Rockhound

I went through all the VAGC precedent opinions and came up with nothing on the definition of probably, but in looking at BVA cases I came across one that relates "probably" to have the same weight as "as likely as not" to have 50% against and 50% for and if their is no evidence to the contrary, then the evidence stand in equipoise. which means when the evidence stands equally for or against the Veterans claim, it shall be ruled in the Veterans favor. Now if I can also get the neuro doctor to at least agree with the neuropsychiatric exam results, then it looks like I may be able to prove my claim. But to be on the safe side, I am hoping to get the neuro doctor to use the VA's terminology which would bolster my claim. I also need him to officially diagnose me with one or both of a cognitive depression disorder and/or cognitive personality disorder or syndrome. Hopefully getting him to say that the personality disorder the VA C&P Examiner in 1974 had opinioned on and the cognitive personality disorder were as likely as not one and the same. I say this because of the statement my previous Psychiatrist put into my progress notes that she didn't see that I exibited any personality disorder as defined by the DSM IV schedule of mental disorders. Man I hope that nerology appointment date comes soon. I'm sure it's going to lead to quite a few tests and exams after seeing the examination worksheet for TBI's. One of the symptoms that is asked about is sleep disturbances, don't you have to be asleep first for you to have sleep disturbance? Hell, most times I can't get to sleep. LoL I guess I better try, I need to give my eyes a brake, they've been open way to long today, come monday I will have to buy another bottle of liquid tears, my eye lids feel like sandpaper on my eyes. Rockhound Rider

I was hoping their was some clarification or opinion that states what you have said above. without the VA proper verbage, I'd rather not depend on a Rater to make the distinction. I once read an opinion which had the VA changing its verbage to more represent the legal language of the courts, but it's been awhile since I read that opinion and it's going to take some more digging I guess to see if it is of any help here, I was hoping someone may have had this cross reference somehow to make this search easier. Thanks for the imput, but I would feel better if I had it in writing from the VA or the Courts. Rockhound Rider

With all the changes since 1973, how am I to be sure that the DC code which reflected ICD codes back then and the DSM IV used today, is the correct one, when It doesn't appear to corrilate with my symptoms back then.

A number of times I have compiled information from my C-File, to either loose it to a natural catastrafy, fire, lost during my many moves, or just to scattered about to be of much good. I plan this time to place each page in a protective sleeve and then in a hard binder. My main question deals with the evidence I compile. A lot of it seems worthless as far as my current claims go or for those I think could be claims. 1. How to differentiate your evidence from what is medically usefull and what isn't, such as buddy letter, personel files or information, school records, SSDI records and the evidence used their, that can also be used in a VA claim? 2. How to appropriately lable stuff? 3. Do you duplicate information for each seperate claim so you don't have to sort thru other claims or files? 4. I don't have many claims to be concerned about, but do I set up a folder for each claim with the evidence I used and the corespondences dealing with that claim? I have many questions, but it would make this post go on and on. I need some help since my mind does not work so well in this department, planning and then exicuting the plan is like getting through a brick wall that is to high to climb over for me, so I need a bit of help on this. Also, I want to provide my Neuro doctor as complete a history of my medical problems and such and I wonder if I should just put it all, so long as it appears appropriet, in a folder for his preview before I see him. So he can say that he has reviewed everything. Some of this stuff may not even be a part of my C-File, but could well be relivent. Your help and suggestion would be most helpful, I'm sure. Rockhound Rider

Berta: Are you probably trying to confuse me? LoL LoL LoL. How the heck am I supposed to determine where on the line from point "0" to point "1" my probably statement lies? 0____________.5_____________1 I can't very well take the test over again so soon, I would know how to scew the test in my favor, at least I think I could. I guess that is why I need more tests to quantify that I do have congnitive dysfunction and that it is related to my brain injury in service, but can I expect the VA Neuro Doctor to give such an opinion? The best I have been able to get is a maybe, probably, or sorry, that is for the VA C&P Examiner to determine. I guess what the definition of probably is that there needs to be other supporting evidence when added to the equation would then have someone believe one way or another, less than or more than. It's seems I am in a waiting game once again, as I wait for an appointment with a Nero Doctor and then see what he does and says. Rockhound Rider p.s. Just thought of this. Maybe I should show the Neuro Doctor the probability line and ask him where he thinks my neuropsychiatric exam results put me. If at the time he can only put it slightly in the negative, then I guess I should find out what he needs to move it into the positive side between .5 and 1. I guess I answer part of my question.

