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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Most Common VA Disabilities Claimed for Compensation:   

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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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Question

I had this C& P done on the 16th. From start to finish was 1hr and 45 mins. the doctor hardly touched me and looked mostly at her computer. the statement about me having flat feet going into boot camp. I am not sure how she came to that because I didn't tell her that. Any feedback or suggestions would be helpful. I have my PTSD C& P on the 26th.

 

Thank You!

Gulf War General Medical Examination Disability Benefits Questionnaire
* Internal VA or DoD Use Only*

1. Medical record review ------------------------

[X] Other, describe: VBMS

2. Medical history ------------------

 

a. No symptoms, abnormal findings or complaints: No answer provided b. Skin and scars: No answer provided
c. Hematologic/lymphatic: No answer provided
d. Eye: No answer provided

 CONFIDENTIAL Page 5 of 43

e. Hearing loss, tinnitus and ear: Hearing Loss and Tinnitus

f. Sinus, nose, throat, dental and oral: Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx

g. Breast: No answer provided
h. Respiratory: Respiratory Conditions (other than tuberculosis and sleep apnea)
i. Cardiovascular: No answer provided

j. Digestive and abdominal wall: Intestinal Conditions (other than Surgical

and Infectious)
k. Kidney and urinary tract: No answer provided
l. Reproductive: Gynecological Conditions
m. Musculoskeletal: The following conditions have been reported

Joints and extremities: Ankle

Feet: Flatfeet
n. Endocrine: No answer provided
o. Neurologic: No answer provided
p. Psychiatric: PTSD (Initial or Review)

q. Infectious disease, immune disorder or nutritional deficiency: No answer

provided

r. Miscellaneous conditions: No answer provided

3. Diagnosed illnesses with no etiology ---------------------------------------

From the conditions identified and for which Questionnaires were completed, are there any diagnosed illnesses for which no etiology was established?
[ ] Yes [X] No

4. Additional signs and/or symptoms that may represent an "undiagnosed illness" or "diagnosed medically unexplained chronic

multisymptom illness" -----------------------------------------------------------------------------

 CONFIDENTIAL Page 6 of 43

Does the Veteran report any additional signs and/or symptoms not addressed through completion of DBQs identified in the above sections?
[ ] Yes [X] No

5. Physical Exam ----------------

Normal PE, except as noted on additional Questionnaires included as part of this

report

6. Functional impact of additional signs and/or symptoms that may represent an "undiagnosed illness" or "diagnosed medically

unexplained chronic multisymptom illness"

----------------------------------------------------------------------------- [ ] Yes [X] No

7. Remarks, if any: -------------------

E-file reviewed including buddy statement. Veteran does have fatigue and trouble sleeping that should be further examined with PTSD exam by mental health examiner for insomnia.

Veteran reports she had a cold and URi multiple times while in service. She was given an inhaler and was told she hadd possible exercise induced asthma but it only seemd to flare up during change in seasons and was related to more of her sinuses and rhinitis. See rhinitis and sinusitis exam for more information on her "respiratory" complaint.

****************************************************************************

Intestinal Conditions (other than surgical or infectious), including irritable bowel syndrome, Crohn's disease, ulcerative

colitis and diverticulitis Disability Benefits Questionnaire

Name of patient/Veteran:

Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination

Request?
[X] Yes [ ] No

 CONFIDENTIAL Page 7 of 43

ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this

document:
[X] In-person examination

Evidence Review
---------------
Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA) [X] CPRS

1. Diagnosis
------------
Does the Veteran now have or has he/she ever been diagnosed with an intestinal condition (other than surgical or infectious)?
[X] Yes [ ] No

[X] Irritable bowel syndrome ICD code: K58.0
Date of diagnosis: 2004

2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's

intestinal condition (brief summary):
Veteran reports constipation started while in boot camp in 2004. The diarrhea started while in Iraq in 2009. It alternated dairrhea and constipation. She saw a GI doctor in 2009 and she took Miralax and another medication for ulcers. She tested negative for h. pylori and ova and aprasites and those were negative. She avoided food triggers and alternated between culcolax and miralax and imdoium. Symptoms continue to the present day. She was also given zofran for nausea.

b. Is continuous medication required for control of the Veteran's intestinal

condition? [X] Yes [ ] No

If yes, list only those medications required for the intestinal condition:

miralax imodium probiotics

c. Has the Veteran had surgical treatment for an intestinal condition?

 CONFIDENTIAL Page 8 of 43

[ ] Yes [X] No

3. Signs and symptoms
---------------------
Does the Veteran have any signs or symptoms attributable to any non-surgical non-infectious intestinal conditions?
[X] Yes [ ] No

If yes, check all that apply:

[X] Alternating diarrhea and constipation If checked, describe:

alternating diarrhea and constipation but it varies.

Usually
at all

2-3 days of diarrhea followed by almost a week of not going

[X] Abdominal distension If checked, describe:

swollen abdomen, appears 2-3 months pregnant usually. Cramping and gurgling in the stomac

[X] Nausea
If checked, describe:

feels sick to stomach

[X] Vomiting
If checked, describe:

takes zofran

[X] Other, describe:
passes out and sweats sometimes and has sharp pains ont he left side of abdomen

4. Symptom episodes, attacks and exacerbations ----------------------------------------------
Does the Veteran have episodes of bowel disturbance with abdominal distress, or exacerbations or attacks of the intestinal condition?

[X] Yes [ ] No
If yes, indicate severity and frequency: (check all that apply) [X] Episodes of bowel disturbance with abdominal distress

If checked, indicate frequency: [ ] Occasional episodes
[X] Frequent episodes

 CONFIDENTIAL Page 9 of 43

[ ] More or less constant abdominal distress

5. Weight loss
--------------
Does the Veteran have weight loss attributable to an intestinal condition (other than surgical or infectious condition)?
[ ] Yes [X] No

6. Malnutrition, complications and other general health effects ---------------------------------------------------------------
Does the Veteran have malnutrition, serious complications or other general health effects attributable to the intestinal condition?
[ ] Yes [X] No

7. Tumors and neoplasms
-----------------------
a. Does the Veteran have a benign or malignant neoplasm or metastases

related
to any of the diagnoses in the Diagnosis section? [ ] Yes [X] No

8. Other pertinent physical findings, complications, conditions, signs, symptoms and scars

-----------------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings,

complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above?
[ ] Yes [X] No

b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above?
[ ] Yes [X] No

c. Comments, if any:

9. Diagnostic testing
---------------------
a. Has laboratory testing been performed?

[ ] Yes [X] No

b. Have imaging studies or diagnostic procedures been performed and are the results available?
[ ] Yes [X] No

c. Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No

10. Functional impact
---------------------
Does the Veteran's intestinal condition impact his or her ability to

CONFIDENTIAL Page 10 of 43

work?
[X] Yes [ ] No

If yes, describe the impact of each of the Veteran's intestinal conditions, providing one or more examples:

frequent bathroom breaks

11. Remarks, if any: --------------------

E-file reviewed. Veteran's IBS is a diagnosable chronic multisymptom

illness with a partially explained etiology that is at least as likely as

not related to an exposure event in Southwest Asia as symptoms did not start until she was in Iraq.

