Did he just service connect me for RA?

[Jessamine]

Hey all. You guys were amazing and so helpful when I went through my last C&P exam so I figured I would try my luck again.

 

Short story is I was medboarded out in 2004 for a rather nastu ankle fracture that was misdiagnosed as a sprain for 2 months at Fort Gordon. So i was reading through my most recent c&p expecting it to be tanked again and he closed the report with

 

"Upon review of this case, it becomes apparent that the multiple joint complains while AD are consistent with Rheumatoid arthritis even though it wasn't diagnosed on active duty. This is conformed by records reviewed by  DOCTOR DOCTOR dated 3/16/18. 

 

Veteran has been seen and evaluated by an outside rheumatologist and hasbeen diagnosed. Treatment started in 2018"

He was only doing a knee and ankle c&p and he mentioned both hips, feet, ankles, knees, etc. So I'm shocked. Does this mean what I think it does? 

[Jessamine]

11 hours ago, doc25 said:

It looks to me like an inadequate C&P exam. The examiner clearly and unmistakably fails to use the legal terminology to substantiate your claim.

I don't see the minimum threshold of "at least as likely as not" the veteran's condition is due to or the result of military service/SC condition. The rationale is insufficient.

This will most likely delay the process and will get sent back to the examiner for clarification. It's not a granted or denied claim. That's the good news.

If it does get denied. You'll need to appeal immeadiately on the basis that the examiner failed to provide the legal terminology to substantiate your claim.

 

Drat, I was hoping to kill to birds with one stone. This C&P wasn't for RA at all, it was for the ankles, feet and knees, but since he kept going back to the RA repeatedly, I was hopeful since the DAV ended up putting one in for me. Hopefully this one is still good for what it was intended for? Eeek, I am so glad that I have additional IMO's and DBQ's just in case this isn't enough to at least increase the ankle, and connect the feet and knee. Thank you for your help!

[Jessamine]

17 hours ago, vetquest said:

I really appreciate how the VA is able to miss records that are in our favor.  If your records that are referenced as missing are important I would get with your VSO and resubmit them.  Even so, when your case is completed by the RO look to see if these records were included in evidence used to make decision.  That could be the basis of a CUE.  I know it is a little late but it is good to have these records available at a C&P incase the doctor says he does not have them. 

Reading the exams the doctor states "Upon review for this case, it becomes apparent that the multiple joint complaints while AD are consistent with Rheumatoid Arthritis even though it was not diagnosed while active duty."  This sounds like a good exam where the doctor is trying to say you had RA in service.  I think the doctor is new to the VA and how they do things though.  A really good statement would be something like "it is more likely then not".  They are trying to relate your RA to service in my opinion but we do not know if the raters know how to read when it is not in their preferred format.  The second issue I see with your C&P is that the examiner notes that pain is your most prevalent feature.  The VA is supposed to take this into consideration but they do not recognize pain a lot of times.  If you have strong civilian evidence that is a good thing.  Does your civilian doctor state you had RA in service?  If they do it would be nice to see if they are willing to state "it is more likely then not that the Veteran had RA in service" in a DBQ or IMO.

Buck, Broncovet?

Right? What is so disheartening is I know they were given surgical reports and xrays repeatedly, so the wording he uses makes me feel a bit less good about it. I mean, technically it wasn't for the RA, it was ankle increase, feet and a knee, but I got hopeful lol. My regular doc is a gem, his DBQ's (he's done one annually for the past 2 years, with xrays too) are very strong and he even flat out stated the misdianosis of a fracture as a sprain would be malpractice in any other scenario. I was emailing DAV first thing this morning asking them to resubmit everything again. I am nervous now as to whether this C&P is adequate for it's intended purpose. I am also nervous to return the 5103 response saying "no additional evidence" for the separate claim that actually is for RA, if their c&p dude can't see it. Thank you so much for your help in navigating all of this messiness. 

[vetquest]

I cannot stress how important it is to have a doctor state it is more than likely than not that your RA is related to your ankle injury that occurred in service.  If he is out for your best interests he should add this to your DBQ or IMO.  Your C&P examiner eluded to this but did not come out and say it but if your doctor is willing to say this it brings up reasonable doubt and that is supposed to be done in the veteran's best interest.  Please speak to your doctor and see if he is willing to add this.

[Jessamine]

1 minute ago, vetquest said:

I cannot stress how important it is to have a doctor state it is more than likely than not that your RA is related to your ankle injury that occurred in service.  If he is out for your best interests he should add this to your DBQ or IMO.  Your C&P examiner eluded to this but did not come out and say it but if your doctor is willing to say this it brings up reasonable doubt and that is supposed to be done in the veteran's best interest.  Please speak to your doctor and see if he is willing to add this.

I was very lucky with Dr. R, he did use that phrasing in 3 of the 4 (he did them for Fibro & RA), and on the 3rd one he said it was "unquestionably caused by medical negligence and a misdiagnosis of a fracture, thus delayed critical treatment while in service". I don't know how his will hold up against this guy's, since he is their chief c&p examiner, but I am hoping well.  I will reach out and see if he can amend his 4th one for consistency. Thank you so much! Hopefully there is a light at the end of the tunnel somewhere. LOL my meds are more than my mortgage at this point

[vetquest]

That is great, when there are two conflicting medical opinions they are supposed to resolve reasonable doubt in the favor of the veteran.  The RO might not do this but BVA usually does, not that you want to have to go that far.

[bigoc]

Just found this topic.  Interestingly I had a similar experience with joints other than SC being being mentioned in a 2015 C&P.  I am rated for RA under 5002 for both feet, left wrist, and right hand.  I opened an increase April of 2019 for the rated conditions.  In August I called to check and found out I was being evaluated for my right shoulder.  I never claimed it even though I should have. I never saw this mentioned in my 2015 C&P.  This 2015 exam shows bilateral joint involvement in the feet, ankles, wrists, hands, knees, and shoulders.   

I am thinking this is from an "inferred" issue.  I found that the VA is supposed to consider all possible service connected claims even if not formally requested.  If you have claimed a condition and then mention something else  related or the exam or testing finds something else that could be service connected the VA is supposed to investigate and connect if possible.  

Bottom line is I am filling for these other conditions once the final decision is in on my current claim.

I went through Gordon in 2002 for communications.  I would not want to be stuck there any longer than AIT demanded.  Training bases suck.