Need Advice On Appealing My Claim

[NHB]

Not long ago I filed for a disability increase on my lower back injury. I have gone over a year with out any type of relief, one VA doctor in the ER told me I was a junkie just looking for drugs. Hmm mm then refused treatment to me, I have had a pain scale of 10 and the only way I could get the VA to do any type of treatments was to go through Senator Lindsey Graham of South Carolina and finally the VA farmed me out to a civilian doctor for pain injections.

Now lets get to my questions:

I requested a second C&P exam on both exams they left out key information

A. I use assisted device called a cane to help not fall due to the left side giving out and numbness in the

right leg.

B. Incontinence need I say more.

C. This is from my C&P exam: Does the Veteran report flare-ups of the thoracolumbar spine (back)?

[ ] Yes [X] No

I am and had been in a flare up with a pain scale of 10 for over a year. Confused.

D. Is there objective evidence of localized tenderness or pain on palpation

of the joints or associated soft tissue of the thoracolumbar spine

(back)?

[X] Yes [ ] No

If yes, describe including location, severity and relationship to

condition(s):

tenderness along spine, likely due to fibromyalgia

I have in my spine alone and all noted on my problem list in medical file: arthritis, chronic low back pain, unsteady gait, lumb/lumbosac dis degen disease, obesity depression, low back pain.

I was diagnosed about a year a ago with fibromyalgia I can tell the difference in my back and fibro pain.

Is the Veteran being examined immediately after repetitive use over time?

[ ] Yes [X] No

If the examination is not being conducted immediately after

repetitive use over time.

[X] The examination is neither medically consistent or inconsistent

with the Veteran's statements describing functional loss

with

repetitive use over time.

Does pain, weakness, fatigability or incoordination significantly limit

functional ability with repeated use over a period of time?

[ ] Yes [ ] No [X] Unable to say w/o mere speculation

If unable to say w/o mere speculation, please explain:

Unable to distinguish symptoms from lumbar strain/arthritis and fibromyalgia.

Does the Veteran have any other neurologic abnormalities or findings related

to a thoracolumbar spine (back) condition (such as bowel or bladder

problems/pathologic reflexes)?

[ ] Yes [X] No

This is in my medical records and he asked this question, actually in both C&P exams.

Does the Veteran's thoracolumbar spine (back) condition impact on his or

her

ability to work?

[ ] Yes [X] No

Previously in exam: Does the Veteran report having any functional loss or functional

impairment of the thoracolumbar spine (back) (regardless of repetitive use)?

[X] Yes [ ] No

If yes, document the Veteran's description of functional loss or

functional impairment in his or her own words.

Can stand for about 1 hour and walk about a mile.

So I am refiling with every problem area listed above, my depression is based on the constant pain in my back, fibromyalgia can date back to the back injury, however, can cause feelings of anxiety and depression, which may worsen fibromyalgia symptoms. I also have sleep apenea.

Ok, I can't sleep because of the pain average 4 hours a night, I am depressed due to pain lack of sleep feeling anxious due to the pain, lack of sleep, depressed and the fibromyalgia, I am unable to sit or stand for any length of time that just leaning back in a chair or car seat is very painful in my back.

What are your thoughts should I refile and take my doctors notes and highlight the areas in my medical record and force the C&P board to reevaluate?

I am confused on the above but also I came into possession of a letter with a person with the exact same problems and received 100% disability, so I asked Senator Grahams office and the VA office where McDonald's office is located if this was discrimination? Still do not have a response. Should I attach this letter from the VA to my records and notes?

Thanks for your help.

[Guest]

I am confused on the above but also I came into possession of a letter with a person with the exact same problems and received 100% disability, so I asked Senator Grahams office and the VA office where McDonald's office is located if this was discrimination? Still do not have a response. Should I attach this letter from the VA to my records and notes?

First things first, you should never want to compare a veterans rating to yours. You should not have that veterans' letter/information. The veteran that was awarded 100% most likely have something you don't, a medical opinion with a solid medical rationale. You need a medical opinion with a good medical rationale to win your claim. Keep in mind that VA will not take your word for it, they want a medical doctor opinion and a medical rationale. Remember evidence wins not accusing discrimination. It is very hard to prove discrimination in a court of law and in politics, I don't think they even care. You probably need to be seen and treated by a Rheumatologist.

[FormerMember]

<<<<<<<<<<<<<<<<<The veteran that was awarded 100% most likely have something you don't, a medical opinion with a solid medical rationale. >>>>>>>>>>>>>>>>>>>>>>

Problem solved. We have been saying this since the advent of DBQs. There is no box to check that says "It's more likely than less likely that Mr. NHB's injuries/diseases are related to his service in the USAF". It took me 14 years to get that through my thick skull because my VSO ''disremembered " to tell me I needed one. After reading BVA decision number 2,065, it suddenly dawned on me why some Vets win and some lose. Thank you Pete992 for once again cutting the Gordian knot and explaining this VA medical mystery.

[broncovet]

NHB

You need another medical opinion such as an IME/IMO to win benefits. Your doctors opinion can ONLY be trumped with another doctor, not you, not me, not judge Sheldon, or not Michelle Obama. Its the law. The doc's opinion on medical issues is final, even when wrong, because we dont have the right to say he is wrong on medical issues. If you dont like the law, you can work to change it, but it has nothing to do with discrimination, and everything to do with the letters behind your doc's name. His medical degree means his testimony is presumed correct until or unless the Veteran challenges his credentials at appeal. The VA only orders ONE C and P exam, per issue, unless that exam is dated (old). Its frustrating and I have had bad exams before, and I had the same problem and choices as you do.

So, here are your choices:

1. Do nothing, in which case your claim will highly likely be denied. Lay evidence, such as your comparing yourself to another Veteran, wont suffice, because only a medical professional statement can refute another medical professional. Senator Graham, unless he is a medical professional specializing in back pain, wont be able to refute this medical exam.

2. Get your own doctor, or another VA doctor, to refute that doc's findings.

3. If your claim is denied, then you or your representative can challenge the credentials of the doc, since we dont know, at this point, if this doc has an MD (he may not) or, even if he has professional medical experience with back pain. In other words, if your doc has little or no experience/training on back/spine issues, then the BVA could order another VA C and P exam, if your challenge on appeal is upheld. That is, if the judge agrees that the doc was not "competent" to make such a medical determination, then he could order a new exam. The judge wont change the exam, but he could say that doc has little or no experience in back pain so his evaluation is not credible. This will likely take a long time, probably several years and delay your benefits.

4. Go to medical school, get your degree, and refute the docs medical findings.

5. Run for Congress, get elected, and get this law changed. If you accomplish this, then you probably wont need the money from VA. Senator Graham is unlikely to change the law, because this will take an act of congress, and it would need to be signed by the president.

I recommend number 2, which is consistent with what Pete and Asknod suggested.

Edited June 18, 2015 by broncovet

[Fat]

Funny BroncoVet.

Seriously, get a private orthopedic back doctor to examine and refute the VA doctors report.