lumbosacral Filing for Increase in S/C disabilities - just getting started

[Crabcake]

Greetings all! I thank you all - in advance - for the wealth of information available on this site to help vets. I stumbled upon it while researching what to do, where to start, etc. on filing for an increase for my S/C rated disabilities. At this point, what I have is: a full copy of my service records, and I have filed a notice of intent this week with VA. I am going to chronologically organize & flag my service records this weekend so I can identify where these things are noted in them.

This will be long, but I want to lay out as complete a starting picture as possible to help understand my situation in hopes of getting advice on how to proceed. I've been fortunate to have had good health insurance through my employer for years, and have used it for treatment as needed vs. the VA because of how cumbersome getting to & through the VA system can be. In the last two years, my insurance is now an HDHP, which means until I pay out of pocket $3500, insurance doesn't kick in, so I need to start utilizing the VA for these issues because I cannot afford to pay for the injections, films, treatment, etc. anymore.

The neck, shoulder and low back issues stemmed from a combination of a fall I took during a training exercise carrying way more gear on my back than I should have; a fall during a squadron event; and, a motor vehicle accident. What I feel may complicate things is that I have also been in a few car accidents since being S/C rated; none were my fault; I'm sadly just a crash magnet for inattentive drivers. The last one caused a minor rotator cuff tear in my left shoulder, further aggravated my cervical spine pain (to include shooting pain down my arms and fingers) and lumbar area & SI joints (to include severe shooting pain down both legs to the ankles). Following each accident, I've gone through ortho treatment, MRIs/x-rays, PT, injections in the SI joints and left shoulder, etc. And in 'settling' each accident, the insurance companies cite my 'pre-existing conditions' as reasons for low settlements.

I had a bad flare-up of both the neck & low back problems earlier this week with the shooting pain down arms & legs, and went to the Durham, NC VA hospital ER because I'm not assigned a VA PCM yet (that appt is next week). The ER did x-rays which - according to the ER doc - showed: loss of disc space and degenerative changes in cervical & lumbar spine and SI joints and my cervical spine is too straight vs. curved - all of which is resulting in the nerves from cervical & lumbar areas being pinched causing my shoulders/arms/fingers to go numb, as well as the shooting pain down my legs. She also noted arthritis in my spine, but I didn't catch the specific locations. Her discharge diagnosis reads: neck/back pain; degenerative disc disease. I was prescribed cyclobenzaprine, prednisone, 800mg iburprofen, and hydrocodone/acet.

What I currently have S/C per eBenefits (all from 2000, retroactive to end of service in 1998, except the lumbosacral strain which was increased in 2005 from 10%)

• Lumbosacral strain to include coccyx condition (previously claimed as coccyx fracture)(VCAA)  20% Service Connected 

• Refractive error (claimed as astigmatism) Not Service Connected                             

• Degenerative joint disease and rheumatoid arthritis, secondary to a coccyx fracture -Not Service Connected                     

• Bursitis, right shoulder   0%          Service Connected

• Bursitis, left shoulder     10%        Service Connected                         

• Allergic rhinitis   0%          Service Connected

• Cervical strain    0%          Service Connected                         

• Tinnitus                10%        Service Connected

What has arisen/increased in severity (why I'm seeking an increase/file new claim/s):

• Sacroiliac joint pain - I know I verbalized this repeatedly in my C&P exams, but not sure it was factored into or as part of the lumbosacral strain rating or not, but this pain is noted in my service records with the word "sciatica", and it is excruciating. I remember describing it to the C&P examiner as someone smashing my tailbone area with a baseball bat. If you have this, you understand. I get injections about every other year for them, and take 500 mg naproxen to ease flare-ups in between injections.
• Shooting pain (sciatica, radiculopathy ... I've been told both and not sure what the difference is) in both legs to my feet and arms to include my fingers.
• Anxiety - I believe this is secondary to my injuries. I barely drive because I have panic attacks as a result of the pain I'm in and the fear of yet another potential accident worsening my injuries. I had a panic attack in my ortho's office when he suggested I might need surgery on my shoulder. I cannot sit in the dentist's chair without Xanax because the sounds and feeling have me clenching my jaw and fists (never had this problem before the injuries).  I saw a psychologist after my last accident about the panic attacks, and my private PCM put me on anxiety meds, but I don't attend regular counseling, as there isn't much we can do except understand the triggers, perform exercises when they come on, and take my meds when it happens. Consequently, I work full time from home, barely drive anywhere, and take Xanax whenever I go to the doctor for anything other than a routine exam.
• Hearing - I was rated for tinnitus; however, I believe I mentioned to C&P examiner that I also had (at that time) some hearing loss/challenges. This has - over time - gotten far worse. I cannot differentiate conversations from background noises (e.g., music, tv, etc.), and I strain to hear people who speak in normal tones. I also experience a severe 'crackling' sound in my left ear if there is any loud noise (e.g., firetruck passing, in church if sitting too close to speakers, music being played too loudly - for me). The cause for the tinnitus (and I suspect the hearing loss) was from escorting media on the flightline during deployments as well as through other high-noise areas on base where - because of the need for interaction with the media and those they interviewed (make sure they weren't saying things they shouldn't) - it wasn't conducive to wear any sort of hearing protection.

Questions I have to get started:

1) What is the most effective way to request my C&P exam documents and any films/x-rays/to see how earlier decisions were reached and what they considered for each S/C disability? I was initially evaluated at the VA in Wilmington, DE, and the low back strain (originally 10%) was increased in Winston Salem, NC.

2) How (if at all) does my having been in the car accidents (since being rated) impact my claim for increased pain/problems/aggravation of these injuries? Will the VA say 'too bad, not our fault', or are they considered aggravations/worsening of conditions and therefore 'rate-able' or able to be considered for increase?

