Gny Skinner

How do I get to the actual BVA court decisions. I see others post them on here sometimes but I have never been able to find the site where I can search on issues and find decisions.

I submitted a claim for kidney stones and it came back service connected but at 0%. It says to be rated at 10% the evidence needs to show "only an occasional attack of colic, not infected and not requiring catheter drainage. (38CFR4.124a) The problem is that the Dr who completed the DBQ left that question unanswered. I filed an appeal and included a statement that said: The DBQ completed by Dr. Donald Cohen incorrectly answered the question 4C, "DOES THE VETERAN HAVE ANY SIGNS OR SYMPTOMS DUE TO UROLITHIASIS?" AS NEGATIVE. My medical records show clearly and repeatedly that I have had many signs and symptoms due to urolithiasis (stones that form in my urinary tract). By correctly checking question 4C as YES he would have been further instructed to indicate the severity which would have included: 1)occasional attacks of colic and 2)causing voiding dysfunction. The appeal came back denied, still SC but still at 0% with the exact same reasoning. It says that the current evidence fails to show your condition warrants a higher evaluation. How am I suppose to get that question corrected if they won't take my word for it. I know I can not get any letter from my VA doctor, I was told point blank "We are told to stay out of all VA issues. You won't get any nexus letters here" I have had so many kidney stones, both while on active duty and since retirement. The last one required surgery. They have all my records showing this? My surgery was through the VA so they definitely have that. The list of evidence shows everything but I question whether they actually reviewed all of it. I certainly plan to appeal, again, but what evidence can I add to prove this one point? Thanks

I filed for Mood disorder - Unspecified. I went to my C&P and had a PH D Psychologist complete my DBQ stating the claimed condition was at least as likely as not incurred in or caused by the claimed in service injury. His rationale included the fact that my service records didn't reflect anything because of fear of impact on military service and opinions of others. This was not a claim of PTSD which is important. It is for Mood disorder - Unspecified. In the Dr. complete write up he referred to my hyper vigilance. The claim was denied stating "service treatment records do not contain complaints, treatment or diagnosis for this condition. Evidence does not show an event, disease or injury in service. It goes on to state that although we received the lay statement from your spouse and by yourself and the examiner provided a positive opinion, service connection is denied because there were no in service event found in your service treatment records to show a link between your current mood disorder, unspecified and your military service. I appealed and wrote another statement. In that I stated the 3 reasons they gave for denial 1)not in service records, 2)no in service event and 3)VA did not find a link. I went on to state 1)VA contractor gave a positive diagnosis, 2)VA contractor gave a positive rational supporting an in service event and 3) (using their own words) SC may be granted for a disability which began in military service OR was caused by some event OR experience in service. I stated the credentials of the Dr. and restated his diagnosis and his rationale. My appeal was denied and here is what they said: We have denied your claim for SC for mood disorder, unspecified (claimed as mental condition) because your service treatment records are silent for a complaint of, treatment for, or diagnosis of a mental condition. VA examination dated 6/13/18, provided an incorrect medical opinion. We can not grant sc on subjective reported incidents or reported stressor since separation from service. There has to be objective medical evidence of a condition during service. We went back with the criteria for sc and required the examiner to review the objective data and the examiner provided an addendum on 2/15/19, noted that there is no indication of any occupational problems during military service or any treatment during service. The examiner noted that you did not begin mental health treatment until about 20 years after military retirement. So, my question, How can the VA do this? They went back to the Dr. and had him change his diagnosis without even talking to me. The letters provided by myself and my wife addressed the reason I waited until now, basically it has gotten so bad my wife is saying "GO GET HELP" My service records don't show any treatment because of just what the Dr said, I didn't want to be labeled a sick bay commando so I didn't go to see a doc, pretty much for anything which is hurting me now big time. But I just don't see how they can have the Dr change his diagnosis without even talking to me. The first time they denied it they said it was because there was no in service event. The second time they said it was because the Dr changed his diagnosis. Of course I plan to appeal, but any advice would be helpful. Thanks

I filed claim in Jan 2018 through my VSO. I have been seen at the VA twice since then. I am getting ready to file another claim but am not using the VSO I had in Jan. Do I need to file another form VA 21-4142? And what is the difference between these two forms? The VA should have all of my records except possibly what was documented just since my decision letter from July. I just want to make sure I fill out all the proper forms.

