Newbie - Organized And Ready To File!

[Kimmy]

Hello, I am the Wifey of a Desert Storm Vet who is has serious knee problems (issues with: ACL, meniscus, cartilage, degenerative arthritis, can't fully extend). He just had two knee surgeries with in the past 6 months. This site and the howtoassembleyourclaim.com site have helped us get all of the elements relatively quickly. Using what we have learned here, we were able to request and have received his complete medical records. And we also located some of his original sick call slips! We organized the sent the copies of the knee related items to his surgeon. Yesterday, my husband picked up a very detailed nexus letter from his surgeon along with all of the doctor's surgical notes and office visit notes. Today he is going to the hospital to pick up the printed MRI images from both knees. We have the marriage and birth certificates, the certified DD-214 and other documentation. Now are ready to go! Copying and assembling this weekend. Next week we will be submitting the original filing of the 21-526.

We will keep you posted. Thanks again.

[SP4RVN1971]

First,Thank him for his Service!! It sounds like it's going your way!!

God bless, and NEVER GIVE UP!!

Edited June 23, 2012 by SP4RVN1971

[PainterBK]

Hello, I am the Wifey of a Desert Storm Vet who is has serious knee problems (issues with: ACL, meniscus, cartilage, degenerative arthritis, can't fully extend). He just had two knee surgeries with in the past 6 months. This site and the howtoassembleyourclaim.com site have helped us get all of the elements relatively quickly. Using what we have learned here, we were able to request and have received his complete medical records. And we also located some of his original sick call slips! We organized the sent the copies of the knee related items to his surgeon. Yesterday, my husband picked up a very detailed nexus letter from his surgeon along with all of the doctor's surgical notes and office visit notes. Today he is going to the hospital to pick up the printed MRI images from both knees. We have the marriage and birth certificates, the certified DD-214 and other documentation. Now are ready to go! Copying and assembling this weekend. Next week we will be submitting the original filing of the 21-526.

We will keep you posted. Thanks again.

Welcome. You've come to a great site. I'm fairly new here, but have gained alot of knowledge & benifitted from sound

advice already. Sounds like you're very organized. Thanks for your husbands service & Good Luck to you both.

Bob K

[carlie]

Hello, I am the Wifey of a Desert Storm Vet who is has serious knee problems (issues with: ACL, meniscus, cartilage, degenerative arthritis, can't fully extend). He just had two knee surgeries with in the past 6 months. This site and the howtoassembleyourclaim.com site have helped us get all of the elements relatively quickly.

Using what we have learned here, we were able to request and have received his complete medical records. And we also located some of his original sick call slips!

We organized the sent the copies of the knee related items to his surgeon.

Yesterday, my husband picked up a very detailed nexus letter from his surgeon

along with all of the doctor's surgical notes and office visit notes.

Today he is going to the hospital to pick up the printed MRI images from both knees.

We have the marriage and birth certificates, the certified DD-214 and other documentation.

are ready to go! Copying and assembling this weekend.

Next week we will be submitting the original filing of the 21-526.

We will keep you posted. Thanks again.

Whoa - since this is his one and only shot at an original claim - hang on there a minute if you can.

Do you have the exact conditions / diagnosis, any medical problems that might be secondary to his knee

such as any effect on the other knee from compensating or back, hips or ankles,

any other issues that happened when whatever happened to his knee, anything else shown in SMR's/STR's

that he still has any problems with etc . .

This nexus letter - did the doc state they have reviewed the vets SMR's/STR's and the current xyz

is more likely/as likely as not, the result of - a progression of 123 as shown in the SMR's/STR's

dated XX/XX/XXXX, XX/XX/XXXX ?

Did the doc do ROM measurements, comment on any effects this does to working, etc. . ?

Did the doc make mention and comment on the surgical scars, if they are malnourished,

painful,tender, any keloid formations, etc. . .

If the scars meet the skin criteria - and the knee gets SC'd - the scars should be requested

under secondary, so if they are claimed in the original 21-526 this might save a couple of

years down the road.

