Re-filing a claim that was deemed not service connected

[dethnode]

Ok, first let me say, I am sorry for the long winded post, and also if this is not in the proper place.

I served on active duty USAF for 7 years from 2003 to 2010.  Prior to joining, there were no instances of ever having back problems or even a day of back pain.  During my service, I had several documented lower back pain clinic visits.  Most of the time, I was given a exemption from physical training and some Ibuprofen. On three occasions, I was sent to physical therapy and to chiropractic services.  Never were there any advanced imaging tests performed.  After I separated in 2010, I did not file any claims for disability.  I continued to have back problems that I would go see my primary care physician for and would be treated with muscle relaxers and/or steroids.  In 2012, a friend that I kept in touch with from service told me I should go and file a claim, so I did.  I filed for three issues (knee pain, back pain, and shoulder pain) on the advice of my VSO. The knee pain I had before I went in and it was documented before I went in, so I figured that to be a waste of time.  The shoulder pain was just a click in my shoulder that was not really painful and caused no difference in my daily life so I did not see that as relevant. However, the back pain did not start until I joined service, and had become an issue that was more often painful that it was not painful.  So I filed, and went to my C&P and they did an X-ray and ROM test for all three claims.  Several months later I got a letter in the mail (to the wrong name) but with my information, that all three of the claims had been deemed not service connected.  

I was fresh out of college and just starting a new job, with newborn son, and basically running in every direction just to get day to day things accomplished and at the time the back pain while a pain in the butt, was more of a nuisance than anything else. So from that time until last 2015, I have been treated by my PCP approximately 2 or 3 times a year with steroids and muscle relaxers for lower back pain, and have seen a chiropractor on occasion.   In 2015, I had a flare up of back pain, that sent me to my doctor, this was different, it was the same pain but much more intense.  The PCP said it sounded like a herniated disc, but that they would treat it with physical therapy.  I asked "can we please do an MRI to confirm"? His response was that the MRI is an expensive test and that it is better to do the physical therapy and see if it gets better. Well over a 3 month period of physical therapy it did gradually get better but did not return to the same.  Then, 1 month ago, while picking up a pair of shoes, I could not stand back up, every attempt to straighten my lower back was met with excruciating pain.  I was home alone with 3 children, my wife was at work.  My youngest (7 months old at the time) was in his crib crying, and I was stuck on my hands and knees.  I called my wife who came home to help.  But when she attempted to help me stand, my legs were numb (like not there numb), the pain in my lower back when attempting to stand sent me into screams of pain.  We had no choice but to call for an ambulance to take me to the ER.  When they placed me on the stretcher and straightened my lower back, for the first time in my life, I blacked out.  At the ER they finally ordered an MRI, and it was confirmed I had a herniated disc, with several fragments pressing against the nerve root. They referred me to a neurologist and he recommended I let it wait 4 weeks to self heal and then determine if I wanted surgery.  Two weeks in, I called him and said schedule the surgery. I had paid radiating down my right leg.  I was unable to sit, drive, stand, walk.  The only thing I could do was lay on my side with my knees bent 30 degrees.  He performed the surgery and said that things were worse than the initial MRI, he said he did remove several bone fragments from my nerve root, and that I had sever disc degeneration to the point that there is almost no disc left.  He said I am likely looking at fusion in the next 5 to 10 years. 

 

So, now that brings us to present day.  I have called a different VSO and scheduled an appt. I am going to re-file my claim.  Is there any chance of this turning out favorably for me?

