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Increased Ratings

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Medic711

Question

First off, sorry for the double post. I was not sure if I posted in the correct section.

I will try to keep this short and simple. I got injured, got transitioned into WTU in Texas, received a line of duty and got med boarded after fighting to stay in.

During the the med-board I was receiving treatment at BAMC and I was told that because of my surgical needs I would need to get out and then come back in on a waiver. I had fractured my spine and severely herniated 3 disks with nerve damage. After about 4 months of fighting the Medboard I was told that I would have no issues returning back to active duty as long as I took a low military disability rating. I agreed and took 10% and was immediately rated with the VA at 50% in Texas where i did my comp and pension exam. This was in 2009.

2010 I had my surgery and there were major complications. I was in ICU for 9 days and now as a result of the surgery I am no longer able to have children. I have never tried to increase my rating or contact the VA in regards to the initial comp and pension exam that was done prior to surgery. I was told by several friend who are also VA patients that I should see a service officer with the DAV and see what could be done.

I went to the DAV here in Gainesville Florida and brought my medical files in with all of my personal records and he basically said he thought I should be 100%. I am not sure the process involved for increased ratings but he added about 9 issues to my file that had never been mentioned. As of right now, from the initial comp and pension done back 2009, I have 30% for adjustment disorder and 10% on my spine.

I was just curious since my line of duty is on my spine, how its evaluated so low? I cannot put shoes or socks on anymore and have lost the ability to have kids due to the nerve damage in my lower spine. Should this be something I expect to see increased since I have had surgery on it? I have 2 rods and 6 screws in my lower spine and piraformis syndrome along with a whole list of associated issues. I am 30 years old and unable to perform the type of work I use too and am having a host of mental health issues.

I see a PTSD doctor and about 5 other mental health doctors in regards to my angst, depression, etc. As I stated above this is my first time doing a ratings increase and I am not sure what to expect. I would like to share the information my DAV rep applied for on my behalf and if anyone can possibly help me understand what to expect and prepare for, I would be much obliged.

Here are the NEW findings per DAV for service connection.

1. Pharyngitis

2. Head injury

3.Allergic rhinitis

4.Low Back Pain L3-S1

5.Syncope

6.PTSD w/Anxiety and Depression

7.Epigastric abdominal pain

8. painful right shoulder

9.Sinusitis

10. Gerd

This is for Ratings Increase

1.Chronic adjustment disorder

2.Degenerative of the spine

3. Deformity of the penis

4. Limited motion of the wrist.

I really appreciate any advice, tips, mentoring etc anyone has to offer. It has taken a lot of therapy for me to admit that I need help and to actually seek it out. I have slowly lost all my humility while dealing with the VA over the past couple years and I have heard great things about the people on this forum.

Thank you

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3 answers to this question

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“I was just curious since my line of duty is on my spine, how its evaluated so low? I cannot put shoes or socks on anymore and have lost the ability to have kids due to the nerve damage in my lower spine. Should this be something I expect to see increased since I have had surgery on it? I have 2 rods and 6 screws in my lower spine and piraformis syndrome along with a whole list of associated issues. I am 30 years old and unable to perform the type of work I use too and am having a host of mental health issues. “

“2010 I had my surgery and there were major complications “

Was the surgery done at a VA Hospital?

Has your DAV rep considered a 1151 potential here as well as higher rating for the spine disability?

Is this what DAV considered for the higher spine rating?

“Degenerative of the spine “

Are you employed?

If not has the DAV given you a TDIU 21-8940 form to fill out and send to the VARO?

Have you applied for SSDI?

“if anyone can possibly help me understand what to expect and prepare for, I would be much obliged.

Some of the conditions listed are very vague.

1. Pharyngitis this will need a nexus from your SMRS (proof of inservice cause)

2. Head injury this will need a nexus as well from your service and ratable residual

3.Allergic rhinitis ditto

4.Low Back Pain L3-S1 could be determined as due to (secondary to)the spine issue

and possibly due to the piraformis syndrome.

5.Syncope this is a symptom and not ratable as far as I know.....unless due to a dfiagnosed condition that could cause it

6.PTSD w/Anxiety and Depression You already have a MH rating. They might increase that rating but they dont award 2 separate MH ratings.

7.Epigastric abdominal pain You need an inservice cause for this and it is probably due to the GERD unless you have been prescribed NSAIDS by and that would surely be considered a valid nexus to the GERD by the VA

8. painful right shoulder....inservice nexus needed and diagnosis

9.Sinusitis inservice nexus needed

10 Gerd inservice nexus in your AMRS or prescribed NSAIDS as cause.

Numbers 1, 3,and 9 are all related in my opinion.

