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lfredrick123

Continued Exams- Please review for details

Question

Here is the most recent CT Exam 

GOOD SAMARITAN MEDICAL CENTER

 

 

 

 

Adm: 6/6/2017, D/C: 6/6/2017

CT Chest Abdomen And Pelvis Wo Contrast]

Resulted: 06/06/17 1617, Result status: Final

result

Ordering provider:

Resulted by: MD

Performed: 06/06/17 1522 - 06/06/17 1539 Resulting lab: SVB STRESS SERVICES

Narrative:

CT OF THE CHEST, ABDOMEN AND PELVIS WITHOUT INTRAVENOUS CONTRAST

EXAM DATE AND TIME: 6/6/2017 3:22 PM

INDICATION: Lung mass. Vascular disorder of the kidneys.

TECHNIQUE: Routine CT of the chest, abdomen and pelvis without IV

contrast. Dose reduction techniques were employed.

COMPARISON: None available.

FINDINGS:

CHEST:

Lungs: Evaluation lung bases is hindered by extensive respiratory

motion artifact. There is patchy left greater than right bilateral

lower lobe consolidations, consistent with pneumonia and/or

atelectasis. The upper lobes appear clear.

Mediastinum/Hila: There is mild cardiomegaly. Aortic valvular

calcifications are noted. Calcified plaque is seen in the aortic arch.

No mediastinal or hilar adenopathy. Tracheostomy tube appears in

satisfactory position.

Pleura: Tiny left pleural effusion.

Chest Wall: Right-sided VP shunt catheter is seen in the subcutaneous

right anterior chest wall, terminating in the right upper quadrant of

the abdomen.

ABDOMEN:

Liver: Normal size and homogeneous, without focal suspicious

parenchymal lesion.

Gallbladder/Bile Ducts: Few tiny calcified gallstones are seen

layering in the gallbladder, which otherwise appears unremarkable.

There is no biliary dilation.

Pancreas: The pancreas appears normal.

Spleen: The spleen appears normal.

Adrenals: The adrenal glands appear normal.

Kidneys: 3.3 cm simple left upper pole renal cyst. No hydronephrosis

or nephrolithiasis.

Bowel: Numerous colonic diverticuli are noted, without CT evidence of

acute diverticulitis.

Mesentery/Omentum/Peritoneum: The mesentery, omentum and peritoneum

appear normal.

Lymph Nodes: Lymph nodes appear normal. No adenopathy.

Vessels: Calcified plaque in the abdominal aorta, without evidence of

aneurysm.

Abdominal Wall: The abdominal wall appears normal.

PELVIS: Unremarkable urinary bladder. Unremarkable prostate gland. No

free air. No free fluid.

Printed on 6/8/2017 9:37 AM Page 1

GOOD SAMARITAN MEDICAL CENTER

200 Exempla Cir

Lafayette CO 80026

FREDRICK,GERALD W

MRN: S0406306

DOB: 2/28/1940, Sex: M

Adm: 6/6/2017, D/C: 6/6/2017

CT Chest Abdomen And Pelvis Wo Contrast [213904399]

(continued)

Resulted: 06/06/17 1617, Result status: Final

result

BONES: Multilevel degenerative changes in the lumbar spine are noted.

No destructive bony lytic or sclerotic osseous lesion.

IMPRESSION:

1. Patchy bilateral lower lobe left greater than right

consolidations, possibly representing atelectasis and/or pneumonia.

Evaluation of these regions are hindered by extensive respiratory

motion artifacts. Underlying mass, while considered less likely cannot

entirely be excluded. Follow-up chest CT suggested after resolution of

acute symptoms.

2. Right-sided VP shunt apparently in satisfactory position, tip

terminating right upper quadrant.

3. Cholelithiasis, without CT evidence of acute cholecystitis.

4. Diverticulosis, without CT evidence of acute diverticulitis.

THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED:

 MD

6/6/2017 4:17 PM

Contributed By:

Printed

What do you see in this report? 

as compared to the initial finding in February?

