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michaeld4263@gmail.com

Would I qualify for S/C Secondary disability

Question

I was scheduled for a Comp & Pen examination at the Madison VA hospital, in Madison Wisconsin. When I checked in I was told by the clerk that I would have a three hour examination. However, that was not the case. Dr._______ spent approximately twenty minutes with me and told me that I did not have a service connected disability. She didn't take and ROM measurement for anything. She treated me with such disdain, as though I was just a piece of lint. I need to digress for a minute. I'm medically retired from the Army with a forty percent disability rating. My disability is considered service-connected. Back to the issue at hand. My service connected disability is a rare form of arthritis called Reactive Arthritis, it can go in and out of remission. I have limped for the past 31 years, which has caused me to have significant issues with my gait. This,in turn, has caused numerous medical issues that are secondary, both knees need to be replaced, I have arthritis in my hips, I have degenerative disc disease, my fourth and fifth vertebra are bulging out and are considered severe, and lastly because my gait in my left foot is so significant my private sector and the VA podiatrist recommend that the foot be rebuilt.  

Today I received a call from an individual from the VA under-secretary office. She listened to my complaint concerning the Doctor. Then She read my C-file, which contained the findings of the DR. who did/didn't perform the Comp and Pen. The Doctor's findings stated that the X-ray didn't show any inflammation in the joints, which would indicate the reactive arthritis is active. However My excellent VSO wrote-up my claim so that all the issues I mentioned would be considered secondary disability that were caused and/ or aggravated by my right knee that I initially injured when I slipped and fell on the stairs of a mammoth forklift and then spent three months in an air force hospital until they came up with a diagnosis of Reactive Arthritis. I was then medically retired from the Army with a 40% disability rating. Sorry for that digression. From 1985 to the present I have walked with a significant limp with my right knee, which my private sector Doctors have stated, in writing, has caused me to develop a significant problem with my gait, which in turn caused the knees, ankles, hips and back trouble that prevents me from working as a teacher. The Doctor who did the comp and pen stated that all the secondary issues that I mentioned were due to obesity.  She wouldn't even listen when I tried to explain that with all the medical issues I have, makes extremely difficult and painful to be active. Another issue with the doctor is when I ask her if she read the letters that my private sector doctors wrote, she stated " I couldn't find them", the letters were in the system with about 125 pages of medical documentation.  I just can't comprehend that after limping for over 30 years, thus screwing up my gait significantly, which my private sector doctors state is the reason for all the secondary issues. The Dr. States that it is more than likely the issues were caused by obesity. She doesn't even consider how difficult it is doing physical exercise or just to get around. I walk with a walker because my knees always give out, without any warning. Please advise me. 

I wrote the entry to see if anyone in the community has any advice, suggestions, resources, Anything. I would be so grateful, thankful, and appreciative 

Everyone who reads this I so sorry that it's so long 

Thank You,

Michael 

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Michael,

I had to look it up because I had not heard of it before,

"Reactive arthritis can affect the heels, toes, fingers, low back, and joints, especially of the knees or ankles. Though it often goes away on its own, reactive arthritis can be prolonged and severe enough to require seeing a specialist. Effective treatment is available for reactive arthritis. Reactive arthritis tends to occur most often in men between ages 20 and 50. Most cases of reactive arthritis appear as a short episode. Occasionally, it becomes chronic."

"Reactive arthritis is a painful form of inflammatory arthritis (joint disease due to inflammation). It occurs in reaction to an infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms, but can cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If you develop arthritis within one month of diarrhea or a genital infection – especially with a discharge – see a health care provider. You may have reactive arthritis."

So, I believe that your C&P examiner probably did not know what it is either.

That said, did you get the letter (denial) back from the VA (rater) yet?  By your post, I think you will get denied, however, you may not, so nothing is anything until you get the letter.

Now, we do know that you are service connected for it at 40%, so what and how is/was that rated?  Do you know the code they used to rate you in your original award letter?  That will help determine where to go from here.

You will need to appeal, but you may need help from a doctor that has experience with the VA, etc...  I have not done that yet, but plenty have on this site, so you should get some good advice here.

From what I read in the definitions, and that your have been SC'd for it, if my finger hurt, I would claim a secondary for it.

Just sayin,

Hamslice

 

 

Edited by Hamslice
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I agree with the others.  You likely need to challenge the compentency of the examiner, based on the answers to my next questions:

1.  Find out what the c and P doc's credentials are.  Did he have training or experience in your claimed disability?  If not, challenge the examiner on that bases.  

