Question about opening a new claim

[toomnyhats]

I have a few separate questions.

I was granted 100% P&T, no exams required, along with the rest of the benefits (Chapter 35, Commisary, etc) based on cervical neck aggravation in service. We discovered later after discharge that I have a narrow spinal canal, I am now an incomplete tetraplegic with some remaining function in my left arm and not much in my right.  They granted 20% for neck with the following secondaries: 100% loss of use of legs, 70% Right Arm w/loss of use, 30% on left arm radiculopathy.  I also have an independent 60% on bladder granted almost immediately after filing my claim in 2015, because they found in my str where I had gone in for bladder spasms, however it is not listed as a secondary to the neck. I also have 10% tinnitus.

I had to have my colon removed and an ileostomy placed due to neurogenic bowel.  This was never addressed in the nod. When I mentioned it, I was told that they would see the secondaries automatically or we could file a new claim.   My neck claim never went to the board because I had two good letters (IME and IMO) stating that aggravation was more likely than not caused by service.  So after the Form 9 was filed, they eventually granted the items listed above.   My question is should I file a new claim for the neurogenic bowel.  I'm not looking at it from a monetary standpoint now, but looking at the future. If I were to get a bowel obstruction and die, my husband would not get anything since it's not service connected.  

Question number two relates to the bladder.  I'm am deteriorating in my hand and arm function to the point that it is difficult to intermittently cath.  My urologist thinks it is time to place a supra pubic catheter.  I saw somewhere that this is rated at 100%..does anyone know if that is correct? If so, then I assume the 60% for bladder would go up.  

Question 3 relates to the fact that I have loss of use of both legs, loss of use of both sphincters.  If they connect the neurogenic bowel, would that put me in the SMC O category?

And one last comment, I'm being urged not to rock the boat because there was no documentation regarding my neck, however the IMO did a great job documenting clearly why he would not expect me to seek treatment for neck pain because it typically starts at a low level (as mine did) and most people just treat it at home via OTC and heat.  There is also a steady stream of continuity of treatment starting 2 years after I was discharged.  He also specifically said that my degeneration occurred at a much more rapid pace than it would have had I not been doing the strenuous work I was doing.  I believe that, along with a great letter from my VA SCI doc plus full exam is what got me granted but I'm sure it was sitting on the fence and could have gone either way.  I am, of course very happy we avoided having to take it to the board of appeals.  So asking all the experts out there...would I be rocking the boat to request the connection of my neurogenic bowel?

Thanks much!

 

 

[Berta]

I found your  decision here:   sorry I didnt realise you had posted it at hadit

https://community.hadit.com/topic/71930-made-100-pt-have-questions/?page=4#comment-446278

 

[Berta]

I seem to think in addition to the 

"100% loss of use of the lower extremities, 30% radiculopathy - left upper extremity, 70%  loss of use of the right upper extremity" they would need to consider loss of use of hand......as lower , anatomically ,than the loss of use of the uppr right extremity....it will take me a while to think about that-and I will try to find something at BVA on that.

 

[toomnyhats]

Thanks Berta.  Regarding my right extremity...both are actually going..hand and shoulder.  I have to use special silverware to eat because my grip is minimal and I can't raise my arm above 60 degrees.  Also, interesting to me is that we the original claim was filed, it included neurogenic bowel (ileostomy and colectomy) which was of course denied because they didn't connect the neck.  When the NOD was file, nothing was put in about the bowel which it should have been included.  That is the one that is really eating at me.

toomnyhats

[toomnyhats]

Berta,

My SMC confusion.

SMC's  Pasted below. They did rate the upper extremity with loss of use of hand because it's my K.  I have extremely degenerative shoulders (R worse than left) with partial rotator cuff tears from using a manual wheelchair and using loft-strand crutches. I thought I was mostly walking with my legs but was actually walking with my shoulders.  Unfortunately nobody warned me about preservation of upper extremities. (It was not the VA - they are the ones that educated me on it but too late by then).  We don't believe the loss of function getting worse in my right hand is related to shoulders.  My hand started to deteriorate after a second surgery on C6-7 for radiculopathy on the left.  Pretty sure the cord was compressed some and continues to be intermittently pushed on.  I also don't understand why I didn't get additional K's (foot and and both buttocks).  They way I understand it, those can be given even if rated in a higher category for LOU until it gets to R and then no K's allowed.

 

 My ratings confusion is 

1) Why they didn't connect the neurogenic bowel and colectomy

2) Why they rated it as paraplegia when clearly all four extremities are involved, my level is cervical and I'm a C1 ASIA C according to my most recent annual.  I initially started out as C5 years ago and it has been steadily creeping up (probably because I have no more room in my cervical canal)

 

We've started the process of everything relating to 100% P&T  (housing grant, higher tech hand controls and new van, retro for my daughter for Chapter 35 DEA, ChampVA for my husband, ID's) and I guess hearing someone say that they could go back and decide to take the ratings away is a scary thought, especially since I felt like I was flying by the seat of my pants with nothing in my str about my neck.  But they knew that and still granted (I keep telling myself lol)

Thanks for your help with this....you guys are awesome!!

toomnyhats

 

 

[toomnyhats]

broncovet - thanks for the info.  Both #1 and #2 are what prompted me to look further into this.  My husband has been my wonderful caretaker for 15 years and he deserves everything he can get should I die before him.  I've only been service connected since 2015 so I still have 7 years to get to that 10 year mark.  I have an SMC of M.  I'm kind of a control freak so going through my VSO was tough because they don't always want to share and share info alike  But she calmed me multiple times and truly did do a great job, even though she scared me a bit about them coming back  and taking a closer look at things.  But from the beginning she was honest about this being a long shot since there was nothing in my str about my neck pain and from that long shot...here I am 100% P&T with full benefits for my family.  

[broncovet]

I would not trouble yourself about reductions unless you have "actually improved under ordinary conditions of life".  From what you posted, your conditions have worsened not improved.  Remember, that "ordinary conditions of life" means that you are working, and it does not sound like you are likely to go back to work any time soon.  This "5 year protection" for 100 percent P  and T means that its highly unlikely you will be reduced in rating.  Given that you are 100 percent P and T, both sections a and b, below, apply to you.  Read them over and this may give you confidence and decrease worry about possible reductions:

https://www.law.cornell.edu/cfr/text/38/3.344

Its my opinion that you should focus on increases that will/could result in additional compensation, and not concern yourself over issues which wont result in more money, UNLESS you feel there is a good chance of death from NSC conditions PRIOR to the 10 year mark for hubbies DIC.  

Hopefully, you have already purchased the free life insurance, your first 10,000.  https://www.benefits.va.gov/INSURANCE/disabledvet.asp   The 2 year limit applies, not to the effective date, but to the date of decision.  

Also read about DIC eligibility here:

https://benefits.va.gov/compensation/types-dependency_and_indemnity.asp   Its possible your family may become eligible in 5 years vs the full 10, but I dont know your situation and whether or not this applies to you or not.