Private Doctor Nexus Statement

[deedub75]

Hello All,

I'm new to the forum although I've been on the site to read comments in the past.  

 

 

I've been battling the VA for years trying to get SC for my knees and my back.  I am claiming bilateral knee tendinitis and and bulging disc in my lower back secondary to my service connected right ankle injury and bilateral pes planus.  Every time I appealed, the VA kept sending my claim back to the same NP that keeps denying me over and over.  Every time new information was presented she would come up with a different reason to deny me.  She just keeps doubling down on false information.  First, she said I had a normal gait.  I provided a copy of my exit exam stating I had an abnormal gait.  She then said my gait wasn't bad enough.  My case ended up at BVA where the judge remanded it basically saying that the examiner was ignoring my abnormal gait and other issues.  She then denied it again saying that my age and weight was the cause of my knee and back issues.  I have put on weight but when I originally filed these claims and attended exams I was around 170 pounds or so.  

A couple of months ago, I decided to ask my orthopedic surgeon if he'd be willing to write a nexus statement for me.  I asked him if it was possible that pes planus and a bad ankle could cause knee and back issues and he said it absolutely can.  He couldn't believe that the VA would say it was impossible.  I found a nexus statement online and actually wrote it for him.  I gave him a handful of my records to review showing that the VA had diagnosed me with knee and back issues so he was comfortable saying that he revived my VA records.  I sent this in as a supplemental claim and got a call today from a contract company for a C&P exam.  I was kind of surprised that exams were ordered but I figured that maybe they want to find out the current severity of my conditions.  The person did mention medical opinions which have me a bit worried now.  

I believe I am seeing a general practice nurse practitioner.  If this NP says my knee and back issues are less likely than not caused by my SC pes planus and right ankle, could she really override what my board certified orthopedic surgeon says?

 

[ruby]

Deebbud,

the section your looking for 3.159 (5/08) duty to assist.

1. Competent. Medical evidence means evidence provided by a person who is qualified through education, training or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also mean statements conveying sound medical principles found in MEDICAL TREATISE. It would also include statements contained in authoritative writings such as medical and scientific articles and research reports or analyses

i always wrote see section etc. duty to assist then I would type that section, number, it as evidence and provided a copy.  I did this because no one could say oh I didn’t know, if it went to the highest court every piece of evidence would be in my file to support my claim.

 

[ruby]

Buck,

if the VA acknowledge they recieved a claim but never adjudicated the claim is that a cue. 
 

[ruby]

Dust off,

I have a complete copy date stamped by the VA.

thanks 

[Miken2c74]

This is like deja vu. I have been fighting with VA for 6 years on two of the same issues. Bilateral Pes Planus and knee conditions. At the 4 or 5 year mark they sent me to a C&P examination, the examiner did a horrible job administering the exam. Me not knowing I could challenge the exam, I went out and had an Orthopedic Surgeon with over 30 years experience in that field as well as performing VA C&P exams. I had my records in tow, she looked through my records and was amazed that VA would deny with abundance of evidence that was actually on file. Here recently I have appealed that claim again, but this time I challenged that exam, submitted buddy statements and all that. Now everything they need to adjudicate this claim is there. If they deny I go to HLR and if they still deny I go to the Board. 

[Miken2c74]

Oh yeah and most of my insight came form this forum. Thanks guys. Even if I was not commenting I was reading. That helped me alot to be able to read it and know where to find the information.

[Berta]

A properly written IMO/IME that follows the IMO/IME criteria here at hadit, 

even if it costs you $$$$, will be the best investment you might ever make.

Pes Planus is well known to cause back, knee and hip problems.*

I know that because I have pes planus.

* and  that is-it is well known in the field of podiatry as well as by orthopedic doctors.

I have custom orthos ,redone every few years. My neighbor was given cheap inserts because his SC knee replacements had made one leg longer than the other one.

His VA Dr said everybody has one leg longer than the other.That is technically true but not everybody had the knee surgery he has had.

I showed him my orthos and he was shocked at the difference between the cheap insoles the VA gave him so he raised a little hell with them and now has better orthos, but I dont know if the VA supplied them or he got them himself at a podiatrist's office.

They say one out of every 3 seniors falls every year.

If they require good orthotics,because foot problems can affect  one's balance, neither Medicare or CHAMPVA will pay for them - I have paid from 350 to 540 bucks for them.

M daughter was due  home from the Mil when my first pair was ready many years ago ( it takes 4-6 weeks).

The podiatrist told me to only start out by using them for a few hours a day. With my baby service woman home, on leave, I forgot what the Dr said and was on my feet for hours cooking and showing her my garden , a new roof I had  , my new PC, and all that stuff, with the orthos still in my shoes.

I woke up the next morning without a chronic back ache I had had  every morning for years.The back ache never came back and all my bone scans over the years had revealed there is nothing wrong with my spine.

Maybe the VA does a better job with foot problems these days, that does not mean however, that some C & P doctor would have a single clue on this type of disability.

These claims can be bolstered by good podiatric internet print outs , that a IMO/IME doctor could use as well, to support their opinions.