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Navy ELT to EMT-P

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Everything posted by Navy ELT to EMT-P

  1. No this was actually done prior to my C/P. I filled a FDC and assumed that he would also fill out DBQs. He is defiantly a advocate but he will not fill out a DBQ, he feels that the checkbox format limits his way to express his military decision making. My C/P exam was done by a contracted provider. The doc seemed, by her questions to be looking for evidence to support my claims, but who knows.... Like he says, I had symptoms of sleep apnea in the service but was not diagnosed until 5 years after discharge. I know that this would be a tough claim so I wanted to have all my ducks in a row. On my hypertension, I had several readings in the service, towards the end with by diastolic above 90. That should have probably been referenced also as my claim is for HTN as a primary SC condition. This sets me up to have it as a secondary. I have pretty strong buddy statements from a shipmate and my wife as well. Thank you for your thoughts as always
  2. Hi All. My claim for Sleep apnea, Hypertension and Rhinitis just hit the "pending decision phase". I dont know how it will turn out but I wanted to post a copy of my IME/Nexus from Dr Ellis. I am curious about your thoughts. By the way, his practice is very vet friendly and the cost of the exam and report was 500. Expert Medical Eval_2.pdf
  3. Hi all. Last year with the help here my wife was upgraded from 40 to 100% We couldn't have done it without this group. Now I am reaching out for help with a claim for myself. I want to file as a FDC and while I will use my county VSO, I want to drive the boat on this. Here is my story. I served from 1999-2005 in the Navy aboard submarines. I was healthy through most of my service except for allergies and some sinus infections. In early 2005 i began to have a lot of sleep issues and started drinking to help fall asleep. On submarines any use of sleep aids was disqualifying so I didn't seek treatment. In mid 2005 I was concerned about my alcohol use and sought help. I was first dx with insomnia and prescribed Ambian. I was then referred to substance abuse where they prescribed trazadone for sleep and dx me with depression/anxiety and alcohol dependence. Also while not officially diagnosed my BPs were all pre-hypertensive with diastolics in the 90s. Since I have gotten out sleep has been continuously an issue and I was on ambian and lunesta for several years. My blood pressure has continued to rise. No issues with any substance abuse however. I recently moved and switched providers. I went in for a physical and had blood pressures around 200/120. My doc started me on 2 BP meds and referred me for a sleep study. My sleep study showed severe sleep apnea and I have been prescribed a CPAP. I asked my doc if I likely had sleep apnea that was undiagnosed since I was in the Navy and she said defiantly and its very possibly at least partially causing your high blood pressure. So, after swallowing lots of pride and at the instance of my wife I am starting the claims process. I felt un entitled because I work and don't want to admit that I'm not 100% healthy. I want to file a FDC and have read hundreds of posts about the process. I am wondering if I should only file for the Sleep Apnea and if its approved add the HTN. Or should I look at filing for everything at once. Also my doc is willing to fill out my DBQ and write a Nexus, however she hasn't written a VA letter before and has asked me if I know what it should look like. Given my situation any thoughts? Thanks all.
  4. Hi all, I need a little advice with my DW's claim for increased ratings. The claim is 14 months long and has been stuck in gathering of evidence. She has had her c/p exams and 1 months ago we told the VA both in writing and through IRIS that all evidence was submitted and to decide the claim asap. At this point is there any thing else we should do? Monthly IRIS emails? BTW the claim is in Waco and she has already been granted hardship status.
  5. Hi all, DW has 2 c/p exams for existing sc CFS, R shoulder, Lower back and New Depression secondary to CFS, HTN, secondary to CFS scheduled for june. The big one is the CFS which is SC for 10 years at 40 percent. She is applying for a rating updrade as her symptoms have gotten worse. Her personal doc filled out a DBQ for the CFS that meets the guidelines for 100 percent. At this point should we call to see if they will cancel the C/P for CFS? Also is there ever any luck asking to move up a scheduled c/p appt. This claim is 18 months ago and we have all of the evidence other than the c/p submitted. Her doc also dx Fibro. This is a new dx but from the same untreated mono that caused the CFS. Should we ammend the claim to add that or submit a second FDC now or wait till this claim is resolved and submit a FDC at that point? Thanks all for the advice.
