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Found out newer VA ratings for my case
#139980 04/14/09 09:46 PM
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Rated as I said in other post as
Ankylosing Spondylitis 10%
COPD 10%
non service connected
in early 2007, without any current medical information on me and without a compensation and physical exam. Submitted then current VA xrays I requested showing most of my spine fused and damaged from the AS and submitted private doctors records showing I was in respiratory failure and on out patient oxygen theray and heard nothing back from VA. Submitted separate claim for Pension with evidence and got approved for all the above as they put it without any ratings mentioned.

Filed a notice of disagreement on ratings and service connection and got a denial response on that review for service connection, as though I mentioned service connection only. Called today because I have a regional hearing coming up.

They now show only 60% for the COPD even though the CFRs say 100% for either respiratory failure or if on out patient oxygen therapy, and they have medical proof of both I submitted in 2007. On the AS with all 3 sections of my spine fused or damaged on the xrays they still only have it at...10%. They have now stuck in the ratings a 20% for a fracture of my back, from a 1971 accident I mentioned in my 1974 case, when all that damage is from AS plus tons more in their own xrays and I never mentioned the fracture or the accident in my 2006 filing which reopened automatically the 1974 case. It listed a spinal fracture, back pain, and hip pain which I reported for over a year in service but it was to be 14 years later before it is diagnosed as AS when new xrays were done by my new private doctor showing massive AS damage to my back.

They have refused to give me a C&P exam over years. When I traveled over 600 mile to see the regional hospital in Albuquerque Rheumi he refused to even examine my back or look at it, with my chin a few inches off of my chest as he talks to a human question mark LOL

Anyway another 600+ mile trip in two weeks for the hearing, to over a mile up city with me in respiratory failure on oxygen. Good grief--Dwight

Re: Found out newer VA ratings for my case
Free10 #140116 04/16/09 08:04 AM
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Had an interesting VA day. Went for my yearly, or longer VA physical LOL today to the outpatient clinic here. I took this with me and asked if he agreed would he sign it

"My medical opinion based off of service medical records for Dwight X XXXXXXXX and his past medical history and the nature of Ankylosing Spondylitis that more likely than not he had it while in service and it was also being aggravated, by the physical demands of service as noted in those records. His spinal damage and COPD and Iritis are all medical conditions of this disease and an active disease process in this individual."

He said yep and did, and put a copy in my medical file too. I then asked if I could have a copy of the last summer trip over 600 miles to see the rheumy last summer which other than a nice discussion of my disease and history seemed to go nowhere and he had no info like xrays on me and didn't want to examine me. When a girl at the outpatient hospital I know tried to pull it up it showed basically nothing. But when I asked him for a copy I found his real report on the visit and it stated a number of things I can use to counter VA's assertions, such as he states my disease started in my early 20s or about the time I was in service, with hip pain, which is what I had in service. He also made some comments on my physical shape or condition which I can use to show I am not at 10% on AS, as VA claims but way past it, with unfavorable ankylosing of sections of my spine, or a between an honest 60-100% on the CFRs just on the AS.

While I was at the VA outpatient clinic I also asked the doc there to fill out a thing for VA to get house bound added to my current pension and said I could pick it up in a few days to send in. I think it was a strong day for the home team especially with the hearing coming up. I am going to try and see my private doctor too in a few weeks to see if he will sign one stating about the same that I probably did have AS while in service but use different wording so it doesn't look like cookie cutter statements. Notice I am also making sure they are being told not just this but all of this is related to AS linking all to service and saying this is an active process. I will send in the reminder on rating AS to my file Parker posted noting this along with the latest physical evidence I got today from the rheumy's report.

I got a definite feeling of change and cooperation today at least locally at the VA outpatient clinic so maybe things are going to change at the VA. I won't believe it until I see but I feel much better locally now. The one thing I can look forward too with my 600+ miles for the hearing is the look on the face of the VA Affairs person when they SEE me. Not a lot of human question marks walking around especially rated at 10% for AS LOL Have a good one people--Dwight



Re: Found out newer VA ratings for my case
Free10 #140319 04/18/09 06:55 PM
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One more note on the VA regional at least here in my region I thought might be worth mentioning on a bright note. I requested a copy of my C file just a few weeks ago which I had never seen and it arrived just a few weeks later and I thought that was amazing fast from the VA for such a request--Dwight

