NOD Help for Secondary Conditions.

[AllTheWay]

Greetings to all members to Hadit. 

The question may have been answered in the forum but I can't find and answer anywhere  so therefor any help would be greatly appreciated.

I have recently file a  secondary claim for bilateral knee conditions caused by my bilateral flat feet which I am rated at 50% for. I do have a diagnosis for both  knees which were submitted.

The examiner opined that I do have a bilateral knee condition that is less than likely than not caused by bilateral pes planus.

The examiners rational was " that  the veterans bilateral condition was due to a specific incident or injury while in service and not by pes plans".

To me, the examiner does see a direct service connection for my knee condition.

I was denied bases on  the examiners opinion but the rating official did not consider the examiners rationale.

I am in the middle of doing an NOD instead of a reconsideration, even though I filed as secondary,  Is there a reg out there that states that the rater can do a direct service connection being that I have an event or injury while in service, I do have a diagnosis, and looks like the examiner stated it was caused by an incident or injury while in service (looks like a nexus)?

Thank you all in advance for your help.

 

 

[broncovet]

You also asked about primary and secondary conditions.  Veterans, in order to get benefits are required to get both a law degree as well as a medical degree before an award can take place.  Then they have to go to work for VA for at least 10 years as a rating specialist, so they can understand the entire rating process in their sleep.  Hmmm, maybe not.  

    I dont suggest you "limit" your application for benefits to primary or secondary.  If you guess wrong about what the decision maker is thinking, then you will delay your claim.  Instead, ask for your condition both primary and secondary, and let the decision maker review your evidence and decide which, if any, applies to you.  

[ShrekTheTank]

Bronco is right on here.  You never know what they will find in your file.  Or how they will connect it so let them sort it out.  Then based off of that information you can make your next move with more information and find them the 5 star evidence they need to connect it!

[AllTheWay]

Thank you for the rapid response @broncovet and LightofSolitude. 

The exam was a positive exam in my opinion. The only negative thing was the opinion and rationale.

This is what the examiner stated verbatim:

Opinion: It is the opinion that the Veteran does have bilateral knee conditions that are less likely than not proximately the result of bilateral pes plans and plantar fasciitis.

Rationale: The Veteran has specific diagnosis for the left knee, as mentioned, and the right knee has a dx of recurrent knee strain. From the history these are related to specific injuries in service and not to the bi pes plants and plantar fasciitis.

I do know how the examiners now how to twist things up, but prior to that exam, I had my non VA primary care do a DBQ for the same condition, which I did not include because I plan to use that as well as my recent MRI for new evidence.

Here is what my non VA PCP wrote.

Opinion: After reviewing the veterans treatment records, service records, and MRI findings, as well as completing a thorough history and physical exam, it is my opinion that the veteran has the diagnosis previously stated and that they are likely as not incurred by the diagnosis in service.

Rationale: In 19 blank blank, the veteran was seen in the emergency room from a MVA while in service and was diagnosed with knee strain. The Veterans 20 plus years of military service with strenuous training and multiple combat deployments, along with his diagnosis of bilateral pes planus are as least as likely as not have exacerbated his bilateral knee condition and in his current chronic knee conditions. He did name the condition. he also Cited FM 21-20 about the affects of strenuous training and what injuries that it could cause.

I do have cites from Web Mayo as well as NCBI. I am planning to do a NOD on this one.

 

[AllTheWay]

I do understand what you are saying bronco. I wish I had known how the process had worked over 10 years ago. I was that hero while in service, never complained, because my seniors had brain washed me, especially at Ft Campbell and Bragg. Medical records are thin. Once I had retired, was only awarded 10% for tinnitus. I was ignorant about VA process until a good vet told me what I needed to do. Was good advice. I went fro 10,30, 60,80, and now at 90. I have put my body through a lot and let me tell you, it is catching up to me. What really gets me and what I am trying to service connect, all of my denial letters which I have all says that although there is evidence in your service records, an injury or incident has happened while in service, they still will find a way to deny. I am sure that it happens to lots of vets. We can not win this war unless we keep fighting. Happy Veterans Day to my Hadit family.