Spondylitis Association of America
Posted By: JayNelson Where do I start with VA - 10/10/08 06:20 PM
I served a single enlistment in the Marine Corps. My medical records have it documented that I have Carpel Tunnel in both wrists. It is also documented that I suffered chronic back pain for three of those years.

I underwent physical therapy that almost seemed to make the problem worse with the exercises they were having me do. As a second treatment option, they sent me to the base chiropractor. Chiropractics seemed to help a great deal as I was able to sleep a full 8 hours for a couple of months after each session.

I had filed a disability claim with VA. Unfortunately, the job I worked sent me to Africa for 15 months. The claim was denied due to no responses from me.

Now, five years later, I have been experiencing a lot of hip inflammation. I finally had a doctor recommend me to a rheumatologist. After countless blood tests, X-rays, and an MRI, I have it narrowed down to four candidates:

Ankylosing Spondylitis
Psoriatic Arthritis ( I don't have psoriasis)
Chrone's disease (I don't have any bowel issues)
Reactive Arthritis (Never had an infection problem)

I'll mention that my father and his father etc. have all had back issues and never got a diagnosis. I've had back pain to a lesser degree for as long as I can remember.

That's my history. My true questions are:

Where do I start with reopening a VA claim?

What medications will VA cover if the claim goes through?

Based on my history, what are my odds with getting the claim through?

Any advice would be appreciated. I've always known that I would suffer back and hip pains from family history. I'm hoping the doctor can finally give me a true name for my opponent.
Posted By: BobbyB Re: Where do I start with VA - 10/10/08 10:51 PM
Jay, the first thing that I would do is select a service group such as the DAV or VFW to represent you. I would send a request to the VA asking for a copy of your military medical records if you have not done so. Next, I would go to your private physician and ask them to write you a letter stating that your condition is related to your military service. If your doctor will state that it's possible it will give you a leg to stand on so to speak. A service officer can help you re-apply to the VA. Right know in my case, VA is paying for all the medications I need. I am on weekly Humira shots, Sulindac, Sulfsalizine, Tramadol and a few others. For all the medications related to my service connection, I don't pay anything. If its not service related, I pay $8 dollars for a 30 day supply. If you get your AS or whatever it is service connected, the VA will even pay you for travel expenses. It not much, but its better than what it was.
I think that my AS really started back in 1985, but it wasn't until 2007 that my health really went down hill and my VA primary doctor couldn't figure it out and sent me for a truck load of tests. I was very fortunate that I have a great Rhuemy at the VA. He understands my condition and is really trying to get me better. He hasn't given me everything, but he is still a good doctor. It's really hard to say what your chances are with VA, but if you can get the letter I mentioned it helps. I have a cousin who used to be a service officer for the DAV, and he has been helping me and guiding me. The main thing is don't allow the VA to get you so frustrated that you give up. I hope this helps Bobby
Posted By: JayNelson Re: Where do I start with VA - 10/11/08 01:54 AM
It does help a great deal. I got off the phone with my father an hour ago. Apparently, my uncle and my cousin were both diagnosed with AS. My uncle, age 53, is quickly approaching his death bed. I think he said about 1/3 of his spine is fused. My dad is 50, and still in decent health. I guess it is a lesson in what maintaining an active lifestyle and exercise can do.

Back to the VA issue; I'll look up my nearest DAV office. Does it cost anything? I know VFW charges like $400 bucks for a lifetime membership. Talking to my Rheumy last, he didn't seem to think my time in service is really connected with the issue. I'll see if I can get a letter out of him, but I'm not hopeful.

I hope a diagnosis and the three years of documented back pain are enough to at least get medicine. It would have been nice if the military had put a little effort into diagnosing the issue instead of giving me Flexeril and sending me on my way. They took an X-Ray, pointed at it, and told me "we can see a loss of flexibility there."

Thank you again for the advice.
Posted By: BobbyB Re: Where do I start with VA - 10/11/08 03:06 AM
If I'm not mistaken, I think that the service officers will represent you for free. I joined the DAV last year and my lifetime dues were around 250 bucks. If your problems started in the service, then it should be possible that it was the onset of AS. I had never heard of AS until my Rhuemy told me that he thought I had it. If he will just say that it is possible or likely that its service connected it will go a long way in establishing your claim. Have you been tested to see if you are HLA B27 positive. My Rhuemy said in looking at my x-rays he was 90% that it was AS, and when my results came back HLA B27 positive he made the definite diagnosis.

When I was in the Army, it took them 6 weeks or better to order a bone scan, and then they sent me to a light infantry unit. I'm really not to happy with my primary doc at the VA. When I told her that I had AS she told me that AS was an old mans disease. Since then I just go by what my Rhuemy tells me. I have to drive 3 hours Tuesday to see him.

Posted By: JayNelson Re: Where do I start with VA - 10/11/08 05:27 AM
I believe the latest blood tests he ordered have something to do with testing for that gene. It's hard to tell. He narrowed it down to the four possibilities and told me that the best options for treatment for any of them is Humira or Methotrexate. I know I need to go in for a TB test before trying any of the meds and I need to see what my insurance says.

I don't know if the discovery of others in my family receiving an AS diagnosis will help. I just hope my father takes the time to have himself checked out. He's been using OPC supplements for several years and says they have helped him.
Posted By: BobbyB Re: Where do I start with VA - 10/11/08 03:59 PM
I've been taking Humira since December, and weekly since July. It helps and taking it weekly has realy helped me. The VA is paying for mine and that a blessing. I would definetly get into the VA system and see if they will help with the cost.
Posted By: BobbyB Re: Where do I start with VA - 10/13/08 09:33 PM
Jay, I talked to my cousin who use to be a NSO for the DAV, and he said that if you will need a letter from a doctor stating that your condition is related to your military service for them to reopen the case. Since you missed your appointment a few years back they are going to consider your case closed and you will need evidence to reopen it. He also said that groups like the DAV and VFW will represent you for free, and that you don't have to be a member to get them to help you.
Posted By: JayNelson Re: Where do I start with VA - 10/29/08 10:40 PM
Thanks, my rheumy explained to me that I reported that I've had lower back pain since around age 13. Therefore, it obviously is not directly service related. Looking through my medical records, I see that I told the military docs the same thing years ago. I might get a letter saying that they should have investigated the back complaints further, since early detection is important.

On the bright side, My insurance will cover Humira. Is $70 copay for a 90 day supply good as far as insurance is concerned?
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