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gousto64
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Posts posted by gousto64
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at 30%, what sorts of college-bound additional benefits are you claiming for your child? and, which wizard granted you 30%? and how come I havan't met this wizard person?
the wizard = the department of veterans affairs
well at first we getting 22 dollars for my high school bound children and as of today we are getting 72 dollars for my collage bound child with back pay. now all of this is at the rate of 30%.
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I,m currently receiving 30% and I applied for additional benefits for my college bound child.
Today i received a responds from wizard granting my request but at 30% . I've also requested an increase for additional benefits for myself . I contacted dva and i was told that my claim is in the decision phase .
Known because they granted my request for additional benefits for my college bound child at 30% . Does this mean that they have already decided to deny my claim for an increase for my current disabilities as well as my claim for secondary disabilities .
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Just to be aware - that this decision did not grant the claim
due only to Internet Information --
there were doctors opinions as to the disability, the internet info,
and support of full medical rationale.
carlie
I'LL TRY AGAIN
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Citation Nr: 0902694
Decision Date: 01/27/09 Archive Date: 02/09/09
DOCKET NO. 05-01 859 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in St. Louis,
Missouri
THE ISSUE
Entitlement to service connection for gastroesophageal reflux
disease (GERD), to include as secondary to the service-
connected conditions of chronic obstructive pulmonary disease
("COPD") and cervical disc protrusion at C3 and C4 ("back
disability").
REPRESENTATION
Appellant represented by: The American Legion
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
S. Finn, Associate Counsel
INTRODUCTION
The veteran served on active duty from July 1977 to July
1997.
This matter comes before the Board of Veterans' Appeals
(Board) on appeal from an August 2003 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) St.
Louis, Missouri. The veteran perfected a timely appeal of
the rating action to the Board.
In March 2008, the veteran testified at a Travel Board
hearing before the undersigned Veterans Law Judge. A copy of
this hearing transcript has been associated with the claims
file.
The issue of entitlement to an increased rating in excess of
10 percent for service-connected postoperative cervical
spine, to include radiculopathy of the shoulders has been
withdrawn and is no longer on appeal. (See October 2007
written statement).
FINDING OF FACT
The competent medical evidence of record shows that the
medications the veteran took for his service-connected back
disability and COPD aggravated his GERD.
CONCLUSION OF LAW
The veteran's GERD is proximately due to his service-
connected back disability and COPD. 38 U.S.C.A. §§ 1110,
1131, 5103, 5103A (West 2002); 38 C.F.R §§ 3.159, 3.303,
3.310(a) (2008).
REASONS AND BASES FOR FINDING AND CONCLUSION
I. Duty to Notify and Assist
As provided for by the Veterans Claims Assistance Act of 2000
(VCAA), VA has a duty to notify and assist claimants in
substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100,
5102, 5103, 5103A, 5107, 5126; 38 C.F.R. §§ 3.102, 3.156(a),
3.159 and 3.326(a). In this case, the Board is granting in
full the benefits sought on appeal.
Any defect, if one exists, with respect to either the duty to
notify or the duty to assist must be considered harmless and
will not be discussed.
II. Service Connection for GERD
Service connection may be granted for a disability resulting
from disease or injury incurred in or aggravated by service.
38 U.S.C.A. §§ 1110, 1131; 38 C.F.R.
§ 3.303(a). For the showing of chronic disease in service,
there is required a combination of manifestations sufficient
to identify the disease entity and sufficient observation to
establish chronicity at the time. If chronicity in service
is not established, a showing of continuity of symptoms after
discharge is required to support the claim. 38 C.F.R. §
3.303(
. Service connection may also be granted for any disease diagnosed after discharge when all of the evidence
establishes that the disease was incurred in service. 38
C.F.R. § 3.303(d).
Service connection may also be granted for certain chronic
diseases when it is manifested to a compensable degree within
one year of separation from service. 38 U.S.C.A. §§ 1101,
1112, 1113 (West 2002); 38 C.F.R. §§ 3.307, 3.309.
