C&p Exam Lead To Reduction, Filing An Nod Opinions

[COLTTEAM3]

'There is no recent evidence of any left ankle symptoms or treatment in your VMAC records. You reported to a va examination, you noted stiffness and pain. You also noted not having any current treatment. Upon examination, the examiner noted decreased range of motion of plantar flexion at 20 degrees and dorsiflexion at 5 degrees. However, the examiner went on to say that the decreased range of motion was exaggerated, as the examiner noted that you were able to walk on heals and toes at examination. The examiner did not note any functional impairment with repetitive motion or flare ups. No objective pain was shown on examination. No arthritis was noted. The examiner noted that your left ankle condition has resolved, and that a tiny avulsion fracture of unclear significance was noted in your medical history. The examiner stated that your range of motion deficit and weakness documented is not considered reliable as there is no record of an ankle condition for several years, no swelling or deformity was noted on exam, and weakness was inconsistent. Therefore we cannot use your decreased range of motion noted above for evaluation, and there is no objective evidence of pain noted on examination."

So I have three questions.

1. Should I now go to the VA to seek medical documentation to put in my VA file, I have already initiated a NOD. Or does that not look good on my part. My VSO said it doesn't just wanting to get other opinions?

2. Can I challenge the narrative as it shows and extreme amount of biases from the "exaggerate", i didn't seek treatment for it because i was told there is not much that can be done. however the VA has me on meloxicam.

3. Should i not even bother with the appeal and just leave it at 0 and not poke the "bear" anymore than needed, as it seems to have bitten me this time.

Thanks for all your help brothers and sisters

[Berta]

Is the meloxicam specifically for the left ankle pain?
That could be used to rebutt the denial. How long has VA prescribed this med to you?

Why is this medication prescribed?

"Meloxicam is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Meloxicam is also used to relieve the pain, tenderness,swelling, and stiffness caused by juvenile rheumatoid arthritis (a type of arthritis that affects children) in children 2 years of age and older. Meloxicam is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain, fever, and inflammation."

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601242.html

"Should I now go to the VA to seek medical documentation to put in my VA file"

I sure feel you should. VA justifies it's ratings and C & Ps by acknowledging that a vet gets treatment from them or a private doctor.

Their rationale seems to be, if you dont seek treatment, you dont have a disability at a ratable level.....

I would appeal it and add to the NOD that you have been prescribed meloxicam for the affects of this disability and you do not have osteo arthritis or Rheumatoid arthritis.(Use a copy of the print out above to support that)

(Or do you? They could possibly be secondary conditions from the claimed condition.But hard to really say. Did VA ever rule out osteo or rheumatoid arthritis)

Do I understand that the VA has given you a "0" rating in the past and continued it or did they actually reduce the rating you had??

Edited May 12, 2015 by Berta

[COLTTEAM3]

Berta,

Thanks for the response. The Meloxicam is actually prescribed for an array of service connected disabilities, 20 percent for my back, 20 percent for my shoulder but I was told to use it as a general anti inflammatory. Before I was prescribed this I was prescribed Naproxen, in total I have been prescribed anti inflammatory for 3 years now. I have not been seen for any type of arthritis, Also it has never been ruled out.I haven’t been asked about it in any of my DR appointments or tested for it.

Yes the VA originally rated me at 10 percent then reduced it to 0. However I just don’t want to seem like I’m pulling a fast one during the appeals process, and seeking medical attention for it now that it has been reduced, I thought that it may look unfavorable. As I haven’t been seeking attention for it since I received the rating in 2012.

Also my VSO filed an NOD yesterday stating that I have been prescribed Meloxicam, and that I still have painful motion of the ankle and saying that when I am extensively using the ankle I wear a brace on it. I just don't know if that matters in the NOD, but she said it would help rebut the exaggerated comment in the narrative. A

Edited May 12, 2015 by COLTTEAM3

[Navy04]

Sorry to hear of your bad exam my friend. Really don't know what to say on this one. In my opinion seek treatment and remember that you can always put in for an increase. Getting the SC is the key to start off the race for any Vet. Good luck and God Bless!!!

[Gastone]

Your claim, your decision. 10% SC was what, $1200 a year? Definitely not a make or break amount, but if you got it coming, get it. If you don't still have the degree of disability, so be it. However, you should never automatically accept anything negative the VA Raters and C&P Drs throw at you. To just accept a SC reduction when you still have the disability, UFB!

Was the C & P Dr a Podiatrist or Ortho Specialist?

As for VA treatment, what better way of showing continuity of symptoms and having backup clinical reports on your condition. I went to a VA Podiatris for Planters Fascitis, shots didn't work. The Dr said nothing more to do but rest and ice, Ya. I'd been doing the ice before seeing him. A couple months later still had the pain and limp. A neighbor told me he went to physical rehab for the same thing and it really helped. I got a referral to VA Physical Rehab and after about 2 months, twice a week pain gone and like I never had the problem. That was 2 yrs ago. Sooooooooo, I think you should have the VA start treating your SC condition.

Semper Fi

Gastone

[FormerMember]

CT3---Any rating has to be predicated on the disability before any medication to ameliorate it. https://asknod.wordpress.com/2012/10/27/cavc-jones-v-shinseki-diarrhea-vs-loose-stools/That one has been around for decades but VA keeps trying to cheat on it. It's like strapping on a prosthesis and having VA tell you that what the hey?- you are now no longer are missing that leg and we're retracting your SMC K for it. Jez. That's Ratings 101. Never give anything back or they'll just keep coming back for more. They took 10% back from me in 2010 for skin scarring. What? the scarring went away? I fought for 5 years and got it back when I filed my Writ in January. Never fall for that old saw about pissing VA off. If that was the case they would have hired someone to knock Berta and me off. They tried hard for the year I was in the VAMC but failed.

That 10% when added to a few other ratings becomes a lot more than $1,250 a year. Once it goes over 30% you get spousal/rugrat $. It's a ladder. Never cut off a rung and say it's not essential. When you're over 100% some day, that 10% (which might be more in the future) might be the kicker to get you over an additional 60% for SMC S. Never ever roll over.

a

[COLTTEAM3]

Thanks guys for the responses, I just wanted to ensure that me seeking treatment after the reduction would look bad to the rater during the appeal process. Similar to Gastone I was told the only thing I could do to alleviate the symptoms stiffness and pain would be ice and rest so that cookie provided by asknod is very positive in my opinion for the appeal. However Iast night I talked to my VA primary care provider and they did the following they sent a consultation for the physical therapy and prosthetics for an ankle brace. So when they review the decision will they be able to see in am in PT and the notes from process, or do I have to submit it to them. The PT will be taking place in the VAMC.