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Jaydog

Second Class Petty Officers
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About Jaydog

  • Rank
    E-4 Petty Officer 3rd Class
  • Birthday 09/26/1974

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  • Service Connected Disability
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  1. This is pretty strange. I went and checked my e benefits today and I noticed that I have pending disabilities yet above this you will see my rated disabilities. I have all of them on appeal that are in rated disabilities. it funny because all my pending disabilities say Vet wants service connection. Why would it say that ? thats the whole reason I filed. Anyway any insight would be helpful. Rated Disabilities Disability Rating Decision Related To Effective Date anxiety disorder Not Service Connected lumbosacral strain (claimed as back condition) Not Service Connected depression to include alcohol abuse Not Service Connected bipolar disorder Not Service Connected right shoulder rotator cuff tear (claimed as right shoulder condition) Not Service Connected posttraumatic stress disorder (PTSD) Not Service Connected PTSD - Personal Trauma PTSD - Non-Combat cervical intervertebral disc syndrome (claimed as neck strain) Not Service Connected left shoulder strain with rotator cuff tear 20% Service Connected 09/19/2015 Pending Disabilities Disability Submitted Type Actions Bipolar Disorder-veteran Wants Service Connection 06/17/2016 REP Major Depressive Disorder (mdd)/depression To Include Alcohol Abuse-vet Wants Service Connection 06/17/2016 REP Right Shoulder Rotator Cuff Tear Veteran Wants Service Connection 06/17/2016 REP Anxiety Disorder-vet Wants Service Connection 06/17/2016 REP Ptsd-vet Wants Service Connection 06/17/2016 SEC Lumbosacral Strain-veteran Wants Service Connection 06/17/2016 REP Cervical Intervertebral Disc Syndrome-vet Wants Service Connection 06/17/2016 REP Privacy Act Request 05/31/2016 NEW
  2. Broncovet, I am in agreement with you. I Have been diagnosed with PTSD from VA Doctor and I have had a C&P Exam Last year and she Diagnosed me with MDD and not PTSD. The Exam notes state that the stressor was a least likely than not it happened, but are not linking it to my current mental health issues, but basing it on other issues going on in my life at the time. My MH notes that my current issues are related to MST. Since the VA keeps telling me they are not I had my doctor write something about my current issues and is copied in this thread.... I am not sure what else I can do to prove that my issues are directly related to it.
  3. Andyman73, I completely understand.....Because I waited so long my issues happened before I went in. How they determined that I have no Idea. since i was 18 and joined right out of High school. Sometimes I just want to quite.They make me look like a liar, But they totally contradict themselves. They say my mental issues were not related to service, but they say that I have markers, so they ordered a c & p exam then the examiner stated it was at least likely that MST occurred, but is not linked to my current distress....How could they come up with a statement like that. I guess they are saying no big deal nothing to see hear. What a slap in the face.
  4. I am sure you are correct about that. Well I will just get her to add that piece in the letter. I have Put In a FOIA for my C-File. Not sure how long that will take, but I believe it is something I need since at every turn they basically call me a liar and tell me 20 reasons why its not service related....and while they lay it out that its not they totally contradict themselves as well......WTF Thanks for you advise
  5. Thank you for your input on this. The letter was written by my Psychologist that I was seeing for a few years at the VA and the only person I have told since it happened. I am thinking about what you are saying at the first part about the reason she came up with the Opinion and it is missing, but since she was treating me there are notes in my medical record stating why she came up with her opinion and I hope that would fill in that missing piece. I would like to find people from my unit, but honestly I cant even remember any of their names or where or how to find them. Its been 20 years and about 18 of them I said nothing and pushed everything out of my mind, so I would not remember it.... Look how well that worked.....
  6. Thank you for all you comments and Information. Its always helpful. I called my previous psychologist that treated me down in in Long Beach CA Before I moved to Nevada. I am putting a copy of the letter here. Let me know if this will work as a nexus letter Or do I need to find something else.. Thank you XXXX Davis,PMHNP-BC, MN, MA Veteran's Health Medical Center, Long Beach, CA Anaheim Out-Patient Clinic 2569 W Woodland Dr. June 1, 2016 To Whom It May Concern, This letter is in support of Jason XXXX, (SS# XXXXXXXXX, DOB SEP 26,XXXX) whom I have treated for Post-Traumatic Stress Disorder from October 16, 2013 until January 21, 2016, as he moved out state soon after. I was his attending psychiatric nurse practitioner, and Mr. XXXXX has been active in his mental health treatment through the Veterans' Health Medical Center, Long Beach, CA. It is my opinion, more likely than not, that his PTSD, and Recurrent Major Depression are a direct result of military sexual trauma he experienced while serving on active duty. Please feel free to contact me if you have any further questions. Sincerely, Psychiatric Mental Health Nurse Practitioner Anaheim Community-Based Out-Patient Clinic
  7. I am going to start the process of getting my C-file. I need to see whats in there and they did not use the notes that my VA doctor wrote in my medical notes. Thank you for your input on this issue. Its just strange how they wrote in the letter that they said I had a substance abuse problem Before I joined, Hows that possible I just graduated High School. I was only 18 and I was very responsible. The Assault happened around January or February and that's right around the time my performance went down hill. Service records show you were recognized for outstanding performance in December 1994. In January 1995 you were promoted. Your enrollment in counseling is noted as command directed in August 1995. Discharge action was initiated in January 1996. March 1996 service separation examination shows no complaints of or diagnosis of the record from November 1993 to May 1996. Thank you again for your guidance and input.
