Another Question Regarding A Va Claim

[DICK HILL]

Reference my post on 28 Feb 14 and 3 Mar 14 “More Questions Regarding VA Claim”

I finally received a copy of the Spine Doctor’s 3 Mar 14 report of my 3 Mar 14 visit.

Although as I reported on my 3 Mar 14 post that the doctor would not sign a NEXTUS or IMO, his report does include the following:

“He has hip osteoarthritis. In view of his records, the right hip arthritis or arthrosis in examination of the hip is very consistent to the issues he had while on active duty and deemed at that point to be service connected. Additionally, there are notations dating back during his active duty status he went and saw orthopedics there, saw a PA who diagnosed him with sciatica which is exactly what he has in the right lower extremity today. Therefore, again, I do think he is suffering from exacerbation of these conditions today that are service connected and should be covered under his VA benefits. It is very clear with the documentation of the hip arthritis that was diagnosed while on active duty and also his sciatica as again diagnosed on active duty. This supports his endeavors to try to get this become service connected and I tend to agree. Examination of his right hip today shows pain with FABER with significant groin pain which is consistent of the worsening condition that was previously diagnosed when he was on active duty. Now whether or not this is taken care of within the VA system or outside in the civilian sector still remains to be seen.”

My question now is: Do you think the VA will see the above comments as a NEXTUS between my pain and problems of today and the slipping on stairs injury I suffered in October 1987? Your comments will be greatly appreciated. Dick Hill

[Vync]

Hopefully. It depends on the rater. Some raters want everything spelled out in a certain way with special jargon. Good luck.

[john999]

Did you IME have your SMR's and did he review them? It sounds like he did but he should include a clear statement in the record that he carefully reviewed your service medical records. 1987 has been 25 years ago so you need a good IME/IMO in which your doctor connects all the dots.

[DICK HILL]

Elder - The Doctor did review all my SMRs. Dick Hill

[Berta]

John is correct.

If he stated that he did review them (the SMRs)and referred to them specifically in the opinion (as to dates,entries etc),that would bolster the opinion.


"Do you think the Veterans Affairs will see the above comments as a NEXTUS between my pain and problems of today and the slipping on stairs injury I suffered in October 1987?"

I dont see that specific potential in what you posted here.

But if you had a documented injury (such as evidence of an ER visit) that you believe was directly due to the hips problems ( it is certainly a reasonable contention that the stair fall was caused by your hip disability) your doctor did state the initial condition has been 'excerbated" a key word VA understands...regardless of the cause.


He also does confirm the condition has gotten worse regardless of the stair injury::
"Examination of his right hip today shows pain with FABER with significant groin pain which is consistent of the worsening condition that was previously diagnosed when he was on active duty. "

He did use the FABER test but do you have a copy of his results?

I have never seen mention of this test in any VA opinions,yet a full C & P exam should cover the same premise of FABER..

That test and it's results might be a good idea to be explained a little more by the doctor.

But maybe others here will chime in on the FABER test.I think it is similar to ROM testing. I just have never seen that medical term used by VA before.

Do you already have any SC percent for this condition?

Was your active duty prior to the stair fall in 1987?

Is this the first claim you have filed on the hip problems or were you denied in the past?

If so why did they deny?

[DICK HILL]

For Berta - thanks for your response. Here are replies to your questions:

John is correct.

If he stated that he did review them (the SMRs)and referred to them specifically in the opinion (as to dates,entries etc),that would bolster the opinion. All the doctor’s report says is that he reviewed my records.

"Do you think the Veterans Affairs will see the above comments as a NEXTUS between my pain and problems of today and the slipping on stairs injury I suffered in October 1987?"

I dont see that specific potential in what you posted here.

But if you had a documented injury (such as evidence of an ER visit) that you believe was directly due to the hips problems ( it is certainly a reasonable contention that the stair fall was caused by your hip disability) your doctor did state the initial condition has been 'excerbated" a key word VA understands...regardless of the cause. The slipping on stair injury is documented and is what caused the right hip and sciatica problems. There are 15 documented (SMR) visits regarding right hip and sciatica between October 1987 and November 1988. I retired 30 November 1988. There are an additional 17 documented post service (1989-2012) SF 600s referencing right low back, hip, leg, knee, or foot pain.

