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Iceman's_Wife

VA Form 21-526EZ section 13 assistance needed

Question

My question:  Should all items that impact his disability be listed on the VA Form 21-526EZ?   If something is secondary such as pain, that should be listed?   

BACKGROUND:  I need assistance with VA Form 21-526EZ.    On page 8 section 13, it asks for the list of disabilities.    Does this mean ALL items from his problem list (VA medical records)?    For example I can easily extract 20 items from his VA medical problem list BUT the VA Veterans Advisor only posted 4 line items which do NOT give a complete picture. 

1.  paralysis external nerve (mild)

2. lumoscaral strain  (mild)

3. paralysis median nerve  (mild)

4. degenerative arthritis of spine  (mild)

After 10+ years of progressive degeneration, a year ago, we submitted a form for re-evaluation of his service-connected medical conditions.   The MRI from the 2009 determination is missing from his records.  The comp&pen Dr indicated that it was our responsibility to provide documentation to him on what changed.   We assumed that the comp&pen doctor would conduct an exam/order MRI or could extract the information from his records.   He also indicated that pain (consistently documented as 9/10) is not a consideration for disability, that it is immaterial to VA.   

Only one (from the 4 listed) line items was increased 10%.   The current MRI indicates his spine has moderate to severe degeneration.  

The VA Veterans Advisor indicated that we should NOT resubmit again unless we can get a doctors statement specifically indicating which line item has progressed from mild.  I have asked the Spinal Cord Injury Primary Care doctor for assistance, provided her with research documentation and she said she would but that was 2 months ago and nothing was put in his records.  

In advance, thank you

 

 

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Posted (edited)
10 hours ago, Iceman's_Wife said:

On page 8 section 13, it asks for the list of disabilities.    Does this mean ALL items from his problem list (VA medical records)?

I think you mean page 9 SECTION IV CLAIM INFORMATION. I am not aware of any reason not to put all 20 down. I don’t know what VA VETERANS ADVISOR is.

 

10 hours ago, Iceman's_Wife said:

comp&pen Dr indicated that it was our responsibility to provide documentation to him on what changed.

Are you being treated by a non VA doctor? If so and those records are material then they need to get into the VA file. You may have to do some detective work to locate the MRI. 

 

10 hours ago, Iceman's_Wife said:

He also indicated that pain (consistently documented as 9/10) is not a consideration for disability, that it is immaterial to VA.

There is a case recently that I think disputes that. 

A quick search for "Pain as disability" turned up this - 


Pain as a disability
Asked by broncovet 
 
Posted July 26, 2018
Important take away:

  Quote
 It ultimately states “while a diagnosed condition may result in a disability, the disability itself need not be diagnosed.”  Id. at *11.

Source: http://thomasandrewslaw.blogspot.com/2018/04/saunders-pain-as-disability-decided-by.html

You see the VA denying this stuff all the time:  The VA says there was no "diagnosis" in service, and denies.  There need not be a diagnosis in service, only an "in service event or aggravation".  That is different.  

 

10 hours ago, Iceman's_Wife said:

I have asked the Spinal Cord Injury Primary Care doctor for assistance, provided her with research documentation and she said she would but that was 2 months ago and nothing was put in his records.

You need to check back with this doctor. I had my PCP tell me she would write me a letter. I didn’t follow up with her and she forgot. When I found out it was too late because she had switched to C&P Exams. The squeaky wheel gets the grease. 

Edited by kanewnut
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The "list of disabilities" are the conditions your are claiming/seeking an increase for. Not (necessarily) everything in the VA problem list. The VA problem list is what the VA is treating you for. These may not all be service connected conditions.

The conditions you are claiming can be listed very specific, or can be more general. For example, lets say you have a diagnosis of Asthma, you can list that as the claimed condition. Or, to be more general, you can list it as "respiratory problems." There are opinions either way as to which is the best way to list the conditions. Since these are for increases of already connected conditions, that is not as much of an issue for you, imho.

As far as pain, it does come into play with musculoskeletal conditions, in how it impacts range of motion. The examiner is suppossed to note where in the ROM tests pain begins. If pain does not effect ROM, but is present, it should elicit the lowest compensable rating. Your husband may already be at, or past, the lowest rating already. 

As far as the MRI, you may have to go to the records release department (FOIA office) of the VA where it was completed.  When I was compiling my own records, I knew there were records missing from my "Blue Button" reports. So, I went to the VA and they were able to get records from the departments that were not available to me otherwise.

Pain can also be claimed as somatic symptom disorder, which is a mental health claim. At a consistent 9/10, that may be an avenue to explore.

 

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Posted (edited)

Also, does he also experience radiculopathy as a result of the spinal condition?

Edited by NoZZZ's
misspelling

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18 hours ago, NoZZZ's said:

As far as the MRI, you may have to go to the records release department (FOIA office) of the VA where it was completed.

I had an MRI done at Asheville, NC VAMC. I was being seen at Duke, NC VAMC. I called Duke to see if they had my MRI yet. They told me no. I called Asheville and they told me who the MRI was sent to, who signed for it and when they signed for it. I called Duke back with this information and asked them if they thought they could find the MRI now. That took care of it 

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