How To Know What Injury Or Event Connects Current Issues

[flow1972]

Some of you know, I'm new to all of this.  I feel like I'm trying to build a 5,000 piece puzzle with no picture or instructions to look at.  I currently have 10% SC for Tinnitus.  I have a C&P scheduled for the 18th of November for my PTSD caused by MST Claim.  I have a ton of things in my SMR's as well as CMR's that I have no idea how to connect the dots on.  Is there some "place" or "person" that assists with this stuff???  I feel lost, and I'm a Data person.

I have currently diagnosed conditions:

1. Carpal Tunnel

2. Raynaud's

3. IBS/Spastic Colon

4.  Current Gastritis 

5.  Just had my Tonsils out at 46 (yep...tonsil lesion after decades of recurrent pharyngitis/Strep/Tonsilitus)

6.  Lower back disk degeneration (been on my Xrays for years)

7.  Arthritis in hands (not RH)

8.  Cold Sores

9.  Asthma/Allergies

10.  Right Hip (Injections a few months ago)

11.  Vertigo (I believe it's Motorist Vestibular Disorientation, but the one time I asked my PCP about it, they thought it may be my allergies causing it)

I left service back in 1996.  I had just had my first child and was still recovering from the affects of Pre-Eclampsia.  ( All over my SMR's.)  No physical at Separation. I have things in my SMR's where I had Asthma as a child but no issues since early childhood (on my Entrance paperwork).  I also have an entry where they state there was a review of my Medical Records (Security Review for Above Top Secret) and "No Chronic Illnesses" or something to that affect.  I literally had 9 cases of URI/Bronchitis/Phneumonia or a related lung issue in my 5 years of service logged in my SMR's. 

There was 12 cases of Strep/Pharyngitis/Tonsillitis along with a visit for some stomach issues that went on for several weeks (pretty sure this is when my IBS started showing up), a broken 9th rib (got kicked by a horse in Germany), Left Ankle Overuse Syndrome (I don't know why it says this because I'm pretty sure that's when I got sever shin-splints in both legs), Right ankle sprain, left knee strain, left hand and wrist injury, left thigh myalgia 2nd degree strain..then I started having to be given meds for allergies/Asthma episodes again the last few years in service.  I had a ganglian cyst removed from my right hand just a little over a year after I left service...I've read there isn't a "known" true cause but arthritis can be a possible cause...

I'm just overwhelmed with what relates to what and so forth.  My Carpal Tunnel...you know they'll try to say that's 100% due to my work as a Data Analyst when the "know" hand/wrist injuries as well as job duties that require repetition also contribute...I even have a note in my SMR's about my fingers being numb while I was pregnant, but I guarantee they'll attribute that to the Edema from the Pre-E.  So.....how do you work through it all in the best way NOT to screw yourself????

Edited October 29, 2019 by flow1972

[flow1972]

30 minutes ago, vetquest said:

The military was able to say it was pre-existing because they bypassed the review board required for all medical discharges, it was illegal.  It took the work of the NCOA, a retired general, the Navy Times, and a case at the Board of corrections of the Navy to get it corrected.  It took five years, without benefits before I was retired.  The good news is that it shined a light on a process that the Navy was using to bypass the system and other veterans also had their discharges re-evaluated.  Sometimes the system is rigged and all we can do is our best to correct it.

Wow!  No other words for that debacle.  Completely despicable to treat our Veterans that way...

[Vync]

@vetquest did you ever file for VA disability due to pre-existing/aggravation? If you did, were you given a reduced rating?

[vetquest]

No, I received a PTSD rating for my injuries, a rating for headaches caused by my injuries, and for neuropathy in all extremities caused by my injuries.  My disability was not pre-existing and everyone knew it, they just used it to discharge me.  The VA used the excuse that all of my situation was physiological and that no physical manifestations were present.

[Vync]

Wow. If the military tried to justify me out of the military to a pre-existing disability, I would have filed for it.

In my case, I opted to leave service, but did file for and win SC for aggravation of an existing disability. I had to file a CUE for it because the VA applied an unjustified 10% rating reduction.

Quote

§ 3.322 Rating of disabilities aggravated by service.

(a) Aggravation of preservice disability. In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree of disability existing at the time of entrance into active service, whether the particular condition was noted at the time of entrance into active service, or whether it is determined upon the evidence of record to have existed at that time. It is necessary to deduct from the present evaluation the degree, if ascertainable, of the disability existing at the time of entrance into active service, in terms of the rating schedule except that if the disability is total (100 percent) no deduction will be made. If the degree of disability at the time of entrance into service is not ascertainable in terms of the schedule, no deduction will be made.

(b) Aggravation of service-connected disability. Where a disease or injury incurred in peacetime service is aggravated during service in a period of war, or conversely, where a disease or injury incurred in service during a period of war is aggravated during peacetime service, the entire disability flowing from the disease or injury will be service connected based on the war service.

Cross References:

Principles relating to service connection. See § 3.303. Aggravation of preservice disability. See § 3.306.

[26 FR 1583, Feb. 24, 1961]

The VA is supposed to look at your entrance exam and determine the level of disability present at that time in terms of the rating schedule. If they can't do that, are not supposed to reduce the awarded rating by the pre-service amount.

It was for allergic rhinitis. Entrance exam was silent/normal. Rating criteria requires evidence of blockages or polyps. The VA just made up a flat 10% estimation because a doc said I always had it.

My CUE was based on the VA not following the law in effect at the time 3.322(a).

I don't mean to take away from flow's topic, but it is crazy how both the military and the VA can screw things up.

[flow1972]

17 minutes ago, Vync said:

Wow. If the military tried to justify me out of the military to a pre-existing disability, I would have filed for it.

