I know exactly how ankylosing spondylitis is rated, I was trying to explain how you were possibly rated back in 1984 (now it appears it's 1979 as an effective date). And from the looks of it, I was correct in that assumption. If you were service-connected, now back in 1979, for lumbocaral strain, in all likelyhood the DC would have been 5295, and when you applied for an increase your DC was changed to the new rating criteria with a DC of 5237. I was also trying to explain the different senarios of why the VA assigned that DC and not combining it with either DC 5002 or 5003.
As far as the letter from the VA, let me try to explain this again so you understand. Ankylosing spondylitis is a form of rheumatios arthritis, not degenerative arthritis (I mentioned DC 5003 in my prior post in the event that back in 1984 there wasn't any evidence of rheumatiod arthritis but degenerative artritis due to the lumbar strain) and would warrant either the assignement of DC 5240, or both by being hyphenated as 5002-5240. Normally you would be rated under 5240 due to the limitation of motion or DC 5002 if the rheumatiod arthritis is active, whichever rating would result in the higher evaluation. However, if the limitation of motion does not warrant a compensable evalution under 5240, meaning that there is forward flexion greater than 85 degrees, and the disease is active, then you would be given a 10% evalution under the criteria of DC 5002 because there is objective finding of limitation of motion such as muscle spasm or swelling. When the VA hyphenates a DC with another, it identifies the body system affected by the arthritis! Furthermore, you cannot be assigned a 10% or 20% rating under DC 5002 and another 10% or 20% under DC 5240 beacuase, as the letter from VA states, this would by pyramiding. Also as I noted in my prior post, as did the letter from VA, if you have ankylosing spondylitis in another bodily etiology, you can obtain service-connection for that also.
"AND, I'm not sure why you think incapacitating episodes would not apply to me
If you would read my prior post, you would notice that I was reffering to the incapacitating episodes under DC 5243. If your ankylosing spondylitis is an active process, then you could be assigned a rating of 20% or higher under DC 5002 due to "incapacitating exacerbations." These are two totally different rating criteria between the two.
One other thing that doesn't add up with your claim is that you said;
"As of 10/03/06, HINQ shows Service Connected disability 5237-Lumbosacral or Cervical strain 0% Orig Eff Dt Jan 18, 1979. Service Connected low back disorder 0% Orig Eff Dt Apr 20, 1984. Combined %=0
You cannot have two rating for the lower back, provided that "HINQ shows Service Connected disability 5237-Lumbosacral or Cervical strain 0% Orig Eff Dt Jan 18, 1979,' means lumbocasral strain and not cervical! If this is the case, then someone at VA screwed up and enter both into the computer. Having said that, why would the VA assign a 0% evaluation for a lower back condition in 1984, which is a bit over 4 years after you were orginally service-connected. Did you apply for an increase in 1984 which prompted VA to enter something in the computer????? Are you service-connected for the cervical spine also (maybe in 1979????).
"I never said the VA was asking for a nexus. I was merely being sarcastic in saying the "nexus" is in the medical evidence that is already in my C-File
Then what does this mean????? ; "the VARO is still denying me a rate increase because they state there is no nexus."
"The RO DID NOT have to request my SMR's. They sent me a letter with an attached form (that showed Records could not be found). I was informed that it was not even a form VARO uses. It is one that the clinics would have used a long time ago. I think someone took it out of my SMR and copied it and then sent it to me because I had requested my SMR's...Now, I know you probably don't think that way of the VARO. But I don't put anything pass them anymore...At any rate, VARO did have my SMR's because they sent them to me. I requested my SMR's from RO, after I received the letter from NPRC in 03 stating that's who had them. I received a copy of both AF/Army SMR's in February 05, AFTER the 10/04 rating exam and AFTER the second denial (requested reconsideration in August 04 after the first decision letter denying me in June 04).
If you were service-connected and the VA requested additional records friom the the NPRC in St. Louis, then my geuss is you made some type of remark to tyhem that there mught be additional medical records that they didn't have. Even though you were already service-connected at the time and any subsequent SMR's from the DoD would actually be a moot point, the VA MUST obtain any of those brought to light by the veteran in accordance with the VCAA of 2000.
After re-reading everything in these posts, I have to say that your claim is so muddled up. You aren't giving any straight answers as to what is what and you are adding things to each post such as acuisations and so forth, which actually have little to no bearing on your claim what so ever. Before I keep going on and on about this, I will say these things in my obsevations;
1) In all likely hood your problem lies within the statement from the C&P examiner in which he states;
"I conclude that the cause of ankylosing spondylitis is unknown. The onset of ankylosing spondylitis beginning in 1978 is most likely but the only manifest injury
was said due to strain. Her ankylosing spondylitis is not caused by or a result of her low back strain suffered in 1978."
Then he contradicts himself by saying;
"Her low back disorder in 1984 described in service as chronic low back pain is most likely due to the progression of her ankylosing spondylitis."
2) The VA has assigned two ratings for the lower back, which appears to be adding to the confusion. What was the reason for them to assign another rating in 1984, 4 years after the initial rating???? Did you apply for an increase back then, and if so, what were the findings from the C&P exam?????
What does the actually rating decision state from 1979 AND 1984. Not just the DC's but the actaul decision. The older rating decisions probably wont have the "evidence" or "reasons and Bases" section, but rather in a format with the letters "a," "b," ect..., and they are on, I think, VA form 21-679 and 21-679b. They also may be on VA Form 21-6789 too!
3) Like I said before in my previous posts lubosacral strain and ankylosing spondylitis are two different animals and since the VA examiner in part couldn't asociate the two in his findings, this is probably where your problem lies. Having said this, as I said before, normally once you're service-conmnected for a certain bodily etiology, then any subsequent diagnosis is actually a moot point. Depeneding on what the other 3 - 5 IMO's state (I can't tell how many you have as you have contardicted yourself on this) and how thoroughthey where with their rationals, they may not have been enough to orveride the C&P examiners findings. Hell, from the looks of things, the VA didn't have these IMO's before them to consider.
4) The only thing that comes to mind is the VA may have had enough medical evidence to seperate the two and determined (with the medical evidence in front of them, meaning minus the IMO's) that the AS was infact causing the increased disability and not the lumbar strain. I have never seen this happen, but I suppose the VA could do this depending on the medical evidence before them.
If this is the case, you need to get the IMO's to the VA that state the disabilty noted in your SMR's was in fact the early manifestation or the aggravation of AS. I say aggravation because, generally AS begins in childhood and takes year and years to maifest itself!
5) You need to read the entire SOC
. There is a "reason and bases" section, which in all likely hood went into more detail as to why the claim was denied than the first rating decision did. If it is a compltete cut and paste job, which I doubt it was, of the first rating decision as you said it was, then go back and read the entire rating decision.
6) If the VA was able to seorate the two condition as I said in number 4, then the bottom line is you're missin g the nexus between the two!
I'm willing to bet that there is much more to this situation that is being presented. I say this because each post by you brings to light something else. Furthermore, since your claim was also reviewed by the Appeals Team, the chances of them overlooking something as simple as you have presented it is actually pretty remote. I'm not saying it couldn't happen, but the chances aren't in your favor.
I wish you the best of luch in getting this resolved.
Edited by Vike17, 23 July 2007 - 01:39 AM.