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I Received My Decision Letter Today And Need Guidance



I received my decision letter today and need help on deciding what I need to do.  I filed a claim for other contentions but request quidance on just one.  I simply don't understand how VA can ignore evidence and state that there is none.  The claim was for bilateral radiculopathy SECONDARY to lower back. Should I ask for reconsideration?  Will the notes for a third epidural injection last Friday be enough for new and material evidence?  The following is ver batum from the decision letter:


nerve damage - left leg and foot

  • The evidence does not show that nerve damage - left leg and foot is related to the service-connected condition of arthritis, thoracic spine, nor is there any evidence of this disability during military service.
  • The evidence does not show a current diagnosed disability.  The evidence does not show that your condition resulted from, or was agravated by. a service-connected disability.  Your service treatment records do not contain complaints, treatment, or diagnosis for this condition.

Excerpts from doctors notes (two different doctors) and  MRI results submitted with the claim or uplaoded via eBenefits for treatment after the claim was filed.

Non VA primary care physician:  Musculoskeletal symptoms still having L sciatica, taking gababentin - no change in sxs.  L leg pain and numbness in the bottom of the right foot.  Pain is intermittent but numbness is there all the time.  Plan:  request consultation by specialist pain management, unknown specialty - L sciatica, has had MRI LSS.

MRI:At L4-5, anterolisthesis appears to be related to bilateral pars defects.  There is uncovering of the posterior disc but no appreciable bulge or protrusion is seen.  There is mild effacement of the thecal sac across the midline related to anterolisthesis.  There is direct impingement of both exiting nerve roots due to anterolisthesis and resultant foraminal  narrowing.At L5-S1, there is broad-based disc bulge without focal protrusion.  There is mild to moderate effacement of the thecal sac across the midline.  There is probable impingement of the descending S1 nerve root on the left within its lateral recess as best seen on T2 axial image #23 due to disc bulge and posterioir element hypertrophy.  There is moderate foraminal narrowing bilaterally,  with probable impingement of both exiting L5 nerve roots.  This is more likely on the left due to combination of disc bulge and facet joint hypertrophy.

Pain Management:

Second epidural:    He has quite a bit of loss of disk height at the L4-L5 and L5-S1 levels.  The left iliac crest proved to be too difficult to work around and I was unable to place the needle in the right location.  Lateral views show quite a bit of anterolisthesis of L4 on L5 due to pars defects as noted on the MRI.  This made it impossible for me to get into the appropriate location and the procedure was aborted.

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Almost all of us have claims with solid evidence but for some reason, the rater does not appear to see it our way? From reading your evidence, it seems like they would have to go your way? Besides, what else can you do? So, now you now can file a NOD but how do you gather evidence that is better than this? For now anyway, you may have to get an IMO/IME which costs more money but can solidify your case further. This is one of those cases where it just does not make sense because the evidence you have appears to meet the legal conditions for granting SC. It makes one wonder if they actually got down to the pages that had your evidence or maybe they just did not see it in the first place? That's why it's so important to get a copy of your C-file (my current battle) to see what the rater saw when they made your decision...

This stuff can drive you crazy....but hang it there...

Godspeed  Rootbeer22


Edited by rootbeer22
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I am assuming that you are service connected for lower back and your claims are secondary to the lower back.  If so, I don't see where your doctors have connected them.  Your doctors need to state that your secondary conditions are "at least as likely as not" due to your lower back and state the medical reasoning behind their statement.  Without this nexus you're dead in the water.  IMHO. 

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