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arthritic shoulder previously rated as "residuals, musculoskeletal"


flynsolo2

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Hey everyone,

 

I recently had to have surgery on my shoulder (that was service connected); after surgery, they told me that my shoulder does have arthritis now. I filed for an increase for my shoulder and filed a secondary arthritis claim. The increase will be re-evaluated at a later date (they felt it was too soon after surgery, as it has only been several months), but they have now changed my claim shoulder claim to state, "right shoulder bicipital tendonitis, right shoulder arthritis/bursitis (previously rated as residuals, right shoulder musculoskeletal strain)" and kept the rating exactly the same. Anyone know how I can fight this? Is it not possible to have it be a secondary claim? I honestly think because I am at 93% and this would put me at 95%, the VA has denied every claim I have brought forth and instead combines every claim with an existing one and has kept my ratings the same. I feel so defeated sometimes.... 

 

Edited by flynsolo2 (see edit history)
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Good questions.  Vets tell me one of the toughest is to get from 90 to 100 percent.  

Did you get a new VARO decision or are you relying upon ebenefits?  

If you got a new decision, and you are certain that another decision is not coming for the arthritis, then you should appeal by filing a NOD.  

Remember, you cant get compensated for the symptom of "shoulder pain" with BOTH arthritis AND again with tendonitis.  Pyramiding prevents us from being compensated for the same symptom twice.  

Once SC, focus on "symptoms" because that is what your are compensated for.  

Check your decision to see if you are compensated for "all" the symptoms, pain, loss of range of motion, and especially any symptoms which affect your work, such as "unable to lift over 15 pounds", if a doctor so stated, for example.  

Are you on arthritis meds, and does this arthritis show up on medical tests, such as an xray?  

If it does, you can consider sending in a 38 cfr 3.156 re open, especially if this (these) medical tests "were not" in the evidence section of your decision.  

In short, my advice:

1.  Get a copy of your medical records and see which symptoms are documented.  

2.  Wait for your decision.  

3.  After you get the decision, based on your medically documented shoulder related symptoms, consider whether an appeal to the Board or 38 cfr 3.156 is warranted.  

4.  Did your doctor write a nexus statment linking arthritis to your already sc condition?  If so, that sounds like secondary to me.  

5.  If you need more help, such as wording your nod, whether or not to file reopen, ask here on hadit and myself or others may be able to help further.  

6.  Lastly consider other conditions, including tdiu, if you are not working, and apply for that, if applicable.  There are more than one way to get to 100 percent, and it does not always matter when you go to the grocery store.  Have they ever said, "Ok, mr Jones.  Is this money from TDIU for your milk, or is it from 100 percent P and T?".  I have never had that happen.  So, get to 100 percent via any legal method that works for you.  

Edited by broncovet (see edit history)
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@broncovet Thank you for the encouraging words. I will wait for my decision letter through the mail and see what is actually stated (I really wish the VA would come into the 21st century and put all of this on ebenefits instead of snail mail).  I only looked on ebenefits and saw the change in wording with arthritis previously rated as muscoskeletal, so I will try to be patient and see what the decision states.  I do have the MRI w/contrast and xrays that showed arthritis; I do not remember if they stated what it was caused by, but, I will look (I had an outside doctor do this exam because the VA doctors kept telling me nothing was wrong when my shoulder would completely dislocate and fall out of the socket and the VA only did a xray). However, VA did cover surgical costs along with physical therapy, so they recognized the condition is SC. 

You are right. I am trying every avenue to get to that 100%-they noted my left shoulder but denied it being service connected or secondary and said it is not because of my right shoulder and back injuries (what I was claiming, because my right shoulder is my dominant side but now left shoulder is injured). I am going to try to fight that too. 

I will update when I know more. They just did the decision last Friday, so I should receive the packet in the mail soon. Thanks again for your insight.....

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24 minutes ago, flynsolo2 said:

I am trying every avenue to get to that 100%

If you are working but you are currently on convalescence due to your surgery, you can apply for a convalescent 100% rating until your doctor releases you to go back to work, if and I say if there is a recovery time period. I think you can get several months but you have to have a medical statement that you cannot work for a period of time.

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While ebenefits is "notoriously unreliable" I may suggest  you check the "letters" section in ebenefits/va.gov.

If you can print out a letter that says you are 100 percent, you are good to go!.  Va does not like Veterans running around with a letter from them that says you are 100 percent if you are something less than 100 percent.  

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Keep the faith and stay in the fight, the machine in my opinion wants you to quit. Best of luck to you in your recovery, but without more information I’m not sure I’d be concerned about the wording as this is normal. You’re percentage stated the same and that’s more important, conditions are often updated when new information becomes available. 

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