IMEF-Gunny

b. The claimed condition, which clearly and unmistakably existed prior to service, was not aggravated beyond its natural progression by an in-service event, injury or illness. This statement of opinion by the Psychologist cannot possibly be clearly and unmistakably be proven as factual. When comparing the "Dr’s Impression" during boot camp, which was the product of a 5-10 minute conversation with a Navy Corpsman, as evidence by his signature on page 24 of my SRB’s and that report reviewed by Marsha Beaugrand, an MSC as evidenced by her signature on page 25 of my SRB’s. Neither of these people indicated a "diagnosis", nor would they be qualified to do such with such a limited knowledge of history. I never spoke with Mrs Beaugrand personally, only the Corpsman. Mrs Beaugrand even states, per Corpsman’s notes, no current sign of depression, fit for duty. The statement "significant history of depression" bears no evidence. That statement was an "Impression/opinion" of Mrs Beaugrand. It was based off of those two single incidents during childhood. There is no way, other than speculation, that any percentage of "pre-existing" MDD could be measured prior to entering service; therefore, no way to measure the impact that "verified" stressors capable of causing PTSD, as acknowledged by the VA psychologist during his exam, could cause of level which it could aggravated said depression. c. Rationale: It would be speculation to determine the presence of aggravation due to any trauma occurring during veteran's military service. It would also be speculation then to determine a percentage of disability that existed before service, as well as any percentage that may have occurred during service or aggravated by service. This conclusion is based on the following: 1) Veteran has multiple established factors increasing the likelihood of depression including relationship difficulties, early family risk factors, and alcohol abuse. "Multiple" established factors do not exist in any of my records. Family reporting does not reflect any issues pre-war, quite the contrary actually. There is no evidence of pre-war "relationship difficulties", but a great deal of evidence of that post-war. Two incidents of teen alcohol use does not establish a history of alcohol abuse. Alcohol abuse, as noted in my SRB by Mrs Beaugard is the only information that this opinion is based on. Hers was, as indicated by her, an "Impression" from reviewing the Corpsman’s notes. These established factors are likely associated with significant aspects of veteran's depression. Separating out the portion of depression attributable to trauma in the presence of these other larger factors would be a questionable exercise at best. These are not "Established" by evidence or fact at all. The statement above in regard to the doctor’s ability to "separate what portion of depression is attributable to trauma, trauma that he himself acknowledges took place at a level capable of causing PTSD, would be a questionable exercise" would also then, mean that his opinion that he gives in regard to depression, which is the basis for his belief that this is not caused by/aggravated by, service would be equally as questionable. Therefore, there is no way, in his opinion, to distinguish if aggravation occurred or at what percentage or level, but only that I have depression, anxiety and many other mental health and cognitive issues as evidenced by his C&P exam. 2) The literature to establish a connection between trauma and depression does not exist in a way that allows application in this situation. PTSD and Major Depression likely have some level of concordance (having one diagnosis increases the likelihood of having the other diagnosis); however, even this literature has not established firm levels of concordance depending on the severity of trauma, family history, and other risk factors not to mention the more than 25 years between the trauma and current functioning such as exists for the veteran. In addition, this literature is about diagnosed PTSD, not just a trauma having occurred. Similarly, there is literature on connection between general stresses and depression but again not in a manner that allows the assessment of a 25 year lapse between stress and current depression. Therefor, assigning any opinion in regard to cause/effect and aggravation would be limited to speculation and not clear and convincing against the veteran. Nor is there any evidence that supports this doctor’s idea, assumption that I spent 25 years "relatively" symptom free. I would also ask VA to consider, what does "relatively" mean in regard to mental health? 3) Veteran's depression is very mild. This statement conflicts, wildly, with the doctor’s findings, with exception to his interpretation of the MMPI. My records with VA do not reflect mild depression, nor does evidence in my file. I would ask that VA take this into consideration before making a decision on my claim. This C&P and follow up medical opinion does not, in any way, show clear and unmistakable evidence to prove that mental health issues and or aggravation of such was not caused or increased by service. The evidence supports otherwise and the doctor refutes his own opinion in his responses. Speculation, in one way or the other, cannot clearly establish against service connection. As per VA’s duty to assist, VA should find in favor of the veteran.