2.  Did you get a copy of the exam, or are you speculating as to what the doc said based upon your conversation with him?  (Dont do that.  The VA will have the report only and make a decision accordingly)  Did the examiner say, "He can't find (some of your medical records)?"   This exam should be thrown out if the report says this.  Its not an exam without your medical file, its a guess.  If the examiner even hinted he did not read your whole file, then this missing portion can become new and material evidence under 38 CFR 3.156.  

3.  The bottom line is you will need favorable evidence to get your SC.  This exam, based on your post, is not favorable.  This means you will likely need an IMO, or, at least, a favorable opinion such as your private doctor.  Dont forget the Caluza triangle.. I have posted many times on Caluza and so have others, so I wont repeat that here.  

Edited by broncovet
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Micheal

you might look up the'' Loss of use'' regulations if you have drop foot you can claim that  or any type of loss of use  because of your S.C. DISABILITY'S

Check Out James Cripps post here on hadit

I agree with broncovet, go get a IMO with a specialist  to rebut this C&P Dr.

If  your denied (which is more likely)...NOD, send in your notice of Disagreement and request a DRO Hearing    submit your new IMO..and any other favorable evidence you have & at the DRO Hearing you can face the decision officer face to face and show him/her your S.C. Disability's are real & present your new evidence....detail lay statement from you  how hard it is for you during everyday life.

you can submit your new evidence before the Hearing  but take copies with you to the hearing  ask the DRO if he has your new medical evidence from your  IMO Specialist.

its always good to have back up  to prove your case  in case there's a mix up with your Records. (you will have them)

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You stated:

 "Another issue with the doctor is when I ask her if she read the letters that my private sector doctors wrote, she stated " I couldn't find them", the letters were in the system with about 125 pages of medical documentation. "

If these letters were in the form of an IMO/IME ,with a full medical rationale, and the decision is a denial and VA does not list them or consider those letter at all, it is a CUE under 38 CFR 4.6.

It is possible the C & P doctor never read them ,but that the rater will.

Then again the VA ignored my IMOs for years and the BVA was the first entity to read them. (AO DMII claim) I had not developed the CUE under 38 CFR 4.6 idea in those days.

I had even asked Acting Secretary Mansfield (this was around 2006)via a letter about this  and copies of the IM0s, to send them to my RO (Buffalo) himself and then maybe they would acknowledge them.

His letter to them stating the IMOs were enclosed for their attention was in my C file but not even an acting VA Secretary's letter got them to read my IMOs.

Since then I have been successful by filing CUE Immediately because they made legal errors in every claim I have had since 1995.

The fastest CUE was when Nehmer Phila sent me a letter saying my husband did not have AO IHD when he was in Vietnam and they denied my 2010 AO IHD claim.

I whipped out a CUE so fast (Dec 3 decision in 2011) that the 800 # person, when I called for a status on something else ,about 3 weeks after filing the CUE, seems very shocked that the same claim they denied on Dec 3rd, had been awarded by then, right before Christmas.In mere weeks.She said her PC info must be wrong.I asked again for whatever I called for in the first place and I assured her the award on what they had recently denied , was correct.

The bastards...how many Vietnam vets or their survivors might have gotten that BS letter?

Many vets who went to Vietnam were still teenagers when they got there .How could they have full blown IHD in their SMRs?

I filed the CUE Via IRIS, as a complaint,  and via fax to the director of Nehmer Philadelphia.

When they awarded the AO IHD claim they also awarded 3 or 4 additional CUE claims within the award, that had been pending for YEARS at my RO,that were contingent on a proper AO rating.

If the "letters" complied with the IMO/IME format here at hadit, and since you sent them more then one IME as I understand this, I say just be patient for the actual decision.

38 CFR 4.6 is one of the most powerful regulations we have.

I should have filed CUE on my very first VA decision in 1997 when they withheld my most probative piece of evidence from the C & P examiner.

One could say it was, in essence, an IMO.

It was a 6 page autopsy from the Medical Examiner.

As my H VAC testimony during Shreddergate mentioned, I had enclosed 53 USPS tracking slips of probative evidence the VA had received ,since 1995, but had refused to consider for any of my claims.

I know there are good raters at the ROs...but they work there along with idiots...and we cannot pick who we get.

I think that all might change in the future....but I think any change will come from veterans themselves letting the new Secretary know how bad the claims process is....and who the raters are who cant even read. ( They can be identified by their decisions. VAROs know who they are)

 

 

 

Edited by Berta
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I was 18 Ms Berta....64 now

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