 

02/19/2017 6:16 PM

Ordered By:

, MD

Result Status:

Final result

 

CT ABDOMEN AND PELVIS WO CONTRAST - Details

 

About This Test

The My Chart portal may not provide a complete representation of the laboratory test results in your medical record. 
If you have questions, please contact your physician. If the report is not complete, you may contact Health Information Management for a complete report.

·        Details

Narrative

HISTORY:
76M. Diarrhea. Noncontrast CT abdomen and pelvis with coronal
and sagittal reformats.
FINDINGS:
Mild basilar atelectasis.
Mild cardiomegaly.
Right abdominal ventriculoperitoneal shunt partially seen
extending along the liver.
Dependent cholelithiasis without pericholecystic inflammation.
Unremarkable spleen, adrenals, pancreas.
Retroperitoneal lipomatosis with mildly atretic kidneys.
Left renal 3.3 cm hypodense lesion with indeterminate density.
Diffuse fluid-filled stomach, small bowel, and large bowel
without evidence of obstruction compatible with infectious
gastroenteritis/enterocolitis and diarrhea.
Normal appendix, axial image 64.
Distal colonic diverticulosis without diverticulitis.
Central mesenteric misty appearance with subcentimeter lymph
nodes.
Unremarkable bladder.
No free fluid or free air.
Small fat-containing inguinal hernia is without inflammation.
Bowel seen immediately deep to the umbilicus.
No acute osseous finding.
IMPRESSION:
1. Diffuse fluid-filled stomach and bowel compatible with
infectious gastroenteritis or enterocolitis.
2. Indeterminate left renal 3.3 cm lesion, most, a hyperdense
cyst. Recommend all sound further evaluate if not stable on
prior exams.
3. Cholelithiasis.
4. Central mesenteric misty appearance with subcentimeter lymph
nodes most commonly associated with mesenteric panniculitis or
sclerosing mesenteritis. Consider 6 month follow-up CT abdomen.

 

Component Results

There is no component information for this result.

General Information

Collected:

02/19/2017 7:02 PM

Resulted:

02/19/2017 7:02 PM

Ordered By:

 MD

Result Status:

Final result

Help Please!!!!

Blood Testing

KAPPA/LAMBDA LIGHT CHAINS FREE WITH RATIO, SERUM
KAPPA LIGHT CHAIN, FREE, SERUM Reference Range: 3.3-19.4 (mg/L)     Actual  41.3 H


LAMBDA LIGHT CHAIN, FREE, SERUM Reference Range: 5.7-26.3 (mg/L)  Actual   24.2
KAPPA/LAMBDA LIGHT CHAINS FREE WITH RATIO, SERUM Reference Range: 0.26-1.65  Actual   1.71 H

 

DOB: 02/28/1940
Sex: M
Phone: 
Patient ID: 
Age: 77
Fasting:
Specimen: KS400824A
Requisition: 7737005
Report Status: FINAL / SEE REPORT
Collected: 05/31/2017 17:19
Received: 06/02/2017 06:23
Reported: 06/09/2017 05:21
Client #: 70300946

Quest, Quest Diagnostics, the associated logo, Nichols Institute, Interactive Insights and all associated Quest Diagnostics marks are the registered trademarks of Quest Diagnostics. All third party marks - '®' and '™' - are the
property of their respective owners. Privacy policy can be found at: http://questdiagnostics.com/home/privacy-policy/online-privacy.html. © 2017 Quest Diagnostics Incorporated. All rights reserved.

