New To This Forum -- My Claim Has Been In The Ratings

[rdawg]

I filed my original claim for degenerative disc disease of the lumbar spine on 30MAr2006. They denied it within 60 days. The SOC said my SMRs show I was treated for DDD/back injury in service but no permenant/chronic condition existed. That was my fault, I signed the 21-4142 to realease my Private Dr's records and put it in my mailbox with the little flag up and the VA never got it. So I submitted a radiology report showing DDD of the lumbar spine on Jul28. It went into the rating board on Jul28 with SMRs and the radiologist report. I called and they said a decision had been made (OCT19th) and I would recieve a letter soon. I caled back and they said it was back in the rating board (OCT23rd). I can't get anyone to tell me why it came out and went right back in. Sometimes they tell me it will be 7-10 days, other times they say it will be 60-90 days.

I'm confused and I can't seem to get a straight answer.

[Guest jstacy]

DId you get a C@P exam for the back? If not, you need to do what you can to get one. Without a medical opinion that links the current condition to in service injury, It is like trying to perform a root canal on a rattle snake, You can and will get bit.

[rdawg]

NO. no C&P yet. They said they had everything they needed to decide my claim. Are they just delaying so they can deny?

I did appoint the AL as my rep and they had me get my Dr. to write a letter in support of claim. He linked my current condition to service. I submitted that around the end of SEP06. My rep said it would go right into the rating board. Is he correct? or was that piece of evidence waiting until the CF came out of the rating board? Is this why it came out and went right back in?

If it was going to be denied why did it take so long and why didin't they schedule me for a C&P exam back in July when they said it was ready to rate? It was ready for denial.

[Guest jstacy]

You dont have to get a C@P exam if a doctor makes the nexus, maybe they will rate it with the information they have. Did the doctor do a range of motion test? I am ataching the C@P criteria for the MD to use. This is what the VA rates IVDS or spinal issues on.

http://www.vba.va.gov/bln/21/Benefits/exams/disexm53.htm

If you have not, you may want to get the doc to use that format.

[rdawg]

Thanks jstacy. My doctor did not use this form or do a range of motion test.

I stil don't see how they could have said it was ready to rate with just the radiologist report back in July. Someone at the 800 number said I could get 10% with the info they had. I get so many different stories from them it's unbelievable.

thanks again.

[Guest jstacy]

That is why I am suprised you did not get a C@P exam for many docs do know the criteria the VA uses to rate disabilities.

Also there is a schedule of rating disabilities for the spine. http://ecfr.gpoaccess.gov/cgi/t/text/text-...0.1.1.5.2.96.26

Edited November 2, 2006 by jstacy

[rdawg]

thanks again. both links are very helpful. I'll keep pressing the RO for a C&P exam.