"It's a little like wrestling a gorilla. You don't quit when you're tired.
You quit when the gorilla is tired." — Robert Straus
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Spine Pain Independent Medical Opinion
James Shields, MD, MBA...A Board Certified Physician
Veteran Spine Pain, Weakness, Stiffness, Neck or Cervical Pain, Fibromyalgia,
Intervertebral Disk Syndrome, Decreased Range of Motion, Degenerative Arthritis
of the Spine, Hip Pain or Weakness, Shoulder Pain or Weakness
Greg served in the Air Force as a C-17 loadmaster in both Operations Enduring
Freedom and Iraqi Freedom. Greg's practice includes VA disability compensation
appeals, Individual Unemployability (TDIU) claims, MST, PTSD and other mental health disability claims and appeals and other veterans disability claims processes. Attorney
Rada offers free telephone case evaluations as well as nationwide representation.
Call today! 844-838-7529
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Brett Valette, Ph.D.
Providing Military Veterans Personalized Psychological and Medical Evaluations. Complete the Contact form, and you'll get a personal phone call from us. We listen, and want to know what you are going through. We provide Independent Medical Evaluations (IME), Independent Medical Opinions (IMO) and nexus letters for ratings reviews, secondary conditions, medical conditions, discharge upgrades, and many types of denied claims. We also provide Social Security Disability claim reports.
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Jim Strickland is a Vietnam era Army veteran and nationally recognized expert on VA
disability benefits. Jim writes extensively about VA and Social Security disability benefits.
Jim's Mailbag is a regular column featured at Stateside Legal where veterans, servicemembers,
and family members can ask Jim their questions about VA and Social Security disability benefits.
Pro Tip: If you want to be sure the C & P doesn't hurt you, you're gonna need an IMO.
The IMO is how claims and appeals are won.
Compensation and Pension Examinations
The VA C & P Exam
Question: Is there any scientific data to support linking Central Sleep Apnea to DM 2 and or PTSD . Key is central not obstructive.
Jim's Reply: I'm aware of some data that suggests that CSA may be associated with DM2 and Metabolic Syndrome. However, I don't believe a cause and effect is as clear as it might be in other cases. I'm not aware of any connection to PTSD without associated TBI.
I've discovered BVA appeals that give some insight as to claims and decisions by BVA regarding CSA. If you'll click here and then type in <central sleep apnea> in the search field and then select a year or two to search you'll discover plenty of reading on the topic.
If you are trying to make a connection or nexus for the purpose of claiming a secondary condition, you're likely going to need an expert IMO for your claim or appeal. An IMO is the very best way to win a claim or appeal as VA gives these opinions a lot of weight in their decision. Good luck!
Question: When are you allowed to file for 1151 benefits for a secondary condition? Only after you’ve been granted benefits for the primary condition, or immediately upon learning of the secondary condition? Thank you.
Jim's Reply: Title 38 U.S. Code § 1151 isn't a benefit in the way you're thinking of it. This piece of the code comes into play if you're injured by VA medical treatment or voc rehab. I usually think of it as a sort of mini-medical malpractice suit where both the burden of evidence and the award are lower than a tort claim.
I believe that you're asking when you are allowed to file a claim for a secondary condition? The answer to that is at any time after you have the primary condition rated. For example: The Vietnam veteran who is diagnosed with type II diabetes is awarded a presumptive rating of 40% by The Schedule for that condition. Once his service connection and the 40% rating are in place the veteran could then go on to file for conditions like peripheral artery disease, carotid artery disease, renal artery disease, coronary artery disease, thyroid disease, retinopathy, and a host of other conditions that DMII is known to cause, contribute to or aggravate.
That same sort of cascading effects may be applied to a service connected injury that causes other disabling conditions. If you lost your lower leg on a mine, you may have hip and back problems over time.
I'll caution that the VA doesn't blindly accept any premise you may offer. There has to be some science to support an allegation and claim of a secondary condition. Overreaching (my active duty broken arm caused my liver cancer 30 years later) will just get you a denial PDQ. If there are doubts, get an IMO.