The Dr. was a non VA MH Psychologist. He was hired by QTC Medical Services for my evaluation. He had a Doctorate in Psychology and started working VA Compensation related claims in 2012. There were 2 documents in his review. The first is titled INTERNAL VETERANS AFFAIRS USE MEDICAL OPINION DISABILITY BENEFITS QUESTIONNAIRE. That form is 3 pages long, with Sections I - VIII. I couldn't find a form number on it. He checked the box 3A. that says THE CLAIMED CONDITION WAS AT LEAST AS LIKELY AS NOT (50 percent or greater probability) INCURRED IN OR CAUSED BY THE CLAIMED INSERVICE INJURY, EVENT, OR ILLNESS, PROVIDE RATIONALE IN SECTION C. 3C. RATIONALE: Claimant cited onset of symptoms during military service with worsening post military service. Issues of stigma addresses the lack of military treatment and self-report (feared impact on military service and opinions of other.) His wife has been the primary motivator for any discussions of mental health at all. Symptoms appear consistent with those reported as emerging during service and have strong military themes. There is no other etiology indicated based upon review of records. The detailed report is 8 pages long (because he typed that much stuff), (think it is form 21-0960P-1 only has 2 sections to it and is titled: Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire 1.DIAGNOSIS a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? YES .....If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnosis: Mental Disorder Diagnosis #1:Mood Disorder, Unspecified 3. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (check only one) 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. In his full writeup he is clearly stating that the major issues are service connected (he lists the clinical stuff), never reported due to issues of stigma, and have gotten progressively worse over the years to the point of seeking treatment. He says PTSD screens were negative for a diagnosis of PTSD. The prior screens and this diagnosis all point to words like anxiety, irritability, depression, poor sleep, poor concentration, avoidance, procrastination, forgetfulness etc. Symptoms consistent with Major Depressive Disorder. I think that is why the diagnosis came through as 9435 Mood Disorder unspecified, at least as likely as not caused by inservice injury or event. The DBQ for PTSD is form 21-0960P-3 and has a section VI that talks about the traumatic event. The form the Dr. used for my diagnosis doesn't even have that section or anything like it. We have filed the NOD so I'll let you know what they say. Who knows how long that will be but for now it is just a wait and see issue.

Found it, code 9435, current va website says, Mood Disorder other than specified above

Broncovet, doc25, and Berta. Thank you for chiming in on this. I will definitely read all the websites referenced. I actually did go to an attorney and that's why the cue issue came up. I was searching for an attorney with experience in filing a Gulf War Illness claim and he actually spotted the possible cue issue. I put a halt to it until I researched it more because he charges 20% of back pay. If this went through it could be a big paycheck which is fine but only if it does not affect what I would have to pay back to the government for being overpaid. That is really my question here. I was paid at 10% for the last 17 years. That reduced my retirement pay by 10%. If this went through and say I would now be paid at for instance 40% for the last 17 years would that also say that I was overpaid by DOD by the incremental 30%? I wouldn't have been at the magic 50% threshold to make the VA pay incremental. I would not want to get a giant check from the VA and immediately have to pay it all back. To me that's just not worth the hassle. I'm still unsure if I need a trigger for mood disorder. I did file the nod for that and the trigger was definitely discussed during my C&P and in my records. Not my military service records but the records that I submitted in addition to that that the doctor reviewed. The doctor just did not mention it in his rationale so the nod that we filed brought it up again and said basically look at what you have, it's there. I have been reading everything I can on filing for Gulf War Illness because I understand it is difficult to prove. The attorney thought that because they did not identify me as a Gulf War veteran on my 1999 claim but they finally admitted to it on my 2018 claim that perhaps that was cause for a cue going back to 1999 and claiming Gulf War Illness for the identified issues at that time.