You can go to the VA Schedule of ratings here at hadit and compare how your disabilities match up to the rating schedules there. It is very hard to determine without diagnostic codes for some of them.

I dont get this:

“I agreed and took 10% and was immediately rated with the VA at 50% in Texas where i did my comp and pension exam. This was in 2009. “

As of right now, from the initial comp and pension done back 2009, I have 30% for adjustment disorder and 10% on my spine. “

Your profile says 40% ?

It sounds to me that you are far worse off now after the surgery then before you had it.

If VA performed the surgery, your DAV rep knows all about Section 1151 claims.

If VA causes a veteran additional disability due to negligence, the additional disability will be rated 'as if' service connected under 38 USC 1151.

Or the claim can be filed as a secondary claim for additional disability due to SC spinal disability,without raising any negligence factor.

Do you have your complete medical records as to the surgery?

Do you have a copy of the LOD and a copy of your complete SMRS?

If the DAV does suggest you file for TDIU ( or even if they dont ,the form is here at hadit)

List your most prominent SC disability first. I would think that would be the spine issues first and then the MH issue that VA has already diagnosed you with and has granted SC on

If the SSA awards you Solely for any SC disabilities you have now,this is excellent evidence for TDIU.

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One more point....

This is for Ratings Increase

1.Chronic adjustment disorder is this what VA pays you comp for now?

2.Degenerative of the spine Do you actually have a degenerative spine disability? or is there a different diagnosis for it that you are getting comp for now?

3. Deformity of the penis This is the SMC K award .

4. Limited motion of the wrist. this is very vague...do you have a "0" SC rating now for that?

has it been described as carpal tunnel syndrome in your med recs?

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I apologize for any gaps of information. I did have my surgery at a VA hospital. The DAV rep has never said anything to me at all about a 1511. My meeting with him was not at all what I had expected it to be. I had all of my paperwork, line of duty etc and he basically kept telling me to calm down and not be so nervous and basically said we need to add those 9 things I listed. I personally had no intentions of claiming a lot of what was on there. The DAV mentioned that the next step in his opinion would be for some type of unemployable paperwork. I have never tried to file for SSDI. That is what I see listed on the paper that he provided me as a SC increase in rating for degenerative spine.

There are a lot of things that I was really confused about. I was initially rated at 50% in Texas and when I came to Florida it was dropped to 40% for some reason. I just took it for what it was and never bothered to ask. I have been unemployed since I have been out of the military but I have been working on a degree (which has been like pulling teeth). He never asked me how any of the conditions in my medical files were tied in to anything being considered SC. I was prescribed an inhaler for my sinuses when I was active and now I go through about 2 a week and have really bad sinus headaches. He said that because I am "dependent" on the inhaler, it is service connected? I have super bad anxiety and have panic attacks due to them. When I was taking a math class a few semesters ago, I passed out and hit my head on the wall of the classroom and had to receive several stitches. He said that this is Service Connected to my depression, angst etc.

I have been on at least 100 medications in the past few years so I can definitely see where the NSAIDS would come into play. Here is a breakdown of what I understand my disability to be.

30% adjustment disorder

10% Degenerative arthritis of the spine

10% limited motion of the wrist

0% Allergic or vasomotor rhinitis

0% Deformity of the penis.

I only want to specifically challenge the adjustment disorder, spine and related issues.

I went online after speaking with a peer and filled out the form for an increase in ratings for my back and sinus's and was given ridiculous results. This is why I went to the DAV guy. I obviously have no clue what I am doing so hopefully they would.

I have all of my military treatment files as well as whatever the VA has done for me. ( I expect the VA has them on file, or should I request my files be printed?) When I was being seen by the Neuro and Ortho doctors in Texas, I received very detailed notes in regards to what was going on with my back. I submitted this as evidence along with my PEB paperwork etc. I also turned in my fitness records, and peer evaluations to show my character in service. Another things I did not mention was I have an issue with a weak bladder from post surgery. I really just want to understand how the system works and what I need to do to get everything handled properly and ethically.

I received my VA disability literally right after I exited out. I was able to start VA treatment while active during my medboard. I broke my wrist in basic training and cut my cast off and continued through basic with a broken scaphoid. I never asked for this to be placed on my list but I guess the Army decided to do it for me.

My biggest issue I have (and its documented) was me fighting to stay in active duty and recover in WTU and the med board and peb officers telling me that if I took a low Military rating I would be allowed to get a waiver and come back in after my surgery with the VA hospital.

Sorry for the rant. I hope I answered the questions needed.

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