degenerative arthritis 90% On My Own...now With Questions

[4wheeler]

Thanks to all of you for being so informative.

I read and reread many of the posts and decided to be my own advocate...best advice I learned, and I am a huge advocate of.

Submitted 11 conditions on 1DEC14, which was my retirement date as an FDC. Claim completed 11APR15 (just past the 125 day mark).

Came out to 92%, rounded down to 90%.

I will be appealing/asking for reconsideration for the following:

Awarded 20% for degenerative arthritis of the lumbar spine also claimed as spondylolisthesis. Explanation: "Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees."

Rationale for disagreeing: During my retirement physical, forward flexion was rated at 30 degrees with a geniometer (sp?). During C+P, PA wanted me to push past initial point of pain until it hurt too much (my mistake, I know) and he eyeballed 60% flexion. Currently on muscle relaxers. Justification of 38CFR3.102

Awarded 10% for rectal prolapse.

Explanation: "We have assigned a 10% evaluation for your rectal prolapse based on mild prolapse, occasional moderate leakage."

Rationale for disagreeing: During my C+P, explained to the PA about frequency of 95% of bowel movements results in prolapse, which I believe meets the higher evaluation of 30% due to frequently recurring - "A higher evaluation of 30% is not warranted for prolapse of rectum unless the evidence shows symptoms are moderate, persistent, or frequently recurring."

Awarded non-SC for internal hemorrhoids.

Explanation: "SC for hemorrhoids, internal is denied because the medical evidence of record fails to show that this disability has been clinically diagnosed."

Rationale for disagreeing: Clinically diagnosed while I was on active duty, noted on retirement physical, continues to occur.

Awarded non-SC for right and left knee disability.

Explanation: SC..is denied becasue the medical evidence of record fails to show that this disability has been clinically diagnosed.

Rationale for disagreeing: Full range of motion, but pain upon bearing weight (no, I am not overweight).

I will be filing a NOD, and asking for DRO hearing. Comments, recommendations, etc.?

My ratings:

70%: PTSD

21%: Bilateral lower extremity radiculopathy (10% each side)

50%: Sleep Apnea

20%: Back

10%: Rear end blowout (recurrent) - sorry my attempt at a joke at a serious problem

10%: Tinnitus

0%: Left elbow arthritis

0%: Junctional escape rhythm

0%: right elbow epicondylitis

No SC: Internal Hemorrhoids

No SC: Left knee disability

No SC: Right knee disability

4wheeler

[Notorious Kelly]

Congratulations!

[Navy04]

Welcome aboard and congrats on the 90% SC. You can always request an increase if you think any of the conditions has worsened. Good luck

[Berta]

You did VERY well! and by all means appeal anything you do not agree with.

I have friend whose claim has been in the system for about 10 years and is a member here,I think but never posts...

He never followed through on any of my advise and was surprised when I told him that there is enough info here at hadit for anyone to learn how to succeed in their claim.

I am very glad that we might have helped you get through the claims process but I can see you took the bull by the horns yourself.

"Submitted 11 conditions on 1DEC14, which was my retirement date as an FDC"

Do you mean retirement from the Mil?

If so you have probably accessed the CRDP/CRSC info here. already.

Did the VA make a statement as to TDIU consideration in the decision, or are you employed?

[Pete53]

If you are not working the VA should give you 100% TDIU. Our old friend Alex Humpfrey deceased used to cite a claim he got 100% TDIU for a client based on 10% for rectal prolapse. Congrats on your win but the VA rarely ever gives the proper rating on first go round.

Good Luck

[dhazelwood]

:) :))

Edited April 23, 2015 by dhazelwood

[dhazelwood]

:)

Edited April 23, 2015 by dhazelwood