MostDaysIhavenoidea

So I have always just assumed that you find an Independent medical examiner to perform an Independent Medical Exam that renders his Independent Medical Opinion to provider a NEXUS letter; the Nexus letter being the 1.) inciting event on active duty, 2.) official diagnosis of condition and 3.) the Medical Rational/pathology linking 1 to 2 "more likely than not" . The Caluza elements is a brand new term completely but upon my very basic understanding of these elements....are they not the same 3 elements of a nexus letter? Also while reading through some of the post it kinda seems like maybe IMEs, IMOs, and Nexus reports are not all the same and so now am pretty sure I'm confused. What are the differences and what holds more value in obtaining for a successful claim? Also, is there any value in having both a Nexus letter and a DBQ performed by independent medical examiners? If a nexus letter cost $500 and a DBQ cost $500 and you only have $500..... which one would you buy or would you borrow anther $500 from a friend to get both?

So tinnitus outside of Noise Induced? Maybe... 1.) TBI residual/post concussive syndrome 2.) Meniere's --> symptoms include (i)tinnitus, (ii) vertigo, (iii) fluctuate hearing loss history of blast exposures and TBIs --> post-traumatic menieres 3.) Industrial Chemical/solvent exposure 4.) Tympanic membrane perferation 5.) Otosclerosis 6.) Chronic/Recurrent ear infections ....so at the end of the day, tinnitus is a symptom of damage to the hair cells, most often cause by exposure to prolonged noise exposure. High frequency ringing most commonly linked to traumatic; low frequency ringing is usually part of aging

So with a previous skull fracture, is it possible to go the route of preexisting condition without symptoms or issues upon enlistment became aggravated and worsened due to time in service? Preexisting condition would have to have been without medical concern or symptoms or they wouldn't have allowed you to enlist I think I read somewhere you are airborne qualified maybe? Can that jump badge give you the presumption of "cumulative TBIs" and degenerative disc disease due to the numerous jumps you've completed? Also, any blast exposure while on active duty? I guess blast exposures are now on the list to be considered a form of TBI Also, I didn't see your MOS.... you weren't exposed to JP4, JP5, JP8, aircraft exhaust, diesel exhaust, engine de-greasers, hydraulic fluids by chance? Environmental exposures would be another link to migraines. Cervical disc disease is linked to cervicogenic headaches, if you were airborne, seems like your occupational of jumping out of aircraft would predispose you to neck and back issues

Aviation related occupation or firefighter ? AFFF (aqueous film forming foam)used by firefighters, often on the flight line and boats. Apparently that's kinda a big deal. I was told firefighters where instructed to swim in the stuff as part of their training. Anyways, if your MOS is one which would predispose you to that stuff seems like you should bring that to the attention of the provider or make sure it's somehow uploaded in your additional evidence as to how your occupation caused your exposure; like "My MOS as a firefighter required I swim in AFFF as part of my required training" or " I was on the flight line when some ID10T decided to mess with the giant fire extinguisher and I was covered in the foam stuff" exposed by direct skin contact, breathing/respiratory, swallowed/GI, mucous membranes of eyes/nose/mouth

So PTSD is a no but Chronic adjustment disorder is a go. I would think that even if the notion of your "inciting event" being at age 17, if you didn't have any symptoms going into service then it would seem as though your time on active duty precipitated and aggravated your Adjustment disorder. I am assuming here but it doesn't seem like any branch would accept anyone with a chronic adjustment disorder, that would be like allowing someone to enlist with a known history of "failure to adapt". Make sure details on how this condition creates a disability for you; ie) inability of establish effective and meaningful relationships (occupationally and socially); chronic sleep disturbances (inability to fall asleep, stay asleep, restless sleep); difficulty with concentration and focus; inability to adapt to stressful situations....

...an there is definitely a link between OSA and hypertension. So lack of oxygen whilst sleeping--> kidneys kick on red blood cell production (to get more volunteers to bring in oxygen)-->increased red blood cell count --> increase blood pressure probably way more simplified than need but yes, elevated blood pressure is a well known consequence of OSA. Also in regard to the initial question. I think maybe both obstructive and central sleep apnea is linked to PSTD, make sure your NEXUS hits on both, the PSTD aggravates the Central Sleep Apnea which further contributes to and aggravates your Obstructive Sleep Apnea....idk, just a thought obstructive-->physical obstruction link increase neck circumferance central-->the nightmares/terrors, interruptions of REM sleep, not physical

https://www.va.gov/OGC/docs/2017/VAOPGCPREC1-2017.pdf Not sure how helpful this is or if it's already been discuss in regards to the link between weight gain and heart disease/high blood pressure/diabetes. Obesity doesn't appear to be a disability per say but if using the service connect diagnosis of obesity as a "bridge condition" leading to/contributing to/aggravating other conditions considered disabling then I suppose those conditions would fall into the secondary conditions. Also, it does appear that hypertension rated at 10% disabiling kinda gives you another 30% under renal dysfunction! Rating Renal dysfunction: Requiring regular dialysis, or precluding more than sedentary activity from one of the following: persistent edema and albuminuria; or, BUN more than 80mg%; or, creatinine more than 8mg%; or, markedly decreased function of kidney or other organ systems, especially cardiovascular 100 Persistent edema and albuminuria with BUN 40 to 80mg%; or, creatinine 4 to 8mg%; or, generalized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion 80 Constant albuminuria with some edema; or, definite decrease in kidney function; or, hypertension at least 40 percent disabling under diagnostic code 7101 60 Albumin constant or recurring with hyaline and granular casts or red blood cells; or, transient or slight edema or hypertension at least 10 percent disabling under diagnostic code 7101 30 Albumin and casts with history of acute nephritis; or, hypertension non-compensable under diagnostic code 7101