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Most Recently I Was Diagnosed With Myelopathy , Cervical Stenosis,
Question: Most recently I was diagnosed with Myelopathy, Cervical Stenosis, Cervical spondylosis and Myelomalacia Diagnosis code( 336.9) The diagnosis resulted in major neck surgery and the implanting of 20 screws into C-3-4, C4-5, C5-6 and C6-C7. I am currently receiving several VA disabilities ratings for other physical problems most caused from exposure to Agent Orange. My question is:
Could my exposure to Agent Orange contributed to these diagnosis?
Could my exposure to Agent Orange contributed to these diagnosis?
Most recently I was diagnosed with Myelopathy, Cervical Stenosis, Cervical spondylosis and Myelomalacia Diagnosis code( 336.9) The diagnosis resulted in major neck surgery and the implanting of 20 screws into C-3-4, C4-5, C5-6 and C6-C7. I am currently receiving several VA disabilities ratings for other physical problems most caused from exposure to Agent Orange. My question is:
Could my exposure to Agent Orange contributed to these diagnosis?
Could my exposure to Agent Orange contributed to these diagnosis?
Brief Answer:
Service Connected conditions to Agent Orange
Detailed Answer:
Thank you for your question regarding Agent Orange Exposure and your condition of myelopathy, cervical stenosis, cervical spondylosis and myelomalacia which has resulted in major reparative surgeries over virtually the entire cervical spine with the implanting of 20 medical screws.
As a VA Neurologist who sees C&P (Compensation and Pension) patients regularly exposed to Agent Orange I can tell you 2 things about YOUR own condition and then, what I think you should do.
1. If you are already receiving or in the other process of soliciting benefits for other ailments/disabilities as possible residuals to Agent Orange Exposure (AOE) then, the following list of recognized service connected causes is probably not anything you don't already know but I'll post it here for convenience sake.
2. Your condition of the myelopathy with cervical stenosis and spondylosis with myelomalacia is not known to be as the result of AOE. However, what I recommend to all patients who ask the question of whether or not something is or is not connectable my response is the same......"It never hurts to try"....unless your time and finances cannot support a NEGATIVE RESPONSE for a claim.
In other words, some people ask for my honest opinion on their condition to be accepted as a residual to AOE because to them....it's at least a 90% chance they simply don't want to spend the time or money (travel costs, attorney fees, other expenses) on submitting an application. In those cases I tell them that in my experience the boards basically will look at whether or not you have a SPECIFIC DISEASE that has been RECOGNIZED by CONGRESS as compensable as a consequence of AOE. That would be the following list of disease or ailments:
BIOCHEMICAL/METABOLIC DISORDERS
AL Amyloidosis, Diabetes Mellitus Type 2, Porphyria Cutanea Tarda
CANCERS
Chronic B-cell Leukemias, Hodgkin's Disease, Multiple Myeloma,
Non-Hodgkin's Lymphoma, Soft Tissue Sarcomas (EXCEPT osteo-,
chondro-, Kaposi's sarcoma, or mesothelioma), Prostate Cancer,
Respiratory System Cancers (certain parts of the respiratory tract)
SKIN DISORDERS
Chloracne
CARDIAC
Ischemic Heart Disease
NERVOUS SYSTEM
Parkinson's Disease, Peripheral Neuropathy, (EARLY ONSET- within 12
months of exposure)
As you can see from the above list of RECOGNIZED conditions caused by AOE- your particular problem of significant degenerative arthritic disease of the cervical spine resulting in MYELOMALACIA (wasting/atrophy) of the spinal cord in those stenosed (narrowed) regions of the c-spine and your condition of myelopathy is not on Congress's list of KNOWN DISEASE PROCESSES that would then, stand a much better chance of being SC'ed if other criteria were met (i.e. at least 10% disability, occurrence within 12 months of AOE). Some of the listed consequences (MOSTLY the cancers) to AOE can occur outside of the commonly cited 12 months from 1st date of exposure.