Re: Found out newer VA ratings for my case
Free10 #141610 05/02/09 12:32 AM
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OK went up yesterday for the hearing and made sure I got there about 3 hours early in case there was a problem on the 300+ mile trip I could still probably make it in time and because I needed to talk for the first time with the DAV rep. I got there and laid out my chain of interconnecting evidence along with the more recent VA rheumatologist report I recently received along with the signed doctor's opinion generally stating I had it in service and it was being aggravated by it's demands. She went perfect and asked if I wanted to wait for the hearing or maybe get it finished then. I said sooner is fine with me and she went in to see the RO Officer, and she said when she came back two minutes later the hearing was canceled since it was no longer needed and they would notify me to report for a C&P exam in the next two months--Dwight

Re: Found out newer VA ratings for my case
Free10 #141998 05/05/09 09:00 PM
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Found out today by letter they have two back to back C&P exams scheduled for two weeks from now in Albuquerque for me. One is respiratory (pulmonary clinic) and the other doesn't say what it is. May call to try and find out what that exam is about so I can be sure and bring what I will be needing with me or I can just bring it all since it is all not that much--Dwight

Re: Found out newer VA ratings for my case
Free10 #143698 05/25/09 01:39 PM
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Originally Posted By: Free10
Found out today by letter they have two back to back C&P exams scheduled for two weeks from now in Albuquerque for me. One is respiratory (pulmonary clinic) and the other doesn't say what it is. May call to try and find out what that exam is about so I can be sure and bring what I will be needing with me or I can just bring it all since it is all not that much--Dwight


An update on the exams went the 320 plus miles up to Albuquerque for them and the pulmonary exam wasn't impressive with the limited tests done. The other exam was for the AS and the COPD opinions for the RO. He said he was asked if my story was possible that I had undiagnosed AS in service and a believable story. He said he had my records but didn't say he had looked at them yet but I brought my own of course and showed him a few high points of them such as the x-ray then and the x-ray techs comments I was beginning to lose my lordotic curve and the other doctors notes stating the source of the hip/buttock pain on repeated questioning seemed to be a dime size area of the sacroiliac joints. This plus the immediate after service years medical records I have with a fracture of the spine in a wreck and the low back pain plus stiffness along with iritis attacks starting he said all painted a perfect picture of the disease THEN and not 20 years later when it was finally diagnosed making it "believable" I had AS in service then. He said even getting the diagnoses wrong multiple times was typical as well for this disease or what I have been telling VA RO all along.

On the physical exam it was rather short and sweet lasting a few minutes as the major issues were rather obvious dealing with this human question mark's spine LOL Just asked me while standing to try and bend backwards, side ways, and forward, and forward to a limited extent is all I have left. Asked me to move my arms with a few routines since I have had troubles in one shoulder and the elbow on that arm. I told him neither of those were especially bothering me at that time. He asked me to do a squat as far down as possible and I did and to squeeze his fingers for a grip test. He was very nice and respectful through out it and even seem to feel badly about how bad a shape I was in and having to live with this disease virtually my entire adult life. I told him no big deal I had a lot of fun, though at times it seemed terrible in the past to me experiencing the pain and problems of AS.

We shall see what the VA says now and what his report actually says in 3 to 4 months though lately they seem to have my case in high gear and happening much faster than they tell me to expect to wait. We shall see---Dwight






Re: Found out newer VA ratings for my case
Free10 #143751 05/26/09 12:30 AM
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Hey! congrats on what appears to be a great C&P! Mine went similar but sadly, my current VA docs totally disagree with that doc. so the fight is continued.

Hope to hear you get ALL you deserve! Make sure you go thru Voc Rehab too.


~ Trudi
35 yo mum to 5 kids!
dx with 'probable AS' in the middle of 1995 in the Navy. positive inflammatory spondyloarthritis dx by the end of that year. no meds really work yet. am trying sulfasalazine plus a lot of alternative therapies.
www.madebytrudi.blogspot.com
Re: Found out newer VA ratings for my case
TrudiD #143783 05/26/09 05:56 AM
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Originally Posted By: TrudiD
Hey! congrats on what appears to be a great C&P! Mine went similar but sadly, my current VA docs totally disagree with that doc. so the fight is continued.

Hope to hear you get ALL you deserve! Make sure you go thru Voc Rehab too.


I have two statements or one is a report from VA docs in my case file and these C&Ps for me were not just for ratings I don't think, but also so the RO could get another medical opinion on my service connected part of my case and maybe an opposing one against the other docs opinions already in my case. I have noticed in other cases them doing this reading the BVA's past cases on this disease. I don't trust them at all yet, but the rater seemed to be way on my side of this but only his report will tell for sure. But you also get into the fact they don't make the actual decisions on the ratings and the rest, but by suits at the VA RO. I will see in a few weeks if the local VA outpatient doc can access their report and print it up for me which will be faster if he can and will then making a formal request for it.