"The presumption of sound condition has not been addressed. The VA has to show that the MDD was NOT resolved before you entered the service. Did they do that? I dont see it." Actually, I spoke with a corpsman for 5-10 minutes in bootcamp and the "opinion" came from someone with a science degree after review the corpsmans notes. The last line in those papers were "Deemed fit for duty, return to company". I posted the info on the comp & pen forum for Berta in a post titled My letter refuting VA........

Thank you for the input. I knew when they queried the same psychologist to expound, it would go this way. I am still trying to get an IMO and my claim went to prep for decision immediately, so, I', certain that is going to be denial, NOD and a 4 - 7 year wait!

The VA sent back for a medical opinion, since their doc said I was MDD pre-existing, to inquire about possible aggrivation.......here is his response. Seems denial is imminent.....bear in mind, NO WHERE in my history, records, buddy statements, etc is there evidence of being "relatively symptom free" for 25 years.....quite the contrary, the Pre-existing opinion was based on (2) minor incidents with alcohol as a teen, that was not addressed at MEPS.....but two weeks into training at bootcamp......and I saw a navy corpsman and a his superior who was not a psychologist. ........and they wonder why vets get frustrated and go ape shit...... b. The claimed condition, which clearly and unmistakably existed prior to service, was not aggravated beyond its natural progression by an in-service event, injury or illness. c. Rationale: It would be speculation to determine the presence of aggravation due to any trauma occurring during veteran's military service. This conclusion is based on the following: 1) Veteran has multiple established factors increasing the likelihood of depression including relationship difficulties, early family risk factors, and alcohol abuse. These established factors are likely associated with significant aspects of veteran's depression. Separating out the portion of depression attributable to trauma in the presence of these other larger factors would be a questionable exercise at best. 2) The literature to establish a connection between trauma and depression does not exist in a way that allows application in this situation. PTSD and Major Depression likely have some level of concordance (having one diagnosis increases the likelihood of having the other diagnosis); however, even this literature has not established firm levels of concordance depending on the severity of trauma, family history, and other risk factors not to mention the more than 25 years between the trauma and current functioning such as exists for the veteran. In addition, this literature is about diagnosed PTSD, not just a trauma having occurred. Similarly, there is literature on connection between general stresses and depression but again not in a manner that allows the assessment of a 25 year lapse between stress and current depression. 3) Veteran's depression is very mild. The mildness of the depression suggests that any portion of depression attributable to aggravation would be very small. Smaller than the accuracy of current psychological strategies to measure. *************************************************************************

He rates my depression as VERY MILD based on MMPI scores.....he ties my "Depression being pre-existing" to 2 incidents as a teen.....he sites "realtionship struggles".....those happened AFTER Gulf War.......he acknowledges suicidal ideation, judges me....in the 30% range but then says no connecttion, very mild and can't speculate what happened in the Gulf.....but acknowledges that my stressors meet the crieria to cause PTSD..........Fuuuuuuuuuuuck .......I give the xxxx up!

So, here is the same doctor's answer......looks like I'm getting a denial letter soon.......this guy is NOT budging ......he uses the word "speculation".......isn't that synonomous with opinion if you disregard the combat theater and the fact that there is no evidence, Anywhere in my files, that indicate the last 25 years was "Relatively symptom free"........what a joke this has been...... b. The claimed condition, which clearly and unmistakably existed prior to service, was not aggravated beyond its natural progression by an in-service event, injury or illness. c. Rationale: It would be speculation to determine the presence of aggravation due to any trauma occurring during veteran's military service. This conclusion is based on the following: 1) Veteran has multiple established factors increasing the likelihood of depression including relationship difficulties, early family risk factors, and alcohol abuse. These established factors are likely associated with significant aspects of veteran's depression. Separating out the portion of depression attributable to trauma in the presence of these other larger factors would be a questionable exercise at best. 2) The literature to establish a connection between trauma and depression does not exist in a way that allows application in this situation. PTSD and Major Depression likely have some level of concordance (having one diagnosis increases the likelihood of having the other diagnosis); however, even this literature has not established firm levels of concordance depending on the severity of trauma, family history, and other risk factors not to mention the more than 25 years between the trauma and current functioning such as exists for the veteran. In addition, this literature is about diagnosed PTSD, not just a trauma having occurred. Similarly, there is literature on connection between general stresses and depression but again not in a manner that allows the assessment of a 25 year lapse between stress and current depression. 3) Veteran's depression is very mild. The mildness of the depression suggests that any portion of depression attributable to aggravation would be very small. Smaller than the accuracy of current psychological strategies to measure.

