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Back Problems-been Denied


Billyboy

Question

Hello All;

In 2003 I filed my claim and in that claim I filed for lower back problems. The VA denied lower back stating; “Your treatment records subsequent to service show sporadic complaints of back pain over the past few years. There is no evidence to show that you have a chronic back disability associated with your Coast Guard service, therefore service connection is denied”

I have a buddy statement that I chipped and scrapped lead paint on my hands and knees, stooping and bending over to do this work.

What they have acknowledge in the 50 % MDD (claimed as PTSD, night sweats and sleep disorder)

A buddy statement that I slipped and fell on my back striking my head.

CT Scan of the back of my skull.

Buddy statement that I handed heavy clips up to the person on the platform of the 40MM cannon.

(Tinnitus 10%)

From time of discharge (1962) until 1991-1993 my first 2 Dr’s are dead and all records destroyed.

I have Dr. statement from 1991-1993 saying lower back pain.

I recently had x-rays and the Dr. called and informed me I have “Severe Arthritis” of the lower back.

This from the radiology report;

“Large right lateral bridging osteophytes at L1-L2; anterior intervertebral endplate osteophytes from L1 to L5”

What would you suggest I do now? bill

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  • HadIt.com Elder

You'll need an Independent Medical Opinion from a doctor stating that your current back condition is somehow related to the incidents while you were in the service. Buddy statements aren't really going to help in this situation, they just state how your condition affected you. There has to be a medical determination, and only a doctor can do this.

Remember, your Service Medical Records must show a "chronic" condition while in service. If they do not show this, then continuity of treatment is needed from time of discharge to the present. If you have a couple of lower back episodes while in service over a number of years, this isn't going to cut it. The VA will probably state that this was "Acute and Transitory." Now if you had these couple of episodes while in the service and a few treatments after service, this becomes a judgement call on the rater.

Your best bet is to get an Independent Medical Opinion. I hope this helps!

Vike 17

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Don't want to sound negative as all claims are different, but I helped a veteran with a claim for a back injury he said he received while in the military. We got his SMR's. Nothing in there except for a few dates of going to sick bay for what was listed as back strain. Nothing was in his SMR's at all about him going to sick bay to be treated for the back injury, even though the veteran said the accident did happen and he did go to sick bay immediately after it happened. He said he started seeing doctors as soon as he was released from the miitary, but since he had waited so long in getting the very old records, the doctors were no longer practicing and he couldn't get the records. He even was able to get a buddy letter stating that he was aboard the ship when the accident occurred. Didn't seem to help his claim. I think the worse thing he had going against him was the fact that he hurt his back, during civilian employment, several times. He stated that this was due to the fact that he already had back problems, dating back to the accident in the military. Didn't help. He did have doctors records indicating that some of his problems appeared to be old in nature. He also did have some records of seeing doctors for back problems before he had any injury at work.

I helped him a great deal trying to do all we could to try and get this claim approved, but again, he couldn't get the old records that the VARO stated they wanted showing treatment within one year of his separation, no actual accident showed up in his SMR's, even though he stated it did occur and he had a buddy letter to back it up, and then he had medical records showing that he was seen for back injuries that were work related. As hard as we tried, they kept denying the claim, even at the BVA level. At that point, he dropped it.

I am only writing this story of this incident because of the importance of having specific evidence or it is so easy for them to deny your claim. Even with his testimony of what happened and his buddy letter, the VARO immediately denied the claim based a lot on the fact that no where did he have enough evidence to show the accident actually occurred and that there was any actual damage done to his back. Having the work related injuries did not help his claim either.

Maybe some of the information here will help someone else when they are trying to start their claim or may be in the same situation as this veteran was.

mssoup1

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  • HadIt.com Elder

Mssoup1,

If the veteran's SMR show a couple of treatments of 'back strain,' but not an actual back injury, and he can't get any treatment records right after discharge but has a currnent back condition diagnosed by a doctor, he would need a very good Independent medical opinion connecting the two. The doctor would have to make references in the IMO to sound medical literature for this to hold any water. A simple statement where the doctor opined that he thought the current condition would be more than likely the result of the inservice ocurrance probably wouldn't go very far.