So, in your particular case unfortunately, I think it would be a difficult climb to show connection because you (or your doctor....could even be your VA physician) would need to present pretty compelling evidence from the literature that AOE results in severe arthritic or degenerative joint or disc disease to cause everything that happened from an orthopedic point of view in the neck. But even then, the neurological problems associated with the MYELOMALACIA (i.e. your condition of MYELOPATHY) would not be due to the AOE but rather to the spondylopathy (arthritis in the neck).
But, I always counsel patients to press foreward and make their arguments with as much medical support as they can muster and then, to see what the board thinks once the VA examination has taken place, the examining doctor has weighed in, and the evidence that you can bring in terms of literature citations that provide compelling evidence that there is a relationship between AOE and the condition in question). You also have a chance at appealing that decision, requesting a repeat examination as well as obtaining a 2nd opinion on the outside if you choose. You just never know what the Board might say on a 2nd go around.
So for example, if the AOE argument as a cause or contributing factor to the spondylopathy of the c-spine isn't accepted could there be some other service exposure of some sort that could be tied to the generation of such widespread and significant arthritic degenerative disease-- such as repeated traumatic injuries to the neck, or being in a job that required frequent or excessive use of the neck with a lot of repetitive daily ranging of the neck in different directions which could've accelerated any process of arthritis beyond its "natural course?"
Get the idea?
If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating if you feel so inclined? Again, many thanks for submitting your inquiry and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you get any testing done so drop me a line please and I'm hoping all the best for you.
This query has utilized a total of 60 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Service Connected conditions to Agent Orange
Detailed Answer:
Thank you for your question regarding Agent Orange Exposure and your condition of myelopathy, cervical stenosis, cervical spondylosis and myelomalacia which has resulted in major reparative surgeries over virtually the entire cervical spine with the implanting of 20 medical screws.
As a VA Neurologist who sees C&P (Compensation and Pension) patients regularly exposed to Agent Orange I can tell you 2 things about YOUR own condition and then, what I think you should do.
1. If you are already receiving or in the other process of soliciting benefits for other ailments/disabilities as possible residuals to Agent Orange Exposure (AOE) then, the following list of recognized service connected causes is probably not anything you don't already know but I'll post it here for convenience sake.
2. Your condition of the myelopathy with cervical stenosis and spondylosis with myelomalacia is not known to be as the result of AOE. However, what I recommend to all patients who ask the question of whether or not something is or is not connectable my response is the same......"It never hurts to try"....unless your time and finances cannot support a NEGATIVE RESPONSE for a claim.
In other words, some people ask for my honest opinion on their condition to be accepted as a residual to AOE because to them....it's at least a 90% chance they simply don't want to spend the time or money (travel costs, attorney fees, other expenses) on submitting an application. In those cases I tell them that in my experience the boards basically will look at whether or not you have a SPECIFIC DISEASE that has been RECOGNIZED by CONGRESS as compensable as a consequence of AOE. That would be the following list of disease or ailments:
BIOCHEMICAL/METABOLIC DISORDERS
AL Amyloidosis, Diabetes Mellitus Type 2, Porphyria Cutanea Tarda
CANCERS
Chronic B-cell Leukemias, Hodgkin's Disease, Multiple Myeloma,
Non-Hodgkin's Lymphoma, Soft Tissue Sarcomas (EXCEPT osteo-,
chondro-, Kaposi's sarcoma, or mesothelioma), Prostate Cancer,
Respiratory System Cancers (certain parts of the respiratory tract)
SKIN DISORDERS
Chloracne
CARDIAC
Ischemic Heart Disease
NERVOUS SYSTEM
Parkinson's Disease, Peripheral Neuropathy, (EARLY ONSET- within 12
months of exposure)
As you can see from the above list of RECOGNIZED conditions caused by AOE- your particular problem of significant degenerative arthritic disease of the cervical spine resulting in MYELOMALACIA (wasting/atrophy) of the spinal cord in those stenosed (narrowed) regions of the c-spine and your condition of myelopathy is not on Congress's list of KNOWN DISEASE PROCESSES that would then, stand a much better chance of being SC'ed if other criteria were met (i.e. at least 10% disability, occurrence within 12 months of AOE). Some of the listed consequences (MOSTLY the cancers) to AOE can occur outside of the commonly cited 12 months from 1st date of exposure.
