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TBI vet here, I think a miracle happened...

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eli

Question

I've been a reader here for years, rarely talk, took advice, filed my claim, was denied, appealed, you know the drill.  I'll try to give the basics of my story from hell.

During the Gulf War, stateside, I had an accident while we were loading aircraft and I was knocked unconscious.  Being the gentlemen that they were, my buddies carried me to the side and finished loading the aircraft.  Afterwards they laid me on the couch in the break room and I came to sometime later.  The accident wasn't documented,  But I did start showing up at the base hospital complaining of nausea, vomiting, headaches and sleep problems.  One doctor was so irritated at my complaints that she called my sup and told him to stop sending me to the ER and to tell me to suck it up.  I actually have a copy of her remarks in my file.  There was no way in hell I was going to admit to wetting the bed, but I was washing my bed sheets more often.  Several other odd things happened and at least one was documented thank God.  I had a seizure and wandered into a restricted area without my line badge on.  When I was addressed by the person in charge of the area I was incoherent and he told my sup to write me up for disrespecting him.  TG he did write me up, again I have a copy of this.  None of us thought, hey this is a seizure.

I finally had insurance and a great doctor.  An epileptologist, she said your MRI shoes major brain scarring, what building did you jump out of head first?  I told her about the accident in the military.  She said since you're a vet, get yourself into one of the new VA epilepsy centers of excellence.  At this point I'm averaging 55 seizures a month, can no longer work and have to file for ssdi.  Someone says why aren't you using vet benefits and why haven't you filed a claim.  "Huh?  You mean I have vet benefits?"

Fast forward...claim filed, claim denied, they say yes you have epilepsy but no record of accident.

I appeal.  Denied.

I track down one of my supervisors that was with me on the aircraft that night and he writes a witness statement re the TBI accident.  My current Epileptologist fills out the DBQ and writes a letter stating that I suffered a head trauma during the accident, that the spell I had (wandering into the restricted area) was indeed a seizure and that my epilepsy is the result of said head trauma.  Of course she didn't use the wording I tried to explain to her.  She's foreign and wrote it in medical terms.

They reopened my claim, new evidence?  This time my denial says we admit you had a head trauma accident but you haven't been diagnosed with a TBI and you don't show residuals of a TBI.  And the evidence wasn't good enough?

Me, last week when I got the denial....what???????????????????????????????????????  Although I'm not surprised.

 

Here's what  just happened, I mean ty Jesus, I just happened to see.  And please let me know if this isn't important.  Esp since these records are listed as evidence on my SOC.

VAMC Doctors notes, he's a Neurologist:

Year event type started:  1991

Frequency: 12 per month (my comment-> of the worst seizure type)

Injuries from events:  Head trauma

Traumatic Brain Injury: YES

Traumatic Brain Injury Severity/Loss of Consciousness: moderate 30 min to 24 hours

Type of TBI: closed

***If this is the diagnosis from my VA doctor then didn't VA screw up with their denials?

My last denial/SOC letter dated 11/21/17 says, quote:

Evidence:  Treatment reports VAMC Durham, for the period June 19, 2013 thru Sept 3, 2015

My 2/13/17 denial/SOC also lists the Durham records in evidence.

 

So yeah, I'd love some feedback on this situation.

I was planning on submitting 2 more IMO's stating I have a diagnosis of TBI when I submitted my form 9 from this last denial, assuming I'd be heading to BVA.

Oh dear hadit experts, whatever if anything does this mean????

Edited by eli
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Make the point that you had a TBI quack, (you can cite that scandal, and I know it all was posted about here some time ago- and MAKE SURE they get the IMO prior to any BVA transfer....

you might have a CUE basis on some of the past denials-----

Do you use ebenefits?

What is the last status you had on the claim? Did you file the NOD by now?  I am confused on the denial dates here but

can you scan and attach this denial letter  here:

"
"My last denial letter dated 11/21/17 says, quote:"

Cover C file # and your name prior to scanning it

"If this is the diagnosis from my VA doctor then didn't VA screw up with their denials?"

