Claim Denied Issued A Ssoc Supplemental Statement Of Case What Now ?

[mrmark1999]

ok i got my SSOC today im not shure wher i sit now .

EVIDENCE

it had a list of evidence

1 soc was sent dated sept 7 2011

2 report of telephone contact taken on sept 13 2011

3 vs form 9 receve October 11 2011

4 report of telephone contact jan 4 2012

5 treatment reords ABC Podiatry Dated from Aug 26 2010 to apr 14 2011

6 VA examination Columbus VA Outpatient Clinic Dated feb 14 2012

ADJUICATIVE ACTIONS :

09-07-2011 The veteran was furnshed a statement of case outlining actions taken on the claim

10-11-2011 Substanitve Apepeal Receved

DECISION:

Service Connection for bilateral Achellies Tendonitis remains denied.

REASON AND BASIS

since we issued our Statement of the case to you on September 7 2011 we received additional evidence in support of your appeal. Treatment records from ABC Podiatry not you have bilateral foot and ankle pain with diagnoses of Achilles tendonitis and plantar heel spurs. No relationship is shown between your current diagnosis of Achilles tendonitis and your military service.

You attended the VA examination at the Columbus VA Outpatient Clinic on February 14, 2012 to determine any relationship between your current Achilles tendonitis and your military service. After a physical examination and review of your claims file including your service treatment and private treatment records, the examiner opined that your current Achilles tendonitis is less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner provided the following rationale: "Achilles tendonitis is documented in note dated November 15, 1995 in the service treatment records (STRs). Thereafter, there is no mention of this condition in the STRs. He had no ankle condition noted on physical exams on May 21, 1996 and July 24, 1997. Letters by Dr. Schilling dated February 23, 2011 documents that veteran saw this provider on August 26, 2010 with "increasing pain gradually over the month precding presentation on his left ankle". Based on review of the medical evidence, it appears more likely that veteran's current Achilles tendonitis is a result of his occupation as a mailman where he has to walk up to 16 miles per day. Plantar faciitis is not documented in the service treatment records. Per note by Dr. Gutheil dated January 11, 2011, onset of plantar faciitis had been 3 months earlier."

The evidence of record continues to show that your current Achilles tendonitis is not related to the one event of Achilles tendonitis while in service. Therefore, service connection for Achilles tendonitis remains denied.

on My first SOC it states

in the SOC it says

REASONS AND BASES:

We received your NOD and in additional evidence in support of your claim . this additional evidence indicated a current diagnosis of bilateral Acheilles tendononitis there for , a VA examination and opinion was scheduled for you to comply with the VA's Duty to Assist , you were notified of this appointment and the importance of attending this appointment .Youlive in Pickerington, Ohio and the VAMC Chillicothe is yourjurisdiction . you didnotreport to this examanation because you did not want to go to the VAMC Chillicothie. This cancellation reason is not considered "good cause".Examples of good cause include, but are not limited to the illness or hospitalization of the claimant ,death of an immeadate family member ,etc.

You were denied service connection for bilateral Acheilles tendononitis in the ratin desison dated december 3, 2009 because although there was evidence of this disability in service , we did not have current diagnosis of this disability."

it is not enough , for a grant of service connection that a disability has been sustained in service. in addition there must be residual disability attributable thereto. Your service treatment records show that you were diagnosed with bilateral Acheilles tendononitisn Augest 21,1995. These same records donot show evidence of a chronic disability. Tofulfill the requirements for chronicity, the claimed illness must have persisted for a period of 6 months. the 6 month period of chronicity is measured from the earliest date on witch all pertinent evidence establishes that the signs or symptoms of the disability first became manifest. at this time we do not have contemporaneous or objective evidence of a continuity of symptomatology since your discharge from the military. the first evidence we have that you have a diagnosis of bilateral Acheilles tendononitis is Augest 26,2010 from ABC podiatry. this is approximately 15 years post discharge from the military.

Regulations state when a claimant fails to report for an examination scheduled in conjunction with an original compensation clam ,the claim shall be rated based on the evidence of record. When the examination was schedule in conjunction with any other original claim, a reopened claim for benefit that was previously disallowed , or a claim for increase the claim shall be denied . You did not report to your Va examination : therefore ,your Claim for service connection for bilateral Acheilles tendononitis cannot be established and remains denied ."

by the way i did not miss my exam I had it re scheduled to a closer exam location (I know now that was a big mistake )the va assumed i misssed when it was being recheduled i got all of that worked out and got my c&p in febuary do not understand where they get the idea that my bilateral Acheilles tendononitis is not service connected i had it diagnosed in the millitary and was told the same thing here is som 800 mg motrin and to strech what can be my next step on fight ing this my current doctor gave me a IMO showing the connection to my millitary service and a continuing issues let me know what you think

thank you

mark

[mrmark1999]

thanks berta im just reposting some of what you had listed so i can print and give to my doc for some further guide lines

"Independent Medical Opinions can often be the only way a veteran or widow can succeed on a VA claim.

Opinions obtained from private treating doctors are often free yet most independent medical opinions are needed from doctors with full expertise in the field of the disability can be very costly.

However an award can easily absorb this cost with a few comp checks or the increases in comp that the claimant might never obtain without an IMO.

A Valid IMO must contain the following:

1)The doctor must have all medical records available and refer to them directly in the opinion.

