personal statement

[pyrotaz]

Good evening,

 

When submitting a claim how many of you write a personal statement and submit it with the claim?

[brokensoldier244th]

I do a summary topsheet of what is going on, what im claiming, and page numbers or dates to relevant stuff in my records so that its easier to find for the rater. Hasn't steered me wrong yet. My wife put in a statement once about my snoring and stopping breathing when I filed several years ago for sleep apnea. 

[Carl the Engineer]

Every-time..

Tell them whats wrong, when it happened and that you were in the service at the time.  Or, if secondary, what service connected disability is causing what you are claiming.

Plain speak,

Hamslice

As an example, when I claimed "stiff neck", I wrote that I "hit my head at least three times a week getting in and out of my squad car at work because of my stiff neck", that I had injured while on active duty.  I was awarded DDD and DJD of the cervical spine and received 20% for Range of Motion.

[brokensoldier244th]

Quote

Here is an excerpt example of a claim I filed back in 2006 for an increase. This is similar to what I have included with any claim I have sent in as the first first page/s of supporting statement. 

 

 

 

I am claiming worsening right leg radiculopathy, and service connection for left leg radiculopathy.

 

I am also claiming Erectile dysfunction, secondary to Degenerative Disc Disease/nerve compression 

Supporting Symptoms
- Left Leg (My right leg is already rated and complaints of my left leg having similar conditions have already been established and noted)
numbness
weakness/’giving out’
sciatic pain
Possibly secondary to invertebral disc syndrome
And related to right leg radiculopathy sciatic pain*
*rated September 2002 

- Walking disability
My walking has changed due to pain and weakness in legs.

-Right leg radiculopathy (rated) has increased-is now constant
-Left leg extremity numbness (unrated) has increased-is almost constant
-Rt. leg muscle weakness

-Left leg weakness

-Diminshed reflexes, both Rt. and Left legs
 

Documentation for claim
Dr. Sellon’s narrative, Lincoln Family Wellness 6AUG2010

-Prescribed Paxil for premature ejaculation secondary to DDD/radiculopathy L5-S1

 

VAMC records, PCP Ward, 08/05/2010

-Prescribed Meloxicam 15mg daily, Gabapantin 300mg 2x’s daily, Prednisone 5mg x 6 days burst for Pain

X-Ray Records, PCP Ward 08/05/2010-Confirmed Mild Disc Spacing L5-S1 and L 2-3. This has worsened since original x-rays in 2001. 

 

Supporting evidence, Kolette Satterfield-Spouse

Supporting evidence letter-Lynn Heckman, -Coworker

 

Various other documents in C-file (enclosed and noted below)
Overall Diminished quality of life

11JUL2001 clinic screening notes " that all 10 toes felt numb" (see screening, Batallion Aid Station Doc #1)

12JUL2001, Dr. Dunkleburger notes "b/l parasthesis" in his exam notes (see Exam notes #1)

29JUL2001 personal statement: within 2 weeks of the injury note bilateral numbness while standing, sitting, and lying down. While more pronounced in my Rt. foot at the time, I noted it present in both feet.

8AUG2001 MRI exam: MRI examination notes “defect L5-s1, at and inferior to the interspace, compatible with disc herniation possibly with a disc fragment, with displacement of the right s1 nerve Root. A mild anterior extradural impression on the thecal sac at l4-5 is compatible with a mild disc bulge”.

22AUG2001 Neurological consult: “MRI of the lumber spine demonstrations significant degenerative disc disease at L5-S1. There is a right para central herniated nucleus pulposus that extend inferior behind the body of S1 with some displacement of the right S1 nerve root”

31OCT2001 DA3947 Request for Medical Board: “Persistent low back pain secondary to herniated nucleus pulposus with radiculopathy”

2002 C&P exam: noted diminished reflex in both extremities, left and right (1/4 deep tendon reflex Rt and Left extremity).

NOTE: Examiner notes that “…he says that his left foot is basically is completely okay at this point and does not really cause him problems….” But I answered in response to his questioning about which leg was currently causing me pain and numbness at that time in the examination. A little later examiner notes “he has back pain daily, shooting pain and numbness in right leg periodically throughout the day, but he does have some numbness and shooting pain into the right leg and foot at some point at least once a day and usually a couple to a few times a day”. This should have been noted for my Left leg and I believe that the examiner errored while typing the summary by typing “Right” twice. It makes no diagnostic sense, otherwise. Dr. Sellon, also concurs with this assessment after examining my medical records of the injury and forward.

 

 

 

 

VA Claim Example.pdf

Edited March 13, 2020 by brokensoldier244th

[GBArmy]

Just about any claim you submit should have a statement in support of claim,  form 21-4138, for each disability claimed, if more than one. It's a buddy letter from yourself kinda. You want to talk to your symptoms of the disability and how that relates to your daily life. Re-state or comment, for the record, what should already should be in your evidence. Especially include those symptoms that are called out on the dbq for your disability.

[Guest]

You can write a letter in support about your claim but the proper form is VA FORM 21-4138. https://www.va.gov/vaforms/form_detail.asp?FormNo=21-4138.

When submitting any claim, I fill out this form and attach any medical evidence to it. I include my service records and any current records that proves a diagnosis and or disability.  If you have an IMO/IME, you could add them also.  It appears that VA is very lazy so I try to give them everything up front. This should help but keep in mind that VA will sometimes deny a veteran's claim just to deny it and the veteran is force to file an appeal.