Clinical Diagnoses in a Special Forces Group

[Snaquebite]

Good article

Clinical Diagnoses in a Special Forces Group: The Musculoskeletal Burden
James H. Lynch, MD, MS and Mark P. Pallis, DO, FAAO

27533

[JJ_BPK]

Good read, so far, pg5..

I wonder if this could in some way help with a VA claim? The VA accepts The Nexus letter from private physicians. This is not a Nexus letter but it might help those that are trying to get one, by bringing their Doc up to speed, so to speak..

I have worked with a couple Doc's that understand the Nexus letter process.. Others have been a complete blank stare and you need to coach them thru the why's-n-Where'4s..

:munchin

[Snaquebite]

Good read, so far, pg5..

I wonder if this could in some way help with a VA claim? The VA accepts The Nexus letter from private physicians. This is not a Nexus letter but it might help those that are trying to get one, by bringing their Doc up to speed, so to speak..

I have worked with a couple Doc's that understand the Nexus letter process.. Others have been a complete blank stare and you need to coach them thru the why's-n-Where'4s..

:munchin

Never heard of a Nexus letter

[JJ_BPK]

Never heard of a Nexus letter

The Nexus letter is an outside "influence" in the VA claim process.

In my case, my claim(S) were rejected (aren't they all??) by the VA.

I went to my private doc's and asked for a evaluation on the topic of the claim,, and also asked for a letter that stated that " more likely than not" the claim was a result of injuries sustained while on AD, as per my records. The Doc has to have a specialty that corresponds with the claim. For example, I went to a ENT who refereed me to an Audiologist for my hearing. Both wrote Lexus letters for me.

http://www.veteranscorner.org/thenexusletter.htm

http://veteransinfo.tripod.com/nexus2.pdf

AFTER I submitted the Lexus letter, I was told by my VA primary care doc that he could have written the letter, based the the VA hearing test, that the VA rejected???

Net Net, It would be smart if all vets that start a claim, pushed for a Lexus letter as initial claim documentation.

As to the post, If you are dealing with a doctor that is not looking at your claim with 1st hand knowledge of military injuries, this report might help..

[Snaquebite]

Thanks JJ

[Firedude]

I have read this clinical diagnosis and two trains of thought have come to mind.

First where these two MD's state,
"Many Special Forces Soldiers seek treatment from their Special Forces Medical Sergeants (18Ds) and never report to the clinic. In fact, it is only after several weeks of treatment by the medic that many Soldiers even report
to the physicians or therapist."

Many team members many times over won't talk/see the team medic for at least a couple of days post injury. And this is mostly for sprain/strains which the proper recommendation is RICE. We have all seen it or been the one to be seen. These cases can often be resolved at the team level and result in nothing else then some time off of physical activity without referrals to a higher medical care.
But even then, proper documentation for even the most trivial injuries need to be filled out and filed.

Secondly, I do believe there is a need for advance orthopedic studies for 18D's. If the higher medical authorities do in-fact realize that an injured soldier does go to their 18D for primary care, then that 18D should be able to provide the proper skills to assist his teammate with the best possible outcome and recovery.

[miclo18d]

I have read this clinical diagnosis and two trains of thought have come to mind.

First where these two MD's state,
"Many Special Forces Soldiers seek treatment from their Special Forces Medical Sergeants (18Ds) and never report to the clinic. In fact, it is only after several weeks of treatment by the medic that many Soldiers even report
to the physicians or therapist."

Many team members many times over won't talk/see the team medic for at least a couple of days post injury. And this is mostly for sprain/strains which the proper recommendation is RICE. We have all seen it or been the one to be seen. These cases can often be resolved at the team level and result in nothing else then some time off of physical activity without referrals to a higher medical care.
But even then, proper documentation for even the most trivial injuries need to be filled out and filed.