So, in your particular case unfortunately, I think it would be a difficult climb to show connection because you (or your doctor....could even be your VA physician) would need to present pretty compelling evidence from the literature that AOE results in severe arthritic or degenerative joint or disc disease to cause everything that happened from an orthopedic point of view in the neck. But even then, the neurological problems associated with the MYELOMALACIA (i.e. your condition of MYELOPATHY) would not be due to the AOE but rather to the spondylopathy (arthritis in the neck).
But, I always counsel patients to press foreward and make their arguments with as much medical support as they can muster and then, to see what the board thinks once the VA examination has taken place, the examining doctor has weighed in, and the evidence that you can bring in terms of literature citations that provide compelling evidence that there is a relationship between AOE and the condition in question). You also have a chance at appealing that decision, requesting a repeat examination as well as obtaining a 2nd opinion on the outside if you choose. You just never know what the Board might say on a 2nd go around.
So for example, if the AOE argument as a cause or contributing factor to the spondylopathy of the c-spine isn't accepted could there be some other service exposure of some sort that could be tied to the generation of such widespread and significant arthritic degenerative disease-- such as repeated traumatic injuries to the neck, or being in a job that required frequent or excessive use of the neck with a lot of repetitive daily ranging of the neck in different directions which could've accelerated any process of arthritis beyond its "natural course?"
Get the idea?
If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating if you feel so inclined? Again, many thanks for submitting your inquiry and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you get any testing done so drop me a line please and I'm hoping all the best for you.
This query has utilized a total of 60 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Service Connected conditions to Agent Orange
Detailed Answer:
Thank you for your question regarding Agent Orange Exposure and your condition of myelopathy, cervical stenosis, cervical spondylosis and myelomalacia which has resulted in major reparative surgeries over virtually the entire cervical spine with the implanting of 20 medical screws.
As a VA Neurologist who sees C&P (Compensation and Pension) patients regularly exposed to Agent Orange I can tell you 2 things about YOUR own condition and then, what I think you should do.
1. If you are already receiving or in the other process of soliciting benefits for other ailments/disabilities as possible residuals to Agent Orange Exposure (AOE) then, the following list of recognized service connected causes is probably not anything you don't already know but I'll post it here for convenience sake.
2. Your condition of the myelopathy with cervical stenosis and spondylosis with myelomalacia is not known to be as the result of AOE. However, what I recommend to all patients who ask the question of whether or not something is or is not connectable my response is the same......"It never hurts to try"....unless your time and finances cannot support a NEGATIVE RESPONSE for a claim.
In other words, some people ask for my honest opinion on their condition to be accepted as a residual to AOE because to them....it's at least a 90% chance they simply don't want to spend the time or money (travel costs, attorney fees, other expenses) on submitting an application. In those cases I tell them that in my experience the boards basically will look at whether or not you have a SPECIFIC DISEASE that has been RECOGNIZED by CONGRESS as compensable as a consequence of AOE. That would be the following list of disease or ailments:
BIOCHEMICAL/METABOLIC DISORDERS
AL Amyloidosis, Diabetes Mellitus Type 2, Porphyria Cutanea Tarda
CANCERS
Chronic B-cell Leukemias, Hodgkin's Disease, Multiple Myeloma,
Non-Hodgkin's Lymphoma, Soft Tissue Sarcomas (EXCEPT osteo-,
chondro-, Kaposi's sarcoma, or mesothelioma), Prostate Cancer,
Respiratory System Cancers (certain parts of the respiratory tract)
SKIN DISORDERS
Chloracne
CARDIAC
Ischemic Heart Disease
NERVOUS SYSTEM
Parkinson's Disease, Peripheral Neuropathy, (EARLY ONSET- within 12
months of exposure)
As you can see from the above list of RECOGNIZED conditions caused by AOE- your particular problem of significant degenerative arthritic disease of the cervical spine resulting in MYELOMALACIA (wasting/atrophy) of the spinal cord in those stenosed (narrowed) regions of the c-spine and your condition of myelopathy is not on Congress's list of KNOWN DISEASE PROCESSES that would then, stand a much better chance of being SC'ed if other criteria were met (i.e. at least 10% disability, occurrence within 12 months of AOE). Some of the listed consequences (MOSTLY the cancers) to AOE can occur outside of the commonly cited 12 months from 1st date of exposure.
