Jump to content
  • veteranscrisisline-badge-chat-1.gif

  • Advertisemnt

  • Trouble Remembering? This helped me.

    I have memory problems and as some of you may know I highly recommend Evernote and have for years. Though I've found that writing helps me remember more. I ran across Tom's videos on youtube, I'm a bit geeky and I also use an IPad so if you take notes on your IPad or you are thinking of going paperless check it out. I'm really happy with it, I use it with a program called Noteshelf 2.

    Click here to purchase your digital journal. HadIt.com receives a commission on each purchase.

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Ads

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

  • 0
Sign in to follow this  
dwbell99

Is this a Clear and Unmistakable Error (CUE) ?

Question

FACT 1: Veteran's left ankle is 10% service connected.

FACT 2: Submitted claim: It is this provider's medical opinion (My Doc / IMO) that Veteran's chronic L5-S1 disc degeneration & bilateral lower extremity sciatica are more likely than not  50% secondary connected (due to abnormal gait caused by service connected left ankle disability).

FACT 3: The DECISION of the Rating Decision: Service connection for degenerative disc disease, lumbar spine (claimed as back) is denied. REASON: We have denied your claim for service connection for degenerative disc disease, lumbar spine (claimed as back) since this condition neither occurred in not was caused by service.

FACT 4: Favorable Findings of the Rating Decision:
- Private examination for Dr. IMO (Board-certified Anesthesiology and Pain Management) 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).

*************
Claim History
*************
1. Submitted claim 7/19/2016: Service Connected back.

2. Rating Decision 11/29/2016: Service Connected back denied.

3. Submitted corrected claim 11/18/2017: Back is more likely than not 50% secondary connected (due to abnormal gait caused by service connected left ankle disability).

4. VA received claim 11/18/2017: Existing appeal for back so (reopen) appeal.

5. Rating Decision 11/21/2018: Service connection for back is denied. NOTE: Was the same decision as previous Rating Decision 11/29/2016 and did not address the corrected claim that back was secondary service connected to service connected ankle.

Edited by dwbell99

Share this post


Link to post
Share on other sites

Recommended Posts

  • 0

I noticed the Supplemental claim states this:

"6. Favorable Findings warrants veteran's entitlement to secondary service connection for back and bilateral sciatica since it said that "Private examination for Dr. REDACTED (Board-certified Anesthesiology and Pain Management) opined that chronic L5-S1 disc degeneration & bilaterla lower extremity sciatica are more likely than not less secondary connected (due to abnormal gait caused by service connected left ankle disability)" 38 CFR § 3.104 - Binding nature of decisions"

I had assumed, in prior reply that the VA manipulated the exact wording of your IMO by stating the "less" part

If they did that too must be addressed in the Supplemental claim.And in your IRIS complaint.
 

Share this post


Link to post
Share on other sites
  • 0

Berta, 

1. How is this for a IRIS complaint?

VA Rater manipulated the VA examiners medical opinion by making two changes  (1) from rating "claimed bilateral lower extremity sciatica" to "claimed condition" so that it would apply to his "degenerative disc disease, lumbar spine (claimed as back)" and (2) from "is less likely than not (less than 50 percent probability) proximately due to or the result of the veteran's left ankle osteoarthritis." to "is less likely that not (less than 50 percent probability due to or the result of your service connected condition.".

    VA Examiners medical opinion: Therefore, any currently diagnosed condition(s) related to the veteran's claimed bilateral lower extremity sciatica, is less likely than not (less than 50 percent probability) proximately due to or the result of the veteran's left ankle osteoarthritis.
    
    VA Raters comments in REASON FOR DESISION in Rating Decision: On VA examination dated January 29, 2018, the examiner opined that your claimed condition is less likely that not (less than 50 percent probability due to or the result of your service connected condition.

2. Can you review the Main Points of my proposed Supplemental Claim (see attached file)

Back Supplemental Claim Main Points.pdf

Edited by dwbell99
add file

Share this post


Link to post
Share on other sites
  • 0

I suggest under# 6 in the download that you use 'Independent Medical Opinion' from Dr .........instead of the acronym "IMO."

I think this is well done, but I also think you might have to consider getting a stronger IMO ( actually an IME)

from a doctor fully versed in all of these conditions, and who can rule out any other etiology or cause for the secondary conditions that you claim are due to the SC ankle condition.

I have very little experience with your  type of back conditions. Others here have those conditions. I know foot disabilities can lead to many other problems because of the fact that they throw off the spinal alignment.

I mentioned here before and  on the older hadit board, that BVA awarded TDIU for a vet, who started out with SC flat feet, but he had considerable medical evidence that this affected his knees, hips, and back and he could no longer work due to the secondaries the SC feet had caused.

Nothing is impossible but it can often take a lot of medical evidence.