****************************************************************************

Sinusitis, Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx

Disability Benefits Questionnaire

Name of patient/Veteran:

Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination

Request? [X] Yes[ ] No

ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this

document:
[X] In-person examination

Evidence Review
---------------
Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA) [X] CPRS

SECTION I: Diagnosis:

 CONFIDENTIAL Page 11 of 43

---------------------
Does the Veteran now have or has he/she ever been diagnosed with a sinus, nose, throat, larynx, or pharynx condition? (This is the condition the Veteran is claiming or for which an exam has been requested)
[X] Yes [ ] No

[X] Chronic sinusitis ICD code: J32.9 Date of diagnosis: 2004 [X] Allergic rhinitis ICD code: 477.9 Date of diagnosis: 2004

SECTION II: Medical history ---------------------------

Veteran reports she had drainage and a head cold with stuffiness and she was treated with sudafed and tessalon perles. She had been coughing and had a sore throat and the congestion was in her chest so at night she would have a hard time breathing and had a hard time breathing when running. She was

given
an inhaler and nasal spray and allergy meds which helped. She had questionable exericse induced asthma, btu she notes it was only when she had a cold or sinus infection that she had the breathing problems. The allergies and rhinitws continue to the prfesent day. She gets URI at least 3 times througout the year.

SECTION III: Nose, throat, larynx or pharynx conditions -------------------------------------------------------
Does the Veteran have any of the following nose, throat, larynx or pharynx conditions?
[X] Yes [ ] No

[X] Sinusitis [X] Rhinitis

1. Sinusitis
------------
a. Indicate the sinuses/type of sinusitis currently affected by the

Veteran's
chronic sinusitis (check all that apply):
[ ] None [X] Maxillary [ ] Frontal
[ ] Ethmoid [ ] Sphenoid [ ] Pansinusitis

b. Does the Veteran currently have any findings, signs or symptoms attributable to chronic sinusitis?
[X] Yes [ ] No

If yes, check all that apply:

[ ] Chronic sinusitis detected only by imaging studies (see Diagnostic testing section)

[X] Episodes of sinusitis
[ ] Near constant sinusitis

If checked, describe frequency:

CONFIDENTIAL Page 12 of 43

[X] Headaches
[X] Pain of affected sinus
[X] Tenderness of affected sinus [X] Purulent discharge
[ ] Crusting
[ ] Other

For all checked conditions, describe:

c. Has the Veteran had NON-INCAPACITATING episodes of sinusitis characterized

by headaches, pain and purulent discharge or crusting in the past 12 months?
[X] Yes [ ] No

If yes, provide the total number of non-incapacitating episodes over the past 12 months:
[ ] 1 [ ] 2 [X] 3 [ ] 4 [ ] 5 [ ] 6 [ ] 7 or more

d. Has the Veteran had INCAPACITATING episodes of sinusitis requiring prolonged (4 to 6 weeks) of antibiotics treatment in the past 12 months? [ ] Yes [X] No

NOTE: For VA purposes, an incapacitating episode of sinusitis means one that requires bed rest and treatment prescribed by a physician.

If yes, provide the total number of incapacitating episodes of sinusitis requiring prolonged (4 to 6 weeks) of antibiotic treatment over past 12 months:
[ ] 1 [ ] 2 [ ] 3 or more

e. Has the Veteran had sinus surgery? [ ] Yes [X] No

If yes, specify type of surgery:
[ ] Radical (open sinus surgery) [ ] Endoscopic [ ] Other:

Type of procedure, sinuses operated on and side(s):

Date(s) of surgery (if repeated sinus surgery, provide all dates of surgery):

If Veteran has had radical sinus surgery, did chronic osteomyelitis follow

the surgery? [ ] Yes [ ] No

f. Has the Veteran had repeated sinus-related surgical procedures performed? [ ] Yes[X] No

2. Rhinitis -----------

 CONFIDENTIAL Page 13 of 43

a. Is there greater than 50% obstruction of the nasal passage on both sides due to rhinitis?
[ ] Yes [X] No

b. Is there complete obstruction on the left side due to rhinitis? [ ] Yes [X] No

c. Is there complete obstruction on the right side due to rhinitis? [X] Yes [ ] No

d. Is there permanent hypertrophy of the nasal turbinates? [X] Yes [ ] No

e. Are there nasal polyps? [ ] Yes [X] No

f. Does the Veteran have any of the following granulomatous conditions? [ ] Yes [X] No

If yes, check all that apply:
[ ] Granulomatous rhinitis [ ] Rhinoscleroma
[ ] Wegener's granulomatosis [ ] Lethal midline granuloma [ ] Other granulomatous infection, describe:

6. Other pertinent physical findings, complications, conditions, signs, symptoms and scars

-----------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings,

complications, conditions, signs or symptoms related to the conditions listed in the Diagnosis Section above?
[ ] Yes[X] No

b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above?
[ ] Yes[X] No

c. Comments, if any: No answer provided

d. Does the Veteran have loss of part of the nose or other scars of the nose exposing both nasal passages?
[ ] Yes[X] No

e. Does the Veteran have loss of part of the nose or other scars causing loss

of part of one ala? [ ] Yes[X] No

f. Does the Veteran have loss of part of the nose or other scars causing

 CONFIDENTIAL Page 14 of 43

other obvious disfigurement? [ ] Yes[X] No

SECTION IV: Diagnostic testing
------------------------------
a. Have imaging studies of the sinuses or other areas been performed?