So, in your particular case unfortunately, I think it would be a difficult climb to show connection because you (or your doctor....could even be your VA physician) would need to present pretty compelling evidence from the literature that AOE results in severe arthritic or degenerative joint or disc disease to cause everything that happened from an orthopedic point of view in the neck. But even then, the neurological problems associated with the MYELOMALACIA (i.e. your condition of MYELOPATHY) would not be due to the AOE but rather to the spondylopathy (arthritis in the neck).
But, I always counsel patients to press foreward and make their arguments with as much medical support as they can muster and then, to see what the board thinks once the VA examination has taken place, the examining doctor has weighed in, and the evidence that you can bring in terms of literature citations that provide compelling evidence that there is a relationship between AOE and the condition in question). You also have a chance at appealing that decision, requesting a repeat examination as well as obtaining a 2nd opinion on the outside if you choose. You just never know what the Board might say on a 2nd go around.
So for example, if the AOE argument as a cause or contributing factor to the spondylopathy of the c-spine isn't accepted could there be some other service exposure of some sort that could be tied to the generation of such widespread and significant arthritic degenerative disease-- such as repeated traumatic injuries to the neck, or being in a job that required frequent or excessive use of the neck with a lot of repetitive daily ranging of the neck in different directions which could've accelerated any process of arthritis beyond its "natural course?"
Get the idea?
If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating if you feel so inclined? Again, many thanks for submitting your inquiry and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you get any testing done so drop me a line please and I'm hoping all the best for you.
This query has utilized a total of 60 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Service Connected conditions to Agent Orange
Detailed Answer:
Thank you for your question regarding Agent Orange Exposure and your condition of myelopathy, cervical stenosis, cervical spondylosis and myelomalacia which has resulted in major reparative surgeries over virtually the entire cervical spine with the implanting of 20 medical screws.
As a VA Neurologist who sees C&P (Compensation and Pension) patients regularly exposed to Agent Orange I can tell you 2 things about YOUR own condition and then, what I think you should do.
1. If you are already receiving or in the other process of soliciting benefits for other ailments/disabilities as possible residuals to Agent Orange Exposure (AOE) then, the following list of recognized service connected causes is probably not anything you don't already know but I'll post it here for convenience sake.
2. Your condition of the myelopathy with cervical stenosis and spondylosis with myelomalacia is not known to be as the result of AOE. However, what I recommend to all patients who ask the question of whether or not something is or is not connectable my response is the same......"It never hurts to try"....unless your time and finances cannot support a NEGATIVE RESPONSE for a claim.
In other words, some people ask for my honest opinion on their condition to be accepted as a residual to AOE because to them....it's at least a 90% chance they simply don't want to spend the time or money (travel costs, attorney fees, other expenses) on submitting an application. In those cases I tell them that in my experience the boards basically will look at whether or not you have a SPECIFIC DISEASE that has been RECOGNIZED by CONGRESS as compensable as a consequence of AOE. That would be the following list of disease or ailments:
BIOCHEMICAL/METABOLIC DISORDERS
AL Amyloidosis, Diabetes Mellitus Type 2, Porphyria Cutanea Tarda
CANCERS
Chronic B-cell Leukemias, Hodgkin's Disease, Multiple Myeloma,
Non-Hodgkin's Lymphoma, Soft Tissue Sarcomas (EXCEPT osteo-,
chondro-, Kaposi's sarcoma, or mesothelioma), Prostate Cancer,
Respiratory System Cancers (certain parts of the respiratory tract)
SKIN DISORDERS
Chloracne
CARDIAC
Ischemic Heart Disease
NERVOUS SYSTEM
Parkinson's Disease, Peripheral Neuropathy, (EARLY ONSET- within 12
months of exposure)
As you can see from the above list of RECOGNIZED conditions caused by AOE- your particular problem of significant degenerative arthritic disease of the cervical spine resulting in MYELOMALACIA (wasting/atrophy) of the spinal cord in those stenosed (narrowed) regions of the c-spine and your condition of myelopathy is not on Congress's list of KNOWN DISEASE PROCESSES that would then, stand a much better chance of being SC'ed if other criteria were met (i.e. at least 10% disability, occurrence within 12 months of AOE). Some of the listed consequences (MOSTLY the cancers) to AOE can occur outside of the commonly cited 12 months from 1st date of exposure.