  8. Thanks for the reply Berta. I agree that "The series of experiences you found to be distressing, you reported antagonistic harassment by superiors related to alcohol rehabilitation contributed to his distress." I never said it was in the interview. They added that in. What I said in the examination after the personal assault that happened to me I was basically walking around in a fog the whole time and the only thing that let my mind calm down was drinking and that got me in trouble a lot. After That point my Behavior changed and the images of what happened I could not get out of my head, so when they said it was a series of experiences from drinking which leads to my distress. I guess I need to make myself more clear. I believe everything related to the military was distressing to me, Because it was a constant reminder of what happened and that person was in the unit near me, so I was constantly on guard, so pretty much where ever I went I was always watching my back. I really started to become paranoid. I don't know how i can correct this ? If they say that the stressor occurred how can they say that it does not affect me. That incident changed my whole view of the world....This Document makes me out to look like a lair. Also they did not use the notes in my VA medical file which states I have PTSD Related to MST. How come there is no mention of that ?
  9. Hello, I have a few questions. I just received a letter from the VA. I was not expecting anything. I opened the letter and they did a review under the special initiative. First off I do not know what that means anyway. It was just more in depth than the letter i received when they first denied my claim in September 2015. I read through it and basically what they are saying as to why they denied me was because they state that I had a substance abuse problem before I joined. I am not sure how they came up with that. I was 18 when I joined right out of high school. I am trying to think why they would say that. Anyway it should not even be part of the decision. I enclosed the letter I received . It also stated that my timeline is off and i am contradicting myself in my statements. First off the incident happened in 1995 and I did not say anything about it until July of 2014. I now believe because so much time has passed they don't believe me and the want to blame it on something else. I believe the statements they say I contradict myself are probably the one where I did not disclose yet and I tried to get benefit from the VA without disclosing it. Now i feel like theirs no path forward for me to get approved May 23, 2016 Dear Mr. DEPARTMENT OF VETERANS AFFAIRS ?. A special review of your file was mandated on January 6, 2016. Enclosed is the decision that finalizes the previous provisional evaluation completed on your claim under. The special initiative discussed in our letters dated August 29, 2013, September 9, 2015, and January 21, 2016. Please see the attached finalized decision and appeal rights provided with this letter. You submitted Notices of Disagreement on September 10, 2013, September 25, 2015, and December 4, 2015. These Notices of Disagreement were received premature as you were not properly notified of the decision which finalized the rating decisions. This letter tells you about what we decided. It includes a copy of our rating decision that gives the evidence used and reasons for our decision. We have also included information about additional benefits, what to do if you disagree with our decision, and who to contact if you have questions or need assistance. What We Decided We dete1mined that the following conditions were not related to your military service, so service connection couldn’t be granted: Medical Description Right shoulder rotator cuff tear (claimed as right shoulder condition) Lurnbosacral strain (claimed as back condition) Cervical intervertebral disc syndrome (claimed as neck strain) Anxiety disorder Posttraumatic stress disorder (PTSD) Bipolar disorder Deoression to include alcohol abuse We determined that the following service connected condition hasn't changed: Medical Description Percent (%) Assigned Left shoulder strain with rotator cuff tear 20% We have enclosed a copy of your Rating Decision for your review. It provides a detailed explanation of our decision, the evidence considered, and the reasons for our decision. Your Rating Decision and this letter constitute our decision based on a special review of your claim mandated on January 6, 2016. We enclosed a VA Form 21-8764, "Disability Compensation Award Attachment-Important Information," which explains certain factors concerning your benefits. Are You Entitled to Additional Benefits? If you served overseas in support of a combat operation you may be eligible for mental health counseling at no cost to you at the Veteran's Resource Center. For more information on this benefit please visit http://www.myhealth.va.gov/mhv-portal-web/. You may be eligible for medical care by the VA health care system for any service connected disability. You may apply for medical care or treatment at the nearest medical facility. If you apply in person, present a copy of this letter to the Patient Registration/Eligibility Section. If you apply by writing a letter, include your VA file number and a copy of this letter. You should contact yom State ofiice of Veteran's affairs for information on any tax, license, or fee-related benefits for which you may be eligible as a Veteran (or surviving dependent of a Veteran). State offices of Veteran's affairs are available at http://www.va.gov/statedva.htm. The VA provides Blind Rehabilitation services to eligible blind, low vision, or visually impaired Veterans to help them regain their independence and quality of life. The Veteran's blindness, low vision, or vision impairment does NOT have to be related or caused by military service. If you need help with yam vision loss, please contact yam nearest Visual Impairment Services Team Coordinator (VIST) at the eye clinic at yam nearest VA Medical Center. For more information, go to http://www.rehab.va.gov/blindrehab/. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you must complete and retmn to us the enclosed VA Form 21-0958, "Notice of Disagreement" in order to initiate your appeal. You have one year from the date of this letter to appeal the decision. The enclosed VA Form 4107, "Your Rights to Appeal Our Decision, " explains yam right to appeal. What Is eBenefits? eBenefits provides electronic resomces in a self-service environment to Servicemembers, Veterans, and their families. Use of these resomces often helps us serve you faster! Through the eBenefits website you can: • Submit claims for benefits and/or upload documents directly to the VA • Request to add or change yam dependents • Update yam contact and direct deposit information and view payment history • Request a Veterans Service Officer to represent you • Track the status of yom claim or appeal • Obtain verification of yom military service, civil service preference, or VA benefits • And much more! Enrolling in eBenefits is easy. Just visit www.eBenefits.va.gov for more information. Ifyou submit a claim in the future, consider filing through eBenefits. Filing electrortically, especially if you participate in om fully developed claim program, may result in faster decision than if you submit yom claim through the mail. If You Have Questions or Need Assistance Ifyou have any questions, you may contact us by telephone, e-mail, or letter. If vou Here is what to do. Telephone Call us at l-800-827-1000. If you use a Telecommunications Device for the Deaf (TDD), the Federal number is 711. Use the Internet Send electronic inquiries through the Internet at httos://iris.va.gov. Write VA now uses a centralized mail system. For all written communications, put your full name and VA file number on the letter. Please mail or fax all written correspondence to the appropriate address listed on the attached Where to Send Your Written Corresoondence. Inall cases, be sure to refer to your VA file numbe..-.. If you are looking for general information about benefits and eligibility, you should visit our website at https://www.va.gov, or search the Frequently Asked Questions (FAQs) at https://iris.va.gov. We sent a copy of this letter to your representative, California Department of Veterans Affairs, whom you can also contact if you have questions or need assistance. Sincerely yours, Director VA Regional Office Enclosures: Where to Send Your Written Correspondence Rating Decision VA Form 21-8764 VA Form 4107 VA Form 21-0958 cc: CA DVA 21/144 jsl079:ng DEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office Represented By: CALIFORNIA DEPARTMENT OF VETERANS AFFAIRS Rating Decision 05/20/2016 · INTRODUCTION The records reflect that you are a veteran of the Gulf War Era. You served in the Army from January 18, 1994 to May 21, 1996. A special review of your file was mandated on January 6, 2016. Enclosed is the decision that finalizes the previous provisional evaluation completed on your claim under the special initiative discussed in our letter dated August 29, 2013, September 9; 2015, and January 21, 2016. You submitted Notices of Disagreement on September 10, 2013, September 25, 2015, and December 4, 2015. These notices of disagreement were received premature as you were not properly notified of the decision which finalized the rating decisions. Please see the attached finalized decision and appeal rights provided with this letter. Based on the review and the evidence listed below, we have made the following decision(s). 2 of 10 DECISION 1. Evaluation of left shoulder strain with rotator cuff tear, which is currently 20 percent disabling, is continued. 2. Service connection for cervical intervertebral disc syndrome (claimed as neck strain) is denied. 3. Service connection for right shoulder rotator cuff tear (claimed as right shoulder condition) is denied. 4. Service connection for lumbosacral strain (claimed as back condition) is denied. 5. Service connection for posttraumatic stress disorder is denied. 6. Service connection for anxiety disorder is denied. 7. Service connection for bipolar disorder is denied. 8. Service connection for depression to include alcohol abuse is denied. EVIDENCE VA Form 21-526, Veterans Application for Compensation and/or Pension received August 12, 2012 • 5103 Notice Letter dated December 12, 2012 • Martinez VAMC reports (in VVA) VA compensation examination conducted April 17, 2013 VA Form 21-4138, Statement in Support of Claim received May 27, 2013 • VA rating decision dated August 23, 2013 VA letter dated August 29, 2013 VA Form 21-0958, Notice of Disagreement received September 10, 2013 Correspondence from the veteran received September 10, 2013 VA Form 21-078la, Statement in Support of Claim for Service Connection for Post­ Traumatic Stress Disorder (PTSD) Secondary to Personal Assault received August 21, 2014 VA Form 21-526ez, Application for Disability Compensation and Related Compensation Benefits received August 21, 2014 • Service treatment reports from 11/1992 to 3/2000 Kaiser Permanente records from 1/2004 to March 2006 Sacramento County Mental Health records 3/2007 UC Davis records 1/2006 to 1/2010 Contra Costa records 9/2005 to 9/2014 John Miur Health records 1/2005 Request for VA treatment reports from Long Beach, Sacramento VAMCs dated October 9, 2014 • DPRIS reply received October 9, 2014, and October 17, 2014, indicating no service personnel Records are available • VA Form 21-0820, Report of General Information dated October 20, 2014 • Service personnel records from November 1993 to May 1996 VA Form 21-0820, Report of General Information dated January 31, 2015 VA Form 21-0820, Report of General Information dated April 2, 2015, from MST coordinator VA compensation examination conducted July 2015 VA letter dated August 5, 2015 • Statement from Shawn received August 22, 2015 • VA Form 21-0781a, Statement in Support of Claim for Service Connection for Post­ Traumatic Stress Disorder (PTSD) Secondary to Personal Assault received August 22, 2015 VA rating decision dated September 8, 2015 VA letter dated September 9, 2015 • Notice of disagreement received September 25, 2015 (Premature Notice of disagreement) • Long Beach VAMC/Anaheim CBOC reports 3/2014 to 9/2015 VA Form 21-526ez, Application for Disability Compensation and Related Compensation Benefits received October 1, 2015 • VA Form 21-0958, Notice of Disagreement received December 4, 2015 (premahrre NOD) VA Form 21-0820, Report of General Information dated January 5, 2016 • Fax request dated January 5, 2016 to Martinez VAMC • Compensation examinations conducted November 2015 Martinez VAMC 9/1997 to 6/1999 VA rating decision dated January 19,, 2016 VA letter dated January 21, 2016 REASONS FOR DECISION 1. Evaluation of left shoulder strain with rotator cuff tear currently evaluated as 20 percent disabling. The evaluation of left shoulder strain with rotator cuff tear is continued as 20 percent disabling. (38 CFR §3.32l(a); 38 CFR §3.32l(b)(l)} We have assigned a 20 percent evaluation for your left shoulder strain with rotator cuff tear based on: • Limited motion of the arm at shoulder level Additional symptom(s) include: • Painful motion of the shoulder The provisions of38 CFR §4.40 and §4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, in coordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and are not warranted. Although there was additional loss of range of motion with repetitive movements, these changes did not rise to the next higher level of disability. A higher evaluation of 30 percent is not warranted for limitation of motion of the arm unless the evidence shows: • Limited motion of the arm to 25 degrees from the side. 2. Service connection for cervical intervertebral disc syndrome (claimed as neck strain). Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for cervical intervertebral disc syndrome (claimed as neck strain secondary to left shoulder) is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA medical opinion found no link between your diagnosed medical condition and military service. Your service treatment reports from November 1993 to May I 996 show no complaints of or diagnosis of cervical spine, neck condition. You were provided a VA compensation examination in November 2015. The examiner reviewed the claims file, including service treatment reports, private medical reports, the history and the evidence presented at the examination. The examiner opined the neck condition is less likely than not due to the service connected left shoulder strain. The examiner indicated the neck condition is more likely due to left cervical radiculopathy 3. Service connection for right shoulder rotator cuff tear (claimed as right shoulder condition). Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for right shoulder rotator cuff tear (claimed as right shoulder condition secondary to left shoulder strain) is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA medical opinion found no link between your diagnosed medical condition and military service. Your service treatment reports from November 1993 to May 1996 show no complaints of or diagnQsis of a right shoulder disability. You were provided a VA compensation examination in November 2015. The examiner reviewed the claims file, including service treatment reports, private medical reports, the history and the evidence presented at the examination. The examiner opined the right shoulder condition is less likely than not due to the service connected left shoulder strain. The examiner indicated the condition may be right shoulder weakness and pains may also be secondary to a cervical radiculopathy and/or an undiagnosed rotator cuff tendinopathy. 4. Service connection for lumbosacral strain (claimed as back condition). Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for lumbosacral strain (claimed as back condition secondary to left shoulder strain) is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA medical opinion found no link between your diagnosed medical condition and military service. Your service treatment reports from November 1993 to May 1996 show no complaints of or diagnosis of a low back disability. You were provided VA compensation in November 2015. The examiner reviewed the claims file, the service treatment reports, the post service treatment reports, the history and the evidence from the VA examination. The examiner opined it is less likely than not the lumbar spine condition is secondary to left shoulder strain. As a result of the claimant's inability to lift heavy objects with either his left or right shoulder it would ·be highly unlikely for the claimant's unilateral or bilateral shoulder condition to cause a lumbar strain since the claimant is unable to lift heavy objects that would strain his lumbar spine. Also, since the claimant’s post-service Medical records have not established a baseline back condition because his post-service medical records have been silent for post-service back condition; there is no evidence of aggravation. 5. Service connection for posttraumatic stress disorder. Service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with 38 CFR 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. A diagnosis of posttraumatic stress disorder must meet all diagnostic criteria as stated in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. The evidence does not show a confirmed diagnosis of posttraumatic stress disorder which would permit a finding of service connection. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. You submitted a lay statement to Support your claim. A credible lay statement may establish what was seen, heard, and directly experienced. The lay evidence was found not to be competent and sufficient in this case to establish a diagnosis of your condition or to show that a diagnosis had been made by a medical professional. You submitted a lay statement to support your claim. A credible lay statement may establish what was seen, heard, and directly experienced. The lay evidence was found not to be competent or credible evidence of the symptoms of your claimed condition. Although, some evidence supports your claim, we found other medical evidence more persuasive because it is supported by an accurate account of the medical history and/or it is the most detailed and reliable depiction of your medical condition. While some evidence supports your claim, we found other medical evidence more persuasive because it is supported by your relevant military And/or personal history. The VA medical opinion found no link between your diagnosed medical condition and military service. You submitted lay evidence that your claimed disability is 7 -=-r- of 10 Related to events or treatment in service. We have determined that the service treatment records and post service evidence contradict your statement(s) of a connection between your service and your claimed condition, and find the other evidence is more credible when considered in light of all the evidence. November 1993 service entrance examination shows a history of substance abuse before service. Service records show you were recognized for outstanding performance in December 1994. In January 1995 you were.promoted. Your enrollment in counseling is noted as command directed in August 1995. Discharge action was initiated in January 1996. March 1996 service separation examination shows no complaints of or diagnosis of the record from November 1993 to May 1996. You have provided statements in August 2014 and August 2015, regarding you’re claimed in­ service event. The time frame you identified is not consistent with the timing of the onset of the substance abuse counseling. The time line indicates onset over one year after your release from active duty. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. InJanuary 2005 you are diagnosed with bipolar disorder. The correspondence frodocumenting his recollection of the history has been reviewed. Because we were able to identify a marker in your service treatment reports you were scheduled for a VA compensation examination which was conducted in July 2015. The examiner indicated you do not have a diagnosis of posttraumatic stress disorder. The examiner did not diagnose posttraumatic stress disorder. 6. Service connection for anxiety disorder. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for anxiety disorder is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no 3lr 8 of 10 Continuity of symptoms from service to the present. The VA medical opinion found no link between your diagnosed medical condition and military service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The VA medical opinion found no link between your diagnosed medical condition and military service. November 1993 service entrance examination shows a history of substance abuse before service. Service records show you were recognized for outstanding performance in December 1994. In January 1995 you were promoted. Your enrollment in counseling is noted as command directed in August 1995. Discharge action was initiated in January 1996. March 1996 service separation examination shows no complaints of or diagnosis of the record from November 1993 to May 1996. You have provided statements in August 2014 and August 2015, regarding your claimed in­ service event. The time frame you identified is not consistent with the timing of the onset of the substance abuse counseling. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. In January 2005 you are diagnosed with bipolar disorder. The correspondence from documenting his recollection of the history has been reviewed. Because we were able to identify a marker in your service treatment reports you were scheduled for a VA compensation examination which was conducted in July 2015. The examiner diagnosed major depressive disorder and other specified anxiety disorder. The examiner indicated it is at least as likely as not the stressor occurred. However the examiner indicated The series of experiences you found to be distressing, you reported antagonistic harassment by superiors related to alcohol rehabilitation contributed to his distress. The examiner indicated it cannot be said with confidence that his depression or anxieties are solely attributed to the claimed in service event. Your depressive symptoms are reported to be related to significant negative views of self and guilt/shame over past alcohol abuse and its sequelae including domestic violence, Dills, impact on his military career, and current alienation from wife and child. 7. Service connection for bipolar disorder. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. 9 of 10 Service connection for bipolar disorder is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. Although, some evidence supports your claim, we found other medical evidence more persuasive because it is supported by an accurate account of the medical history and/or it is the most detailed and reliable depiction of your medical condition. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. In January 2005 you are diagnosed with bipolar disorder. 8. Service connection for depression to include alcohol abuse. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for depression, dysthmic disorder to include alcohol abuse is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The VA medical opinion found no link between your diagnosed medical condition and military service. November 1993 service entrance examination shows a history of substance abuse before service. Service records show you were recognized for outstanding performance in December 1994. In January 1995 you were promoted. Your enrollment in counseling is noted as command directed in August 1995. Discharge action was initiated in January 1996. March 1996 service separation examination shows no complaints of or diagnosis of the record from November 1993 to May 1996. You have provided statements in August 2014 and August 2015, regarding you’re claimed in­ service event. The time frame you identified is not consistent with the timing of the onset of the substance abuse counseling. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. InJanuary 2005 you are diagnosed with bipolar disorder. JASON SIPES 552 35 1079 10 of 1O The correspondence fro, documenting his recollection of the history has been reviewed. Because we were able to identify a marker in your service treatment reports you were scheduled for a VA compensation examination which was conducted in July 2015. The examiner diagnosed major depressive disorder and other specified anxiety disorder. The examiner indicated it is at least as likely as not the" stressor occurred. However the examiner indicated The series of experiences you found to be distressing, you reported antagonistic harassment by superiors related to alcohol rehabilitation contributed to his distress. The examiner indicated it cannot be said with confidence that his depression or anxieties are solely attributed to the claimed inservice event. Your depressive symptoms are reported to be related to significant negative views of self and guilt/shame over past alcohol abuse and its sequelae including domestic violence, Dills, impact on his military career, and current alienation from wife and child. REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our web site, www.va.gov.
  10. Jaydog