These results have been sent to the person that ordered the tests. Your receipt of these results should not be viewed as medical advice and is not meant to
replace discussion with your doctor or other healthcare professional.
Performing Sites
AMD Quest Diagnostics/Nichols Chantilly-Chantilly VA, 14225 Newbrook Drive, Chantilly, VA 20151-2228 Laboratory Director: Patrick W Mason M.D.,PhD
EZ Quest Diagnostics/Nichols SJC-San Juan Capistrano,, 33608 Ortega Hwy, San Juan Capistrano, CA 92675-2042 Laboratory Director: Jon Nakamoto
MD,PhD
THYROGLOBULIN
THYROGLOBULIN Reference Range: <0.1 (ng/mL)
Reference range applies to differentiated thyroid
cancer patients following treatment. The presence of
measurable thyroglobulin indicates the presence of
thyroglobulin-producing thyroid tissue. Clinical
correlation is advised.
This test was performed using the Beckman Coulter
Chemiluminescent method. Values obtained from
different assay methods cannot be used interchangeably.
Thyroglobulin levels, regardless
of value, should not be interpreted as absolute
evidence of the presence or absence of disease.
THYROID CANCER (THYROGLOBULIN) MONITOR
THYROGLOBULIN ANTIBODY Reference Range: <=1 (IU/mL)
This Thyroglobulin antibody test was performed
using the Beckman Coulter Immunoenzymatic method.
Values obtained from different assay methods cannot be
used interchangeably. Thyroglobulin antibody levels,
regardless of value, should not be interpreted as
absolute evidence of the presence or absence of
disease.
If the sample contains anti-thyroglobulin antibodies
of greater than 1 IU/mL, the presence of these
autoantibodies may cause falsely low thyroglobulin
values.
SEROTONIN, SERUM
SEROTONIN, SERUM Reference Range: 56-244 (ng/mL)
This test was developed and its analytical performance
characteristics have been determined by Quest Diagnostics
Nichols Institute San Juan Capistrano. It has not been
cleared or approved by FDA. This assay has been validated
pursuant to the CLIA regulations and is used for clinical
purposes.
10.4 H


Performing Location Name/Address:
DENVER VA MEDICAL CENTER 
Lab Test: Immunogloblin Panel NOS
Lab Type: Chemistry/Hematology Ordering
Provider:

Specimen: Serum (substance) Ordering
Location:
DENVER VA
MEDICAL CENTER
Date/Time Collected: 29 Mar 2017 @ 1525 Collected
Location:

Test Name Result Units Reference Range Status Performing
Location
IGA 464 High mg/dL (79-356) Final DENVER VA


And last but not least  Pulmonary

15 Mar 2017 @ 1328
Note Title: CHEST CLINIC CONSULT REPORT (T)
Location: VA Eastrn Colrado HlthCare Sy
Signed By: 
Date/Time Signed: 15 Mar 2017 @ 1717
Note
LOCAL TITLE: CHEST CLINIC CONSULT REPORT (T)
STANDARD TITLE: PULMONARY OUTPATIENT CONSULT
DATE OF NOTE: MAR 15, 2017@13:28 ENTRY DATE: MAR 15, 2017@13:28:53
AUTHOR: 
URGENCY: STATUS: COMPLETED
REASON FOR CONSULT: Suppressive therapy
Mr. is a 77 yo man with a history as below presents for initial care.
Doing ok right now. Has been having wheezing intermittently which improves with
budesonide and duonebs. Uses vent at night (BiPAP 25/5 with 8LPM bleed in) and
is on oxygen during the day 2-2.5 LPM TTO. Continues to have a chronic
productive cough of thick, yellow sputum through his trach. No recent blood. No
recent fevers > 100.4, chills or night sweats. No nausea, vomiting or
abdominal
pain. Had a bout of diarrhea that resolved early Feb 2017.
Per Linda, his wife, started developing breathing trouble and was diagnosed with
COPD in 2000. Since then, he had been experiencing shortness of breath with
exertion and treated albuterol PRN. Subsequently, had a cerebellar dural AVM
rupture complicated by chronic hypoventilation necessitating a tracheostomy. He
has since then developed multiple infections with most recent sputum cultures
5/2015 growing klebsiella, psuedomonas, and stenotrophomonas.
He has since been hospitalized multiple times for pneumonia, (twice in the last
year). Since 2008, has had approximately 27-28 hospitalizations.
FREDRICK, GERALD WALTER CONFIDENTIAL Page 9 of 18
Up about 8 lbs since 12/2016. Oxygen levels have been stable.
Per St. Joes discharge (2/2017):
"Mr. Fredrick is a 76yr old male who presented with COPD exacerbation with
thick
mucous and wheezing, complicating his tenuous resp status with chronic resp
failure from prior ICH, requiring trans-trach O2 and nocturnal vent at
baseline. He actually was only modestly ill with this, afebrile and without
sepsis. Started on IV steroids and frequent nebs along with supportive care. His
initial CXR was read as LLL pneumonia. WBC and procalcitonin was negative,
however. Subsequent resp pathogens panel was pos for RSV. His abx were stopped.
He improved with respect to his wheezing and was stronger on am of discharge as
well. Felt to be safe going home with the excellent care from his wife."
MEDICAL HISTORY:
?COPD although no history of smoking, but hx of occupational exposure.
Cerebellar dural AVM s/p hemorrhage 2008 necessitating tracheostomy due to
chronic hypoventilation
Chronic bacterial colonization due to hypoventilation with 2 hospitalizations in
the past year
Arteriosclerosis.
? possible pleural plaque related to asbestos exposure.
Tics
Social history:
Worked with a lot of tanks in Fort Knox and had significant exposure to fumes
and probably asbestos and herbicides, Was an artillery tank mechanical. Army 1962-1964.
Reserves for four years after that. Baggage handler for United after that.
Smoking: Never smoker
Alcohol: Rarely
Drugs: None
Family history:
None

