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I have more questions than I can find answers so I thought I would create a post to see if any of these can be answered? I apologize for the length. I have read, read, and read some more on this board for years and I very much appreciate any assistance that can be offered. I will also be donating to support this all-important forum once I can get through this snail-pace of a process!
I separated from service almost 6 years ago after 14 years in. I am currently rated at 30% disabled as I received 10% each for tinnitus, hypertension and a metatarsal fracture that occurred in service. I also received 0% connection for chronic thoracic & lumbar strain due to morbid obesity (?!). This grant to service connection dates back to the day after I got out of the service. I am not “morbidly obese” and this really bothers me that they have this described as such. I mean, why would they service connect if it’s due to being overweight?? Makes no sense to me. Are they inferring that they are taking responsibility for being so called “obese” as well? We all know that you get kicked out of service if you are outside the physical readiness/weight requirements … very frustrating and even insulting.
The C&P examiner told me that he didn’t have time to evaluate everything I had claimed so he didn’t even look at some of my claimed issues physically, but I was still denied by the VA regardless as no service connection for some of these unexamined claims. Anyways, the C&P doctor told me to basically push through my discomfort (discomfort was evident) when conducting the range of motion part of my back exam, and he even placed his hand on my back when telling me to push further. I did not know at the time that he was not looking out for my best interests…so my range of motion came back within normal limits. I feel that this was wrong on his part but I did not know at the time, and I am afraid if I did complain about this now that I could risk losing my service connection? My back is in very poor condition from the service. In fact, I was on light duty when I separated because of a back injury I sustained a few months prior to my separation. I do have copies of my STR’s and I have numerous complaints of back pain throughout my many years in that nothing was done about as they were just complaints noted, and I do not have the STR from the back injury. I was sent to medical and they shot something into my back and I immediately felt relief but my back has not been the same ever since. My back issues are causing me an excessive amount of lost time at my current job. I just went to the VA at the end of last month as a walk-in because the pain was so much and they took x-rays and named FIVE things wrong with just my lower back. I am now waiting for the VA to send these x-rays to my civilian doctor to have a comprehensive MRI done at the local (non-VA) hospital and then I will go forward from there in deciding how to approach this. The VA doctor “just” said I have facet joint arthritis, but VA radiology noted five things wrong?
My first question is how should I proceed with adding these conditions and/or getting an increase from 0%? Does anyone know what “chronic thoracic & lumbar strain” service connection covers? Is it just strains or does it encompass the whole lower and middle back and all associated conditions of these areas? My x-rays from the VA in August of this year report “superior plate wedging at T12, this is age-indeterminate and correlation with physical exam for symptoms of point tenderness would be beneficial (again, I was a walk-in at my local VA clinic that day and the doctor didn’t have time to see me…). Multilevel anterior endplate spurring throughout the lumbar spine. Lower lumbar predominant facet anthropathy. Bony neural foraminal narrowing at L5-S1. Mild Vascular Calcification”. This was all through x-rays so I am sure an MRI will show more…which I will have done soon.
Should I even complain about this C&P doctor at this point almost 6 years later or would I risk losing the service connection? I need to know what they have on my back at the VA that caused the service connection, I do know this. I do not have a copy of the record of my back injury from right before I got out and I am thinking/hoping that they do, but I will not know until I get the C-File. I need my C-File (I know, I should have requested it long ago…I am learning).
My main question is, can I request a copy of my C-File while I have an open appeal (on other first year out of service claims — open since 11/2019) and I also just put in for two new claims at the beginning of this month that are moving fairly quickly. I have heard that requesting your C-File can cause delays and possibly affect open claims and appeals you have on-going…and I of course do not want to cause any kind of a delay. Since my separation I have only filed my initial first year claims and I filed appeal on some of those denials. I have waited all of these years and not done anything more because I was under the presumption that you cannot file any new claims until the appeal is processed and closed. I did though just file two new claims this month once I was informed that presumption was wrong.
Lastly, does anyone have any recommendations in how I should proceed with all of these new back findings (and also what becomes of the MRI in a couple of weeks) with regard to my already service connected chronic thoracic & lumbar strain — due to morbid obesity(!!). New and material evidence to reopen? New individual/separate claims? File for an increase in rating? Secondary’s? Or, should I wait until I have my C-File to see what they are basing the back service connection off of? Also, shouldn’t thoracic and lumbar be two different conditions/disabilities?
Sorry this is an overwhelming amount of information; I am so overwhelmed and discouraged by this whole process…and pushing through constant pain to boot.
Any suggestions would be greatly appreciated!