The standards to meet the current DSM IV have changed so much and it appears that my Acute Schizophrenic episode is now listed as Schizophreninform disorder. If one were to look at my original medical summery notes of my condition, there is no way that it meets this standard for this particular diagnsosis. Looking at the current standards for DSM IV, it would appear that I more meet the standards for Schizoaffective disoder, depressive type, back then. How do I see about getting a current evaluation of my condition then and whether it is the same as what I am suffering now, not withstanding that a brain injury complicates this process? My psychotic episode was quite acute, with less than a 24 hr. onset that anyone could attest to. It was after a catatonic faze and after being medicated for a couple of days, that I at least came to my senses, enough to get out of bed and wonder into the shower room of the psychiactric ward, I was a patient on, an then proceded to pass out or become catatonic again, who knows and it was at this time I received my head injury. After I regained consciousness, I could not remember the past two or three days leading up to that time, but I had an almost instant recall as to where I was after exiting the shower room, since I was familiar with the psychiatric ward from my duties at the hospital. I'm at the point that I am so confused, that I am droping my psychiatric claim or for what I believed was a CUE claim, that I am now going to spend my efforts trying to SC my head/brain injury as Residuals from a TBI, which I have now been able to get some helpful evidence to show that probably my problems after being medically seperated from service, stem from this injury and not from the psychiatric illness I believed it was from. My head hurts and is swimming over this, it's no wonder I couldn't get a hand hold of this case in the past. to many twists and turns and not very many of my own making. Rockhound Rider B) B)

Thanks Berta: I plan to make sure the Neuro doctor sees this statement in the summery of my neuropsychiatric exam results. I want a more definite answer than just probably. I don't want the VARO to ignor it as meaningless, which I am sure they will, compaired to what a C&P examiner might say. Rockhound Rider

I was looking at the Nexus form that was posted on Hadit here and in the boxes where it lists, "Related to", & "At least as likely as not related to"' it also lists, " Possibly related to." I have the results of a neuropsychiatric exam that states that indicated I have both a cognitive depression disorder and a cognitive personality disorder/syndrome that is probably due to the head injury I sustained in service. Shouldn't the nexus statement form conform to the VA standards and read thusly, "less Likely than," "as likely as," & " more likely than"? Why can't the Dr's and examiners use this form of language, and why don't they? They know that an injury occured, because of the medical records clearly show it, and it is even shown backed up by a fracture of the nasal bone from a fall, further that a minor concussion was diagnosed supported by an EEG test. also that their was a short period of unconciousness and a period of retrograde amnesia of the time before the injury. Why then must they use a seperate language, such as Probably or possibly, and if they do, what weight do they carry as apposed to the more formal and definite statements used in VA claims? The use of these seperate languages only make it necessary for us to seek out private IMO, so that the language can then be formalized to meet the VA Claims standards, so that our claims can have at least a fighting chance of winning. I am frustrated that now, once again, in order for me to win my claim, I must once again be forced to pay out of my own pocket for an IMO who will be willing to write an opinion that uses the VA's claims more formal nexus statement language. Right now I am waiting on an appointment with a Neurologist, to see what he will do for me after review of my latest neuropsychiatric exam results and whether or not he will concure with the findings and give me a statement to put in my medical files that is probative to my claim and not some statement that continues to say my head injury may have been the cause or was probably the cause Where does probably stand for anyway, is it less than 50%, equal-50/50%, or is it greater than 50%? Is their some Precident Opinion on this somewhere? Rockhound Rider

This is another reason why the VA should not be both judge and jury, that is developing cases with the Veteran and then Deciding if they are to be awarded. Their should be a definite seperation of the two processes, one that protects the Veterans interests and one that protects the governments interests. I look at it, like a farmer trying to raise chickens and foxes in the same hen house. while you trying to raise the chickenes the foxes are eating them before their ready to go to market. Rockhound Rider

