davidlj1958

No been using Doctor Bash for the most. David

Gosh I just got the CD C-File and it was a nightmare. I see tons of copies of records every where. Another Vet's educational loan info from 1990 as well as his SSAN. Another vet's patient information from a local MD in my area. No wonder my claims are being denied they can not find stuff or even research the files as well as other peoples personal information.

Boy do I know that all too well. My pulmonary M.D. wrote a letter but even as I asked him he insisted on sending out the letter in his own format. The VA just blew it away saying that it was old evidence and could not be considered. I have used this doctor since 1993 upon my active duty return from Saudi Arabia. Five months later I failed a county PFT exam for the fire department.

No other than he is very busy I even get to see him from time to time as I work at NIH. David

I figured that I may look into this. Brian W. Case, MD, MS Board Certified, Occupational Medicine Diplomate, ABPM IME Examiner http://www.caseime.com/ Specialty Focus: Occupational Medicine Disability Medicine Experience: 12 years performing IMEs >2000 IMEs performed Education: MD, Loma Linda University MS, University of Cincinnati IME Training: SEAK, AADEP, ACOEM, and ABIME

Interesting the doctor stated in my Dec 2012 DBQ C&P Exam that the claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. Rationale was that there are multiple references in the veteran’s service record of medical visits for lower back pain and sciatic type numbness in the right leg. The problem is the logical extension of those problems. Diagnosis Lumbar spinal arthritis ICD code 724.4, Intervertebral disc syndrome (IVDS) and incapacitating episodes Date of diagnosis: 12.28.2012 that I had incapacitating episodes over the past 12 months due to IVDS which the doctor remarked as being yes of at least 2 weeks but less than 4 weeks. Furthermore the doctor stated that "This veteran developed lower back pain while in service and sought medical attention which included physical therapy, medications and bed rest. He was SIQ and was limited duty several times while in service. After leaving the service, he mentioned the problem to his physician in the 1990's and underwent physical therapy but more recently, for 10+ years he has only taken aspirin and done the exercises provided by the former physical therapist. He was absent from work for 2 weeks in the past 12 months and did not seek medical advice. In addition, he develops leg numbness, usually on the right and at times on the left" . That my thoracolumbar spine (back) condition impacted on his ability to work that the condition impacted on his ability to work and that his job requires being up and about and during a flare-up, he needs to sit. I was denied of having any back issues and sciatica Over all the exam did not go the best at the start as the doctor refused to exam the MRI from Dec 1995 but settled down. If I had known better I would not have pushed myself and stopped right when the pain started. At least he had read most of my service medical records. The doctor who did my pulmonary had not and I found foul ups all over in the report wrong references to dates, Not referring to some service PFT's at all nor the fact that I had failed a fire fighter physical (PFT) not even six months from my return from Saudi Arabia in Dec 82 (The FF exam had been May 93). Nor was the MD a specialist in pulmonary care and diagnosed me from a 2005 exam as having COPD which was strange as my 93 to present pulmonary doctor said all along Asthma.

I happen to work at NIH and he lives around the Bethesda area. I had a two hour exam with Doctor Bash. He loves lots of documentation as it makes a stronger case.

In my Pulmonary DBQ C&P exam in Wash DC back in December of 2012 the doctor was not a specialist in that field just a GP diagnosed me as having COPD based off the so called earliest non service exam in 2005 which had no diagnoses what so ever. Big mistake as my current MD Pulmonary specialist diagnosed me back in 1993 five months after my return from Saudi Arabia Oct -Dec 1992 active duty period with asthma

He was tied up for four months on mine and it cost the standard amount. Was it everything I wanted not really but at least I was able to gain access to it and upload it online to the VA 3 days before the denial letter came out. Just worn out on this deal how some can do it for many years is beyond me I have only been on the fight since 2012. David

Doctor Bash is still very busy but he still knows me ;-) David

Darn I know of the applications of the products at MCAS (H) Tustin down loaded the material and used it in my claims. But somehow it never was even addressed by the VA. Prior to 1942, the Site, neighboring the Marine Corps Air Station (MCAS) Tustin Parcels and surrounding properties adjacent to MCAS Tustin were used for agricultural cultivation (EDR, 2007). As part of the agricultural activities, pesticides and herbicides were applied to the Site (Finding of Suitability to Transfer [FOST 2], 2001). In 1942 the MCAS Tustin was constructed on neighboring parcels to the east. However, agricultural activities continued to be conducted on the Site until approximately 1968. In 1996, laboratory analysis of soil samples collected from areas to the west and northeast of the Site (Neighborhoods E and G) revealed dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethene (DDE), dichlorodiphenyldichloroethane (DDD), alpha-chlordane, dieldrin, endosulfan II, gamma-chlordane, methoxychlor and metals above the laboratory detection limits (FOST 2, 2001). In 1996, laboratory analysis of soil samples collected between 1-foot and 11-feet below ground surface from two borings advanced on Agricultural Area I (Parcel 6, approximately 50 acres) revealed DDE up to 7 micrograms per kilogram (ug/kg) and DDT up to 5 ug/kg in the 1-foot samples, which are below the 2005 California Human Health Screening Levels (CHHSLs) levels for residential use of 1,700 ug/kg. In addition, laboratory analysis of soil samples collected between 1-foot and 12-feet below ground surface from 9 borings advanced on Agricultural Area II (greater than 100 acres) revealed DDD up to 5 ug/kg, DDE up to 73 ug/kg, DDT up to 130 ug/kg, chlordane up to 0.88 ug/kg, dieldrin up to 4.3 ug/kg, endosulfan up to 38 ug/kg and methoxychlor up to 27 ug/kg (BNI, 1996). In 2001, the United States Environmental Protection Agency (USEPA), the California Regional Water Quality Control Board - Santa Ana Region (Regional Board) and the Department of Toxic Substances Control (DTSC) concurred with the Department of the Navy's (DoN) findings in the FOST that the former agricultural areas were suitable for transfer as unrestricted residential use (FOST 2, 2001). However, the frequency and sample depths of the soil samples collected in 1996 are insufficient to characterize agricultural use areas under current DTSC guidance. In addition, information regarding the potential presence of pesticides in soil within areas that were previously used for agricultural cultivation, i..e., Parcels 4, 5, 7, 8 10 and 14 and subsequently developed as part of MCAS Tustin was not reasonably ascertainable.

