tdiu New Guy Wth Big Problem.

[kymike]

Hello everyone, my name is Mike. I'm a veteran of the first Gulf War. I been coming to this forum for about six months but until now I've never posted anything.

My computer and writing skills are a little rusty and been hesitent to speak up. But these are desperate times for me, so I'm forced to overcome my social anxiety and awkwardness.

I'm pleased to find this forum and all you great vets. Just being amongst you all and knowing somebody out there cares has made a big difference in my attitude.

I'll get to the chase. I'm sure on of you guys can point me in the right direction. I've a history of lower back and SI joint problems going back to GW1 in 1991.

I had a Lumbar fusion L2-S1 on 3/3/10 at VAMC Louisville for my " service connected" degenerative disk disease and HNP. VARO payed my temporary UI.

Everything seemed fine. Before surgury, on 12/30/2009 I filled for an increase for my DDD which was at 40%, and for unemployability,bi-lateral radiculapathy, stenosis,

... basicly residules from my service connected surguries. On 12/21/10 I get a letter from RO saying that they are denying all my secondary claims, unemployability,

and a proposing to reduce my SC from back to 10% because the rater made a mistake when he increase me from 10% back pain/ SI joint pain and recharacterized it as

DDD w/ HNP in june of 2005 without asking for a medical opinion from the C&P doc.

I'm angry, depressed, in severe pain, on Morphine and can't tie my own shoes. So they want to pull this crap now.

I need you guys help sorting this out. I'm hoping that you moderators out there can help me ask the right questions in the appropriate forum.

Thanks in advance. I hope somebody else can't sleep and can clue in on the first steps I need to take to staighten out this mess.

[Philip Rogers]

I think you'll need to get a favorable IMO that attributes your current status to the original injury, which may be costly but well worth the expense, in the end. Under the 5yr protection rule I feel the VA needed to call a CUE on themselves and they haven't, as of yet. I'm sure someone will correct me if I'm wrong. jmo

pr

[broncovet]

Altho Im not a lawyer, it appears the VA is "all wet" trying to reduce your benefits. The VA has to prove CUE, BUT, as pointed out below, it is not the same CUE as Vets must meet, as it is not based exclusively on the record at the time. You see, the VA needs to follow all the applicable regulations to reduce, or it wont stand:

COPY WRITTEN MATERIAL FROM VBM HAS BEEN EDITED OUT

BY ADMIN.

PLEASE DO NOT POST SOMETHING LENGTHLY THAT HAS

COPY WRITE PROTECTION.

[broncovet]

I will add that the VA does not HAVE to have medical evidence to grant benefits, so them taking them away because they say you lack evidence is bogus. Here is a case, explaining that medical evidence is not always required:

http://vetlawyers.com/vetblog/index.php/2009/10/davidson-v-shinseki-necessity-of-medical-evidence/

[Berta]

Did you ask for a hearing on this in time?

I feel you will need a strong IMO for a real doctor to connect the dots here.

They will need all available records (SMRs and all med recs) and I would send them a copy of any C & Ps that were done as well.

The IMO doctor should be an expert in this filed of disability ( there is mpre info on IMOs in our IMO forum here) and you should prepare a brief cover letteer stating why you feel the VA is medically wrong in their decision.

If a hearing as been requested this gives you a little more time to obtain an IMO.

[kymike]

Did you ask for a hearing on this in time?

I feel you will need a strong IMO for a real doctor to connect the dots here.

They will need all available records (SMRs and all med recs) and I would send them a copy of any C & Ps that were done as well.

The IMO doctor should be an expert in this filed of disability ( there is mpre info on IMOs in our IMO forum here) and you should prepare a brief cover letteer stating why you feel the VA is medically wrong in their decision.

If a hearing as been requested this gives you a little more time to obtain an IMO.

I agree, the only thing is the VA has not clearly defined their CUE. The have not attempted to meet their burden of proof. I'm " trying ' to attach my 2005 C&P exam and my active problems list. i think that SI joint pain is a symptom of DDD with Radiculopathy. also I'm including my Active Problems List date 4-12-96, which shows the onset of my Lumbar problems as of 4-12-96. I was discharged from active duty on 8-9-95. So these diagnosis' are the time frame for service connected diseases. I'm dog sitting for to french bull dogs and this computer is giving my fits.

[halos2]

Put in your appeal NOD asap request for a Personal Hearing with a DRO and a de novo review. Get with your VSO to gather evidence you need/already have, and an seek examination by a Medical Doctor stating your diagnosis, and disability, and limitations to working ability or adaptability needed for employment...You need to have ALL of your SMR and complete C-FILE to see what the VA is determining to use besides your letters you received with their proposal to reduce..

I was deemed deceased, proved I was alive, then VARO proposed to sever and I filled an appeal requesting a Personal Hearing with a DRO and a de novo review. It took 7 months to get my hearing and about another 7 to get my transcript(make sure you sign paper requesting this) and their decision...on mine they cued themselves and raised my compensation from 30 to 50 at this time...I gathered evidence from the internet, had 2 IMO's and gobs of medical treatment evidence for years too I presented.

DRO= Decision Review Officer

NOD = Notice of Disagreement

De novo-=Your C-File is to be reviewed by the DRO each and every page to validate evidence and to read the valid documentation in all the file

VSO=Veterans Service Officer

IMO= Independent Medical Opinion. IME Independent Medical Exam...

Personal Hearing-You present ALL NEW evidence to validate your case/condition/diagnosis/disability.

Edited June 26, 2011 by halos2