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megajunk

Please help me decipher this DBQ for Back (Thoracolumbar Spine) Conditions

Question

I recently (October 2018) made my first claim and was examined and rated @ 10% for Tinnitus.  Immediately afterwards, I received a letter from the VA stating that they had made an appointment for me for back pain that was from a claim in March of 2000.  (I left the USAF in January, 2000).  This is the result of that C&P exam.

I was also sent a letter about foot pain that I had claimed in 2000.  I ended up filling out more paperwork to explain condition, and sending in medical records from private doctors.  I believe that they combined the foot pain, and the back pain into one claim.

I cannot see anything on eBenefits regarding the status these claims since they are so old (that's what they told me). 

I am also soliciting opinions as to what the effective date for these claims would be.  

Please let me know what you think regarding this DBQ from a C&P exam:

Thank you VERY much!   

Thanks!

 

mhv_Xxxxxxxx_.pdf

Edited by megajunk
Reduce size of 1st post. Added file of back C&P exam results

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22 hours ago, megajunk said:

I recently (October 2018) made my first claim and was examined and rated @ 10% for Tinnitus.  Immediately afterwards, I received a letter from the VA stating that they had made an appointment for me for back pain that was from a claim in March of 2000.  (I left the USAF in January, 2000).  This is the result of that C&P exam.

I was also sent a letter about foot pain that I had claimed in 2000.  I ended up filling out more paperwork to explain condition, and sending in medical records from private doctors.  I believe that they combined the foot pain, and the back pain into one claim.

I cannot see anything on eBenefits regarding the status these claims since they are so old (that's what they told me). 

I am also soliciting opinions as to what the effective date for these claims would be.  

Please let me know what you think regarding this DBQ from a C&P exam:

Thank you VERY much!

    *************************************************************************
 LOCAL TITLE: COMPENSATION & PENSION EXAM                        
STANDARD TITLE: C & P EXAMINATION NOTE                          
DATE OF NOTE: DEC 21, 2018@09:30     ENTRY DATE: DEC 21, 2018@16:02:11                      
     URGENCY:                            STATUS: COMPLETED                     


                      Back (Thoracolumbar Spine) Conditions
                        Disability Benefits Questionnaire

    Name of patient/Veteran:   Xxxxxxxx XXXX
    
    Is this DBQ being completed in conjunction with a VA 21-2507, C&P 
Examination
    Request?
    [X] Yes   [ ] No
    

    ACE and Evidence Review
    -----------------------
    Indicate method used to obtain medical information to complete this 
document:
    
    [X] In-person examination
    

    Evidence Review
    ---------------
    Evidence reviewed (check all that apply):
    
    [X] VA e-folder (VBMS or Virtual VA)
    [X] CPRS


    1. Diagnosis
    ------------
    Does the Veteran now have or has he/she ever been diagnosed with a
    thoracolumbar spine (back) condition?
    [X] Yes   [ ] No

    Thoracolumbar Common Diagnoses:
        No response provided.

          Diagnosis #1:  THORACOLUMBAR STRAIN.
          ICD code:  48532005
          Date of diagnosis:  Uncertain
          
    2. Medical history
    ------------------
    a. Describe the history (including onset and course) of the Veteran's
    thoracolumbar spine (back) condition (brief summary):
       -- relates -- "I had to change really heavy parts in the bottom load of
       the air craft while I was in the military. They had these monorails but
       they didn't always work so we had to pick them up a lot of times. I can
       remember having back pain and having physical therapy in the Air Force 
and
       having to go to traction but that's all I can remember about what they
       did.  Since then I have always had back pain, upper and lower back. I 
have
       pain all the time, especially if I try to stand up for ten or more
       minutes. I can try to lean against something and put pressure and that
       seems to help. At night when I am sleeping it will wake me up with pain
       and I have to roll out of bed and walk around for a minute. I have just
       been living with the pain."