TEST RESULTS:
CT Hi-res 3/12/17
Impression:
Consolidations at both lung bases, infection not excluded
Coronary artery calcification.
Cardiomegaly
Tracheostomy tube
VITAL SIGNS:
Temp:97.2 F [36.2 C] (12/30/2016 13:10)
Pulse:63 (12/30/2016 13:10)
Resp:20 (12/30/2016 13:10)
BP:102/62 (12/30/2016 13:10)
Height:71 in [180.3 cm] (12/30/2016 13:10)
Weight:231.7 lb [105.3 kg] (02/22/2017 13:11)
Pain:7 (12/30/2016 13:10)
Pulse Ox rest:
" " walk:
PHYSICAL EXAM:
Gen: Male


 

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3 answers to this question

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  • 1

I tried to find any past posts from you on google and an entry into my profile here turned up.

It seems you are the wife of the veteran...?

Can you post the IMO from Dr. Ellis here?

Has the VA rejected this IMO or is your husband still in the appeals process due to the recent C & P exam?

Can you tell us exactly what disability(ies) he is claiming?

The C & P exam states:

"Worked with a lot of tanks in Fort Knox and had significant exposure to fumes
and probably asbestos and herbicides, Was an artillery tank mechanical. Army 1962-1964.
Reserves for four years after that. Baggage handler for United after that."

Does the VA  have as evidence, a documented statement made by the Chief of Environmental Command, that you mentioned as to the 1962-1962 spraying at Ft Knox? Was your husband tyhere between 1962-1963?

 

I will focus solely on the stroke.I assume the stroke was formally claimed as secondary to the 10% ---if the 10% SC is for HBP. ?

Does the VA have (whether from private doctors or VA health care) significant changes in his HBP, in spite of HBP meds?

What meds and dosage was he on for the HBP?

Do his VA medical records reveal the stroke was due to HBP?

Did Dr Ellis cite any asbtracts or literature regarding the fact that HBP can cause stroke?

Dr Ellis stated he had suffered a " cerebral hemorrhage to left superior petrosal sinus dural arteriovenous fistula".

I suggest you use the search feature I just used:

https://www.google.com/search?rlz=1C1CHBF_enUS695US695&q=hign+blood+pressure+cause+of++cerebral+hemorrhage+to+left+superior+petrosal+sinus+dural+arteriovenous+fistula&oq=hign+blood+pressure+cause+of++cerebral+hemorrhage+to+left+superior+petrosal+sinus+dural+arteriovenous+fistula&gs_l=psy-ab.12...71730.85365.0.88001.40.31.0.0.0.0.1034.3761.6-2j2.4.0....0...1.1.64.psy-ab..37.0.0.tDQLWys7R_U

to bolster Dr. Ellis's opinion as to how HBP cause cause this type of catastrophic stroke..

You could find 2 or 3 three good medical references from good sources and have your VSO ( or yourself) send then to the VA in support of the claim ( which I assume is still pending and has not been denied).

My husband had a catastrophic stroke due to VA health vcare itself. His HBP was inproperly treated and he was given another med for 6 years prior to his death, for a condition I found that he did not even have, and this med contraindicated the HBP med (which was at the  wrong dosage anyhow, and VA agreed that these medical errors ( among others) had contributed to his death.

