awgv001

Yes, this is surprising to me as well, I was first given an exam via psych to see if I had the right PTSD numbers, then saw psychiatrist for the meds, and an LCSW for regular counseling. After that first evaluation it became a part of my list, and had treated me ever since...I would use myhealth.gov to send a secure message to them in regard to this, and what you're trying to do, and what issues you have faced so they can get their end straightened out.

@broncovet if you remember some of my other posts, you would find that this scenario is exactly what I'm currently dealing with. What are the best ways to combat this? I'm already in appeals up to the BVA level now. I have a referral for a new neuro, I'm wondering how much I can/should get done with these appointments, if permitted (like the standard workup, but also perhaps an IMO, or a DBQ?) idk if VA permits them for these things, or if that I have to pay out of pocket for the "extra work" if they will even approach these at all. Perhaps @Richard1954 knows more on this subject? Current arsenal is 2 statements (aside from my own), 2 Nexus statements (they tossed the first one in favor of a doctor who didn't provide TBI diagnosis, the 2nd one elaborates quite well), and chronic illness. What more can I do? They seem to be developing to deny and shutting me down on all fronts!!!

Forgive me, what is your question here? I'm not sure I understand this...are you saying that they changed your diagnosis for PTSD to "OTSRD" after 16 years because of a bad C&P?? I would start with an amendment, and then sending the amendment to the DRO...but you can go about it however you like. (Information is provided on your RO website under "Request your medical records" ) Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients. We can assist you with the following - access to your medical records obtaining copies of your medical records requests to amend your medical records completion of forms for benefits, insurance, and other reasons You could file an amendment for the C&P and attempt to get them to correct the portions you believe are incorrect, which has helped me in the past. Also, alternatively, you can always get/request a second opinion, or remark the it was an inadequate exam (list reasons for inadequacy). I have a re-exam coming up myself for PTSD (5 years diagnosed). If you have your historical exams, you could also use those to discuss "what changed" if anything between the service connection, any re-exams, and the new "bad" exam.

@Berta just posted a ton of valid and valuable information there. Bud, I know it's stressful, at many points I have been overwhelmed by the process, I learned to channel the stress into energy resolving problems and gathering information about all types of claims. Gotta do something with my time besides whittle sticks anyways, lol! You don't know if you don't try, if it helps, write down the details with major points of discussion when you seek another OSA doc, cause I get tongue tied a lot at Dr's appointments, like for the question ~~~ "How would you describe your memory loss" My Answer - Blank stare like baby deer in headlights. "uhhh" Give it a shot, if you get rejected, don't take it personally, find an (appropriate) doc that will write you an IMO! And -- in conjunction with what @broncovet said, for your "in service event" - could the OSA be linked to any other contention you already are SC'd for? Though it may not be necessary - An avenue would be perhaps to contact that person you got a statement from originally, and ask them if they keep in contact with another buddy that was around at that time too. You can absolutely use multiple statements for the same claim/injury/event. The more witnesses the better, as long as the details don't get "spider-webbed". Always proofread them before submission. Example - When I requested a statement from one person, I shared a copy of the statement from the previous individual, because sometimes reading over details from another person can "re-awaken" old corridors of memory. I did this continuously until something finally caught with my old peers. Edit - I also wanted to put something into context that hopefully puts more spotlight on "odd scenarios" that can be encountered. I hope you find this story encouraging, despite the time it's taken me to "figure it out". It's my fault my claim has dragged on as long as it has because I wasn't aware of all of the details and items needed. Navigating through VA claims with compounded problems of concentration, memory loss, and comprehension is the main reason why my claim had to drag on this long, but it also part of the reason it will warrant a "higher" rating, once fairly adjudicated and in finality - Service connection.. TLDR (story) - If I had not continued to pursue more answers and evidence my claim would be dead in the water today. Evidence can spring up at almost anytime and it's up to us to be able to recognize if/how/what evidence is useful. Don't let one adversarial doctor jack up your entire claim. Storytime - As you may know, I have been repeatedly denied for TBI in my claims. It's been at least a decade since the first injury occurred with more of the same injuries occurring over the next year or so following. That being said, when I contacted my peers, many of them did not recall the injuries I had sustained, or the details as to my observed behavior - mainly because it wasn't long after I developed significant nerve damage, my unit had pushed me out to a different one. It was from that junction, that it became slightly more difficult to stay in contact, as they had to carry on without me. Thus begins a conundrum wrapped in an Enigma. Now, compounded by years of having moved on, the gap is far and wide, and more details become lost in the ebb of time. It was until this year that I was able to find and contact one person who recalled the injuries, and was able to provide details (because you can't report your own blackouts, other than when you come "back to") Further problems evolved because of the first neuro I saw, he wrote some details, but missed the most important ones. Fast forward another 3 years, and I mention something to my psych, who then puts me through referral to neuro again. This time I get a diagnosis, and an evaluation w/ Nexus, and a buddy statement, but it's not enough, claim gets struck down even with all the caluza elements. Appealed. Fast forward another 4 years, 2 buddy statements, 2 nexus w/IMO, and chronic diagnosis, and now I'm once again referred back out to neuro - this time to do a "more thorough" workup, because part of the denial involved "inconclusive diagnosis" - So now I just have to make sure I have a second opinion to utilize before I reach the BVA...Easy Peasy right? (that's a joke) ---so yes, around a decade after the injuries occurred, it was imperative that I went to go get a second opinion, request a DBQ (because I never had one for TBI, and was never issued a C&P either), and write down any major points of my denial to further discuss with the neuro's I go see.