So, in your particular case unfortunately, I think it would be a difficult climb to show connection because you (or your doctor....could even be your VA physician) would need to present pretty compelling evidence from the literature that AOE results in severe arthritic or degenerative joint or disc disease to cause everything that happened from an orthopedic point of view in the neck. But even then, the neurological problems associated with the MYELOMALACIA (i.e. your condition of MYELOPATHY) would not be due to the AOE but rather to the spondylopathy (arthritis in the neck).
But, I always counsel patients to press foreward and make their arguments with as much medical support as they can muster and then, to see what the board thinks once the VA examination has taken place, the examining doctor has weighed in, and the evidence that you can bring in terms of literature citations that provide compelling evidence that there is a relationship between AOE and the condition in question). You also have a chance at appealing that decision, requesting a repeat examination as well as obtaining a 2nd opinion on the outside if you choose. You just never know what the Board might say on a 2nd go around.
So for example, if the AOE argument as a cause or contributing factor to the spondylopathy of the c-spine isn't accepted could there be some other service exposure of some sort that could be tied to the generation of such widespread and significant arthritic degenerative disease-- such as repeated traumatic injuries to the neck, or being in a job that required frequent or excessive use of the neck with a lot of repetitive daily ranging of the neck in different directions which could've accelerated any process of arthritis beyond its "natural course?"
Get the idea?
If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating if you feel so inclined? Again, many thanks for submitting your inquiry and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you get any testing done so drop me a line please and I'm hoping all the best for you.
This query has utilized a total of 60 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Saghafi, Thank you. I feel fortunate to have connected to a professional that has the training and expertise in Neurology in addition to working with the VA. I fully understand your report and will move forward to expand my claim. I'm already being compensated for other disabilities. The VA is not my enemy, they are just doing their best to take care of those of us who are authentic disabled veterans while managing the moneys so it is there for other veterans who are really dealing with disabilities connected to their service. Briefly, my surgeon did say that he had operated on several veterans who had the same diagnosis that I was dealing with. My Neurologist recently discovered a new study published 9/9/15 where exposure to Agent Orange increased the risk for an increase to Monoclonal Gammopathy MGUS. He thought that my increase in a plasma cell disorder had the effect that also increase myelomalacia which therefore related to agent orange. I'm putting in my claim hoping to also assist my fellow veterans. Thank you again for your professionalism and diligence. Capt XXXXXXX
Dr. Saghafi, Thank you. I feel fortunate to have connected to a professional that has the training and expertise in Neurology in addition to working with the VA. I fully understand your report and will move forward to expand my claim. I'm already being compensated for other disabilities. The VA is not my enemy, they are just doing their best to take care of those of us who are authentic disabled veterans while managing the moneys so it is there for other veterans who are really dealing with disabilities connected to their service. Briefly, my surgeon did say that he had operated on several veterans who had the same diagnosis that I was dealing with. My Neurologist recently discovered a new study published 9/9/15 where exposure to Agent Orange increased the risk for an increase to Monoclonal Gammopathy MGUS. He thought that my increase in a plasma cell disorder had the effect that also increase myelomalacia which therefore related to agent orange. I'm putting in my claim hoping to also assist my fellow veterans. Thank you again for your professionalism and diligence. Capt XXXXXXX
Brief Answer:
Good to know you have support from your treating neurologist
Detailed Answer:
Thank very much for your kind message and it is a pleasure to make your acquaintance Capt. XXXXXXX
I wholeheartedly agree with your point of view and am a strong advocate for doing our best to identify those vets with claims of service connected disabilities and impairments brought about by chemical substances such as AO.