  6. Cmdr Bob thanks for the reply. We have her records. The point of the BDQ from her md was to explain the current level of symptoms (should be 100) as it is already sc at 40 percent. Would this not help?
  7. The C/P is going to be do be some by the VA. I'm considering the Ellis Clinic and Dr Bash for the IME so both are versed in VA speak.
  8. Hi all Question is for my dw who has a c/p exam scheduled for june. This is a claim to upgrade her CFS 40% sc and shoulder pain 10 sc. There has been a progression of symptoms and lots of treatment. We want to go with a IMO/IME and am trying to figure out timing. Is it ok to do that now or should we wait until we have the c/p results? Would the c/p examiner look at a IME as part of his/her exam? Second part. She has also been dx with fibromiligia. This was dx after her first rating, however the symptoms were there prior to discharge and I think a nexus letter will be pretty easy to form. So here is the question- we dont want to delay the current claim by adding to it. Should the fibro be discussed in this IME or in a second one for a later claim? Will it being in this IME muddy the water, or can this IME be used in this claim and again in another one after this is decided? Thanks
  9. I found the BDQs. My thoughts were to have her private MD fill these out as she is not very familiar with the verbage the VA needs and then to have a secondary IMO or IME (not sure yet) to tie it up in a bundle. What do you all think?
  10. Thanks all for the good feedback. I this has given me a lot of information and a good place to start. I will probably ask more questions but more focused. Any other input would be greatly appreaciated.
  11. Thanks for the thoughts. She isn't a gulf war vet but the CFS I already rated as sc as is the right shoulder. We don't have a VSO worth anything and are trying hard to find one. I saw the disability question forms on line. Can her docs (who don't know much about VA rattings) fill these out? We were thinking about Dr Ellis or Dr Bash for a full IMO.
  12. There has been great advice here so far. I'm not doc, but I am licenced paramedic, and I have many patients that are chronic pain sufferers. The point I want to add is to be very cautious with heavy narcotics like OxyContin and fentanyl. They work great and sure you have been warned about the addictive properties. What is more insidious is how they give such short term relief, with no high for the chronic pain pt just relief, then as the months and years go by doses area increased until you are almost in a permanent state of withdrawal. And of course there are the hundreds of accidental overdoses I've treated. For some Cymbalta or Neurontin work great. Trigger point injections can provide a lot of relief but have risk. This really sounds like reffered pain. Most likely spinal however organs (gal bladder, spleen, pericardium) can refer pain as well. Keep striving for a diagnosis. Don't give up. Limit the narcotic use to breakthrough pain control. And keep your spirits up. Best wishes.
  13. Thanks for the reply- this might be a rookie question but if she is already sc for CFS and her right shoulder does it make a difference if the rest are rated as such. She received treatment for the shoulders CFS and symptoms consistent with fibro. The depression, from her doctor was caused by the CFS (sc). A lot of medical research states that hypertension can be caused by CSF. The left shoulder was declined initially by the VA but this is new evidence. These are reasons I'm considering paying for a good IMO. So at this point should we continue with the claim as filed or add the missing diagnoses. We really want to get a adjustment on the CHF as soon as possible. Thanks so much all.
