For those who follow this board, you have read about the issue with how the military disability boards rate ankylosing spondylitis, per the VASRD, for disabled service members being medically separated or retired.
The VASRD, DOD and service regulations all have requirements to rate the disease for the active process of the disease (code 5002) and for the residual effects caused by the disease (5200 series of codes). In 2003, the VA modified the of the 5200 series codes from spinal injuries and diseases. The intent was to make the criteria more objective and to give more distinction as to the cause of the residual damage. At that time, the VA introduced code 5240, ankylosing spondylitis. The 5240 criteria only covered the spinal range of motion issues associated with the disease.
The Army and the Air Force PEB's have since erroneously extrapolated the intent of this new code to now be the only criteria required to rate ankylosing spondylitis. (I have yet get any information on how the Navy/Marines are rating AS since the change.) The Army/USAF PEB's now feel they are no longer obliged to considerer the rating criteria for the systemic and constitutional aspects of disease, (covered under code 5002). This has a severely detrimental effect on the disabled service member, as often the ratings under 5002 would be high enough to lead to retirement vice separation.
A recent case in point was that of SAA member, SPC(R) Linwood Hoffman. In 2003 he was placed on temporary disability retirement for ankylosing spondylitis with a 40% rating under code 5002. This year, during a mandatory periodic review, the Army PEB rating SPC Hoffman at 20% under code 5240 even though his condition has worsened since 2003. This ruling means he will lose his disability retirement and benefits to include his and his family's health care coverage. Bear in mind that the VA DoD, nor any of the Services, have established policy stated that consideration under code 5002 was no longer required for rating Ankylosing Spondylitis disabilities given the 203 changes. The Army PEB opined that the had to follow the VASRD, the intent of the 2003 VA change eliminated 5002 consideration, and the regulations and policies (to include their own) just needed to catch up. While point one is correct, the last two points could not be further from the truth.
I have been monitoring the VA board of Appeals database (
http://www.index.va.gov/search/va/bva.html ) for cases that might address this subject and demonstrate current VA requirements for ankylosing spondylitis ratings. A recently posted 2005 case has spoken. While the entire case is available by citation number at the link above, the key aspects of the decision are below:
Citation Nr: 0518317 Decision Date: 07/05/05 Archive Date: 07/14/05
THE ISSUE Entitlement to an increased rating for ankylosing spondylitis (formerly characterized as spondylolysis with spondylolisthesis of L5, S1), currently rated as 40 percent disabling.
CONCLUSION OF LAW:
The criteria for a rating in excess of 40 percent for ankylosing spondylitis (formerly characterized as spondylolysis with spondylolisthesis of L5, S1) have not been met. 38 U.S.C.A. § 1155 (West 2002);
38 C.F.R. § 4.71a, Diagnostic Codes 5002, 5292, 5293, 5295 (as in effect prior to September 23, 2002);
38 C.F.R. § 4.71a, Diagnostic Code 5293 (as in effect from September 23, 2002 through September 25, 2003);
38 C.F.R. § 4.71a, Diagnostic Codes 5002, 5240, and 5243 (effective from September 26, 2003).
Note: The 5293 and 5243 codes were for the service member’s intervertebral disc syndrome related to his service connected ankylosing spondylitis
The VA Board of Appeals have clearly stated that the LAW requires that 5002 criteria be considered when rating Ankylosing Spondylitis post the introduction of VASRD code 5240.
I have passed this information on to the DoD action officer who is currently investigating military ankylosing spondylitis disability cases and I will pass it on to the VA policy personnel as well.
Mike
Thanks for this info, I have recently been medially retired from the USMC under the 40% rating but my VA rating came back at 10%, I was looking for someone in the DC metro area to talk to about appealing this decision or am I stuck with this rating?
Were you discharged for AS? If so under what rating code? If AS and 40%, I need to talk with you as soon as possible.
Thanks,
Yes it was a discharge due to AS.
I too was discharged about 3 yrs ago from the US Army with service connected AS. I got a VA disability rating of 10% at time of discharge.
I have been seeing the VA and obtaining my meds through them. I have done a bit of moving around (from Savannah, GA to Raleigh, NC) so as of now I am transitioning from one VA to another. I have a appointment to be screened by a Dr. in Feb.so as of now I am in transition and have no primary care physician..
My AS has gotten worse in the past few years. I have questined the 10% disability rating since I was assigned it.. as it sure does not make sence. I am sure disqualified from more than 10% of the jobs out there! How does the VA justify a 10% rating? I intend to try and get a review of my condition. Hopefuly this will result in a higher disability rating?
I am currently taking the meds: Arthrotec75, Darvocett, Morphine sulifate 15mg.
Feel free to contact me @ SgtYates@msn.com if you should need more info.