I need to know this before the next decision comes down from the VA in case they spin the case against me again so I will know what I am up against and can prepare to ask for a hearing again. I am not taking anything for granted until I get the written decision I think is fair and I am sure not getting my hopes up, even though all of it right now I have been seeing and hearing from the VA leads me to think I have it already won over the last 30 days. If my case sails through I hope it represents a new era for all Vets and especially those with AS cases and the like. Thanks Trudi and will keep everyone posted on this--Dwight

Last edited by Free10; 05/26/09 05:57 AM.
Re: Found out newer VA ratings for my case
Free10 #147447 06/30/09 08:20 PM
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An update on progress, I got a VA decision letter on my application for a higher rating for the VA pension I receive. I had the local outpatient VA Doc file it for AA and the VA letter said they were raising my rating to housebound as of May 1 and my COPD rating to 100% because the doctor had claimed my COPD was worse and I was now on home oxygen. This is interesting since I sent them copies of the oxygen being delivered to my home in 2007 and they ignored it and rated me strictly off my breathing tests done around then and rated me at only 60% on the COPD. I even sent them letters objecting to this low rating since on home oxygen it is rated at 100% according to the CFR for it and they never answered me on it.

They also said all other disabilities for AS are now rated at 60%. That would be a way low rating for all of it. I should have another 100% just off of unfavorable ankylosing of the entire spine.

They said in the VA letter yesterday they were deferring decisions on the AA rating and the service connect part until completion of required development.

I now get $1,204 a month instead of $985. I will not appeal this until I see what the other decisions are from them in the weeks or months ahead since correct decisions in the service connected case would make any errors here in this decision moot. It is progress though--Dwight

Re: Found out newer VA ratings for my case
Free10 #147468 07/01/09 02:00 AM
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good to hear

Re: Found out newer VA ratings for my case
BobbyB #147487 07/01/09 07:25 AM
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Every little bit helps Bobby. Thanks---Dwight

Re: Found out newer VA ratings for my case
Free10 #148045 07/08/09 02:36 AM
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Hey everyone!! I'm new to the board. As I read through these stories it is really sickening to believe veterans have to put up with all of this BS.

Here is my story; I just retired from the Army (20 years and currently on terminal leave). I have been at Ft Stewart for the past 8 years dealing with chronic back pain, neck pain (sustained while in a car accident going to a PLDC graduation). I went through 5 years of Motrin and prednisone/suck it up therapy, when my mother emailed the frigging President (yep GB and I didn't know anything about it). I could have killed her at the time. However, it really helped me. Dpt of the Army was requesting tests from the pentagon!!!!!! Where I ran into a problem was ortho said I needed to see rheum and visa versa. Finally, a doctor called the rheum. (only one rheum in Savannah that Tricare will pay for) and they agreed to see me. Rheum. would not diagnose me with AS because I was HLA-B27 Neg (which is really a false positive). I went to Walter Reed to be a liaison for 3ID and got in with an excellent Navy Rheum. (Dr. Holmes (I owe him a lot)). He finally got me on Remicade and it is working wonders. I know that I have been running on and on. But my concern is; after 5 years of no therapy really, I have 3 vertabrae fused in my neck, r/ wrist fused, SI joints fused etc... I am dreading what my disability rating is going to be and my struggles to appeal it. I wish you all of the best in dealing with the VA (Organized Crime)

Re: Found out newer VA ratings for my case
RBaum #148127 07/09/09 01:24 AM
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If you have fusion your disability rating will 'probably' go a lot easier for you. but you never know with the VA!


~ Trudi
35 yo mum to 5 kids!
dx with 'probable AS' in the middle of 1995 in the Navy. positive inflammatory spondyloarthritis dx by the end of that year. no meds really work yet. am trying sulfasalazine plus a lot of alternative therapies.
www.madebytrudi.blogspot.com
Re: Found out newer VA ratings for my case
RBaum #148146 07/09/09 02:42 AM
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Well your "accident" may not have been an accident but possibly AS. Most AS starts at least in males in the late teens to early 20s. At 19 I started having hip pain or buttock pain which was being caused mostly likely the damage being done in the sacrum area but by 22-23 I have an "accident" fracturing my back. My theory is now the spaces between the joints were narrowing enough that in the accident the joints no longer had full motion to bend before fracturing. This narrowing theory was not being picked up on the x-rays then, but neither was the other damage being done by the AS even years later. Of course medical assumed it was just the force of the wreck, since they and I were clueless I had AS then, the wreck caused the back problems and later the "arthritis" I told them I thought was developing in my back a few years later as stiffness started setting in.