There is no other part of the Department of Veterans Affairs disability benefits application and adjudication process that is so intimidating as the Compensation & Pension (C & P) exam. Grizzled veterans who have jumped out of airplanes and confronted the enemy in countries around the planet are known to cower in fear of meeting a C & P examiner. The examiner may be a Veterans Health Administration employee or a contractor with a company like LHI and offer varying exams and services. There are other contractors who perform C & P exams and they may operate at a VA facility or out of private offices where they normally practice. The examiner may be a physician or a physician assistant or a registered nurse practitioner or you may be offered a hearing exam by an audiologist and so on. Most exams are perfunctory and often confusing to the veteran. Your key to success is simple; Speak the truth about your symptoms without embellishing symptoms but not minimizing anything. Make brief notes to yourself of anything you want to say. If you don't have a cheat sheet, you'll forget...you know you will. Don't ever display anger or be a smartass. There is nothing you can do to make this any better but to maintain your cool. Keep reading.
Separating Fact From Fiction
The Must Do & Must Not Do of the C & P Exam
* The examiner does not make the decision about your claim.
* You may take records with you but the examiner may refuse them.
* The examiner won't treat you or prescribe medicines.
* NEVER try to fake any symptom. If you aren't prescribed a neck brace, don't wear one.
* The examiner will only perform the task assigned by an order of the regional office.
* You do not have to allow the examiner to cause you pain or discomfort during the exam by manipulating joints, etc.
* The examiner does not have any insight about how your claim will be decided. Don't ask.
* You may request that a family member or friend join you during the exam. The examiner may agree or refuse your request.
* DO NOT attempt to secretly record any part of the exam.
* DO make notes for yourself before you go. This is the only way you'll be sure to tell the examiner all the details you want to share.
* DO NOT over-exert yourself trying to please the examiner. This exam is about your worst symptoms, not the best.
* DO be courteous at all times. Don't complain to the examiner about all the indignities you've suffered. Focus on the reason you're there.
* DO use your common sense. This exam probably won't make or break the decision about your claim but it can help.
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The NPRC
Military Records
C&P Service Clinician’s Guide
When the examiner says, “more likely than not”
or “at least as likely as not”, how
does that affect the outcome of your claim?
Denis McDonough
Secretary of Veterans Affairs
Are You Rated For A Spine Condition?
Mistakes Have Been made!
Accuracy of Claims Decisions Involving
Conditions of the Spine
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Nexus and IMO Letters
When You Hit A Dead End
The Department of Veterans Affairs
White House Hotline
855 - 948 - 2311
< Denis.McDonough@va.gov >
Yes, this really works. No, it doesn't ring in the White House. The email address and phone number are staffed by a seemingly serious group of players, many who are veterans, and if you have a legit issue, telling these folks is like bringing in the artillery. Let's prepare for your call or email. Make some notes before you proceed so you don't forget anything. I prefer email since there's no waiting for someone to answer and I can take my time to prepare the story in just the right detail. Be sure to include your DOB, your last 4, contact info...a couple of numbers, your preferred email and such. Describe the problem as briefly as you can. Less is more. Include the necessary components but don't tell your life story. Don't rant. Be polite...military courtesy will get you places that hollering IN ALL CAPS won't. Respect! Don't waste their time with bogus complaints about your feelings being hurt. If you appropriately utilize this service, I'll vouch that this works like a champ. Tell them you read about this at The VAWatchdog Dot Org...they know who we are.
The VA Watchdog Dot Org
Since 2005, We're Keeping An Eye On Your VA
Because Somebody Has To!
Welcome Home! I'm Jim Strickland. I'm an Army vet, I was 91-D20 in USAREUR at the
98th General Hospital near Camp Baumholder 1967 - 1970. I publish the VAWatchdog
Dot Org to help you obtain the benefits you earned by your service to our country.
I'll also share what I'm reading today, the important stuff. An informed veteran
is a successful veteran. Feedback is always welcomed.
Veterans Law Attorney Drew Early
Graduate of the US Military Academy West Point
20 years of active Army service, multiple deployments, tours with 2 Infantry
Division, 10th Mountain Division , XVIII Airborne Corps, and Third Army,
Airborne and Master Explosive Ordnance Disposal badges.
Graduate of the Command and General Staff College Master's Degree in
Strategic Planning from the School of Advanced Military Studies
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disability claim
Find out how to file a claim for disability compensation
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Veteran
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Thomas Grieder, MD PhD
25 Years Service as a VA Psychiatrist
Lead Psychiatrist East Los Angeles
PTSD Clinical Team
I'm Jim Strickland
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You may file claims on eBenefits or you can mail them in using certified mail or you can even fax them in.
Download VA benefit letters
To receive some benefits, Veterans need a letter proving their status.
Jim Strickland
jim912@gmail.com
Title 38 - Pensions, Bonuses, and Veterans' Relief
Volume: 1
Date: 2019-07-01
Original Date: 2019-07-01
Title: PART 17 - MEDICAL
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