I'll take a crack at this ~~~ So, I had to rely on buddy statements a LOT myself due to similar issues of toughing it out and not seeing Doc when I should have. I have had claims struck down for the same or similar reasons during re-open, and one DRO review still denied and im sitting in appeals (NOD my claim up to BVA before one year) What does your letter state in regard to presumption??? You mention the one-year thing, so I assume that's what you mean about your diagnosis and such. CUE is not valid until a claim is finalized (denied by VARO, and/or BVA when appealing higher up to the CVAC) When Berta said you needed a direct link, yes, this meant a Nexus. I have a general Nexus form that can be used for this I have found to be extremely helpful.

I concur with @pete992 on this one, I myself have only ever had VA doctors write IMO's, fill out DBQ's etc. If your OSA dr won't do it, you could probably speak to your PCP about your situation (MYHEALTH.GOV SECURED MESSAGING IS GREAT FOR RELAYING INFO BACK AND FORTH!) and what you're trying to do, and that you want to request an alternative OSA to review your info, and write an opinion It's my personal opinion that a veteran shouldn't have to seek outside avenues for something that can/is provided by the VA and alleviates out of pocket expenses for your service issues (connected or pending connection)

I wish it were that simple @El Train however, I never had a C&P to begin with for TBI - only referral (2016) to VA neuro who evaluated and diagnosed, and then the DRO rater shot it down as an "inconclusive diagnosis" but that's no longer important while my claim awaits the BVA as I will most likely get this new referral done and get further evaluation to help solidify my claim. I have evidence with a conclusive diagnosis, and a nexus for my back problems related to the TBI as well, or at least linked to service. The biggest hurdle has just been getting TBI SC'd, and no telling how long my wait will be for a hearing at BVA (April 2019 docket, does not qualify for expediting) so nearly at a year now. No big deal to me, like I said, I'm 100% certain that if they do their job right at the BVA there will be no issue moving forward. I'll be at the 100% mark, and potentially SMC (s) and/or CRSC as a future endeavor on dealing with the DoD side of things. Until then, we wait in line! Has anyone ever had a back-dated diagnosis? I guess what I'm looking for is the diagnosis to be "when the injury occurred" since it is impact/trauma related, after all, that is precisely when the injury manifests, but not necessarily the symptoms. I think the new neuro referral may be able to shed more light on this...thankfully the M21-1 and correlation to secondary disabilities is a thing, or I believe there would be no chance to have my claim backdated as far as I believe it should go (When I claimed migraines, tinnitus, and visual changes that I was separated for) I'll have to bring that up at the appointment. Unless something changes rather quickly I think I'll have it done before my hearing, and be able to get copies etc to come charging in with more substantial evidence.

Yeah @El Train, and it makes no sense sometimes to me how I have been denied repeatedly, even though I have a majority of the "regular" symptoms, and in service event/trauma...(as well as all other caluza elements) they rubber stamped a denial saying "You did not have a conclusive diagnosis of TBI"...Bull hockey!! Again, I'm just glad to be getting another referral to a new neuro---something so hopefully I have another shot at a better explanation and a more detailed exam --- I'd be more than happy to attend a C&P exam if they would finally issue one for me... Interestingly enough, the workups for TBI that I did sound nothing like what @Richard1954 has had, so now I'm really confused as to what they have had me doing this whole time. I had CT/MRI - and a couple of questionnaires, and a test of touching fingertips to my nose, but no memory tests, or pictures or anything like that....wth???? When did I join the circus????

ohhhh, i get it now, i was the one confused about what they were trying to tell you. *facepalm*

@blahsaysme2u I just don't like letting a VSO tell me what is or isn't possible, and pursue the truth myslf.

