How much evidence is needed?

[Andyman73]

I recently spoke with the VARO in regards to my current claims.  I wonder how much evidence do I need to make a connection? 

When I fell down a flight of stairs, during boot camp in November 1992, I was given the full once over by the ER staff.  At the time my neck  was hurting, as was many other body parts.  But when they checked me over, they found no specific injury.  VARO told me that this in itself is not enough to quantify scheduling a C&P exam.  I had a an exam for my neck with x-rays, which showed some recalcification of C-5 and C-6.  And I have radiculapathy symptoms in both arms.  The only difference being the first claim was filed as secondary to my back.  I had completely forgotten about my neck hurting after that fall.  And pretty much ever since then I've been on pain meds of varying degrees and flavors.  The current claim was filed as a primary SC claim.

Next I have a claim for painful jaw condition.  I have about 6 entries in my STR from both medical and dental visits.  I was having intense pain in my jaw muscles, from clenching my teeth.  I don't recall ever being DXd with anything, and they weren't able to pinpoint the cause.  Of course they weren't even considering stress as the cause.  Now my teeth are quite worn, my dentist has noted for years that my teeth look like I've been using sand paper as chewing gum.  My jaw aches all the time, even though the intense muscle pain occurs infrequently, it still happens.

I'm going to my PCP on Monday, do I need to address these issues with him? 

Andyman

[Navy4life]

Andyman;

Regarding your fall in 1992, I have similar issues.  I had several fractures and sprains to both feet/ankles and right now I sit at 10% for left ankle and that is it!  I have been trying now since 2013 to get my feet/ankles S/C.  I too have the SMR's to proved the AD injuries but for me I never filed for any type of disability until 2013.  All that time I did however keep all SMR's and I had my outside doctor's information to back it up and I have my podiatrist at the VA backing me up with a Nexus letter.

When you fell what was the result of it?  Fracture or Sprain?  Was that your only issue while on AD for that contention?  What was the ER's results?

If all you have is the ONE ER visit while on AD that is going to be an uphill battle regarding linking your neck injury.  Secondly, you state you completely forgot about your neck pain?  Have you not had any treatment to your neck?  If so, I would supply that information.  If not, again, it's going to be tough to connect the neck contention.

As far as the jaw issues, do you suffer from TMJ?  If so can you prove it is s/c while on AD?  You have to have the connections in order to get the award of S/C.  How long have you been seeing your current dentist?  Will he/she provide a DBQ on your behalf?  

[pwrslm]

Depending on how long ago boot camp was, it still may be possible to link the ER visit to a current condition.  If your MRI/XRay shows an old injury, not accounted for from any other medical record, the case could be made that the ER failed to properly diagnose your injury.  C5/C6 vertebra damage could demonstrate this, but you also need an MD who agree's with the history, and will provide a nexus for you.

[Navy4life]

6 minutes ago, pwrslm said:

Depending on how long ago boot camp was, it still may be possible to link the ER visit to a current condition.  If your MRI/XRay shows an old injury, not accounted for from any other medical record, the case could be made that the ER failed to properly diagnose your injury.  C5/C6 vertebra damage could demonstrate this, but you also need an MD who agree's with the history, and will provide a nexus for you.

His post states boot camp was 1992....

[pwrslm]

I would think that if he is 40-45 at this point, it would be possible.  65-75 it would be very difficult.

 

After 45-55, degenerative disc syndrome kicks in, older age see's faster progression of the DDS, or IVDS as the new VA Regs call it.  The older you get, the more difficult it is to determine the age of the injury.

Edited January 20, 2016 by pwrslm

[Andyman73]

1 hour ago, Navy4life said:

Andyman;

Regarding your fall in 1992, I have similar issues.  I had several fractures and sprains to both feet/ankles and right now I sit at 10% for left ankle and that is it!  I have been trying now since 2013 to get my feet/ankles S/C.  I too have the SMR's to proved the AD injuries but for me I never filed for any type of disability until 2013.  All that time I did however keep all SMR's and I had my outside doctor's information to back it up and I have my podiatrist at the VA backing me up with a Nexus letter.

I landed knees first, then chest, legs rebounded towards the back of my head.  I ended up with bruised knees and compression injury to my lower back.  The back was SC right away, the knees took nearly 2 years from EAS to be SCd.  There are multiple STR entries for both.  The knees took that long because my PCP at the time was trying so hard to avoid SC my knees.  That was resolved a few months after she retired.

When you fell what was the result of it?  Fracture or Sprain?  Was that your only issue while on AD for that contention?  What was the ER's results?

The ER DXd me with contusions(bruises) on my knees and low back strain.  I went to sick call for treatment 3-4 times a year over my 6 yr enlistment.  They wrote up my problem list which shows complaint of pain in those areas and my neck.  Their check didn't show a specific injury to my neck, just difuse neck pain.  An x-ray in 2000 showed an old fracture of one of my knee caps, which was right before I was granted SC for my knees.

If all you have is the ONE ER visit while on AD that is going to be an uphill battle regarding linking your neck injury.  Secondly, you state you completely forgot about your neck pain?  Have you not had any treatment to your neck?  If so, I would supply that information.  If not, again, it's going to be tough to connect the neck contention.

I had an ER visit for chest pain/angina, but that was a few years later.  I only forgot my neck pain due to the amount of NSAIDs I was taking, which was enough to leave only more painful body parts clamoring for my attention.  I had so much trouble sleeping that I resorted to OTC sleep aids and booze.  I've been taking VA prescribed NSAIDs since day one.   I mentioned my neck bothering me and the cervical radiculapathy to my PCP sometime ago.

As far as the jaw issues, do you suffer from TMJ?  If so can you prove it is s/c while on AD?  You have to have the connections in order to get the award of S/C.  How long have you been seeing your current dentist?  Will he/she provide a DBQ on your behalf?  

I was never DXd with TMJ, or bruxism, but went to sick call, and after several visits was then referred to dental for further eval.  I was prescribed muscle relaxers to help alleviate the pain.  Current dentist...3-4 years or so.  He was the main force pushing me to get evaluated for SA.  He said that many people who snore and have excessive wear on their teeth tend to also have SA.  I do, he saved my life.  I did mention to his hygenist about the faint seam or ridge along my cheeks, she said that is due to long term clenching my teeth.  As for DBQ, I will call and ask them.

I will ask my PCP about the neck issue, as a starting point, since I will be seeing him this coming Monday.  Same for jaw.

Thanks, Navy and pwrslm.

Semper Fi

Andyman

[Andyman73]

Ok, update time,

I saw my PCP on Friday.  Spoke about a bunch of stuff.  He requested a MRI for my neck.  He looked at my current VA treatment records and saw where it has been over 3 years now since I started complaining about my neck, shortly after my 39th birthday.  He saw the x-ray report from last year's exam and the radiologist noted spurs on C4, C-5, and C-6.  He also saw his own notes from before that timeframe, about my complaining of numbness and tingling.  It has progressed to include hot spots on the surface of my for-arms and backs of my hands, that feels like a steam scald or sunburn.

I told him about the Jaw pain, but also said that I already have an appointment with my private dentist.

As for my lowback/hip pain, we discussed in detail.  He showed me what the illiac crest is...the broad bony plates in your hip/pelvic region.  I now have an appointment with a physiatrist for further treatment regarding that.  Hopefully will be able to get some good info in regards to what is causing my pain and if it is in fact caused by my low back conditions.

Semper Fi.

Andyman