From what you posted here so far..........in my opinion

INDEED they screwed up!

This might be fixable sooner than later.

(possible violation of 38 CFR 4.6- searchable here- and my Favorite regulation of all.

 

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http://www.disabledveterans.org/2016/06/02/secretary-bob-mcdonald-announces-tbi-scandal-fix/

https://community.hadit.com/topic/66552-tbi-scandal-unqualified-va-docs-update/#gsc.tab=0

 

More here  and with a google search as well..........this fiasco was a Disgrace .

When did the VA first treat you for TBI? The symptoms you had../nausea etc etc, indicate that someone should have considered you for an MRI to rule in or out neurological problems.

How long after beginning treatment at VA, did they give you an MRI?

Do you have a copy of the MRI results?

 

 

Edited by Berta
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They said TBI was denied and a re-opened claim for epilepsy was denied.

What was the date of this exam:

“Year event type started:  1991

Frequency: 12 per month (my comment-> of the worst seizure type)

Injuries from events:  Head trauma

Traumatic Brain Injury: YES

Traumatic Brain Injury Severity/Loss of Consciousness: moderate 30 min to 24 hours

Type of TBI: closed”

Can you make out the doctor’s signature (name?) as he/she could be googled to see what expertise he had)

“Added point of interest.  I am also one of the TBI vets that received a C&P by an unqualified doctor.”

 

Did you receive a letter from VA telling you that you were one of the 25,000 vets they buggered on the flawed exams?

 

If so is it possible that the above C & P exam came after that letter but the VA disregarded the newer favorable TBI  C & P exam?

Something sure is wrong here.

 

Others will chime in as well……….and I will go over the decision again….

The part of the decisions we needed is pages 21/22

 

The Evidence list is on page one of the decision.

 

I should have specified just their rationale (pages  21/22- of the decisons not of the pdf pages) and the evidence list- but that’s OK-

They always send us a bunch of the regulations ( hoping we don’t read them or understand them)

 

Something is definitely wrong here.

It looks to me as if they never even read those reports in the evidence list.

 

They did mention the lay statement which is Probative, but stated –words to the affect that the Buddy cannot opine on a medical issue.

 TRUE! But the raters are not allowed to opine on medical conditions either..

 

“Listing “ medical reports as evidence does not mean they actually considered them because they made no specific referral to any of them at all , not any medical rationale whatsoever, as to why those reports were ignored.

 But they did verify they have them.

I will be searching ing a CAVC or OGC precedent you might be able to use against them but a simple CUE  ( asking them to CUE themselves- info in our CUE forum on that)within the appellate period, might turn this around real fast.

It looks like a beauty. I agree it is a Thank You Jesus moment.

And I hope by entering ASKNOD's  (asknod) name here , he might have a google alert set up , and catch this and he will also show up here on this one.Alex Graham.

 

 

 

 

 

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Thank You - Alex (asknod is reading this even as I am posting)

Lots for me to look over again.  Sometimes I think I have seen it all... but then the VA gets creative again....

God has blessed me with the ability to help vets. And It was a promise I had to keep as well--- hours before my husband died, he told me to go after them on the 1151 he had filed ( did that)and also to help his brothers and sisters who have served.( still trying to do that) 

Lots here today and I have a prayer meeting tomorrow and we always pray for our nation's veterans.

"Do I file the form 9, lay out all this info and wait for my BVA hearing"

You have time- I will prepare a "GCY" claim for you- might not be until Wednesday-

GCY - go CUE yourself VA....and I have to finish my seond request to the Sec to make this tactic into a fast letter...

Three of us here have been successful with my tactic on that.The decisions came faster and they were (with a few skirmished in my case, correct.  Allan 2005 and SPO used my idea and I have used it many times.

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Added point of interest.  I am also one of the TBI vets that received a C&P by an unqualified doctor.

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