Secondly, I do believe there is a need for advance orthopedic studies for 18D's. If the higher medical authorities do in-fact realize that an injured soldier does go to their 18D for primary care, then that 18D should be able to provide the proper skills to assist his teammate with the best possible outcome and recovery.
I concur. I was guilty of not documenting sprains and strains. I did however push my guys to the Bn Docs for just about everything else. Of course when I did that I went with them with SF600 in hand.

As far as injuries go, I think demographics are important. Ranger Vs SF for example is going to have an average age difference and with that will be different overuse injuries. The older SF guys are going to be more long term lumbar back, knee, and shoulder injuries that guys have been dealing with for most of their careers. Hidden because they don't want to end up in the S3 or at HHC or worse....SWCS :eek:!

I had/have back and ankle problems. The only reason I have a 10% rating at the VA was a well documented over pressure injury to my left ear with nerve damage. The back and ankle problems that fill most of my medical record didn't even draw a few questions at the VA. I tried to ham them up and got nothing. Just another bloated government bureaucracy that screws over soldiers to keep their bottom line low to keep themselves afloat.

The real conversation should be why do we have to fight for our promised medical treatment? Soldiers are soldiers and will fight on through injury and pain, that is our job. Even when documented it's practically impossible to get treatment or compensation for your sustained injuries.

:boohoo:boohoo:boohoo I'll step off the soapbox for awhile.

[FlagDayNCO]

Thanks for sharing, as I'll likely resubmit my claims again. As mentioned, I find it very disturbing that the VA does everything in it's power to negate the claims we submit.

Another part of the problem are the DA Civilians (mostly MDs) that discredit our submissions.

I felt like I was talking to a wall, as the Civy Doc read the injury reports about my back, my wrist, my ear, etc. I'm not looking for any compensation, but would have liked my service related injuries recognized for what they were.

Funny thing is when I went through the process to go back into a Army Reserve unit a few years ago, the DA Civy Doc then recognized the injuries in an attempt to disqualify me from enlistment.

The whole process just left me disgusted and I seek medical care through my own Doctors.

:mad:

[MR2]

Shouldn't applying for any VA benefit automatically qualify you for a psychological disability?

[The Reaper]

Meanwhile, there are five times the number of people claiming Vietnam service as ever set foot in country, much less saw action.

I was at the VA hospital yesterday. The patients seemed to fall into a couple of categories. Mostly older (sixty-five plus), mostly indigent appearing, and a few younger (OEF and OIF aged vets) with no visible trauma.

My friends who work there tell me that the number of people drawing compensation and pensions for PTSD, TBI, etc. are stunning.

I suspect that there are a lot more people claiming disabilities, out of a population which by and large, never left the FOB.

My injuries during my team time, which did not result in hospitalization, are pretty much unrecorded. As noted, medics, do your team brothers a favor and write up the injuries. And the rest of you guys need to make sure your own injuries are properly annotated in your records. Injuries are part of the job, but when you are older and broken, you will be glad that you documented them.

Just my .02, YMMV.

TR

[Firedude]

Just an idea here, but has anyone looked at ways to prevent injuries in SF? With all the money and training they put into you it looks like they would look at different ways to prevent injury, oh crap I am talking about the Army, they don't think ahead.

How about looking at everyone wearing joint support on ruck marches etc as a preventive measure? What about back braces? Granted not any good for compression injuries like on jumps, but might help with rucking injuries from bending etc.

Any other ideas on how to reduce the injury's?

I don't have any ideas about how to reduce injuries. They are going to happen. The ruck isn't going to go just ruck itself. And how Miclo18D brought up the point of SF soldiers being an older group of individuals is going to lend itself to more injuries that are going to last longer as many of you here can testify. Old guys just don't heal like the young pups can.

