Usaf9498

I served in the USAF from 1994-1998. Deployed to Bahrain, Turkey and Saudi, and was at Khobar Towers in 1995 when it was bombed. I am currently rated at 90% total. 70% PTSD from the bombing, 50% sleep apnea secondary to PTSD and 10% Tinnitus. I have suffered from IBS for over 20 years. It was finally getting bad enough this spring that I went to the VA and talked to my primary care. She ordered a colonoscopy and referred me to the GI department. Colonoscopy came back relatively normal, with a few polyps removed and biopsied all coming back negative. They put me on fiber twice a day which has improved my issue a little. My GI nurse told me in a video conference yesterday that she was finally officially diagnosing me with IBS type D. About the same time I was having the worst of the IBS issues this spring, I also started having severe joint pain. I was referred to rheumatology and was sent in for a CT scan, and gobs of blood work and x rays. They diagnosed me with Ankylosing Spondylitis. My bloodwork did show that I am HLA-b27 positive, but have no family history of AS or any type of auto immune diaseases. I am injecting myself in each leg once a month with 300mg Cosenyx. The injections help but they are talking about adding a pill to help get it under control 100%. It is really affecting my knees, my thumbs, and my ankles the most and I am afraid of it getting worse. I drive a truck for a living and I really need my joints to work to continue to provide for my family. During the Xrays of everything, they found several masses in my lungs. They did a CT scan and said that they were likely not cancerous, but wanted to do follow up tests in a year to compare to make sure nothing was growing. I was a smoker for a few years so I cannot say that is from the sand but who knows? For about the last 3 years, I have had a few bouts of irisitis/uveitis which my civilian opthamologist said was likely rheumatoid arthiritis. It is also a common side effect of my AS. I take a steroid eye drop when I have flares and when I catch it quick enough, knocks it out before it gets really bad. I have had one flare up since I have been going to the VA, and had them look at it and document it, and now get my prescription eye drops from the VA. I know IBS is a Gulf War Presumptive. I am wondering if my AS would be condsidered GWP also? Would it be secondary to my IBS? Should it be a stand alone claim and the irisitis be secondary to AS? I am not the kind of guy that is trying to claim everything wrong with me is somehow a VA claim, but this stuff just has gotten the better of me and I can see no reason why I am having these issues. As always, I appreciate all of the help!

With the help of many of you answering my questions, I filed my claim online, by myself and starting collecting buddy statements, wife's statement, etc on August 8th. I had all 4 of my C and P exams done and starting the anxious checking ebennys every couple of days. My date showed as January 10th to expect a decision, to January 1st, to January 5th and this morning, it showed complete. I was scared to death to actually check to outcome expecting the absolute worst so I sat there for about 30 minutes just paralyzed to actually click it. I finally got up the courage and to my complete and udder shock, I was awarded 90%. I just sold my business last month because the PTSD was making it so I could hardly interact with my customers so this truly is an amazing outcome and could not come at a better time. Again, thank you all so much for the help, the answering, and the encouragement.

