Help to fight this denial

[ShuMan]

I was denied a claim for left shoulder tendonitis and left shoulder arthritis due to the condition neither occurred in nor was caused by service. I included a nexus letter, here is the medical logic from the nexus.

“The patent demonstrated physical examination findings at the C&P examination 3 months after discharge from the military on 10/30/2009. At the time the examiner reported diagnosis of chronic left shoulder strain and found crepitus on the physical examination. At another C&P examination on 09/29/2015 the examiner reported decreased range of motion and pain with movement on examination, a compensable finding. Additionally, Mr. Vet has a diagnoses of left shoulder tendinitis, osteoarthritis of the left AC joint, left shoulder strain, and impingement syndrome of the left shoulder by an orthopedic specialist on 11/16/2016.”

“The attached medical documentation demonstrates the presence of the conditions in service, a chronic ongoing condition, and a current disability”

I have contacted the doc that wrote me the nexus and she is writing a letter for me and I am filling for a reconsideration.

I believe they denied me due to the chronic should strain not being diagnosed until 3 months after discharge at C&P exam. I thought that since it was within one year it could be service connected.

Does anyone know the regulations I can quote to fight this?

[porgee]

Does anyone know the regulations I can quote to fight this?

http://www.benefits.va.gov/COMPENSATION/claims-postservice-one_year.asp

 

38 minutes ago, porgee said:

Does anyone know the regulations I can quote to fight this?

http://www.benefits.va.gov/COMPENSATION/claims-postservice-one_year.asp

porgee move this to it's own topic here 

 

33 minutes ago, Tbird said:

porgee move this to it's own topic here 

I was trying to post to this topic I guess I hit the wrong button or something happen but thanks Tbird. You can remove the other post if you will

[Vync]

17 hours ago, ShuMan said:

Hey Vync!

Thanks for the response. 

As far as missing the in service event. I am service connected for my right shoulder but my left was only diagnosed 3 months after my discharge date at the C&P exam for my right shoulder. Shouldn't this qualify as my in service event because it was diagnosed within in a year of discharge?

I could be wrong but I thought I heard that somewhere. 

As far as I know, the one year post-service info is found in this VA link (which porgee just shared): http://www.benefits.va.gov/COMPENSATION/claims-postservice-one_year.asp

You have to click through to get to the list of diseases/conditions which qualify.

 

Another approach might be to take the opposite limb secondary approach. I know it tends to work for legs, but am not certain about shoulders. For example, you are SC for one leg and the other leg goes downhill for taking up the extra workload. The Caluza triangle would still apply - You'll need to get a doc to tie it all together with a strong medical opinion. If you can get an ortho specialist, it should carry extra weight compared to other docs. If you don't have an opinion from a specialist, the VA would likely request a C&P exam for you to be evaluated from one of their "specialists" (never know what you will end up getting at the VA though).