As I was attesting to in my previous post, I do not believe 18D's get the proper training for orthopedic type injuries. I do not know what the current curriculum teaches considering these injuries, but I would hope there is more of an emphasis on physical therapy. I learned to identify problems, diagnosis,(knee instability, shoulder apprehension test, etc.) orthopedic injuries but no way of helping the individual except as mentioned before, RICE. Of course documentation and a referral to higher but everyone here knows that doesn't get followed through with many times. The guy with the knee injury just says he will take some time off from running/rucking and eat a bunch of ranger candy (Motrin) and take it easy for a bit. Not wanting to be a pussy.

Since there has always been an emphasis on "taking care of things at the team level", I would hope there is/will be more training on the care of rehab'ing team members.

[kgoerz]

Meanwhile, there are five times the number of people claiming Vietnam service as ever set foot in country, much less saw action.

I was at the VA hospital yesterday. The patients seemed to fall into a couple of categories. Mostly older (sixty-five plus), mostly indigent appearing, and a few younger (OEF and OIF aged vets) with no visible trauma.

My friends who work there tell me that the number of people drawing compensation and pensions for PTSD, TBI, etc. are stunning.

I suspect that there are a lot more people claiming disabilities, out of a population which by and large, never left the FOB.

My injuries during my team time, which did not result in hospitalization, are pretty much unrecorded. As noted, medics, do your team brothers a favor and write up the injuries. And the rest of you guys need to make sure your own injuries are properly annotated in your records. Injuries are part of the job, but when you are older and broken, you will be glad that you documented them.

Just my .02, YMMV.

TR

The entire system is bogged down by false claims. Those are the people that are going to screw it up for the people who really need assistance.
So next time you hear someone giving advice on what to claim. The aliments that are extremely difficult to discredit. Slap him in the side of the head.
I work around all kinds of young prior service people. Almost all are 80% and above. They will collect that money their entire life. Thats the shit they need to investigate and fix.

[The Reaper]

If you think injuries are bad now, wait till females arrive and start training.

TR

[Firedude]

If you think injuries are bad now, wait till females arrive and start training.

TR

Does that mean there will be female goats????:confused::confused::confused:

[Firedude]

They need to spend $$$ on prevention and as you pointed out more training in ortho would be a good start. As a former 11B a long long time ago I am familiar with the mentality and ignoring pain to the point of crossing the line from hard ass to dumb ass. I have done that myself.

I am thinking of sports medicine experts teach proper walking/rucking, looking at ways to support the joints during heavy rucking and other ways to reduce injuries. Have an expert come out and eval the body mechanics of your team while rucking etc. To just say injuries are going to happen is not a good way to look at it. Yes they will happen but if you can reduce the number and severity of the injuries it is a win win it that the Army gets a better solder, does not have to pay out as much in medical and VA while the soldiers quality of life in old age is better.

Lets face it the old ALICE pack sucked for me. I have a long torso and it hit me about mid back. One size fits all is stupid, make gear that fits soldiers and it adjustable. Boots are another area. Make boots designed for better impact cushioning, this is not new technology in the civilian world. Instead they spend money or revising haircut standard and getting new dress blue uniforms and lets not even talk about the ACU Charlie Foxtrot. This needs to start with the 18 y/o 11B before they become 18x

As you QPs know its the little things that count and your leather personnel carriers are very very important.

Points very well taken. Sports medicine should be incorporated as should physical therapy. These are relatively new bastions of medicine. How much should they be taken up in the training of a new 18D? I think, at least some portion, but the course is already inundated with other material.

The curriculum is already heavy towards trauma (as well it should be) along with a multitude of other branches of medicine. I just don't know what to cut out to add these other methods of treatment. Extend the course? But it is already a long odyssey. Obviously, I'm not one to make decisions at this level, but this is a good opportunity to voice concerns to those that might be in a position.

As is such, to make suggestions to change issued gear such as boots or rucks as Brush Okie suggests. Please heed his words. I have a feeling current members of SWC are on this forum, and maybe someone here has the latitude and foresight to at least look upon these forums and gather intel from past members and possibly make decisions for the betterment of SF.

I will drink my beer now after this exhausting diatribe. Please forgive me;)