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Gulf War Syndrome Nexus Letter

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I was a 0331 machinegunner in the USMC. I was awarded the Combat Action Ribbon, Naval Achievement medal for actions in Iraq, and PUC. I have been disgusted by the VA so far. My file has been on hold because they sent my records to another veteran. I thought it was a prank call until the veteran started rattling off my SSN, address, phone number, DOB, etc.

I recieved a C & P Exam and the examiner noted in the report:

Diagnostic Impression: 1. Fibromyalgia. 2. Irritable Bowel Syndrome.

Discussion: Based upon the classic history for both irritable bowel syndrome and fibromyalgia, I do think that the Veteran suffers from both of these disorders primarily, but it would be speculation on my judgement to say that it is truly Gulf War Syndrome when he is so classic for each in and of themselves.

I have already provided a nexus letter from my doctor stating that my fibromyalgia and IBS "is due" to the activities and exposures while he was in Iraq. After the C & P Exam i will submit the following nexus:

To Whom It May Concern:

Veteran has been a patient of mine for several years. I have also reviewed his Military Service Medical Records. While in Iraq he was constantly exposed to Industrial Pollution, Raw Sewage, Smoke from Burning Trash and Feces, Solvents, Pesticide-Treated Uniforms, DEET, Raw Sewage, Vehicle and JP8 Exhaust Fumes, and Environmental Pesticides. He was also given numerous vaccinations to include Anthrax vaccinations.

In 2003 upon returning from Iraq, as evident in his Military File, he complained of Diarrhea, Chronic Fatigue, Difficulty Remembering, Muscle Aches, Headaches, Swollen Stiff and Painful Joints, Weakness, Dizziness and Light Headedness. He also listed he had health concerns about the exposures and events during his deployment.

In regards to his Fibromyalgia:

His Fibromyalgia is characterized as widespread musculoskeletal pain and tender points, with associated fatigue, sleep disturbance, stiffness, headaches, irritable bowel symptoms, depression, and anxiety. These symptoms are constant and refractory to therapy.

In regards to his Irritable Bowel Syndrome:

His Irritable Bowel Syndrome is characterized by constant daily abdominal distress. The symptoms consist of constant episodes of severe diarrhea and constipation with mucous in the stool.

In regards to his Migraine Headaches:

His migraines are characteristic of prostrating attacks occurring on average of two to three times per month.

It is my medical opinion that these medically unexplained chronic multi-symptom illnesses are more likely than not a direct result of his exposures and military service.Sincerely,John Smith, M.D.

Before I submit the Nexus letter, does he need to change any wording?

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Are you an OIF OEF veteran or a Gulf War veteran?

The VBM published by the National Veterans Legal Service Program makes the point on page 181 (2009 Edition) that they believe "beneficial rules created for veterans of the first Persian Gulf War apply to veterans of Operation Iraqi Freedom."

You certainly have the disabilities that qualify for service connection if they are chroinc and fulfill the requirements within 38 CFR 3,317 (38 USC 1117) and the VA has of the lastest info in the VBM has extended the presumptive period for “qualifying chronic disabilities due to Persian Gulf War (and to include OIF vets) to December 31,2011.

Are you able to post and scan here any denial you got from the VA? (Cover personal stuff)

I am baffled why they denied -based on what we see here-

and wonder if they are questioning your period of service????

The VBM is a veterans advocates "Bible' so to speak and has been recognized by the VA itself as bonafide source and citation for the legalise of the VA claims process.

“FEDERAL CIRCUIT COURT OF APPEALS CITES NVLSP’S VETERANS BENEFITS MANUAL AS AUTHORITY FOR VETERANS LAW

Federal courts always include in their written decisions citations to authorities of law that support the court’s rulings. Usually these citations are to one or more statutes, regulations, or past court decisions. But sometimes, the courts cite well-recognized treatises as support for their rulings.

In its March 2009 decision in Holton v. Shinseki, 557 F.3d 1362 (Fed. Cir. 2009), the U.S. Court of Appeals for the Federal Circuit cited to both a statute and NVLSP’s Veterans Benefits Manual for the legal proposition that in order to receive disability compensation, a veteran must generally show, among other things, that it was at least as likely as not that he suffered an injury or contracted a disease while in service.”

