less likely than not incurred in or caused by her service???

[LODI]

Thank you all for your service and help! I was a 88M Combat truck driver, E-5 in the Army. I did 2 tours to Iraq June 2006-Oct 2007 with 10,000 miles. Then got called up IRR and deployed again to Iraq April-2009-May-2010 and drove ANOTHER 10,000 miles. Because I was too busy on missions and had a million other things to worry about like IED's, I didn't complain about my wrist.  Everyone was in pain but we just drove on running on adrenaline. And because there is no "paper trail" , my wrist condition is not connected to service. After all the miles and loads I've secured....

Even though I am 90% SERVICE CONNECTED for PTSD, arthritis, lumbar strain, degenerative disc syndrome, tinnitus, bilateral knees and ankles. It seems like they just don't want to give me the 100%... I am in PAIN and am in my 30's feeling like I'm in my 80's. I did the RAMP and am not sure if that is going to back fire on me or not. Any help is appreciated!!! Thank you all again for your time and service!!!! Please read what follows I am beyond frustrated.

 

RESTATEMENT OF REQUESTED OPINION:

a. Opinion from general remarks: MEDICAL OPINION REQUEST TYPE OF MEDICAL OPINION REQUESTED: Direct service connection

OPINION: Direct service connection Does the Veteran have a diagnosis of

(a) right wrist condition that is at least as likely as not (50 percent or greater probability) incurred in or caused by (the) potential injury to the wrist from driving hazardous roads in Iraq during service? Rationale must be provided in the appropriate section.

b. Indicate type of exam for which opinion has been requested: right wrist condition TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] b. The condition claimed was less likely than not (less than 50% probability) incurred in or caused by the claimed in-service injury, event or illness. 

c. Rationale: The veteran's efile has been reviewed. The veteran is diagnosed with right hand tendonitis and right wrist tendonitis. Entry exam 4/11/20012 was silent for pre-existing condition. Upon review of STRs, there is no documentation of Veteran's complaints of hand or wrist pain that I can find in available service treatment records. PDHA 12/2/2007 specificaly notes no wrist or hand pain. She had a general medical exam just after separation 8/27/2010 that mentions no issue/condition with her hand or wrist. CPRS records reviewed and PCP note from 6/10/10 notes no hand or wrist complaint. Although it is documented the veteran did drive over 10,000 miles in service there is no documentation of pain complaints during or after her deployment while in service that I can find. The first documented visit for her right hand/wrist condition was 8/31/2017, several years after separation. Based on this, it is difficult to connect her current hand/wrist condition to her service. Therefore, the veteran has a diagnosis of Right hand and wrist tendonitis that is less likely than not incurred in or caused by her service.

[JKWilliamsSr]

The issue here is determining service condition because there are no complaints in your service records for your wrist and hand injuries.  Your best bet may be buddy letters from people that served with you and/or letters from your spouse if you are/were married at the time of service.  If you can provide statements that will show symptomology.  The key here are letters that state knowledge of symptoms and not a diagnosis.  this is admissible and the VA is required to consider such evidence.

[Buck52]

Unless you can show some where that you complain about your Wrist/Hand  to your fellow soldiers or buddy's  its unfortunate but this will he a headache to prove for service connection.

Most combat veterans don't have the time to go get medically checked out unless its a server injury

(I never did and that was a big mistake)...Its a big mistake not  to get medically checked out while in the service.for anything.

  Hey  what we know now we should have known then.

[Buck52]

If your looking to get to 100%   with your 90% combined rating  you will need an additional 50% increase.

   So recheck all your S.C. CONDITIONS  IF ANY HAVE WORSEN file for increase on all of the conditions that a Dr states have got worse...that's your best way to reach the 100%.

Also ask the Dr's about your S.C. Conditions that could cause you other problems   this is called secondary conditions  once they are S.C.  THEY BECOME PART OF THE ORIGINAL CONDITION so check those out!!!

PTSD & The medications you take check that for OSA (Sleep Apnea) your Dr may refer you to the sleep clinic and you may get a diagnose for Sleep Apnea? and required to use a C-Pap Machine

...you can file a secondary claim for that in way of your PTSD /Med's  but you will need a qualified Dr to state in his/her opinion ''it is likely as not '' your S/A is related to your SC PTSD Med's and he needs to name these Med's. and go into details about it ,this is usually rated at 50% or higher depending on how server the OSA/Sleep Apnea is.?

[LODI]

Thank you for your advice!!!!

[doc25]

On 2/12/2019 at 8:33 PM, LODI said:

Thank you all for your service and help! I was a 88M Combat truck driver, E-5 in the Army. I did 2 tours to Iraq June 2006-Oct 2007 with 10,000 miles. Then got called up IRR and deployed again to Iraq April-2009-May-2010 and drove ANOTHER 10,000 miles. Because I was too busy on missions and had a million other things to worry about like IED's, I didn't complain about my wrist.  Everyone was in pain but we just drove on running on adrenaline. And because there is no "paper trail" , my wrist condition is not connected to service. After all the miles and loads I've secured....

Even though I am 90% SERVICE CONNECTED for PTSD, arthritis, lumbar strain, degenerative disc syndrome, tinnitus, bilateral knees and ankles. It seems like they just don't want to give me the 100%... I am in PAIN and am in my 30's feeling like I'm in my 80's. I did the RAMP and am not sure if that is going to back fire on me or not. Any help is appreciated!!! Thank you all again for your time and service!!!! Please read what follows I am beyond frustrated.