Gonzo, you need to prepare for an appeal. Were you just routinly discharged upon serving your time or were you medically seperated? Get with a local DAV rep or even a local VFW. Both have trained personnel who can help with writing an appeal. Make sure you have all your records. Make copies of everything. Make sure you tell your doc in FEB every little detail, no matter how trivial it may seem to you. Your military job definitely would have aggrivated your condition. Good luck and keep checking here for updates.
I am new here, but I am in the process of getting back a decision for AS.
I got out of the Marine Corps in JAN 2001 and I did get the antrhax series. I got out undiagnosed and with 0% service connected on my lower back.
Finally the VA diagnosed me with AS and just recently Reiter's. I have put in my paper work for an increase of disability for AS.
Needless to say I am sweating this decision. Not looking forward to the appeals process--if necessary.
My doctor at the VA told me that he had a guy come out of desert storm with 10% service connected disability and not for AS. He was diagnosed with AS by the VA and got 100%.
Riplinger,
Welcome aboard!
I put this up on another thread thinking this is important to at least read:
The scary thing about Anthrax series is I came down with AS symptoms right after I got my first shot. It took seven years to get diagnosed with AS though.
I recently read a account of a pilot that fought the DOD for retirement pay and won. He conviced a federal court that anthrax had something to do with arthritis flare ups right after he got the shots. Here is the link:
http://www.gulfwarvets.com/anthrax_courtdecision.htm
One thing to remember when you go for your rating diagnosis is to keep yourself AS qualified. My records showed that the primary reason the military booted me was because of AS. Without that I probably wouldn't have had the rating I got. If you get the VA to show you are deffently a AS factor you can use that in your case.
I was discharged from the military in 1976 after a job related accident. I was discgarged with zero disability rating. The military didnt find that I had AS, but deemed me unfit for military service. After seeing a specialist for spine conditions, and getting the blood test to check for the HLA-27 gene, I was then diagnosed with AS.
I took these findings to the VA hospital and immediatly filed for a service connected disability. After about 18 months I was denied and had to file an appeal. After waiting another 6 months I was awarded 40% service connected disability rating. I stayed at 40% for 15 years until I suffered a fall at work. My rheumotoligst examined me, determined that my AS had been aggrevated to the point that I was no longer able to work, and I again filed for an increase in my VA SC compensation. I then joined the local DAV chapter as a lifetime member, and they represented me in my quest for an increase in my SC disability rating. Once again I was denied and had to file an appeal. After about 18 months I was awarded a total of 120% SC disability, with a status of unemployabilty. The total of 120% was a combination of limited range of motion of the thorasic spine, cervical spine, lumbar spine, restrictive lung disease, due to the kyphosis and not being able to get a full breath. I recieved back pay from the day I filed for the increase, which was paid in one lump sum.
I hope this will help some veteran with AS find some hope and perhaps recieve the help they deserve.
What is/was your disability rating? Since you have been rated unemployable, I think I can safely assume that you were rated under 100%. (I too have a unemployable rating for AS. I am rated 70% plus the unemployable to get the 100%).
I just found this board. I was recently discharged (medical) from the USAF less than a year ago. I was discharged because of an AS diagnosis. In January I recieved my VA rating of 10%. I am not sure what to do for medication of treatment. Can anyone give me some info on what do to and where to go. I am currently taking the last of my Enbrel and Methotrexate, but it will be running out very soon and I do not think that my new medical insurance will cover these exepensive meds.
In January I recieved my VA rating of 10%.
You are covered for all of your treatment related to AS by the VA. Go to the nearest VAMC and have them start treating you. Since Enbrel is the big one, it will save you allot of $$$.
Oh, and BTW, Welcome to the group....
Hey everyone. I'm active duty in the Air Force right now as was just diagnosed with AS. I actually just found out today and will find out when my rheumatologist appointment is tomorrow. I was doing some searches and found this site. I've had the bad back pain for about a year now, which was triggered while I was on a deployment to Iraq. Basically I wanted to see if you guys could give me some advice on what I should do to take care of myself with the AS and the discharge I guess I will be getting? Thanks for the help in advance.
James
Well, finding us this early in the process is a definite, definite benefit. Read through the issues on this board and you will get a great education. Stay in touch and don't concur to any MEB's and PEB's without know what all the consequences are. We are here to help you along the way.
I am new here. I am a VietNam vet with 40% disability for Spondylolisthesis discharged with that medical condition early in May '71.
I always thought that Ankylosing Spondylolisthesis was different from just Spondylolisthesis - more severe. But from reading the first post, the VA is considering both the same? I'm not sure if I understood that.
Also, I understand that unless my x-rays show some serious slippage of vertebraes, I'm at the top of my rating scale and can't receive any higher percentage.
When I went for my C&P exam, the PA who examined me had me lay down and then proceeded to force my knee up to my chest. I guess he didn't believe me when I told him I couldn't stand to have him push it any harder. My wife was present in the room when this happened and I did file a complaint with the Patient Advocate at the VA Hospital but unfortunately for me she is also a patient of the PA (unbelieveable).