[MikeHunt]

And if they have a problem with it:

Quote

III.iv.5.A.4.c.  Requesting Clarification From Private Physicians

VA, pursuant to 38 U.S.C. 5103A(a), has a duty to return for clarification unclear or insufficient private examination reports or VA progress notes if it reasonably appears that a request for clarification could provide relevant information necessary to properly decide a claim that is otherwise not in the record and cannot be obtained in some other way.  VA’s duty is limited to those instances in which the missing information is relevant, factual, and objective – not a matter of opinion – and bears greatly on the probative value of the private medical examination report.    If a private medical examination report reasonably appears to contain information necessary to properly decide a claim, but is unclear or not suitable for rating purposes and the information contained in the report otherwise cannot be obtained, VA has a duty to either  ask the private examiner to clarify the report request that the claimant obtain the necessary information to clarify the report, or explain why clarification is not needed.  Any request for clarification to a private examiner or claimant should clearly indicate what further action needs to be taken to make the insufficient private examination report acceptable for VA consideration.  If no response is received from the private examiner or claimant, continue adjudicating the claim.    References:  For more information on requesting clarification of medical reports, see 38 CFR 4.2, and Savage v. Shinseki, 24 Vet.App. 259 (2011), and requesting non-Federal or private records, see M21-1, Part I, 1.C.2.

 

[Berta]

Any doctor will need a copy of your SMRs to establish an inservice nexus.

Did your MOS involve continuously  handling heavy equipment? Did you have any bad falls while in service?

Can you recall what happened before you went to a medic in service? Even though you dont seem to have a reason for it? Something caused the back pain.

 "The knee pain I had before I went in and it was documented before I went in, so I figured that to b  etc..."

If a pre existing disability "aggravates" a NSC disability, (the back in your case) the VA can service connect the level of the "aggravation".

Was tyh knee pain given any diagnosis? Do you still have knee problems?

The aggravation regulations are in this BVA award:

https://www.va.gov/vetapp09/files2/0916280.txt

 

[dethnode]

I do not have any ongoing knee pain, and do not wish to file a claim for it.  I truly am not trying to get more than I deserve, I'm not claiming anything and everything that i might could get away with.  I only want to claim my back because that is an issue that still affects my daily life.  I'm an accountant, but sitting for long periods of time is impossible, that makes my job difficult to do.  

 

In the military, I was a communications tech.  I ran cables and installed telephones.  I climbed ladders constantly, and worked with my arms above my head often extending my back.  I know that I fell off of a ladder once and the next morning I went to the doctor for lower back pain, but I do not remember if the fall is documented or just the lower back pain.  I know that I was sent to physical therapy for lower back pain while in service at least on 3 occasions.  On one occasion I was practicing martial arts, and felt a pop in my back and the next morning I went to sick call for lower back pain.  

My appointment with my DAV is on Monday.  I have a letter from my neurologist stating that I do have severe disc degeneration.  I was put told by him after my last flare up to not go to work for 4 weeks, does that count as incapacitated. Then after my surgery I was told to rest and not to leave the house for 2 weeks.  He has told me if I wish to avoid further damage to my back I should never lift anything over 25 lbs again.  

He will write all of this, but he doesn't want to write that it is at least as likely as not related to the aggravation to my disc that occurred while in service.  I am considering getting an IMO from either Dr. Ellis or Dr. Anaise.  Just wondering if one were better than the other, and if it seems like it would be necessary.

[MikeHunt]

11 minutes ago, dethnode said:

 I went to the doctor for lower back pain,

I was sent to physical therapy for lower back pain while in service at least on 3 occasions. 

I went to sick call for lower back pain.

Slam-dunk for a VA exam.

See if the two you mentioned answer, then ask how much they're charging.

You could ask the DAV for a vet friendly clinician. If they don't know, which I'd guess they won't, ask other POAs or a CVSO.

I got a successful IMO/DBQ for a fraction of what one quoted me- Everyone loves to make money off Veterans.

In your case though, it doesn't sound like a long shot. Ask the DAV to print the STRs, extract the relevant records, explain *briefly* the treatment is also in VA STRs, but you're providing dupes for an easy reference with the 526EZ.

Then it's on you and the VA doc.

[dethnode]

I called and spoke to Dr. Anaise,

He said that there was no way if i do get a rating that I could get it back dated to when I filed in 2012 and they denied saying it wasn't service connected.

Does this sound accurate to you guys?

[dethnode]

18 hours ago, dethnode said:

I called and spoke to Dr. Anaise,

He said that there was no way if i do get a rating that I could get it back dated to when I filed in 2012 and they denied saying it wasn't service connected.

Does this sound accurate to you guys?

Anyone?