 

RESTATEMENT OF REQUESTED OPINION:

a. Opinion from general remarks: MEDICAL OPINION REQUEST TYPE OF MEDICAL OPINION REQUESTED: Direct service connection

OPINION: Direct service connection Does the Veteran have a diagnosis of

(a) right wrist condition that is at least as likely as not (50 percent or greater probability) incurred in or caused by (the) potential injury to the wrist from driving hazardous roads in Iraq during service? Rationale must be provided in the appropriate section.

b. Indicate type of exam for which opinion has been requested: right wrist condition TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] b. The condition claimed was less likely than not (less than 50% probability) incurred in or caused by the claimed in-service injury, event or illness. 

c. Rationale: The veteran's efile has been reviewed. The veteran is diagnosed with right hand tendonitis and right wrist tendonitis. Entry exam 4/11/20012 was silent for pre-existing condition. Upon review of STRs, there is no documentation of Veteran's complaints of hand or wrist pain that I can find in available service treatment records. PDHA 12/2/2007 specificaly notes no wrist or hand pain. She had a general medical exam just after separation 8/27/2010 that mentions no issue/condition with her hand or wrist. CPRS records reviewed and PCP note from 6/10/10 notes no hand or wrist complaint. Although it is documented the veteran did drive over 10,000 miles in service there is no documentation of pain complaints during or after her deployment while in service that I can find. The first documented visit for her right hand/wrist condition was 8/31/2017, several years after separation. Based on this, it is difficult to connect her current hand/wrist condition to her service. Therefore, the veteran has a diagnosis of Right hand and wrist tendonitis that is less likely than not incurred in or caused by her service.

Unfortunately, the Veteran's Benefits Administration is not in the business of giving us 100%, alot of times not even a 0% rating . They're in the business of delaying and denying.

But, fortunately for us, there are certain laws and there are ways around the delaying and denying that are favorable for us.

You mentioned getting a 100% rating. I won't sugar coat it.It's going to be a tough road to take with your unfavorable nexus of opinion for your claim. The examiner did not find the medical evidence to substantiate your claim.

Don't get me wrong. I do believe you because someone that is in "constant and chronic pain" has no reason to lie about how and when it started. I'm positive your pain continues to the present. By any chance are you diagnosed with Carpal Tunnel Syndrome either by a private doctor or a VA doctor? You were a combat truck driver. I believe this article may pertain to you.   https://cdllife.com/2015/carpal-tunnel-syndrome-8-symptoms-and-6-solutions-for-truckers/

You are service-connected Arthritis. Where is the arthritis located? Hands? Elbows? Shoulders? Spine? Hips? Knees? Ankles?

JKWilliams  brings up a valid point with the buddy statements;consider this information for Lay Evidence in your hand or wrist claim appeal because you're going to appeal, correct? It'll be difficult, just get in the mindset of putting in the work to help your appealed claim.

https://www.veteranslawblog.org/lay-evidence-in-a-va-claim/

I recommend you read this article that has some good information on Lay Evidence also.

AuthorsCopies4-Coyle-Ishizawar-Seesel.PDF

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

I agree with Buck52; you can take that route for increase of your SC conditions you have already. You will need to build enough medical evidence, meaning continued treatment for your SC conditions that are present for worsened symptoms. 6 months to a year worth of built up medical evidence is a reasonable amount of time

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

The other option we have as veterans is Secondary-Service Connection. This means that a Secondary condition was manifested due to or the direct result of a Service-Connected disability.

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

Individual Unemployability, could be another path. Have you lost jobs or earning capacity(ex. promotion opportunities) because of your SC conditions? Are you currently unemployed? IU might be something to consider.

So, now you have four paths to get to 100%. It's totally up to you which path you wish to take. As, I mentioned before, get in the mindset of putting in the work, research, do your homework, keep asking questions. You won't be alone whichever path you choose to take.

Best wishes.

 

 

 

 

[JKWilliamsSr]

LODI since the information may not be in your SMR's your best bet is to go with Lay/Buddy statements.  Any letters you can get where people can attest to your symptoms while in service will help in a big way.  I think this is a tool that many veterans are not aware of how powerful these statements are. Now I have seen that raters often ignore these statements and do not find them credible but case law does not allow them to do that.  If they are going to make the assertion that lay statements are not viable they have to prove it with something of substance.  A rater cannot just use their opinion here.

Keep in mind and this is critical IMO..... Lay statement are to be used to state they saw symptomology and should not be used to state an opinion of diagnosis.  For example the statement could say that they noticed that when you would bend your knee you were in obvious pain or something like after physical activity they noticed your knee was swollen and you would have to ice it down.  They should not say something like when you bent your knee you were in pain and it showed you had arthritis.

Here is some case law on lay statements:

Lay persons are not competent to opine as to medical etiology or render medical opinions; however, lay testimony is competent to establish the presence of observable symptomatology associated with an injury or illness and may provide sufficient support for a claim of service connection. Barr v. Nicholson, 21 Vet.App. 303 (2007).

 

Edited February 14, 2019 by JKWilliamsSr
additional info