Tomorrow I am going to my own Orthopedic Surgeon to have him take a look at my back and my x-rays (unfortunately for me all my previous x-rays were destroyed so there is nothing to compare them to). I have not been able to work and before my exam I was working on a very limited basis.
I am looking for advice about if I am eligible for a higher percentage - what I have to show that my pain has increased - any advice you can give me. Thanks, John
John,
I think your condition is more of an issue of vertabra sliipage vice inflammatory process. However, the VA uses similar rating criteria for assigning rating for the disabilities caused by the residuals of spinal injury and disease. What code are they rating your condition under?
Mike
Thanks for the reply,Mike, my decision reads "chronic lumbosacral strain,with spondylolisthesis with spondylolsis 40%."
Is there a VA code attached to that decision. 5237? 5243?
Mike
I am guessing you have not been rated since 2003. In 2003 they changed the criteria for rating disease and injury to the spine.
This link goes to the VASRD. It will show you the current criteria.
http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=d741c52f7d5b47cff93ecd0ec686fc0a&rgn=div5&view=text&node=38:1.0.1.1.5&idno=38
You should search for code 5237 or 5243.
Mike
I have a lot of reading to do. I was last evaluated in 2001. I currently have a 40% disability and I understood that they could not take that away from me since I have had it since 1971. Is that true?
Wonder what made the VA change it's rating system for back injuries? Is there no longer a 5292 rating?
I have been having a lot of problems since my last c&p exam so that's why I went in for another exam. Is it next to impossible to increase my rate?
John,
Contact the DAV and have them do the new claim for you. They will be good enough to get you 70% with out blinking an eye. Took my rep a short 2 years for me to go from 40-70-100.
Ken,
I was told that it costs $230 to join the DAV and after being put out of work by the PA at the VA Hospital on Feb. 1st, my financial situation is really bad. Do you know if they have a sliding scale for those of us with financial problems.
I have a VA rep but I really don't think he is doing much more than just sending paperwork in.
Thanks, John
A life membership may very well cost $230. But, the DAV must represent all Veterans, and do. There is no requirement to be a member. They will take your case.
I contacted the DAV - they have an office in my VA Hospital and I have an appointment to bring all my stuff in and talk with them on March 28th. I also found out that I could pay $40 and pay on the installment plan. I was encouraged to find out that they are completely funded by members and donations - no government connection. I have to thank you very much for your help - and I'll let you know how I make out. John
John,
Did the DAV rep lead you to beleive you had to be a member of the DAV? I sure hope not. I know allot of them push membership for the wrong reason. They get recruiting $$ from the National HQ.
I stress that ALL veterans can use the DAV to file a claim and DO NOT have to be a member.
Yes, I am a life member. But I joined years ago.
No, Ken, he did not. But if I can pay as I go, I will. My wife tried to get me to join years ago but I never did. He was real helpful - my wife talked to him. Said I needed to get all my medical reports together and meet with him. That's why I don't have an appointment until the 28th, my doctor will be getting my report to me next week and my primary care doctor has been putting me off for 4 weeks getting his report. So I'm hoping I'll have that week too.
All these years, I have mostly been self-treating and being real careful not to hurt my back - gave up all sports when I was hurt in Vietnam but I've been able to manage and you get used to being in pain all the time. At least I'm still around. John
Ken,
I just received my medical report back from my orthopedic surgeon and there is something that I don't understand - he states in his report that I have Grade I Spondylolisthesis which is the least. He does report that since my exam I'm totally disabled. I know I'm not able to move around at all but Grade I doesn't seem to equal how I feel. Can you be Grade I and be totally disabled?
I realize that you're not a medical doctor but I could use some insight in this. thanks, John
John,
Are you being treated just for Spondylolisthesis, or is that in addition to another issue such as AS?
Grade 1 Spondylolisthesis means that the vertibrate are 25% or less out of line. Since 24% is Grade 1, one can become totally disabled due to it I assume.
Ken,
My decision on the last VA exam in 2000 said "chronic lumbosacral strain, with spondylolisthsis and bilateral spondylolysis which is 40% disabling under diagnostic code 5292 because there is evidence showing severe limitation of motion of the lumbar spine. The VA examination showed that the veteran has restriction of the lumbar spine limited to 10 to 12 degrees."
It also said "Consideration was given to possible entitlement to an extraschedular evaluation for this condition. This is not warranted as there is no evidence that the current case presents such an exceptional or unusual disability picture as to render impractical the application of the regular schedular standards." I really don't understand what all that means.
This was at the 2000 c&p exam and I was so thrilled to get it upped to 40% I didn't really absorb the whole three page report.