I was contacted a couple of weeks ago by LHI and scheduled my PTSD exam today and my Sleep Apnea exam tomorrow. I drove the hour to te appointment and arrived on time to an office attached to a home with a separate entrance. As I walked in , the doctor, a PHD, introduced herself and asked me how I was. I said well, nervous. She said yes I bet commented that I did not sleep well either most likely. And she was right, I was up a good portion of the night last night. She started off by asking about my childhood, what it was like, if my parents fought, drank a lot, stayed married, etc. She then asked about my hobbies as a kid, my friendships, grades etc. We then went on to my jobs as an adult and ended up with what I am doing now. No real questions on what my work life is like. I am self employed but selling my business. She asked why I was selling and I told her because I cannot deal with people any longer in a retail capacity. My anxiety makes it painful. She asked about my deployments and if I had anything to add about the bombing. I told her that due to therapy I had remembered a lot more and told her about the explosion, the glass, the blood, the next day etc. She specifically asked me to tell her about being told to guard the flightline with a maglite and I told her. She was good about not pulling the scabs but asked what she needed to I suppose. We went on to my relationship with my wife and kids. How many kids I have, What my kids hobbies are, what sports they play, how their grades are etc. I filled out a few questionnaires and the she asked me if I has kids. I looked at her odd but then answered yes, I had two, and she asked me their ages. (I thought I was the forgetful crazy one). We talked about how much I drank and I was honest, 8-10 beers per day. She asked if it caused me to miss work, I said no. She asked if I drank until I was intoxicated and I said not often. She asked if it caused me stomach issues and I said no. She asked me about suicide and I told her I did not entertain it. I said I often death would make the pain stop, but that I had not fancied doing it myself. She asked if I was depressed and I said I think so? I have depression, anxiety, I'm always on edge, I don't sleep, panic attacks, avoid people. But I said honestly, I don't know what all is wrong with me. I said I was diagnosed with PTSD by the VA and until they tell me otherwise, that's what I have. She asked me if I had anything else to add and I told her no, that I do not think so. I kind of broke down at that point and cried a little. I have no earthly idea why, I think the stress just got the better of me. She explained that she would write her report, suggested group therapy at the conclusion of CPT therapy, suggested I look into vocational rehab for a new career and wished me well. She said my therapist had asked taken very good detailed notes that would help her a lot. Very nice lady. I was there about an hour and a half. She did stop and explain why I was feeling some things which I thought was really nice of her. I think she genuinely cared. All in all, I think it went fairly well. I sure hope so anyway. I'm kind of surprised that she did not ask more about my symptoms but maybe she got what she needed from the docs notes.

Got two calls back to back yesterday from LHI to schedule my last two C&Ps. They scheduled my PTSD exam in a town about an hour away on November 20th and my Sleep Apnea exam on the 21st here in Kansas City. Glad that they are finally scheduled and I can hopefully look forward to seeing the outcome of my claim. I have had my fingers crossed since I filed the claim August 8th.

I filed for PTSD, and secondaries to PTSD for hearing loss, tinnitus, and sleep apnea on Aug 8th. So far, I have only had my hearing loss C and P. I called in to Peggy and asked to schedule an appointment to view my C-File. The gentleman I spoke with said why don't you go to Amvets at the Kansas City VAMC, that they were a CVSO and could let me view my C-File there instead of driving to Wichita which is my Regional, which is 4 hours away. I said great then called Amvets in KC. No answer and no voicemail so I sent an email. I got an immediate response back from an auto reply saying the KC Amvets office closed for good a few days earlier and to email a guy in St. Louis for help. I did and he said no problem, he had a way for me to view my file. Several days passed and then nothing. I emailed asking for a status update and he said that I did not sign a POA so he could no longer help me. He never offered to have me sign one, just sorry. I can't help. So, my options are drive 8 hours round trip to Wichita, use a VSO, or wait for a copy of my file in the mail. Can you give a VSO POA for nothing more that to see your C-File or do they then have control of your claim moving forward?

So I called Peggy just and asked if I should upload the files again. Peggy, who goes by Sherell, asked me what files I could not see. I told her all of them. She read off every file that I had uploaded, and explained that they do not use VA.gov to process claims, that they see something entirely different that what we see on our end. So it looks like the files are still there, just not able to be seen by me. That makes me feel better, but, I would still like to be able to see them to see what they have looked at etc. I also asked about not having a C&P scheduled yet for my PTSD and sleep apnea. She stated that if I had good enough medical records showing recent findings, a C&P would not be needed in every case. she stated that there was nothing on her end that said they would be scheduling a C&P exam at his time. I just can't imagine that they will decide on sleep apnea with a 7 year old in home sleep study from a civilian doc. Or if they do it will be favorable. The PTSD is possible I suppose since I am currently diagnosed and in treatment from the VA but I still think they would do a C&P.

Before, it showed all forms that I had uploaded. My DD214, personal account, buddy letters, sleep study etc. This is what it shows now. So either that stuff is all gone or they removed it all after it was viewed. But it literally says "You haven't turned in any documents to the VA" but I assure you I have and they were there, and now they are not.

The odd part is they were there for a month, then they weren't. Even if someone were viewing them on the VA side, you'd think they would still show up on my side. But, I'll look today and see if they have shown back up.

I just logged on to VA.GOV today for the heck of it to see if anything has changed to my claim status. To my surprise, none of the docs that I have uploaded to the claim are there. The were all there Wednesday when I uploaded a new form, but today, it says I have not uploaded anything. There should be close to 10 docs. Very odd. I will log back in Monday and see if they are there I guess. If not, I have them all on my hard drive so I will resubmit them if need be

Wild A$$ Guess

I called the regional office back and spoke with someone else. She said the system was partially still down but that she could add a note to my file, I assume my C-File, stating that I called in to the regional office and that there was a mistake on my hobbies. She also suggested I go into ebenefits and upload a statement saying I was challenging the mistake. I explained that I think there is a way to correct that, not challenge it, if done quickly enough. She advised that I call back this afternoon and see if the system is back up. I asked if there was someone above her that I could talk to. She said at the time that I call back, and the system is back up, there is. She said there is no point in going above her now with the system down. She advised that if I can see the C&P on myhealthevet, that I should send my PCP a message there. I told her the PCP had nothing to do with the C&P. I am getting first names and writing it all down along with phones numbers called, times and dates. Nobody seems to want to give me last names. I called back to my VAMC and spoke with c&P again. Got a different guy. He took down my info, verified spelling and asked who did the C&P. He said that he would notify her of my situation and if she has any questions, she would contact me.

I called the hospital this morning and spoke with the C and P scheduler. She stated that there was nothing that she could do there, that I had to go to the regional office and gave me their phone number. I called the regional office and spoke to Charles and he stated that their system was down this morning so he could not add notes to my file. He did state that he thinks I need to request new exam. I stated that I don't think I need a whole new exam, just an addendum to the existing exam saying that I do not nor have I ever ridden motorcycles. He said that it will then be my word against the doctors at that point. He suggested that I call back later when his system was back up, or mail or fax in a written statement. I don't think he really knows what to do .

Geeky would you happen to know how to find the head of the c&p examiners? I definitely want to get the motorcycle thing corrected and maybe at the time, I can ask about the 21 year thing?

