Favorable findings supports claim

[dwbell99]

In the situation below, does the Favorable findings below support what is claimed?

CLAIMED: chronic L5-S1 disc degeneration & bilateral lower extremity sciatica are more likely due to abnormal gait caused by service connected left ankle disability.   

Favorable finding identified in this decision:
- Private examination for Dr. IMO opined that chronic L5-S1 disc degeneration & bilateral lower extremity sciatica are more likely than not less secondary connected (due to abnormal gait caused by service connected left ankle disability).

 

Edited October 31, 2019 by dwbell99
updated claim history

[Vync]

2 minutes ago, dwbell99 said:

thanks, understand.  I sent 3 files to vetquest to peruse. Trying to limit the exposure to them. May send them as attachments later.  'The chat site is a free one on slack, just used the tinyurl to make posting cleaner

I completely understand. I used to hang out in the chat room when I had more time, but I work and can only post/respond during breaks. I hope you can get this claim turned around because the VA often makes stupid mistakes.

[dwbell99]

2 minutes ago, Vync said:

I completely understand. I used to hang out in the chat room when I had more time, but I work and can only post/respond during breaks. I hope you can get this claim turned around because the VA often makes stupid mistakes.

thanks, I will keep posting update here though

Edited October 17, 2019 by dwbell99
Is there a better 39 CFR reference for the following?

[dwbell99]

1. The DECISION of Rating Decision 11/21/2018 rated the wrong service connection method. 38 CFR § 3.303 - 3.344

[Richard1954]

Each case is different.   Research that I have done indicates that this is possible for a person with an  injury to a lower limb , can  in time    cause damage to a knee  or lower back, but it is the limp that would be caused by the lower limb injury,  that actually causes damage to  a knee or back.  And,  it would take years for the limp to do damage  to the back or knees. With that said, I am not an  expert.  I have attached a couple of  discussion  papers that talk about  "Limping and back pain"  and  "symptoms in the opposite or uninjured leg". These papers were generated by the Canadian  Government concerning  workplace place and Insurance appeals.  The are created to prove or discredit such conditions.  The are very informative. 

If your Independent Medical opinion (IMO)   indicated that it is more likely than not that your back and Knee injury was caused by your ankle injury, and the opinion explains sound medical principles to justify the opinion,  and the VA ignores this opinion, you may have a CUE claim . The VA is required to weight the evidence and when there are two separate opinions one for and one against the claim the VA is required under normal circumstances to give the benefit of doubt to the Veteran.  However, if the independent  medical opinion fails to state that all of your medical records were reviewed, or if the examiner fails to justify his opinion with sound medical principles, the VA can deny the claim.  Your denial should explain why the claim was denied.

To win such a claim,  you have to show that the IMO was sound, and you may  also have to show that the C/P examiner made errors or omitted facts that would help you claim. Basically, you have to pick apart the C/P examiners report.

Recently, I had a claim that was denied concerning my left knee. I had an IMO, that was justified medically and the VA and C/P examiner chose to ignore it. I won my case on appeal because I was able to show factual bias on the C/P examiners part, that she also failed to document valid information that would help my claim, and that she falsified  her reference when trying to justify her claim, ( she actually reworded a sentence in a document that she used as medical reference to deny my claim).  In addition, I won a new C/P claim during the process and the second examiner agreed with the IMO. My IMO was written by Dr. Anise who can be found if you google his name with medical statement in the search. 

The attached documents may help you to over come the denials. ( By the way I learned about these documents because in my case the examiner quoted a non existing line in one of them)

 

 

symptoms in the opposite or uninjured leg.pdf Limping and Back Pain.pdf

[vetquest]

@dwbell99, I have read what you posted on the chat room and really request that you redact and post here.  I am concerned by the unprofessional rating decision.  With spell check this is not acceptable today.  In your rating decision I am also concerned about reasonable doubt.  In the DBQ I could not see where the doctor made a decision of as likely or likely not a result of service, is this the full DBQ?  Do you also have the IMO that your doctor wrote?  This is something that you would get much better advice from the full community.

Your writeup is quite impressive but too long, you quoted citation numbers but you need docket numbers.

I believe you have a strong reasonable doubt appeal.   Where the rater said the VA examination was more objectively based, this is an opinion, not a fact.   I also think the rater might have shot himself in the foot quoting Hayes vs Brown, 5 Vet. App.60 (1993).   

You will get some really good advice here and I wish you would trust the community.

[dwbell99]

Here are the claim files for review. Will be offline until Sunday night. Any suggestions will be greatly appreciated.

Back IMO medical opinion.pdf Back DBQ by VA (VES 22618612612).pdf Back Rating Decision.pdf Back Supplemental Claim.pdf

Edited October 18, 2019 by dwbell99