Have you taken a look at or gotten any of these filled out?

http://www.vba.va.gov/pubs/forms/VBA-21-0960M-9-ARE.pdf

http://www.vba.va.gov/pubs/forms/VBA-21-0960M-10-ARE.pdf

JMHO

[carlie]

bump

[Berta]

Carlie is CORRECT!

He can certainly get the 21-526 into the system, and then the VA will respond in a few months with a VCAA letter, telling him exactly what evidence they need.

He needs to claim his prime disability and claim any secondaries due to it.

A good IMO doctor can write it up the best way ,as to the secondary conditions, as they too need a full medical rationale as to why the main disability caused other physical problems.

As Carlie said any IMO doctor needs to read and then refer directly to the veteran's SMRs for the nexus statement .

We have IMO info here in or IMO forum for the proper wording of IMOs.

Carlie raised good points that bear repeating:

Do his SMRs reveal exactly how this disability is related to his service?

Do the sick call slips say exactly why he was treated inservice? Was the problem the result of an inservice accident ,injury, or fall?

Is the inservice cause of his current disability clearly documented in his SMRs.

These are the “Nexus “ factors.

Any IMO doctor can make a nexus statement with a rationale based on service records but the documented evidence in the SMRs or 201 Personnel file must back that up.

Also-can he prove with medical evidence either from a VAMC or private doctors,that his knee disability has been continuously treated from his discharge from service?

This can be problematic for many veterans who have an inservice nexus to their current disability, yet they have no paper trail that continues to confirm the post service diagnosis and treatment for it.

I don't think that is an issue you need to be concerned with as it appears your husband's problem definitely got progressively worse after service.

Still these are the 'landmines' VA looks for in attempts to deny claims.

For example-I have a vet friend whose current disability as been stated by VA to be entirely due to non service ,post service causes,with a full medical rationale from 2 VA C & P doctors that I feel is an accurate assessment because I know this case well.

He paid for an IMO that says the same thing, that also includes speculation on the inservice cause but VA doesnt deal with speculation in IMOs.

The IMO wont help this veteran.

This is why VA asks for info on all medical doctors/ facilities that provided treatment for the possible service connected condition.

.

Did his Discharge Certificate note this knee problem?

Has he found his unit web site on the internet, if he eventually might need a “Buddy statement” as an eyewitness account of the inservice cause for the current disability?

Edited June 27, 2012 by Berta

[Kimmy]

Hi Carlie and Berta.

The SMRs show exactly how the injuries happened. The sick call slips details exactly what happened (the cause) and the time they happened. Then the medical records go on to tell the diangnosis and treatment of each incident. Basically the medical records show the injury (acl, minuscus) and treatment (physcial threapy, crutches, followup), and the progression and worsening of knees' condition over the years during his service in the military.

The claim states all of the condition codes for each knee. I don't have it in front of me right now to detail it for you. But there are six condition codes listed for each knee. Degenerative Arthritis, Cartilge, Injury due to trama, Scarring - I can't remember the other things right now. Each conditions is noted in the surgoeon office visits and surgerical notes.

Hubby's SMRs directly and specifically describes multiple incidents over mutiple years the knee injuries, conditions and treatments. He has had the same orthopedic surgeon since he got out the army. We provided him with the records and an example of the nexus format. The surgerons letter says that he reviewed the medical records (and lists the date and injuries) reviewed and how this related to the current condtions. And then goes on to state his opinion (more likely than not..). For example: the service medical records talks about cartilage damage. The surgeons letter talks about reviewing that injury and treatment dates the included the orthoscopic pictures and MRI images that actually show the cartilage damage, ACL, minuscus tears and arthritis and describes the the age and progression of injuries. It is very detailed. He does this for each knee. He also provided all of his surgical and office visit notes. Some of the office visit notes talk about his gait and ware of his shoes and talks about the % of flexion and extension of his legs and that progression over time.

I honestly don't know what else we could provide. The package was sent on Wednesday and was received and signed for on Thursday. At this point, God is working it out as He as always done for us.

We have not addressed secondary issues at this point. It took so much effort to get the orginal filing done that we have not had time to develop those properly. We will work on that next.