I never suggest IMO/IMEs without the fact that I needed them for one claim I had, so I got 3 and even ordered a fourth but the award came before I even got the 4th IMO. 

So I know how expensive it can be ,but it is often the best investment any veteran can make. It is very difficult for the VA to go against a strong IMO/IME from an expert in the field of the specific disability.(ies).

 

 

 

Edited by Berta

Share this post


Link to post
Share on other sites
  • 0
1 hour ago, Berta said:

I suggest under# 6 in the download that you use 'Independent Medical Opinion' from Dr .........instead of the acronym "IMO."

I think this is well done, but I also think you might have to consider getting a stronger IMO ( actually an IME)

from a doctor fully versed in all of these conditions, and who can rule out any other etiology or cause for the secondary conditions that you claim are due to the SC ankle condition.

I have very little experience with your  type of back conditions. Others here have those conditions. I know foot disabilities can lead to many other problems because of the fact that they throw off the spinal alignment.

I mentioned here before and  on the older hadit board, that BVA awarded TDIU for a vet, who started out with SC flat feet, but he had considerable medical evidence that this affected his knees, hips, and back and he could no longer work due to the secondaries the SC feet had caused.

Nothing is impossible but it can often take a lot of medical evidence.

I never suggest IMO/IMEs without the fact that I needed them for one claim I had, so I got 3 and even ordered a fourth but the award came before I even got the 4th IMO. 

So I know how expensive it can be ,but it is often the best investment any veteran can make. It is very difficult for the VA to go against a strong IMO/IME from an expert in the field of the specific disability.(ies).

 

 

 

*. I changed #6 from IMO to Independent Medical Opinion.

*. I have requested medical opinions from my pain doctor and my back surgeon. Asked both to comment on (1) back secondary service connected to the service connected ankle, (2) ankylosis/forward flexion in my back (for rating purposes), and employabiliity due to survice connected back (after awarded back secondary to ankle).

*. Researching court cases to support my 'concerns' in the Supplemental Claim.
4. VA examiner's medical opinion is of questionable probative value because she/her:    
    (d) competency is suspect since she her medical clinical specialty is Pediatric Emergency Medicine.
            "Evidence from a source that is not competent to establish a fact does not have probative value on that fact." 
                M21-1, III.iv.5.A.2.e.  Determining the Probative Value of Evidence
            "Evidence from a source not having the requisite competency to offer a particular type of evidence has no probative value."
            M21-1, III.iv.5.A.1.f.  Overview of Evaluating Evidence

 

Edited by dwbell99
deleted repetitive info

Share this post


Link to post
Share on other sites
  • 0

Good , but they need to make a strong statement as to how your SC ankle problem has medically caused these affects to your back, etc.with no other possible cause (etiology)

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

  • Ads

  • Our picks

    • Need your support - T-shirts Available - Please buy a mug or a membership
      if you have been thinking about subscribing to an ad-free forum or buying a mug now would a very helpful time to do that.

      Thank you for your support
      • 18 replies
    • OK everyone thanks for all the advice I need your help I called VSO complained about length of time on Wednesday of this week today I checked my E benefits and my ratings are in for my ankles that they were denying me 10% for each bilateral which makes 21% I was originally 80% now they’re still saying I’m 80% 

      I’m 50% pes planus 30% migraine headaches 20% lumbar 10% tinnitus and now bilateral 21% so 10% left and right ankle Can someone else please do the math because I come up with 86% which makes me 90 what am I missing please help and thank you
    • I was denied SC for IBS and GERD IN 2011. In 2019 I was awarded SC for GERD. This CUE  is for 2011, both GERD and IBS. There are some odd aspects regarding the 2011 decision, the way it was written and the C&P report and the way it was written. I've tried to present this as clearly as I can. Note: the decision contradicts itself. the decision also contradicts the C&P Report. Honestly, I think the rater just got confused because the C&P was so poorly written. *THIS CUE HAS NOT YET BEEN SUBMITTED*Please let me know what you think. Appreciate all comments and suggestions. Thanks.

       

      VA RATING DECISION MARCH 23 2011 GERD IBS.pdf C P REPORT 7312010 GERD IBS.pdf GERD IBS CUE 2011(1).pdf

      C P ADDENDUM REQUEST RE DIAGNOSIS 7232010.pdf
      • 56 replies
    • 14 Questions about VA Disability Compensation Benefits Claims
      When a Veteran starts considering whether or not to file a Veterans Affairs Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about when it comes to filing Veterans Affairs Disability Claims. [Reprinted here with permission from Veterans Law Blog]
      • 0 replies
    • Disabled Veterans Property Tax Exemptions by State
      Alabama 
      A disabled veteran in Alabama may receive a full property tax exemption on his/her primary residence if the veteran is 100 percent disabled as a result of service and has a net annual income of $12,000 or less.
      • 0 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines