• Announcements

    • How to get your questions answered.

      How to get your questions answered. A few observations, and requests of all members. All folks who come here are volunteers who do this on their own time and their own dime.To avoid burning out our best contributors please follow these guidelinesf you are reading a post and it reminds you of a question you want to ask, start a new topic, if you place your question in someone thread it will be difficult to distinguish your question from the original poster, you will get better results posting a new topic with your question. 1. Before Posting please do a search and see if your question has already been answered. If you find the answer print it out and put it in a file to use as a reference file, I find this helpful myself. 2. If you can not find the answer and you do post a question, please print out those answers and refer to them to avoid duplicate questions. 3. Refer to the Frequently Asked Questions4. Duplicate questions will come up from time to time but the keeping them to the minimum will lighten the load on the regular volunteers.5. Respect folks privacy do not request their personal phone numbers for claims help, it is inappropriate and not why they are here.6. Keep the topics focused on veterans issues, in closing Search first Search ... Ask second.it may save a lot of time or at the very least enlighten you.
    • Listen Live Every Wed 5:30 PM CST to SVR Radio, Veterans Issues are discussed with various guests.

      Listen Live Every Wed 5:30 PM CST to SVR Radio, Veterans Issues are discussed with various guests. Please check the little home I am carving out for our SVR partners. http://www.hadit.com/svr.html
    • A bit about Tbird and HadIt.com for those who've asked...