Service connection may also be established on a secondary
basis for a disability which is proximately due to or the
result of a service-connected disease or injury; or, for any
increase in severity of a non-service-connected disease or
injury that is proximately due to or the result of a service-
connected disease or injury, and not due to the natural
progression of the non-service-connected disease. 38 C.F.R.
§ 3.310 (2005); Allen v. Brown, 7 Vet. App. 439 (1995) (en
banc).
In order to establish service connection for the claimed
disorder, there must be (1) a current disability; (2) medical
or, in certain circumstances, lay evidence of the in-service
incurrence or aggravation of a disease or injury; and (3)
medical evidence of a nexus between the claimed in-service
disease or injury and the current disability. See Hickson v.
West, 12 Vet. App. 247, 253 (1999).
Here, the veteran claims that his GERD is secondary to
medications taken for his service-connected COPD and C3-C4
disc protrusion with neural foraminal encroachment. His
basic contention is that his claimed disorder was caused by
the use of Prednisone. In an October 1997 rating decision,
service connection was awarded for COPD and a June 1996
Supplemental Statement of the Case granted service connection
for the back disability.
Medical treatment records reflect that the veteran used
Prednisone from 1996 to November 1999. (See Treatment record
dated from May 1996 to September 1999).
The veteran was also noted to be using Ranitidine during an
August 2000 VA respiratory diseases examination. Recent VA
medical records indicate treatment and medication for GERD.
A January 2002 VA record reflects that GERD was among the
diseases in the veteran's medical history. The section of
the veteran's December 2004 VA spine examination report
addressing his past medical history indicates that he had to
take Omeprazole "due to his chronic gastroesophageal; reflux
problems with long-term therapy on nonsteroidals and
[P]rednisone therapy."
In April 2005, R.H., M.D., noted that he had treated the
veteran since August 2003. The veteran was noted to have a
history of peptic ulcer disease and gastritis and was
currently being treated with 20 mg of Omeprazole daily. In
regard to the risk factors for developing this disease
process, the veteran's prior history of Prednisone use for
many years was "at least partially a contributing factor."
The veteran underwent a VA esophagus and hiatal hernia
examination in June 2005. In the report of this examination,
the examiner did not specify which records had been reviewed
in conjunction with the examination; she did, however, note
prior records, including a January 2003 MRI and an undated
EMG report. During the examination, the veteran noted that
he had not been on Prednisone since his discharge from
service. The examiner rendered a diagnosis of erosive
esophagitis secondary to reflux. She stressed that there was
no evidence to suggest that this diagnosis "is secondary"
to his steroid use, as he had not been on steroids since
1997. The veteran was noted to have a multitude of factors
resulting in erosive esophagitis, including alcohol and
smoking and "his narcotic as well as nonsteroidal use for
pain control as well as his reflux." The VA examiner,
however, did not address whether the veteran's steroid use
aggravated his GERD.
The Board also observes that, in February 2008, T.N., D.O.,
noted that Prednisone was well-documented to markedly
sensitize and worsen GERD, gastritis, and duodenitis, all of
which the veteran was noted to have. He also stated that the
veteran had a current diagnosis of GERD and that it was at
least likely as not that the Prednisone he took for his lung
condition caused his current condition of GERD.
The Board requested a VHA opinion in October 2008 for
clarification of the etiology of the veteran's GERD. The VA
examiner noted the veteran's history and medication use of
oral, inhaled, and injected steroids, as well as anti-
inflammatory agents for his COPD and disc problems. He
stated that two of the medications have been associated with
the development of esophagitis, gastritis, and peptic ulcer
disease. He noted that the veteran had a prior endoscopy
that documented the presence of gastritis and esophagitis;
and, that this usually occurs temporally with recent or
ongoing use of NSAIDs or oral steroids. With regard to the
complications, the examiner stated that:
t is felt that steroids and NSAIDs do have a
causal relationship and this association has been
well-documented in many medical papers. However,
with respect to chronic reflux, there is no data to
suggest that steroids or NSAIDs cause chronic
reflux or GERD.
He further stated that:
[W]hile steroids and NSAIDs may not have caused
GERD, certainly these medications can exacerbate
reflux symptoms. Furthermore, these medications
can cause espophagitis, gastritis, and ulcers,
complications [that] the veteran has been found to
have on endoscopy.
