I received a proposal to reduce

[mclevela726]

Hello,

I received a proposal to reduce the evaluations of my  Intervertebral Disc Syndrome with Radiculopathy (previously rated as intervertebral disc syndrome w/ DDD of L5-S1); Radiculopathy, Left Lower Extremity; Radiculopathy Right Lower Extremity on February 7th, 2019. 

To be more specific, the proposal states "We have reviewed medical records concerning your service-connected disabilities and noted some improvement, We propose to reduce our evaluations of the disabling effects for conditions as follows:

Intervertebral Disc Syndrome with Radiculopathy (previously rated as intervertebral disc syndrome w/ DDD of L5-S1) - Current: 40% | Proposed: 20%

Left Lower Extremity - Current: 40% | Proposed: 20%

Radiculopathy Right Lower Extremity - 40% | Proposed: 20%"

The proposal also states, "What Evidence Can you Submit...the best type of evidence is a statement from a physician who recently treated or examined you". As such I submitted a letter from my Private PCP February 12th, 2019, containing his statement. In his statement, my PCP said that my conditions of lower extremity radiculopathies are "moderate to severe". and there has been "no change". I also submitted a record from a recent urgent care visit (regarding the above conditions) and an SOC with that letter.

In the SOC I stated, "Lastly, I argue that the evidence VA used to propose reduction in evaluations, in addition to the evidence I am submitting here, does not support a reduction in evaluations (with all above named conditions being currently evaluated at 40% and being proposed to reduce to 20%) nor does it support the idea that a material improvement in the above named conditions is clearly shown nor would clearly be shown under ordinary conditions of life. (38 CFR § 3.344 Stabilization of disability evaluations)." [Of note: In the last year I have had a new MRI of my lumbar spine (which showed "significant abnormalities"), been through acupucture (with no improvement shown), been through the pain clinic (with no improvement shown), been through aqua therapy (with no improvement shown), as well as a trip to the ER and a trip urgent care and placed on medications. Which is why I argued what I argued.

Additionally, my Neurologist also prepared a Thoracolumbar DBQ, for which I just received and that I will be submitting to VA on Monday.

Having said all that, I am completely exhausted when it comes to fighting VA. I hope all of what has been done works! Because I no longer have it in me to fight for something that is already taking so much out of me.

What more can I do?

Thanks.

Clyv

 

[Berta]

It looks to me that you have excellent evidence to combat the proposed reduction.

Make sure the VA gets it all ( copies that is) before the deadline for any response.

It is a travesty that we have to fight for what we get and then often have to fight to keep it.

 

 

 

[broncovet]

It makes a big difference "when" you received that raitng. Was it 5 years or less, 10, or 20 years?  Are you P and T?    Attorney Katrina Eagle had an excellent post up on what to do with PR's.  Her post has been taken down for several years now.  

I do however, think it still applies.  

In sum, she suggested asking for a hearing.  

Perhaps more importantly, she suggested you argue your condition has NOT improved since your last rating decision.  You see if they did not address your IDS, and added SMC S, or another condition, the VA acknowledges you still qualify as of the decision date.  So she suggested not attempting to show you meet the criteria today, but rather it has not had "sustained improvement" under ordinary conditions of life.  Ordinary people work, while disabled people dont.  Therefore, if you have been rated 5 years or more, and you are not working, its unlikey they will be able to reduce you.  

Of couse if you dont dispute it, the va will be happy to reduce you.  

 

[Buck52]

This is all good. However you need a qualified Dr to give his opinion , they won't listen to us, were not Dr's

a IMO/IME from a specialist would seal the deal on this P/P T/R  of what you mention above.

via DRO Hearing at your R.O..

  ALSO you can look the DRO in the eyes and he can see up close your disability is real, sometimes these P/P/T/R  are not as bad as most would think,  if you have shown your condition has actually got worse a increase is applied and not a reduction.  but this needs to come from a Qualified Dr.

[mclevela726]

1 hour ago, Berta said:

It looks to me that you have excellent evidence to combat the proposed reduction.

Make sure the VA gets it all ( copies that is) before the deadline for any response.

It is a travesty that we have to fight for what we get and then often have to fight to keep it.

 

Thank you Ms. Berta.

