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Appeal To The Board


Chris Barnes
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Question

Just received my third turn down from VA.  They say I can appeal to the board.  The reason for turn down is because “Not enough evidence to show service connection.”  They have records of me having physical therapy and sick calls for my back.  Isn’t any evidence some evidence?  Have people had good results from, “Appealing To The  Board?”

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I estimate at least 50 percent (probably more) of Vets here on hadit won their claim at the BVA.  I would be in that category, as I won mine at the BVA.  As always, "records of sick calls and pt for your back" is insufficient, by itself for service connection.  Here is what you need:

1. Current diagnosis of a back condition.  

2.  In service event or aggravation.  Your PT and sick calls may provide that documentation.

3.  Nexus, or doctors statement that your "in service event" (which led to back condition) is at least as likely as not the cause of your current back condition.  

    Once you get these 3 Caluza elements, you are good to go at the BVA.  You "may" need to hire an IMO to supply a nexus. (likely).  

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So you might be having the same issue I had.  Did the doctor give it a diagnosis?  I had all the basses covered but they did not have a name for it.  Bronco nailed it above, you have got to have all 3 or they will deny all the time.

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2 hours ago, broncovet said:

I estimate at least 50 percent (probably more) of Vets here on hadit won their claim at the BVA.  I would be in that category, as I won mine at the BVA.  As always, "records of sick calls and pt for your back" is insufficient, by itself for service connection.  Here is what you need:

1. Current diagnosis of a back condition.  

2.  In service event or aggravation.  Your PT and sick calls may provide that documentation.

3.  Nexus, or doctors statement that your "in service event" (which led to back condition) is at least as likely as not the cause of your current back condition.  

    Once you get these 3 Caluza elements, you are good to go at the BVA.  You "may" need to hire an IMO to supply a nexus. (likely).  

 broncovet ,

Can you put up a redacted copy of the reason and bases of their decision what We Decided?

That will help this veteran  to know how and what they used in making their decision  it will help other veterans as well.

Thanks

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Buck...I cant post a reasons and bases for decision for "Chris Barnes".  He will have to post that.  

The reasons and bases for decision on my claims probably wont help Chris Barnes..we have a different set of facts, and that leads to a different outcome.  

That said, if Chris Barnes wants to post his reasons and bases for decision, that would help us help you.  

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I just looked on myhealth page and pulled up VA hospital records showing lower back visit only 2 1/2 months after I was discharged.  Another for lower back four months later and another VA hospital visit for lower back two years later.  After that I finally had insurance and went to regular doctors for it.

By the way the wreck they are talking about happened on my way to drill for activation.  They said since it was three days before the activation date, it’s not covered.  I was living out of state and I came to town three days before activation and was in a car wreck halfway.

 

 

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16 minutes ago, Chris Barnes said:

VA hospital records showing lower back visit only 2 1/2 months after I was discharged.  Another for lower back four months later and another VA hospital visit for lower back two years later.  After that I finally had insurance and went to regular doctors for it.

You could make copies of all these and high light the relevant parts. Then sent it to the VARO with attention to whoever sent you the rating.

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Ok Chris Barnes, I will take a stab and hopefully this helps.

You seem to satisfy the first criteria of a service injury or sickness.

Next, you need a certified diagnosis of a current back issue. This needs to be confirmed through x-ray, MRI, or nerve conduction test.

The therapy helps with treatment evidence; however you need a diagnosed injury to satisfy chronicity or worsening of condition since leaving military.

I would visit a orthopedic back specialist and bring all your military and physical notes.

If they can confirm a injury (herniation, nerve impingement, degenerative joint disease as evidenced, etc), then ask them to opinion if the initial military injury has a relation with the current diagnosis.

If you can secure all three levels of the evidence, then submit appeal to the BVA.

1. In service injury or sickness

2. Current diagnosis. Preferably by a specialist.

3. Nexus- statement of medical rationale of causation between military illness/injury and current diagnosis.

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4 hours ago, Fat said:

Ok Chris Barnes, I will take a stab and hopefully this helps.

You seem to satisfy the first criteria of a service injury or sickness.

Next, you need a certified diagnosis of a current back issue. This needs to be confirmed through x-ray, MRI, or nerve conduction test.

The therapy helps with treatment evidence; however you need a diagnosed injury to satisfy chronicity or worsening of condition since leaving military.

