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Emailed Alison Hicky About Claim

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diver

Question

I emailed Allison Hickey yesterday regarding my claim at 12 by 330 I received a phone call from the assistant director of the Seattle VA. The email was about the denial of my claim for chronic severe hip pain secondary to my service conected knees and sciatica secondary to my lumbar strain. I talked to him for about 20 minutes and explained that in the decision reasoning they stated that there were no current and active diagnoses for my hips. I told him that I spent a month trying to get into the va ortho to get a diagnoses and I was told that I have an active diagnoses in my VA records from 2006. Again it is an ACTIVE diagnoses. So I told the assistant director that that means that the reasoning for the denial was false and needed to be corrected. I also told him that with the imo that stated that my chronic hip pain ARE caused from my service connected knee condition and the C&P exam stated that it was at least (that sucks but at least its something) as likely as not there should be enough evidence to find in my favor. I also stated that with the findings from the C&P the rating would be 20% for 1 hip and 10% for the other hip.

As for my sciatica, again the rater stated that there were no diagnoses of sciatica. I informed the assistant director that the Dr at the va showed me the diagnoses for sciatica and for lumbosacral spondylosis without myelopathy of L5 S1 and that the MRI on 12/20/14 has a 4mm bulge. And that the diagnoses show up in the myhealthyvet Blue button list. The C&P dr stated that lumbar strain cannot cause sciatica. To counter that I found 8 BVA decisions from 2014 alone that have sciatica with lumbar strain including one that specifically states “ service connection for left & right lower extremity sciatica associated with a service connected lumbar strain is granted”. I sent an email containing all the Citation NRs to the RO that has my file.

Well I hope that I did the right thing here and that it will help my claims. He stated that I will hear back from him in a weak or two after they have a chance to review the decision of the claim and whether they find that there is enough evidence to overturn the denial and grant my connection for them.

So my questions are

  1. Did I do the right thing with this claim.
  2. Does anyone have BVA claims for chronic hip disorders that I can use as evidence? I did not really find any and I must admit I am very new at researching the BVA decisions.
  3. And finally. How is sciatica rated? I know the basic but what I have is pain in both butt cheeks down to mid thy and down the back of my left leg. Are they rated separately or are they rated as one? I have not been able to track this down. I have seen both legs being rated separately but I have not seen anything about the butt cheeks.

thank you all

diver

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Your claims for sciatica is rated by va as "radiculopathy" and each lower extremity is rated separately with a bilateral factor included. Sciatica is a symptom with radiculopathy being the actual diagnosis. They know this but they sometimes play dumb and leave this point out when rating. Stress this point if needed. ..

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So if I have this correct they will rate radiculopathy at say 10% then each cheek and my left leg could be rated at say 10% each also?

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diver,

I think you did the right thing except for stating you found 8 BVA decisions supporting your claim. You need to find some BVA decisions supporting your claim ASAP. You can go to www.bva.va.com and click on "search decisions" and type in key words in the search block such as "sciatica, radiculopathy, etc."

You can search under 38 CFR part 4 and find the Schedule of Ratings for the medical conditions matching your medical condition and get an idea as to how it is rated. I have sciatica in my left leg and hip and my ortho doctor (spine specialist) stated it was caused by spinal stenosis at the L5-S1 level. You can find spinal stenosis in 38 CFR part 4.71a.

Good luck to you.

GP

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I just received a call from the ro in the Philippines. She stated that I have been rated 10% for my left leg sciatica including my left hip and nothing for my right side. I don't know how I feel it's great to have the increase but my chronic hip pain is 15 years old and my sciatica is only a couple of years old. They are going to try to have the actual rater that made the decision call me to explain why they did what they did.

Diver

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Ok the call. The raiter stated that the hip was added because the diagnosis for my hips is for hip pain and that that can not be rated. She stated that if I get a diagnosis of something other than hip pain then they can rate it. My sciatica was rated because it runs down my left hip. she also said that the diagnosis is all they need because they know that with my back and knees it will cause the hip problems.

Question if I am rated on only one side is it still bilateral? I think not but I hope I'm wrong.

Diver

Edited by diver
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