       
       
    b. Does the Veteran report flare-ups of the thoracolumbar spine (back)?
    [X] Yes   [ ] No
        If yes, document the Veteran's description of the flare-ups in his or 
her
        own words:
           see History
           

    c. Does the Veteran report having any functional loss or functional
    impairment of the thoracolumbar spine (back) (regardless of repetitive use)?
    [X] Yes   [ ] No
        If yes, document the Veteran's description of functional loss or
        functional impairment in his or her own words.
           see History
           

    3. Range of motion (ROM) and functional limitation
    --------------------------------------------------
    a. Initial range of motion
    
       [ ] All normal
       [X] Abnormal or outside of normal range
       [ ] Unable to test (please explain)
       [ ] Not indicated (please explain)
       
           Forward Flexion (0 to 90):           0 to 60 degrees
           Extension (0 to 30):                 0 to 30 degrees
           Right Lateral Flexion (0 to 30):     0 to 30 degrees
           Left Lateral Flexion (0 to 30):      0 to 30 degrees
           Right Lateral Rotation (0 to 30):    0 to 30 degrees
           Left Lateral Rotation (0 to 30):     0 to 30 degrees

           If abnormal, does the range of motion itself contribute to a
           functional loss? [ ] Yes (please explain)   [X] No

       Description of pain (select best response):
         Pain noted on exam but does not result in/cause functional loss
         
         If noted on exam, which ROM exhibited pain (select all that apply)?
           Forward Flexion
           
       Is there evidence of pain with weight bearing? [X] Yes   [ ] No
       
       Is there objective evidence of localized tenderness or pain on palpation
       of the joints or associated soft tissue of the thoracolumbar spine 
(back)?
       [ ] Yes   [X] No
       
    b. Observed repetitive use
    
       Is the Veteran able to perform repetitive use testing with at least three
       repetitions? [X] Yes   [ ] No
          Is there additional loss of function or range of motion after three
          repetitions? [ ] Yes   [X] No

    c. Repeated use over time
    
       Is the Veteran being examined immediately after repetitive use over time?
       [ ] Yes   [X] No
       
           If the examination is not being conducted immediately after 
repetitive
           use over time:
           [ ] The examination is medically consistent with the Veteran's
               statements describing functional loss with repetitive use over
               time.
           [ ] The examination is medically inconsistent with the Veteran's
               statements describing functional loss with repetitive use over
               time.  Please explain.
           [X] The examination is neither medically consistent or inconsistent
               with the Veteran's statements describing functional loss with
               repetitive use over time.
               
       Does pain, weakness, fatigability or incoordination significantly limit
       functional ability with repeated use over a period of time?
       [ ] Yes   [ ] No   [X] Unable to say w/o mere speculation
           If unable to say w/o mere speculation, please explain:

           Exam was not conducted under stated condition
           
           

    d. Flare-ups
    
       Is the exam being conducted during a flare-up? [X] Yes   [ ] No
       
       Does pain, weakness, fatigability or incoordination significantly limit
       functional ability with flare-ups?
       [X] Yes   [ ] No   [ ] Unable to say w/o mere speculation
           Select all factors that cause this functional loss:
             Pain
             
           Able to describe in terms of range of motion: [ ] Yes   [X] No
              If no, please describe:
              No change in ROM
              
              

    e. Guarding and muscle spasm
    
       Does the Veteran have guarding or muscle spasm of the thoracolumbar spine
       (back)? [ ] Yes   [X] No
       

    f. Additional factors contributing to disability
    
       In addition to those addressed above, are there additional contributing
       factors of disability?  Please select all that apply and describe:
         Interference with sitting, Interference with standing
         
    4. Muscle strength testing
    --------------------------
    a. Rate strength according to the following scale:
    
       0/5 No muscle movement
       1/5 Palpable or visible muscle contraction, but no joint movement
       2/5 Active movement with gravity eliminated
       3/5 Active movement against gravity
       4/5 Active movement against some resistance
       5/5 Normal strength
       
