Please Advise

[Jabo]

I am a 70% SC Vet , I am rated 20% for lumbar strain (I fell of the top of a commo rig on a 2 1/2 truck and landed across the trailer hitch . I have been having trouble with my lower back and legs for years , I am 50% rated for flat feet (they did not say but I belive this to be caused by my gait change) I have started having ed and Incontinence issues , My primary ordered new xrays an it shows increased wear and tear , she has ordered another mri  4 years ago I tried to connect periphial  neuropathy and radiculopathy to the lumbar strain . I was denied because the VA said I did not have radiculopathy diagnosed (it is refered to as my having it in my VA medical records ) and that it was not caused by lumbar strain . I have seen many places that this is . 

 My question is this I want to try again . The back problems have increased I realize that the lumbar strain is predicated on ROM . I also know that this is very much how the CP goes . So an increase here is very hard . I want to know how I can file for the sciatica and incontinence issues and should I try for my hip pain and knee pain My knees have been xrayed and I have arthritis this was also mentioned in my service records and I have never filed for it . Any advice is welcomed as this time I intend to cross my t and dot my I before I file . I do not want to fail because I did not present my evidence . I am still working but This is starting to effect my work and evry aspect of my life . 

[pacmanx1]

1 hour ago, Jabo said:

I am still working but This is starting to effect my work and evry aspect of my life . 

Since you are ready have a service-connected rating, all you need to do is file secondary claims to them. Make sure you get an IMO/IME (Independent Medical Opinion/Independent Medical Examination) that your secondary condition claimed is as least likely as not caused by or the result of your service-connected disability. The doctor will have to give a good medical rationale how they are related. Also, most people that suffer from chronic pain normally suffer from some kind of mental health disorder. Not saying that you are crazy, but it was explained to me that my chronic pain issues cause me to be moody and have mood issues and you can also claim depression secondary to your back and or feet. Another separate claim you can file is for incontinence if you are being treated for it.  So, you are going to need updated treatment records that diagnose you any claim that you file and a medical opinion that they are related.

Edited June 27, 2021 by pacmanx1

[Jabo]

1 hour ago, pacmanx1 said:

Since you are ready have a service-connected rating, all you need to do is file secondary claims to them. Make sure you get am IMO/IME (Independent Medical Opinion/Independent Medical Examination) that your secondary condition claimed is as least likely as not caused by or the result of your service-connected disability. The doctor will have to give a good medical rationale how they are related. Also, most people that suffer from chronic pain normally suffer from some kind of mental health disorder. Not saying that you are crazy, but it was explained to me that my chronic pain issues cause me to be moody and have mood issues and you can also claim depression secondary to your back and or feet. Another separate claim you can file is for incontinence if you are being treated for it.  So, you are going to need updated treatment records that diagnose you any claim that you file and a medical opinion that they are related.

Thank you , I am in the Nashville tn area I was wondering if anyone knows of a Doctor I could see who would fill out a dbq ? I do not have any insurance other then the va but I would pay out of pocket for this exam . any suggestions are welcome and I will add the depression / mood issues my wife and family and co workers have all spoke up about my mood swings / anger issues .

[pacmanx1]

You can go to your Primary Care Provider and ask them to refer you to the mental health clinic and go from there. Start documenting treatment records that you have a diagnosed condition and then file a claim for depression. 

[broncovet]

If you want all your I's dotted, and t's crossed make sure (for every condition claimed) that you have documentation of:

1.  Current diagnosis

2.  In service event or aggravation

3.  Nexus, or docs opinion your current diagnosis is at least as likely as not due to an inservice event.  

     With secondary conditions this is modified slightly:

A.  You still need a current diagnosis

B.  Your doc has to opine that your (secondary condition) was at least as likely as not  caused or aggravated by by an already SC condition. 

[john999]

You got some really good advice, Jabo.  Regarding your depression as secondary to chronic pain that should be a given, but not to the VA.  I have chronic pain and it is depressing due to not being able to enjoy life as much as I used to do.  My chronic pain also affected my work and did directly lead to my being unable to work.   With your current 70% you could probably apply for TDIU if you are unable to work.  I had 70% for depression when I filed for TDIU many years ago.  If you do get SC'ed for a mental health condition the VA and SSDI have a harder time denying your unemployable claims.  No one can look inside your head and say just how your depression is affecting you.  With chronic pain and depression one condition will interact with the other and make both worse.    I also was taking opiate pain meds which relieved the pain for a while but worsened my depression.

[Jabo]

Thank you all for the help and advice I will start on the depresion 

route . I have been getting push back on it anyway from my wife . LOL