I will have to look up the code that actually shows mood disorder but it was definitely on the list that I looked at just last night. And the doctor was a civilian psychiatrist I believe that was hired specifically for the c&p exam. It was all there the trigger it just was not in my service medical record. I know I can get a buddy statement because I have a buddy who is already service-connected for PTSD for this exact same trigger. We were stationed together when it happened. I'm not trying to claim a cue for the mood disorder. I think it will be easy to prove that it did happen and that I was in fact there and I do already have the diagnosis

Broncovet, doc25, and Berta. Thank you for chiming in on this. I will definitely read all the websites referenced. I actually did go to an attorney and that's why the cue issue came up. I was searching for an attorney with experience in filing a Gulf War Illness claim and he actually spotted the possible cue issue. I put a halt to it until I researched it more because he charges 20% of back pay. If this went through it could be a big paycheck which is fine but only if it does not affect what I would have to pay back to the government for being overpaid. That is really my question here. I was paid at 10% for the last 17 years. That reduced my retirement pay by 10%. If this went through and say I would now be paid at for instance 40% for the last 17 years would that also say that I was overpaid by DOD by the incremental 30%? I wouldn't have been at the magic 50% threshold to make the VA pay incremental. I would not want to get a giant check from the VA and immediately have to pay it all back. To me that's just not worth the hassle. I'm still unsure if I need a trigger for mood disorder. I did file the nod for that and the trigger was definitely discussed during my C&P and in my records. Not my military service records but the records that I submitted in addition to that that the doctor reviewed. The doctor just did not mention it in his rationale so the nod that we filed brought it up again and said basically look at what you have, it's there. I have been reading everything I can on filing for Gulf War Illness because I understand it is difficult to prove. The attorney thought that because they did not identify me as a Gulf War veteran on my 1999 claim but they finally admitted to it on my 2018 claim that perhaps that was cause for a cue going back to 1999 and claiming Gulf War Illness for the identified issues at that time.

Scan_Doc0002.pdf Scan_Doc0003.pdf Scan_Doc0004.pdf Scan_Doc0005.pdf Scan_Doc0006.pdf Scan_Doc0007.pdf Scan_Doc0008.pdf