    Is this a nexus statement

    Thank you for the info. I will do that if thing come back bad again. I thought that they stated while" it is as least likely than not MST occurred" I read it as they say there is a 50% chance or greater that it happened. this stuff is crazy ,,,, everything hands on 1 word
  11. Jaydog

    Is this a nexus statement

    I am going to, but I submitted the documentation that I received from my DR. counteracting what they said in the exam. I just received a Paper from the VA asking if i wish to do a DRO Review or the traditional way. I have Been sending N & M evidence since it was denied. I just need to be patient to see what happens. I guess the hardest thing is having to relive all this shit over and over again and every time I cant function right for a few months. Maybe they just don't believe me, but why would I make something up like that.
  12. Jaydog

    Is this a nexus statement

    I discharged In 1996 and I did not start getting treatment until about 2 years ago because i did not disclose until my world was falling apart. I just don't understand why my DR. notes would be so different that my C & P exam. Its like they didn't even read the notes and they just went off of the exam and thats it
  13. Jaydog

    Is this a nexus statement

    This was the The c & p Exam notes. The previous were notes from my doctor at the VA. LOCAL TITLE: C&P PTSD STANDARD TITLE: MENTAL HEALTH C & P EXAMINATION CONSULT DATE OF NOTE: JUL 08, 2015@10:00 ENTRY DATE: JUL 29, 2015@18:07:05 AUTHOR: xxxxxxxxx EXP COSIGNER: URGENCY: STATUS: COMPLETED Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only * Name of patient/Veteran: xxxxxxx. SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? CONFIDENTIAL Page 5 of 54 [ ] Yes [X] No If no diagnosis of PTSD, check all that apply: [X] Veteran's symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria [X] Veteran has another Mental Disorder diagnosis. Continue to complete this Questionnaire and/or the Eating Disorder Questionnaire: 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: Major Depressive Disorder, Recurrent, Moderate ICD code: 292.32 Comments, if any: Although Veteran has been treated for Bipolar II disorder, his long hours of work are more conceputalized as avoidance rather than hyperproductivity during those hours at work. Veteran does express chronic irritability toward self and others. He denied other hypomanic behaviors that met criteria for Bipolar II disorder at the present time. Mental Disorder Diagnosis #2: Other Specified Anxiety Disorder ICD code: 300.09 Comments, if any: Subthreshold for features of Social Anxiety Disorder and Other Stressor Related Disorder. Please see "remarks" section below for further detail. b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): N/A 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [X] Yes [ ] No [ ] Not applicable (N/A) If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: Pervasive feelings of shame, negative view of self, passive suicidal ideation without intent, anhedonia, isolation, anergia, absent libido are more accounted for by Major Depressive Disorder. CONFIDENTIAL Avoidance of social contact and relationships were reportedly related to negative views of self, and negative self-appraisal. Anxiety symptoms were reportedly largely related to interpersonal relationships. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [X] No [ ] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes [ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes [X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: CONFIDENTIAL If no, check all records reviewed: [X] Military service treatment records [X] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [X] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [X] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: b. Was pertinent information from collateral sources reviewed? [ ] Yes [X] No 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): was born and raised in northern California, although relocated frequently as his father served in the U.S. Coast Guard. He is the 3rd of 2 brothers and 2 sisters and grew up in an intact family. Veteran denied social or behavioral problems during development, was social and made friends, and denied any history of childhood physical, sexual, or emotional abuse or any exposure to violence in the home. He enlisted in the military at age 18, serving from 1994-1996 when he was discharged due to failed alcohol rehabilitation; discharge status was honorable. xxxxxxxxx reported continued problems related to alcohol use and worked sporadic jobs after discharge. In 2005, he married his 1st wife and had two children who are now 11 and 10 years old. He and ex-wife divorced in 2006, and he last had any contact with his children approximately 1.5 years ago. He married again in 2011 and has 1 child age 3 y/o. He and his wife moved to xxxxxxx approximately 2 years ago for a job transfer for him to manage a dealership in xxxxx. He reported challenges with his wife, as he stated being emotionally shut down with her, about which he feels very guilty. He denied any intimate partner violence in his current marriage. b. Relevant Occupational and Educational history (pre-military, military, and post-military): CONFIDENTIAL xxxxxx completed high school and attended some college. While in the military, he worked as a mechanic and after discharge, worked in various jobs. Most recently he has been working as a sales manager at a car dealership in xxxxxxx, and stated that he works approximately 13 hours per day, 6 days a week, "to avoid going home." He reported feeling that his work provides a place for him to focus on tasks, though he acknowledged that it is not service of productivity as much as it serves his avoidance. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): xxxxxxx denied any mental health treatment prior to the military, although VA progress notes indicate that he reported onset of depressive symptoms at age 13 (see notes MH-Medication Management by xxxxxxxxx, MD on 5/1/08 and MH Biopsychosocial signed by J xxxxx xxxxxxxx, LCSW on 6/26/08). During the military, after his DUI and continued alcohol use, he reported to be referred to an Alcohol and Drug Program "for a few weeks" that included some group and individual sessions, though he reported not receiving much benefit. After the military, xxxxxxxx was hospitalized once in 2005 for suicide attempt by drug overdose and multiple times in 2006 for suicidal ideation in the context of alcohol use. He was treated in the community at xxxxx xxxxxxxxxxxx CDDP and outpatient treatment. VA medical records indicate sporadic and minimal engagement, first presenting to VANCHCS in 1999 (2 visits), 2003 (1 visit); he engaged in medication management visits 2008-2013 for the treatment of depression by xxxxxxxx at VANCHCS. He relocated to xxxxxxx in 2013 and started being treated by xxxxxxxxxxxxxxx, NP on 10/16/2013 for bipolar II disorder. His current psychiatric medication regimen includes quetiapine 50 mg, gabapentin 100 mg, sertraline 100 mg, and buspar 5 mg. On 8/6/2014, he disclosed to xxxxxxx regarding an incident during the military in 1995 when he was sleeping after a party and was fondled by a man to which he attributes his current distress, and his treatment was adjusted to include PTSD 2/2 MST. This disclosure precipitated his submitted statement for service connection for PTSD due to MST dated 8/21/2014, after 1st denial of claim for depression/anxiety on 8/23/2013 and his notice of disagreement on 9/10/2013. He attended a screening and 1 group appointment for men with MST support, but has not received psychotherapy for mental health problems since