[ ] Yes[X] No
b. Has endoscopy been performed?: No
c. Has the Veteran had a biopsy of the larynx or pharynx?: No
d. Has the Veteran had pulmonary function testing to assess for upper airway obstruction due to laryngeal stenosis?: No
e. Are there any other significant diagnostic test findings and/or results?
No answer provided

SECTION V: Functional impact and remarks ----------------------------------------
1. Functional impact
--------------------

Does the Veteran's sinus, nose, throat, larynx or pharynx condition impact

his or her ability to work? [ ] Yes [X] No

2. Remarks, if any:
-------------------
E-file reviewed. Veteran's rhinits and sinusitis is a diagnosable

chronic
multisymptom illness with a partially explained etiology that is at least as likely as not related to an exposure event in Southwest Asia as symptoms did not start until she was in Iraq and she was exposed to noxious fumes and

dust
storms which negatively impact the sinuses and cause chronic inflammation.

****************************************************************************

Ankle Conditions
Disability Benefits Questionnaire

Name of patient/Veteran:

Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination

Request?

 CONFIDENTIAL Page 15 of 43

[X] Yes [ ] No

ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this

document:
[X] In-person examination

Evidence Review
---------------
Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA) [X] CPRS

1. Diagnosis
------------
a. List the claimed condition(s) that pertain to this DBQ: ankle strain

b. Select diagnoses associated with the claim condition(s) (Check all that apply):

[X] Other (specify):

Other diagnosis: ankle strain
ICD Code: 845
Side affected: Both
Date of diagnosis: Right:2004
Date of diagnosis: Left:2004 ********************************************************************

c. Comments (if any): No response provided

2. Medical History
------------------
a. Describe the history (including onset and course) of the Veteran's

ankle
condition (brief summary): Veteran reports she rolled her ankles while in boot camp a few times and had shin splints and she has had ongoing ankle pain since. She did physical therapy before which helped. The pain

contineus
to the present day.

b. Does the Veteran report flare-ups of the ankle? [X] Yes [ ] No

If yes, document the Veteran's description of the flare-ups in his or

 CONFIDENTIAL Page 16 of 43

her
own words:

ankles give out on her at times. Dull and achy pain. Swells by the end off

the day.

c. Does the Veteran report having any functional loss or functional impairment of the joint or extremity being evaluated on this DBQ (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:
has to take breaks or sit after prolonged standing

3. Range of motion (ROM) and functional limitations ---------------------------------------------------
a. Initial range of motion

Right ankle

----------- [X] All Normal

[ ] Abnormal or outside of normal range [ ] Unable to test (please explain)
[ ] Not indicated (please explain)

Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

Description of pain (select best response):
Pain noted on examination and causes functional loss

If noted on examination, which ROM exhibited pain (select all that apply)? Dorsiflexion, Plantar Flexion

Is there evidence of pain with weight bearing? [X] Yes [ ] No

Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [X] Yes [ ] No

If yes, describe including location, severity and relationship to condition(s):

tender over lateral mallelolus
Is there objective evidence of crepitus? [ ] Yes [X] No

Left ankle

---------- [X] All Normal

[ ] Abnormal or outside of normal range

 CONFIDENTIAL Page 17 of 43

[ ] Unable to test (please explain) [ ] Not indicated (please explain)

Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

Description of pain (select best response):
Pain noted on examination and causes functional loss

If noted on examination, which ROM exhibited pain (select all that apply)? Dorsiflexion, Plantar Flexion

Is there evidence of pain with weight bearing? [X] Yes [ ] No

Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [X] Yes [ ] No

If yes, describe including location, severity and relationship to condition(s):

tender over lateral mallelolus
Is there objective evidence of crepitus? [ ] Yes [X] No

b. Observed repetitive use

Right ankle

-----------
Is the Veteran able to perform repetitive use testing with at least three repetitions? [X] Yes [ ] No

Is there additional loss of function or range of motion after three repetitions? [X] Yes [ ] No

Select all factors that cause this functional loss: Pain, Lack of enduance

ROM after 3 repetitions:
Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

Left ankle

----------
Is the Veteran able to perform repetitive use testing with at least three repetitions? [X] Yes [ ] No

Is there additional loss of function or range of motion after three repetitions? [X] Yes [ ] No

Select all factors that cause this functional loss:

 CONFIDENTIAL Page 18 of 43

Pain, Lack of endurance

ROM after 3 repetitions:
Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

c. Repeated use over time

Right ankle

-----------
Is the Veteran being examined immediately after repetitive use over time? [X] Yes [ ] No

Does pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time?
[X] Yes [ ] No [ ] Unable to say w/o mere speculation

Select all factors that cause this functional loss: Pain, Lack of endurance

Able to describe in terms of range of motion? [X] Yes

Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

Left ankle

[ ] No

----------
Is the Veteran being examined immediately after repetitive use over time? [X] Yes [ ] No

Does pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time?
[X] Yes [ ] No [ ] Unable to say w/o mere speculation

Select all factors that cause this functional loss: Pain, Lack of endurance

Able to describe in terms of range of motion? [X] Yes

Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

d. Flare-ups

Right ankle

-----------
Is the examination being conducted during a flare-up?

[ ] No

Does pain, weakness, fatigability or incoordination significantly limit functional ability with flare-up?
[X] Yes [ ] No [ ] Unable to say w/o mere speculation

[X] Yes

[ ] No

 CONFIDENTIAL Page 19 of 43

Select all factors that cause this functional loss: Pain, Lack of endurance

Able to describe in terms or range of motion? [X] Yes

Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

Left ankle

----------
Is the examination being conducted during a flare-up?