But my point is that I had to take VA step by step ,in proving why his HBP increased to the point of causing his stroke ( it was not a hemorrhagic stroke but due to IHD and DMIi (AO) as an ischemic stroke.

I did not have an IMO but I bolstered my lay medical opinion with documented facts within his VA medical records, and also with numerous abstracts from solid medical sources ( VA used Merck in those days, so I too used Merck as evidence)that proved that undertreated HBP, or untreated HBP, or HBP meds contraindicated by other meds that made them ineffective, caused my husband's catastrophic stroke.

I also had proved that he had muptiple TIAs, leading up to this stroke, and many ER visits etc etc etc and they agreedthat their malpractice ( on his stroke and other conditions) had caused his death.

My point is that I see no abstracts or citations at all from Dr Ellis in the scanned opinions on anything.

Dr Ellis , as far as I know is not a Neurologist,so this is why I suggest you use the search link above and carefully find any abstracts or studies that prove the fact that the 10% HBP caused the major CVA.

 

 

Others can read the IMO from Dr Ellis here in my profile as to the other claims and opine on them:

https://community.hadit.com/profile/20390-lfredrick123/?do=content&type=core_statuses_reply&change_section=1

I dont read stuff posted in my profile and dont know how long it was there.

It came up when I googled your handle  and hadit.com

Edited by Berta
added mor info

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One other question-

was the dural arteriovenas fistula discovered due to a  catheter cerebral (brain) angiography, prior to his stroke?

was he ever diagnosed with pusatile tinnitus - meaning a loud swishing noise in his ear?

well 3 questions

Did Dr Ellis determine that his VA medical care for the HBP or any NSC condition was proper?

gee another question-was he ever treated by VA for a seizure of unknown cause?

 

 

 

Edited by Berta

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Hi Berta. Thank you for your help. We originally filed the claim for CVA/Stroke due to HTN which is what Dr Ellis wrote. The Dural AV Fistula we believe was formed due to the head injury he had that wasnt treated but the cut to his hand that nearly severd his fingers was service connected for 10%. In 1962 unless you were knocked totally out unconscious they paid little attention to a head wack. So he never got it treated just the fingers sutured back together. He got that without any difficulty because I had a small notation of it in his record but nothing on the head bump. I am told that while AVMs are considered congenital they can form from a head trauma. We never knew he had it until the stroke.

I am the veterans wife and 24hr caregiver. He had complained for as long as I knew him of headaches and pain in his neck and shoulder. He also had tinnitus that for him was a buzzing. The C and P examiner asked him about ringing. He tried to tell her he had buzzing and no ringing, and he had many years of problems trying to pop his ears. She just ignored what he said basically. The swooshing could have been pulsitile they never addressed it, could also explain why he had long stand fluid in the mastoid air cells. 

We are still waiting on DRO/Appeal now over 2 years for that. The HTN we believe started in Service when they were doing heavy spraying of Herbicides and Insecticides, Heavy breathing of Diesel exhaust and fumes, and solvents he used on his work assignment. It is very clear the HTN was not well controlled until after the stroke, and as I said I have statements from others that show he had the exposures and the environment he was in. likewise I tracked down the now retired Colonel who was in charge of public works and he sent me a statement that they had been using DDT.Chlordane, Lindane, 2.4.5T + 2,4,D (Brush Killer) , Malathion, Diazinon, Silvex, and Nicotine Sulfate. Benzene in the Diesel and solvents, and of course Triclorethane and PCB.

The tanks contained asbestos and silica that came from the churning of soils by the tracks, on the Tanks, and was found as fireproofing on their components and fire blankets. The buildings were laced with it and in Germany were falling apart due to the age they were, not to mention the heat stoves they had. Just an enormous mess of exposures to things, I also found that in Germany they were using HIDAL sub kits for spraying of vectors, so it was airborn. That along with Industial Hygiene surveys that showed big concerns from 1956-64.

We have stroke of course, CAD. A Fib, Chronic Obstuctive Lung Disease, (Asbestos),HTN, ED. Loss of use for both legs and arms, headaches, and hearing loss/ tinnitus. I did post the IMO here to Bronco Vet and its a link to open it. I will open it again here for you at the end of this.

