63Sierra - New Member Looking For Guidance

[63SIERRA]

Troy I would like your opinion on a claim. I was in an on post car accident while on active duty. The civillian wife hit me in the rear with her car, into the back of my car at a redlight, she had break failure. her husband had did a not so good break job on thier car the day before. I was in alot of pain, and went on sick call. I was diagnosed initially with a fracture pars and spodylolysis and put in a back brace and put on a dead mans profile . I went back in a week, saw another doc, and he said back was broke, but not in accident. He put on the medical record . " old seat belt injury " with a question mark behind it. like he wasnt sure. So ok, I was on active duty for abt a year after that. with frequent visits to sick call with back pain complaints. all documented. So when my tour was up, I filed for several different contentions, with back condition as one of them. The va deny me in 1996 said the back condition know as pars defect, with sponylolisis is a congenital defect, and no related to millitary service. I didnt think to much of it at the time, burt recently started research. I looked thru my active duty medical records, and another doctor diagnosoed my back condition as spondylolysis thesis. I recently went to a chiropractor, and his diagnosis is L-5 spondylolisis thesis. He showed me the xrays and told me my back had been jacked up for a long time, and would take years to get results, and there basically were not alot of good options. He told me what happens is the pars bones, that hold the vertebre in thier proper alignment, can fracture from either blunt force inpact such as car accidents. or if they are weak for whatever reason. Then it lets the vertebre shift forward, out of alignment. Then u start getting nerves pinched an pain, such as I have now, and have been having since the accident while on active duty. So I sent the chiropractic diagnosis to the VA. I also sent a copy of the in service medical record where the doctor diagnosed me with spondylolysid thesis. Which is alot different that just spondylolysis. I had never had, nor complained of any back pain, or problems anytime before the on post car accident. I have had pain and problems with my back ever since the accident, and recieve pain meds from the va for it even now. So my questions are, being I filed for a back condition as a generic term, and the VA assigned the wrong diagnosis, and denied me on that wrong diagnosis,. do I have grounds for a CUE claim. ? if not, should I at least win my current appeal?

2. How can I find out, exactly what evidence the Va had at the time they adjudicated my claim , in other words, how can I find out if they had access to the medical slip where the doctor clearly wrote. " sponylolislis thesis. (I have sent the va a copy with my appeal, so they have it now, but I want to know if they had it then.

Edited September 16, 2013 by 63SIERRA

[63SIERRA]

YOU GUYS ROCK.!! Just because you are taking the time and interest to hash out my case, and giving ideas and angles to try and help me, means alot to me. It makes alot of sense what yall are saying. As hoppy stated the lies likely started with the in service docs, and grew into a very ugly tree from there. The current RO figures, well he bought it once, lets sell it to him again., NO DICE!

[63SIERRA]

And as freespirit stated, the facts are there, the VA game is to try and distract you from the truth, and take you the back roads, to muddle things up, focus on irrelevant detail, and try to make you look like a liar. Im not falling for it this time. Im going to keep throwing the facts at the top of the pile, and make them deal with them.

[free_spirit_etc]

Hang in there Sierra!

Hoppy is one smart guy! And he really knows his stuff about the VA and what it takes to win...despite all the games!

[Hoppy]

Free,

You have put a lot of work and thought into this and I do not want to overwrite your comments. This is just the way I write things up. It is basically a regurgitation of much of what is already on this thread.

I want to back up here a little bit and clarify. In a previous post I stated that the denial was not based on any congenital condition even though they mentioned one during their discussion of the evidence. The reason I thought the congenital condition was not in the mix is because they would have needed to show that the congenital condition was expected to produce the symptoms that he was experiencing. They did not address symptoms of any congenital condition. Rather the denial was based on the interpretation of the evidence that his condition was acute and involved a strain.

After the denial 63 sierra says he has a diagnosis of spondylolisthesis both in the military and post service. I find medical literature that says this condition has complications including chronic lower back and leg pain. Time to get a nexus statement.

The car accident is not the main issue at this time. I am not suggesting that the car accident etiology of the Spondylolisthesis be established to advance the claim. If anything rebutting the determination that the car accident was not the cause is a preemptive strike that would protect against further delays due to an adjudicator citing the congenital condition as yet another reason for a denial (see IMO statement below). The rater in my claim caused an additional 2 year of delay by refusing to schedule a C&P and citing irrelevant diagnoses noted in my medical records as the reason for denying my claim. The rater said there was evidence in the file that my angioedema was caused by post service employment. There was evidence of a condition not necessarily related to angioedema noted in association with post service employment. However, the condition was occurring while I was at work and at home. Additionally, the angioedema condition onset while I was in the military nine years prior to my working for that employer. The RO delayed my claim over 6 years by making decisions that were equated to meritless medical opinions and refusing to schedule a C&P.

If they raise the issue of a congenital condition that rebuts the presumption of soundness then the argument can get very complex. My statements about interpretation of the bone scans and xray is getting into an area that may not even come into play. I just sometimes put stuff up to stay ahead of the VA’s game. I could even take the argument farther and get into the possibility of false negatives and whether or not the time frame between the accident and the tests would have impacted the reliability of the test, etc. Many diagnostic procedures are plagued by false results. I would think the presumption of soundness would need to be rebutted by reliable tests. All of which should be addressed by an expert in the field.

Now back to what I think is the real issue in 63 sierra’s claim. A IMO which provides a link between the symptoms in the military and the diagnosis of spondylolisthesis needs to be in the evidence record. You could submit the literature showing the complications including chronic pain and the in service and post service diagnosis as new and material and maybe they will re-open and give you a C&P to address nexus. The complications of Spondylolisthesis resulting in chronic back and leg pain are well established in the medical literature. If you ask me the new evidence described above should result in a C&P. I just do not like to suggest that you rely on the VA.

Or get a doctor involved and work out a statement your SO and the doctor can live with.

Repetitive lifting trauma, unreported accidents or even the reported accident while in the military could easily have accumulated to explain the development of Spondylolisthesis and the reported ongoing symptoms of lower back and leg pain both in the military and present. The known complications of Spondylolisthesis including chronic lower back and leg pain clearly support a determination that it is more likely than not that the current symptoms of back and leg pain are related to the original diagnosis while serving in the armed forces. Have the doctor site some literature and or clinical experience in support of this statement. Just leave it at that

Even though there appears to be some statements by military clinicians trying to say the condition was ongoing prior to the car accident this does not rebut the presumption of soundness. Most importantly, even though the decision refers to a congenital condition I do not recall seeing this clearly supported by any doctor’s opinions. Correct me if I am wrong.

If you want to make preemptive statements that might keep the VA from dragging this out then do so. A preemptive statement may include an opinion that; the denial shows a diagnosis of a congenital condition. There is no supporting medical opinion specific to this case identifying the cause of the veteran’s symptoms as due to a congenital condition or other events predating service. There is no expectation that the unconfirmed congenital condition would exclusively explain the symptoms experienced in the military or present in their entirety. Have the doctor site some literature or clinical experience in support of this statement.

I will be offline until Friday.

[phillipflatt]

I need help with herbicide claim

[carlie]

I need help with herbicide claim

Welcome.

Please start a new topic with your info and questions, post it under the AO Forum.

Thanks.