What is and how is it applied “predominantly” and the means of VA’s process of determination. My Dec 2012 C&P Exam Page 4 stated a Diagnosis of Hypertension ICD code: 401.9 date of diagnosis: 1998 If indeed the medical officer had properly reviewed my service medical records it would have noted a far earlier date. In my (SMR) the date is 2.24.82 My Dec 2012 C&P Exam Page 4 stated item 6 Remarks if any that my EKG was done then and that I had no prior available for comparison. One can extapolate that the (C-File) was not present for a proper review by the medical doctor who conducted the direct test. Since I was bounced from floor to floor I perceive that the records were only at one location and that was the medical officer who I checked in and out with. So this causes me to reflect if indeed the Neurologist who conducted the exam for my back that I was also denied may not have had all of my records to see the big picture and not only parts of it. We really did not hit things off and it really seemed adversarial from the start. My Dec 2012 C&P Exam Page 5 Medical History stated unknown for © for the required BP readings to be taken in order to meet the standard of note 1. So appears to be an oops here if they reviewed the service medical records it should have been marked unknown they would have marked NOTE (1): Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm. As such I was indeed granted a service connection for hypertension with an evaluation of 0 percent effective August 24, 2012. So here I am with the incorrect date of diagnosis and the C&P MO not listing whether or not I had been examined in my service medical records. I know that I meet the standard of note 1 As listed in VFR-2004 Tile 38 Volume 1 Part 4 Subpart B 4.30 Diseases of the Arteries and Veins 7101 Hypertensive vascular disease (hypertension and isolated systolic hypertension). But leads me to this : My Dec 2012 C&P Exam Page 5 Medical History stated No for (d) which leads me to my question of What is and how is it applied "predominantly” and the means of VA’s process of determination. As I have been documented with a diastolic (22) times over 100 in my service and non-service medical records. The systolic blood pressure 7101 was exceeded a total of (6) times. Seeing that isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm. I am back again how is prdominatly applied?

Just looking about and I found this as it I hope provides some background on the knees. Back in October the wonderful provisional decision based on a special initiative to complete my pending case No Final Rating Decision dated October 17, 2013. Came in for me and they denied the claim I had for asthma and my knees. Date: August 14, 1998 VAOPGCPREC 9-98 Subj: Multiple Ratings for Musculoskeletal Disability and Applicability of 38 C.F.R. §§ 4.40, 4.45, and 4.59 Web link is: http://view.officeapps.live.com/op/view.aspx?src=http%3A%2F%2Fwww.va.gov%2Fogc%2Fdocs%2F1998%2Fprc09-98.doc

Well I just had a small surprise. Then the one before that. Provisional decision based on a special initiative to complete my pending case No Final Rating Decision dated October 17, 2013 Based on the review of the evidence listed the VA made several decisions on my claim. My original claim as well as the list of binders had copies of this missing DD-214 as well as many VBA-21-4138 statement in support of this and my other claims and other documentation . As such I do question as how the (VA) was able to determine a service connection for claims since it can then claim that I was not on active service since the Philadelphia VA RO office clearly indicated in the introduction the there was no reflective period of coverage in a DD-214 for such. However my service medical records reflect patient care for this so called period of missing time. The missing period of coverage was indeed provided in both my original package and in two packages listed as six Binders inside binder IA table of contents tab 11. Noted issues report of separation DD Form-214. The missing period of time for the approved disability is also under the DD-214 period. So the VARO failed to connected that it had acknowledged the service medical record book entries but did not. At least to me it appears that the RO did fail to break down the list of evidence it had used in this process of working the review of my claims. In (b) I had a large (Number) VA Form 21-4138, Statement in Support of Claim, from me. I had even sent a separate letter that contained notice of the shipment of the six binders and attached the table of contents of each of the six binders to both the Philadelphia VA RO and the Baltimore VA RO as this was a joint working claim between the two RO's. VA RO decision letter states that the evidence was the following. a) Package of mixed medical records from the Veteran, received January 14, 2013 b) Six binders of mixed evidence received from Veteran August 21, 2013 So I requested a full copy of my case file so I could obtain a base line of how they came about the processes of my claim denials. This is a request for documents under 38 U.S.C. §§ 5701(b)(1) and 5702; 38 C.F.R. §§ 1.525, 1.526, and 1.577 (2011); and the Freedom of Information Act (FOIA), 5 U.S.C. § 552, on behalf of myself,. I hereby request a copy of all documents contained in my VA claims folder, to include all documents in the right flap, left flap and center flap, as well as any temporary files. Please forward the copied documents directly to me However all the Baltimore office supplied me was the material I had been successful in uploading electronically in August of last year. So a large part of the evidence used in the provisional decision based on a special initiative to complete my pending case No Final Rating Decision dated October 17, 2013. Was not provided at all appears to be missing and no trail record of where it is now. The six binders weight alone shipped in two boxes came out to 41 pounds the FOIA case file material that was sent to me was only 2 pounds.