The fistuala was discovered when  he had the stroke that blocked the petrosal sinus and the cerebellar hematoma not just hemorrhage during a cerebral arteriogram. They then did the emboliztion to stop the bleed, and the neurosurgeon went in to remove as he called it the biggest blood clot he has ever seen in 43 years of neurosurgery. This clearly is what caused the veins to block and rupture. The exposures are what broke the veins down to begin with.

The VA does have a written statement from the Chief from another case in a 2001 BVA decision I found. It was from that that I tracked him backwars myself because VA and DOD kept denying it. I found it all on my own without their help. I sought the surveys, and I researched every single thing I could find. I had a toxicologist explain the link and health effects and I found many peer studies on the issues, and have given VA the info. Still waiting. He was there at the very time the surveys were done. and he was in Germany when the HIDAL sprayers were in use.

Dr Ellis sent along several peer studies, we had the Toxicologist review, and opine on the chemicals in use. As well as numerous articles on Carbon Monoxide,Diesel, Triclorethane and of course the Pesticides .

 I have affidavits from other lay persons who knew all this, and soldiers who also experienced it. So I think they have plenty on it and its connection to it.

Here is Dr Ellis' opinion that I redacted.

November 20, 2015

--------------------------------

Re: --------------------------

VA Fe: ------------------------ DOB: ----------- Sex: Male

Expert Medical Opinion Concerning Service Connected Disability         

 

Department of Veterans Affairs:

 

This veteran served honorably in the United States Army from 5/8/1962 to 5/11/1964 and then four years in the Ready Reserves.

 

In May of 2008, Mr. ----------- had a stroke and has a tracheostomy and is not able to talk.

He is in a wheel chair and is not able to come to be examined. His wife, ------- has power

of attorney. My following opinions are based upon my phone conversation with --------------and review of medical records 18.1 cm thick.

 

He was in good health when he went into the United States Army. He served in the Tank

Corps as a turret artillery repairman.

 

 

SERVICE CONNECTED INJURIES, DISEASES and CONDITIONS

 

HYPERTENSION AND STROKE:

 

His military service records indicate that on 3/13/62, at the age of 22, his blood pressure

was 140190 and after exercise, 144/84. The medical records indicate that he continued to have high blood pressure after the military.  He was treated for his hypertension.

 

In May of 2008, he suffered a large cerebral hemorrhage secondary to a left superior

petrosal sinus dural arteriovenous fistula. The stroke was devastating. He is in a

wheelchair with tracheostomy. He is home bound and needs constant care.

 

Service Connected Diagnoses:

7007 Hypertension.

8009 Hemorrhage of Brain Vessels.

 

Service Connected Disability:

10% 7007 Hypertension.

100% 8009 Hemorrhage of Brain Vessels.

 

11302015 - VA Claims Intake Center, Janesville WI

BEST COPY

Nov 30 15 08:30a VFW Dept of  __SVC Office ____________________

__________, M.D. November 20, 2015

 

Re: _______________) Opinion Concerning Service Connected Disability

 

Causal Relationship and Connectedness to Military Service:

It is my medical opinion, that it is more likely than not, that the blood pressure of 140/90

is objective proof that this service man at the young age of 22 had high blood pressure

while in military service. It is my medical opinion, that it is more likely than not, that the

continued hypertension caused increased pressure in the  Blood vessels of the brain which caused abnormal anatomical changes in the blood vessels in the brain. It is my medical opinion, that it is more likely than not that the said abnormal  changes in the blood vessels in the brain and the hypertension caused the vessels to bleed pouring blood into this veteran’s brain tissue causing the May 2008, cerebrovascular accident (stroke) and permanent brain damage.

 

It is my medical opinion that it is more likely than not that service connected stroke has

made this veteran home bound and in need of special adaptation for home bound care.

 

RESTRICTIVE LUNG DISEASE/CHRONJC OBSTRUCTIVE PULMONARY DISEASE:

 

While in the service he was frequently around volatile hydrocarbons such as diesel fumes,oils and solvents. He developed shortness of breath while in the service. The medical records show that he had continued worsening of his shortness of breath after the service.