       Hip flexion:
         Right: [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         Left:  [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         
       Knee extension:
         Right: [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         Left:  [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         
       Ankle plantar flexion:
         Right: [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         Left:  [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         
       Ankle dorsiflexion:
         Right: [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 
0/5
         Left:  [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         
       Great toe extension:
         Right: [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         Left:  [X] 5/5   [ ] 4/5   [ ] 3/5   [ ] 2/5   [ ] 1/5   [ ] 0/5
         
    b. Does the Veteran have muscle atrophy?
       [ ] Yes   [X] No
       
    5. Reflex exam
    --------------
    Rate deep tendon reflexes (DTRs) according to the following scale:
    
       0  Absent
       1+ Hypoactive
       2+ Normal
       3+ Hyperactive without clonus
       4+ Hyperactive with clonus

       Knee:
         Right: [ ] 0   [ ] 1+   [X] 2+   [ ] 3+   [ ] 4+
         Left:  [ ] 0   [ ] 1+   [X] 2+   [ ] 3+   [ ] 4+
         
       Ankle:
         Right: [ ] 0   [ ] 1+   [X] 2+   [ ] 3+   [ ] 4+
         Left:  [ ] 0   [ ] 1+   [X] 2+   [ ] 3+   [ ] 4+
         
    6. Sensory exam
    ---------------
    Provide results for sensation to light touch (dermatome) testing:
    
       Upper anterior thigh (L2):
         Right: [X] Normal   [ ] Decreased   [ ] Absent
         Left:  [X] Normal   [ ] Decreased   [ ] Absent
         
       Thigh/knee (L3/4):
         Right: [X] Normal   [ ] Decreased   [ ] Absent
         Left:  [X] Normal   [ ] Decreased   [ ] Absent
         
       Lower leg/ankle (L4/L5/S1):
         Right: [X] Normal   [ ] Decreased   [ ] Absent
         Left:  [X] Normal   [ ] Decreased   [ ] Absent
         
       Foot/toes (L5):
         Right: [X] Normal   [ ] Decreased   [ ] Absent
         Left:  [X] Normal   [ ] Decreased   [ ] Absent
         
    7. Straight leg raising test
    ----------------------------
    Provide straight leg raising test results:
       Right: [X] Negative   [ ] Positive   [ ] Unable to perform
       Left:  [X] Negative   [ ] Positive   [ ] Unable to perform

    8. Radiculopathy
    ----------------
    Does the Veteran have radicular pain or any other signs or symptoms due to
    radiculopathy?
    [ ] Yes   [X] No
    
    9. Ankylosis
    ------------
    Is there ankylosis of the spine? [ ] Yes   [X] No

    10. Other neurologic abnormalities
    ----------------------------------
    Does the Veteran have any other neurologic abnormalities or findings related
    to a thoracolumbar spine (back) condition (such as bowel or bladder
    problems/pathologic reflexes)?
    [ ] Yes   [X] No

    11. Intervertebral disc syndrome (IVDS) and episodes requiring bed rest
    -----------------------------------------------------------------------
    a. Does the Veteran have IVDS of the thoracolumbar spine?
       [ ] Yes   [X] No
       

    12. Assistive devices
    ---------------------
    a. Does the Veteran use any assistive device(s) as a normal mode of
       locomotion, although occasional locomotion by other methods may be
       possible?
       [ ] Yes   [X] No
       

    b. If the Veteran uses any assistive devices, specify the condition and
       identify the assistive device used for each condition:
       No response provided.
       
    13. Remaining effective function of the extremities
    ---------------------------------------------------
    Due to a thoracolumbar spine (back) condition, is there functional 
impairment
    of an extremity such that no effective function remains other than that 
which
    would be equally well served by an amputation with prosthesis? (Functions of
    the upper extremity include grasping, manipulation, etc.; functions of the
    lower extremity include balance and propulsion, etc.)
    