the mid-1990s at Kaiser when he was being treated for alcohol abuse and attending AA. He reported to continue to be abstinent from alcohol d. Relevant Legal and Behavioral history (pre-military, military, and CONFIDENTIAL post-military): Prior to the military, Veteran went to juvenile hall for being drunk in public. During the military, Veteran denied any demotions or Article 15s. Veteran was arrested in 1995 for domestic violence against his wife. He denied current problems with behavioral violence or legal issues. e. Relevant Substance abuse history (pre-military, military, and post-military): Mr. Sipes reported use of alcohol 1x when 15 y/o and was arrested for being drunk in public. He denied drinking again until he was in the service and began drinking heaviily while in the service. He reported having one "wet reckless" detainment as he was driving wet but under the BAC limit, and received 1 DUI in 1996. He reported drinking heavily "off and on" from 1996 - 2008. He reported attending AA and has a sponsor; last drink was reportedly July 15, 2008. He reported being in contact with his sponsor by phone. He denied current use of nicotine, marijuana, cocaine, opiates, hallucinogens or other illicit substances. f. Other, if any: No response provided. 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: reported that in 1995, he and a group of friends were in the barracks after a party when he was fondled while asleep by a man behind him. He reported pushing the person away when he realized it was a man, which discontinued it for the rest of the night. The next morning, he reported to threaten to kill the man if he came near him or tried to touch him again. He also reported antagonism by his superiors in response to his problems with alcohol abuse. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [ ] Yes [X] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No CONFIDENTIAL Is the stressor related to personal assault, e.g. military sexual trauma? [X] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. It is at least as likely as not that the stressor occurred. Veteran attributes increase in quantity and frequency of drinking and disturbed self-image after this incident, although that is unclear, as he reportedly had been drinking even prior to this incident. Veteran stated in his statement of disagreement with denial of claim for depression/anxiety on 9/10/2013: "I will not say it was one single event that happened during my time in service. It was a series of experiences that happened during my service... I still have a very hard time when ever I hear helicopters and smell diesel fuel exhaust." When queried in the exam interview about the "series of experiences" that he found to be distressing, he reported that antagonistic harassment by superiors related to alcohol rehabilitation contributed to his distress. The intrusive reminders of diesel exhaust and helicopters are not consistent with the MST and the experience of antagonism by his superiors do not meet criterion A for PTSD. Clinical symptoms appear to be more consistent with major depressive disorder with strong anxiety features contributing to avoidance. Please see "Remarks" below for further results from the examination. 4. PTSD Diagnostic Criteria --------------------------- No response provided 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Difficulty in establishing and maintaining effective work and social relationships [X] Suicidal ideation 6. Behavioral Observations -------------------------- Appearance and Behavior: A&Ox4, appeared stated age, casually CONFIDENTIAL dressed/groomed, avoidant eye contact, clammy palms consistent with presentation of anxiety, cooperative with interview, polite, did not require redirection. Motor Activity: No PMA/PMR, no abnormal movements Speech: regular rate and rhythm, normal prosody and tone Mood: Anxious, dysphoric Affect: congruent with content, restricted range of affect Thought Process: linear, goal oriented Thought Content: the patient reported passive suicidal/homicidal ideation, but denies intent. No evidence of psychosis, mania, or other formal thought disorder. Perception: No evidence of auditory/visual hallucinations. Insight/Judgment: limited/limited; intact/intact 7. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 8. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 9. Remarks, (including any testing results) if any -------------------------------------------------- xxxxxxxxx was examined via clinical interview and the gold-standard Clinician-Administered PTSD Scale (CAPS-5), and self-report measures via Minnesota Multiphasic Personality Inventory (2nd edition; MMPI-II), Millon Clinical Multiaxial Inventory (3rd edition; MCMI-III), Beck Depression Inventory (2nd edition; BDI-II), Alcohol Use Disorders Identification Test (AUDIT), and Life Events Checklist (LEC). In addition to this examiner, with the patient's verbal consent, another licensed psychologist observed the examination for disability examination training purposes. On the LEC, Veteran endorsed witnessing a friend accidentally shooting himself in the leg and taking him to the hospital, and experiencing the sexual molestation during the military by another man. On the CAPS-5, xxxx endorsed physical sensations associated with anxiety, feelings of hopelessness and sadness, feelings of alienation, self-blame, shame, anhedonia, irritability, guardedness, and exaggerated startle response. He denied other symptoms of PTSD, or other symptoms could not be determined as directly associated with the military sexual molestation incident. His symptoms were most consistent with Major Depressive Disorder (BDI-II = CONFIDENTIAL 55) and Other Specified Anxiety Disorder (subthreshold for Social Anxiety Disorder and Other Stressor-Related Disorder). Consistent with self-report during clinical interview, Veteran's anxiety, disturbed and negative self-image, guilt, irritability, and poor mood contribute to avoiding interaction with family at home (thus leading him to be at work for 13 hrs/day, 6 days/week, but not necessarily reflecting hyperproductivity at work). His score on the AUDIT was 4, indicating no current alcohol use disorder. xxxxxxxxxxxx' results on the MMPI-II reflected a response pattern of overendorsing distress, leading to an invalid profile that should not be interpreted (MMPI-II F = 104; F-K = 17; FBS = 90). Similarly, his responses on the MCMI-III also reflected a pattern of responses that overly portrayed himself in a negative light(MCMI-III X BR = 100; Z BR = 98). Due to these response patterns, dissimulation and/or characterological factors could not be ruled out at the present time. Thus, while it is at least as likely as not that the MST occurred, Veteran's responses and report of his symptoms are not consistent with a PTSD diagnosis and are better accounted for by Major Depressive Disorder and Other Specified Anxiety Disorder (subthreshold for Social Anxiety Disorder and Other Stressor-Related Disorder). He does appear to have difficulty with social functioning apart from his current wife and child, and he reported avoidance of even those intimate relationships. He denied current impaired occupational functioning, though did report often expressing irritation with work colleagues. Veteran's depressive symptoms were reported to be related to significant negative views of self and guilt/shame over his past alcohol abuse and its sequelae including domestic violence, DUIs, impact on his military career, and current alienation from wife and child. It cannot be said with confidence that his depression or anxiety are solely attributed to the MST. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application.
  14. Jaydog