Source : NVLSP web site

Edited by Berta

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I am an Iraq War Veteran. I have not been denied or granted yet. My file is on hold because the VA sent all of my records (personal and military) to another veteran by mistake. Therefore, they are being audited. My VSO is worried that because the VA doctor used the word "speculation" that they are going to attempt to say I have the fibro and IBS but they are not related to my service in Iraq. He suggested i get a doctor letter connecting the dots with the phrase "more likely than not" in it. He believes that if they deny i can win on appeal that I can win, but is trying to avoid going down that long process. He thinks the nexus letter will help prevent that. The reason he is worried is the letter from the RO said to "determine if the listed disabilities are connected to GWS due to exposures". I am trying to make sure my nexus letter includes all the key words and phrases the VA looks for before turning it in (I have reviewed veterans files, more likely than not, no other risk factors, etc.). My VSO is just trying to make sure we have every base covered. And yes Berta, I posted this in another post.

VA Examination:

Diagnostic Impression: 1. Fibromyalgia. 2. Irritable Bowel Syndrome.

Discussion: Based upon the classic history for both irritable bowel syndrome and fibromyalgia, I do think that the Veteran suffers from both of these disorders primarily, but it would be speculation on my judgement to say that it is truly Gulf War Syndrome when he is so classic for each in and of themselves.

He said he does not know why the doctor didn't use the at least as likely, less likely than not, etc.

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Veteran has been a patient of mine for several years. I have also reviewed his Military Service Medical Records. While in Iraq he was constantly exposed to Industrial Pollution, Raw Sewage, Smoke from Burning Trash and Feces, Solvents, Pesticide-Treated Uniforms, DEET, Raw Sewage, Vehicle and JP8 Exhaust Fumes, and Environmental Pesticides. He was also given numerous vaccinations to include Anthrax vaccinations.

Is this information in your records? If not, I think a simple statement that the doctor has reviewed your SMRs and it is his/her medical opinion that your conditions are military related. Are there treatment records in your file that shows you were treated for exposure of Industrial Pollution, Raw Sewage, Smoke from Burning Trash and Feces, Solvents, Pesticide-Treated Uniforms, DEET, Raw Sewage, Vehicle and JP8 Exhaust Fumes, and Environmental Pesticides? If not a simple statement will do, not your opinion and not what you or the doctor can research. My point being is that you could have been treated for the symptoms and not treated for the exposure of the above conditions. In other words you could have been treated for diarrhea, fatigue, concentration problems, muscle aches, headaches, and joint pain while in service and currently going through the same conditions and VA is "supposed" to award the claim automatically. We all here at hadit knows that there is nothing in VA's vocabulary that really means automatic but it gives you a better chance of winning service connection. If I am wrong someone else will chime in. The key things are you should have suffered from these conditions in service and they are still current and documented

http://www.publichealth.va.gov/docs/gulfwa...etter_aug09.pdf

Page 6

Conditions Automatically Recognized for Service Connection

Enacted in 1994, Public Law 103-446 allows VA to pay compensation to Gulf War Veterans with certain chronic disabilities resulting from illnesses that VA could not diagnose that appeared during active duty in the Gulf War or within a specified time period after their Gulf War service, which led to a degree of disability of 10 percent or more.

Three health conditions suffered by some Gulf War Veterans are presumptively (automatically) recognized by VA for service connection. These are fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. In 2001, Public Law 107-103, expanded the definition of "qualifying chronic disability" to include these three conditions.

VA encourages Veterans with these conditions—including those denied service connection before this law was passed—to apply for VA disability compensation.

Edited by pete992

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This information is in my military records. I listed all of these symptoms I began experiencing on my Post Deployment Form when we left Iraq. I also found some pictures from tour showing some of the conditions. My private doctor has been treating me for the Fibro, IBS, and headaches. Below is the nexus letter I am about to submit. I am trying to make sure that it is worded correct in VA wording (contains all the special words). I do not have any specific treatment for exposure to Industrial Pollution, Raw Sewage, Smoke from Burning Trash and Feces, Solvents, Pesticide-Treated Uniforms, DEET, Raw Sewage, Vehicle and JP8 Exhaust Fumes, and Environmental Pesticides.

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