I'm trying to get my percentage above that because it has become so disabling for me. I have worked for myself for the past 30 years building furniture and I could take the time off whenever I needed to. If I had to hold a job, my boss would have never been able to put up with my time away from the job. So I'm waiting for my appointment with the DAV rep and see what he thinks of all this. I have not recovered from the rough handling at the c&p exam in February and that has set me way back. I am so discouraged that a PA at the Veterans Hospital would do that. Thanks for all your help, John
I too have been diagnosed with spondylolysis, herniated discs, osteoarthritis, osteophytes, lordosis, DJD,and DDD all by the VA...for 10 years now and I have tried to get 100% unemployability twice and have been denied twice....I cant even put my own shoes on......My recent VA turn down was 7 days ago after almost two yrs of waiting......I am going to appeal as I am severley debilitated and had to leave my job which was at the VA in Denver and I cannot even walk some days or much do anything else 20 days a month or more..I am currently rated at 40%, and I feel 150% disabled.
Does anyone have any advice for me?
Please help. I live in Branson Missouri
feel free to email me @ nitrorodz1@aol.com
Welcome to the Group Nitro.
I suggest you contact the DAV ASAP and have them handle your appeal from here on out.
Ken,
A couple of posts ago, you asked me some specific questions about my VA diagnosis - I wrote back but was wondering if that answered your questions and if there was something significant about my VA report. It was the post before Nitrohead. I see the DAV rep tomorrow morning - and get fitted for a back brace. Anyone have any experience with those? I have a corset the VA issued which helps too but my orthopedic surgeon suggested I wear whatever makes me feel good that day. Any thoughts would be appreciated. Thanks, John
Can't say as I do...........
Hello,
I am John's wife and have been following this post with great interest. I am writing for John because at this point in his contacts with the VA, he is completely worn out. He did meet with the DAV rep yesterday and that was the best meeting that he has had with anyone connected with this c & p evaluation. The DAV rep was very knowledgeable and most importantly, very supportive. He remarked that a person would not be given a 40% disability if he wasn't really hurt. My husband said he was the first person that he had spoke with in the whole process that had said that and it really meant a lot to him. We walked out of that office with renewed hope.
Until we went down to records and got the last two visit notes from the VA Clinic. We went there mainly to get established to get prescriptions because we no longer can afford to keep the prescription coverage on our medical insurance. What we found was that the first visit which was only a routine physical included notes from the doctor that my husband was exaggerating his symptoms because the doctor could see he was sitting comfortably in a chair. If he had asked him if he were comfortable, he would have gotten a long sad answer. My husband has lived with this injury every day since 1969 - he is used to being in pain - to complain about each and every day would only be depressing. He tries to live and push the pain in the background.
Then he was treated at the Clinic for his back and on the notes the only part that couldn't be transcribed because of "phone or computer problems" was the part about how the doctor found numbness in his feet and diagnosed him with a pinched nerve in his back. According to the notes, she has no recollection of that part of the exam. So that really put him in a very depressed state of mind. I am not so naive that I believe that the VA is going to make this process easy. But when you are really hurt and even the doctors are misrepresenting the record, you lose faith in the whole system.
If we had not talked with the DAV rep yesterday, the despair around here could not be coped with. But we both appreciate all your help and information in this process and your referral to the DAV. Diane
It's important to be honest in these appointments. It takes a lot of pride swallowing, I admit it and it's hard. I make it a point to comment on how comfortable I am, even if it is contrary to how I look at the moment. I'm also in the habit of constantly shifting around so people can see that I'm trying to ease pan and get more comfy. I also freely admit that I push through the pain just so things get done. I have a house and family to run, they can't wait for me to have a "good day". I also commented at my last exam that I consider a good day as 4 on the 1-10 pain scale.
I hear what you're saying, Jay. When we went for the first visit just trying to get meds we thought we should just stick to that subject not realizing that the VA Clinic doctor was also "examining" him for his back. It has been a real eye opening experience. My husband has been on numerous VA exams over the years since he was first officially disabled by the VA and never in all those years was he treated like he has been over the past three months. I have a feeling that they are on a campaign to just get information favorable to their argument and deny the claim. But for the VA Clinic doctor to be dragging her feet to prescribe him pain medication is so surprisingly. Thanks for your reply, Diane
Diane, stick with it. Never give up hope. I was medically retired in 01 and am still fighting for any compensation. My rating and status has been screwed up since the beginning. My father also has AS and is a retired Marine. He has benefits but is still fighting for proper classification etc.
The whole process is broke and Mike has been working hard with DOD etc. to get things fixed so future troops don't have such a hassle.
Thanks for the encouragement, Jay. We'll hang in there - we've been through reevaulations before - even had his disability taken away in the early days (after 10 years, you keep what you have) and found that you can't do it alone.
When you say Mike is taking issues to the DOD, is he active military? Is there anything those of us can do to lend support? I think that all vets need to work together because there is power in numbers but you don't know where to start when you want to be an advocate. Thanks again, we really appreciate your support and kind words, Diane
Diane,
a few of us have given our information to Mike and he has used that as ammo to point out flaws in the current system. For example I was medically retired by an MEB but classified under the wrong codes and wrong status, this meant they didn't really retire me and they didn't give me any benefits. All they did was say I was too broke to re-enlist after 9 1/2 years of service. If you read through some of the threads in this forum you can get an idea of some of the work he's been doing and the big wigs he's been working with to fix the situation.