I got my Hearing Loss C&P Tuesday Morning. This morning it was available on myhealthevet. When she asked about my hobbies, she specifically asked me if I rode motorcycles. I told her no. Never have. Sure enough under hobbies ( SEE below) It lists my hobbies as motorcycles and hunting. Good news is it looks like it will be easy to service connect my hearing loss, however, it is not enough for a rating. Tinnitus should be rated and looks to be service connected from what I can see. Other good news is she stated that there was not a hearing test done in STRs so hearing loss during service is not ruled out. Sounds to me like this should be fairly easy but I know not to count my chickens before they hatch. Date/Time: 10 Sep 2019 @ 0803 Note Title: KC-AUDIOLOGY Location: VA Heartland-West VISN 15 Signed By: BREAUX,KATHERINE A Co-signed By: BREAUX,KATHERINE A Date/Time Signed: 10 Sep 2019 @ 0805 Note LOCAL TITLE: KC-AUDIOLOGY STANDARD TITLE: AUDIOLOGY NOTE DATE OF NOTE: SEP 10, 2019@08:03 ENTRY DATE: SEP 10, 2019@08:03:23 AUTHOR: BREAUX,KATHERINE A EXP COSIGNER: URGENCY: STATUS: COMPLETED S: The veteran has requested an Audiology Compensation/Pension examination. The case history information is included in the CAPRI report. O: The following procedures were performed: Work Related or Medical Disability Examination 99456, SP206, RVU=90 A: The disability assessment included a review of medical and service records, review of past, social, family, occupational, and military history. A comprehensive audiometry examination, formulation of a diagnosis, assessment of capabilities, and completion of necessary documentation was administered. The audiological findings were discussed with the veteran and will be forwarded to the compensation pension department. P: The patient was informed to return for further treatment when necessary pending their eligibility status. Time: 90 mins /es/ Katherine A Breaux Clinical Audiologist Au.D., CCC-A Signed: 09/10/2019 08:05 Date/Time: 10 Sep 2019 @ 0730 Note Title: C&P AUDIO Location: VA Heartland-West VISN 15 Signed By: BREAUX,KATHERINE A Co-signed By: BREAUX,KATHERINE A Date/Time Signed: 10 Sep 2019 @ 1330 Note LOCAL TITLE: C&P AUDIO STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: SEP 10, 2019@07:30 ENTRY DATE: SEP 10, 2019@13:30:56 AUTHOR: BREAUX,KATHERINE A EXP COSIGNER: URGENCY: STATUS: COMPLETED Hearing Loss and Tinnitus Disability Benefits Questionnaire 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): Case History: Post: Union Iron Worker, tile setter helper, insurance sales, retial. Hobbies: Motorcycle, hunting Right: 10@ 500, 0 @1000, 10 @ 2000, 10 @ 3000, 10 @ 4000 Left: 0 @ 500, 0 @ 1000, 20 @ 2000, 0 @ 3000, 5 @ 4000 This exam is for: Hearing loss and/or tinnitus (audiologist, performing current exam) SECTION 1: HEARING LOSS (HL) ----------------------------- 1. Objective Findings --------------------- a. Puretone thresholds in decibels (air conduction): RIGHT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 15 | 15 | 25 | 30 | 60 | 50 | 40 | 33 | +=======================================================================+ LEFT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 15 | 15 | 30 | 20 | 25 | 20 | 15 | 23 | +=======================================================================+ * The puretone threshold at 500 Hz is not used in determining the evaluation but is used in determining whether or not a ratable hearing loss exists. ** The average of B, C, D, and E. *** CNT - Could Not Test b. Were there one or more frequency(ies) that could not be tested: No c. Validity of puretone test results: Test results are valid for rating purposes. d. Speech Discrimination Score (Maryland CNC word list): +=======================+ | RIGHT EAR | 88% | |=============+=========| | LEFT EAR | 96% | +=======================+ e. Appropriateness of Use of Word Recognition Score (Maryland CNC word list): Right Ear: Is Word Discrimination Score available? Yes Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. Left Ear: Is Word Discrimination Score available? Yes Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. f. Audiologic Findings Summary of Immittance (Tympanometry) Findings: +=============================================================================+ | | RIGHT EAR | LEFT EAR | |=====================+===========================+===========================| | Acoustic immittance | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal | |=====================+===========================+===========================| | Ipsilateral | | | | Acoustic Reflexes | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal | |=====================+===========================+===========================| | Contralateral | | | | Acoustic Reflexes | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal | |=====================+===========================+===========================| | Unable to interpret | | | | reflexes due to | [ ] | [ ] | | artifact | | | |=====================+===========================+===========================| | Unable to obtain/ | | | | maintain seal | [ ] | [ ] | +=============================================================================+ 2. Diagnosis ------------ RIGHT EAR --------- [ ] Normal hearing [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.3 [ ] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: [ ] Significant changes in hearing thresholds in service*** LEFT EAR -------- [ ] Normal hearing [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.3 [ ] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: [ ] Significant changes in hearing thresholds in service*** NOTES: * The Veteran may have hearing loss at a level that is not considered to be a disability for VA purposes. This can occur when the auditory thresholds are greater than 25 dB at one or more frequencies in the 500-4000 Hz range. ** The Veteran may have impaired hearing, but it does not meet the criteria to be considered a disability for VA purposes. For VA purposes, the diagnosis of hearing impairment is based upon testing at frequency ranges of 500, 1000, 2000, 3000, and 4000 Hz. If there is no HL in the 500-4000 Hz range, but there is HL above 4000 Hz, check this box. *** The Veteran may have a significant change in hearing threshold in service, but it does not meet the criteria to be considered a disability for VA purposes. (A significant change in hearing threshold may indicate noise exposure or acoustic trauma.) 