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Sequoiahiker

Appeal advice...denied broken wrist

Question

I just joined the forums and I'm new to navigating the VA system.  So far it hasn't been that bad.  I filed a claim in March 2017 for the following:

Left ankle-sprained on an airborne jump.  Claimed approved at 10% rating

Skin condition from Desert Storm- Claim denied as I was never treated when I was in.  

Left wrist/hand- Broke hand during an airborne jump and went to the hospital on Ft. Bragg and was in a cast. Claim was denied, VA said not service connected.

 

so here's my issue.  I had a C&P exam for the ankle and my medical,records supported it.  I never had a C&P for my wrist or an exam and I'm sure since it was in a cast it should be in my records.  The doctor was really helpful and when I asked,him he said he was just looking at the ankle.

I am thinking I want and shou,d do a NOD appeal as I know I had a broken hand and it was in a cast.  I feel as though they should have done a C&P exam.  Not sure what I should say in my appeal........? Obviously I wou,d re-state the circumstances and point out the lack of an exam being done, I'm not sure how they can reach that conclusion.........

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Posting a redacted copy of your recent Award/Denial Letter would help greatly. The Raters explanation regarding the claimed but Denied Issues is very important. The Evidence Review by the Rater as well the Why the issue was not SC'd could determine your plan of attack.

Do you currently have a Medical Disability DX'd that is or could be linked to your Inservice verified event/accident? The "I'm sure" regarding your SMR's indicates you're not 100% CERTAIN that the Wrist Injury documentation is actually in your SMR. Do you have in your possession now or have you as yet, requested a complete copy of your MSR including the MSR?

Do you agree with the 10% SC for your ankle?          Semper Fi

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When you do a NOD, resist the temptation to give "your" reasons for the NOD, but instead do it the "VA way".  Trust me, the VA will do it "the VA way", and they would have to try to convert "your reasons" to the VA way.  They probably dont do a good job of converting "your reasons" to the VA way.  You need to show VA how you meet the criteria for your rating, not how bad you need the money, for example.  Your reason may be that you need the money for a car payment.  That's fine, but it wont get you benefits.  Show the VA how you meet the criteria.  The criteria for service connection is DOCUMENTATION of the following:

1.  Current diagnosis.  Ok, so you broke your hand in service.  What symptoms do you have now?  Did it heal up and no residuals?  (If so, no benefits)  Do you have pain in your left hand?  Do you have a reduction in use of the hand?  Is there a painful scar?  If you have no symptoms from the broken hand, you can not expect benefits.  VA wont pay you for the pain you experienced in the service when you broke your hand.  Rather, they will compensate you for a hand that is painful, that does not work, has arthritis, etc.  

2.  In service event or aggravation.   Do you have the fracture documented?  Is it in your records?  Dont assume, get your records and read it.  

3.  Nexus or doctors opinion that your current diagnois (number one, above) is "at least as likely as not" related to your in service event or aggravation.  

    AFTER you get service connection, your rating will be based on "symptoms".  If you have no symptoms from your broken hand in service, you dont get compensation.  I know.  You may have symptoms "later".  For example, I have arthritis of the knees from a leg fracture in service.  Yes, both knees.  When one knee is "bad" you favor it and make the other knee bad also.  But, I have to prove that also, and that would come also with a doctors opinion that my left knee arthritis is "at least as likely as not" due to the right knee arthiritis, which was linked to service.  

The VA way is 1 through 3.  Its called the Caluza elements, or Caluza triangle.  

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Thank you Broncovet...........this was probably the best written advice I've received.

I will admit that I am assuming the injury is in my SMR as I don't have a copy.  I guess I'm assuming because I was treated at Womack Arny Medical Center, but wouldn't be the first time they e "lost" records.  

Imdo jave what I feel is residual effects that have developed over the last year or two.  Some lack of motion and maybe arthritis.  I would have felt better about the denial if they had at least examined it in a C&P exam.  They did my ankle that I sprained and was awarded 10%.

for the denial it says:

Explanation:

service connection for left wrist condition is denied since this condition neither occurred in nor was caused by service.

Now that I read it it may be because I didn't claim the proper injury.  I said wrist and it was actually a fracture to the bone in the left hand between the pinky and the wrist.....commonly known as a "boxers" fracture.  Could that be the reason...?

 

anyways, the info you gave greatly helps me out.  Thank you 

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I keep repeating this over and over:  You need to order your medical records (all of them) and see what the diagnosis was "in service" and what the diagnosis is now, if any.  You have to have a current diagnosis, and I certainly dont know if you have one or not.  

C and P exams CAN "fix" things, and some things can not be fixed by a C and P exam.  Keep in mind the Caluza Triangle, required for service connection.  You must have all 3, if any one of these is absent or inadequate, its an automtatic, pretty much, denial.  

A C and P examiner, for example can not "fix" your undocumented "in service event".  If those medical records are inaccurate, incomplete, or missing altogether (likely), then a c and P exaam wont make an "in service event" happen.  Sometimes, the c and P examiner "may" provide you with the requisite nexus, but that does not always happen either, reminding you the examiner is paid by your opponent.  (Of course, Im assuming you have correctly understood that the VA is not a friendly guy that will fight to get YOUR benefits, like the VA would have us beleive.  They are, in fact, our adversary as they have a financial interest in the delay or denial of your benefits, regardless of how much smoke VA blows you to the contrary.  

Its possible your claim is fixed with your submission of "new and material evidence" (38 CFR 3.156 either B or C).  

Or, you may be a victim of "top sheeting" where the Veteran rating specialist who rated you did not bother to read all your evidence.  

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So in a NOD can you introduce new evidence...?  In my NOD can I say that it was more a broken hand and that is what is causing the wrist mans hand issues or wou,d I be better off filing a brand new claim....?

I almost feel as though when I made my initial claim I put wrist when in all actuality I should have put left hand.......

I guess too I was a little naive but not requesting my SMR prior to,starting.

 

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