It's encouraging to see a spouse take an interest in battling AS and the system. Keep it up.
I did read through a few posts and I'm encouraged to hear that he is taking on such a huge job.
My husband and I have been married for 31 years and he has lived with his disability all that time. We also knew each other before he went to Vietnam so I knew him before his injury. So I really see how his injury has completely changed his life. And I have read so much about current enlisted men particularly the contaminated water and wonder why they are being put this all of this. I also read posts from atomic vets and all their sad stories.
If there is some way for some of us to help also, we would really like to. Thanks to you and all the others who responded to this post. It has been incredibly helpful and the referral to the DAV rep has given my husband renewed hope. It was the DAV rep who said to him "you are really hurt" - brought tears to his eyes after dealing with the VA who only was trying to prove he was exaggerating. Sad situation that we are treating our vets who gave so much this way. Thanks again, Diane
I know it has been a while since my last post but, I am finaly getting off the proverbial couch and submitting my appeal paperwork with the DAV.
I sent LTC Parker my DA Form 199 a while back. On the form it stated VA codes 5099 & 5002 recomended disability percentage of 20%.
Am I to understand this correctly to mean that I should try and have this ammended? Or do I just need to get a review done through the DAV / VA to upgrade my disability percentage? (Am I coded correctly?)
The VA says I have a 10% disability, and on my DA form 199 it states 20%.. Why the discrepency?
My condition has gotten progressively worse over the years since my medical seperation. I am on constant pain pills. However I consider myself lucky to be able to lead a somewhat "normal" lifestyly. Allthough when I realy exert myself physicaly I find myself "paying for it" dearly the next day..
I drive a tractor trailer pulling a step deck trailer now, traveling all over the country. I understand this is not the ideal job for someone in my predictament but, it is the job that keeps the lights turned on and the morgage paid..
Having this condition sure as heck disqualifies me from more than 10% or even 20% of the jobs out there.
I wish I could have stayed in the military. I so deeply wanted to stay.. but, it was not ment to be I guess. Hooah, OOOH RAAH, and Semper Fi!
I understand this is not the ideal job for someone in my predictament but, it is the job that keeps the lights turned on and the morgage paid..
Having this condition sure as heck disqualifies me from more than 10% or even 20% of the jobs out there.
I hear ya Scott! I too did what I had to do for 15 years so I could pay the bills. Hardest thing I've ever done in my life is putting my disability retirement paperwork in. Ended up being one of the best things too, as I feel 100% better now that I no longer have to work.
I wish I could have stayed in the military. I so deeply wanted to stay.. but, it was not ment to be I guess.
Wonder how many of us that were "kicked out" of the Military due to AS feel that way? I for one had all the intentions in the world to do 20+.....
I am in the process of medical evaluation for AS. It looks like the likely diagnosis. I believe that I may have had it since I was a teen.
In 1997, I was medically discharged for a mood disorder and rated 10% by the Army. The VA upped this to 40% due to asthma. During my service, I had repeated medical visits for knee pain during basic training and later, wrist pain diagnosed as tendonitis (with no confirmatory tests done).
Should I revisit this and if so, how do I begin?
I was diagnosed with AS a year ago, luckly it was caught early enough that my symptoms are only mild in my hip joints and now that I take Humira, Aleave and work out regularly that I will for the most part be fine till I get old and grey.
I can tell you this, there is a small chance that if you have AS and recieve an Anthrax vaccine that it can aggrevat AS and or Arthritis and cause a flare up. I have read that many places. Not everyone will have this problem, unfortunatly I have not been deployed yet, I want to be but won't and I guess thats a good thing since I won't have to take that chance with the vaccine.
I am new to the site. I was recently denied service connection for AS because it was diagnosed 5 years after discharge. I served in the Marine Corps and developed iritis while deployed in Iraq and also have X-ray reports showing sacroiliitis a few months after discharge. I have had multiple joint problems since service. I did receive the anthrax series. I am going to appeal the decision but was hoping I could gather some advice or opinions regarding the denial. I understand arthritis has a presumptive period of 1 year after discharge. I am unclear why I was denied with in service and presumptive period evidence. My VA examiner only commented on my spine and did not address eye involvement or link any other joint pain to the disease. Anyone have any advice for my appeal?
Mike
I am in a very similar situation. My AS was caught early and I am currently on Humira and doing pretty will with regular exercise. I will be going to a deployable unit in the near future and will likely have to take the anthrax shot. Can you take the Anthrax shot while on Humira? Is anthrax a live vaccine?
