u/Dadxf0ur — reddlx

Greetings all,

I have a 70% combined rating with the following:

30% rating for right knee degenerative arthritis, other than posttraumatic, chondromalacia patellae, s/p meniscectomy
10% rating for left foot plantar fasciitis
10% rating for left ankle lateral collateral ligament sprain
10% rating for left knee degenerative arthritis, other than posttraumatic
10% rating for right knee degenerative arthritis, other than posttraumatic, chondromalacia patellae
10% rating for temporomandibular joint dysfunction (TMD)
10% rating for right knee degenerative arthritis, other than posttraumatic, chondromalacia patellae, instability

I have been repeatedly denied for lower back pain secondary to the bilateral knee issues and the left foot plantar fasciitis. NOTE: the findings below are from an MRI in December 2023:

Findings
- From the MRI L3-L4: Degenerated disc and mild facet arthrosis. Mild bilateral neural foraminal 9.
- L4-L5: Degenerated disc and facet arthrosis. No significant spinal canal narrowing. There is mild to moderate neural foraminal narrowing bilaterally.
- L5-S1: Degenerated disc as well as broad-based disc protrusion and facet arthrosis. There is mild spinal canal narrowing. There is moderate to severe neural foraminal narrowing bilaterally effacing the exiting nerve roots
Impression
- Lumbar stenosis with neurogenic claudication
- Lumbar spondylolisthesis
- Lumbar spondylosis; more likely than not progressive degenerative changes to lumbosacral spine are related to chronic bilateral knee arthropathies and chronic left ankle plantar fasciitis
- Cervical radiculopathy

I need guidance on two items:

Medical records
- I was stationed at
  - Keesler for tech school
  - Bolling AFB (1990-94)
  - Onizuka AS (1994-96)
  - I submitted a 10-5345a to the Dept of Veteran Affairs requesting a personal copy of my medical records. However, they replied saying the do not have my medical records and suggested I submit a 10-5345 to the ROI. I called Bolling now (Joint Base Anacostia-Bolling) and they cannot find my records anywhere.
  - What are my options here?
Next steps for appealing the lower back
- My back is getting much worse to the point where:
  - A round of golf will result in sever pain for about a week following; I won't even attempt to walk while playing.
  - My back will begin hurting and spasming after walking about 1-2 miles
  - I need 2 Tylenol, 2 Naproxen, 2 Flexeril, and 2 Gabapentin to fall asleep each night
- I see my neurologist in June to discuss spinal fusion; I will give him a ChatGPT nexus letter template at that time to see if he will complete the detailed nexus letter
- Should I look into a service like Claim Climbers to help with my appeal?

I have already submitted an intent to file to hang on my original file date from 2023, so I do not want to file the appeal until I have a fair amount of new supporting evidence, including the new imaging. I would appreciate any help and advice. Thanks.