Why do some VSO's feel the need to do this >_< who's side are they on??? Some of them only seem to move paperwork and complain - while others fight tooth and nail for vets up at the BVA...sorry to hear about your experience My VSO kept telling me I should just file for IU and move on, and the usual "be happy with what you have, don't rock the boat" NONSENSE!!! If I had listened I would still be at 40%, jobless, and homeless. They never approached me with IU until I got ptsd connected myself.

Plenty of weight, that's nearly the best thing you can do I believe, and to go hand in hand with statements (spouse or other) would be pretty hard to argue around.

Thanks Richard! Yeah, I just got another referral back out to neuro - thanks to my pcp - idk when yet, but anything that develops from this round will help bolster my claim i'm sure, cause otherwise I only have the workups done in 2016 to go with, and for whatever reason, the VA wrote in the denial that it was an "inconclusive diagnosis"....I asked the doctor about it and showed him the statement my (2016) neuro wrote, and he was just like....."It's spelled out right here" "Tbi due to trauma in service" -- so none of us know as to what the va is talking about, but its a claim sitting at the bva anyways so I'm not too concerned...once it gets up to that level with the information I have, I hope someone calls the rater and asks them what the hell they were thinking when they wrote their own opinion in the denial based on an older letter, and threw out the diagnosis from my most recent neuro without at LEAST giving benefit of the doubt since one neuro says yes, and the other says no. ---Note on this - it wasn't "actually" a "NO tbi" from the first neuro - what happened was that he wasn't actually evaluating me for a TBI, but for the migraines...so he recorded the episode of syncope, but not the fall. That one slip of details has cost me 8 years of headaches so far, at least until I reach bva. That being said, when I did the workups with the neuro, they never had me do memory tests or anything of the sort, they just filled out an evaluation sheet and asked me several questions, and prescribed a med for my migraines that "takes the edge off" unlike standard ibuprofen. I still have not had a C&P for TBI even since those workups over 4 years ago now, and after turning in statements and other evidence...they are planning on giving me a new MRI/CT.... I don't have the active duty records - all I have in regard to that is several witness statements from people who were serving with me and saw it happen ---- except for the things they consider secondary to the tbi, as I did not report the head trauma, but came out with tinnitus, visual changes (possibly diplopia), severe migraines, and memory loss. Not sure how to tie those in, because when speaking to my doctor he was like "migraines and tinnitus have a wide variety of sources they could arise from" - in a way, I feel like he was helping me prepare my future arguments....I'm not a doctor, so it's up to them to opine that these other contentions are "more likely than not" secondary to the tbi in the first place....yikes. I forget names, I recently picked up a high school yearbook, and there's people in there I can't remember for the life of me, birthdays, appointments....I totally understand, if I didn't keep a little pocket book or small diary, I would get lost on what I was doing today. I've made it a pretty regular routine of combing through Hadit in the mornings and it seems to have stuck over the years, and I hope that it has helped others with some of my guidance...I know it has certainly helped me! (SC'd for PTSD thanks to hadit!) It's been a while since my last "success" but the ball has been rolling on some claims for years now. Again, thanks for the feedback @Richard1954 - I wonder if a veteran can request a C&P for tbi somehow??? Maybe I just haven't spoken to the right person yet.

Yes, it may be service connected, but a DBQ helps show BEYOND the back (Item 1B) and also has a request box for the examiner that lets them link other issues to your back troubles. Specifically, the sciatica. My suggestion is to open the dbq and read it top to bottom, you'll see. The dbq would be considered N&M evidence and would reopen your claim.

Coming from a Spiney with Sciatica ( I feel for you ), get the DBQ for thoracolumbar (lower back problem, right???)This one is for Spine(lower) https://www.vba.va.gov/pubs/forms/VBA-21-0960M-14-ARE.pdf There ya go, make the soonest appt with your PCP to get this filled out, be sure to discuss symptoms, and also do a Hip DBQ too....make as many appts as needed to get these doc'd and then utilize them as your weapons of evidence. This one is for Hip conditions as you will have at least painful motion with sciatica through the hip --- https://www.vba.va.gov/pubs/forms/VBA-21-0960M-8-ARE.pdf I found that sticky notes are a veterans best friend when it comes to DBQ's - to arrange dates, write details (cause i forget at least 70% of my entire day), and assist the doctor so they spend less time searching, and more focus on me and the DBQ. ---- If your VA doctor refuses to do one, leave, and request another (VA)doctor who will...I have so many people telling me that their doc won't fill out DBQ's I wanna have them print out an article to carry with them...as to what the "professional reasons" are.....I got no clue, maybe if they felt they were being forced to lie or something. Didn't find much when googling "professional reasons to reject a medical exam" either. Q: Who is authorized to complete a DBQ? A: Providers with active medical licenses must sign and attest to a medical condition on completed DBQs. The DBQ can be completed either by: Veterans' private treatment providers, or Veterans Health Administration (VHA) clinicians. Some providers may decline for professional reasons Some specialty disciplines may decline for professional reasons

Had this happen, even with evidence of in service event and treatment for all of 2016 -- still came back denied, and with no C&P either. --Now I'm armed with all caluza elements, and going in this week for DBQ's! That'll show 'em.

