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Question

Hey brothers and sisters,

So I just had my C&P for my right shoulder secondary to my left shoulder injury. Since I've injured I tend to put more strain on my right shoulder to compensate for functional loss. This has caused me to have pain and limited ROM in both shoulders. This scumbag at the VA left his opinion. Even though all my tests showed limited ROM and pain on movement of right shoulder. What's next?

 

MEDICAL OPINION SUMMARY
 -----------------------
 RESTATEMENT OF REQUESTED OPINION: 
 a. Opinion from general remarks: Secondary Service Connection.
 Is the Veteran's shoulder condition right at least as likely as not (50
 percent or greater probability) proximately due to or the result of rotator
 cuff tendonitis, left shoulder (non dominant)?
 b. Indicate type of exam for which opinion has been requested: RIGHT 
SHOULDER
 TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE
 CONNECTION ]
 b. The condition claimed is less likely than not (less than 50%
 probability) proximately due to or the result of the Veteran's service
 connected condition. 
 c. Rationale: Within the concept of a pathologic entity of one specific site
 or joint of the human body (right shoulder in this case) it is very
 hypothetical to theorize or to try to conceptualize that such a pathologic
 process would be secondary to a SC pathological process at a separate site
 such as ROTATOR CUFF TENDONITIS, LEFT SHOULDER (NON DOMINANT).
 To ascribe a distant pathologic entity (RIGHT SHOULDER) to be secondary to
 the already mentioned SC condition, does not fit within the realm of a peer
 reviewed logical manifestation of diseases as written over centuries in the
 medical books. Even trying to force a connection between such SC condition
 and the RIGHT SHOULDER condition imperils the scientific knowledge in
 medicine that tries to explain disease processes and their interconnections
 in the most logical, reasonable and responsible ways. There is no evidence 
in
 the scientific medical literature of such connection.
 Therefore, the claimed condition is less likely than not proximately due to
 or the result of the Veteran's service connected condition. And the SC
 condition neither aggravates the RIGHT SHOULDER condition.

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"...There is no evidence in the scientific medical literature of such connection."

What a load of crap. There is plenty of evidence! You need to get a letter (a nexus statement) from a certified doctor linking your right shoulder to the left's conditions. This doctor is a certifiable quack and should have his licenses revoked, but the VA loves doctors like this guy. Do some research on favoring limbs over the other due to surgery and its affects. There is plenty of literature. PT specialists deal with this stuff ALL THE TIME! You can even use medical journal articles to disprove this snake.

Let's face it. There is no "disease" that links problems like was stated in a the letter. But we're not talking linking a "disease" we're talking about favored and therefore, more strained use to one shoulder over that of the injured one. Very clever of this "doctor" to phrase it in the way that he did. 

Fight this. Get your VSO to help you. Get your doctor or surgeon or someone who knows your medical record to refute this garbage.

Semper Fi,

Sgt. Wilky

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You are going to need to get an IMO to disprove this exam.  He did a royal job of stating that your favoring your right shoulder due to a left injury is not plausible.  What you need is another doctor to refute this.  His one Achilles heel in the exam is he appears to have gone overboard in denying your condition could be cased by the injury.  Find some peer reviewed medical reports that state this is true and you can blow his whole premise out of the water.  Start at the nearest medical library to research this.  

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Go to Google Scholar. You can also find other sources of proof but it must have been written by a medical professional. Journal articles are peer reviewed, so it is the state of the art in medical literature at the time it was published. Your examiner made a sweeping claim that states this knowledge he has provided has been established for hundreds of years. Make a liar out of him.  Find journal articles that describe the condition as you presented it. Get 5-10 at a minimum. This is proof that 

1. The examiner provided invalid information about your condition.

2. That there is scientific medical literature that shows that there is a connection between A and B.

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