u/Bourbonballr

A while back, I fell down the stairs after my service-connected knee gave out. The fall itself, along with the cause, is well documented in the emergency room records and in follow-up appointments with VA orthopedic doctors. At first, we believed the only injury was an AC joint separation in my shoulder. Since then, I’ve developed increased pain, reduced range of motion, and nerve pain radiating down my arm with shoulder movement. An MRI completed last week revealed a full rotator cuff tear.

I originally filed a claim for the shoulder injury, but it was denied because the examiner’s medical opinion did not even address the fall. Instead, she stated that the knee and shoulder are separate joints, so the knee could not have caused the shoulder injury. I currently have an HLR pending for the shoulder strain(AC joint separation) that is still waiting to be assigned.

My question is: should I withdraw the HLR and file a supplemental claim instead adding the rotator cuff. Or should I leave the HLR in place and file a new claim for the torn rotator cuff and nerve pain caused by the shoulder impingement since they are separate diagnostic codes and rated separately. If and when the HLR comes through does that help with the backdate? Or will the new claims backdate since they were the same incident?

So here is a weird one. I have a secondary claim in for a condition related to my service-connected knee. It was originally denied, but the HLR came back with a Duty to Assist error. About two weeks ago they completed a records-only exam. Then yesterday I was sent to an in-person exam for the same issue.

The examiner told me the exam was for a DBQ and a direct service connection opinion only. She spent about 10 minutes reading through my file while I just sat there quietly. After that, she noticed I had brought a folder and asked what I had with me.

I spent a few minutes going through everything:

• My in-service knee surgery,
• evidence showing a long-term limp,
• treatment records since service,
• and the IMO from my orthopedic doctor.

After that, she started asking detailed questions about what I did during service, my MOS duties, physical demands, and how long I had been dealing with the condition.

At the end, she told me, “I don’t think this is secondary to your knee. I think this is directly related to the things you did in service.”

She then told me to go home, write a statement supporting a direct service connection theory, and submit it over the weekend. She also said that if the claim gets denied, I need to request a copy of her Medical Opinion and DBQ so I can challenge the decision.

After that, she completed the measurements and physical portion of the exam, and I left.

I filed a secondary claim and had a strong IMO from my private ortho. The problem is it was submitted late in the process, so the rater never addressed it. The C&P examiner gave a negative opinion with very weak rationale. My ortho then wrote a detailed rebuttal pointing that out, but the claim was still denied.

I requested an HLR, and it came back with a duty to assist error for the inadequate rationale and failure to consider the IMO. A few weeks ago, they did an ACE exam. I submitted a FOIA request and got that opinion—it was negative too. Still have not recovered final decision.

Now, out of nowhere, I’ve been scheduled for a new in-person exam with X-rays for the same issue.

Why would they order another exam at this stage?