I have a re-exam coming up for the same things (except migraines, not TBI yet) - I have been SC'd for 5+ years for ptsd and several more for the migraines, and yes, the VA considers these ailments periodically because of the varying treatment options/and us finding our own way to getting better... That being said, many of us don't get better through the treatments, and become unstable without regular medication....and just because you are "ok" with the meds doesn't mean that the ailments don't exist anymore, or having changing severity...If you have been receiving treatment regularly, then you have fairly undeniable proof that you're trying....and that most likely your ratings won't change...this is ALSO an opportunity to show the VA that symptoms have potentially worsened and can grant you an increased rating without you having to file for one, which is my approach to these exams. I'm actually happy to be going to mine so that I have the best opportunity to clarify on my contentions having learned more about the CFR and ratings criteria so that I can explain my case better than just "I could be better or worse" Try not to take is as a personal shot like the VA is trying to attack you. Not everything with them is doom and gloom. Expect them to re-evaluate you until you get an award letter stating "there will be no future exams" for the contentions you are sent in for.

Bwuk, bwuk bwuk bwuk, ...bwuk bwuk Yes, I have had several claims over the years. It could be a profound amount of different things that we will never get to see! It could beeee-----an error of the IT department, a decision by a reviewer who wanted a last minute glance before getting pulled into the big boss's office for a scolding on granting so many claims it could be, it could be......You're gonna have to wait and see is the only thing left to do, unless you WANT to submit new and material evidence now and slam your claim back into snail mode while theyrepopulate the info of your claim, scour through it, and assess the new information and how it contrasts with the latter. Bwuk.

@broncovet I submitted at least 1 of each of the Caluza elements back in 2015 when I filed a "New" claim for TBI so it doesn't quite fit the bill for your (#2) I suppose....not sure how its handled since it has been adjudicated once, however it is still open and in appeals now, but no matter, and it came back with them saying it was an "inconclusive diagnosis" at the last point of denial --- though we had done second level TBI evaluations as well as a separate statement from my neuro himself that says quote "Based on my initial evaluation, and his medical records, I am treating him for symptoms related to a traumatic brain injury resulting from trauma that occurred during his military service. This diagnosis and my treatments are in each of my clinical notes for your review." Diagnosis, check, IMO, check.....I'm having a DBQ done on Tuesday for TBI with my PCP while my claim sits in appeals at the BVA..... OH - I can see that how the doctor wrote that could confuse a rater since his verbiage was "symptoms related to TBI" --- they just said...well, that's not specifically TBI. So the next doctor wrote - "I concur with the diagnosis of TBI caused by ...... he suffered on active duty." W/ subsequent chronic headaches as a consequence...it is my medical opinion that it is more likely than not that the current symptoms of tbi...are a direct consequence of the injury he sustained on active duty." So, if anything, I hope that the second doctor make it pretty bulletproof and straightforward.

I'm not a conspiracy theorist, but man, the site going down gave me a fright of a news release saying "This was an intended attack on the Hadit community, they know all of our proven methods to prevent paying out so we can attract more stakeholders...VA claims have been overly successful since its inception, and it must be stopped!!!...Now, where did I park my Rolls-Royce...*squeezes key fob overhead* --Whoops, I meant my Rolls-Royce, not my Lamborghini *digs in pocket for other key fob* -- Now down to Office Depot to get more paper shredders and matches.... Admit nothing, Deny everything, make counter-accusations.

