pacmanx1

John, I read this a few months ago and forgot where I read it. Checking the reg. today, I came across it again and thought that it may help a veteran so I decided to post it.

This is not your award letter. You will get an award letter from the regional office that is close to you. Your claim(s) have not been decided yet.

Now begins the big long wait for VA to make their decision and send you, your award letter. If you had your C & P exam at the VAMC hospital, you can go to the release of information office in a week or so and request a copy of it to figure out what was stated on your exam. Hope the best

Campaigns and expeditions. In considering claims of veterans who engaged in combat during campaigns or expeditions satisfactory lay or other evidence of incurrence or aggravation in such combat of an injury or disease, if consistent with the circumstances, conditions or hardships of such service will be accepted as sufficient proof of service connection, even when there is no official record of incurrence or aggravation. Service connection for such injury or disease may be rebutted by clear and convincing evidence to the contrary. CFR 38 3.305 ©

You do not need a nexus (doctor statement). Since you are still on active duty make sure that you get everything documented that you want to claim. Make sure you get a complete copy of your military records before you leave the military. Also make sure that you address every issue on you retirement physical.

When did you get out of the military? If it has been less than a year then you "may not" need a letter, it depends on when you were discharged.

OK, I want you to know that this is my opinion and I could very much be wrong or way off. There is a lot in red so I will try to sum it up for you. VA will probably increase your already service connected mood disorder. Your increase maybe 100% schedular or 70% and award you TDIU and pay you the 100% rate. VA may also request that you have a fiduciary (wife will have control of your VA money). The report says that you were hospitalized for a mood disorder in June 2009; it says that you have severe depression that causes problems with your daily activities and that you cannot be left alone. VA may also consider A & A since you have to have someone with you at all times. I think I covered the most important stuff; you will just have to wait to find out what VA will do. Others may chime in.

Have you tried to ask your doctor to put a note in your progress reports? VA doctors do not like writing statements, IMOs, or letters but some of them will put something in your treatment records that may help your claim.

Carlie, have you seen this; § 4.96 Special provisions regarding evaluation of respiratory conditions. (a) Rating coexisting respiratory conditions. Ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other. Where there is lung or pleural involvement, ratings under diagnostic codes 6819 and 6820 will not be combined with each other or with diagnostic codes 6600 through 6817 or 6822 through 6847. A single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. However, in cases protected by the provisions of Pub. L. 90–493, the graduated ratings of 50 and 30 percent for inactive tuberculosis will not be elevated. Also as JBasser said; § 4.7 Higher of two evaluations. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. Of course you already know, that since you have already won your service connection, if VA tries to low-ball you, you can disagree your rating back to the BVA for a higher rating. Hope this helps.

I think this page will help explain: http://ifap.ed.gov/d...scharge/va.html

You may also want to ask them for what all the necessary documents, that you and your family need to bring before going to make sure you have every thing you need.

Congrats

Found On: http://www.veteranst...s-health-alert/ October 14, 2010 RESEARCH ANSWERS FOR GULF WAR VETERANS Sarin Exposure and Late Onset Heart Damage

Congrats.

Having an appeal at the DRO level is "supposed" to be faster maybe 30 to 90 days, a Traditional Appeal maybe 4 to 6 years. These time frames are not set in stone but again the DRO should be faster. As John999 said, if you lose at the DRO level, you can still appeal to the BVA.

Renee, it really depends on all the evidence. When were you discharged from the military? When did you file your claim? When did you get a denial letter? Did you file a NOD within a year of you receiving your denial letter? The VA could have used the doctor's statement as new and material evidence.

Congrats.

Sandy, since your claim was denied in 2009, you are past the appeal time frame. You can file a new claim for service connection for back condition secondary to your already service connected left and right knee conditions. You can also try to get a doctor statement that you are unemployable due to your service connected conditions and try to file a reopen claim for TDIU. Hope this helps

No, I posted this to show that fibromyalgia, IBS and Sleep Disorder can all be rated separately without pyramiding. My claim is still with the DRO as of Jun 3, 2010. It is close to what I am going through but a little different.

