Never Diagnosed

[jacanah83]

I'll try to keep this brief, my last two posts ended up looking like books. I've been on a 10%SC disability since the late 80's. I've been trying since 2008 to get it increased as the condition has worsened and I never believed the condition was diagnosed correctly, they've been calling it polyarthralgia since my discharge because that's what the Navy called it. Anyway, I've taken the advice of several people on here and have gotten an IMO. I had an MRI done two weeks ago and discussed the results with my doctor. It shows 3 bulging discs in the lumbar spine causing spinal stenosis. Her diagnosis of the lumbar spine is degenerative disc desease, also have it in my neck with two discs almost non-existent. My local senators office is assisting me with filing my next claim and I wanted some guidance from some of you folks that may have gone through something like this. First question I believe I already know the answer to but I'm going to ask it anyway. At this point I feel like I was robbed of a career in the Navy as they never even tried to find the cause of the pain I was having. From the research I've done, had they looked at this from a neuroligical standpoint they might have seen the problems with my spine and might have been able to treat it. So, the question is, is it possible to have a disability rating revised at the time of discharge if it's proven that not enough was done to properly diagnose the problem? I requested my medical records from my time in the Navy and my enlistment physical clearly shows that I had scoleosis of the spine so they knew of a problem when I joined then did nothing about it when I had a problem with it.

Second question is should I file with the degenerative disc desease as the primary condition with the stenosis as a secondary condition? And, can the degenerative disc desease in the curvical spine be added as a third condition somewhat after the fact? I'm not even sure where these problems even came from. I've never had to spend the night in a hospital until I had appendicitis a couple of years ago. The only guess I've got is falling off a hay wagon helping the neighbor put up some square bales when I was about 18 with the first trailer into the barn. I fell on wooden pallets flat on my back but really didn't feel as if I'd injured myself. (I was doing it for free to help my neighbor out, would hate to find out I destroyed my spine for free. LOL)

Thanks for your help.

[Berta]

"So, the question is, is it possible to have a disability rating revised at the time of discharge if it's proven that not enough was done to properly diagnose the problem? I requested my medical records from my time in the Navy and my enlistment physical clearly shows that I had scoleosis of the spine so they knew of a problem when I joined then did nothing about it when I had a problem with it."

If this was a VA disability rating, they gave you a diagnostic code, and if the medical evidence they had at time of that rating warranted a different code and a different
percentage, it is possible that you have basis for a CUE claim.

http://www.disabled-world.com/health/orthopedics/polyarthralgia.php

It does sound like you did not have polyarthralgia, :
"Anyway, I've taken the advice of several people on here and have gotten an IMO. I had an MRI done two weeks ago and discussed the results with my doctor. It shows 3 bulging discs in the lumbar spine causing spinal stenosis. Her diagnosis of the lumbar spine is degenerative disc desease, also have it in my neck with two discs almost non-existent."

Did the IMO doctor stick to the IMO criteria here at hadit?

Did they give a full medical rational as to how the misdiagnosed polyarthralgia was in fact stenosis with DDD, stemming from your military period of service?

Did the IMO doctor directly associate the opinion with excerpts and dates from your SMRs and Discharge certificate as to how the stenosis and DDD stemmed from your service?

Did you have any situation in service that could have caused spinal injury, although it seems this disability began in service anyhow, so maybe no need for initial inservice cause ....

others will chime in here on that point..........

"Second question is should I file with the degenerative disc desease as the primary condition with the stenosis as a secondary condition? And, can the degenerative disc desease in the curvical spine be added as a third condition somewhat after the fact "

If you can scan and attach the IMO here (cover doc's name, and your name, c file etc prior to scanning it, I think we can answer that question.

Has VA been treating you all this time for polyarthralgia?

Have you had any type of treatment at all for the spine, neck problems from the VA or from any private doctor?

I moved hay and raised livestock for 8 years, and falls happen..I sure would not think that was the cause of the problems you have now.

Probably VA is the cause if they have been treating you for something you dont have.,overlooking a neuro cause for your disabilities.,that would only make them get worse in time.

BTW , was the IMO doctor a Neurologist?

Edited April 8, 2015 by Berta

[broncovet]

I just posted, "claim basics", but will go over it with you. It sounds like you are already service connected but there may be an issue with the diagnosis.

You need MEDICAL evidence that documents:

1. Your service connected condition has increased.

2. If there is a conflict in the current diagnosis vs that with what you were service connected with, you need also, to resolve that conflict with medical evidence. In other words, a doctor needs to say "The military diagnosis of polyarthralgia" has been updated to "degenerative disk disease." And, he needs to give his rationale, such as polyarthralgia caused the DDD, or that polyarthralgia is an early symptom of his advanced DDD".

You have to have some sort of link from polyarthralgia to DDD, and this needs to be medical evidence. YOur opinion wont suffice.