      The following is on my About page, but some have been asking how this all happened. So here is my little story. Tbird US Navy 1983 – 1990 E-6 HadIt.com the website domain registered Jan 20, 1997 the domain is registered and paid for through Jan 21, 2023 at which time I plan to register it for another 15 years Lord willing and the creek don't rise. I guess the best place to start is Jan 1991; I had gotten out of the navy Dec 1990. At my separation seminar, there was a DAV rep Jim Milton he told us to bring our medical records in and he would look through them for us and let us know if we should file a claim with the VA. Well, bless his heart, he opened my medical file, reads the first insert, looks me straight in the eye, and says you will be 50% for the rest of your life and he would file the claim for me. 50% was for surgery I had in the service. True to his word he met with me and talked with me for a long time filled out my paper work and urged me to file for PTSD. I would not file the PTSD claim, nor even discuss it. By Feb 1991 I had moved to the San Francisco bay area and was staying at a friends apartment and pretty much I was just a puddle. In desperation one night I called suicide hot line, I had no job, no idea about going to the VA. They talked with me for a long time and explained to me that I could go to the local VA hospital even if I did not have insurance. Now, I know what you are thinking if I was 50% why didn't I just go to the VA in the first place, two reasons 1, this was Feb 1991 and the 50% didn't come till May and 2, even if it had come through it is unlikely that I would have had the mental acuity at the time to put the two together. I relate this here because it is where so many of our brothers and sisters are coming from, perhaps where you started. Fuzzy and unsure, in pain and sometimes homeless they come to the VA hospital for help. And that is where I ended up. Up to the pysch ward I went, blah, blah, blah, a few days later I was released with a promise of a call from the out patient program, which I would soon be entering. Blah, blah, blah, after many missed communications, and no call backs I was at the Day Hospital everyday M-F. And this brothers and sisters is where I began to learn and formulate my plan for HadIt.com. Veterans, veterans everywhere…I spent a year in the day hospital and about another year at a sheltered workshop before I got back on my feet. So I just talked to veterans everyday waiting for appointments, waiting for prescriptions, waiting for a vet rep and I started to learn the system. While in the navy I was data analyst and had to learn a 5 volume manual and just about anything you were suppose to do was in that manual. So I figured there must be a manual on how to do a VA claim or at the very least regulations. So I found out about the Code of Federal Regulations, United States Code, Veterans Affairs Manuals and so on and so forth. Of course this was 1991/1992 I was living in a tiny studio apartment in a particularly bad neighborhood, working in a sheltered workshop making a nickel per envelope I stuffed throw in PTSD and you will see that it was a difficult task for me to get somewhere where they had copies of these, let alone that they would let me look at. And there was so much knowledge around me, it was like the gold rush in those days, I could just sit on a bench a veteran would sit down next to me a little conversation later I had another nugget, I made copious notes. Phone numbers to call, ask for this guy or that guy he'll give you the straight scoop and they'd slip me a piece of paper with a number on it. You want to read this regulation or that one and another slip of paper into my hand. I spent a lot of time on those benches watching the squirrels they gathered their nuts and I gathered mine :) So I'm thinking I could put a little handbook together print it out and hand it out at the VA. Or perhaps fliers. Still formulating, time goes by, 1994/1995 I am being treated for PTSD regularly and doing and feeling much better and I go to work for a company as a marketing systems analyst and I discover the internet. Well let me tell you that was perhaps one of the most significant life changing events I have ever experienced. And I might add finally a positive one :) It seemed only natural to me that surely there must be a website that contained all the knowledge I wanted, well as it turned out not so much, lots of stuff but I wanted to get straight to the claims information and there was a lot of stuff to wade through to get to it. So taking my lesson from the squirrels earlier I started to gather, gather, gather…and learn HTML and work as a marketing systems analyst and work my claim. 1996/1997 major PTSD cork blows and unemployed. Working my claim, working the website. 20 Jan 1997 register HadIt.com domain name right after getting off the phone with the VA and saying I've had it with this. As fate would have it the old DAV board goes down just as mine opens up and folks start to wander in. So HadIt.com has two main components the website which supports the discussion board with links, articles, research resources etc. The website starts to grow, I can't tell you how many times I had to switch servers for space and features. I continue on a downward trend and in 1998 ended up back home in St Louis living in my sisters basement in therapy and working it, I swear I would have swung a dead chicken around my head at midnight naked if I thought it would have helped. The website continued to do great during this time, I just stayed in the basement bought new software, new books, and learned how to make things work and I continued to use this knowledge to make HadIt.com better. My 100% finally came through from the VA and I had a friend who is an advocate who helped me thru my SSDI claim, he was literally at my side thru the entire process and that came through for me. My therapist and sister continued to try and get me to leave the basement, but to no avail. At some point in 1998 or 1999 I put a counter on the website and was shocked to discover how many visitors we were getting. Time goes by my sister gets married and I move from the basement to the upstairs, there is much celebration that Aunt T is living in the light again. More time goes by and I settle into my life in St Louis and spend more time on the site trying new things, finding more information. 2003 I buy my own home VA loan. For years now I have just considered HadIt.com my job and I get up every morning go to the office and work for several hours, take an afternoon break and see where the rest of day takes me. I have a place in the office to use the computer and a comfortable to place to read journals and articles and take notes. Blah, blah, blah so that is my story and HadIt.com's intertwined.
    • HadIt.com Pass It On Cards

      Hi I've updated our HadIt.com Pass It On Cards. They are in a PDF format you can print them out cut them there are 12 to a page. If you have found HadIt.com helpful and would like to pass it on to other veterans this is an easy way to do it.I hope you find them helpful, feel free to leave a few anywhere veterans gather, veterans centers, veterans hospitals, public libraries, be creative. Please make sure though, that if you want to leave some at any business you ask permission first.Here you go http://www.hadit.com...it_on_cards.pdf
    • VA Training and Fast Letter Forum Index