 

 

[mclevela726]

55 minutes ago, broncovet said:

It makes a big difference "when" you received that raitng. Was it 5 years or less, 10, or 20 years?  Are you P and T?    Attorney Katrina Eagle had an excellent post up on what to do with PR's.  Her post has been taken down for several years now.  

I do however, think it still applies.  

In sum, she suggested asking for a hearing.  

Perhaps more importantly, she suggested you argue your condition has NOT improved since your last rating decision.  You see if they did not address your IDS, and added SMC S, or another condition, the VA acknowledges you still qualify as of the decision date.  So she suggested not attempting to show you meet the criteria today, but rather it has not had "sustained improvement" under ordinary conditions of life.  Ordinary people work, while disabled people dont.  Therefore, if you have been rated 5 years or more, and you are not working, its unlikey they will be able to reduce you.  

Of couse if you dont dispute it, the va will be happy to reduce you.  

 

Thanks Broncovet,

It have had my rating for more than 5 years.

As such, while I feel like I need to work on it, this is what I'm adding to my SOC regarding the proposal (please let me know if I should change/clarify anything):

Enclosed with this Statement of Claim is VA Form 21-0960M-14; prepared by my neurologist, Dr. XXXX, MD, in support of my claim with regard to the reductions proposed on January 31^st, 2019, and February 1^st, respectively, of my conditions of Intervertbral Disc Syndrome with radiculopathy (previously rated as intervertebral disc syndrome with degenerative joint disease of L5-S1); Radiculopathy, left lower extremity associated with intervertebral disc syndrome with radiculopathy; and Radiculopathy, right lower extremity associated with intervertebral disc syndrome with radiculopathy.

 

Additionally, I contend that

 

CONTENTION 1: With regard to 38 CFR 3.344 (a) “It is essential that the entire record of examinations and the medical-industrial history be reviewed” I contend that none of the evidence for which VA relied upon to propose these reductions reviewed my entire medical-industrial history and they do not show that my entire medical-industrial history has been taken into consideration (e.g. I was employed as a Fire Fighter for the US Forest Service after military service and now I am employed in a sedentary job in administration.) and therefor they do not clearly show improvement, neither implied or actual, in the conditions of Intervertbral Disc Syndrome with radiculopathy (previously rated as intervertebral disc syndrome with degenerative joint disease of L5-S1); Radiculopathy, left lower extremity associated with intervertebral disc syndrome with radiculopathy; and Radiculopathy, right lower extremity associated with intervertebral disc syndrome with radiculopathy, therefore I contend that reductions proposed on January 31^st, 2019, and February 1^st, respectively, be considered null and void.

 

CONTENTION 2: With regard to 38 CFR 3.344 (a) “Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life” I contend that ordinary people under the ordinary conditions of life do not attend 10 medically prescribed sessions of acupuncture in two months to control their symptoms nor do they seek medical treatment from a pain clinic during the same year and after the acupuncture sessions. I also contend that ordinary people under the ordinary conditions of life do not seek nor do they attend a medically prescribed KT Aquatic Program to control their symptoms (i.e. pain, etc.).  And I further contend that ordinary people under the ordinary conditions of life are not placed on sedating/symptom inducing medications (i.e. Flexeril, Trileptal, Tramadol, Lyrica, Neurontin, etc.) nor are they given injections (i.e. Toradol, etc.) nor would they continually seek treatments for such.  Lastly, with regard to 38 CFR 3.344 (a), I contend that no reasonably placed person would conclude that “sustained, material improvement under the ordinary conditions of life” has been shown with having such knowledge as above, and for which is clearly outlined in my VAMC treatment records and C-File. Therefore, I contend that the reductions proposed on January 31^st, 2019, and February 1^st, respectively, with regard to the conditions of Intervertbral Disc Syndrome with radiculopathy (previously rated as intervertebral disc syndrome with degenerative joint disease of L5-S1); Radiculopathy, left lower extremity associated with intervertebral disc syndrome with radiculopathy; and Radiculopathy, right lower extremity associated with intervertebral disc syndrome with radiculopathy be considered null and void.

Thanks again!

[mclevela726]

Just to clarify. Other than the acupuncture, all the other the treatments, medications, and such took place during the dates of the evidence VA relied upon, and continue to take place!