Just checked Ebennies again.....updated since 8am, shows C&P exam today, 8am, scheduled/kept.....looks like the doc already answered their request for medical opinion this morning.....

For me, it is much like my stomach issues......at times, I get lulled into a false sense of "hey, maybe this is over" because I have a couple of good days.....then bam, no. I have come to the conclusion that It will never be over......but I will continue to try to learn to manage it as best I can. Good luck and never give up!

So, in last week......Prep for decision, back to review of evidence, back to prep for decion, back to review of evidence, Friday, back to gathering of evidence with a new request from VA med facility. Called this morning, they have requested a medical opinion from Robley Rex, where my C&P took place....I'd venture a guess......possibly clarification on whether service could have aggrivated pre-existing MDD? Sounds like my refute and evidence and quoting regulation/laws atleast made them second guess the C&P decision.......should see something soon....good/bad or indifferent.

Back from review of evidence to prep for decision again......anxiety & Ebenefits is a poor match. Looks like someone is actively involved today.....that's a good thing I suppose.

Holys*%t.....so, I loaded all of the forms the VA requested and within less than an hour the request showed review complete, back in prep for decision.....never seen that fast of movement before....good or bad!

So, this morning a new request showed up for a 21-4142 form to release medical info from local VA clinic (I already uploaded my entire VA med file in June when I filed FDC), a 21-0781 Request for Stressor (Which I have already uploaded to my claim in June when I filed FDC), along with a buddy statement from a Marine who was next to me when the stressor in question occurred (Uploaded in June when I filed FDC! File was in prep for decision, sent back for review of evidence and now a new request for evidence that the VA has had since June........Makes one wonder if they read anything in your claim......

So, I'm discussing the VA with an associate of mine. He was Air Force, Operation Southern Watch 1996 Kuwait. He comments that he doesn't have VA benefits because he had to get out with a General (under honorable conditions) discharge. He was told this by the local VSO back in 1996-1997. I was shocked that he went all these years believing that he did not qualify for benefits from the VA. The VSO took one look at his discharge papers and said "Can't help you, you don't qualify". Moral of the story.......We are our brother's keeper. If you travel the path, down the rabbit hole if you will, of navigating the maze that is the VA......pay that experience forward and assist your fellow veterans......As we were in the 40's, 50's, 60's, etc.....we are all in this together!

My interpretation would be "clarification" of your previous diagnosis (Actually reading as symptomology of PTSD), he alludes to stressors....I'd say he is saying proper diagnosis would be PTSD, rather that a culmination of anxiety, depression and adjustment disorder. Just my .02

Prep for decision.....back to review of evidence, but hey....movement is movement right! Maybe I'm pessimistic, but I think a denial is looming due to the C&P.....or my failure to re-iterate the "why" instead of the "how" in my C&P.......stupid damn anxiety!

Had a MH appointment yesterday at my VAMC. They upped my meds......which was definitely needed. My therapist strongly disagreed with the C&P doctors assessment/diagnosis. She said, she's been doing this a long time and has treated a lot of PTSD vets over the years......she said "I know it when I see it"! She's a very nice lady, but seemed perturbed < sp by his opinion. Still in prep for decision......funny thing is, I don't care about the money aspect of GWI or MH.....I'd just like the government to have the integrity to admit they knew what we were subjected to and they were willing to sacrifice us for their end goal......like agent orange.....they knew, they covered up, denied, destroyed records........maybe someday!

Yes sir, I have done so. Unfortunate that the success or failures of a C&P exam can and will be decided by a veteran's choice of words, but that is the reality of it.

I scheduled a MH appointment with a local provider, even prior to the C&P for a second opinion. That appointment is August 18th. I told them that I was diagnosed by VA with PTSD and wanted a second opinion. I have already printed all of my paperwork that I provided to VA for my claim, in a folder and ready to go.

Just checked Ebenefits, moved to preperation for decision.......here comes the hammer!