 

Service Connected Diagnosis:

6604  Chronic Obstructive Pulmonary Disease with Restrictive Component.

Service Connected Disability: 30%

 

 6604 Chronic Obstructive Pulmonary Disease with Restrictive Component.

Causal Relationship and Connectedness to Military Service

 

It is my medical opinion, that it is more likely than not, that this veterans exposures

volatile hydrocarbons while in the tank corps caused injury to his lung tissues and causing chronic obstructive pulmonary disease and restrictive lung disease. This veteran never smoked. He has not been around any other type of smoke, fumes or chemicals that could cause the injury to his lungs. It takes very little exposure to volatile hydrocarbons to cause lung damage. For example, if a child ingests hydrocarbons such as gasoline or oil, the treatment is to not induce vomiting but let the material go on through the alimentary system. Even the very small amount of fumes from vomiting can cause further damage to the lungs.

 

NOISE INDUCED HEARING LOSS and TINNITUS:

 

This veteran was in the Tank Corps. He was around the

as around other equipment. He was also around artillery

in the service.

Service Connected Diagnoses:

6100 Noise Induced Hearing Loss.

6260 Noise Induced Tinnitus.

 

 

 

 

Service Connected Disability

0% 6100 Noise Induced Hearing Loss.

10% 6260 Noise Induced Tinnitus

 

11302015 - VA Claims Intake Center, Janesville WI

BEST COPY

Nov 30 15 08:29a VFW Dept of -- SVC Office --------- p.3

----------, M.D. November 20, 2015

Re----------------- Medical Opinion Concerning Service Connected Disability

 

 

Causal Relationship and Connectedness to Military Service:

It is my medical opinion, that it is more likely than not that this veteran was frequently

around noises louder than 95 decibels while in tanks and around artillery. Whenever the

noise level is so loud that a normal conversation cannot be carried on, it is over 90 to 95

decibels. if one has to shout, it is definitely over 95 decibels.

 

It is my medical opinion, that it is more likely than not, that his noise exposures in the

service caused injury to the hearing cells in his ears and caused noise induced tinnitus and

noise induced hearing loss. That his noise induced hearing loss is currently rated at 0%,

does not mean that he does not have noise induced hearing loss. it only means that his

injured hearing cells have not yet caused enough hearing loss to be rated.

 

RECORDS REVIEWED:

Attached is the ------------------ list of records reviewed. The records are 18.1 cm

Thick.

 

MEDICAL OPINION and CAUSE of INJURY:

My medical opinions are based upon my examination of the veteran, review of medical

and/or service records, my education training and experience and upon reasonable

medical probability and reasonable medical certainty. It is my medical opinion that the

injuries, impairments and disabilities set forth in my diagnosis and computation of service connected disability were, more likely than not, due to and consequence of this veteran’s military service.

 

Respectfully,

 

_____________ MD.

Curriculum Vitae Summary (For full ci go to www.EllisClinic.com)

Fellowships:

American College of Occupational I and Environmental Medicine

American College of Family Physicians

Board Certifications:

American Board of Family Medicine

American Board of Environmental medicine

Professional Certifications;

Certified Forensic Consultant, CFCa

Board Certified, American Board of Forensic Examiners

Board Certified, American Board of Forensic Medicine

Board Certified. American Board of Independent Medical Examiners

Fellow, American Board of Disability AnaIysists

JEJrI:va File Yrtl2O5.freg2O.1 12O1wpcJ

 

Enclosures:

1. List of Records Reviewed

2. Curricuum Vitae of --------------MD

 

 

 

 