He concluded that a number of factors can worsen or aggravate
reflux including steroids as well as smoking; and, that it
was as least likely as not that steroids and/or NSAIDs
aggravated his GERD.
The veteran also submitted numerous studies linking gastritis
to steroid use. (See Gastritis Causes, at
http://www.emedicinehealth.com (last visited Feb. 23, 2008);
Major Side Effects of Glucocorticoids, at
http://uptodateonline.com (last visited Apr. 7, 2005);
Prednisone The Drug We Love to Hate, at http://ibdcrohns.
about.com (last visited at Feb. 2008 ); et. al. The Board
notes that medical treatise evidence can, in some
circumstances, constitute competent medical evidence. See
Wallin v. West, 11 Vet. App. 509, 514 (1998); see also 38
C.F.R. § 3.159(a)(1) [competent medical evidence may include
statements contained in authoritative writings such as
medical and scientific articles and research reports and
analyses]. However, the Court has held that medical evidence
that is speculative, general or inconclusive in nature cannot
support a claim. See Obert v. Brown, 5 Vet. App. 30, 33
(1993); see also Beausoleil v. Brown, 8 Vet. App. 459, 463
(1996); Libertine v. Brown, 9 Vet. App. 521, 523 (1996).
In reviewing the above evidence, the Board notes that the
evidence indicates a multifactorial etiology of GERD. In any
event, the evidence clearly shows that the medication used
for the veteran's COPD and back disability at least
aggravated the veteran's GERD. What is less clear is the
extent to which the medication played a causal role with
GERD. Regardless, the Board is satisfied that the inquiries
necessitated by 38 C.F.R. § 3.303(B) as to any "baseline"
disability have thus been fully addressed, and any doubt in
this instance should be resolved in the veteran's favor. See
Mittleider v. West, 11 Vet. App. 181, 182 (1998) (when it is
not possible to separate the effects of a nonservice-
connected condition from those of a service-connected
condition, reasonable doubt should be resolved in the
claimant's favor with regard to the question of whether
certain signs and symptoms can be attributed to the service-
connected condition).
While both VA examiners concluded that the medications taken
for the service-connected low back disability and COPD did
not cause the veteran's GERD, at least one VA examiner
concluded that the medications taken for the service-
connected back disability and COPD aggravated the GERD. When
the aggravation of a non-service-connected disorder is
proximately due to or the result of a service-connected
disorder, service connection is warranted. Allen v. Brown, 7
Vet. App. 439, 448 (1995). The Board finds the statement of
the VA examiner, combined with the private positive nexus
opinions submitted by the veteran, to be sufficient medical
evidence of a link between the medications and the veteran's
claimed aggravation of his GERD. Overall, the preponderance
of the evidence is in favor of the veteran's claim, as such
service connection is warranted on a secondary basis.
ORDER
Entitlement to service connection for GERD, to include as
secondary to the service-connected conditions of COPD and
cervical disc back disability, is granted.
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I did some research on this doctor please me what you think.
The American Board of Psychiatry & NeurologySpecialty Certification
Psychiatry
American Board of Psychiatry and Neurology (ABPN) certification in the specialty “Psychiatry” assures that the Physician possesses the knowledge, skills, and experience requisite to the provision of high-quality patient care. To maintain board certification, the Physician participates in an extensive process that involves completing accredited education and specialty training and periodic oral and written exams to demonstrate competency in the field of Psychiatry. A Psychiatrist specializes in the prevention, diagnosis and treatment of mental, addictive and emotional disorders such as schizophrenia and other psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. The Psychiatrist is able to understand the biologic, psychologic and social components of illness, and therefore is uniquely prepared to treat the whole person. A Psychiatrist is qualified to order diagnostic laboratory tests and to prescribe medications, evaluate and treat psychologic and interpersonal problems, and to intervene with families who are coping with stress, crises and other problems in living.
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Other than you telling him this, what evidence did he use to support your statement? It can be used against you if the Doctor did not use any medical evidence because VA will not take your word for it. It is not a good rational without medical evidence
(documents) supporting the statement that he reviewed and considered in this statement.