Yes, the VA did not apply Duty to Assist, in my case, even with statements, nexus, diagnosis, I was never issued a C&P for my claims across a several year span and with re-opens and HLR. My plan is to utilize a DBQ I found for TBI specifically (though it wasn't found on the list of 70 DBQ's on the VA website, smh... On the DBQ I plan to request my PCP (He's a physiatrist) to backdate the diagnosis, and explain in detail how I was diagnosed (VA Neuro) back in 2016, however the manifestation of the injury precludes that diagnosis because of the related secondary symptoms and therefore should be guided by the date of the original claim for the SC'd Migraines. It's obviously complicated, but I believe that the DBQ would save me a potential remand at the BVA level, and grant me the best EED. (2013) See below for more details to this question. Thanks

Thanks for you input. When a claim is filed, a veteran may not have all of the information about their own contentions to properly file a claim, such as recognizing specific diseases or injuries. This is to help guide veterans who come through and what avenues they can approach to get a correct diagnosis, or discovery. ---yes, in theory the backlog would be reduced tremendously if everyone knew what to file, and when. However, a veteran seeking justice for their claims will have to be able to provide information that they should have benefit at a specific time for an unclaimed contention. It's not the veteran's fault for not having a medical understanding for their ailments, nor should they be punished for not claiming a specific contention by its medical name at the time they filed their claim. My point is, I was SC'd for migraines in 2013 when I should have been SC'd for TBI w/ secondaries as Migraines, along with tinnitus, and visual changes. The TBI was diagnosed years later, and links the Migraines to a TBI that was not yet SC'd. To further prove beyond a reasonable doubt that my claim for TBI should have been established at the same time my Migraines were SC'd I'm looking for any possible way to strengthen my claim, and for it to bear the best possible EED. How the relationship to causal injury is handled is wrote out in the M21-1. The effective date assigned for a secondary SC disability cannot be earlier than the effective date assigned for the causal or primary SC disability. When a claim for SC for a disability is pending and subsequent development of the claim reveals that the disability is caused by a disability that may be associated with service, the decision maker must investigate the possibility of SC for the unclaimed causal disability as well as SC on a secondary basis for the claimed disability. The duty to investigate SC for the causal disability as within scope of the claimed issue is prompted when the claimed disability is shown to be secondary to the unclaimed causal disability, and when the criteria under 38 CFR 3.159(c)(4) have been satisfied. If the causal or primary disability is, in fact, related to service, the pending claim reasonably encompasses a claim for benefits for the causal disability. The effective date of benefits for the causal disability is guided by the date of receipt of the claim for the secondary disability. Example: A Veteran claims SC for right leg pain and numbness. Development of the claim confirms a diagnosis of radiculopathy that is secondary to an unclaimed back injury. The back injury was sustained in service. Sufficient evidence to establish SC for the back disability is of record. Consider the unclaimed back disability within scope of the claimed radiculopathy and establish SC for both issues with an effective date assigned based on the date of receipt of the claim for SC for radiculopathy.

Welcome to Hadit! - Yes they can reduce you if there is medical proof that symptoms have improved (without medication)...However the VA is required to timely notify you of the changes so that you can act on them, and appeal if necessary.

How does an individual go about obtaining a backdated diagnosis - I'll give an example - Veteran is in service and reports secondary symptoms of a well known issue. The veteran is not a doctor, and doesn't recognize that these symptoms reflect upon a much bigger issue. They put in a claim for the secondary conditions, and are unchallenged for service connection, however, the causal injury/disease is ignored,undiscovered, or omitted for some reason or another. Everything points to the causal injury as being the "origin" of the secondary conditions. A diagnosis for the causal injury/disease finally happens, years after the veteran exits service, and now it's up to the veteran to make corrections and attempt to repair their claims history. There is information in regard to "causal relationships to SC'd secondaries and original injuries via ---- M21-1 III.iv.5.C.3.g. Correlation Between Effective Date for Primary and Secondary SC Disabilities Would it benefit the veteran to have an exam that reflects that the causal injury has a backdated diagnosis date, or something that shows that "the disease manifested on XXXX date, the day the injury etc. occurred" just to spell it out, creating a fairly damming case for EED's as well as proof of diagnosis, and cover all the "when's"?

--OH--edit, and also because there's not a DBQ for TBI that I found, or I'd do it that way too. There was one person I recently saw on the forums that got one even though the VA came back and said it wasn't warranted for them...? I mean, I'm awaiting a bva hearing right now, but since I have the nexus, event of injury (statements included), and the chronic diagnosis........ VA obviously failed me on "duty to assist" by never issuing one after the initial claim, re-open, DRO, and then now the appeal. Or.....just wait, cause the BVA should lay the smack-down on this claim once it hits the table. In essence, I'm desperately trying to prevent an unnecessary REMAND. I'm fortunate that I'm not suffering a financial crisis at the moment, but that could change overnight, thanks, Murphy's Law. Some other important TBI info I found here that falls within the timeline that I was evaluated, and remarks on the shoddy performance in the initial review/diagnosis etc. of TBI https://www.va.gov/oig/pubs/VAOIG-16-04558-249.pdf Included is basically the same form that was used and I posted details of above...I'll pop into my local office and have my PCP (physiatrist) fill it out. TBIdbq.pdf