[ ] No

[X] Yes

[ ] No

Does pain, weakness, fatigability or incoordination significantly limit functional ability with flare-up?
[X] Yes [ ] No [ ] Unable to say w/o mere speculation

Select all factors that cause this functional loss: Pain, Lack of endurance

Able to describe in terms of range of motion? [X] Yes

Dorsiflexion (0-20): 0 to 20 degrees Plantar Flexion (0-45): 0 to 45 degrees

e. Additional factors contributing to disability

Right ankle

[ ] No

-----------
In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe:

Swelling, Instability of station, Disturbance of locomotion, Interference with standing

Left ankle

----------
In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe:

Swelling, Instability of station, Disturbance of locomotion, Interference with standing

4. Muscle strength testing
--------------------------
a. Muscle strength - rate strength according to the following scale

0/5 No muscle movement
1/5 Palpable or visible muscle contraction, but no joint movement 2/5 Active movement with gravity eliminated
3/5 Active movement against gravity
4/5 Active movement against some resistance
5/5 Normal strength

 CONFIDENTIAL Page 20 of 43

Right ankle:
Rate Strength: Plantar Flexion: 5/5

Dorsiflexion: 5/5
Is there a reduction in muscle strength? [ ] Yes

Left ankle:
Rate Strength: Plantar Flexion: 5/5

Dorsiflexion: 5/5
Is there a reduction in muscle strength? [ ] Yes

b. Does the Veteran have muscle atrophy? [ ] Yes

c. Comments, if any: No response provided

[X] No

[X] No [X] No

5. Ankylosis
------------
Complete this section if Veteran has ankylosis of the ankle

a. Indicate severity of ankylosis and side affected (check all that apply):

Right side:
[ ] In plantar flexion
[ ] In dorsiflexion
[ ] With an abduction deformity
[ ] With an inversion deformity
[ ] With an eversion deformity
[ ] In good weight-bearing position [ ] In good weight-bearing

position
[ ] In poor weight-bearing position [ ] In poor weight-bearing

position
[X] No ankylosis

b. Comments, if any:
No response provided

6. Joint stability ------------------ Right ankle

Is ankle instability or dislocation suspected?

[X] No ankylosis

[ ] No

[X] Yes If yes, complete the following:

Anterior Drawer Test
Is there laxity compared

Left side:
[ ] In plantar flexion

[ ] In dorsiflexion
[ ] With an abduction deformity

[ ] With an inversion deformity [ ] With an eversion deformity

CONFIDENTIAL Page 21 of 43

with opposite side?

[ ] Yes

[X] No

[ ] Unable to test

Talar Tilt Test
Is there laxity compared with opposite side?

Left ankle
Is ankle instability or dislocation suspected?

[ ] Yes

[X] No

[X] Yes If yes, complete the following:

Anterior Drawer Test
Is there laxity compared with opposite side?

Talar Tilt Test
Is there laxity compared with opposite side?

[ ] Yes

[ ] Yes

[ ] Unable to test

[ ] No

[X] No

[X] No

7. Additional comments
----------------------
Does the Veteran now have or has he or she ever had "shin splints",

stress
fractures, achilles tendonitis, achilles tendon rupture, malunion of calcaneus (os calcis) or talus (astragalus), or has the Veteran had a talectomy (astragalectomy)? [X] Yes [ ] No

If yes, indicate condition and complete the appropriate sections below:

[X] Shin splints (medial tibial stress syndrome) Indicate side affected: [ ] Right [ ] Left [X] Both

Does this condition affect ROM of ankle?
[X] Yes (If "yes", complete ROM section of ankle on this DBQ) [ ] No

Does this condition affect ROM of knee?

[ ] Yes (If "yes", complete VA Form 21-0960M-9 Knee and Lower Leg

Conditions) [X] No

Describe current symptoms: pain in the shins with prolonged standding or walking

[X] Achilles tendonitis or achilles tendon rupture Indicate side affected: [ ] Right [ ] Left [X] Both

CONFIDENTIAL Page 22 of 43

Describe current symptoms: pain in the backs of the ankles shooting up

the back of the shins

8. Surgical procedures ----------------------

No response provided

9. Other pertinent physical findings, complications conditions, signs, symptoms

and scars

-------------------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings, complications,

conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? [ ] Yes [X] No

b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No

c. Comments, if any:
No response provided

10. Assistive devices
---------------------
a. Does the Veteran use any assistive devices as a normal mode of locomotion,

although occasional locomotion by other methods may be possible? [ ] Yes [X] No

b. If the Veteran uses any assistive devices, specify the condition and identify the assistive device used for each condition:

No response provided

11. Remaining effective function of the extremities ---------------------------------------------------
Due to the Veteran's ankle condition, is there functional impairment of

an
extremity such that no effective functions remain other than that which would be equally well served by an amputation with prosthesis? (Functions of the upper extremity include grasping, manipulation, etc., while functions for the lower extremity include balance and propulsion, etc.)
[ ] Yes, functioning is so diminished that amputation with prosthesis would

equally serve the Veteran. [X] No

12. Diagnostic testing ---------------------- CONFIDENTIAL Page 23 of 43

a. Have imaging studies of the ankle been performed and are the results available? [ ] Yes [X] No

b. Are there any other significant diagnostic test findings or results? [ ] Yes [X] No

c. If any test results are other than normal, indicate relationship of abnormal

findings to diagnosed conditions: No response provided

13. Functional impact
---------------------
Regardless of the Veteran's current employment status, do the

condition(s)
listed in the Diagnosis Section impact his or her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)?
[X] Yes [ ] No

If yes, describe the functional impact of each condition, providing one or more examples:

limits standing and walking prolonged, has to take frequent breaks or sit

down

14. Remarks, if any -------------------

E-file reviewed. Veteran's ankle sprain is a diagnosable chronic multisymptom

illness with a partially explained etiology that is less than likely as not related to an exposure event in Southwest Asia as symptoms are related to sprain not to an exposure event.

****************************************************************************

Foot Conditions, including Flatfoot (Pes Planus) Disability Benefits Questionnaire

Name of patient/Veteran:

Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination

Request?
[X] Yes [ ] No

ACE and Evidence Review

 CONFIDENTIAL Page 24 of 43

-----------------------

Indicate method used to obtain medical information to complete this document:

[X] In-person examination

Evidence Review
---------------
Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA) [X] CPRS

1. Diagnosis
------------
a. List the claimed condition(s) that pertain to this DBQ:

pes planus
b. Select diagnoses associated with the claimed condition(s):

[X] Flat foot (pes planus)
ICD code: 728.71
Side affected: Both
Date of diagnosis: Right: 2003 Date of diagnosis: Left: 2003

c. Comments (if any): No response provided

d. Was an opinion requested about this condition (internal VA only)? [X] Yes [ ] No [ ] N/A

