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Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities. Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Tuesday & Wednesday at 7AM Central.
Take control of your medical evidence related to your benefits and visit https://podcast.prestigeveteranmctx.info/veteran/ for more information and to connect directly with us!
Hey guys, it's Leah B from Prestige Veteran Medical Consulting. I'm a US Army veteran, physician assistant, and former compensation and pension examiner. So today, wanna come on and discuss shoulder injuries and specifically rotator cuff injuries and VA disability. So a lot of veterans have shoulder injuries and are service connected for shoulder injuries, and this is just super common due to occupational stressors a lot of times or secondary to other service connected disabilities. So again, welcome back, to our Prestige Veteran Medical Consulting podcast where we discuss the complex world of VA disability in a way that makes sense and helps you get the benefits you've earned.
Speaker 1:Again, I'm Leah for those of you who don't know me, and we're gonna dive into something that affects a lot of veterans and how that relates to VA claims. So what is a rotator cuff injury? So let's start with the basics. The rotator cuff is a group of four muscles and tendons that keep your shoulder joint stable. Okay?
Speaker 1:So it allows you to lift your arm, rotate it, keep it steady for just about every movement of the upper body, any kind of upper body movement. So injuries to the rotator cuff are common among veterans, especially those who served in physically demanding type jobs, involving repeated lifting. If you're an 11 guy, even supply, so overhead movement, heavy gear. If you had direct trauma to the joint during training or combat, these injuries can show up as things like tears, like partial or complete tears of the rotator cuff. You can have tendonitis.
Speaker 1:You can develop impingement syndrome. You can have other complications after surgical repair if you've had surgery in service or after service. So what are some of those symptoms? Pain, limited range of motion, weakness, decreased ability to do basic tasks like things like lifting groceries, putting on a shirt, reaching overhead. So I always like to go over some medical literature that we like to use.
Speaker 1:So some medical literature on rotator cuff injuries that may be helpful for you or your doctor when looking at this, if they wanna write you a short medical opinion. So these injuries are not only common, but they're well documented in the medical literature. So a study in the, let me put my notes here, a study in the American Journal of Sports Medicine found that shoulder injuries are among the top five musculoskeletal injuries in active duty service members. And according to the Armed Forces Health Surveillance Center, there were over four hundred thousand medical visits related to shoulder injuries across the military over just six years. Okay?
Speaker 1:So rotator cuff issues like tears and tendinopathy were especially frequent and roles required physical labor, repetitive motion, or combat training. One interesting point from a 2021 study in the orthopedic journal of sports medicine, military personnel often delay treatment, which increases the risk of chronic degeneration and long term disability. So if you're a veteran that's dealing with chronic shoulder pain, this isn't just bad luck. There's science and data showing that connection between military that there is a connection between military service and rotator cuff injuries. K?
Speaker 1:So how does this connect to your VA disability claim? Okay? So to get rated, you have to establish a service connection for your rotator cuff injury. That can happen in a few different ways. Right?
Speaker 1:So if it happened during active duty and is documented in like your service treatment records or any other records, if it developed over time from the wear and tear of military service, you can potentially get a direct service connection. If it's secondary to another service connected disability, like a cervical spine issue, or an imbalance from the other side, even if it wasn't diagnosed during service, you might still be able to link it to your service. You just need strong, you know, evidence, whether it's your treating doctor saying it, the C and P exam the C and P examiner, you know, reviewing your both shoulders and saying, hey, it's my professional medical opinion that these things are related. Right? So let's talk about how the VA rate rates rotator cuff injuries.
Speaker 1:So rotator cuff conditions are usually rated under diagnostic codes 5200 and fifty two zero three, which are covered which cover the shoulder and arm. So what are some of the factors that VA looks at when they look at the shoulder? So they're gonna look at your range of motion, how far you can lift or rotate your arm, pain, fatigue, weakness during use, whether you've had surgery, like a rotator cuff repair, or even a shoulder replacement. If it affects your dominant arm or your non dominant arm, they're gonna look at these things. Ratings can range from ten to forty percent, but in more severe complex cases, they may even go higher, especially if there's functional loss or secondary conditions or if they're impacting your employability.
Speaker 1:So medical evidence matters, right? So having good documentation from your treating doctor, physical therapy, whoever, your surgeons, That doesn't mean you can't get service connected for something if you've got a shoulder injury and you never A lot of people just don't go to the doctor, right? But things like strength testing, range of motion measurements can be helpful. Imaging studies can help identify what is actually going on in that shoulder joint, especially if it's like an MRI. A detailed explanation of how your shoulder condition affects your daily life and work, if you keep a journal.
Speaker 1:You can get a nexus letter. While they're never required, they can sometimes be helpful in some cases. Again, it can be something as short as your doctor writing why they believe it's related to service, or you can get a robust medical opinion that has lots of literature. But again, some of that literature we discussed earlier can be used. There's nothing wrong with you bringing it to your doctor and seeing if they agree or disagree.
Speaker 1:Some of the best things you can do is follow-up with a VA accredited legal professional, like a VSO or an accredited claims agent or an attorney to help you if you've been denied before. If you if it's a new claim, VSOs are often very helpful. You know, if you if you have that medical evidence, you go to the C and P exam, hopefully you'll get service connected. There's always appeals options if you get denied. Again, following up with those accredited legal professionals are sometimes the best options.
Speaker 1:Va.gov also does a really good job of giving some instructions on that Appeals Modernization Act on how you can do different types of appeals. So I hope this was helpful. Please drop some comments if you guys have any questions or if you have any thoughts on rotator cuff injuries, if you've had any experience with this. And as always, thank you for watching, and I'll talk to you guys soon. Okay.
Speaker 1:See you.