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1151 Spine Claim

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63Charlie

Question

In 2007, I went to the VA because I was having back pain.

A thoracic MRI was ordered.

Two different VA doctors said they reviewed my MRI and that it was normal.

Kept working in construction and kept complaining to the VA about back pain.

They sent me to another VA doctor that said I had a small fatty cell lipoma in my right scapular area.of my back.

I asked him if this was causing the pain and he said that they are usually painless.

I was hurting all of the time and called them(VA) and said I'm tired of the back pain and I want the thing cut out.

I was getting nowhere with them so I started taking OTC meds for chronic pain,

Three years roll by and I'm still valiantly trying to keep up doing my construction job in agony.

Stepped in a pot hole on a job site, twisted my kneed badly, and ripped my right meniscus on my knee and had a MCL sprain.

Knee never healed back right so I was unable to return to my former job involving heavy manual labor..

I decided I needed to file for SSDI.

Gathered my VA records and records from private docs for SSDI.

Got a copy of my MRI from 2007 on my back and the radiologist reported multiple herniated discs abutting my spinal cord in my thoracic spine.

All of my suffering and chronic pain complaints and not one VA doctor read my radiology report.

This is a clear case of medical negligence.

My spine is a total wreck now, Got a consult in two weeks with an ortho spine surgeon.

I currently think I have about nine herniated discs, and some are causing marked spinal cord compression, and many neurological abnormalities, scoliosis, loss of cervical lordosis from all the muscle spasms, numbness in my extremities, and more.

Thanks to VA  doctors I kept doing heavy lifting at work. believing their diagnosis until it was too late for my spine.

This line of work accelerated the progression of my IVDS.

It's too late.

I'm screwed for the rest of my pain-ridden life.

 

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I am unable to read the recent posts...but caught one. from this same vet this AM....cannot find it now...

If you got the lawyer info ( cant hire for 1151s) from a VA Blog site, that info is not correct.

http://vabenefitblog.com/file-a-section-1151-claim-for-va-medical-malpractice/

You do not need a lawyer anyhow, you need an IMO/IME.

The IMO/IME criteria is here at hadit.

I think that is the same advise I gave you in April here....

I am a successful 1151er...,multiple claims.

They do not like to award 1151.

Evidence and perseverance  is what awards them.

I didn't have any IMOs for my 1151s but I think I recommended an IMO doc here sometime ago.

Unless you have a medical background like me ( courtesy of the VA) you will need a strong IMO for this claim.

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to add...getting a Section 1151 award solely due to anxiety or any MH issue is VERY difficult to do.

Can you scan and attach that decision here as to their "Reasons and Bases" and evidence list?

ALL vet reps ,.VSOs ....etc are trained in 1151 claims.

Can you also attach the same info from the recent denial? (Cover C file # etc prior to scanning it.)

 

 

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The spine claim denial by VA.

 

IMG_20160621_0001.pdf

 

Wasn't working in February 2016.

SSDI since 2010.

So, according to the VA...multiple misdiagnosis of an exam(MRI) is not negligence.

Failure to timely treat when they should have, and spinal disease allowed to progress without medical care until it rendered me disabled is "unfortunate", according to the VA.

But not their fault, according to the VA.

 

 

The VA GREATLY minimized my spine conditions.

Maybe someone didn't feel like typing it all in.

I'm "sure" that was an "honest" mistake.

 

  

Edited by 63Charlie
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It seemed that VA thought you were working on Feb 2016, as I read this...others will give their take on it as well.

What is the SSDI specifically for?

There was an obvious change from the "normal" MRI of Feb 10, 2009 compared to the MRI of June 13, 2011.

Perhaps they thought the change was due to your employment....yet you were on SSDI in 2010.

Section 1151 claims need a full review of every available medical record.

Was the VA aware of the SSDI records? If so did they obtain them?

I cannot tell if those records would be relevant for this claim because we dont know what the SSDI was for.

Claims like this need a strong IMO/IME with a full medical rationale as to how the VA did not take proper steps to correctly evaluate and treat conditions like this.

And IMO doctor will review every single medical record and study those MRIs carefully.

MRI results  are analysed at the VA,( at least they should be) so there should be some MRI documentation on both of them.

An MRI was very important to my 1151 claims. MRIs need to be interpreted by IMO doctors.

My husband's doctor at that time told him he was being sent to Syracuse for brain surgery.I immediately got ahold of the doctor who had given her the MRI results by phone, and she had interpreted the whole MRI ass backwards.

I had a non professional neuro  background ( my Army husband died from a brain tumor) and with that phone call and a copy of the MRI results  2 years later, and other documented medical evidence ,I was above to prove malpractice.

These cases need IMO/IMEs to succeed.

 

 

 

 

 

 

 

 

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All of the spinal problems were claimed during my SSDI.

There were other elements/disabilities claimed as well.

The ALJ didn't mention my longstanding spine problems/chronic pain symptoms specifically in the award.

It appeared the ALJ focused on my work related knee injury and unsuccessful rehab treatment afterwards to form the basis of his opinion.

Although I submitted loads of VA medical records/MRI/Xrays,diagnosis to support my spine issues for SSDI

If the judge had specified my spinal issues as to being the determining cause for the SSDI award it would be favorable toward my VA claim.

 

 

About the denial letter....... I was never given a medical C&P examination for my claim. The explanation for denial seems to involve a medical determination opined by the RO, shouldn't the VA have gotten a doctor's opinion?

The VA had deferred my spine claim, Ebennies said they were scheduling me for a C&P exam for my spine, but the C&P never happened, and a denial of my claim was rendered.

The VA had obtained a copy of my Social Security records.

As for needing an IMO.....Dr. Bash has been hired.

Edited by 63Charlie
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