Also I have been told that I should not be on Humira while deployed (Afghanistan or Iraq) because of the increased risk of TB. Has anyone else heard of this? I am not even sure I will be able to get Humira while deployed. I am hoping that if I can't take Humira I won't have too bad of flare ups for the 7-8 months I am deployed and I can handle it with NSAIDS.
Hi Mike.
I am new to this site but have had AS since 1984, but not diagnosed until after my retirement physical in 1998, due to uveitis.
I did not seek a disability rating until 2006. Initially denied as AS but 10% for lower back pain. This is when I learned that my rhuematologist is my best hope of getting this straight. He reviewed my entire medical record and identified everything symptom that I had as evidence of AS. These included urethritis, uveitis, tendonitis, plantar fascitis, and others.
I reopened my claim with this IMO (independent medical opinion), and currently have 20% for AS, 40% total. One thing that I noted on the VA exam is that they are only looking at the back, none of the other areas affected, such as obstructive sleep apnea, pain and mobility of the neck, shoulders, hips and knees. Also, my last bout of uveitis changed my glasses prescription.
I recently discussed this with my rhuematologist, who is an active duty air force doctor at BAMC. He told me that he sees this with many service members when they go to the VA. I told him that my research in other forums has shown that the IMO is extremely important, and he is currently working on a new one for me to file with my notice of disagreement, including all of my secondary conditions, quality of life, and employability. Truthfully, it has become nearly impossible for me to work, even though I am taking Humira and Clinoril.
Hopefully I will know how this turns out within the year.
Joe
I am currently in a bind as well. I served my 4 years in active duty Air Force. I got out in May of 2009. But 2 years into my service I was having severe hip pain. They sent me to physical therapy and the doctor there told me I had a "butt sprain". That was their diagnosis for me for about a year and half. Then when it started getting really bad, they finally gave me a MRI. Which of course showed massive inflamation. I was refered off base, and a rhumotologist (my spelling is horrible) gave me 2 different medication, which failed, and then did the tests and diagnosed me with AS. After that I was prescribed Humira (which works amazing). This was all 3 months before my seperation date. So it was service connected. When i applied for VA disability, they told me that I didn't have enough info to get AS approved. So that was denied. And now I went to a doctor for my civilian job and they are telling me it's a pre-existing condition.
I have already had a informal appeals hearing and they are reconsidering my decision. I brought all the paperwork from the physical therapy and the actual diagnosis from the civilian doctor. They said those were new to them, even though it was sent with the package. But after reading this thread, i fear that it will only get me a 10%, if that.
So as they sit there and figure it out, I guess I will just sit here in a whole lot of pain and hope they come to a decision soon. Hats off to all others that have to deal with this.
I am in the D.C. / NOVA area, looking for a good AS doctor- both in civilian/private practice and in the VA system. Can anyone recommend an AS specialist? I have encountered several bad ones.
The VA has not ruled on my claim yet. Any advice there?
I am also fighting the army to get a medical board (MEB).
Background:
I am a 19 year Army Reserve veteran (Major). I was in the Ft. Belvoir Warrior Transition Unit (WTU) diagnosed with Osteoarthritis of my hips. The army docs say I do not have AS, however I do have *ALL* the symptoms! My army doctor certified that I was "fit for duty" pending total hip replacement on both hips (she said I could walk after the surgery to take the PT test!). The "fit" rating allowed her to request REFRAD (release from active duty) orders, so now I am left on the outside with no pay or benefits. I filed a VA claim in August 2010 when I was released, but it is still working thru the system. I have been fighting for a medical board, but the army will not even give me that. The army claims "pre-existing conditions" even though I have an approved line of duty with "service aggravation" and I was able to walk OK when I was mobilized a year earlier, and passed 2 PT tests. I meet the "8 year active duty" rule, but the army is also not following that.
Anybody else have this scenario? and any suggestions as to how to fight it? I am entitled to an MEB, PEB, and service compensation. How to get it?
I am sure Mike Parker will be along soon Maj Ed. He is one of the foremost authorities on this.
i am curently going thru a PEB for AS and bursitus in both my hips. i am waiting on my VA rating right now and should be recieving them hopefully within the next 2 - 3 weeks. The army put on my paperwork that i had the AS when i came into the army although i never had any problems or issues before i did i suffered in pain for 2 years before the army drs even figured out what was wrong and diagnosed me
MAJ ED,
Already heard of your situation from Dan Franklin although I did not know about the AS aspect. I sent Dan an email on my thoughts.
Beth,
For both the Army and VA you have presumptions that your condition incurred in service and/or was aggravated by service. The standard for overcomming these presumptions is clear and unmistakable evidence to the contrary. Do not allow them to call your condition EPTS w/o aggravation without providing the clear and unmistakable evidence use to overcome the presumptions. Challenge the decision if you disagree that have met this standard.
The standard is addressed in the 14 October 2008 DoD DTM. Ask your PEBLO for a copy.