      VA Training and Fast Letter Forum Index The following is the index with links to the various Training and Fast Letters plus a few miscellaneous. These letters are not necessarily in the original formatting. I have tried to present them in an easy-to-read form instead of some forms as originally presented. Some of the paragraphs were WAAAAYYY too long. lol - HadIt.com Member fanaticbooks Something to be aware.... Some of these letters may be rescinded, outdated, or otherwise no longer viable. I have still included them because sometimes they provide additional insight or just plain more information than the newest version. Use them wisely. The oldest letters will display at the bottom with the latest letters displayed at the top, all in sequential numbers. Coding of the letters... FL = Fast Letter TL = Training Letter First two numbers = last two digits of year of origin Training Letter http://www.hadit.com/forums/index.php?/topic/40694-va-tl-00-07/ http://www.hadit.com/forums/index.php?/topic/40693-va-tl-00-06/ Fast Letter Number Title http://www.hadit.com/forums/index.php?/topic/44262-va-fl-11-15/ http://www.hadit.com/forums/index.php?/topic/44260-va-fl-11-13/ http://www.hadit.com/forums/index.php?/topic/44261-va-fl-11-11/ http://www.hadit.com/forums/index.php?/topic/44310-va-fl-11-09/ http://www.hadit.com/forums/index.php?/topic/42151-va-fl-11-03/ http://www.hadit.com/forums/index.php?/topic/40957-va-fl-10-49/ http://www.hadit.com/forums/index.php?/topic/40958-va-fl-10-46/ http://www.hadit.com/forums/index.php?/topic/40959-va-fl-10-45/ http://www.hadit.com/forums/index.php?/topic/40960-va-fl-10-42/ http://www.hadit.com/forums/index.php?/topic/40961-va-fl-10-39/ http://www.hadit.com/forums/index.php?/topic/40962-va-fl-10-35/ http://www.hadit.com/forums/index.php?/topic/40963-va-fl-10-34/ http://www.hadit.com/forums/index.php?/topic/40964-va-fl-10-32/ http://www.hadit.com/forums/index.php?/topic/40966-va-fl-10-30/ http://www.hadit.com/forums/index.php?/topic/40967-va-fl-10-26/ http://www.hadit.com/forums/index.php?/topic/40968-va-fl-10-25/ http://www.hadit.com/forums/index.php?/topic/40819-va-fl-10-24e1/ http://www.hadit.com/forums/index.php?/topic/40818-va-fl-10-24/ http://www.hadit.com/forums/index.php?/topic/40817-va-fl-10-22/ http://www.hadit.com/forums/index.php?/topic/40814-va-fl-10-04/ http://www.hadit.com/forums/index.php?/topic/40969-va-fl-10-03/ http://www.hadit.com/forums/index.php?/topic/40812-va-fl-10-02/ http://www.hadit.com/forums/index.php?/topic/40808-va-fl-09-52/ http://www.hadit.com/forums/index.php?/topic/40806-va-fl-09-50/ http://www.hadit.com/forums/index.php?/topic/40970-va-fl-09-41/ http://www.hadit.com/forums/index.php?/topic/40971-va-fl-09-38/ http://www.hadit.com/forums/index.php?/topic/40804-va-fl-09-33/ http://www.hadit.com/forums/index.php?/topic/40972-va-fl-09-28/ http://www.hadit.com/forums/index.php?/topic/40671-va-fl-09-27/ http://www.hadit.com/forums/index.php?/topic/40973-va-fl-09-26/ http://www.hadit.com/forums/index.php?/topic/40803-va-fl-09-25/ http://www.hadit.com/forums/index.php?/topic/40802-va-fl-09-21e2/ http://www.hadit.com/forums/index.php?/topic/40801-va-fl-09-21/ http://www.hadit.com/forums/index.php?/topic/40799-va-fl-09-20/ http://www.hadit.com/forums/index.php?/topic/40798-va-fl-09-17/ http://www.hadit.com/forums/index.php?/topic/40974-va-fl-09-15/ http://www.hadit.com/forums/index.php?/topic/40975-va-fl-09-13/ http://www.hadit.com/forums/index.php?/topic/40797-va-fl-09-10e1/ http://www.hadit.com/forums/index.php?/topic/40796-va-fl-09-10/ http://www.hadit.com/forums/index.php?/topic/40795-va-fl-09-09/ http://www.hadit.com/forums/index.php?/topic/40976-va-fl-09-08/ http://www.hadit.com/forums/index.php?/topic/40794-va-fl-09-07/ http://www.hadit.com/forums/index.php?/topic/40793-va-fl-09-06/ http://www.hadit.com/forums/index.php?/topic/40977-va-fl-09-05/ http://www.hadit.com/forums/index.php?/topic/40731-va-fl-08-41/ http://www.hadit.com/forums/index.php?/topic/40730-va-fl-08-38/ http://www.hadit.com/forums/index.php?