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Secondary To Asymptomatic Or 0% Rated Disease

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I served on the ground in Vietnam in 1967 & 1968. I currently have asymptomatic/smoldering Multiple Myeloma. Multiple Myeloma is one of the diseases listed on the agent orange presumptive list. In reviewing the VA Rating Schedule it appears that anyone with a service connected disease considered to be asymptomatic is rated at 0% service connected. I have been having problems with neuropathy in my extremities for several years which is gradually progressing. My local orthopaedic spine specialist recently conducted several diagnostic tests and concluded that my neuropathy was not caused by spinal stenosis or other orthopaedic problems. I was referred to my local neurologist who also conducted various tests and concluded that my neuropathy was secondary to my smoldering multiple myeloma.

At tne end of my appointment with the neurologist I asked him to write me a independent medical opinion. The first letter he provided was not detailed enough to pass muster with the VA so I prepared a proposed letter and included the necessary details required by VA and asked him to sign it if he agreed with the content. His medical assistant typed the letter on the doctor's letterhead and the doctor signed it without making any changes to my proposed letter. In the letter the doctor states "severe symmetrical distal polyneuropathy in his lower extremities that is primarily sensory" and he also stated "Considering every possible sound medical etiology/principle, to at least the 50% level of probability, I am of the opinion that the patient's neuropathy of his lower extremities is more likely than not secondary to his currently diagnosed smoldering multiple myeloma." My neuropathy is chronic not acute or sub-acute as listed on the agent orange presumptive list.

QUESTION: Will the VA give a rating for a secondary condition when the service connected primary condition is rated at 0% and considered asymptomatic or should I wait until my Multiple Myeloma becomes active before filing the neuropathy claim? Although I have some of the symptoms of active Multiple Myeloma (e.g- recurrent infections/pneumonia twice in past five years, low back pain, pain in legs, neuropathy, etc.) it appears Multiple Myeloma is not considered active until you have actual tumors or lesions in your bones, kidney problems, anemia and over 30% plasma cells in your bone marrow. According to the VA disability rating schedule, severe neuropathy would be rated at 20% for each leg or maximum total of 30% for both legs.

Suggestions and comments would be appreciated. Thanks... Georgiapapa

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