Progress Notes on C&P Exam

[vgorman0306]

Hey guys, 

 

     I don't know if I'm in the right place but i was needing some clarification. After fighting with the military for six years, the C&P examiner stated that my condition precludes me from any physical occupation. 

I developed asthma back in 2012, while in service. Is that typical wording for pretty much everyone? I guess my English isn't that great and i would like someone to please explain to me what that entails? The examiner 

also stated that there is a 50% chance or greater that my injury was incurred in the line of duty, does that mean that they service connected me? 

 

thank you for responding. 

[vgorman0306]

@Berta

On her rationale for the " as likely as not" ( 50% or greater probability) was as follows 

"The veteran has documentation in strs of her wheezing x4 days with treatment for URI during active service. She continued to seek medical treatment for her wheezing and cough post active duty service. on 04/2013 was diagnosed with asthma. This is within the first years of active duty service and is a nexus to her wheezing in service as likely as not asthma in service.
 

"The veteran currently has multiple medications to include a monthly injection due to her severe persistent asthma. She is treated by private pulmonologist. She has a daily nebulizer which she carries to school with her just in case of exacerbation. She has approximately 3 exacerbation monthly beyond her day to day severe asthma."

Medications

Requires chronic low dose cortecosteroids

other, describe: nucala 100 mg- inject once monthly

inhalation bronchodilator therapy, daily

inhalation anti-inflammatory medication, daily

other inhaled medication, describe: Advair, albuterol, nebulizer, proventil, daily

"Does the veterans condition require the use of oral bronchodilators?" Yes

also, my PFT's are as follows 

Pre-bronchodilator:

FVC: 66% predicted

FEV-1 50% predicted

FEV-1/FVC 68% 

Post-bronchodilator:

FVC: 65% predicted

FEV-1 56% predicted

FEV-1/FVC 76% 

she stated that the FEV-1/FVC accurately measures my level of disability but I was on all me medications while I was being examined. 

 

 

 

[Berta]

Thanks for that additional info- it does establish the service nexus.

[kanewnut]

On 7/4/2019 at 5:21 PM, vgorman0306 said:

I'm 24 about to be 25 and used to be very active and fit but now im pretty much in bed most of the time. Things tend to be more laborious than before. It's depressing and I just want my life back again.

I can understand how you feel. I didn't get my life back and severe chronic pain led to severe depression. Hopefully you can find something that will keep you from getting depressed.

[Richard1954]

On 7/4/2019 at 5:13 PM, vgorman0306 said:

 

On her rationale for the " as likely as not" ( 50% or greater probability) was as follows 

"The veteran has documentation in strs of her wheezing x4 days with treatment for URI during active service. She continued to seek medical treatment for her wheezing and cough post active duty service. on 04/2013 was diagnosed with asthma. This is within the first years of active duty service and is a nexus to her wheezing in service as likely as not asthma in service.
 

"The veteran currently has multiple medications to include a monthly injection due to her severe persistent asthma. She is treated by private pulmonologist. She has a daily nebulizer which she carries to school with her just in case of exacerbation. She has approximately 3 exacerbation monthly beyond her day to day severe asthma."

Medications

Requires chronic low dose cortecosteroids

other, describe: nucala 100 mg- inject once monthly

inhalation bronchodilator therapy, daily

inhalation anti-inflammatory medication, daily

other inhaled medication, describe: Advair, albuterol, nebulizer, proventil, daily

"Does the veterans condition require the use of oral bronchodilators?" Yes

also, my PFT's are as follows 

Pre-bronchodilator:

FVC: 66% predicted

FEV-1 50% predicted

FEV-1/FVC 68% 

Post-bronchodilator:

FVC: 65% predicted

FEV-1 56% predicted

FEV-1/FVC 76% 

she stated that the FEV-1/FVC accurately measures my level of disability but I was on all me medications while I was being examined. 

 

 

 

Based on the above FEV-1 FVC your rating would be 10% because a rating is based on teh FEV-1FVC  post bronchodilator... if your rated 10% and the examiner said you cannot not work... the examiner would have to write a very detailed reason for her opinion.. you are on low dose steroids also so this would go against your not being able to work.

The smart thing to do when you have a c/p exam scheduled is to not take your meds until after the examination.. You want the c/p examiner to see you  when your are off the meds to get a far assessment of your actual condition.

Ok so I have asthma it is rated 60%..  I use a nebulizer 3 times a day , in addition to albuterol , spirva, and  high dose Symbicort  when I was rated at 60% my FEV-1FVC was 45% and I was on oral steroids... even with my Asthma condition, It was never mentioned that I could not work because of the Asthma and I never felt that I could not work because of the Asthma.

I don't want to discourage you  but based on all I know about the va ratings for asthma under 6602 I seriously doubt that you would get anything higher than 10%... 

Also I have gone to many C/P exams and after the exam I would weigh in my head if the examiner was going to go my way.. only to find out later the examiner didn't do me any favors.. You can't put much hope into a C/P examiner regardless what they tell you during the exam... 

Wish I had a better opinion for you..... 

[Buck52]

On 7/4/2019 at 9:23 AM, vgorman0306 said:

Hey guys, 

 

     I don't know if I'm in the right place but i was needing some clarification. After fighting with the military for six years, the C&P examiner stated that my condition precludes me from any physical occupation. 

I developed asthma back in 2012, while in service. Is that typical wording for pretty much everyone? I guess my English isn't that great and i would like someone to please explain to me what that entails? The examiner 

also stated that there is a 50% chance or greater that my injury was incurred in the line of duty, does that mean that they service connected me? 

 

thank you for responding. 

yes its all favorable from this examiner.

Having being service connected for asthma ,  you might want to look into other possibility's for secondary claims that are caused from your asthma.

just a thought! 

[vgorman0306]

@Richard1954

The reason why ( which I know doesn't matter to the rater) I was on my medicine is because they called me in to test the next day.  So from what you are saying the rater goes by the post-bronchodilator and not the pre?

Still, with max therapy and all my meds, that seems to be bad, shouldn't my numbers be normal?  I'm on low doses of steroids every day to keep my immune system controlled because I am that sensitive. and I also take another immune-suppressant shot monthly that stays in my system until I get my next shot. 

 

Thank you for your input, any little pieces of info and opinions help