It is also very good to hear that your neurologist would like to support the notion that your myelomalacia could be contributed to by an increased titer of M protein. I would say that if not for your severe arthropathy of the neck for which you've had rectification at virtually every cervical level that the argument may be more easily accepted by the ruling board.
As you've presented the case my gestalt is that the compromise to the spinal cord itself causing whatever symptom complex you have is more likely than not due to the chronic compressive effects of the bony arthropathy and of course, surgical manipulation to fix all of that..which I'm sure in and of itself was somewhat of a Herculean feat by the surgeon.
MGUS is not something for which there is a lot of evidence available for how it behaves in the setting of neuropathy or myelopathy when such severe spinal canal stenosis and cord compression is going on. There is evidence of MGUS being related to symptoms of PERIPHERAL NEUROPATHY when all other causes have been eliminated but not necessarily in a CAUSE/EFFECT manner therefore, even in the absence of other causative factors the jury is still out on just how MUCH neuropathy MGUS can cause.
However, as I said previously if your neurologist feels that he/she can synthesize a compelling amount of evidence in the literature that puts MGUS in a causative or contributory role then, it should be presented and taken under consideration.
The adjudicators are really lovers of relevant bibliographies when it comes to these sorts of complaints of AOE so perhaps your neurologist is onto something. The problem with MGUS is that there is so much that is unknown about how it behaves clinically that rarely (when it comes to neuropathy) can it be legitimately tagged as the CAUSE of a patient's neuropathy or myelopathy. More often than not it is found in association which is often not sufficient for C&P claims that are grounded in cause and effect.
Therefore, if your neurologist keeps those tips in mind with respect to what the raters and adjudicators are looking for when presenting the evidence you may have a easier approach for that to be accepted as part of your myelopathic picture.
Lots of luck to you and please let me know how things turn out....I'm interested because if your neurologist is successful in your case and you pass the specific citations that he/she used for your case I'll be happy to look into using that same argument for any of your comrades if it means somehow offsetting the terrible effects and consequences that chemical had on a lot of peoples' lives.
BTW, the last bit of information I pass on to you is for the purpose of giving you something that could be useful in the future regarding MGUS not for putting you on edge for anything. But, having the condition of MGUS is known to SLIGHTLY INCREASE the risk of developing a blood cancer known as MYELOMA....also referred to interchangeably as MULTIPLE MYELOMA. This cancer is LISTED under the known and compensable cancers Congress has tied to AOE. I hope you don't have this entity and never get it....but just file it away for safekeeping.
Cheers Sir!
Once again if I've provided useful information in responding to your query and you have no further comments would you do the favor of making sure the QUERY is closed and rated according to the quality of answers you felt I offered?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you are successful in getting a service question for the myelomalacia based on having MGUS. I promise that your comrades will benefit from the XXXXXXX VISN if you just let me know.
This query has utilized a total of 98 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Good to know you have support from your treating neurologist
Detailed Answer:
Thank very much for your kind message and it is a pleasure to make your acquaintance Capt. XXXXXXX
I wholeheartedly agree with your point of view and am a strong advocate for doing our best to identify those vets with claims of service connected disabilities and impairments brought about by chemical substances such as AO.
It is also very good to hear that your neurologist would like to support the notion that your myelomalacia could be contributed to by an increased titer of M protein. I would say that if not for your severe arthropathy of the neck for which you've had rectification at virtually every cervical level that the argument may be more easily accepted by the ruling board.
As you've presented the case my gestalt is that the compromise to the spinal cord itself causing whatever symptom complex you have is more likely than not due to the chronic compressive effects of the bony arthropathy and of course, surgical manipulation to fix all of that..which I'm sure in and of itself was somewhat of a Herculean feat by the surgeon.
MGUS is not something for which there is a lot of evidence available for how it behaves in the setting of neuropathy or myelopathy when such severe spinal canal stenosis and cord compression is going on. There is evidence of MGUS being related to symptoms of PERIPHERAL NEUROPATHY when all other causes have been eliminated but not necessarily in a CAUSE/EFFECT manner therefore, even in the absence of other causative factors the jury is still out on just how MUCH neuropathy MGUS can cause.