Mike
I was rated at first by the army board at 10% went back with a
lawyer and thank goodness the doctor on the board demanded that
they call the top rhemotologist in the army and very well respected doctor right then and there in my appeal hearing..to hear what he said...I believe only due to him I received a 30% rating that thank goodness put me out at 14 years with medical. The va rated me at 50% adding in separately my severe uveitis and something else I cannot remember. This was in 1994. I need now to go back and apply for unemployability since I am so severe I can no longer work and I cannot support my family on %1300 a month...the meds I have had to take have caused ulcers, severe anemia, and blockages in my small bowel...I also have severe apnea etc...I am concerned now to apply worried that I will be rated lower...do we know if we have any protection after 10 years..I will have 20 in 2014...and is the military reviewing all AS cases?? I was told the severity of my condition and Uveitis..where I was cared for at Walter Reed and almost died I should have received at least 60% when I was put out.
I highly suggest that you use the DAV or the Purple Heart folks to do your re-eval paperwork. Make sure that they evaluate your entire body. Have them do that first (do not apply for unemployable at first). After you receive then new (if any) rating and it is not 100% then apply for the unemployable.
I was just told in April that I have AS. Been taking Humira and has been working great. I just had my PEBLO counseling to start the MEB process on 27 FEB. I am nervous about what will come back from all the findings. I am 28 yrs old and been in for almost 11 yrs.
Mike,
Sorry I have been away for ages. You may not remember that long ago but thanks for all this action you have been taking to help others in the ratings fight. There is a lad who is just now going through the ratings at Landstuhl and I passed him your contact information here in this forum. I told him to contact you as our Man in DC. I hope you do not mind!
Cheers
Doug
Ok, here it goes, I just had a c&p done. My case started in 2003 when I was ADSEP'd from the Navy, been fighting the VA since. Here is the modified copy of my latest C&P.
I got copies of my complete C-file from the VA. The c&p exam I had in 2004, the doctor stated that my back pain was more likely than not related to my service in the Navy. But I was denied service connection because there was not an official diagnosis, just stated back pain.
I also had a C&P exam on 16 Mar 2012, where the Dr. states that my Ankylosing Spondylitis is more likely than not related to my service. The following is a breakdown of the dr notes from the recent C&P:
Bilateral Hip Condition:
R hip flexion : 20
R hip extension: 5
L hip flexion : 20
L hip extension : 5
Painful motion begins at 5 on both
Abduction lost beyond 10 degrees yes (Both)
Adduction limited - can not cross legs yes (Both)
Rotation limited - Veteran cant toe-out more than 15 degrees yes (Both)
Patient in severe pain, repetitive use ROM not completed
Functional loss of hip and thigh - yes (Both)
Less movement than normal, Weakened movement, Excess fatigability, pain on movement, instability of station, disturbance of locomotion, interference with sitting, standing, and or weight-bearing these are all marked for both Hips.
localized tenderness or pain to palpitation for joints/soft tissue of either hip (yes - Both)
Muscle strength test -
Hip Flexion 4/5 on both
Hip abduction and hip extension 3/5 on both
Images were taken, degenerative arthritis is documented in both hips, and Ankylosing Spondylitis seen on x-ray results.
Cervical spine condition:
ROM:
forward flexion ends: 20
painful motion: 15
extension ends : 5
painful : 5
right and left lateral flexion ends : 5
painful motion : 5
right and left lateral rotation ends: 10
painful : 10
did not do repetitive ROM test, too much pain
Functional loss:
less movement than normal, weakened movement, excess fatigability, pain on movement, interference with sitting, standing, weight bearing
localized tenderness - yes
reflex exams:
biceps : 1+ (both)
triceps : 0 (both)
brachioradials : 1+ (both)
sensory all normal
x-rays show Ankylosing Spondylitis
Thoracolumbar spine condition:
forward flexion : 10 - ends with pain
extension - 10 - ends with pain
right lateral / left lateral flexion : 5 - ends with pain
right / left lateral rotation : 10 - with pain
did not complete repetitions
Functional loss: yes
less movement than normal, excess fatigability, instability of station, disturbance of locomotion, interference with sitting, standing, and/or weight bearing
Localized tenderness ; yes
guarding / muscle spasm of thoraculumbar spine (
yes, abnormal gait
Muscle strength : Hip flexion; knee extension;ankle plantar flexion; ankle dorsiflexion ; great toe extension - all 4/5 on both
reflexes : knee and ankle ; 0 - both sides
all sensory normal
Radiculopathy yes: l/r lower extremity ; moderate (both) paresthesias and or dysesthesias ; moderate (both)
nerve roots involved: L2/L3/L4 (both)(femoral nerve) ; L4/L5/S1/S2/S3 (sciatic nerve) (both)
severity of radiculopathy and side affected : Moderate - Both
Intervertebral disc syndrome and incapacitating episodes, yes to both
Images: Ankylosing Spondylitis and Scoliosis noted on thoracic and lumbar spine x-ray results
Pain and decreased ROM affect the veterans ability to work
Medical opinion of VA Examiner:
patient was diagnosed with Ankylosing Spondylitis in April 2011, However, symptoms began in 2001, during his enlistment. This is clearly supported when reviewing his medical records. The veteran was seen on multiple occasions for his ongoing back pain, but never officially diagnosed until recently.