2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's

foot
condition (brief summary):
Pes planus was noted on enlistment exam. She did not have pain in her eet when she first enlisted but the pain int he feet started in boot camp. She was treated with motrin and insoles which did not help. She contiues to

have
the foot pain now if she stands on them prolonged. She still takes motrin adn she soaks them and uses topical rubs.

b. Does the Veteran report pain of the foot being evaluated on this DBQ? [X] Yes [ ] No

 CONFIDENTIAL Page 25 of 43

If yes, document the Veteran's description of pain in his or her own

words:
aching and cramping and sore

c. Does the Veteran report that flare-ups impact the function of the foot? [X] Yes [ ] No

If yes, document the Veteran's description of flare-ups in his or her

own words:
limtis prolonged standing and walking

d. Does the Veteran report having any functional loss or functional impairment of the foot being evaluated on this DBQ (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:
limits weight bearing

3. Flatfoot (pes planus)
------------------------
a. Does the Veteran have pain on use of the feet? [X] Yes

If yes, indicate side affected: [ ] Right [ ] Left [X] Both If yes, is the pain accentuated on use? [X] Yes [ ] No

[ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both
b. Does the Veteran have pain on manipulation of the feet? [X] Yes

If yes, indicate side affected: [ ] Right [ ] Left [X] Both
If yes, is the pain accentuated on manipulation? [X] Yes [ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both c. Is there indication of swelling on use? [X] Yes [ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both
d. Does the Veteran have characteristic callouses? [ ] Yes [X] No e. Effects of use of arch supports, built-up shoes or orthotics:

Tried But Remains Symptomatic -----------------------------

[ ] No

Device Side Not Relieved:

 CONFIDENTIAL Page 26 of 43

[X] Arch Supports [ ] Right [ ] Left [X] Both

f. Does the Veteran have extreme tenderness of plantar surfaces on one or both feet? [X] Yes [ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both

Is the tenderness improved by orthopedic shoes or appliances? RIGHT - [ ] Yes [X] No [ ] N/A

LEFT - [ ] Yes [X] No [ ] N/A

g. Does the Veteran have decreased longitudinal arch height of one or both feet

on weight-bearing? [X] Yes [ ] No
If yes, indicate side affected: [ ] Right [ ] Left [X] Both

h. Is there objective evidence of marked deformity of one or both feet (pronation, abduction etc.)? [X] Yes [ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both

i. Is there marked pronation of one or both feet? [X] Yes [ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both

Is the condition improved by orthopedic shoes or appliances? RIGHT - [ ] Yes [X] No [ ] N/A

LEFT - [ ] Yes [X] No [ ] N/A

j. For one or both feet, does the weight-bearing line fall over or medial to the great toe? [X] Yes [ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both

k. Is there a lower extremity deformity other than pes planus, causing alteration of the weight-bearing line? [ ] Yes [X] No

l. Does the Veteran have "inward" bowing of the Achilles tendon (i.e., hindfoot

valgus, with lateral deviation of the heel) of one or both feet? [X] Yes [ ] No

If yes, indicate side affected: [ ] Right [ ] Left [X] Both

m. Does the Veteran have marked inward displacement and severe spasm of the Achilles tendon (rigid hindfoot) on manipulation of one or both feet?
[X] Yes [ ] No

 CONFIDENTIAL Page 27 of 43

If yes, indicate side affected: [ ] Right [ ] Left [X] Both

Is the marked inward displacement and severe spasm of the Achilles tendon improved by orthopedic shoes or appliances?

RIGHT - [ ] Yes [X] No [ ] N/A

LEFT - [ ] Yes [X] No [ ] N/A
n. Comments: No comments provided

4. Morton's neuroma (Morton's disease) and metatarsalgia --------------------------------------------------------
No response provided

5. Hammer toe -------------
No response provided

6. Hallux valgus ----------------
No response provided

7. Hallux rigidus -----------------
No response provided

8. Acquired pes cavus (clawfoot) --------------------------------
No response provided

9. Malunion or nonunion of tarsal or metatarsal bones -----------------------------------------------------
No response provided

10. Foot injuries and other conditions --------------------------------------
No response provided

11. Surgical procedures -----------------------
No response provided

12. Pain --------
RIGHT FOOT:

Is there pain on physical exam? [X] Yes [ ] No

If yes, (there is pain on physical exam), does the pain contribute to

CONFIDENTIAL Page 28 of 43

functional loss? [X] Yes [ ] No

(Further description of limitations requested in Section XIII below.)

LEFT FOOT:

Is there pain on physical exam? [X] Yes [ ] No

If yes, (there is pain on physical exam), does the pain contribute to functional loss?
[X] Yes [ ] No

(Further description of limitations requested in Section XIII below.)

13. Functional loss and limitation of motion --------------------------------------------
a. Contributing factors of disability (check all that apply and indicate side

affected):

[X] Pain on movement
Side affected: [ ] Right [ ] Left [X] Both

[X] Pain on weight-bearing
Side affected: [ ] Right [ ] Left [X] Both

[X] Swelling
Side affected: [ ] Right [ ] Left [X] Both

[X] Disturbance of locomotion
Side affected: [ ] Right [ ] Left [X] Both

[X] Interference with standing
Side affected: [ ] Right [ ] Left [X] Both

[X] Lack of endurance
Side affected: [ ] Right [ ] Left [X] Both

Contributing factors of disability associated with limitation of motion:

b. Is there pain, weakness, fatigability, or incoordination that significantly limits functional ability during flare-ups or when the foot is used repeatedly over a period of time?

RIGHT FOOT: [X] Yes [ ] No

If yes, (there is a functional loss due to pain, during flare-ups
and/or when the joint is used repeatedly over a period of time) please

 CONFIDENTIAL Page 29 of 43

describe the functional loss: limits weight bearing

LEFT FOOT: [X] Yes [ ] No

If yes, (there is a functional loss due to pain, during flare-ups
and/or when the joint is used repeatedly over a period of time) please describe the functional loss:
limite weight bearing

c. Is there any other functional loss during flare-ups or when the foot is used

repeatedly over a period of time? RIGHT FOOT: [ ] Yes [X] No
LEFT FOOT: [ ] Yes [X] No

14. Other pertinent physical findings, complications, conditions, signs, symptoms and scars

------------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings, complications,

conditions, signs or symptoms related to any conditions listed in the Diagnosis section above?
[ ] Yes [X] No

b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis section above?
[ ] Yes [X] No

c. Comments: No comments provided

15. Assistive devices
---------------------
a. Does the Veteran use any assistive devices as a normal mode of locomotion,

although occasional locomotion by other methods may be possible? [ ] Yes [X] No

b. If the Veteran uses any assistive devices, specify the condition and identify the assistive device used for each condition:
No response provided.