I retired with 20yrs from the Marines. My question up front, should I file a CUE for my initial 2000 decision or would I just be awarded a higher VA pay offset by a reduction in my military retirement pay with a net zero gain? Here is the background 10/99 retired and filed claim for Headaches, Degenerative changes to T5-T7, right knee condition, left knee condition, low back condition, left foot condition, chest muscle pain, lung condition, myopia and astigmatism and pinguicula of the eyes. 5/22/00 Rating Decision headaches 10%, Degenerative changes to T5-T7 SC with 0% and NSC for everything else. 7/25/00 SMRs were taken in and reviewed, were not available before. 7/31/2000 Rating Decision We reviewed your SMRs and no changes warranted. States that records show being seen for low back pain, left foot condition and chest muscle pain however they did not find pain during the C&P therefore denied SC. Other issues not shown in MSRs so denied SC 11/13/01 Deferred Rating Decision (in lieu of VA Form 21-6789) VCAA 2000 Rehabilitation Case End products: 020 and 684. DOC: Pending. Don't know why the “9” indicator was previously used-VID screen does not show Gulf War service. 12/11/01 Letter.. Due to change in the law, we are reconsidering SC for bilateral knee condition, low back condition, left foot condition, chest muscle pain a lung condition and vision problems 4/15/2002 Rating Decision – everything exactly the same, no changes. I never had a VSO or help/advise of any kind. I never filed any NODS, appeals, anything. I just thought each time they sent me something that they have all my records and it is all right there, there is nothing new so no need for me to send them anything. Nothing has happened for 16 years Fast forward 4/3/18 filed claim for reevaluate headaches and degenerative arthritis of spine, new claim for tinnitus, kidney stones, vertigo, hearing loss, GERD and mood disorder (Not PTSD). 7/9/18 Rating Decision The records reflect that you are a veteran of the Gulf War Era and Peacetime. headaches increased to 50%, degenerative spine increased to 20%, tinnitus 10%, Kidney stones SC with 0% (a higher evaluation of 10% is not warranted unless the evidence shows: only an occasional attack of colic, not infected and not requiring catheter drainage) Dr. left this particular question unanswered, vertigo denied SC, Hearing loss denied SC (loss not significant enough), GERD denied SC, (no C&P ) sent letter that had in service but used OTC for treatment Mood disorder denied SC, STR show no complaint, treatment or diagnosis. Evidence shows no event, disease or injury. VA contractor exam shows you currently have mood disorder, unspecified, and provided a positive opinion without giving a rational supported by an in service event. Although we received the lay statement from your spouse and by yourself and the examiner provided a positive opinion, sc is denied because there were no in service event found in your STR to show a link between your current mood disorder, unspecified and your military service. 12/12/18 submitted a NOD for Kidney stone, GERD and mood disorder. So, in 2001 they wrongly had me classified as NOT a Gulf War Era veteran. I did serve in theater in the Gulf War and my service record clearly shows that, and did at that time. I never noticed this error in the 2001 decision until just now. This does show a Clear and Unmistakeable Error that can easily be proven. I noticed this because I am preparing to file a claim under 3.317 undiagnosed illness. I believe that if they had 1)properly assisted me in gathering evidence 2) properly classified me as a Gulf War Era veteran and 3) evaluated my initial claim under 3.317 I would have been granted a much higher rating. However, I don't know that I would have reached the magic 50% threshold so as to not reduce my retirement pay. I believe I should have been evaluated based on 4.59 Painful Motion and granted at least the lowest compensable rating for each joint. Would that have been 10% for each knee and each shoulder, 10% for lower back pain and 10% for left foot condition? I believe I should have been evaluated based on code 5321 for chest pain not caused by any other condition and rated based on the slight to sever scale, again, awarding at least the lowest compensable rating of 10%. And possible 10% for lung condition, breathing issues that to this date have never been diagnosed other than they exist. If I file a CUE and they agree but only award 40% or less but still greater than the 10% I was paid over the past 18 or so years, will I then have to repay the portion of my retirement check that they end up paying me in VA back pay? So thankful for the advise of this experienced group. Gunny

Update, I got a notice that they received my request. I also looked online and saw that my request for my c-file was closed May 4th. Then 2 days ago I got a cd in the mail with a 193 page pdf file on it. Bottom line is there is no c-file there. It is my VA medical records from 2008 to current (which I already have) and the information I have sent to them requesting my records and their replies back to me. It has 3 very interesting copies of computer screens that basically say they can't find my records. The first is on 1/17/18 and is a copy of the COVERS screen that was sent to another person requesting my records. The second is a copy of an email on 4/13/18 from the same person asking the other person to follow up on the previous request because nothing had been received. The third is an email dated 4/16 from a "coach" copying the 4/13 email and sending it to yet another person stating to locate the c-file and ship it to the scanning vendor. Then there is also an interesting email in there with no date or names that says: "The following vet shows to have a claim pending with the VBMS document pending scan banner. The listed items show nothing. The COVERS location shows to be Station 376 location DCSS1 but there are obviously documents missing such as STR's and prior rating decisions as this is CESTED as a 020 with the percentages of disability listed in the Corporate record. Any additional information that you could provide would be greatly appreciated as always. Date of original request was 4/13/18. I have read several posts on here that say to make an appointment with the RO and ask to see my c-file. I have no idea where my RO is? I retired out of Madison WI and lived here for 20 years. I moved to FL in 2017 and transferred to the Daytona Beach VA. Where is my RO? I have the time to call and make an appointment. I would love to go in and see what they have. Thanks