The veteran's condition (back, bilateral hip) is at least as likely as not incurred in or caused by his military service.
Sorry this is so long, but I wanted to get an accurate opinion, and to do so, I have to give the full picture.
Do you have an opinion on what I may get as far as service connection goes? A best case scenario will be fine.
Hello, I am new to all of this. I have been experiancing excruciating pain in my left SI for the last two years following a rough landing under an MC-6 Chute during the Q-course in May of 2010. It didn't start off that bad but it escalated to the point where I couldn't get myself dressed or walk. I have seen many Dr's at Ft. Bragg with little to no success and have started the med board with a diagnosis of Sacroillitis and general low back pain.I have been unresponsive too half a dozen stereroid injections,RF abilations and an Epidural. I finally got a referal to Pain management at UNC chapel hill and I finally have some function back but only because the pain is masked by narcotics. I just found out last night that my mother has advanced ankylosing spondylitis and takes humira and a miriad of other medications. I hadn't spoken to her in years( Family issues) but we have started to patch things up. I read up on AS and it fits exactly with my symptoms. I went in to my clinic this morning and after much convincing I got the PA to order a test for HLA-B27. I won't know if I have the gene for 2 weeks. I just don't want to get screwed over by the rating board. I have been to AFG/IRQ multiple times and have recieved all 6 anthrax series injections and have had many GI related issues just sucked it up along with most stuff. I don't want the board to rule this unrelated to service if the cause isn't even fully understood. I have endured the hardest training the military has to offer(IMO) and I can't imagine that it didn't at least escalate my condition.I would have been fired long ago if this was a civy job. I have lost my career, I don't want to lose the benifits and pay as well. I won't be able to hold a job as it stands now and my board process just started. What can I do? Any help would be amazing. Thanks. SSG A.
Well I got into UNC rhumetology and they have started me on a two week course of predisone for some type of diagnostic tool I'm assuming. Pain spread to my right side as well a month ago. Some help so far on the prednisone but it has only been two days. My med board has started and i'm still just kind of floating in a sea of uncertainty.....
Recent AS research is showing specific genes that are involved and that “It is looking more like AS is not an autoimmune disease, but really an unusual response to infection. These genes working together probably impair the immune system’s ability to rid the body of some of these bacteria or their products" according to a researcher working with the support of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services’ National Institutes of Health. Drs. Arnett & Reveille were involved with the research.
So the argument is causation and/or aggravation. Military service put you at risk. Live vaccines such as smallpox and anthrax may have done it.
I didn't get the anthrax shot but certainly got the live smallpox virus in Basic and a squad member actually came down with smallpox (touched the injection site when advised not to) and had to be hospitalized for smallpox when smallpox is eradicated according to the World Health Organization. Smallpox only exists in biowarfare labs. I got 6 typhoid shots as well but no knowing whether that was a live virus it just made everyone I know sick within days of taking the shots.
I served from 1987 - 1991 (US Army) but was never deployed to the Gulf. I wasn't diagnosed with AS until 1999 but I had been complaining to VA doctors about back & neck problems, headaches, chronic fatigue since 1994 and they said I must be psychotic since I was otherwise healthy (other than elevated ALT levels since I had an infection in Basic that had me hospitalized for 2 weeks).
Ill keep this short as i can.
Can anyone please, please, tell me if diagnosed with Anklosing Spondylitis during active duty and forced medical discharge to finally get only 10% years later and cannot get more because the reasoning given is that they say it is "hereditary" because of the common HLA-B27 blood antigen that many or most irish english french blooded american people carry is happening to them???
My younger brother is a Marine and was Forced out after 2 years of appealing to stay in. He is young and has it soo bad for years it takes him 30 minutes daily just to put his socks on. We live together, and we are tough as a box of nails, but it brings Tears to my eyes to watch my Hero deteriate daily. We are all each other has, as we lost both of our parents years back. He only can get 10% for AS, 20% for depression. VA wont give him a % on his eyes problems, Raynauds, Fibromyalgia and all the other stuff...
All this started just after an injury and just after the Anthrax and Many Other unknown shots were given while lined up in the showers in the middle of the night (many times) During Basic Training.
He needs to contact the DAV and have them represent him.
I was not discharged for AS (however had I seen a doctor who knew what they were doing while I was in the military I would have been). It took me years to finally get my 40% rating for AS and I had to hire a respresentative who helped me finally get that rating. It was torture dealing with VA as they treated me like I was an idiot. Once my representatives name was on my stuff (he is feared here in Utah and has a very high success rate), things started moving along. It helped to have someone who knew all the legal lingo.