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Injured a "not yet" SC'ed condition...

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awgv001

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So, I destroyed my lumbar spine (multiple herniations) at my job, but had already been seeing the VA and getting treatment for low back pain for some time. Had MRI and Xray with the VA, and sent copies to my WC Doc.

Currently on medical leave from work due to the extent of injury, however, now also in the process of filing claims outside of the VA. It's amazing to me that workers have a "no-fault" ruling, but the VA does not without more-than-extensive medical proof and more?

I'm trying to balance out the information between the different services, yet they both are trying to overlap one another with services like spinal injections and physical therapy.

I'm going to set the record straight with the VA, providing my Doc hears me out on this one before trying to shove me through the door, but we'll see how that goes, either way, doubling up treatments will not benefit anyone obviously.

What am I to do?

Edited by awgv001
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22 hours ago, awgv001 said:

So, I destroyed my lumbar spine (multiple herniations) at my job, but had already been seeing the VA and getting treatment for low back pain for some time. Had MRI and Xray with the VA, and sent copies to my WC Doc.

Currently on medical leave from work due to the extent of injury, however, now also in the process of filing claims outside of the VA. It's amazing to me that workers have a "no-fault" ruling, but the VA does not without more-than-extensive medical proof and more?

I'm trying to balance out the information between the different services, yet they both are trying to overlap one another with services like spinal injections and physical therapy.

I'm going to set the record straight with the VA, providing my Doc hears me out on this one before trying to shove me through the door, but we'll see how that goes, either way, doubling up treatments will not benefit anyone obviously.

What am I to do?

 

Here's some advice from another topic here:

I'm not an expert on WC, but if it was me, I would go the WC route until they release you. In addition to medical treatment, they are also replacing your lost income. If services from the VA result in a further injury, WC might not like that.

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That article was extremely encouraging, and I believe I have found myself on the right track again with this.

Another question--- is a forensic C and P required for a SC on PTSD diagnosis, or since my (VA) LCSW recognized and documented the diagnosis/symptoms etc and I have plenty of evidence backing everything up could it possibly just be "accepted"?

Vync, thank you for your time in finding that post, I'll be sure to straighten the VA out, and caution them about the new injuries recieved so there's no cache22

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A VA  MH professional must make the PTSD diagnosis.

If you fall under the 2010 PTSD regulations ( regarding "fear of and/or close proximity to" hostile activity, or you have the PH, CAR, or CIB on your DD 214, ) the VA will likely concede the stressor but they will want to know about it.

All other PTSD claims ( MST PTSD claims are explained here as well under a search)

will need adequate proof of a stressor.

The C & P is required for a diagnosis and also for rating purposes.

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10 minutes ago, Berta said:

A VA  MH professional must make the PTSD diagnosis.

If you fall under the 2010 PTSD regulations ( regarding "fear of and/or close proximity to" hostile activity, or you have the PH, CAR, or CIB on your DD 214, ) the VA will likely concede the stressor but they will want to know about it.

All other PTSD claims ( MST PTSD claims are explained here as well under a search)

will need adequate proof of a stressor.

The C & P is required for a diagnosis and also for rating purposes.

Thank you so much Berta,

My claim falls under the MST/PTSD group, and I have proofs of stressors (unfortunately, this happened more than once) via Buddy Statements, in service counseling by SNCO, and a proof of a drop in my overall performance in my SR's

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Okay, so VA MH docs made the PTSD Dx, along with the TBI, and MDD (although I didn't know they Dx this, so it wasn't part of what I claimed....should I have?)

went to VSO this week, looks my 2nd claim ever is almost to the finish line. I think.

To my understanding, I'm most likely not going to get CandP for the other contentions, based on the length of treatment I have been having, plus proof of stressors etc. We'll see how it goes, as it should be much longer (hopefully!)

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3 hours ago, awgv001 said:

Okay, so VA MH docs made the PTSD Dx, along with the TBI, and MDD (although I didn't know they Dx this, so it wasn't part of what I claimed....should I have?)

went to VSO this week, looks my 2nd claim ever is almost to the finish line. I think.

To my understanding, I'm most likely not going to get CandP for the other contentions, based on the length of treatment I have been having, plus proof of stressors etc. We'll see how it goes, as it should be much longer (hopefully!)

That's promising. I hope everything works out well for you.

Keep in mind that if you end up unable to work due to your disabilities, you might consider filing for SSDI and/or filing for individual unemployability IU status of you qualify.

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