Advice On Proving A Nexus To Service (Migraines And Eczema …

Some quick background, I served for 5 years 8 months (with a break in service).  I came in pretty much normal, no major medical problems.  I had childhood allergies, like many had, and asthma and grew out of both well over 12 years before joining the Army.

 

During my first term of service I injured my back, but it wasn’t too bad at the time (herniated L4/5, 0% rating as there was rare pain and didn’t even warrant any real treatment).  When I rejoined I was still in normal health, nothing out of the ordinary (besides that injury).

 

The back got worse during service, now both the L4/5 and the L5/S1 are herniated and I require ESI 1-2x a year to control the pain (don’t really want to do the surgey if another treatment still works).  After I left service it was upgraded to 10% and 10% for sciatica.  The doctor did not do a ROM, or evaluate (or even ask) about the sciatica.  My award letter did note this and stated that if I provided the ROM they will re-evaluate.

 

I also developed OSA during my second period, most likely do to the 12hr rotating shifts and other nasty things in that nasty command center I lived out of for 3 years.  While relatively mild (IMO at least, I know people with FAR worse), it does require a CPAP and was awarded 50%.

 

My ulnar nerve (left arm) has minor paralysis, was awarded 10% for it.

 

Hypertension (stage 1, controlled with medication) I was given 0%.

 

I also was diagnosed with Allergic Rhinitis but forgot to claim it, I have already started a claim for that (should be fairly easy, diagnosed 2 years into my second term, confirmed diagnosis after service, same treatment the entire time).  Perential, not seasonal.  Antihistimines and flonase.

 

Now for the ones that were denied, which is where I am asking for advice.

 

Eczema, I was not diagnosed until a few months after service.  I had these rashes a lot during my second term (started about a year into it).  The TMC just called them fungal infections (no actual tests done, just visual inspection) and gave me anti-fungal creams and hydrocortizone.  There are a few instances of this in my records, but I stopped going when all I was getting was stuff I could grab at the PX OTC (with my work hours, sick call was on a day off).  After service I went to a local doctor (I am overseas, should have mentioned that…) whom thought it might be irritation from soap or hard water.  Changed soap, went on vacation, etc and no change.  After a few visits he refered me to an allergist.  The allergist diagnosed Eczema (AD) and started treatment, topical steroids (a little stronger than hydrocortisone) and antihistimes (basically the same thing I was getting before).

 

He reviewed my service records and said the fungal infections I had before were probably the first instance of it, either a misdiagnosis or the fungal infections were secondary due to untreated eczema (constant scratching increasing the chance of a fungal infection).  The rashes in service were in the same locations as the rashes I still have now.  The statement I got from him was weak, I didn’t know about all the magic words.

 

The other condition is migraines, I have approximately 11 (I need to count again) ER visits for headaches/migraines in the last 3 years of service.  I have a number of ER visits after service for the same (average 3-7 a year, ones servere enough to warrant an ER visit, almost 1 a month but those I can control and they go away in 2-4 hours… mostly).  This was denied because I never saw a neurologist, nor got an official diagnosis (just the ER records stating visit for migraines).

 

Now for what I have done.

 

I have contacted the DAV to represent me, they have been very helpful so far (but hard to talk to due to the timezone difference).  The hospital that did my C&P (ordered by the VA, via the US Embassy here) was terrible (they are no longer approved).  They didn’t do the ROM for my back, I only saw a generalist for 5 minutes, no review of records, nothing.  My claim for Eczema (which was added on) I never even went to the hospital for…  My rep at the DAV said the best way would be to do an FDC, with new evidence, vice an appeal (due to the long wait on appeals).  So that is what I’m working towards.

 

I have the ROM for the back, and a new DBQ to match.  That should be fine, the doctor ACTUALLY did a physical, read my records and talking to me.

 

My allergist did a DBQ for my eczema, he also provided me with a medical certificate that states how long he’s treated me for, what he treats me for (with those international numbers, I forget what they are called, for each diagnosis) and that in his medical opinion it is more likely that my fungal infections were most likely secondary infections due to undiagnosed and untreated eczema.

 

I also saw a nuerologist, whom I spoke to for quite some time, and he also reviewed the relevant records.  He provided me with a DBQ and medical certificate officially diagnosing me with migraines (also started me on treatments, wow that makes a difference… been 2 months since my last migraine).  On the DBQ he states have suffered from migraines for many years, as well as OSA inducted morning headaches.

 

Now for the questions.

 

What am I missing?

 

Is there anything I should do, or add for those two things that I am contending?

 

I want to make sure everything is in order when I put it in the mail.  I am honestly not that worried about the percentage (of course, I’d like what is correct), I just want the SC status so that I can cover the cost of treatment.

 

Is there anything I should add in my own statement, besides just what evidence I’m bringing in, and what I believe is correct?

 

Should I seek out more doctors to get additional statements?  It’s not easy to do over here, their doctors tend to work in black and white so they don’t want to put anything on paper unless they are 100% certian.  I actually had one doctor tell me he agrees, but when I asked if he could write a statement to that he said “But that’s just my opinion, it doesn’t mean anything.”

 

In my research I came across an appeal case that mentioned the veteran submitted articles from medical journals, highlighted, in support of his contention.  Is that a good idea to do, as I do have many that support my eczema claim.  Or would that come across wrong, like I’m trying to tell the RO how to do their job?

 

What is the best way to organize everything before I send it in?  Of course I’ll send it to the DAV (as they are my VSO), but what will make it easiest for them to make a decision?

 

I think that’s about it, I can provide more detailed (exact quotes of what was said where) if needed.

 

Thanks.