Upcoming C&Ps (same day) for ratings increase for feet pain/knee/migraines/PTSD

[JaeT.21]

Hello, I have C&P exams all in one day in January. Any advice on what to expect?

Here's a synopsis on what I'm up against/working with. 

- PTSD increase is based off several years of VA mental health treatment and a Nexus letter written by my mental health doctor, which named PTSD, Depression, Chronic Pain Syndrome with depression, Panic D/O with Agoraphobia and survivor's guilt as a diagnosis (last 3 are recently added to records).

- Knee pain- VA issued me a big knee brace and my primary care (tricare) orthopedics specialist just put me an Ankle-Foot Orthosis (AFO) brace because she says I have drop foot and weakened ankle support which tried to compensate for my weak knee/muscle strength

- Foot pain- I reviewed all of my previous C&P exams and realized my foot pain rating had dropped from 30% to 10% because the rater misquoted me (lied) on the C&P exam. I told him these insoles and stuff didn't work. that my feet hurt all the time. He wrote, I said they were not effective insoles and I have to use all kinds of feet massages equipment to get through my work days. 

The primary care sent me to this foot pain doctor. All she did was cortisone shots (3 times) in my feet and tried to up-sell me on her brand of insoles. 

- Migraines- Been at zero percent since retirement. Last year I was hospitalized twice and misdiagnosed with having TIA and strokes/CVA. My VA advocate put in a secondary claim to my service connected cervical damage.  End result not service connected for CVA/TIA.

However,  ALL TESTS revealed that I've never had a stroke.  The neurologist diagnosed me with Hemiplegic Migraines. These rare migraines an mimic strokes, causing weakness on one side of the body. They can last from a few hours or in my case,first one lasted 3 months.

The neurologist provided a letter stating that all of the hospital doctors had misdiagnosed me with having CVAa.  He also diagnosed me with exertional headaches.

 

I know I'm no more special than the millions of other veterans out here, but this "deny 'til they die" tactic is wearing me down.

 

Thanks for any advice.

 

 

 

[vetquest]

First I would suggest that you start a migraine diary asap.  These are used by doctors to judge the seriousness of your migraines.  It is a pain but it does help, you can find many on the internet.

Be honest at your C&P but let them know what your worst day is like, do not say I am doing great.  "I am good today but earlier this week I had a migraine that sent me to bed."  The same for your feet and PTSD.

I might also try to get some buddy letters from your manager at work if they are willing.  This shows the seriousness and financial impact of your disability.  I lost my job of 25 years over losing too much time off from work and not being my best while at the job due to my disabilities and the medications that were necessary.  It took me ten years, this will hopefully not happen to you, to get my case through the BVA which granted TDIU and full benefits.  The BVA cited employer letters as one of the highlights of evidence that showed I was not able to perform my job due to my disability.

No you are not special but it is trying none the less.  Loss of income and pain are not good for the mind or a good way of living.  It creates it's own stress and this is something that you need to look after.  If you were not depressed when you begin working with the VA, you will be when you get done.

Good luck drawing good doctors for your C&P's and keep us apprised as to the results.  Sometimes, many, you will get denied by the RO with a poorly done rating.  Never quit at this point, always appeal if you are not given the full benefit that you deserve.  Go to the BVA if necessary.  It is a long process but the BVA reads your evidence and applies it much better than the RO.

 

[ShrekTheTank]

Vetquest is dead on here!  Follow what he said and you will succeed!  

Trust me I started out here at 30% and am headed to the CAVC to get to 100% P&T

[Buck52]

I Agree here with Shrek & Vetquest  Great Advice please follow it.

You should not have any problems getting your increase if you have the medical Documentation and Dr's Notes to show your  condition and symptoms have indeed worsen.

**Note, Don't be shy at your exam  if you feel the examiner is not touching on something (they read about your conditions your claiming for increase mostly off the computer) and may or may not ask to many questions  but if you need to speak up  you better do that...just say excuse me Dr ,Did you read the part Dr Smith mention about my Migraines, or what the MH Phyistrist mention about my PTSD Symptoms getting worse.

if you don't think they have or if they don't ask you any questions about them   speak up...just be nice when you ask.

Its always good to have any favorable  documentation at your Exam to back you up  incase the VA Never sent in all the information the examiner needs.

[Richard1954]

4 hours ago, JaeT.21 said:

orthopedics specialist just put me an Ankle-Foot Orthosis (AFO) brace because she says I have drop foot

I think you have received excellent advice from the other responses....but 

Drop foot is a condition caused by neurological conditions , such as MS or nerve impingement caused by degenerative disc conditions due to a back injury.   I have had drop foot for over 20 years caused by my back injury... I am not a doctor but I seriously doubt that a knee disorder has anything to do with your drop foot unless you have had knee ligament surgery . Drop foot is normally  caused by  a damaged Sciatica nerve or Posterior Tibial nerve. Normally, a nerve conductive test is required to substantiate this condition.  People with painful disorders of the  sole of the foot may have a similar gait but do not have drop foot.  Because you mentioned foot pain,  I suspect this is causing your problem.

Actual cases of Drop foot  render the foot useless,  and the person is no better off than if the foot had been amputated.   It is rated as loss of use, and can result in a K rating as well as a percentage rating,  but  the  VA  will normally require a nerve conductive test before they rate it. 

I am not saying you don't have the condition,  I am just saying I would not be quick to blame it as secondary to the knee.

Here is a link from Wikipedia  it  describes Drop foot and the causes 

 

[sixthscents]

Richard1954 is correct here. However I have seen drop foot caused also by ples planus or diabetes. Also there are lots of things to consider when filing a claim. What exactly did you file compensation for? I didn't see that but maybe I missed it.

 

Sixth

[sixthscents]

Oh and as this is my area of specialization (ie Loss of USE claims) I can also say that Richard is a bit wrong when he states that drop foot normally results in complete loss of use. That actually varies. However is is DEAD ON when he says the the nerve conduction test is the benchmark diagnostic for any claim due to neuropathy or radiculapathy. It would also be "new and material evidence"... so there is that. In any case don't let them wear you down. Seriously rekindle that anger at the sheer ineptitude and injustice. Look I know many many people at the VA are great but... yeah it certainly seems like dent until you die but... but... if you keep the claim alive then when you win there is all that glorious backpay!!!!! WOOT!!!

You can win buddy. Especially with the people here helping you.

Sixth