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Peripheral Neuropathy - Private Neurologist C&p


green

Question

I paid to have a private neurologist complete the C&P paperwork for peripheral neuropathy. The paperwork was not filled out in it's entirety. It does not note "mild" or "moderate" but does note small fiber peripheral neuropathy in hands and feet, no motor reflex in knees and ankle, diminished reflex in elbow, decreased sensitivity to cold, notes numbness in feet to the knee and my hands to the elbow, also notes numbness in outside thigh from hip to knee. I'm using this along with years of statements in my VA medical files referencing peripheral neuropathy. An EMG was not conducted.

Any idea where the VA will go from here and the rating this information might indicate?

Thank you!

Green

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Grrrrrrrr. They love to use mild, moderate, or severe when they rate nerves. Isn't that right on the DBQ? The doc didn't use that?


What did the VA examiner state when they examined you for your nerves?

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Did they give a full medical rationale as to why it is a secondary disability, caused due to an established SC you have now??

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There is a section for pain and numbness and although the dr. marked that I have it, he didn't rate it none - severe. All my reflexes were either rated as decreased or absent, monofilament all listed as decreased or absent, position sense as decreased in lower extremities, vibration sensation as decreased, cold sensation decreased in lower extremity. The severity section she did not fill out at all. I'm guessing that is because the section is tied to certain nerves and the realitiy is that peripheral neuropathy is tied to small fibers not necessarily to the radial, median, ulnar, sciatic or femoral.

Under 6B the DR stated "small fiber diabetic neuropathy in hands bilaterally as well as lower extremity bilaterally to above the knee"

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Berta, in the doctor's notes he states that I'm a diabetic and have had it over 30 years, it reads as they are citing that as the cause.


and I'm service connected for diabetes

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Green: What was DX'd first? Have you been DX'd with PN by the VA? Back in 2010 I had to have an EMG and a full Blood workup (rule out AIDS and other STDs that can cause PN) before I could get the PN DX from my VA PC Dr and get a referral to VA Neurologist. After all the testing finally got a DX of Idiopathathic Bilateral PN for my feet. Had to see (3) different VA Neurologists before got one to agree "More Likely than Not" a result of AO exposure in 69.

Semper Fi

Gastone

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I was diagnosed with diabetes 32 years ago. There are all sorts of references in my VA med records that I have PN going back to 2000. I'm wondering if I should go see another neurologist and make sure they fill out the form in its entirety prior to filing for the secondary.

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"Berta, in the doctor's notes he states that I'm a diabetic and have had it over 30 years, it reads as they are citing that as the cause.

and I'm service connected for diabetes"

PN is a well known consequence of Diabetes

It is in the VA Diabetes Training letter, available here under a search.

An endocrinologist and even a cardiologist would know that, as well as an internist.

I just hope the VA awards this as secondary to you without a lot of BS.

It is very difficult for them to attribute PN to any other etiology, when one has diabetes.

But One never knows what to expect from VA.

The way VA rates PN is on our VA Schedule of Ratings section.

The ratings and diagnostic codes are about half wey throught this document.

VASRD is one of our most important documents here.

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  • HadIt.com Elder

I was dx'ed with PN in hands and feet. The C&P's were done by a neurologist and internist. The neurologist said the PN was secondary to my DMII. The internist said only the feet were secondary to the DMII. Who did the VA believe.....why the internist of course. I got the hands on appeal at 10% each.

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