I have found medical generally worthless on many counts over many decades in or out of the service. You may want to research this disease more and to look at all the possible conditions it can cause as it might have been the cause of many things long before the diagnosis and diagnosed wrong back then and you may have many more to come.

Fused in VA jargon means nothing if the spine is straight and with no complications, such as swallowing, breathing, walking ect as I understand it. There is even a Catch22 where the VA examiner can state (Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examinerís assessment that the range of motion is normal for that individual will be accepted.)

Catch22

http://en.wikipedia.org/wiki/Catch-22_(logic)

http://www.youtube.com/watch?v=kLNnWw1YHGg

More interesting catch22s are if you have COPD they deny you outpatient oxygen if you are a smoker saying it saves them money and won't help smokers. It saves them a lot because if you are on oxygen the COPD is a 100% rating. The way around this is to get a private doctor to prescribe it and send it in or have a doctor apply of say housebound or AA and send the info in you are on oxygen. They seem to totally ignore anything the vet himself sends in normally. Also cataract surgery is a 30% rating and the VA eye doc told me I had to be totally blind, to get the cataracts removed by them. You see at that point blindness itself is rateable.

The VA also would like to find if there is anything then can find on the entrance exam or in your medical history prior to service to where they can then claim the AS existed prior to service and use one of their own doctors/examiners to make that claim to deny it. Of course under law pre existing is "assumed" to be aggravated so you should still win, but there is always Catch22 with them to where the VA then claims no aggravation was seen in service because things like medical visits and flareups "don't count" and the ultimate Catch22 is VA can claim all aggravation or physical decline was simply the result of the "normal disease progression". Here are some BVA rulings on others with AS and aggravation.

http://www.index.va.gov/search/va/va_sea...=&UA=Search

One way I would think to argue aggravation is if they admit you had it while in or when being seen at the VA and they failed to treat it which would have led to a worsen outcome for the patient than normal. You would need a rheumy to back it up in writing this would be the case.

Worrying does nothing but makes you feel bad and doesn't make things better and in fact makes things worse. Expect nothing but learn and prepare for the unexpected to the extreme. Never worry. I do not expect to win still even though they seem to be saying it is headed that way and if I do then I will believe it and will be grinning. I will also know over the next 10 years they can change it, if I live that long which I seriously doubt LOL Just have fun.


If you have any questions just ask--Dwight


Last edited by Free10; 07/09/09 02:47 AM.
Re: Found out newer VA ratings for my case
Free10 #176505 06/07/10 05:45 PM
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Just found out more. They are refusing me any special ratings for pension above housebound, and claim my compensation case was closed and they refuse to reopen it stating my AS was not service connected, even with 2 doctors stating it was seen in service in my service medical records, and they waited a year to tell me all this with no explanation as to why. Yes, I can appeal but in my shape and being 62 years of age I won't live that long.

Re: Found out newer VA ratings for my case
Free10 #177515 06/20/10 04:38 AM
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I'm new to this site and I'm looking for advice.

I just went through 18 months of VA c&p evals because of my hips, back and neck. I received:
40% for my back DDD (degenerating disc disease) limited range of motion.
30% Headaches from neck pain
20% for neck pain with limited motion
10% for each hip sacroiliitis, limited motion and pain

So after all that Iím at 70% total from the VA.

About a month later I went to a civilian Rheumatologist who diagnosed my with AS. I went through the health care side of VA to get my medication for free and the VA rheumy said I should have the VA reprocess my claim as AS he said I might get a higher rating but I donít want to lose the rating I have, after reading a lot of the post on this site it seems they donít rate AS very high.

Please help!

Re: Found out newer VA ratings for my case
stoltzie #177626 06/21/10 04:54 PM
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Just get copies of the latest medical reports since your last ratings and turn them in with a request ASAP (think back pay if they raise them from the time you file them). You are not likely to go down on ratings and may go up on them or not. Nothing seems to get high ratings with the VA as they will not pay what they owe to us, but that is another subject. At least now you know it is AS that is causing all these problems you have.

Re: Found out newer VA ratings for my case
BobbyB #231854 04/22/12 02:16 PM
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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.


Losing is NOT an OPTION! Never give up hope, because A.S. never gives up! Always remember, stand as tall and proud as you can, no matter who you are, you are SOMEONE!
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