- Single Judge Application; Spellers v. Wilkie; the Court held in Spellers v. Wilkie, with respect to the diagnostic code for incomplete paralysis of the sciatic nerve, which also rates the condition based solely on the level of severity (i.e., mild, moderate, severe), the “lack of objective criteria for differentiating between the specified severity levels means that any evidence indicating severity of incomplete paralysis of the sciatic nerve is necessarily relevant to the schedular rating level.” 30 Vet.App. 211, 219 (2018) (emphasis omitted);
- Single Judge Application; tinnitus; Murphy v. Wilkie, 983 F.3d 1313, 1318 (Fed. Cir. 2020) (endorsing Clemons and explaining that “VA shall afford lenity to a veteran’s filings; evidence developed in processing that claim; claimant’s description of the claim; the symptoms the claimant describes; and the information the claimant submits or that the Secretary obtains in support of the claim; The Board did not, however, address the reasonably raised issue of whether the veteran’s specific claim for tinnitus encompassed a claim for a vestibular condition manifesting in dizziness, as required by Clemons. In Clemons, the Court explained that, because lay claimants generally lack the medical knowledge to narrow the universe of a claim to a particular diagnosis, VA “should construe a claim based on the reasonable expectations of the non-expert, self-represented claimant and the evidence developed in processing that claim.” 23 Vet.App. at 5. “[T]he claimant’s intent in filing a claim is paramount to construing its breadth,” and factors relevant to that inquiry include “the claimant’s description of the claim; the symptoms the claimant describes; and the information the claimant submits or that the Secretary obtains in support of the claim.” Id. The Court ultimately held that the Board may not deny a claim because a lay claimant’s hypothesized diagnosis proves incorrect; rather, the Board must “confront the difficult questions of what current condition actually exist[s] and whether it was incurred in or aggravated by service.” Id. at 6. In so doing, the Board must make “affirmative finding[s] as to the nature of the [claimant’s] condition.” Id. In short, “the fact that the [claimant] may be wrong about the nature of his [or her] condition does not relieve the Secretary of his duty to properly adjudicate the claim.” Id.; see generally Murphy v. Wilkie, 983 F.3d 1313, 1318 (Fed. Cir. 2020) (endorsing Clemons and explaining that “VA shall afford lenity to a veteran’s filings that fail to enumerate precisely the disabilities included within the bounds of a claim,” which “is best accomplished by looking to the veteran’s reasonable expectations in filing the claim and the evidence developed in processing that claim”).;
- Single Judge Application; the ultimate “lesson of our cases is that, while a pro se claimant’s ‘claim must identify the benefit sought,’ the identification need not be explicit in the claim-stating documents, but can also be found indirectly through examination of evidence to which those documents themselves point when sympathetically read.” Shea v. Wilkie, 926 F.3d 1362, 1368–69 (Fed. Cir. 2019). Here, the claim-stating documents pointed, when sympathetically viewed, to a history of symptoms of abdominal pain that yielded a diagnosis of gastritis. And that’s not all. The veteran’s gastritis was expressly linked to service by VA’s own medical examiner—in the context of an examination sought by the Agency as part of the development of Mr. Martinelli’s other claims.; The Secretary says the veteran is out of his depth in suggesting to the Court that melatonin use indicates sleep issues. But even if that were true, the veteran retorts, the Secretary forgets the Court’s ability to take judicial notice of facts generally known. See Tagupa v. McDonald, 27 Vet.App. 95, 100-01 (2014). Indeed, one need look no further than a basic medical dictionary to conclude that his in-service prescription was favorable, material evidence. Melatonin is “a hormone . . . implicated in the regulation of sleep, mood, puberty, and ovarian cycles. It has been tried therapeutically for a number of conditions, including insomnia and jet lag.” DORLAND’S ILLUSTRATED MEDICAL DICTIONARY 1110 (33d ed. 2020). The Board has a responsibility to explain why it rejects favorable, material evidence. Garner v. Tran, 33 Vet.App. 241, 250 (2021).;
- Tinnitus may occur following a single exposure to high-intensity impulse noise, long-term exposure to repetitive impulses, long-term exposure to continuous noise, or exposure to a combination of impulses and continuous noise (Loeb and Smith, 1967; Chermak and Dengerink, 1987; Metternich and Brusis, 1999; Temmel et al., 1999; Stankiewicz et al., 2000; Mrena et al., 2002).”
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Hello, I have more questions than I can find answers so I thought I would create a post to see if any of these can be answered? I apologize for the length. I have read, read, and read some more on this board for years and I very much appreciate any assistance that can be offered.