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    • VBA testimony and GAO report-C & P examiners
      As you all know, C & P exam results control almost all types of claims. VA employees have no choice but to go along with a negative C & P exam that will deny a claim. Some vets are quite willing to rebutt faulty exams and ask for a new C & P exam. For others, it will take a costly IMO/IME in most cases. Ben Krause has this article at his site today: http://tinyurl.com/y9co6zac
      • 9 replies
    • Lumbosacral Strain and Vertebrae fractures caused by osteopenia
      Hi.  I have a couple questions and welcome all recommendations for my disability claim.  I am currently 10% disabled for lumbosacral strain and deferred decision for this and vertebrae fractures caused by osteopenia.  I had a MRI February 2018 and results include moderate compression fracture of L1, mild to moderate compression fracture of L2, moderate to severe compression fracture of L3, mild compression fracture of T11.  Additionally, L3 moderate spinal canal stenosis, L2 mild to moderate retropulsion with mild spinal canal stenosis, multilevel degenerative changes, multilevel disc bulges, disc herniations, L1-L2 mild broad-based disc bulge with mild spinal canal stenosis, L2-L3 mild broad based disc bulge with mild to moderate spinal canal stenosis,  L3-L4 mild to moderate broad based disc bulge and severe bilateral neuroforaminal narrowing.   I have read that these malfunctions should have been claimed individually.  Will the VA evaluate/rate each condition separately?  If not, I may have to appeal or submit a new claim.  What are some thoughts and suggestions.  Do these disabilities belong in the lumbosacral strain or the vertebrae fractures caused by osteopenia.  I am totally in the dark on this stuff.  I am pretty sure no diagnosis codes have been assigned.  What can I do to support my claim?  HELP!!!!!
      • 2 replies
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 1 reply
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 1 reply
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    • Sleep apnea- does the DBQ cover the "medically necessary/required" language?
      Hey everybody! Long time lurker, first time poster.

      My question is regarding the sleep apnea language that specifies that a prescription of a breathing assistance device is "medically necessary" for a 50% rating:

      Assuming that a vet is already prescribed a CPAP/APAP by the VA, does the sleep apnea DBQ portion under 2B "IS CONTINUOUS MEDICATION REQUIRED FOR CONTROL OF A SLEEP DISORDER CONDITION?" fulfill that language requirement?
      • 27 replies
    • VBA testimony and GAO report-C & P examiners
      As you all know, C & P exam results control almost all types of claims. VA employees have no choice but to go along with a negative C & P exam that will deny a claim. Some vets are quite willing to rebutt faulty exams and ask for a new C & P exam. For others, it will take a costly IMO/IME in most cases. Ben Krause has this article at his site today: http://tinyurl.com/y9co6zac
      • 9 replies
    • Lumbosacral Strain and Vertebrae fractures caused by osteopenia
      Hi.  I have a couple questions and welcome all recommendations for my disability claim.  I am currently 10% disabled for lumbosacral strain and deferred decision for this and vertebrae fractures caused by osteopenia.  I had a MRI February 2018 and results include moderate compression fracture of L1, mild to moderate compression fracture of L2, moderate to severe compression fracture of L3, mild compression fracture of T11.  Additionally, L3 moderate spinal canal stenosis, L2 mild to moderate retropulsion with mild spinal canal stenosis, multilevel degenerative changes, multilevel disc bulges, disc herniations, L1-L2 mild broad-based disc bulge with mild spinal canal stenosis, L2-L3 mild broad based disc bulge with mild to moderate spinal canal stenosis,  L3-L4 mild to moderate broad based disc bulge and severe bilateral neuroforaminal narrowing.   I have read that these malfunctions should have been claimed individually.  Will the VA evaluate/rate each condition separately?  If not, I may have to appeal or submit a new claim.  What are some thoughts and suggestions.  Do these disabilities belong in the lumbosacral strain or the vertebrae fractures caused by osteopenia.  I am totally in the dark on this stuff.  I am pretty sure no diagnosis codes have been assigned.  What can I do to support my claim?  HELP!!!!!
      • 2 replies
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 1 reply
    • Ignore Members Who Annoy You - How To
      How To Ignore Members Who Annoy You

      I'd love it if we all got along, no one had a bad day and everyone respected each other however, living in the real world it just doesn't work that way.

      If you find a member adds no value to your knowledge on a topic hover over their name and then choose Ignore User. You cannot ignore moderators and admins but you can ignore others.

      Thousands of veterans have come here for over 20 years to find answers and support. I wish we could help each and every veteran, but some we cannot. Sometimes folks just rub each other the wrong way and that is where the Ignore User feature comes in. Ignore the user and move on...
      • 1 reply
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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
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  • Most Common VA Disabilities Claimed for Compensation:   

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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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