       [X] No

    14. Other pertinent physical findings, complications, conditions, signs,
        symptoms and scars
    ------------------------------------------------------------------------
    a. Does the Veteran have any other pertinent physical findings,
       complications, conditions, signs or symptoms related to any conditions
       listed in the Diagnosis Section above?
       [ ] Yes   [X] No
       
    b. Does the Veteran have any scars (surgical or otherwise) related to any
       conditions or to the treatment of any conditions listed in the Diagnosis
       Section above?
       [ ] Yes   [X] No
       
    c. Comments, if any:
       No response provided
       
    15. Diagnostic testing
    ----------------------
    a. Have imaging studies of the thoracolumbar spine been performed and are 
the
       results available?
       [ ] Yes   [X] No
       
    b. Does the Veteran have a thoracic vertebral fracture with loss of 50
       percent or more of height?
       [ ] Yes   [X] No
       
    c. Are there any other significant diagnostic test findings and/or results?
       [ ] Yes   [X] No
       
    16. Functional impact
    ---------------------
    Does the Veteran's thoracolumbar spine (back) condition impact on his or her
    ability to work?
       [X] Yes   [ ] No
       
           If yes describe the impact of each of the Veteran's thoracolumbar
           spine (back) conditions providing one or more examples:
              unable to do strenuous activities
              
              
    17. Remarks, if any:
    --------------------
     -- "Correia" 
       
     -- Is there evidence of pain on passive ROM testing? No 
     -- Is there evidence of pain when the joint is used in 
        non-weight bearing? No 
     -- If yes, is the opposing joint undamaged?
    
    


****************************************************************************


                                 Medical Opinion
                        Disability Benefits Questionnaire

    Name of patient/Veteran:  Xxxxxxxx XXXX
    
    ACE and Evidence Review
    -----------------------
    Indicate method used to obtain medical information to complete this 
document:
    
    [X] In-person examination
    

    Evidence Review
    ---------------
    Evidence reviewed (check all that apply):
    
    [X] VA e-folder (VBMS or Virtual VA)
    [X] CPRS


    MEDICAL OPINION SUMMARY
    -----------------------
    RESTATEMENT OF REQUESTED OPINION: 

    a. Opinion from general remarks: 
    -- Does the Veteran have a diagnosis of (a) back pain 1995 that is at least
    as 
    likely as not (50 percent or greater probability) incurred in or caused by 
    (the) motor vehicle accident and complaints of back pain during service?

    b. Indicate type of exam for which opinion has been requested: Back

    TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE
    CONNECTION ] 

    a. The condition claimed was at least as likely as not (50% or greater
    probability) incurred in or caused by the claimed in-service injury, event 
or
    illness.   

    c. Rationale: 
    -- C-file review:
    -- no date on note; c/o right upper back pain x 10 days; dx MS strain, right
    upper back/shoulder; tx provided
    -- 04/10/1996 c/o severe back pain x two weeks; dx recurrent musculoskeletal
    pain
    -- 05/03/1995 s/p MVA; activated airbag; dx negative exam, no injuries 
noted,
    minor MS aches
    -- 05/01/1995 c/o right upper back pain x 10 days; dx MS strain right upper
    back/shoulder' tx provided

    -- condition was first noted in the military as documented;
    noted condition is still present during C&P Exam

    *************************************************************************

Thanks!

 

It appears you received a favorable nexus and a rational was provided.

Now to see how you will be rated.

 

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I agree with doc25, this exam is mostly favorable with a nexus.  

However, your question on effective dates is more complex.  

The effective date of your disability is not included in this exam, but may be referenced in your other medical records which we did not read.  You see, your effective date is the later of "facts found" or date you applied.  

I have no idea what condition you were in during the 2000 to 2018 period.  Did you have medical flare ups, documented??  Were you in treatment for the condition?  What did it say on your exit exam??  Did you appeal the denial?  What were the reasons and bases for denial. 

    Since I dont know the answers to the questions I asked, I cant speculate on the effective date.  The date you applied may well be year 2000, per your post, but you still have to show you met the critieria for disability during the period 2000 to 2018, and I dont know what your symptoms were for that period.  

     However, if your back problem was the same in year 2000 as it was in 2018, and you were under treatment for it during that period, you should be able to argue for an eed.  But, if you applied in 2000, had no issues until 2018, it may be very difficult for you to get back pay for that period.  Remember, you are compensated for symptoms, not diagnosis, even tho you must have a diagnosis.  