3) Would the shooting pain in my arms & legs due to the pinched nerves be separate claims from the cervical and lumbosacral strains, or would those items include these items? I keep reading about 'secondary' ailments, but I'm not clear on what that means in regards to the VA process.

4) I used to have a DAV rep helping with my claim, and they still have a POA on record with VA. Is it better to keep working through/with them, or can/should I go it alone?

I'm sure I'll have more questions but for now, hopefully that is enough to get started. And please, feel free to ask any questions to clarify anything I noted and/or make any suggestions/recommendations/etc. It's been so long since I went through this all that I don't know where to start, where to go, what to do, etc. Thanks again!

[Buck52]

you went to VA ER and the ER Dr that seen you ''releases you? without doing a MRI that he said you needed? and then ordered it and  without doing the MRI Testing?

and sent you home?

Did the Dr make a Diagnoses?

I'd go see the Hospital Director about that, that's poor healthcare & neglect

you could have some type of blockage or something  major that needs to be seen asap

A lot of VAMC are training hospitals and the interns are heavily watched over a experienced Dr

If your still in excruciating  pain  go back up there and be seen again  and check with the Hospital Director as to how your being treated.

At least get this documented.

[Crabcake]

2 hours ago, Buck52 said:

you went to VA ER and the ER Dr that seen you ''releases you? without doing a MRI that he said you needed? and then ordered it and  without doing the MRI Testing?

and sent you home?

Did the Dr make a Diagnoses?

I'd go see the Hospital Director about that, that's poor healthcare & neglect

you could have some type of blockage or something  major that needs to be seen asap

A lot of VAMC are training hospitals and the interns are heavily watched over a experienced Dr

If your still in excruciating  pain  go back up there and be seen again  and check with the Hospital Director as to how your being treated.

At least get this documented.

That is correct. The ER doctor on Sunday said he would order an MRI to be scheduled. I asked 'can I just go down now and get it done'; he said it doesn't work that way, has to be scheduled, and his diagnosis on my discharge document was "nerve pain in both legs & arms".

[Buck52]

Yes He is correct about it doesn't work that way in a normal clinical visit

 '' and his diagnosis on my discharge document was "nerve pain in both legs & arms".

That could be any thing and underlying problems do occur.

However in an emergency they are required to render any medical help possible at the time of treatment

Go see the Hospital Director about this  they do have Hospital Patients Advocate's, but I find there not any help at my VAMC 

[Buck52]

you could possibly email the Hosptial Director  via MyHealthyVet ''secure message'' & explain this issue.

your worried about your medical issue and your pain is just getting worse and worse.

[Crabcake]

Thanks for the input Buck; I'll definitely take that into account re: the hospital director. I called yesterday to schedule my MRI since I didn't hear from anyone; it's scheduled for this coming Tuesday morning.

One positive note - I mailed off the release form this past Saturday to link my records into heathevet's site, and today (3 business days after I mailed it) my acct changed to 'premium', and the ER notes & x-ray details were uploaded from the ER (but none of my previous trips to the VA to include 2005/6 or any of my C&P exam notes, but maybe I'm not looking in the right place.

I'm sharing the x-ray reports below, though I am not familiar with the terminology (will research), and I will note that there are things the doctor said & wrote on the x-ray pic (on the Wednesday ER visit) that are not on the radiologist's report, such as arthritis, extremely narrow disc spaces at bottom of c-spine, as well as she told me specifically arthritis & degeneration in the SI joints (I wrote that down along with the other things she noted), which the rad-report is silent to except to say they 'normal appearance'. I also received yesterday the medical records from my private ortho specialist who treated me for and after the last car accident I had (2013), and I've added the x-ray reports for then below as well to show the comparison. Those x-rays were also taken in an ER, but not the VA.

2016 C-Spine:

Findings: The cervical spine is visualized from C1-C7. No prevertebral soft tissue swelling is seen. The cervical alignment is maintained without spondylolisthesis. There is mild (C4/5 and C6/7) to moderate (C5/6) osteophytic changes in the anterior regions of vertebral bodies. No significant foraminal narrowing. No acute fracture is identified. The vertebral body and disc space heights are preserved. The odontoid process is intact.

Impression: No evidence of acute osseous injury to the cervical spine. Moderate degenerative disc disease at C5-C6.

 

2013 C-Spine:

had to attach below

2016 L-Spine:

Findings: There are five lumbar vertebrae in normal alignment with no evidence for fracture or subluxation. There is mild narrowing at the level of T12-L1, L1-L2 and L5-S1. Mild osteophytic changes of L1-L2 and L5 vertebral bodies.. There are no destructive bony lesions.Normal appearance of bilateral SI joints.

Impression: 1. Mild joint space narrowing of T12-L1, L1-L2 and L5-S1 with osteophytic changes as above consistent with mild degenerative joint disease of the lumbar spine.

 

2013 L-Spine:

had to attach below

 

I'm going to keep digging through what I have from prior treatment to see if I have other x-ray reports to compare/show progression, if for no other reason, my own information/awareness.

Edited November 2, 2016 by Crabcake

[Andyman73]

Crabcake,

I find it quite interesting, reading your thread here, I fell down a flight of stairs on day 5 of boot camp, Nov '92, had close to 100lbs of gear on my person, most of it was in my sea/duffle bag. It was flight not tumble down the stairs.  And now I am going through various treatments at my VAMC for SI joint pain issues.  Not too far different than your fall, as far as falling while carrying a heavy load, and the end results.

I wish I had some words of advice or encouragement for you but...I don't even have those words for me.  Buck here won't steer you wrong, tho, and the others too, will give you good intel.

Andy