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Denied Claim For No Diagnoses But Diagnoses In My Medical Records.


diver

Question

Hi everyone. I have been working on my claims that were denied for no diagnoses. What I am looking for is some pointers for what to do about it and I do not have the money for a IMO outside the VA. I have been fighting the VA for my chronic hip pain this last denial said that there is no diagnoses. So I made an appointment and went to the ortho dr for an exam. When she looked into the notes he said that I have diagnoses from 2006 of chronic hip pain. I am now getting an MRI done on just one hip. The C&P examiner stated that there are no diagnoses of hip problems and that it is least likely than not ---. In the exam it does show that I have movement problems that would be rated at 10% and 20%. What should I do to counter this and how do I do it. The VA medical records have the diagnoses. When it comes to the VA I have not known what to do and I just through everything at them and see what sticks.

I was also denied for sciatica. The reasoning was also that there were no diagnoses and also that lumbar strain cannot cause sciatica. Again in my medical records there is a diagnosis for sciatica and that I am being treated for it. I have been also diagnosed with DDD at L5 S1 and that is pinching on the nerve causing the sciatica problem.

With this information should I file a CUE because they are stating that there is not something that they have or just do a NOD. Also what about the findings that “ Sciatica is proximately due to or the result of service connected residuals of a lumbar spine injury 38 U.S.C.A. 1110, 1131 (west 2002); 38C.F.R. 3.310 (2005)” Citation nr: 0600049. Does this not show that sciatica can and should be caused by lumbar injuries and that’s what a strain is.

I am new at researching things and I really don’t know what to send and how to do it. I have always just sent in a NOD stating that I disagree and why I believe they are wrong. No quotes or anything.

Thanks for your help in advance.

Diver

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One of the things that I am concerned about is that I never received the brown envelope. I received a standard envelope with the decision and the deferrals but it did not have the standard forms like right to disagree forms and any tdui forms nothing just very quick this is why they made the decisions and a very short list of what evidence they used. Have they changed their process or what. I am waiting for the brown envelope to try to find out in more depth of what they used for the decisions so I can find what is missing and file it with the NOD. Any ideas on this?

Thanks

Diver

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Make sure you include in the NOD any information you have in your medical records that show that you are, indeed, diagnosed for, and being treated for, those conditions. I would think a C&P exam that said you were not diagnosed with a condition that you are being treated for would be inadequate.

"I was also denied for sciatica. The reasoning was also that there were no diagnoses and also that lumbar strain cannot cause sciatica."

Did the C&P examiner say this? Or did the VA make a medical determination that lumbar strain does not cause sciatica on their own?

Do you have copies of all of your medical records, and exam reports? If not, you want to get them and so you can go over them and point out what your record actually say.

You might find this thread useful:

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diver, if i was you i would go to the records department at your vamc where you see this va doctor. i would do a request for a statement or an opinion to the exact letter the va sent you. get your doctor to make a comment on the part where it says no diagnosis. if you go about a week before your mri then by the time you get your mri results in the doctor has already seen them and it takes about 3 weeks for a va doctor to respond and another 2 weeks for the records department to send you his written statement.

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diver,

The VA has a new form out 21-526 (b) its a secondary supplemental to file a claim that is secondary to your disability its suppose to speed up the claim and make it easier without all the red tape.

if you have a disability that you can claim secondary to your current disability's

I just found out about it today from Veterans Attorney Bob Walsh...He was on hadit radio podcast show today!

...................Buck!

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thanks Free_spirit_etc. what finally happened to your claim for it? and if you were aworded for it what evidence did you finally use?

diver

diver,

I never claimed for this. I am a widow and filed for accrued benefits and DIC after his death. I used IMOs and medical articles.

If we would have known during his lifetime what I know now -- he could have been awarded several claims that he had been denied previously. We would have known to go over the medical records, the decisions, and the law. Back then, we didn't know as much about the VA games, and how to win them. That was before we knew about hadit.

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Highoctane,

I see you have another thread with a similar title. You might want to post this in that thread and so it is easier to follow the rest of the story.

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That one is specific to the retro compensation..this one is about getting my contentions that were denied fixed. I probably shouldn't have went off on the retro tangent here. Sorry..fixed

I wasn't talking about any tangent on retro. I was referring to this thread That was started by you and discusses your claim. I thought maybe you intended to post your comment about what the DAV service officer told you in that thread. That thread has a lot of previous information about your issue.

THIS thread, the one you posted in, is about another issue concerning another veteran. I first read your post and scanned up the thread, and assumed it was posted by diver, as this whole thread was about his issue. But I was a bit confused, and so I finally looked and realized you were not diver, but then I was trying to figure out how your post related, as it was your first post in this thread, but it seemed to assume we had some background info on your claim. Then I clicked on your name to see if I could find some background info -- and noticed you had a thread about your own case (and with a similar title to this thread). So I thought maybe you posted in a different thread than you intended to.

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Oh man...lol...You are right I posted this in the wrong thread..sorry. I meant to post it in my thread..I guess the titles were similar enough I just clicked on the wrong one.

I wasn't talking about any tangent on retro. I was referring to this thread That was started by you and discusses your claim. I thought maybe you intended to post your comment about what the DAV service officer told you in that thread. That thread has a lot of previous information about your issue.

THIS thread, the one you posted in, is about another issue concerning another veteran. I first read your post and scanned up the thread, and assumed it was posted by diver, as this whole thread was about his issue. But I was a bit confused, and so I finally looked and realized you were not diver, but then I was trying to figure out how your post related, as it was your first post in this thread, but it seemed to assume we had some background info on your claim. Then I clicked on your name to see if I could find some background info -- and noticed you had a thread about your own case (and with a similar title to this thread). So I thought maybe you posted in a different thread than you intended to.

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Just my two cents, but the VA is correct (for now).

I am assuming you have a service related injury and the VA is now saying they need a current diagnosis of injury.

Right hip pain is debilitating, but it isn't a formal diagnosis of injury (torn ligament, fractured pelvis bone, hip dislocation, etc).

Hip pain is a residual effect of an injury.

An MRI should identify the injury, which then will substantiate the hip pain.

"NEVER GIVE UP"

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