In my case, I opted to leave service, but did file for and win SC for aggravation of an existing disability. I had to file a CUE for it because the VA applied an unjustified 10% rating reduction.

The VA is supposed to look at your entrance exam and determine the level of disability present at that time in terms of the rating schedule. If they can't do that, are not supposed to reduce the awarded rating by the pre-service amount.

It was for allergic rhinitis. Entrance exam was silent/normal. Rating criteria requires evidence of blockages or polyps. The VA just made up a flat 10% estimation because a doc said I always had it.

My CUE was based on the VA not following the law in effect at the time 3.322(a).

I don't mean to take away from flow's topic, but it is crazy how both the military and the VA can screw things up.

This will probably come up for me.  My entrance exam notes Asthma "No issues since 7 years of age".  It also notes 0 Medication and Zero Known Allergies.  I believe I contracted RSV as an infant and had some "Asthmatic" episodes in early childhood just based on what we had happen with my own daughter and RSV.  I never had any issues after 1st grade that I recall..and no inhalers or anything.  There is even an entry in my records where they did a "Medical Records Review" as part of my security clearance where it states "No history of chronic medical issues".  As soon as I got in to Tech School, I started getting URI's, Walking Pneumonia (once), and Bronchitis quite often.  When I got back from Germany, they sent me to the allergy doc.  It shows "Provisional Diagnosis" - alergic rhinitis and asthmatic bronchitis with allergy testing only showing reaction to dust.  That's one of the things I'm working on getting SC for.  I figure they're going to balk at it because it's on my entrance Exam..but they state in their own words..no issues since age 7..I was on no medications for anything...and they even did a full medical records review.  So...it was "aggravated by service" at the least.  One question I have is...do I need "another diagnosis" to file..or just show that I continue to be prescribed an Inhaler for episodes and meds for allergies?

[Vync]

5 minutes ago, flow1972 said:

This will probably come up for me.  My entrance exam notes Asthma "No issues since 7 years of age".  It also notes 0 Medication and Zero Known Allergies.  I believe I contracted RSV as an infant and had some "Asthmatic" episodes in early childhood just based on what we had happen with my own daughter and RSV.  I never had any issues after 1st grade that I recall..and no inhalers or anything.  There is even an entry in my records where they did a "Medical Records Review" as part of my security clearance where it states "No history of chronic medical issues".  As soon as I got in to Tech School, I started getting URI's, Walking Pneumonia (once), and Bronchitis quite often.  When I got back from Germany, they sent me to the allergy doc.  It shows "Provisional Diagnosis" - alergic rhinitis and asthmatic bronchitis with allergy testing only showing reaction to dust.  That's one of the things I'm working on getting SC for.  I figure they're going to balk at it because it's on my entrance Exam..but they state in their own words..no issues since age 7..I was on no medications for anything...and they even did a full medical records review.  So...it was "aggravated by service" at the least.  One question I have is...do I need "another diagnosis" to file..or just show that I continue to be prescribed an Inhaler for episodes and meds for allergies?

A provisional diagnosis means that they are not 100% sure of the diagnosis because they need more information. Think about how many times any doctor gives you antibiotics? Did they do labs to confirm the exact bacteria causing the infection? Unlikely. They gave it to treat the symptoms even if they could not diagnose the exact root cause.The presence of asthma on your entrance exam is not necessarily a bad thing. If the entrance exam doc had concerns, he would have sent you for PFTs/spirometry and noted any medications and possibly the frequency of use at that time. That's the parts that the VA is supposed to take into account when determining a pre-service level of disability. 

 

Well, for SC, you do need the Caluza elements:
1. Event/illness/injury in service or current SC disability or presumptive condition
2. Current diagnosis
3. Nexus from doc linking 1 and 2

Your diagnosis showed up when you got back from Germany, so that's an in-service diagnosis.

You appear to have a current diagnosis.

The only thing you need to get SC is a doc to opine that is is as likely as not related to service and back it up with strong medical rationale.

 

Let's assume that the VA grants you SC. They would then compare your C&P exam or DBQ to the rating criteria for the disability.

If the VA determines it was caused directly by service, aggravation policies would not apply. But for the sake of this conversation, let's assume they do grant based on aggravation because you said it was in your entrance exam. 

 

For asthma/sinus/bronchitis/etc.., the VA uses §4.97   Schedule of ratings—respiratory system

You can look up the criteria and compare that to what is on your entrance exam. For example, we will look at the asthma ratings:

Quote

6602   Asthma, bronchial:
FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications	100
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids	60
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication	30
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy	10
Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.

Let's look at the minimum rating criteria for 10%. There are several ways to qualify for 10% and they are separated by "or;" statements. Meeting any one of those means you meet that percentage level.

Lets assume the VA grants you 30% today because you need to use an inhaler daily to control your asthma. The VA would take your current level of disability of 30% and subtract the pre-service level of disability from that in order to determine your awarded rating for this disability. 

Let's assume that when you joined, a PFT or spirometry test was performed showing FEV-1 or FEV-1/FVC at 81%. Yeah, the doc diagnosed you with asthma, but didn't think it would hinder your service and gave you the green light to join. Because it did not meet the criteria for 10%, then that would mean your pre-service level of disability, in terms of the schedule, would be 0%. Current rating of 30% - pre-service rating of 0% = 30%. The VA cannot reduce your awarded rating.

Let's assume that the pre-service PFT was fine, but you used your inhaler interminttently (not daily). That would place your pre-service level of disability, in terms of the schedule, at 10%. Current rating of 30% - pre-service rating of 10% = 20%. The VA would reduce your rating from 30% to 20% due to aggravation and that would be your awarded rating for asthma.

 

 

 

Here's a link to my blog here regarding asthma ratings. It gives a more in-depth idea of how they work.