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On these effective dates...question  

Does the VA go by there effective dates? they put up?

like when a veteran first files for his disability  lets say 1998, he gets denied and Appeals that decision and a year later 1999 is awarded Service connection at 0%.  then he  files for increase in 2000 and is given a 50% increase this is 2000 .

  and reopens his claim in 2002 files for increase and is awarded  a 10% increase and a 30% increase (40%increase) 

so now the veteran is at 90% combined rating...ok he is given TDIU P&T because he can't work due to his S.C. Disability's....would they go back to 1998 for his total effective date?

In other words after a Veteran first files for his disability ....does that start his  over all effective date? for increase along the way? or do they use the dates the veteran filed for the increases?  and not when he first filed?

or since the veteran reopen his claim  then that cancels out the 1998 effective date?

if the latter is true  then his effective date for the 50% would be 2000 and his 20 year protection would start this year  correct? (2019) and his TDIU P&T  20 year protection date would be 2022  correct?

Edited by Buck52

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As far as other documents related to the back pain claim, I have nothing.  I did not even remember making this "claim", exactly.  As I was out processing from the AF, I am sure someone at the hospital asked me about medical problems, and I told them I had back and foot pain.  I do not know if there was a claim filed at that time, or not.  I never thought about it again, until I got a letter asking about it, which only happened because I wanted to see about getting hearing aids, and that led to all of this.  So, I guess there must have been a claim filed, but I did not even realize it.

So, no, I never made any appeal, as I didn't know if (and still don't) if it was denied, or what.

Regarding my condition from 2000 to 2018, as I said (and she recorded) 

2. Medical history
    ------------------
    a. Describe the history (including onset and course) of the Veteran's
    thoracolumbar spine (back) condition (brief summary):
       -- relates -- "I had to change really heavy parts in the bottom load of
       the air craft while I was in the military. They had these monorails but
       they didn't always work so we had to pick them up a lot of times. I can
       remember having back pain and having physical therapy in the Air Force 
and
       having to go to traction but that's all I can remember about what they
       did.  Since then I have always had back pain, upper and lower back.
have
       pain all the time, especially if I try to stand up for ten or more
       minutes. I can try to lean against something and put pressure and that
       seems to help. At night when I am sleeping it will wake me up with pain
       and I have to roll out of bed and walk around for a minute. I have just
       been living with the pain."

Not sure if the above has any merit, or not.

The VA has never asked me for more information about my back, only the C&P.  They wanted all sorts of info on the foot pain, however.  

I did see a doctor about my back sometime around 2006.  I called them to get records, but they told me they'd already destroyed them all.

 

Thanks!  I appreciate your help!

 

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Some times a VA Doc will file the claim and not tell you  I had a VA  AUDIOLOGIST one time give me a Hearing test AND he submitted a claim  because I never did  anyway this may have happen to you with your conditions?

You need to request your C-FILE AND SEE WHAT RECORDS YOU HAVE IN IT  THESE RECORDS GOOD VERY WELL BE IN THERE? OR request all your service and medical records From NRPC in  St Louis.

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      I have 4 C&P exams this Friday. All for increases. (Migraine, PTSD/depression/anxiety/chronic pain/agoraphobia, bilateral foot pain and knee pain increase [including VA issued knee brace and civilian issued AFO foot brace]).
      Should I have my wife ad adult kids who both witness and suffer from my mood swings, depression, anxiety and antisocial like living on a daily basis? They can also talk about my constant leg pain and migraines.
      I also want my supervisor to do one regarding my migraines that have me leaving work early, alot. But that is a touchy subject, because I don't want me asking him to affect my employment.  Also I hide a lot from them, to keep my job, like  just suffer with headaches and migraines at work. Or fake my way through the day, pretending to want to be around people. 
       
    • By JaeT.21
      Hello, I have C&P exams all in one day in January. Any advice on what to expect?
      Here's a synopsis on what I'm up against/working with. 
      - PTSD increase is based off several years of VA mental health treatment and a Nexus letter written by my mental health doctor, which named PTSD, Depression, Chronic Pain Syndrome with depression, Panic D/O with Agoraphobia and survivor's guilt as a diagnosis (last 3 are recently added to records).
      - Knee pain- VA issued me a big knee brace and my primary care (tricare) orthopedics specialist just put me an Ankle-Foot Orthosis (AFO) brace because she says I have drop foot and weakened ankle support which tried to compensate for my weak knee/muscle strength
      - Foot pain- I reviewed all of my previous C&P exams and realized my foot pain rating had dropped from 30% to 10% because the rater misquoted me (lied) on the C&P exam. I told him these insoles and stuff didn't work. that my feet hurt all the time. He wrote, I said they were not effective insoles and I have to use all kinds of feet massages equipment to get through my work days. 
      The primary care sent me to this foot pain doctor. All she did was cortisone shots (3 times) in my feet and tried to up-sell me on her brand of insoles. 
      - Migraines- Been at zero percent since retirement. Last year I was hospitalized twice and misdiagnosed with having TIA and strokes/CVA. My VA advocate put in a secondary claim to my service connected cervical damage.  End result not service connected for CVA/TIA.
      However,  ALL TESTS revealed that I've never had a stroke.  The neurologist diagnosed me with Hemiplegic Migraines. These rare migraines an mimic strokes, causing weakness on one side of the body. They can last from a few hours or in my case,first one lasted 3 months.
      The neurologist provided a letter stating that all of the hospital doctors had misdiagnosed me with having CVAa.  He also diagnosed me with exertional headaches.
       
      I know I'm no more special than the millions of other veterans out here, but this "deny 'til they die" tactic is wearing me down.
       
      Thanks for any advice.
       
       
       
    • By bigoc
      I requested connection for psoriatic arthritis of the right hand, left wrist, and both feet.  In addition to these joints the RO requested a C&P exam of shoulder, hip, elbow, wrist, knee, and ankle.  I have no idea why they did this but it is possibly beneficial to me.  I'll attach this part from my c-file at the bottom on this post.  The VA only decided on the four claimed joints.  The other joints that the VA put in the C&P request were never evaluated or referenced in anyway.  This includes no mention in rating decision letter or during the C&P.  
      Fast forward to 2015 I report for a VA requested future exam for the four SC joints.  I made the complaint of joint pain in 11 joints to include the joints stated above from the 2009 C&P.  These were recorded in the results as pain.  In addition to the documentation in the 2015 exam, they VA acknowledged the additional joint pain and suggested I contact them if I wished to claim these.  I stupidly did not see this until recently. 
      Would I be able to get these joints connected and EED back dated to 2009 or 2015 based on an inferred issue and that no decision was made on the other joints?
      Again the VA is the one that requested the additional joints to be evaluated in 2009 and not me.  Then they were never addressed.  I am interested in this because I have been finding information on claims being considered open if the VA never renders a decision.  While they rarely miss a veteran claim they often miss inferred issues.  This seems like a pretty obvious inferred miss to me.  The VA specifically requested the additional joints. Might be a stretch but this would be significant retro.
       

    • By jdelta
      Like the title says, i go to have an exam for fibro, gerd, and eczyma. Now the last one is a toss up, and the gerd maybe too i don't know. A doctor outside the VA diagnosed me with fibro a few years back. He was an idiot though so i don't know if it was documented(probably, but i also have 30 percent for p.s.t.d. so i'm probably being paranoid). Then again this doctor told me it was my weight blah blah blah. I told him multiple times that a few years prior i was going to the gym alot and the pain has become worse as i age amking it harder to be as active. I try to eat good(chicken and rice, oatmeal) most of the times but we are human. So back to the exam, i have only had one for the p.t.s.d. I was in Iraq day one of the war(March 2003). I was around burn pits and was exposed to the aftermaths of exploded tanks and buildings(hell some we even enter to make sure nobody was hiding or any wmd. I'm registered for the burn pits. I just don't know what to expect, will it be questions, will it be a physical? It's an outside contractor, so i'm hoping less va bias. I'm also too the point of drowning in debt. It's trigger my p.t.s.d. to the point my wife can't even sleep due to my nightmares and waking up with night terrors. I have become much angrier and lashing out. Not physically though, but i don't know what state i'll be in if i get another denial(btw with what i mentioned, i have a bva for freaking tinnitus even though i have stated where i have been. I was also a cavalry scout in the army so i was trained for combat. I have lay statements from a battle buddy, mom, wife, ex and a friend. I just need to know what to expect or what else i need to do to have a shot at an approval? I'm also filed for apnea, va diagnosed me and i have a cpap. Never had a chance to have any of this documented in service due to being told to man up. 
    • By Dan T.
      I am serviced connected for ankylosing spondylitis back in 1985. I had a C&P exam on 7-7-19 since I am asking for an increase in my cervical, thoracic, and lumbosacral ratings. After speaking with the DAV to find out progress and info on my exam, the Rep. noted sort of what I expected. Radiculopathy was noted and ROM was 0-15 for cervical, and 0-25 for back. I am currently rated as Cervical 30%, Thoracic 10%, and Lumbosacral 40%. The main question that I have is relating to the thoracic 10% and lumbosacral 40%. I am confused on these two. Is Lumbosacral separate from the thoracic/others ? Since my back ROM is at 0-25, does this mean that my thoracic might increase from the 10% to a higher rating ? I am confused how they break down my ratings from cervical at 30%, Thoracic at 10%, and Lumbosacral at 40%. Did the VA make changes to the names of the spine regions after I was rated and how they would rate each one?....because I don't see Thoracic as a region now. I only see cervical and thoracolumbar. I'm not sure how they would rate/increase me...totally confused. Also, with the radiculopathy, is this something that they will rate also ? I am currently at 90% total combined for all my disabilities. I hope this helps for someone to give me advice/answers.
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    • Thanks for that. So do you have a specific answer or experience with it bouncing between the two?
    • Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.

      The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.

      ...................Buck
        • Like
    • Precedent Setting CAVC cases cited in the M21-1
      A couple months back before I received my decision I started preparing for the appeal I knew I would be filing.  That is how little faith I had in the VA caring about we the veteran. 

      One of the things I did is I went through the entire M21-1 and documented every CAVC precedent case that the VA cited. I did this because I wanted to see what the rater was seeing.  I could not understand for the life of me why so many obviously bad decisions were being handed down.  I think the bottom line is that the wrong type of people are hired as raters.  I think raters should have some kind of legal background.  They do not need to be lawyers but I think paralegals would be a good idea.

      There have been more than 3500 precedent setting decisions from the CAVC since 1989.  Now we need to concede that all of them are not favorable to the veteran but I have learned that in a lot of cases even though the veteran lost a case it some rules were established that assisted other veterans.

      The document I created has about 200 or so decisions cited in the M21-1.   Considering the fact that there are more than 3500 precedent cases out there I think it is safe to assume the VA purposely left out decisions that would make it almost impossible to deny veteran claims.  Case in point. I know of 14 precedent setting decisions that state the VA cannot ignore or give no weight to outside doctors without providing valid medical reasons as to why.  Most of these decision are not cited by the M21.

      It is important that we do our due diligence to make sure we do not get screwed.  I think the M21-1 is incomplete because there is too much information we veterans are finding on our own to get the benefits we deserve

      M21-1 Precedent setting decisions .docx
        • Thanks
        • Like
      • 5 replies
    • Any one heard of this , I filed a claim for this secondary to hypertension, I had a echo cardiogram, that stated the diagnosis was this heart disease. my question is what is the rating for this. attached is the Echo.

      doc00580220191213082945.pdf
      • 7 replies
    • Need your support - T-shirts Available - Please buy a mug or a membership
      if you have been thinking about subscribing to an ad-free forum or buying a mug now would a very helpful time to do that.

      Thank you for your support
      • 18 replies
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