As Berta pointed out, your poly diagnosis could have been wrong and its actually DDD. If you dont have something in your cfile linking these, your increase will likely be denied.

Im not a medical expert, but its possible that your DDD is secondary to poly. Ditto for stenosis. I suggest you see your doc and ask him these questions, ask him to opine (sometimes docs will give you a favorable opinion if you simply ask them.)

If your doc provides you some sort of nexus, or secondary, then you may need to amend your claim in that regard. An example:

Lets say you have a current claim for ddd, and another for stenosis. You talk to the doc, and he says, "yep..that poly you had caused your DDD and your stenosis was secondary to DDD.

In that case, I would amend my claim (va calls it "clarify"..), and cite your evidence. It could save you years of appealate review.

Also, in every case, listen to Berta. She knows her stuff.

[jacanah83]

Thank you Berta and Broncovet for your responses. I haven't gotten the paperwork from the doctors office yet, should have them first of the week. I'll scan them then and attach for your opinions.

To answer a few of the questions:

The doctor is not a neurologist, couldn't afford to go that route. She is with a family practice office nearby. On my second visit to see her she suggested trying Gabapentin as a "test" drug to see if the problem was neurological. The medication had very positive effects so she suggested doing an MRI of my lumbar spine. The DDD in my cervical is already documented by the VA so checking the lumbar seemed like the next place to look. In all of the visits to the VA center in Nashville for 3 seperate C&P's as well as visits to the PCP there have been upteen million x-rays taken of my knees and hips; that's where the pain is. There is low level pain in the lower back but nothing like what was happening in the legs. In over 4 years of regular visits to Nashville there was never an attempt to see if this problem was neurological. The same can be said of the Navy while I was on limited duty for a year. Obviously, there is more technology these days not available in the late 80's but my lumbar spine was never looked at to see if that was the source. Did they overlook such a course of treatment or did they not want to find a problem there? Don't know, but it was never even suggested to go that route.

I was receiving treatment for the polyarthralgia with numerous NSAIDS but none of them had much of an effect on the pain. At one point my PCP changed my prescrip for 800mg Ibuprofen to Meloxicam as he thought the Ibuprofen was jacking up my bp. After taking the Meloxicam for about two weeks (along with a Flexiril and Tramidol) my blood pressure was so high I burst a blood vessel in my nose and ended up in the ER to get the bleeding stopped and the blood pressure down. I then ended up on a bp med and Hydrocodone (along with the Flexiril). None of the meds did any good and the VA doctor was more interested in my vitamin D level than trying to figure out what's been causing over twenty years of pain. I quit taking all of the drugs and discontinued visiting the VA doctor; 220 mile round trip to see him after waiting 3 months just to get an appointment.

As far as filing the claim itself, I've spoken with the veterans representative with Senator Rand Paul's office several times while getting all of the information needed together. Once I have it all in hand I'm to bring it to her office and they are going to assist me with filing the claim and making sure it's worded correctly. I've filed the first three claims on my own and just didn't have everything I needed to raise doubt in their diagnosis of polyarthralgia. I'm going to make notes of everything that you folks suggest here to take with me as well and hope for a better outcome than I've had in the past. I had to do a little research to find out what a CUE was (thank God for Google) but I want to explore that as much as possible. The Navy thought I was trying to find a way to get out of the military. Seems people wanting to get out will complain of knee pain as it is hard to prove or disprove. I know this from a civilian physician I was sent to at the end of my 2nd period of limited duty. He said they couldn't find anything wrong with me and I had to go back to sea or take a medical discharge my Navy doctor wasn't allowed to tell me that. I was E5 after two and a half years, could have taken the Chief's exam at 10 years if all went well and left myself 10 years to make Master Chief before retiring. I was also qualified at all my watch stations on the sub I was on and was a walk through and the Captains signature away from getting my dolphins. Why would I want to work that hard to get that far and then want to get out?

Thanks for your help. This site is a Godsend for vets because of people like you.

[Berta]

"At one point my PCP changed my prescrip for 800mg Ibuprofen to Meloxicam as he thought the Ibuprofen was jacking up my bp. After taking the Meloxicam for about two weeks (along with a Flexiril and Tramidol) my blood pressure was so high I burst a blood vessel in my nose and ended up in the ER to get the bleeding stopped and the blood pressure down."

Absurd treatment.
Meloxicam is as much a NSAID as the ibuprofen is

We have plenty of CUE info here in the CUE forum but I wouldnt worry about that possibility yet.

Unfortunately I do not feel the VA will give your IMO much weight Because she sounds like a GP or, as you said a Family doctor.

Then again the VA might get a negative opinion from a non doctor, and that would give her opinion more weight.

If she added medical treatises to bolster her opinion that would help to, but she is trying to change a diagnosis, and that is why I suggessted a Neuro IMO.

I am glad someone at Rand Paul's office is helping you.