However, as I said previously if your neurologist feels that he/she can synthesize a compelling amount of evidence in the literature that puts MGUS in a causative or contributory role then, it should be presented and taken under consideration.
The adjudicators are really lovers of relevant bibliographies when it comes to these sorts of complaints of AOE so perhaps your neurologist is onto something. The problem with MGUS is that there is so much that is unknown about how it behaves clinically that rarely (when it comes to neuropathy) can it be legitimately tagged as the CAUSE of a patient's neuropathy or myelopathy. More often than not it is found in association which is often not sufficient for C&P claims that are grounded in cause and effect.
Therefore, if your neurologist keeps those tips in mind with respect to what the raters and adjudicators are looking for when presenting the evidence you may have a easier approach for that to be accepted as part of your myelopathic picture.
Lots of luck to you and please let me know how things turn out....I'm interested because if your neurologist is successful in your case and you pass the specific citations that he/she used for your case I'll be happy to look into using that same argument for any of your comrades if it means somehow offsetting the terrible effects and consequences that chemical had on a lot of peoples' lives.
BTW, the last bit of information I pass on to you is for the purpose of giving you something that could be useful in the future regarding MGUS not for putting you on edge for anything. But, having the condition of MGUS is known to SLIGHTLY INCREASE the risk of developing a blood cancer known as MYELOMA....also referred to interchangeably as MULTIPLE MYELOMA. This cancer is LISTED under the known and compensable cancers Congress has tied to AOE. I hope you don't have this entity and never get it....but just file it away for safekeeping.
Cheers Sir!
Once again if I've provided useful information in responding to your query and you have no further comments would you do the favor of making sure the QUERY is closed and rated according to the quality of answers you felt I offered?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you are successful in getting a service question for the myelomalacia based on having MGUS. I promise that your comrades will benefit from the XXXXXXX VISN if you just let me know.
This query has utilized a total of 98 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Good to know you have support from your treating neurologist
Detailed Answer:
Thank very much for your kind message and it is a pleasure to make your acquaintance Capt. XXXXXXX
I wholeheartedly agree with your point of view and am a strong advocate for doing our best to identify those vets with claims of service connected disabilities and impairments brought about by chemical substances such as AO.
It is also very good to hear that your neurologist would like to support the notion that your myelomalacia could be contributed to by an increased titer of M protein. I would say that if not for your severe arthropathy of the neck for which you've had rectification at virtually every cervical level that the argument may be more easily accepted by the ruling board.
As you've presented the case my gestalt is that the compromise to the spinal cord itself causing whatever symptom complex you have is more likely than not due to the chronic compressive effects of the bony arthropathy and of course, surgical manipulation to fix all of that..which I'm sure in and of itself was somewhat of a Herculean feat by the surgeon.
MGUS is not something for which there is a lot of evidence available for how it behaves in the setting of neuropathy or myelopathy when such severe spinal canal stenosis and cord compression is going on. There is evidence of MGUS being related to symptoms of PERIPHERAL NEUROPATHY when all other causes have been eliminated but not necessarily in a CAUSE/EFFECT manner therefore, even in the absence of other causative factors the jury is still out on just how MUCH neuropathy MGUS can cause.
However, as I said previously if your neurologist feels that he/she can synthesize a compelling amount of evidence in the literature that puts MGUS in a causative or contributory role then, it should be presented and taken under consideration.
The adjudicators are really lovers of relevant bibliographies when it comes to these sorts of complaints of AOE so perhaps your neurologist is onto something. The problem with MGUS is that there is so much that is unknown about how it behaves clinically that rarely (when it comes to neuropathy) can it be legitimately tagged as the CAUSE of a patient's neuropathy or myelopathy. More often than not it is found in association which is often not sufficient for C&P claims that are grounded in cause and effect.
Therefore, if your neurologist keeps those tips in mind with respect to what the raters and adjudicators are looking for when presenting the evidence you may have a easier approach for that to be accepted as part of your myelopathic picture.
Lots of luck to you and please let me know how things turn out....I'm interested because if your neurologist is successful in your case and you pass the specific citations that he/she used for your case I'll be happy to look into using that same argument for any of your comrades if it means somehow offsetting the terrible effects and consequences that chemical had on a lot of peoples' lives.