16. Remaining effective function of the extremities ---------------------------------------------------
Due to the Veteran's foot condition, is there functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis? (Functions of the

 CONFIDENTIAL Page 30 of 43

upper extremity include grasping, manipulation, etc., while functions for the lower extremity include balance and propulsion, etc.)

[ ] Yes, functioning is so diminished that amputation with prosthesis would equally serve the Veteran.

[X] No

17. Diagnostic testing
----------------------
a. Have imaging studies of the foot been performed and are the results

available?
[ ] Yes [X] No

b. Are there any other significant diagnostic test findings or results? [ ] Yes [X] No

c. If any test results are other than normal, indicate relationship of abnormal

findings to diagnosed condition: No response provided

18. Functional impact
---------------------
Regardless of the Veteran's current employment status, do the

condition(s)
listed in the Diagnosis section impact his or her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)?
[X] Yes [ ] No

If yes, describe the functional impact of each condition, providing one or more examples:
limits prologned walking andd standing

19. Remarks, if any:
--------------------
E-file reviewed. Veteran's pes planus is a diagnosable chronic

multisymptom
illness with a partially explained etiology that is less than likely as not
related to an exposure event in Southwest Asia as pes planus was present on entrance exam and symptoms started in boot camp before any exposure event in Southwest Asia.

****************************************************************************

CONFIDENTIAL Page 31 of 43

Gynecological Conditions Disability Benefits Questionnaire

Name of patient/Vetera

Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination

Request?
[X] Yes [ ] No

ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this

document:
[X] In-person examination

Evidence Review
---------------
Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA) [X] CPRS

1. Diagnosis
------------
Does the Veteran now have or has she ever had a gynecological condition? Yes

Diagnosis #1: Vaginitis ICD code: 616.1

Date of diagnosis: 2004

2. Medical history
------------------
Describe the history (including cause, onset and course) of each of the Veteran's gynecological conditions:

Veteran was sexually assaulted in boot camp and the vaginits started after that incident. She was treated for the vaginits. She has reoccurring BV now and gets it after her cycle. She also reports she gets a yeast infection before her cycle each month.

3. Symptoms
-----------
Does the Veteran currently have symptoms related to a gynecological condition, including any diseases, injuries or adhesions of the female reproductive organs? Yes

CONFIDENTIAL Page 32 of 43

If yes, indicate current symptoms, including frequency and severity of pain, if any: (check all that apply)
[X] Mild pain: Intermittent pain
[X] Other signs and/or symptoms describe and indicate condition(s)

causing them:

vaginal discharge and odor and itching caused by candidiasis and bacteria

4. Treatment
------------
a. Has the Veteran had treatment for symptoms/findings for any diseases, injuries and/or adhesions of the reproductive organs? Yes

If yes, specify condition(s), organ(s) affected, and treatment: treated with diflucan and flagyl

Date of treatment: recurrent

b. Does the Veteran currently require treatment or medications [for symptoms?] related to reproductive tract conditions? Yes

If yes, list current treatment/medications and the reproductive organ condition(s) being treated:
ongoing diflucan and flagyl treatments when infections occur

c. If yes, indicate effectiveness of treatment in controlling symptoms: [X] Symptoms do not require continuous treatment for the following

organ/condition:
[X] Conditions of the vulva [X] Conditions of the vagina

5. Conditions of the vulva
--------------------------
Has the Veteran been diagnosed with any diseases, injuries or other conditions of the vulva (to include vulvovaginitis)? Yes

If yes, describe:
vulvovaginitis causes itching and burning of the vulva. Treated with diflucan

6. Conditions of the vagina
---------------------------
Has the Veteran been diagnosed with any diseases, injuries or other conditions of the vagina? Yes

If yes, describe:
vaginitis (candida and BV0 treated with diflucan and flagyl

7. Conditions of the cervix
---------------------------
Has the Veteran been diagnosed with any diseases, injuries, adhesions or

 CONFIDENTIAL Page 33 of 43

other conditions of the cervix? No

8. Conditions of the uterus
---------------------------
a. Has the Veteran been diagnosed with any diseases, injuries, adhesions or other conditions of the uterus? No

b. Has the Veteran had a hysterectomy? No
c. Does the Veteran have uterine prolapse? No

d. Does the Veteran have uterine fibroids, enlargement of the uterus and/or displacement of the uterus? No

e. Has the Veteran been diagnosed with any other diseases, injuries, adhesions or other conditions of the uterus? No

9. Conditions of the Fallopian tubes
------------------------------------
Has the Veteran been diagnosed with any diseases, injuries, adhesions or other conditions of the Fallopian tubes (to include pelvic inflammatory disease)? No

10. Conditions of the ovaries -----------------------------
a. Has the Veteran undergone menopause? No

b. Has the Veteran undergone partial or complete oophorectomy? No

c. Does the Veteran have evidence of complete atrophy of 1 or both ovaries? No

d. Has the Veteran been diagnosed with any other diseases, injuries, adhesions and/or other conditions of the ovaries? Yes

If yes, describe:
had ovarian cysts when she was younger but none recently

11. Incontinence
----------------
Does the Veteran have urinary incontinence/leakage? Yes

If yes, is the urinary incontinence/leakage due to a gynecologic condition? Yes

If yes, condition causing it: stress incontinence

If yes, check all that apply:
[X] Does not require/does not use absorbent material [X] Stress incontinence

 CONFIDENTIAL Page 34 of 43

12. Fistulae
------------
a. Does the Veteran have a rectovaginal fistula? No

b. Does the Veteran have a urethrovaginal fistula? None

13. Endometriosis
-----------------
Has the Veteran been diagnosed with endometriosis? No

14. Complications and residuals of pregnancy or other gynecologic procedures ----------------------------------------------------------------------------
a. Has the Veteran had any surgical complications of pregnancy? No

b. Has the Veteran had any other complications resulting from obstetrical or gynecologic conditions or procedures? No

15. Tumors and neoplasms
------------------------
a. Does the Veteran have a benign or malignant neoplasm or metastases related to any of the diagnoses in the Diagnosis section? No

b. Is the neoplasm
No response provided.

c. Does the Veteran currently have any residual conditions or complications

due to the neoplasm (including metastases) or its treatment, other than those

already documented in the report above? No response provided.

d. If there are additional benign or malignant neoplasms or metastases related to any of the diagnoses in the Diagnosis section, describe using the above format:

No response provided.

