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USMCVet13

Received my decision letter and have some questions

Question

I filed a claim for several issues. Some were approved, two were deferred, and a few were denied. I had some questions about the ones where I was denied.

First issue is for my back. The VA's letter says:

"Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. A disability which began in service or was caused by some event in service must be considered "chronic" before service connection can be granted. Service treatment records dated October 11, 2012 and November 7, 2012 show minor back pain and/or stiffness. The medical opinion we received from Dr. [my doctor] M.D. indicates you have back pain, but does not provide a diagnosis for the lumbar spine. The Department of Veterans Affairs does not consider pain to be a disability that is subject to service connection without a definitive diagnosis.

Objective findings at the VA exam reveal normal range of motion without painful motion of the thoracolumbar spine. The VA examiner informed there is insufficient pathology to support a diagnosis. Service connection for lumbar spine is denied because the evidence does not show that this condition was chronic on active duty and has persisted until the present, as a residual disability has not been clinically diagnosed."

The other two issues read more or less the same. So I think I understand why I was denied. They are saying that I need to get a diagnosis, correct? I understand that even if this is service-connected it will probably be at 0% because I still have normal ROM, and I'm fine with that. The other thing is that they didn't reference two visits I made to our BAS in 2006 and 2007 for back pain. It looks like I'll have to correct that and see my doctor again.

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You need to file a NOD.  Further, you will need the "Big 3" for service connection, as always:  

1.  Current diagnosis

2.  In service event or aggravation

3.  Nexus, or docs opinion that 1 and 2 are related.  

       To get sc for these, its likely you will need an IMO/IME that provides documentation of a diagnosis and a nexus.  You can ALSO dispute the disability percentages of issues awarded, and you can dispute the effective date if its wrong too.  

     Here is how VA rates you in this order:

1.  They deny first, ask questions later. (never). 

2.  They delay you as long as possible hoping you die first and dont get your benefits.  

3.  They lowball you on the disability percentages, and lowball you again on the effective dates.  

 

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You got denied because you don't have a diagnosis.  You may get denied because it may be deemed that your four visits to the BAS were for things that were deemed to be acute and transitory, not chronic.  Just FYI, it may happen.

 

If service connection is granted, I'd expect to see a 10.  Painful motion warrants a 10, and I assume you have pain, given that you go see a doc now for your issue.  

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