Peripheral Neuropathy (Paresthesia)

[DevilDog12]

Would anyone be able to read over this and offer some input to what the ratings would be?  Moderate left arm, severe both legs.

COMPENSATION & PENSION NOTE STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: OCT 13, 2016@10:00 ENTRY DATE: OCT 18, 2016AUTHOR: A EXP COSIGNER: URGENCY: STATUS: COMPLETED Peripheral Nerves Conditions (not including Diabetic Sensory-Motor Peripheral Neuropathy) 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 [X] Other (please identify other evidence reviewed): The claims file in VBMS was reviewed by the examiner. The veteran's electronic folder in VBMS was reviewed by the examiner. Evidence Comments: The claims file in VBMS was reviewed by the examiner. The veteran's electronic folder in VBMS was reviewed by the examiner. 1. Diagnosis ------------ Does the Veteran have a peripheral nerve condition or peripheral neuropathy? [X] Yes [ ] No Diagnosis #1: Willis Ekbom Disease ICD code: G25.81 Date of diagnosis: 1998 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's peripheral nerve condition (brief summary): Gradual onset of paresthesia around 2013, with gradual worsening over subsequent years. Paresthesias in bilateral arms and bilateral legs attributed to Willis Ekbom Disease (restless leg syndrome). Gradual onset of restless leg syndrom (Willis Ekbom Disease) around 1998, with gradual worsening over subsequent years. Willis Ekbom Disease now affects bilateral arms and bilateral legs while awake. b. Dominant hand [X] Right [ ] Left [ ] Ambidextrous 3. Symptoms ----------- a. Does the Veteran have any symptoms attributable to any peripheral nerve conditions? [X] Yes [ ] No Constant pain (may be excruciating at times) Right upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Intermittent pain (usually dull) Right upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left upper extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Right lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Left lower extremity: [X] None [ ] Mild [ ] Moderate [ ] Severe Paresthesias and/or dysesthesias Right upper extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe Left upper extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe Right lower extremity: [ ] None [ ] Mild [ ] Moderate [X] Severe Left lower extremity: [ ] None [ ] Mild [ ] Moderate [X] Severe Numbness Right upper extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe Left upper extremity: [ ] None [ ] Mild [X] Moderate [ ] Severe Right lower extremity: [ ] None [ ] Mild [ ] Moderate [X] Severe Left lower extremity: [ ] None [ ] Mild [ ] Moderate [X] Severe 4. Muscle strength testing -------------------------- a. 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 Elbow flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Elbow extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Wrist flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Wrist extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Grip: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Pinch (thumb to index finger): Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Knee extension: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle plantar flexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Ankle dorsiflexion: Right: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 Left: [X] 5/5 [ ] 4/5 [ ] 3/5 [ ] 2/5 [ ] 1/5 [ ] 0/5 b. Does the Veteran have muscle atrophy? [ ] Yes [X] No 5. Reflex exam -------------- Rate deep tendon reflexes (DTRs) according to the following scale: 0 Absent 1+ Hypoactive 2+ Normal 3+ Hyperactive without clonus 4+ Hyperactive with clonus Biceps: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Triceps: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Brachioradialis: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Knee: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Ankle: Right: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ Left: [ ] 0 [ ] 1+ [X] 2+ [ ] 3+ [ ] 4+ 6. Sensory exam --------------- Indicate results for sensation testing for light touch: Shoulder area (C5): Right: [X] Normal [ ] Decreased [ ] Absent Left: [ ] Normal [X] Decreased [ ] Absent Inner/outer forearm (C6/T1): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Hand/fingers (C6-8): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Upper anterior thigh (L2): Right: [ ] Normal [X] Decreased [ ] Absent Left: [ ] Normal [X] Decreased [ ] Absent Thigh/knee (L3/4): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Lower leg/ankle (L4/L5/S1): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Foot/toes (L5): Right: [X] Normal [ ] Decreased [ ] Absent Left: [X] Normal [ ] Decreased [ ] Absent Other sensory findings, if any: Diminished sensation to monofilament testing of the left upper arm, proximal half of right anterior thigh, and proximal half of left anterior thigh. Diminished vibratory sensation of right upper extremity, right lower extremity, and left lower extremity. Diminished temperature sensation of right upper extremity and left lower extremity. Diminished proprioception of right lower extremity and left lower extremity. 7. Trophic changes ------------------ Does the Veteran have trophic changes (characterized by loss of extremity hair, smooth, shiny skin, etc.) attributable to peripheral neuropathy? [ ] Yes [X] No 8. Gait ------- Is the Veteran's gait normal? [X] Yes [ ] No 9. Special tests for median nerve --------------------------------- Were special tests indicated and performed for median nerve evaluation? [ ] Yes [X] No 10. Nerves Affected: Severity evaluation for upper extremity nerves and radicular groups ----------------------------------------------------------------------- a. Radial nerve (musculospiral nerve) Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe b. Median nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe c. Ulnar nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe d. Musculocutaneous nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe e. Circumflex nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe f. Long thoracic nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe g. Upper radicular group (5th & 6th cervicals) Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe h. Middle radicular group Right [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe i. Lower radicular group Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe 11. Nerves Affected: Severity evaluation for lower extremity nerves ------------------------------------------------------------------- a. Sciatic nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Moderately Severe [ ] Severe, with marked muscular atrophy Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Moderately Severe [ ] Severe, with marked muscular atrophy b. External popliteal (common peroneal) nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe c. Musculocutaneous (superficial peroneal) nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe d. Anterior tibial (deep peroneal) nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe e. Internal popliteal (tibial) nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe f. Posterior tibial nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe g. Anterior crural (femoral) nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe h. Internal saphenous nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe i. Obturator nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe j. External cutaneous nerve of the thigh Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe k. Ilio-inguinal nerve Right: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe Left: [ ] Normal [X] Incomplete paralysis [ ] Complete paralysis If Incomplete paralysis is checked, indicate severity: [X] Mild [ ] Moderate [ ] Severe 12. 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: N/A 13. Remaining effective function of the extremities --------------------------------------------------- Due to peripheral nerve conditions, 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 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, if any: None. 15. Diagnostic testing ---------------------- a. Have EMG studies been performed? [ ] Yes [X] No b. Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No 16. Functional impact --------------------- Does the Veteran's peripheral nerve condition and/or peripheral neuropathy impact his or her ability to work? [X] Yes [ ] No If yes, describe impact of each of the Veteran's peripheral nerve and/or peripheral neuropathy condition(s), providing one or more examples: Residual daytime hypersomnolence affects all activities; veteran must avoid or exercise caution when engaging in activities where sudden unexpected onset of sleep could cause harm to self or others; veteran is intolerant of bilateral hand activity during flareups; veteran is intolerant of bilateral upper extremity activity during flareups; veteran is intolerant of prolonged inactivity of the bilateral hands; veteran does not tolerate fine motor activity of the bilateral hands during flareups; veteran frequently fumbles with objects during flareups; veteran is intolerant of bilateral lower extremity activity during flareups; veteran is intolerant of bilateral lower extremities; veteran is intolerant of prolonged inactivity of the bilateral lower extremities; veteran is intolerant of prolonged standing and walking during flareups; and veteran frequently feels unsteady when standing during flareups. 17. Remarks, if any: -------------------- The claims file in VBMS was reviewed by the examiner. The veteran's electronic folder in VBMS was reviewed by the examiner. The Veteran's paresthesia is at least as likely as not (50 percent or greater probability) proximately due to and the result of his service connected willis ekbom disease (restless leg syndrome. The rationale for this opinion is that the veteran's paresthesias in his bilateral arms and bilateral legs have been attributed to Willis Ekbom Disease (restless leg syndrome); and it appears that the veteran's Willis Ekbom Disease is related to a specific exposure event experienced by the Veteran during service in Southwest Asia; as the veteran has had persistent and recurrent symptoms of Willis Ekbom Disease from the time of their initial development soon after the veteran's deployment to the Persian Gulf while the veteran was in the military until the present time; with the current Willis Ekbom Disease symptoms occurring in similar locations, and appearing to be of similar natures, as the restless leg syndrome symptoms the veteran developed while he was in the military; and with the current Willis Ekbom Disease symptoms with similar precipitating, exacerbating, and relieving factors as the restless leg syndrome symptoms the veteran developed while in the military. As the Secondary opinion is favorable, NSC Aggravation is not addressed. As the Secondary opinion is favorable, whether the Veteran's paresthesia was at least as likely as not aggravated beyond its natural progression by his service connected willis ekbom disease (restless leg syndrome) is not addressed. The veteran's paresthesias are not temporary or intermittent flare-ups of a pre- existing disability during service. Therefore, whether the underlying condition was aggravated is not addressed. As the underlying disability was not aggravated, whether the aggravation was beyond the normal disease progression is not addressed. As it is not determined the veteran's period of military service did aggravate the underlying condition which pre-existed service and that the aggravation was beyond normal disease progression, additional information regarding "baseline manifestations" is not addressed. As it is not determined the veteran's period of military service did aggravate the underlying condition which pre-existed service and that the aggravation was beyond normal disease progression, the baseline level of nonservice- connected disability and the level of additional disability which is considered proximately due to the military service is not established. As it is not determined the veteran's period of military service did aggravate the underlying condition which pre-existed service and that the aggravation was beyond normal disease progression, the baseline manifestations, which are due to the effects of nonservice-connected disease or injury (the degree of disability at the time of the veteran's entrance into active duty) are not addressed. As it is not determined the veteran's period of military service did aggravate the underlying condition which pre-existed service and that the aggravation was beyond normal disease progression, the increased manifestations which, in this examiner's opinion, are proximately due to his/her period of military service based on medical considerations (the degree of disability which existed at the time of discharge from active duty) are not addressed. As it is not determined the veteran's period of military service did aggravate the underlying condition which pre-existed service and that the aggravation was beyond normal disease progression, the medical considerations supporting an opinion that increased manifestations of a nonservice-connected disease or injury are proximately due to service are not addressed.