    Is this a nexus statement

    These are just VA Notes. My exam notes are in another threat here.
  15. Jaydog

    Is this a nexus statement

    HerE DOT9. THIS IS THE CURRENT MEDICAL OPINION I HAVE AND THE CONTEXT OF WHAT WAS SAID IN THE NOTES LOCAL TITLE: PSYCHIATRY/ MENTAL HEALTH STANDARD TITLE: PSYCHIATRY NOTE DATE OF NOTE: OCT 21, 2015@08:57 ENTRY DATE: OCT 21, 2015@08:58:02 AUTHOR: M EXP COSIGNER: URGENCY: STATUS: COMPLETED Anaheim CBOC Follow-Up Pt last seen for f/u 8/20/15 w/ plan: Cont present meds w/ only increasing buspar 15mg TID per Pt preference. S/O: Pt reports no apprec benefit from buspar as conts chronically anxious at 5- 10/10max, both freeform and in public, w/ recent bouts of panic 2-3x/wk at unfamiliar environment as trigger, w/ agitation and verbal shortness that conts from a few hrs to throughout rest of day until he can go to sleep. He takes brief walks at work as effort to alleviate anxiety w/ min benefit, and admits he rarely takes full lunch breaks, though does tend to snack at his desk for comfort. He admits being fairly chronically irritable, w/ both verbal sniping and easily agitated, w/ QW rapid onset rage w/ verbal abuse and yelling. He reports trying to press self against tendency of being fairly avoidant at home to avoid rage, and has greater frustration w/ inability to create structure. He reports still recurrent bouts of sadness <3 days, with <3days between, more when less structure on days off, still some chronic anhedonia and amotivation w/ procrastination to initiate, w/ variable task follow throughocc worthlessness, min hopeless/helplessness. He reports same chronic apathy, and still tendency toward social isolation besides wife and child. He reports still great difficulty feeling empathy for others. He denies any SI/HI/PI/A/VH/del. He reports most eves neg ruminations re: current stressors, regrets in response to trauma, and intrusive traumatic memories, to some racing, tangential thoughts w/ occ impulsivity/task compulsivity at work, hyperproductivity, occ hyperactivity He has been unable to go back to MST group d/t work, but was referred and finally did go to Corona Vet Ctr and set up appt for next wk which was very difficult for him. Pt reports still wish for avoidance of the issue, but understanding that the lack of recovery is impededing his QOL. He went to C&P exam which denied his MST and notes indicate that reviewer did not read or disregarded Tx notes that included documentation of PTSD s/s and Dx. Initial eval did not include PTSD because Pt did not yet disclose MST and sequelae. He reports chronic s/s of PTSD re: MST have been worse since C&P: hypervigilance of both recurrence of assualt and others finding out the history, constant pervasive shame, intrusive memories of traumatic events, avoidance of related stimuli---specifically smells, + intolerance of loud noises or crowds, and foreshortening; some hyperstartle, emotional numbing. Reports some recent bizarre dreams>nightmares, some blending of traumatic and mundane content Mental Status Exam: neat grooming, business suit. Pt affect full range, mood calm, demeanor cooperative. EC direct, speech nl rate/rhythm, TP: org'd and Impression: 39 yo man w/ PTSD, chronic, mod-severe r/t MST, and h/o BAD II and ETOH dependence in full/sustained remission, more fully stable w/ above meds. Sleep/energy likely exac'd by untreated OSA.
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