/topic/40729-va-fl-08-36/ http://www.hadit.com/forums/index.php?/topic/40728-va-fl-08-34/ http://www.hadit.com/forums/index.php?/topic/40726-va-fl-08-33/ http://www.hadit.com/forums/index.php?/topic/40725-va-fl-08-31/ http://www.hadit.com/forums/index.php?/topic/40978-va-fl-08-29/ http://www.hadit.com/forums/index.php?/topic/40724-va-fl-08-26/ http://www.hadit.com/forums/index.php?/topic/40723-va-fl-08-23/ http://www.hadit.com/forums/index.php?/topic/40722-va-fl-08-20/ http://www.hadit.com/forums/index.php?/topic/40979-va-fl-08-15/ http://www.hadit.com/forums/index.php?/topic/40721-va-fl-08-12/ http://www.hadit.com/forums/index.php?/topic/40720-va-fl-08-10/ http://www.hadit.com/forums/index.php?/topic/40719-va-fl-08-08/ http://www.hadit.com/forums/index.php?/topic/41580-va-fl-08-02/ http://www.hadit.com/forums/index.php?/topic/40717-va-fl-07-27/ http://www.hadit.com/forums/index.php?/topic/40980-va-fl-07-19/ http://www.hadit.com/forums/index.php?/topic/40981-va-fl-07-15/ http://www.hadit.com/forums/index.php?/topic/40718-va-fl-07-10/ http://www.hadit.com/forums/index.php?/topic/40716-va-fl-07-07/ http://www.hadit.com/forums/index.php?/topic/40715-va-fl-07-06/ http://www.hadit.com/forums/index.php?/topic/40701-va-fl-07-01/ http://www.hadit.com/forums/index.php?/topic/40983-va-fl-06-29/ http://www.hadit.com/forums/index.php?/topic/40699-va-fl-06-28/ http://www.hadit.com/forums/index.php?/topic/40984-va-fl-06-27/ http://www.hadit.com/forums/index.php?/topic/41579-va-fl-06-26/ http://www.hadit.com/forums/index.php?/topic/40698-va-fl-06-25/ http://www.hadit.com/forums/index.php?/topic/40986-va-fl-06-24/ http://www.hadit.com/forums/index.php?/topic/40987-va-fl-06-21/ http://www.hadit.com/forums/index.php?/topic/40988-va-fl-06-19/ http://www.hadit.com/forums/index.php?/topic/40696-va-fl-05-08/ http://www.hadit.com/forums/index.php?/topic/40697-va-fl-04-13/ http://www.hadit.com/forums/index.php?/topic/40989-va-fl-04-06/ http://www.hadit.com/forums/index.php?/topic/42415-va-fl-02-24/ http://www.hadit.com/forums/index.php?/topic/41582-va-fl-01-94/ http://www.hadit.com/forums/index.php?/topic/40990-va-fl-00-44/ http://www.hadit.com/forums/index.php?/topic/41581-va-fl-00-33/ http://www.hadit.com/forums/index.php?/topic/40991-va-fl-99-124/ Miscellaneous http://www.hadit.com/forums/index.php?/topic/40993-best-practice-manual-for-posttraumatic-stress-disorder-ptsd/ http://www.hadit.com/forums/index.php?/topic/44264-auditory-noise-fsh-regulation-no-40-7-appendix-b/ http://www.hadit.com/forums/index.php?/topic/44266-auditory-noise-duty-mosjob-title/ http://www.hadit.com/forums/index.php?/topic/44265-auditory-noise-cam-regulation-40-5/ VHA Directives Number Title http://www.hadit.com/forums/index.php?/topic/41073-va-vha-directive-2010-045/ http://www.hadit.com/forums/index.php?/topic/42174-vha-directive-2010-033/ http://www.hadit.com/forums/index.php?/topic/42175-vha-directive-2010-029/ http://www.hadit.com/forums/index.php?/topic/42176-vha-directive-2010-014/ http://www.hadit.com/forums/index.php?/topic/42177-vha-directive-2010-012/ http://www.hadit.com/forums/index.php?/topic/42178-vha-directive-2010-009/ http://www.hadit.com/forums/index.php?/topic/42179-vha-directive-2009-048/ http://www.hadit.com/forums/index.php?/topic/42180-vha-directive-2009-047/ http://www.hadit.com/forums/index.php?/topic/42150-vha-directive-2008-071/ http://www.hadit.com/forums/index.php?/topic/42181-vha-directive-2008-070/ http://www.hadit.com/forums/index.php?/topic/44263-vha-directive-2008-005/ http://www.hadit.com/forums/index.php?/topic/42182-vha-directive-2007-039/ http://www.hadit.com/forums/index.php?/topic/42183-vha-directive-2007-024/ http://www.hadit.com/forums/index.php?/topic/42184-vha-directive-2007-016/ http://www.hadit.com/forums/index.php?/topic/42185-vha-directive-2007-013/ http://www.hadit.com/forums/index.php?/topic/42186-vha-directive-2006-057/ http://www.hadit.com/forums/index.php?/topic/40994-va-vha-directive-2006-013/ http://www.hadit.com/forums/index.php?/topic/42187-vha-directive-2000-029/