BTW, the last bit of information I pass on to you is for the purpose of giving you something that could be useful in the future regarding MGUS not for putting you on edge for anything. But, having the condition of MGUS is known to SLIGHTLY INCREASE the risk of developing a blood cancer known as MYELOMA....also referred to interchangeably as MULTIPLE MYELOMA. This cancer is LISTED under the known and compensable cancers Congress has tied to AOE. I hope you don't have this entity and never get it....but just file it away for safekeeping.
Cheers Sir!
Once again if I've provided useful information in responding to your query and you have no further comments would you do the favor of making sure the QUERY is closed and rated according to the quality of answers you felt I offered?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you are successful in getting a service question for the myelomalacia based on having MGUS. I promise that your comrades will benefit from the XXXXXXX VISN if you just let me know.
This query has utilized a total of 98 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Good to know you have support from your treating neurologist
Detailed Answer:
Thank very much for your kind message and it is a pleasure to make your acquaintance Capt. XXXXXXX
I wholeheartedly agree with your point of view and am a strong advocate for doing our best to identify those vets with claims of service connected disabilities and impairments brought about by chemical substances such as AO.
It is also very good to hear that your neurologist would like to support the notion that your myelomalacia could be contributed to by an increased titer of M protein. I would say that if not for your severe arthropathy of the neck for which you've had rectification at virtually every cervical level that the argument may be more easily accepted by the ruling board.
As you've presented the case my gestalt is that the compromise to the spinal cord itself causing whatever symptom complex you have is more likely than not due to the chronic compressive effects of the bony arthropathy and of course, surgical manipulation to fix all of that..which I'm sure in and of itself was somewhat of a Herculean feat by the surgeon.
MGUS is not something for which there is a lot of evidence available for how it behaves in the setting of neuropathy or myelopathy when such severe spinal canal stenosis and cord compression is going on. There is evidence of MGUS being related to symptoms of PERIPHERAL NEUROPATHY when all other causes have been eliminated but not necessarily in a CAUSE/EFFECT manner therefore, even in the absence of other causative factors the jury is still out on just how MUCH neuropathy MGUS can cause.
However, as I said previously if your neurologist feels that he/she can synthesize a compelling amount of evidence in the literature that puts MGUS in a causative or contributory role then, it should be presented and taken under consideration.
The adjudicators are really lovers of relevant bibliographies when it comes to these sorts of complaints of AOE so perhaps your neurologist is onto something. The problem with MGUS is that there is so much that is unknown about how it behaves clinically that rarely (when it comes to neuropathy) can it be legitimately tagged as the CAUSE of a patient's neuropathy or myelopathy. More often than not it is found in association which is often not sufficient for C&P claims that are grounded in cause and effect.
Therefore, if your neurologist keeps those tips in mind with respect to what the raters and adjudicators are looking for when presenting the evidence you may have a easier approach for that to be accepted as part of your myelopathic picture.
Lots of luck to you and please let me know how things turn out....I'm interested because if your neurologist is successful in your case and you pass the specific citations that he/she used for your case I'll be happy to look into using that same argument for any of your comrades if it means somehow offsetting the terrible effects and consequences that chemical had on a lot of peoples' lives.
BTW, the last bit of information I pass on to you is for the purpose of giving you something that could be useful in the future regarding MGUS not for putting you on edge for anything. But, having the condition of MGUS is known to SLIGHTLY INCREASE the risk of developing a blood cancer known as MYELOMA....also referred to interchangeably as MULTIPLE MYELOMA. This cancer is LISTED under the known and compensable cancers Congress has tied to AOE. I hope you don't have this entity and never get it....but just file it away for safekeeping.
Cheers Sir!
Once again if I've provided useful information in responding to your query and you have no further comments would you do the favor of making sure the QUERY is closed and rated according to the quality of answers you felt I offered?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in knowing how things evolve for you- especially if you are successful in getting a service question for the myelomalacia based on having MGUS. I promise that your comrades will benefit from the XXXXXXX VISN if you just let me know.
This query has utilized a total of 98 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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