IMHO
Thanks everyone for your advise
My doctor said that if this statement was not enough that he would write another.
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I have smr's that support that the accident accured and i'm being treated by the va for the injuriesOther than you telling him this what evidence did he use to support your statement? It can be used against you if the Doctor did not use any medical evidence because VA will not take your word for it. It is not a good rational without medical evidence(documents) supporting the statement that he reviewed and considered in this statement.
IMHO
and chronic pain .
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Today i went to see the wizard my psychiatrist
and this is what he had to say To whom it may concern:
Mr. Smith is 55 year old man whom I evaluated 10/09/09.
He reports a motor vehicle accident at age 25
while he was on active duty in the military.
Pain symptoms persist, which interfere with his home and work life.
The dignosis is Pain disorder.
I recommend evaluation and treatment in the VA system for this condition.
Will this help my claim.
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Has anyone won a case using internet medical information.
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did you have this in your smr's or did this manifest itself lone after service.
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My rating decision turned around very quick... about 3 weeks after my C&P.
I was rated 50% for anxiety secondary to my back pain..
They upped my rating for my left leg partial paralysis to 40%
And my back rating stayed at 40%..
Total combined rating of 80%..
Thanks for the advice... The statements of support were cited in the abstract of the decision, so they really did help. Also I took my wife to the c&P, and the psychologist would not let her in, so I actually had a panic attack during the C&P. I was really not prepared for that scenario and it freaked me out.
And they connected to my back pain by basically saying it was at least as likely as not caused by my chronic back pain. so it was a coin toss, which put it in my favor. did you have this in your smr's or did this manifest itself lone after service.
thanks everyone
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Pain Management Modules
allen what are you service connected for
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dave tell me more about the testicle pain ,what perctage are you getting for it.
im getting 10% for testical pain.
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im claiming acid reflux secondary to medication im taking. are you claiming the same.
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pete53 did you apply for secondary service connection for side effects of the diclofenac if so did you win.
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This an example only. This is meant only as a guide and not a guarantee you should always consult the Combined Rating Tables 38CFR4.25(a)(opens in new window)
Service Connected Disabilities Calculator
Service Connected Rating Percentage You may enter up to 10 different rated conditions Service Connected Rating Awarded Efficiency Remaining Efficiency Multiplier Total Disability
« » Start point 0 100.000000 Start
% SC Condition #1 50 100 50.000000 50
% SC Condition #2 30 15 35.000 65
% SC Condition #3 10 3.5 31.500 68.5
% SC Condition #4 10 3.15 28.350 68.5
% SC Condition #5 10 2.835 25.515 74.485
% SC Condition #6 0 0 25.515 74.485
% SC Condition #7 0 0 25.51500 74.485
% SC Condition #8 0 0 25.515000 74.485
% SC Condition #9 0 0 25.515000 74.485
% SC Condition #10 0 0 25.515000 74.485
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Hello everybody i have a question for you I'm currently rated at 20% for grade 2 shoulder separation for 10 years . i recently found my smr that states that i have a grade 3 shoulder separation how do i correct this and get back pay.
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Was stationed there for about 2 months before deploying for the east. I ran a clean-up crew. This is good info.
what must we do next
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i was there between 85-87 for a hazardious materials course we ate fish and crab from the piers. do i have anything to worry about.
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I won my ptsd claim at 50% (low balled) but lost on medical, won on 4 other medical issues at 0%.
Will post more later.
zero,s are good they something is wrong keep fighting
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good luck
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thanks everybody
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hello everybody had my c&p exam today and i feel hopeful the doctor listen to all my concerns .know i must weight for a rating.
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I'm receiving 20% sc for right shoulder i'm attempting to get bilateral for left shoulder.
now i did'nt have any problems while on active duty but i'm having problems with my left shoulder,arm and hand. So i began treatment with a private doctor.
upon completion of my last visit he stated that "joint and muscle pain are due to overuse".
My question is this statment helpful ?
. Service connection may also be granted for any
Child In College
in VA Disability Claims Research
Posted
I filed my claim in october.