This topic is now archived and is closed to further replies.

  • 0

Retro Pay Start Time?


Posted · Report post

Finally I got 20 % for my ankles the only real question is that I filed in aug 19 2009 but because they said I did not say there was any pain on my first c&p exam ( I did tell them a bout pain and I did tell the examiner in my 1st C&P exam and in my NOD ) they are going from my doctors first IMO in aug 2010 as the retro active pay when pain was first presented .

they are saying that I was given 0% on first exam I was not given any thing I was denied service connection because I had not had a clinical diagnosis .then I filed a NOD was denied ssoc issued then I has a rescheduled C&P exam they said I missed (I know go to any and all exams no matter what )then I finally got a new exam and was denied sent in a new IMO and now I got approved


1) When should I have been awarded my retro active pay

2) Is there any thing I can do a bout it

3) Can it or will it affect my rating of 20%for Achilles tendonitis if I complain

Share this post

Link to post
Share on other sites

7 answers to this question

Posted · Report post


Share this post

Link to post
Share on other sites

Posted · Report post

You stated:

“they are going from my doctors first IMO in aug 2010 as the retro active pay when pain was first presented . “


“then I finally got a new exam and was denied sent in a new IMO and now I got approved “

Did the new IMO clarify what you believe should be the retro date?

Did the VA list the new IMO as evidence and fully consider it in the award letter?

Do you have copies of the actual C & P exams?

But the retro date might be correct based on this VA statement:

“they are saying that I was given 0% on first exam I was not given any thing I was denied service connection because I had not had a clinical diagnosis “

If that statement is true the VA might have a point. Might.

Then again I succeeded in 2 claims whereby my husband, a VA patient, never had a clinical 'diagnosis' of either DMII or IHD from Vietnam, nor any VA treatment for those conditions , until any years after he died, and the DMII was proven 15 years after death ,never appearing diagnosed at all in his VA medical records. Likewise the IHD.

Of course those claims involved a LOT of leg work, medical research, documentation from other non medical entities, and many VA denials before award came- and for the DMII claim,I obtained 3 IMOs.

Would your new IMO doctor ( I assume they are 2 different doctors ?) be willing to again review your medical records to see if there was anything symptomatic that was documented ,that should have warranted an earlier clinical diagnosis?

“they are saying that I was given 0% on first exam I was not given any thing I was denied service connection because I had not had a clinical diagnosis “

That VA statement bothers me as it seems a little odd. Do you have those C & P results and can you scan them and attach them here? (Cover all personal identifying info)

Were you a VA patient prior to the EED they gave you and had you been seen for this condition by the VA?

(or if a private doctor had treated you for this condition, was VA aware of and did they obtain those private medical records)

This still bothers me:

“they are saying that I was given 0% on first exam I was not given any thing I was denied service connection because I had not had a clinical diagnosis “

Did the medical evidence warrant a higher rating, at that time, or was this a "0" only due to the lack of clinical diagnosis?