Doc24.pdf Doc25.pdf Christinapg1.tif Christinapg2.tif mp.tif TimVBA21-4138.tif Mom.tif

I can upload my STR's pages 24/25, if you'd care to look at the notes. They are not great in terms of being legible, but with enough strain....you can make it out. I got the info on who I talked to because their stamps are legible with their name and titles. These are the two pages the Doc references, 2 of the buddy statements from family members, 1 from a former employer (early 90's and again in 2002-2007) and 1 from my current employer (Supervisor).

There in lies the question and quagmire<sp.......My "admission" of the two events as a child happened in the "truth" room inquisition just prior to me taking the oath. I was not "evaluated" for or deemed to have a pre-existing condition until they sent me to medical, 2nd or 3rd week of bootcamp......then I spoke to a corspman who wrote down this opinion, his superior who held an Master in Science (counceling) then opinined "significant HX of depression/alcohol abuse" based on the corpsman's notes......last sentence in my STR's were "No current signs of depression present, deemed fit for duty, return to company". Soooooooo, that being said.....is pre-existing condition going to be even possible........if not, is a new C&P possible considering the whole basis of the C&P docs rationale was based on two events, that weren't addressed at MEPS, was noted by two persons in bootcamp, neither of which would probably be considered legitimate to diagnose a MH condition in a 5 minute talk with a corpsmen and the fact that the C&P doctor opined that PTSD (the claimed condition) was not directly responsible for my current condition, but alot of my symptoms were due to pre-existing issues he diagnosed as MDD......not to mention, he used the word for his conclusion as "Relatively free of symptoms" in his rationale.....nor did he answer if he could " without clearand unmistakable evidence to the contrary" if my pre-existing MDD could have been aggravated by war. I'm going to guess.....Denial is imminent, as they would rather let me fight it out with the appeals system and atleast get me off their books....

The unfortunate part is, what Peggy tells you is often wrong, which was explained to me by a very helpful fellow that answered one of my calls to be the result of laziness....he said, you will get different answers from different people because some will look at the top line of your files and regurgitate what it says rather than look thru the files for recent activity/requests. I could call and they'd say gathering evidence phase "waiting on STR's"....hang up, call right back and be told In Prep for notification phase "got everything they need and decision has been rendered". I've had no experience with QTC, but I would definitely be inquiring as to "why" my exam has yet to be sent to VARO. VARO will probably never answer that, they will simply put out the request for the exam notes per policy, I'd assume like request for other records (request - wait x days, 2nd request - wait x days, etc.) until they get a reply negative response or the notes. I've learned a couple of things in the last couple of years.....YOU are the only one willing to do the footwork on your claim, exams are more about the "words" you use than the facts of your case and yo have to work VERY hard at controlling anxiety, because VA moves at VA's pace......period! I wish you the best and hope for a positive result for you brother! Hang in there and good luck!

No problem, there are a lot of other factors/items/incidents involved and I hesitate to post everything online. If anyone learns anything from my mistakes, learn that the C&P is your one shot to help someone understand how you have been affected.....I should have been re-directing the questioning or tying it to the "why" I have spent the last two decades struggling with relationships, work, violence, etc......I didn't, I simply let the doc lead the questions and I answered them....I was anxious/nervous. I do not compare myself to a Vietnam veteran in any way, shape or form. I have told my therapist that. I have the utmost respect for all of my brothers who have served, especially those who continue to pay the price for freedom. I have minimized my issues for years and denied that I was the problem, because I don't see that....don't understand why people are afraid of me or find me blunt and intense......but I am in no way a hero by any stretch, I just have something wrong.....whether that's PTSD, MDD, or whatever label it might carry, I don't know.....but it took me 26 years to admit and ask for help and irregardless of the outcome on this side of the coin, I'm happier, as is my family that I'm working toward sorting it out. Thank you all for your input and patience with me. By the way Berta, I would whole heartedly agree with what the C&P doc said in refernce to the war not being consistent with my issues, IF, I had spent 20 years between 1991 and 2017 "relatively" symptom free, but none of the evidence from my life, documents, work history, etc points to that....that was an opinion of the doctor ie; (speculation), without grounds in available fact......that is why I took such great oposition to that statement from him......not to mention, what does "Relatively" mean exactly in regard to mental illness or struggles from mental illness? Thanks again!

Here's a letter and one of the pages from the article ChrisNews.tif ChrisLetter.tif