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Next Steps for Secondary Condition Claim


Kevin Viola

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First some background info: 

      I have an existing service connected disability (left knee @ 30%) and am now diagnosed with a degenerative lumbar scoliosis condition with several compromised discs and severe radiculopathy.  I have submitted an intent to file form to connect this lumbar condition to my knee disability.  The theory is that years of left leg instability has caused the lumbar scoliosis condition.  A private orthopedic specialist is providing a NEXUS letter for the connection (which in his opinion is very strong).  I'm being treated mostly on the private side, though the lumbar condition has also been documented at my last couple of VA yearly physicals. The prognosis is not great, the lumbar region is unstable and I am soon headed for a surgical decision (2 or 3 level lumbar fusion to stabilize the spine).

 

My question: 

   How best to proceed with secondary claim?  Should I submit what I have now (multiple diagnoses with supporting MRI's, NEXUS letter from a private specialist) and put off any surgery - get rated prior to surgery?  Or  proceed with surgery and add that to the secondary claim?

 

Thank you.

Kevin    

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This is my recommendation, UNLESS you have more money than you know what to do with. 

1.  Apply now.  If you apply before April 1, then you will get an extra month of retro, if/when awarded.  

2.  If you have surgery, and your condition worsens, then apply for an increase, and do that right away.  

      You can figure out how much it costs you to delay filing by multiplying the amount of compensation you get times the number of months you delay filing.  

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You'll get a temporary increase to 100% after the surgery for convalescence, then down the road you would probably be re-evaluated again. Surgery doesn't always correct the problem completely, though, so its not like its an automatic denial. Its based on range of motion, just like it usually is. 

 

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I would go with broncovet's advice and file now and not wait.  Your claim might take a while and it might not be done before you need the surgery.  Waiting only costs you money.

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Your "claim date" is the date the VA "receives" your claim, not the date you mail it (like the IRS).  So try to get it to the VARO "before" April 1.  You could try filing with ebenefits, if you havent mailed it already.  

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