3. Etiology ----------- Right Ear Was there a permanent positive threshold shift (worse than reference threshold) greater than normal measurement variability at any frequency between 500 and 6000 Hz for the right ear? No Opinion provided for the right ear: Yes If present, is the Veteran's right ear hearing loss at least as likely as not (50% probability or greater) caused by or a result of an event in military service? Yes Rationale (Provide rationale for either a yes, no answer or speculation reason): The C-file was reviewed. The compensation and pension exam request indicated a chief complaint of hearing loss and tinnitus. The service medical record was reviewed by the examiner. The veteran served honorably in the Air Force from 1994-1998. The veteran's MOS was Aircrew Egress Systems which is rated by the DOD as having a high probability of hazardous noise exposure. The veteran reported being exposed to flight line noise exposure, generators, and tools. Military records indicated an enlistment physical dated 3-11-1994 which showed normal hearing by calibrated audiometry. There were no other hearing exams within the STRs, therefore, hearing loss at military separation was not ruled out. Since hearing loss at military separation was not ruled out, it is at least as likely as not that hearing loss was caused by acoustic trauma during military service. Did hearing loss exist prior to service? No Left Ear Was there a permanent positive threshold shift (worse than reference threshold) greater than normal measurement variability at any frequency between 500 and 6000 Hz for the left ear? No Opinion provided for the left ear: Yes If present, is the Veteran's left ear hearing loss at least as likely as not (50% probability or greater) caused by or a result of an event in military service? No Rationale (Provide rationale for either a yes, no answer or speculation reason): The C-file was reviewed. The compensation and pension exam request indicated a chief complaint of hearing loss and tinnitus. The service medical record was reviewed by the examiner. The veteran served honorably in the Air Force from 1994-1998. The veteran's MOS was Aircrew Egress Systems which is rated by the DOD as having a high probability of hazardous noise exposure. The veteran reported being exposed to flight line noise exposure, generators, and tools. Military records indicated an enlistment physical dated 3-11-1994 which showed normal hearing by calibrated audiometry. There were no other hearing exams within the STRs, therefore, hearing loss at military separation was not ruled out. The veteran currently does not have hearing loss in the left ear that meets VA criteria as disabling 21 years after his exit from the service. As stated in the Handbook of Standard Procedures and Best Practices for Audiology: Compensation and Pension Examinations, impaired hearing is considered to be a disability when the auditory thresholds in any of the frequencies 500, 1000, 2000, 3000, and 4000 Hertz is 40 dB HL or greater; or when the auditory thresholds for at least three of these frequencies are 26 dB HL or greater. The examiner is not denying exposure to noise, rather stating that the exposure did not result in hearing loss that meets criteria for service connection. Therefore, it is less likely as not that hearing loss was caused by acoustic trauma during military service. Did hearing loss exist prior to service? No 4. Functional impact of hearing loss ------------------------------------ Does the Veteran's hearing loss impact ordinary conditions of daily life, including ability to work: No 5. Remarks, if any, pertaining to hearing loss: ----------------------------------------------- No response provided SECTION 2: TINNITUS -------------------- 1. Medical history ------------------ Does the Veteran report recurrent tinnitus: Yes Date and circumstances of onset of tinnitus: The veteran reports constant bilateral tinnitus that started while was in the military during the bombing of "Khobar towers" in Saudi Arabia in 1996. 2. Etiology of tinnitus ----------------------- The Veteran has a diagnosis of clinical hearing loss, and his or her tinnitus is at least as likely as not (50% probability or greater) a symptom associated with the hearing loss, as tinnitus is known to be a symptom associated with hearing loss. 3. Functional impact of tinnitus -------------------------------- Does the Veteran's tinnitus impact ordinary conditions of daily life, including ability to work: No 4. Remarks, if any, pertaining to tinnitus:: -------------------------------------------- No response provided NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. /es/ Katherine A Breaux Clinical Audiologist Au.D., CCC-A Signed: 09/10/2019 13:30

I just did that, and my AFSC, 2A6X3 is listed as highly probable. Like Buck stated, I sure do not recall getting a hearing test at our inprocessing physical at MEPS. I did get one upon separation but it was much less thorough. If I recall, just tell us which ear the beep is in. So, I do not know what they will use as the baseline in determining if it is service connected. I did state to her that my tinnitus started at the bombing so maybe, just maybe, they will figure if the tinnitus started there, the hearing loss started there as well. We shall see.