Citation Nr: 0615044 Decision Date: 05/23/06 Archive Date: 06/02/06 DOCKET NO. 03-12 197A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Boise, Idaho THE ISSUES 1. Entitlement to service connection for irritable bowel syndrome (IBS). 2. Entitlement to service connection for a sleep disorder. ATTORNEY FOR THE BOARD David S. Nelson, Counsel INTRODUCTION The appellant is a veteran who served on active duty from May 1990 to January 1995, including service in Southwest Asia from January 14, 1990, to March 23, 1991. These matters are before the Board of Veterans' Appeals (Board) on appeal from an October 2001 rating decision by the Portland Regional Office (RO) of the Department of Veterans Affairs (VA). The veteran's claim file is in the jurisdiction of the Boise RO. In a statement received in August 2005, the veteran indicated that he was interested in filing a notice of disagreement as to the issue of service connection for pelvic tilt (which was denied in a June 2005 rating decision). However, a note in the file dated in March 2006 reflects that the veteran stated that he was no longer pursuing the appeal related to service connection for pelvic tilt, and that he requested that the issues on appeal be forwarded to the Board for adjudication. He also indicated that he was entirely satisfied with determinations made in a July 2005 rating decision. FINDINGS OF FACT 1. The veteran served in Southwest Asia during the Persian Gulf War. 2. Competent evidence establishes that the veteran has IBS, and a sleep disturbance disorder (dyssomnia) that is either due to undiagnosed illness or is due to his service connected dysthymic disorder . CONCLUSIONS OF LAW 1. Service connection for IBS is warranted. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002 & Supp. 2005); 38 C.F.R. §§ 3.303, 3.310 (2005). 2. Service connection for dyssomnia is warranted. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002 & Supp. 2005); 38 C.F.R. §§ 3.303, 3.310 (2005). REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veterans Claims Assistance Act of 2000 (VCAA), in part, describes VA's duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a). The VCAA applies in the instant case. Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper VCAA notice must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; (3) that the claimant is expected to provide; and (4) must ask the claimant to provide any evidence in his or her possession that pertains to the claim. 38 C.F.R. § 3.159(b)(1). VCAA notice should be provided to a claimant before the initial unfavorable agency of original jurisdiction decision on a claim. Pelegrini v. Principi, 18 Vet. App. 112 (2004). Because the decision below represents a grant of the claims, there is no need to belabor the impact of the VCAA on this matter. While he did not receive any notice regarding ratings of service connected disabilities or effective dates of awards (Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006), the decision below pertains only to service connection; neither the rating of a disability nor the effective date of an award is a matter for consideration by the Board at this time. Hence, the veteran is not prejudiced by the lack of such notice. Factual Background A November 1994 report of medical history reflects that the veteran complained of frequent trouble sleeping. The physical examination portion of the veteran's November 1994 separation examination noted no findings related to a sleep disorder or IBS. On December 1997 rheumatology examination, the veteran reported general complaints of joints locking up and pain throughout his body. Following examination the diagnosis was fibromyalgia syndrome, consistent with his diffuse pain, and possibly a sleep disturbance. The examiner suspected all of these factors were interrelated. A January 1998 VA note essentially stated that the veteran met the DSM-IV criteria for dyssomnia, not otherwise specified. A January 1998 VA medical record, comments on various findings from a sleep study of the veteran, and shows diagnoses of insufficient sleep syndrome, and fibromyalgia. December 1998 to March 2000 VA medical records indicate that assessments of the veteran included IBS and fibromyalgia. On a May 2001 VA intestines examination, the veteran indicated that he had had irritable bowel syndrome for many years. He stated that he had alternating episodes of diarrhea and constipation as well as crampy abdominal pain. The diagnosis was irritable bowel syndrome. The examiner discussed, in brief, the relationship between IBS and fibromyalgia, and indicated that he was not ready to state what that relationship was at this time. On an April 2002 fibromyalgia examination, the veteran indicated that he had undergone several days of chronic back, neck, and leg pain. He complained of abdominal cramps and bloating, and also complained of having trouble getting to sleep at night. He indicated that he might sleep for 2 to 4 hours, but then he would toss and turn and kick his legs all night. He indicated that he woke up unrefreshed. The diagnosis was fibromyalgia. The examiner noted as follows: This patient meets [the] criteria for fibromyalgia with classic symptoms of symmetric above and below the waist chronic body pain, sleep disorder, fatigue, and depression. Additionally, the patient suffers from headaches and irritable bowel syndrome. In a January 2003 addendum to the April 2002 examination, the examiner stated as follows: The question is asked by the regional office regarding the etiology of the patient's irritable bowel symptoms. It should be noted that patients with fibromyalgia often have a constellation of symptoms as part of their syndrome. This includes widespread musculoskeletal pain and tender points, with associated fatigue, sleep disturbance, stiffness, paresthesias, headaches, irritable bowel symptoms, depression, anxiety, Raynaud's phenomenon like symptoms, etc. The etiology of fibromyalgia syndrome is unknown, as is the mechanism of symptomatology, as listed above. The symptoms of irritable bowel syndrome, headaches, depression, etc., are not required for the diagnosis of fibromyalgia, but are often found in association with fibromyalgia, as is the case with this patient. In summary, this patient's irritable bowel syndrome and sleep disorder should be considered part of his fibromyalgia syndrome. On a May 2002 VA mental disorders