My medical records from the VA are there. I didn't start going to the VA when I retired because I got another job and went to a civilian DR. My civilian medical records are also available. What I haven't been able to get are my 20 years of active duty medical records and anything related to my C-file. I dug through the 193 pages more and found this: another print screen of the COVERS screen that shows this info: data received 2/28/12 PRODADM and confirmed 2/28/12 PRODADM permanent transfer request 1/17/18 BIRLS info POA: 097 type claim 376 transfer 5/17/08 prior 330 type cer transfer 2/28/12 prior 330 This information looks to me like they originally scanned my data in on 2/28/12. The date of 5/17/08 doesn't mean anything to me, I didn't file for anything in 2008. I didn't do anything in 2012 either but I'm just guessing that is when they supposedly scanned my stuff in to the system. Then I also found 3 other documents: First is from 1/17/18 from one VA official asking for my c-file. That is because of my initial request for my information. The second is from 4/13/18 from that same VA official to a different person saying "Could you please follow up on the previous request" and he sent a copy of his original request from January. The third is from 4/16/18 from a person with the title IPC Coach stating "Please locate the c-file and ship to the scanning vendor. The PTO request from 1/17/18 is still pending." So, it really looks like they have lost my military medical records. Will that help me or hurt me? I know I have to prove a military connection for my claims. Will this make it easier because they can't disprove anything and they have to error on the side of the veteran, OR will it make it harder because I don't have any proof for anything? Thanks for your input.

I requested my C-file and received a CD today with 193 pages. There is no information about my time in the military at all. I retired in 1999 and this data starts in 2008. There were a couple of emails and print screens that look like they may have lost all my military medical records and all my prior VA stuff. I am rated at 10%. A copy of an email was in there and has codes that I don't understand. I can't copy and paste it here because it is a print screen so I'm retyping it. What do you make of this? To: VAVBAMUS/RO/VSC/TRIAGE; Subject: Documents Pending Scan Good Afternoon: The following Veteran shows to have a claim pending with the VBMS documents pending scan banner. The listed items show nothing. The COVERS location shows to be Station 376 location CDSS1 but there are obviously documents missing such as STR's and prior rating decisions as this is CESTED as a 020 with percentages of disability listed in the Corporate record. Any additional information that you could provide would be greatly appreciated as always. Date of original request was 4/13/018. I don't know what these codes mean or what this may mean for my current claim. Any help is greatly appreciated. Thanks

I went to the VA clinic today and got the form to file and request my C-File. They didn't know where to mail it so I called the VA regional Center and they told me to mail it to Janesville WI. Now I'll just wait and see. Thanks

thanks for the links, I have most of the information but not the actual c-file. I have already filed my claims last month. My original claim was filed in 1996. I have requested my military medical records back in early Jan via the FOIA. I have all my VA and civilian medical records and have looked at everything on the blue button on ebenefits. I have my military service records. The only thing I don't have is the exact C-file information from my 1999 initial claim when I retired. At that time I got 10% for migraines and 0% for back but I don't know any more than that. I still don't know what form to use or where to file for the C-file. I retired out of Madison WI and will be going there next week so maybe I should go to the reserve center and file for it there. What do you think?

I don't know if I have filed the necessary paperwork for my C-File or not, I don't even know what a C-file is. I did file paperwork requesting my medical records from when I was on active duty, 1979-1999. I Don't know what a C-file is and how it differs from my medical records. Today I had an appt. with my VSO and asked him if we had filed the paperwork requesting my C-file. He said No and he didn't really know what is in one and didn't think we needed to file for one. That bothered me. He claims to be one of the best VSO's around. I read on this sight about the C-file all the time and want to know what is in mine. So, exactly how do I file to get mine. And, what is in it, what do they look like? How is it different from my medical records? BTW, I'm 10% SC for migraines and 0% for my back. Thanks