16. Other pertinent physical findings, complications, conditions, signs, symptoms and scars

-----------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions

listed
in the Diagnosis Section above? No

b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? No

c. Comments, if any:

CONFIDENTIAL Page 35 of 43

No response provided.

17. Diagnostic testing
----------------------
a. Has the Veteran had laparoscopy? No

b. Has the Veteran been diagnosed with anemia? No

c. Has the Veteran had any other diagnostic testing and if so, are there significant findings and/or results? No

18. Functional impact
---------------------
Does the Veteran's gynecological condition(s) impact her ability to

work? No

19. Remarks, if any: --------------------

E-file reviewed. Veteran's vaginitis is a diagnosable chronic multisymptom

illness with a partially explained etiology that is less than likely as not
related to an exposure event in Southwest Asia as symptoms are from bacteria overgrowth and not related to exposure events.

****************************************************************************

Knee and Lower Leg Conditions Disability Benefits Questionnaire

Name of patient/Veteran:

Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination

Request?
[X] Yes [ ] No

ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this

document:
[X] In-person examination

Evidence Review

 CONFIDENTIAL Page 36 of 43

---------------
Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA) [X] CPRS

1. Diagnosis
------------
a. List the claimed condition(s) that pertain to this DBQ:

knee dislocation

b. Select diagnoses associated with the claimed condition(s) (Check all that apply):

[X] Recurrent patellar dislocation
Side affected: [ ] Right [X] Left [ ] Both ICD Code: 836
Date of diagnosis: Left 2010

c. Comments (if any): No response provided

d. Was an opinion requested about this condition (internal VA only)? [ ] Yes [X] No [ ] N/A

2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's

knee
and/or lower leg condition (brief summary):
Veteran denies any spoecific injury while in service. She reports left knee started dislocation after military service. She treats it with wearing a brace and ice and heat.

b. Does the Veteran report flare-ups of the knee and/or lower leg? [X] Yes [ ] No

If yes, document the Veteran's description of the flare-ups in his or

her own words:
locks up and a shooting pain

c. Does the Veteran report having any functional loss or functional impairment of the joint or extremity being evaluated on this DBQ, including but not limited to repeated use over time?
[X] Yes [ ] No

If yes, document the Veteran's description of functional loss or functional impairment in his or her own words:
limits standing and bending down and lifting

 CONFIDENTIAL Page 37 of 43

3. Range of motion (ROM) and functional limitation --------------------------------------------------
a. Initial range of motion

Left Knee
---------
[X] All normal
[ ] Abnormal or outside of normal range [ ] Unable to test (please explain)
[ ] Not indicated (please explain)

Flexion (0 to 140): 0 to 140 degrees Extension (140 to 0): 140 to 0 degrees

Description of pain (select best response):
Pain noted on exam and causes functional loss

If noted on exam, which ROM exhibited pain (select all that apply)? Flexion, Extension

Is there evidence of pain with weight bearing? [X] Yes [ ] No

Is there objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue? [X] Yes [ ] No

If yes, describe including location, severity and relationship to condition(s):
ttp behind knee

Is there objective evidence of crepitus? [ ] Yes b. Observed repetitive use

[X] No

Left Knee
---------
Is the Veteran able to perform repetitive use testing with at least three repetitions? [X] Yes [ ] No

Is there additional functional loss or range of motion after three repetitions? [ ] Yes [X] No

c. Repeated use over time

Left Knee
---------
Is the Veteran being examined immediately after repetitive use over time? [X] Yes [ ] No

Does pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time?
[X] Yes [ ] No [ ] Unable to say w/o mere speculation

Select all factors that cause this functional loss:

CONFIDENTIAL Page 38 of 43

Pain, Lack of endurance

Able to describe in terms of range of motion: [X] Yes Flexion (0 to 140): 0 to 140 degrees
Extension (140 to 0): 140 to 0 degrees

d. Flare-ups

Left Knee
---------
Is the exam being conducted during a flare-up? [X] Yes

[ ] No

[ ] No

Does pain, weakness, fatigability or incoordination significantly limit functional ability with flare-ups?
[X] Yes [ ] No [ ] Unable to say w/o mere speculation

Select all factors that cause this functional loss: Pain, Lack of endurance

Able to describe in terms of range of motion: [X] Yes Flexion (0 to 140): 0 to 140 degrees
Extension (140 to 0): 140 to 0 degrees

e. Additional factors contributing to disability

[ ] No

Left Knee
---------
In addition to those addressed above, are there additional contributing factors of disability? Please select all that apply and describe:

Swelling, Instability of station, Disturbance of locomotion, Interference with standing

4. Muscle strength testing
--------------------------
a. Muscle strength - Rate strength according to the following scale:

0/5 No muscle movement
1/5 Palpable or visible muscle contraction, but no joint movement 2/5 Active movement with gravity eliminated
3/5 Active movement against gravity
4/5 Active movement against some resistance
5/5 Normal strength

Rate Strength: 5/5

Left Knee:
Flexion:
Extension:
Is there a reduction in muscle strength?

b. Does the Veteran have muscle atrophy? [ ] Yes [X] No

c. Comments, if any: No response provided

5/5

[ ] Yes

[X] No

CONFIDENTIAL Page 39 of 43

5. Ankylosis ------------

Complete this section if the Veteran has ankylosis of the knee and/or lower leg.

a. Indicate severity of ankylosis and side affected (check all that apply):

Left Side:
[ ] Favorable angle in full extension or in slight flexion between 0 and

10 degrees
[ ] In flexion between 10 and 20 degrees
[ ] In flexion between 20 and 45 degrees
[ ] Extremely unfavorable, in flexion at an angle of 45 degrees or more [X] No ankylosis

b. Indicate angle of ankylosis in degrees: No response provided

c. Comments, if any: No response provided

6. Joint stability tests
------------------------
a. Is there a history of recurrent subluxation?

Left: [ ] None [X] Slight [ ] Moderate b. Is there a history of lateral instability?