examination the veteran indicated that he suffered from a terrible sleep disturbance, and noted that he only got 2 to 4 hours of sleep per night. The examiner stated: The veteran does not appear to meet the DSM-IV criteria for a primary sleep disorder, given that the DSM-IV diagnostic manual specifies that if there is insomnia related to another mental disorder, which in this case is dysthymic disorder, then the diagnosis of dysthymic disorder is more appropriate. Further, a diagnosis of primary sleep disorder should only be considered when the insomnia is the predominant complaint, and is sufficiently severe to warrant independent clinical intention. [The veteran] notes that his insomnia is not the only concern he has, and in fact, he expressed significant concern about his lack of self-confidence regarding employment and going back to school because of concentration deficits, which was another symptoms of dysthymic disorder. The diagnosis was dysthymic disorder. In a letter received in May 2003 a VA physician stated: I have been [the veteran's] primary care provider since 1996 and am quite aware of his medical conditions. [The veteran] clearly has fibromyalgia, sleep disturbance, and irritable bowel syndrome. In addition he has dysthymia and depression, restless leg syndrome, and chronic rhinitis. It is my opinion that while fibromyalgia and irritable bowel syndrome occur together with some degree of frequency, they are separate entities, which occur independently. The presence of irritable bowel syndrome is not a diagnostic criterion for fibromyalgia. In a similar vein, while there is frequent association between fibromyalgia and sleep disturbance, they exist independently. If the sleep disturbance were to be associated with one of the veteran's conditions, the most likely association would be with dysthymia and depression. On an April 2004 fibromyalgia examination the veteran complained of widespread musculoskeletal pain. He also complained of flare-ups of IBS that could last for a couple of days at a time. The diagnosis was fibromyalgia. On a VA mental disorder examination dated in April 2005, the veteran again made complaints of difficulty sleeping, indicating that he slept just 3 to 4 hours at the beginning of each night. The veteran, it was noted, endorsed easy fatigue, irritability, muscle tension, and sleep disturbance. The diagnoses included dysthymic disorder. In a letter received in April 2005, the veteran's longtime VA physician indicated that he had prescribed Oxycodone at night, in an effort to improve the veteran's pain control, and to give him better sleep. Analysis Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Disability which is proximately due to or the result of a service connected disease or injury shall be service connected. 38 C.F.R. § 3.310(a). Service connection (for Persian Gulf veterans) may also be given for unexplained chronic multisymptom illness (such as chronic fatigue syndrome, and irritable bowel syndrome) that is defined by a cluster of signs and symptoms, as well as for disability due to undiagnosed illness. 38 U.S.C.A. § 1117; 38 C.F.R. § 3.317. At the outset, it is noteworthy that it is not in dispute that the veteran has IBS and a sleep disturbance disorder. As he served in Southwest Asia during the Persian Gulf War, and IBS became manifest after such service (and is not shown to be due to nonservice-related intercurrent cause), service connection for IBS is clearly warranted under the controlling law and regulation (i.e., 38 U.S.C.A. § 1117; 38 C.F.R. § 3.317). As for the sleep disturbance disorder (dyssomnia), the record shows that such disability is either due to undiagnosed illness or is related to the veteran's service connected dysthymic disorder. Whichever is the case (as the veteran's VA primary care treating physician has indicated that the sleep disturbance disorder, like IBS, is a separate and distinct disability entity and that matter no longer appears to be in dispute), service connection for such disability is warranted under the governing law and regulations (either under 38 U.S.C.A. § 1117; 38 C.F.R. § 3.317, or under 38 C.F.R. § 3.310). Significantly, it appears that the RO continued to deny service connection for IBS and a sleep disturbance disorder (dyssomnia) because these disabilities have overlapping symptoms with other disabilities which are already service connected. Nothing in this decision recognizing IBS and a sleep disturbance disorder (dyssomnia) as service connected disability entities precludes consideration of 38 C.F.R. § 4.14 when the disabilities are rated. ORDER Service connection for IBS is granted. Service connection for a sleep disturbance disorder (dyssomnia) is granted. ____________________________________________ George R. Senyk Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs

There are only three not thirteen. "Generally, to prove service connection, a claimant must submit; (1) medical evidence of a current disability, (2)medical evidence, or in certain circumstances lay testimony, of in-service incurrence or aggravation of an injury or disease, and (3) medical evidence of a nexus between the current disability and the in-service disease or injury."

The letter should say that your current condition "is at least likely as not cause by or a result of your military service or aggravated by military service" and give a rationale. The rationale would be something that actually happened in service; maybe a neck or back strain, neck injury, arm injury, or vehicle accident. Something that "could" be the cause of your condition. This is just my opinion and others may chime in.

Remember the character Joe Friday, he would frequently say "JUST THE FACTS PLEASE, JUST THE FACTS" Keep this in mind when you are filing a claim. The claim could be an initial claim, a claim for increase or a claim for secondary conditions, filing a NOD, or filing a form 9. It really does not matter. I am not trying to be insensitive but VA does not care. Try to be specific about what you are claiming. Unfortunately long statements are misunderstood and confuse VA employees so getting to the point as soon as you can will help your claim. This is just my opinion

An internal VA email tells employees who may be contacted by CNN regarding MST story: "DO NOT ENGAGE." Found on: http://www.vawatchdo.../nf100910-1.htm

There would be no retro payment and no credit