--------------In cases involving an in-service nexus- the doctor needs to read and refer to the SMRs (servic medical records)

Also the doc needs to have all prior SOC(Statement of Case) decisions from VA particularly those referencing any VA medical opinions

or a copy of the actual C & P (Compensation Pension) results.

2)The doctor should define their medical expertise as to how their background makes their opinion valid.

--------------In other words a psychiatrist cannot really opine on a cardiovascular disease.An internist cannot really opine on a depression

claim.The doctor must have some valid medical expertise that makes his/her IMO(Independendent Medical Oopinion) valid.

3)The doctor should state their opinion in terms of “as least as likely as not”, or “More than likely”

They need to use one of these terms for each issue they are opining on.

Medical statements regarding possible Service Connection:

Is due to- 100%

More likely than not- Greater than 50%

At least as likely as not- 50% (Benefit of doubt goes to Vet)

Not at least as likely as not- Less than 50%

Is not due to- 0%

as to the present disability and the nexus to the veteran’s service medical records or other SC

( Service Connected) disabilities, if the medical evidence warrants them to agree with the claim.

4)They should then refer to specific medical evidence to support their conclusion.

5)They should rule out any other potential etiology if they can-but for Millitary service as causing

the disability.

6)They should briefly quote from and cite any established medical principles or treatises that

support their opinion.

7)They should point out any discrepancies in any VA examiner’s opinion-such as the VA doctor

not considering pertinent evidence of record in the veteran’s SMRs (service medical records) or

Clinical record.

8)They should fully provide medical rationale to rebutt anything that is not medically sound nor

relevant or appropriate in the VA doctor’s opinion.

9)They should attach a full Curriculum Vitae if possible or list their expertise within the opinion

and tell VA of any special medicalbackground they have that also makes their opinion valid.

(For example, how long they have treated patients with the same disability,

any articles they have written, or symposiums attended etc,)

It helps considerably to identify pertinent documents in your SMRs( service medical records) and medical records with easily seen

labels as well as to list and identify these specific documents in a cover letter that requests the medical opinion.

A good IMO doctor reads everything you send but this makes it a little easier for them to prepare the IMO as to referencing specific records.

Send the VA and your vet rep copies of the signed IMO.

And make sure your rep sends them a 21-4138 in support of it- you also- can send this form (available at the VA web site) as a cover letter highlighting this evidence.

PS- Mental disabilities- make sure the doctor states that you are competent to handle your own funds- otherwise, if a big retro award is due-the VA might attempt to declare you incompetent and it takes times to find and have the VA approve of a payee."

I need to add here that a secondary condition to an established SC condition wold not need the IMO doctor to read all of the SMRs.

They just have to state with medical rationale why the second claimed disabilty is due to (secondary to) the initial SC disability.

Edited May 2, 2012 by mrmark1999

[Berta]

As Carlie added to that thread-(I forgot to put this in that specific post):

This is the language tat the VA is familiar with.

The IMO doctor uses one of these terms (hopefully one of the first 3 terms), and then gives their medical rationale.

The entire IMO forum has a lot of good information.

They need to use one of these terms for each issue they are opining on.

Medical statements regarding possible Service Connection:

Is due to- 100%

More likely than not- Greater than 50%

At least as likely as not- 50% (Benefit of doubt goes to Vet)

Not at least as likely as not- Less than 50%

Is not due to- 0%

[mrmark1999]

ok one other question the AMERICAN LEGION said that thir is nothing else i must do right now with the ssoc that they are going to go into the apeals board is there any thing i should or must do to help out my position im am going to see if i can get a better IMO from my doc with the requirements the vay wants but is there any thing i could do to help out my case?

[Berta]

I assume the I-9 has already been filed?

I used to aggressively fight back on every SSOC I got. Doing that awarded my accrued claim and my original DIC claim at the regional level many years ago.

However, these days I think the best thing a veteran can do is to make sure their claim gets to the BVA.

The VA changed the SSOC response deadline from 60 days to a mere 30 days a few years ago.

I aggressively commented against this proposed new reg at the Federal Register site as a few vets, lawyers, and other advocates did. We could not sway the VA.

30 days SSOC response timeframes stink- a vet can hardly get a POA appointment within 30 days, let alone an IMO as I stated in my public comment to VA.

However, you can submit further evidence at any point to the VARO wihin the SSOC response period BUT send it to the BVA too , as soon as you get a docket number there.

I had at least 2,3 claims ,set for BVA transfer, that were awarded at a regional level prior to the formal transfer,because someone at the RO actually finally read the evidence.

I have another potential claim to file. I will attach to it my waiver of further VARO consideration.before they even deny it.

I have developed over 17 years a complete lack of faith whatsoever in my RO's ability

to read.

[mrmark1999]

I have not filed any thing after I received my SSOC the American legion said there is nothing I personally I have to do

I did fill out a form 9 when I originally got my soc do i need to do another one for the SSOC within the 30 days? Or is every thing being handled by the American legion? I am going to my doc to see if I can get a better IMO with a better Diagnosis and opinion IM just not shure where i need to go now or even What will happen next

[Berta]

Only one !-9 form is required but bring up anything in the SSOC that is wrong, when your file is transferred to the BVA-

you could include a statement regarding that when you send in the IMO.