Suggestions on best way to approach recent Decision (Arthritis)

[Frankgs]

I'm not sure the best way to go about my recent decision. Any suggestions would be helpful.

I was granted 20% for psoriatic arthritis (hands, feet,elbow)  all combined to one rating back in 2017. I also had 0% psoriasis since 2013.

 

These were the results from my decision letter: CUE for psoriatic arthritis because they should have been rated separately. Now they rated me 10% for left foot and 10% for right foot based on moderate symptoms (5284). 10% for psoriatic arthritis elbow for flexion limited to 100 degrees. 5 deferred ratings for psoriatic arthritis of each finger in my left hand. They increased psoriasis from 0% to 10% even though I've been on Humira since 2017 and recently changed to  Cosentyx this year. I was denied service connection for low back pain.

X-ray Evidence from 12/2019:

Left Foot: Pes Planus, calcaneal spurring at planter insertion

Right Foot: Pes Planus, calcaneal spurring at planter insertion, mild hallux values, bipartite medial sesamoid bone.

Back: Marginal osteophyte lower thoracic spine, unilateral Left L4 spondylolysis. Mild facet arthropathy lower lumber spine. Significant degenerative changes lower thoracic spine.

 

Edited June 23, 2020 by Frankgs
put the wrong dates

[brokensoldier244th]

Ok, lets start with what you think is wrong about the decision vs what is right with it, from your POV? Is it lower? Wrong ED? What are you asking, exactly? We dont know what you are thinking.

 

[Frankgs]

My bad, I was frustrated when typing....... Should that be the right code for each foot and do I need more evidence for my back or did I xxxx up by claiming low back pain. Do I need a nexus to link my back to my osteoarthritis of each knee?

[broncovet]

Probably yes.  

Direct SC..you need the caluza elements of current diagnosis , in service event, and nexus. 

Secondary SC.  You need a current diagnosis AND a nexus linking your current diagnosis with an already SC condition.  (no in service event is needed, this is redundant and already established with your SC condition)  

So, in other words if you think (more precisely, if your doctor thinks) your osteoarthritis of the knee is related to your other SC conditions then you need a doctor to so state. 

In a similar way, you will also need the same, as above to relate your foot issues to already sc conditions, if it applies.