Left: [X] None [ ] Slight [ ] Moderate c. Is there a history of recurrent effusion?

[ ] Yes [X] No
d. Performance of joint stability testing

Left Knee:

Was joint stability testing performed? [X] Yes
[ ] No
[ ] Not indicated

[ ] Indicated, but not able to perform

[ ] Severe

[ ] Severe

If joint stability testing was performed is there joint instability? [ ] Yes [X] No

If yes (joint stability testing was performed), complete the section

 CONFIDENTIAL Page 40 of 43

below:

- Anterior instability (Lachman test) [X] Normal
[ ] 1+ (0-5 millimeters)
[ ] 2+ (5-10 millimeters)

[ ] 3+ (10-15 millimeters)
- Posterior instability (Posterior drawer test)

[X] Normal
[ ] 1+ (0-5 millimeters)
[ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters)

- Medial instability (Apply valgus pressure to knee in extension and with 30 degrees of flexion)

[X] Normal
[ ] 1+ (0-5 millimeters)
[ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters)

- Lateral instability (Apply varus pressure to knee in extension and with 30 degrees of flexion)

[X] Normal
[ ] 1+ (0-5 millimeters)
[ ] 2+ (5-10 millimeters) [ ] 3+ (10-15 millimeters)

e. Comments, if any: No response provided

7. Additional conditions
------------------------
a. Does the Veteran now have or has he or she ever had recurrent patellar

dislocation, "shin splints" (medial tibial stress syndrome), stress

fractures, chronic exertional compartment syndrome or any other tibial and/or fibular impairment?
[X] Yes [ ] No

If yes, indicate condition and complete the appropriate sections below.

[X] "Shin splints" (medial tibial stress syndrome)
Indicate side affected: [ ] Right [ ] Left [X] Both
Does this condition affect ROM of knee? [ ] Yes [X] No Does this condition affect ROM of ankle? [X] Yes [ ] No

(If yes, complete VA form 21-0960M-2 Ankle Conditions to document

ROM of ankle.)
Describe current symptoms: pain in shins with prolonged walking

or
standing

 CONFIDENTIAL Page 41 of 43

b. Comments, if any: No response provided

8. Meniscal conditions
----------------------
a. Does the Veteran now have or has he or she ever had a meniscus (semilunar

cartilage) condition? [ ] Yes [X] No

b. For all checked boxes above, describe: No response provided

9. Surgical procedures ----------------------
No response provided

10. Other pertinent physical findings, complications, conditions, signs, symptoms and scars

------------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings, complications,

conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above?
[X] Yes [ ] No

If yes, describe (brief summary): popping noted with flexion and extension testing

b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above?
[ ] Yes [X] No

c. Comments, if any: No response provided

11. Assistive devices
---------------------
a. Does the Veteran use any assistive device(s) as a normal mode of

locomotion,
although occasional locomotion by other methods may be possible? [X] Yes [ ] No

If yes, identify assistive device(s) used (check all that apply and indicate frequency):

Assistive Device: -----------------
[X] Brace(s)

Frequency of use: -----------------

[X] Occasional [ ] Regular [ ] Constant

b. If the Veteran uses any assistive devices, specify the condition and identify the assistive device used for each condition:

 CONFIDENTIAL Page 42 of 43

No response provided

12. Remaining effective function of the extremities ---------------------------------------------------
Due to the Veteran's knee and/or lower leg condition(s), is there

functional
impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis? (Functions of the upper extremity include grasping, manipulation, etc., while functions for the lower extremity include balance and propulsion, etc.)

[ ] Yes, functioning is so diminished that amputation with prosthesis would equally serve the Veteran.

[X] No

13. Diagnostic testing
----------------------
a. Have imaging studies of the knee been performed and are the results

available?
[ ] Yes [X] No

b. Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No

c. If any test results are other than normal, indicate relationship of abnormal

findings to diagnosed conditions: No response provided

14. Functional impact
---------------------
Regardless of the Veteran's current employment status, do the

condition(s)
listed in the Diagnosis Section impact his or her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)?
[X] Yes [ ] No

If yes, describe the functional impact of each condition, providing one or more examples:
limits bending, lifting, standing and walking

15. Remarks, if any:
--------------------
E-file reviewed. Veteran does have recurrent knee dislocation that is a is a diagnosable chronic multisymptom illness with a partially explained etiology that is less than likely as not related to an exposure event in Southwest Asia as symptoms did not start until after military service and she had no documented injury in Iraq and exposure would not cause these symptoms.

 

 

 

 

Edited by Stardust

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I'd request another C&P Exam  & State your reasons.

In my opinion this exam looks to be incomplete and  not adequate for rating purposes.

I would think this may get a 0%SC with no rating%

jmo  (just my opinion)

........Buck

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Thanks Buck.

I'm not sure why I was even given a gulf war exam. I didn't request one. They also scheduled me for audio. There is absolutely nothing wrong with my hearing. 

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They may rate the IBS, but the others...I think are unlikely.  Hopefully, you'll get a SC so part of the fight is behind you.  They hit me with a GW exam and then denied any connection to GW as well, unrequested.  I think they are setting up to deny things later.  Good luck!

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19 hours ago, Stardust said:

2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's

foot
condition (brief summary):
Pes planus was noted on enlistment exam. She did not have pain in her eet when she first enlisted but the pain int he feet started in boot camp. She was treated with motrin and insoles which did not help. She contiues to

have
the foot pain now if she stands on them prolonged. She still takes motrin adn she soaks them and uses topical rubs.

You asked why she noted flat feet...she states it was noted on your enlistment exam.  That had to come from the VA.  

I do not think any of the C&P exams were favorable expect for possible the IBS.  I am 30% S/C for IBS and my C&P exam was far more extensive then yours.  I would think you will be S/C for IBS 10-30% range.  

Good luck with your PTSD C&P exam!

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Thanks for your feedback Navy4life.

I actually have a copy of my meds physical and my feet were fine before I joined. The only issue I had was I was underweight so I had to get a waiver. When I actually got a chance to see what was written I was pretty pissed. It's almost as if she made up whatever kind of answer she wanted.  I will let you know how it goes tomorrow. Not looking forward to it at all. 

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