MRI was conducted, the MRI that the examiner had ordered for my back after I had a massive muscle spasm during her attempt to force my leg down on the table while rotating my hips.

He took my file and said he was going to take it back and have it looked at again, I told him that I still wanted to file for what I was discharged from and he said I should get a letter in a few weeks because they were supposed to wait for the MRI before making a decision.

In 85 the VA said no record for any disabilities in service, even though I had just been medically discharged 2 months earlier. 1990 the VA said condition was transient and resolved itself without any residual, 2009 VA said my problems were due to a form of juvenile arthritis and that my problems arise from this, they also stated that the spondylosis, spondylothesis, lumbar strain, degenerative disc disease and facet syndrome that I was diagnosed with while on active duty were due to this juvenile arthritis. She stated that I had a dermatology symptom of Livedo Reticularis that proves this theory, I went to the two different dermatologists at the VA medical center, showed them thaat I had been deinied comp because of this disease and the first one was so pissed and wrote that I did not have livedo and then had me scheduled to see his peer and he also stated that I had no such disease and both were astounded that this examiner could even try to connect the two together.