New To Hadit... Needing Assistance With How To Proceed With Claim

[JFizzle]

Hello Hadit.com Members,

I am new to the site, but I have reviewed a lot of information throughout the different forums and I must say the collaborated efforts to assist an in need fellow veteran is refreshing. Hopefully I am not too much of a burden with my situation and hopefully I can benefit from your guidance because right now I am at a loss on how to approach my claims.

I served the USAF from 2000 to 2007 with an honorable discharge and I am currently 40% service-connected for

• TMJ - 20%
• ACL Reconstruction - Knee Joint Pain - 10%
• Right Ankle condition with Achilles tendonitis -10%

Here is my issue:

In 2005 I suffered facial trauma to my nasal area while participating in a squadron event that has since then continued to affect my breathing to this present day. During the event, one of the participants collided into me very hard at full speed, descending from an airborne position, and inadvertently came downward with his elbow ramming into my nose, which resulted in my visit to the Emergency Room. Upon impact, there was a break in the skin (aka hole) to my nasal area that required 3-4 stitches to reconnect the right alar sidewall to my cheek. My nose instantly bled internally, as well as from the right alar sidewall. I suffered a headache, dizziness, facial pain, and obstructed breathing. The impact felt like my face was broken. During my visit to the Emergency Room, the Emergency Room doctor looked at the injury and after 3 minutes of observation recorded his findings (without an x-ray or CT scan) as a facial laceration (I strongly disagree with this finding because of the symptoms I have experienced since the injury). The Emergency Room doctor then sent one of the aids to stitch my nose, prescribed Motrin for the swelling/pain, and told me to return to the Emergency Room in a week and one of the aids on site can/will remove the stitches. When the stitches were removed, I was still suffering a headache, nasal pain (tenderness), and difficulty breathing through the right side of my nose and made it known to the aid and she documented that. Since this event I have experienced various episodes of sinus troubles and infections (to include sinusitis), and a constant and consistent feeling of a blocked nasal passage.

2009 - sleep study diagnosed mild sleep apnea

Could not tolerate the CPAP machine... felt like I was suffocating

2009 - 2013

Various sinus issues including sinusitis, allergic Rhinitis, and headaches.

referred to ENT doctor and he stated there was a high septal deflection with Internal Nasal Valve narrowing on the side that

may account for my complaints. Would require surgery for correction.

2013 - sleep study diagnosed moderate sleep apnea

Trying to use the machine but it feel like I am suffocating.... may ask for different options on visit in 2 weeks.

My questions are:

Is there away for me to challenge a military ER diagnosis as an incomplete diagnosis to reflect the damage caused?

My initial claim for my nose injury was denied because I claimed facial laceration. I did not have a VSO at the time, but when I acquired one, we put in an appeal claim in for a nose injury which has been pending since 2009. Will a nose injury suffice for a claime or does it need to be more specific?

Could my sleep apnea be service connected if my sleep doctor provides a nexus letter stating that the moderate sleep apnea condition is more likely than not aggravated by the nose injury that occurred in 2005? or would the nose injury need to be connected first? Would a sleep doctor or ENT specialist opinion trump an ER doctor?

Any direction or opinion or answer will be welcomed and respected.... sorry for the long story

JFizzle

Edited December 28, 2013 by JFizzle

[Berta]

It is also possible to attribute the headaches as secondary to the TMJ if a doctor agrees:
“
3.  The competent evidence shows that a current headache 
disability is causally related to her service-connected 
temporomandibular joint (TMJ).”

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp07/Files4/0734430.txt

[Pete53]

Welcome to Hadit.

[JFizzle]

Thanks all for the warm welcoming.

Meghp0405 - Thanks for you guidance. I will focus on the nasal, respiratory, and headache issues. I think that route would be best to tackle first.

Bertha - Thanks for the confirmation.

I recently moved to a state where the VA hospital is more accessible. Due to distance, time, traffic, and work restraints, I utilized more convenient facilities near my job/house for my health concerns. Here are a few questions...

• Is it better to have a VA doctor or your own?
• Will VA doctors assist you with providing a nexus letter and/or DBQ's if they find service connected ailments?
• Does a DBQ replace a nexus letter? Or is it necessary to have both?
• What is the best method to approach a doctor to write a nexus or fill out a DBQ?

[meghp0405]

Doesn't matter upon the Doctor, civilian or VA. Find one that your comfortable with

there are some va clinics that will not use the DBQ's, they will say "these are for the C/P examiner" I have been jumping up and down on desks here and they are now beginning to see the importance and (in some cases) quicker evaluations y using these. I've also had veterans take them to their civilian docs for completion.

a DBQ does not replace the nexus letter. I would recommend that you obtain each.

you will just need to explain to your doctor what you are planning on doing (submittal of claims for re-evaluation) etc; It really depends where you are at and the outlook on the DBQ's at that location. The VA produced a fast letter entailing the DBQ, but many and I mean many VA clinics didn't want to use them and just started telling vets that it was a form for the C/P exams. Too many veterans have now found out, the information is being disseminated and they are being used.

[carlie]

It is also possible to attribute the headaches as secondary to the TMJ if a doctor agrees:
“
3.  The competent evidence shows that a current headache 
disability is causally related to her service-connected 
temporomandibular joint (TMJ).”

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp07/Files4/0734430.txt

Ditto on the great possibility that TMJ can result in secondary headaches.

Good one Berta : - )