  14. Hi all, First of all I am so glad I found this forum. This call for help is for my wife's case, that I am helping with. Here is the background. She served from 1997-1999 in the navy active duty. While in boot she came down with mono. During 18 months of A school her symptoms persisted. She was seen dozens of times at sick call by corpsmen and each time had a pregnancy test and sent back to work. When she finally passed out at work and was taken to see an internal medicine doc, they found she was still positive for mono. In her report the doc stated that her current condition was caused by the poor care she received which was below the standard of care for any military or civilian health care. Nice huh? She was quickly found unfit for duty placed on TDRL to PDRL and got a VA rating. 20% sc CFS, and some ortho stuff that put her at 50 percent total. Now 13 years later her symptoms have worsened, to where she cant work, is home bound 50 percent of the time and often is too exhausted to eat, shower or brush her hair. Before she got sicker she was a respected high school math teacher and this has been hard. Additionally she has been diagnosed with fibromialgia, depression secondary to CFS, her ortho has worsened requiring surgery in both shoulders, hypertension, sleep disturbances, hyperlipidemia. She has only seen civilian docs since leaving the service. She submitted a claim to have her rating increased, she used the local Texas Vet commission VSO and they did a pretty crappy job. Specifically they only put her CFS, hypertension and one shoulder on her claim. Paperwork was lost, ext ect ect. Now it has been filed and she just got her C/P exam scheduled for June. So here are my questions: 1. VSO, we need help with the paperwork, she is to tired and forgetful because of her illness and I am working 60+ hours a week and taking care of 4 kids. Does anybody have a recommendation for a good advocate in the central texas area? We aren't very involved with the vet community. We have had a recommendation for the Jewish War Vets rep in Dallas and are willing to drive, but this recommendation was not based on knowing his record only because we are friends with the JWV Austin post commander. We will drive to Waco, Dallas, San Antonio for somebody that will do a good job. 2. Should she at this time add the additional claims? Fibro, the left shoulder? We have been waiting for 18 months and money is critical. We don't want to add them now if its going to push this all back another year. 3. Looking at the rating guide she really looks like a 60 or 100 percent for CFS, from what I'm saying what are your WAGs? 4. IMO, I think its worth it. Espically to nexus the depression and hypertension, the literature supports this. Who do you all like? Dr Bash, or is there anybody good in texas? What should this cost? Also should we do this before of after the C/P. Also if we don't add the additional claims should the IMO only cover whats on the current claim or everything so it can be used for the next claim as well? I think thats it for now. Any other help you guys ave would be most appreaciated.
  15. Hi all, First of all I am so glad I found this forum. This call for help is for my wife's case, that I am helping with. Here is the background. She served from 1997-1999 in the navy active duty. While in boot she came down with mono. During 18 months of A school her symptoms persisted. She was seen dozens of times at sick call by corpsmen and each time had a pregnancy test and sent back to work. When she finally passed out at work and was taken to see an internal medicine doc, they found she was still positive for mono. In her report the doc stated that her current condition was caused by the poor care she received which was below the standard of care for any military or civilian health care. Nice huh? She was quickly found unfit for duty placed on TDRL to PDRL and got a VA rating. 20% sc CFS, and some ortho stuff that put her at 50 percent total. Now 13 years later her symptoms have worsened, to where she cant work, is home bound 50 percent of the time and often is too exhausted to eat, shower or brush her hair. Before she got sicker she was a respected high school math teacher and this has been hard. Additionally she has been diagnosed with fibromialgia, depression secondary to CFS, her ortho has worsened requiring surgery in both shoulders, hypertension, sleep disturbances, hyperlipidemia. She has only seen civilian docs since leaving the service. She submitted a claim to have her rating increased, she used the local Texas Vet commission VSO and they did a pretty crappy job. Specifically they only put her CFS, hypertension and one shoulder on her claim. Paperwork was lost, ext ect ect. Now it has been filed and she just got her C/P exam scheduled for June. So here are my questions: 1. VSO, we need help with the paperwork, she is to tired and forgetful because of her illness and I am working 60+ hours a week and taking care of 4 kids. Does anybody have a recommendation for a good advocate in the central texas area? We aren't very involved with the vet community. We have had a recommendation for the Jewish War Vets rep in Dallas and are willing to drive, but this recommendation was not based on knowing his record only because we are friends with the JWV Austin post commander. We will drive to Waco, Dallas, San Antonio for somebody that will do a good job. 2. Should she at this time add the additional claims? Fibro, the left shoulder? We have been waiting for 18 months and money is critical. We don't want to add them now if its going to push this all back another year. 3. Looking at the rating guide she really looks like a 60 or 100 percent for CFS, from what I'm saying what are your WAGs? 4. IMO, I think its worth it. Espically to nexus the depression and hypertension, the literature supports this. Who do you all like? Dr Bash, or is there anybody good in texas? What should this cost? Also should we do this before of after the C/P. Also if we don't add the additional claims should the IMO only cover whats on the current claim or everything so it can be used for the next claim as well? I think thats it for now. Any other help you guys ave would be most appreaciated.
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