Spondylitis Association of America Forums General Discussion Military & Veterans Board another c and p

Well, apparentally when I sent my concerns and evidence after I received the last rationale nothing was done. The VFW service officer didn't pass them on, or appeal. I didn't find out until I asked for my status a couple of weeks ago and wanted to confirm they got my updated medical records from my civvie rheumatologist and pain management doctor.

So, I got them to re-open my claim and I have another exam on 10 January.

I am still rated at only 30%, despite the evidence that I should be at 60% (since I take enbrel).

I hope I don't see the same lady that thinks my AS issues are all in my head and that my stiffness and screwed up sleep patterns are a result of being lazy. I have 4 sons (ages 4, 8, 13, and 14) and a 9 month old black lab. I own my own business (work part time) and spent the summer helping build a new house for friends who had a house fire last March.

She's also the lady who only referenced my x-rays from 2002, even though she orders a whole crap load of films every time I see her. At least in my civvie records I have x-rays and an mri from this past Summmer....my rheumie suspected hairline fractures in my pelvis.

Current meds:
enbrel
oxycodone
ambien cr


VA treatment/coverage---- zilch

I'll keep you posted

Well here's hoping that all goes well for you at your exam. I hope you get a good examiner. I hope your service officer gets on the ball for you as well. I will be praying for you as well. Bobby

Jay,
I hope you claim (exam) goes well for you...I just requested a reconsideration in lieu of a BVA for a military misdiagnoses. I was just properly DX by the VA and placed on Humira. With this information I believe the rating should be increased to 60%. I will keep you (and the forum)informed on my claim.

Brian

Just to let you know, the 60% rating for the use of a TNF is an argument based on how other autoimmune diseases are rated. There is nothing in the rating codes for AS or other forms of Spondylitis that states the use of these drugs equals a 60% rating. However, raters can apply extrascheduler procedures when it makes sense to do so.

All we can do is make the argument and see what fly’s. If we make the same argument all across the country, it increases the odds of a particular VA rating office seeing it our way. We can then build off those decisions when and if they come. More likely we will have to keep pushing the argument to the BVA or even the Court of Veteran's Claims to get final resolution.

However, the requirement to rate AS per 5002 for the active process and by various residual damage codes is established but often ignored. This is where most are getting screwed in their ratings. This is where you need make a stand to ensure you get the optimal rating from the established procedure. I have the letter from director of pension and compensation from the VA outlining the proper AS rating process. Please use it to ensure you get rated right. Send me a PM and I will send you a copy.

The TNF 60% rating is an argument that will require buy-in by the VA or by an appellate authority.

Mike

Sending the PM now.

I know the 60% rating for TNF's you showed me months ago related to psoriasis, which I also have but not officially since my rheumy was already getting me enbrel for my AS.

If I don't get the right (proper and just) rating this time I'm firing the VFW guy and writing my congessman and will consider a lawyer.