Daav2000

My understanding is the VA is wrong to deny these claims, because the law does not require veterans to prove that a specific event or exposure happened in the Gulf War. So long as the veteran, (1) served in the Southwest Asia theater of operations, (2) has been diagnosed with IBS, (3) has IBS that has manifested to a degree of 10% or more prior to December 31, 2016 and (4) has IBS that is not due to a supervening event or due to willful misconduct; then service connection should be granted.

Hello, First time poster but I've been around a while. I've recently been denied a claim for IBS. I've included my information below. I feel they have made a CUE in processing my claim. Any thought on how I should move forward? I have diagnosis for IBS(presumptive) was in the Gulf War what else is needed? Thanks Intestinal Conditions (other than surgical or infectious), including irritable bowel syndrome, Crohn's disease, ulcerative colitis and diverticulitis Disability Benefits Questionnaire Name of patient/Veteran: Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS [X] Other (please identify other evidence reviewed): VistaWeb. 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with an intestinal condition (other than surgical or infectious)? [X] Yes [ ] No [X] Irritable bowel syndrome ICD code: XXXXX Date of diagnosis: 11/20/2017 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's intestinal condition (brief summary): Veteran has claimed irregular bowel patterns since service in The Gulf. Veteran reports no problems with his bowels until returning from service in The Gulf. Over the years, he reports developing a pattern of constipation alternating with diarrhea. He reports that if he takes medication for constipation, then he has diarrhea for weeks and admits he is glad for constipation. Veteran reports bloating with constipation and diarrhea. He denies seeing any blood in stools and there is no FH of colon cancer. Veteran denies any nausea or vomiting, or hemorrhoids. He denies any abnormal weight loss. Veteran does report frequent cramping and gas. He admits he is afraid not to ber in the restroom to pass gas as he has soiled himself at work and at home on several occasions. He reports his diarrhea is explosive and uncontrolled. Veteran denies any food that triggers his diarrhea or constipation and reports he eats "normal". He does have prescribed Miralax for his constipation. Veteran does see a Gastroenterologist through the VAMC. He has never had a colonoscopy. b. Is continuous medication required for control of the Veteran's intestinal condition? [X] Yes [ ] No If yes, list only those medications required for the intestinal condition: Miralax for constipation c. Has the Veteran had surgical treatment for an intestinal condition? [ ] Yes [X] No 3. Signs and symptoms --------------------- Does the Veteran have any signs or symptoms attributable to any non-surgical non-infectious intestinal conditions? [X] Yes [ ] No If yes, check all that apply: [X] Alternating diarrhea and constipation If checked, describe: Veteran reports more diarrhea than constipation (most days 5-6 loose stools)with occasional constipation that quickly turns back into diarrhea. [X] Abdominal distension If checked, describe: Veteran reports daily bloating and excessive gas. 4. Symptom episodes, attacks and exacerbations ---------------------------------------------- Does the Veteran have episodes of bowel disturbance with abdominal distress, or exacerbations or attacks of the intestinal condition? [X] Yes [ ] No If yes, indicate severity and frequency: (check all that apply) [X] Episodes of bowel disturbance with abdominal distress If checked, indicate frequency: [ ] Occasional episodes [ ] Frequent episodes [X] More or less constant abdominal distress 5. Weight loss -------------- Does the Veteran have weight loss attributable to an intestinal condition (other than surgical or infectious condition)? [ ] Yes [X] No 6. Malnutrition, complications and other general health effects --------------------------------------------------------------- Does the Veteran have malnutrition, serious complications or other general health effects attributable to the intestinal condition? [ ] Yes [X] No 7. Tumors and neoplasms ----------------------- a. Does the Veteran have a benign or malignant neoplasm or metastases related to any of the diagnoses in the Diagnosis section? [ ] Yes [X] No 8. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ----------------------------------------------------------------------------- a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? [X] Yes [ ] No If yes, describe (brief summary): On exam, Veteran has hyperactive bowel sounds with tender abdomen to palpation. b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No c. Comments, if any: 9. Diagnostic testing --------------------- a. Has laboratory testing been performed? [X] Yes [ ] No If yes, check all that apply: [X] CBC (if anemia due to any intestinal condition is suspected or present) Date of test: 11/19/2016 Hemoglobin: 14.3 Hematocrit: 42.5 White blood cell count: 9.13 Platelets: 246 [X] Other, specify: Ova and Parasites, Giardia, Culture Date of test: 01/05/2017 Results: Negative, Negative, No Salmonella, Shigella, Campylobacter, Shiga-toxin E. coli isolated b. Have imaging studies or diagnostic procedures been performed and are the results available? [ ] Yes [X] No c. Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No 10. Functional impact --------------------- Does the Veteran's intestinal condition impact his or her ability to work? [X] Yes [ ] No If yes, describe the impact of each of the Veteran's intestinal conditions, providing one or more examples: Veteran reports he would have difficulty with performing occupational tasks that would require him to work away from a rest room or that would not allow him to go to the rest room as needed. 11. Remarks, if any: -------------------- 10. Veteran reports he works at a desk in finance and reports he is allowed to go to the rest room as needed. **************************************************** VBMS, CPRS, VistaWeb were reviewed by this examiner for this claim. Veteran was given a diagnosis of IBS (Irritable Bowel Syndrome) 11/20/2017. There is specific etiology stated and there is no mention on the GI consultation notes of when the symptoms started or reference to him serving in The Gulf. Veteran give an account of bowel problems being present since returning from The Gulf in 1991. Veteran has only been seen by the VAMC providers since 2016 with no records discovered to support IBS symptoms being present since returning to the USA from The Gulf in 1991 (25 years later). This Veteran's claimed IBS is less likely than no due to his service in The Gulf. Rated Disabilities Table of Rated Disabilities Disability Rating Decision Related To Effective Date tinnitus 10% Service Connected 11/24/2016 Sensori-neural hearing loss Not Service Connected obstructive sleep apnea Not Service Connected Environmental Hazard in Gulf War chronic fatigue syndrome Not Service Connected Environmental Hazard in Gulf War esophageal stricture 0% Service Connected Burn Pit Exposure 01/25/2017 eosinophilic esophagitis by biopsy with GERD 10% Service Connected Burn Pit Exposure 01/25/2017 allergic rhinitis Not Service Connected Environmental Hazard in Gulf War headaches, unexplained chronic multi-symptom illness 10% Service Connected Environmental Hazard in Gulf War 11/24/2016 post traumatic stress disorder (also claimed as memory loss) 30% Service Connected PTSD - Combat 11/24/2016 erectile dysfunction 0% Service Connected 06/28/2017 fibromyalgia (to include joint and muscle pain) 40% Service Connected Environmental Hazard in Gulf War 07/09/2017 hypertension Not Service Connected Environmental Hazard in Gulf War irritable bowel syndrome Not Service Connected Environmental Hazard in Gulf War