Which tends to suggest they didnt give an actual C & P exam because there was no 'clinical' diagnosis.

I hope others chime in here.

There is a local situation here and the vet does not have a 'clinical' diagnosis.

I have strongly urged the family to get him down to the local VAMC ASAP as well as file a claim.For TDIU.

His inservice nexus is quite well established.

Share this post

Link to post
Share on other sites

Posted · Report post

i am attaching my 2 C&P exams SOC ,SSOC, NOD ans my 2 seprate award letters post-9983-0-38969000-1342964732_thumb.jppost-9983-0-91564100-1342964757_thumb.jppost-9983-0-14378900-1342964781_thumb.jppost-9983-0-07026500-1342964801_thumb.jppost-9983-0-81012100-1342964821_thumb.jppost-9983-0-58454800-1342964842_thumb.jppost-9983-0-67455800-1342964859_thumb.jppost-9983-0-19066900-1342964885_thumb.jppost-9983-0-23088600-1342964909_thumb.jppost-9983-0-75605900-1342964950_thumb.jppost-9983-0-57867000-1342964991_thumb.jppost-9983-0-17022900-1342965003_thumb.jppost-9983-0-77063300-1342965025_thumb.jppost-9983-0-43915500-1342965050_thumb.jppost-9983-0-42296200-1342965074_thumb.jppost-9983-0-86375200-1342965097_thumb.jppost-9983-0-77318300-1342965117_thumb.jppost-9983-0-76619500-1342965137_thumb.jppost-9983-0-51588400-1342965227_thumb.jppost-9983-0-25866100-1342965246_thumb.jppost-9983-0-94646300-1342965266_thumb.jppost-9983-0-35407500-1342965293_thumb.jppost-9983-0-99418700-1342965314_thumb.jppost-9983-0-73606800-1342965337_thumb.jppost-9983-0-27305200-1342965361_thumb.jppost-9983-0-34717400-1342965380_thumb.jppost-9983-0-03296600-1342965399_thumb.jppost-9983-0-47437900-1342965416_thumb.jppost-9983-0-79246100-1342965502_thumb.jppost-9983-0-71275300-1342965523_thumb.jppost-9983-0-87196900-1342965548_thumb.jppost-9983-0-27766000-1342965570_thumb.jppost-9983-0-21370400-1342965599_thumb.jppost-9983-0-84992400-1342965625_thumb.jppost-9983-0-78665900-1342965657_thumb.jppost-9983-0-05364300-1342965686_thumb.jppost-9983-0-86685400-1342965697_thumb.jppost-9983-0-58872000-1342965702_thumb.jppost-9983-0-71343000-1342965719_thumb.jppost-9983-0-82492500-1342965733_thumb.jppost-9983-0-84696100-1342965817_thumb.jppost-9983-0-12553200-1342965850_thumb.jppost-9983-0-32235200-1342965887_thumb.jppost-9983-0-23813800-1342965915_thumb.jppost-9983-0-38981700-1342965954_thumb.jppost-9983-0-70654600-1342965995_thumb.jppost-9983-0-50196000-1342966032_thumb.jp

Share this post

Link to post
Share on other sites

Posted · Report post

I hope all this can help me in determining start of award for retro pay

Share this post

Link to post
Share on other sites

Posted · Report post

I didnt expect so much to be attached here. I read some of the C & P exams and the last decision.

Prior to seeing Dr. Schilling in 2010,did you have any treatment records established with the VA or any private doctor that warranted symptoms enough to warrant a clinical diagnosis prior to the EED they gave you?

Did Dr. Schilling's opinions refer to any treatment records prior to August 2010 that showed symptoms that warranted an earlier diagnosis? (and earlier ratable condition?)

Other then the Family practice record of 1997 as well as of January 2011 and the treatment reports from Dr. Schilling in August 2010 and April 2011, do you have any other medical documentation that your condition raised to a ratable level prior to August 2010?