He also does confirm the condition has gotten worse regardless of the stair injury::

"Examination of his right hip today shows pain with FABER with significant groin pain which is consistent of the worsening condition that was previously diagnosed when he was on active duty. " Patrick's test or FABER test is performed to evaluate pathology of the hip joint or the sacroiliac joint. The test is performed by having the tested leg flexed, abducted, externally rotated, and extended.

He did use the FABER test but do you have a copy of his results? I do not have copy of the FABER test.

I have never seen mention of this test in any VA opinions,yet a full C & P exam should cover the same premise of FABER..

That test and it's results might be a good idea to be explained a little more by the doctor.

But maybe others here will chime in on the FABER test.I think it is similar to ROM testing. I just have never seen that medical term used by VA before.

Do you already have any SC percent for this condition? No. I am SC for heart condition (10%), hearing (30%),

Degenerative Arthritis Thoracic and Lumbar Spine (10%), Plantar Fasccitis (0%), Migraines (0%). The right hip DJD and right sciatica problems are reflected on my original VA Form 21-526e and on both of the 1989 and 1990 VA examination sheets. Only mention by the VA exam is that I had full ROM in right hip. No mention of right sciatica pain.

Was your active duty prior to the stair fall in 1987? I was on active duty at the time of the slipping on stair injury. Active duty dates are 2 December 1965 to 30 November 1988.

Is this the first claim you have filed on the hip problems or were you denied in the past? The right hip DJD and right sciatica problems were claimed on my original VA Form 21-526e claim and is reflected on both of the 1989 and 1990 VA examination sheets. Only mention by the VA exam is that I had full ROM in right hip. No mention of right sciatica pain.

If so why did they deny? Unknown

Again, thanks for your responses. Dick Hill

[Berta]

"If so why did they deny? Unknown"

A copy of the denial should be in your C file.

They should have sent it to you explaining their reasons and Bases and listing the evidence they used..

John999 is right:

"1987 has been 25 years ago so you need a good IME/IMO in which your doctor connects all the dots."

Their might be something in that old denial that was legally wrong ( a potential CUE claim).

But a CUE claim would rest on establishing SC first.

"connecting the dots" can become very beneficial to a claimant, when done by an IMO doctor who can give a full medical rationale...

what I mean is this(but I am not a doctor)

You said "Do you already have any SC percent for this condition? No. I am SC for heart condition (10%), hearing (30%),
Degenerative Arthritis Thoracic and Lumbar Spine (10%), Plantar Fasccitis (0%), Migraines (0%). The right hip DJD and right sciatica problems are reflected on my original VA Form 21-526e and on both of the 1989 and 1990 VA examination sheets. Only mention by the VA exam is that I had full ROM in right hip. No mention of right sciatica pain."

The right hip DJD and right sciatica provblems could be possibly excerbated or caused by the SC Degenerative Arthritis Thoracic and Lumbar Spine (10%),
Did you formally claim an increase in that specific SC rating adding that the right hip and sciatica are secondary?

I Might not even have a clue here on what I am suggesting ....but a strong IMO can connect dots that can lead from one SC to another potential SC.

I assume you have had continuous treatment records since discharge.

I am very surprised that the initial claim was denied and the Reasons and Bases for that denial might well contain some clues as to how to continue with this claim.

" I am SC for heart condition (10%), hearing (30%),
Degenerative Arthritis Thoracic and Lumbar Spine (10%), Plantar Fasccitis (0%), Migraines (0%"

How old are these ratings?

Disabilities get worse in time. Does your medical evidence still match those ratings or should they be higher by now?

You could go to our VA Schedule of Ratings topic here and look up your SCs by diagnostic code and see if the VA % still matches them or if you would fall into a higher rating category by now.

The VA cardio heart ratings for example were rated one way years ago but they changed...forget when...

And I bet the SC (0) plantar facilitis is making everything worse too or vice versa.

Are you able to work?

Edited March 24, 2014 by Berta