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New Claim - Where to begin?


CGMedic17
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Question

Hello All!

My name is Cris, and I served 4 years active duty in the USCG as a BM3. I am here on the recommendation of a co-worker who has had a lot of success in his claim with the VA and he suggested I do the same, stating you need an airtight case.

I am a 30 year old male who suffers from low back pain, which started towards my last 2 years in the CG. I was on small boats my entire career, was a Boarding Officer, Coxswain and Heavy Weather boat crewman. Daily, getting out of bed is rough, taking some time "to get the kinks out." I believe a lot of this has been caused by bouncing around in a small boat for 4 years wearing all of the equipment we were required to. I do not have much documentation of my injury when I was in, with it being attributed to 'wear and tear.'  As I stated, my co-worker has had great success in these forums with his claim, and I am hoping to have the same. I have been seeing a chiropractor for some time now and seem to get little relief from it but nothing of significance. 

I am unsure of a few things... 1. I currently work as a career firefighter/ paramedic and my body has been put through the ringer, does this put me at a disadvantage with a claim? 2. Do I even have a case? even though they could chalk up my injury to my current job with no previous documentation? 3. Where would I even begin? 

Any and all help is wanted and appreciated! Thank you in advance and stay safe!

 

 

 

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Ok so a few questions first.  Have you ever been seen at like sick call or your regular doc for your back? Not  sure how the CG works.

Next it sounds like you have an in service even, but you are going to need an IMO of a doctor who will it is at least likely as not related to your time in service.  

Do you remember when your back pain started?  Do you have any other issues?  

I would go to Ebenefits and start a claim today.  You do not need to finish it just start it as it will preserve your start date, unless you are within one year of service?

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CGMedic17 Shrek's advise is spot on. Just to tag on, I would not only start with the intent to file, but order your c-file. You want to scour thsoes records and hopefully they will have some documentation of your injury. Could be something as simple as a notation you received some aspirin or muscle relaxers. You probably have been out of the CG for a few years, but you have a chance because you are only 30, so it's not terrible. The key will be anything in your str's and the IMO from your doc that says your condition is YEARS old and HAS happened or originated in the service. You want to down play heavy workload in your current job. Maybe OSHA and safety requirements have greatly minimize the "bull work"  as a paramedic???

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It sure is Spot oN! So is GB Army!

Do I even have a case? even though they could chalk up my injury to my current job with no previous documentation? " they  will if they can- 

A good IMO/IME doctor ( you might need an inperson exam) will need a copy of our SMRs and Discharge Certificate- as you might have mentioned the back problems when you mustered out.And any private medical records too.

A good IME doc can rule out any other etiology ( cause) for the current back problems, which are 'aggravated' by your current occupation.

You might need to explain how your CG MOS caused back problems, and that would help the IMO/IME doctor to be able to prepare an air tight opinion.

They will need to follow the IMO/IME criteria here at hadit in the IMO/IME forum.

 

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This BVA decision award for Back pain regarding a Coast Guard veteran:

https://www.va.gov/vetapp18/files7/18117241.txt

As you can see the claim had multiple opinions from VA as well as private doctors and they were all basically deficient.

"The evidence weighs for and against the claim which puts the issue into equipoise. Since his INACDUTRA injuries, the Veteran has sought treatment from private rather than VA providers for much of his care. As such, some of the clinicians have been treating him since the time of his injuries, or at least for many years. While earlier private opinions did not provide requisite rationales, subsequent submissions have attempted to provide a basis for the opinions. While the language utilized did not always track the more-likely-than-not legal standard required for service connection, the clinicians attempted to show that the Veteran’s current disability and symptoms resulted from in-service incurrences, and provided years of treatment notes to support their opinions. Therefore, reading the evidence in a favorable light, it is at least in equipoise and the appeal is granted."

This case shows why any IMO/IME doctor needs to follow the IMO/IME criteria and give a strong rationale for their opinion, using the specific "as like as not" wording. 

Although the above vet had an inservice injury , which I assume you did not have, still these claims can succeed.

But one other thing ..."back pain" is not as specific as a proper diagnosis would be....which I assume a IME doctor would want an MRI result for.

I have seen claims wherey "Back Pain" was too general a term ,for a proper rating.

The VA would be more able  rate your claim if in fact it is diagnosed as DDD of the lumbar spine or 

vertebral degeneration, etc, two of many terms for back issue diagnoses.

 

 

 

 

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I agree with the others, but will add:

1.  Like always, you will need all 3 Caluza elements for your claim to suceed.  Current diagnosis of a back condition by a doctor, Documentation of an in service event, and nexus or doctors opinion that your current diagnosis is related to an in service event.  

2.  If you dont have documentation of an in service event, then an IMO wont help you.  Buddy letters may suffice to establish an in service event.  

3.  Order your cfile and medical records.  See if you have a diagnosis, (back issues), as well as an in service event.  If you have these 2, an IMO doc can provide a nexus.  

4.  Documentation of symptoms "continuity and chronicity" may be required.  Does your condition show up on an xray or MRI?  This should help, if it does.  Generally, SC compensation is paid to Veterans based on their loss of ability to earn a living, to some degree.  Do your back issues limit your ability to work, or is it limited to early morning pain?  I dont know that, but you may have to have documentation of that for a disability rating above 0 percent.  Its gonna boil down to your records, and, as always, evidence.  

I think there may be some restrictions on benefits "unless you are on ACTIVE Duty".  (Excuse my ignorance I dont know if you served on active duty or reserves).

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https://community.hadit.com/topic/53826-read-first-if-getting-an-imo/

(This is the link to the IMO/IME criteria here)

Cris was AD in the CG.

Edited by Berta
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