And if so, it isn't on the Evidence list you attached and should be submitted with your NOD.

The point I was trying to make when I rattled off how I proved 2 disabilities )both determined by VA as lending to my husband's death) which were never diagnosed by VA or even treated at all by VA,

was that medical records can often contain enough symptomatology or other clinical findings (X rays, blood work, MRI narrations, ER certs, Ekgs etc etc that can ,in essence, expose conditions a veteran had never been diagnosed with or treated for by the VA and should have been. Or these documented symptoms could warrant a rating higher then what they presently have.

In the IMO from Dr Schilling, did he in fact make any medical statements that,in his opinion, based on his examinations etc,

and his expertise,

that the disability onset as to a ratable level began sooner then August 2010?

He would still need to refer to some documentation however for that.

I have a podiatrist who told me my ankle condition is due to decades of the types of jobs I had in the past.

I am not a vet but my point is, I didnt seek any medical attention until the condition made it difficult for me to walk.

Orthonics and braces however have helped me significantly- good thing- I have a farm and lots of yard work.

So I was not clinically diagnosed (severe pronation in both feet) up to that point because I had no medical records for that

until I told my primary care doctor I was having balance problems and thought I had MS or an inner ear problem, and she referred me to the podiatrist knowing it was most surely an orthopedic problem.

I hope others chime in here.

Share this post

Link to post
Share on other sites

Posted · Report post

this was my imo from my doctor let me know what u think

un fortunatly when i went to the doctor in the past i only have one time where i complained of heal pain in jan of 2001 and i have allways been told the same stuff streach take motrin so i did not complain i would take motrin for my knees and that took care of my ankles to a point i hate doctors and do not like to go to them unless i want major surgery to fix my issues no way

ABC Podiatry/East

Patient: XXXXX Account No:XXXXXX Date 5/10/2012

Chief Complaint: Pt presents with longstanding foot and ankle pain. Pt has had foot and ankle pain for about 17 years and this is ongoing even through treatment. Pt was first diagnosed with Achilles tendonitis on August 21, 1995. Pt was in boot camp at Paris Island, SC at the time of diagnosis. Pt had been pain free prior to entering camp. Pt had been training and fell with large backpack and injured his right patella and had pain in knee. Pt was seen for this problem and was put in the medical rehab platoon and was there about 3 months. While in rehab, pt noticed tightness and pain in both legs. Pt was then sent for physical therapy and was given stretching instructions as well as ice for inflammation. Pt also had therapeutic ultrasound done for these problems. This was all in the spring and early summer of 1995.

Pt was running and walking during rehab for bilateral leg pain when he started to have tightness and pain in back of calves and heel areas. Pt was seen August 21, 1995 for pain in feet and shoe irritation as well as blister formation from all of the rehab exercise and diagnosed with Achilles tendonitis and was told to rest. September 26, 1995 pt returns to clinic and was given a diagnosis of shin splints a this time, and told to ice and stretch. In November, 1995 according to a medical review pt is still dealing with Achilles tendonitis and taking NSAID for treatment. Pt was seen on May 21, 1996 and July 24, 1997 and while he was still having problems with his Achilles, his knee pain was greater and this was the focus of the visits. However, his ankles were still painful swollen and documented by his marking the box of painful and swollen joints. This box was not specific to his knee or his ankle. Pt went to Marine Reserves and went back to school. Pt was limited in his activity and had increasing pain because of his Achilles tendonitis and subsequently was gaining weight. Pt got married and started a family and his pain never completely resolved. Pt has been and was at the time taking Ibuprofen regularly. Pt was see by his family doctor January 11, 2001 and was still complaining of heel pain esp in right. Pt has been seen at this office since August 26, 2010. Pt had been complaining of shooting pain and sharp pain in both legs and this was exacerbated by walking and standing. Pt had a long history of Achilles tendonitis. Pt was told about shoegear changes, given ¼ heel lifts, told to stretch and changed his NSAID. Pt returned February 11, 2011 for follow up and was cast for custom molded orthotics and told to continue to stretch. Pt picked up orthotics about 1 month later and also received an ankle foot orthosis for his right ankle and heel. Pt admits some minor improvement through the stretching activities given to him by our office. After usage of custom molded orthotics, pt did obtain increasing relief, however this will not be a permanent change and he will likely have continued pain throughout his lifetime.