I would visit a orthopedic back specialist and bring all your military and physical notes.

If they can confirm a injury (herniation, nerve impingement, degenerative joint disease as evidenced, etc), then ask them to opinion if the initial military injury has a relation with the current diagnosis.

If you can secure all three levels of the evidence, then submit appeal to the BVA.

1. In service injury or sickness

2. Current diagnosis. Preferably by a specialist.

3. Nexus- statement of medical rationale of causation between military illness/injury and current diagnosis.

Thanks for the information Fat.  I am currently 100% disabled with social security for my back (multiple fusions and a spinal stimulator). I’m sure my family doctor will write a Nexus statement.  I was wondering if I should get an attorney.  I read on most forums to not waste my time with one.  What do you guys think?

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44 minutes ago, Chris Barnes said:

Thanks for the information Fat.  I am currently 100% disabled with social security for my back (multiple fusions and a spinal stimulator). I’m sure my family doctor will write a Nexus statement.  I was wondering if I should get an attorney.  I read on most forums to not waste my time with one.  What do you guys think?

Get an attorney.

At least you know if an attorney takes your case, there is a good chance he or she see an approval/win.

edit: if memory serves me correct, law firms have a higher winning percentage for appeals than VSOs.

Edited by Hucast21
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I'd go with the majority opinion here. I would also recommend a lawyer. Some evidence is evidence. Lawyers argue the "some' partl that's what they do. If they recommend adding more evidence, you can chose to do that. I wouldn't expect a VSO is going to be able to argue your legal position at a BVA, unless the VSO is exceptional. You have evidence, but as is, it isn't a slam dunk. So hire a lawyer, IMHO.

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Personally I would wait for the BVA to do their thing then get a lawyer when they will pay for it at the CAVC.

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8 minutes ago, shrekthetank1 said:

Personally I would wait for the BVA to do their thing then get a lawyer when they will pay for it at the CAVC.

That can take years if the veteran doesn’t file the correct paperwork. If a veteran doesn’t submit the correct form, their appeal could be stuck in legacy hell (if original claim was filed in 2018 or earlier).

With an attorney, a veteran can request their claim to go under AMA, which saves time with the added benefit of having an attorney present their case before a BVA hearing.

Edited by Hucast21
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It is true it can, but I don't want to give up that much money.  I am going on 5 1/2 years and I am now at the CAVC with my lawyer who is paid for by the ELJA.  

For someone else it might not work for them and they want it resolved sooner!  Do what works for you!

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Well I see you won at the BVA

Do they not have a reason and bases of your Win?

you posted '' I would be in that category, as I won mine at the BVA. ''

???

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On 5/6/2020 at 6:53 PM, Hucast21 said:

Get an attorney.

At least you know if an attorney takes your case, there is a good chance he or she see an approval/win.

edit: if memory serves me correct, law firms have a higher winning percentage for appeals than 

I ran my case thru to a few lawyers for higher migraine rating and service connection for ptsd/major depressive disorder after three denials at the regional level. They refused to take my case for either of them.I ended up winning on my own and keeping all my retro.

Edited by justtryintomakeit
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Outstanding............🤠

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I never have; however I have met vets whom have.

The BVA looks at all records of evidence.

However the primary standard is the CALUZA standard.

If all the elements are met, you should stand a reasonable chance of approval.

🤠............

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On 5/6/2020 at 7:09 PM, Chris Barnes said:

 I was wondering if I should get an attorney.  

You're trying to establish service connection.

Why don't you go see Dr. Ellis and obtain an independent medical examination?

He can provide a solid nexus opinion to support a grant.

You don't need an attorney for this.

IF you have the know-how to file your appeal with the BVA under the evidence docket, and submit your new relevant medical evidence(nexus opinion) on your own, you just saved yourself a boat load of retro money.

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1 hour ago, 63Charlie said:

You're trying to establish service connection.

Why don't you go see Dr. Ellis and obtain an independent medical examination?

He can provide a solid nexus opinion to support a grant.

You don't need an attorney for this.

IF you have the know-how to file your appeal with the BVA under the evidence docket, and submit your new relevant medical evidence(nexus opinion) on your own, you just saved yourself a boat load of retro money.

I called Dr. Ellis office and I can’t get in until July.  
My letter from the VA says I only have 60days from the letter to file an appeal to the board.  It’s confusing to me.  

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