Once he obtained this IMO, he could re-open his claim with this IMO and 'New and Material' evidnence.

Vike 17

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Vike is certainly correct and

"Even with his testimony of what happened and his buddy letter, the VARO immediately denied the claim based a lot on the fact that no where did he have enough evidence to show the accident actually occurred and that there was any actual damage done to his back. Having the work related injuries did not help his claim either."

In a case like this the VARO has no choice but to render a denial.

Although he obtained a buddy statement, had he gotten an actual witness statement to prove the in service accident -that would have helped the claim-but still he would have needed prove of service medical attention directly due to the accident.

A notation of back strain in SMRs is sort of like a notation of callouses in boot camp-it can come from the normal rigors of service and would have to be clearly associated with the accident.

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  • HadIt.com Elder

I know a Veteran who was pinned by a trailer and hurt his back. The incident some treatment in Army plus an IMO from Dr Bash got him service connected. He went no where till he got the IMO.

In my opinion for those who made their claim after 1 year the IMO is the most important thing that they can do.

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Thank you all for your replies. When I started helping him with his claim, I wasn't made aware of all of the facts of the case. After working with him and getting everything he had, I pretty much knew that it would be a wash, but we had gone that far and he had wanted to continue his claim. I stayed with him on it. I am sure that when he said he was hurt on the ship, that it actually happened. I have known him for quite a while and, to my knowledge, he would not have lied about this happening. But, as hard as I tried, we just couldn't find what he needed to make his claim solid. Again, I think the meat of the denial was more due to his getting hurt on the job. Had this not happened and he had continued seeing doctors about his back condition, he may have had a little bit better chance. But, I do feel confortable that we did all we could do.

mssoup1

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  • HadIt.com Elder

My IMO completely redefined the issues involved in my in-service injuries and illnesses. The Army and VA had been hanging on the Personality Disorder concept for years and the IMO blew that out of the water. The VA had also brought up physical injuries I had gotten at the Post Office over the years to deny me TDIU. The IMO destroyed that argument as well. I paid $250 for that opinion. Anyone in the Central Florida region I have a good IMO for you, two of them, in fact. Without the IMO I would still be at 30%.

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  • HadIt.com Elder

Mssoup1,

He would have to get the IMO and have it state something to the affect that his current (Diagnoses here) had its origins predating the work related incident of such and such date. This would more than likely warant service-connection.

Keep in mind that the IMO needs to reference competent medical litrature that supports the doctors rational. I've seen some IMO's (well, actually short statements) signed by physicians that were 2-3 sentences and had no rational for its findings that were completely useless. The VA needs competent medical evidence, by law, in order to grant the benefits sought.

Vike 17

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Again, thanks for your replies. I no longer have his records, so I am trying to remember off the cuff as to what he had and what opinions he had. He did have an IMO that basically stated that it was of his opinion that the start of his back problems did originate from his military service. The doctor could only go so far with statements, since there are no SMR's which actually reflect the accident, only sick bay treatments showing he was seen for back strain. The doctor was taking the veterans word for it that he did, in fact, injure his back while in the military.

I think since the SMR's didn't reflect treatment for any accident, that the only SMR records he had just showed back strain and the fact that he hurt his back while on the job, all had an inpact in denying his claim. In fact, the veteran stated that when he injured his back in the military, they never took any x-rays or anything else. They only gave him some pills and said he had strained his back.

I know that when we went to the BVA hearing, it did not go well. The law judge that he had seemed the least bit interested in what was being said and acted as though he would much rather be somewhere else. In fact, we noticed that he kept looking at his watch. I knew then that we were in trouble. Didn't take long to get the denial back, either. It was just the opposite for my husband. The law judge he had was great. She listened with concern, asked us questions and didn't seem to mind how long it took for us to present my husbands case. The outcome for my husband was very positive for us, even though the whole process took a long time.

It seems that there are so many circumstances within each veterans claim, that anything can happen. Right down to who you have hearing and rating your claim.

Any further responses would be most appreciated.

mssoup1

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  • HadIt.com Elder

If the veterans was a combat veteran then his statements have more value since many records and injuries were not recored for combat vets. His statements should be presumed to be true if he is a combat veterans if they make sense. I read this in the Veterans Benefits Manual.

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