Medications: Fish Oil-capsule, Ibuprofen 800 mg tablet

Past Medical History: Admits Unremarkable.

Past Surgical History: Admits hernia repair.

Past family and Social History: Denies alcohol and tobacco use

Height: 69 inches Weight 273 pounds BMI 40.31 pulse: 74/min Sitting Blood Pressure: 125/90

  • Vascular: Dorsalis pedis and posterior tibial pulses are graded at 2 with digital hair growth present bilateral. CFT with the leg elevated was less than 3 seconds at the distal hallux bilateral. There is no evidence of ischemic skin changes. Temperature was warm at anterior tibia to warm at the distal digits bilateral.
  • Lymphatic: No popliteal lymphadenopathy noted
  • Neurolgical: Pt oriented X3, with appropriate affect, no anxiety or depression. Coordination WNL to right and lefty lower extremity. Exam reveals epicritic sensation is intact along defined dermatones to protective threshod, symmetrical Achilles tendon and patellar deep tendon reflexes with a negative clonus and down going toes. Patient is able to heel and toe walk with ease. Normal sharp/dull, vibratory, proprioception, light touch sensation to right and left foot. DTR Achilles 2/4 right, 2/4 left.
  • Dermatological: No edema, erythema, ecchymosis, open lesions, interdigital macerations or signs of infection evident at this time bilateral.
  • Musculoskeletal: Good muscle strength to all prime movers of the foot and ankle with adequate muscle tone and symmetry bilateral. Decreased ht in medial long arch BL decrease with wt bear. Pain on palpation posterior heel at insertion of Achilles tendon BL. Decreased dorsiflexion in ankle BL with pain at end ROM.
  • Xray analysis: Diagnostic lateral BL x rays show large, mature posterior heel spurs BL with possible fracture line in left posterior heel spur. Decreased caldaneal inclination angle BL with degeneration STJ BL. Plantar heel spur right.

    1. Equinus, BL
    2. Achilles tendonitis, BL-chronic. I believe that this is very likely to be connected to his time in the service by approximately 90% level of certainty. This is because before entering the military there was a health evaluation that made no mention of lower extremity pain or problems.
    3. 3. Early STJ DJD BL


    [*]Diag lateral BL x ray

    [*]Long discussion on eitiology, treatment and prevention of Achilles tendonitis.

    [*]Discuss treatment options for Achilles including physical therapy, home stretching, shoe and insert changes and ultimately surgery either to lengthen Achilles or to inject with platelet rich plasma or use of radiofrequency conlsyion

    [*]I believe that the examiner from February 14, 2012 failed to understand the chronicity of the injury and the fact that he never fully recovered from the initial pain. Pt had other problems from his service including patellar injury at about the same time which were higher priorities at the times of exam in the mid/late 90s therefore his heel pain, even though stil present was not mentioned in the exams. In Aubust, 2010 it was documented that he had gradually gotten worse over the previous month or so, but this condition is intermittently worse at certain times and can be aggrevated by activity or weight as well. However, without the first episode and without full resolution of symptomatology, this would not have been an ongoing issue to this date.

    [*]Pt to return as needed for follow up

    [*]Pt to continue stretching and orthotics/good shoegear

Share this post

Link to post
Share on other sites

Posted · Report post

I would get a witness statement from someone you know stating you were complaining to them of pain at the time of the C&P exam and I would tell them to re-read the NOD. Also tell them the C&P examiner failed to note claims of pain that you specifically remember stating. They usually ask for witness statements on the denial letter. The witnesss statement would be new. However, it reinforces what you said on the NOD. They need to give weight to all medical reports and filings.

This strategy deals directly with the reason for the later claim date accoring to what you posted.

Share this post

Link to post
Share on other sites

  • HadIt.com Twitter