[DevilDog12]

Thank you for the input!  Yes, I have been earning more than than 12k, but it is getting harder and harder to work. I would love to work as long as I can, but as you said, eventually I will not be able to.  I had to give up things I love like hunting, and hiking, and I hate that it has come to this.  I was thoroughly examined at the VA by Neurology, and the C&P examiner did a great job too, and for that I am thankful.  I am currenly at 90% (93 total) so hopefully this will give me that push to 100.

[green]

Just my opinion but it looks to me like you could qualify for mild lower raticular group ratings of both arms (as they note several nerve groups affected) which would give you 20% per arm and add 10% on top of that for bilateral conditions.  You may hit 100%.  That being said, it would surprise me if they don't schedule you for an EMG.  This test is a breeze if you have sensory issues.

Edited October 27, 2016 by green

[jamescripps2]

I agree with Gastone but would rather see you go the TDIU route with an "S" award. Difficult to do if you are still working though. If you go the 100% scheduler route, you can still work. It does appear to me, that on the surface, the C&P examiner did you a good job. The exam should put you over the top. Generally, I would guess maybe a 30% award, but that comment the examiner made about how it affects your working ability adds considerably to the DBQ.

It is not a wise move for anyone to try and guess what a rater might do, but you asked. I almost passed on my 2 cents but I could not resist. Nothing to loose considering that you are already at 93%. Who knows, with the bilateral factor added you just might reach 100 + 60 territory anyway. good luck and thanks for your service!

[DevilDog12]

Thank you guys for your input.  I understand that it's hard to know what a rater might give.  But the feedback is greatly appreciated!

[DevilDog12]

I did have some other tests done, but an EMG was not one of them.  Had a test done where they hooked me up to a machine to check reflexes.  Not sure what it was called, but it wasn't and EMG.  Then had the monofilament test by a private doc.  The C&P examiner also did the monofilament test.  Is the mono test sufficient for rating purposes?  The examiner said that they are used all the time.  Regardless, I will complete any exam that they ask me to.  The more proof the better.  Loosing feeling in a hand, arm, or leg is horrible!  I just hope that I don't lose all feeling completely one day.  If I do hit 100% schedular, could I file for IU or SMC in future?  Or would that be a can of worms that I don't want to open?

[Gastone]

DD12, probably doesn't matter at this point, have you ever been referred to a VMC Neurologist or you PN?

It's been about 6 yrs, but before I could get in to see the VA Neurologist, my VA PCP had to order a complete Blood workup for all STD, Aids Etc. Also, an EMG had to be completed.

In my case, the DX arrived at by the MD Specialist that reviewed the EMG & Blood-work results, was Idiopathic PN. When I finally got to see the VA Neurologist, the IPN DX was in place. The Neurologist just addressed treatment options, refused to discuss a possible AO Nexus. He was 65, about to retire and Toed the VA DENIE  Line. Took seeing 3 different VA Neurologist to find (1) that would write a supportive DBQ.

Semper Fi