("Rockhound Rider B) Why did it take so long for this process? Something is wrong here?Maybe you have a posible Clear Unmistakeable Error in your file ? Once again Congratulations on your endeavours.") Ricky: My main problem for the past 35 plus years has been one of two problems or both. One, which has been the road block in my whole claims process, is that my original diagnosis was for a schizoaffective disordor. The VA said was a personality disorder. Whether or not I had a schizoaffective disorder or not, my life has played out like I had one. Not really being schizophrenic, nor psychotic to the point of being hospitalized, except for that one time. I have had major depression episodes that have plagued me all my life, a few times I got help and othe times I tried miserably to deal with it my self, which leads to my second possible problem. A closed head injury resulting in a minor cerebral concussion, that may be related to recent quantifiable results, that suggest I suffer from both an organic depression disorder and an organic personality disorder with severe executive cognitive dysfunction and minor dysfunction in other cognitive functions. So I can truthfully say that I have been hampered by mental problems that make it very difficult for me to process and control certain aspects of my life. Procrastination to the point of ignoring it or forgetting something altogether seems to be the biggest hurdle I have been trying to overcome. By concentrating on my claim, I tend to have deficits or problems in other parts of my life. My health was one, work was another, and now my social circle has dwindled down to one person besides a long distance relationship with my brothers and sister and to those like yourself I meet on the internet. I could and I suppose you could also write a book about our lives since our days in service, but I find it even too difficult to even try to write a paperback size story of western fiction. I love to read anything about the old west, whether it is historically correct or of pure fiction for intertainment. I thought I could write my own story line, but can't even get past the first chapter. The book is more for my intertainment and theripy, than for publication. If you have read my other posts, they seem to include more infor than they need. I can't help it, I think that it might have something to do with my problems, but without the proper help and insite from others, I can only surmise and wonder how much is related to my problems or how much is controled by my environment, social or otherwise. Anyway, regardless of how things in my life are going right now, If I am going to resolve that part of my life I feel is responsible for how I am now, I must put all my conentration into my claims effects and hope the other aspects of my life do not spirile to far out of control, that I can never get back to my core center again. Rockhound Rider B) p.s. one item I am trying to control again, is my claim records and information, by putting each page in a pertective sleeve and binder, so they won't get damaged or scattered about and lost or misplaced, so they will be where I can get to them much easier than in the past. one or two things at a time is about as good as it gets for me these days.

After thirty-five plus years and finally seeing a taste of what they owe me, helps lifts my spirits a bit, but I won't be happy until either my psychiatric problems or my cognitive dysfunctions due to a closed TBI or both are recognized, and I am either rated at 100% or for TDIU. I feel like the preverbial Woodpecker, pecking away until he gets what he is after. LoL As my sign on name implies, I am a rockhound, traveling around searching for that gold prize at the end of my search. Rockhound Rider

You said you had a broken nose and deviated septum, is this SC and if so, is it rated? If not, do you have at least 50% obstruction to both nostrils? If so, you should be rated at least 10% due to trauma. Their is often times when being overweight has nothing significant to affect Sleep Apnea. In some studies of people with sleep apnea, even after weight loss, whether it was by diet or from gastric bipass or some such surgery, their was little inprovement if any in their sleep apnea symtoms. Find these studies to help prove your IMO's opinion. I weighed in excess of 300lb when I had a sleep study test done. My VA ENT specialist said I was a candidate for a trachiotomy because of sleep apnea due to my obesity. When the sleep study was completed and rated, I only had minor indication of sleep apnea, and that a trachiotomy wasn't necessary nor was a CPAP machine indicated. However they did find that I suffered from Nocturnal Hypoxia while in REM sleep due to a restrictive lund disease and not due to my obesity, although it may be a contributing facter to its severity. Even if I lost weight, I would still have the restrictive lung disease and the nocturnal hypoxia condition. Don't give up and check to see if you can get a reconsideration of your DRO and if you can, ask for a formal meeting so you can make sure your IMO and any new evidence can be formally added to the record. Then they can't ignore the IMO, at least I would think not. If you don't have a VSO, try to find one who seems to agree with you and feel them out as to what they say and think you should proceed. You don't have to do what they say, you can still do it yourself if you find you have to, it's just a bit harder for you and the VSO makes it harder for them to say they don't have something when they know they sent it. Rockhound Rider

I guess I can put this post to rest for now, I received my accrued benefit check today, so all I have to do now is make sure to check my bank account at the first of the month to see that my monthly award check has been received. 10% doesn't seem much now that I got it, but every little bit helps, especially with winter coming fast. THANKS TO ALL WHO HELPED ME THROUGH THIS PROCESS. WHAT I LEARNED FROM THIS CLAIM I CAN USE TO WORK MY ADDITIONAL CLAIMS AND WITH A LOT OR WORK AND A LITTLE LUCK, I WILL SEE SIMILIAR IF NOT BETTER RESULTS ON MY NEXT CLAIM. Rockhound Rider B) B) B) B)

Thanks Angela: This is helpfull in that it points out my whole problem in proving my CUE claim. First I have to show how the personality disorder that was diagnosed by the VA C&P Examiner is the same as the current neuropsychiatric tests suggest was due to the TBI that caused an organic personality syndrome and the causeal link between the two. Which would probably be the depression episodes that continued to plague me up to now, becoming a chronic major depression disorder or as the neuropsychiatric tests indicated, an organic depression disorder. I've asked for a neurological consult for further evaluations as a result of these tests, so that I can further document my TBI as the cause of my personality disorder and depression then and my organic personality syndrome and organic depression disorder now. It may well take a month or two for an appointment, but time is still in my favor. Rockhound Rider

I just received my acrued benefit check for eight months back pay on a 10% increase award from 0%. I held it and looked at it and can't believe it finally came and only took a little over 10 months total. Now all I got to do is figure out sho should get paid first, that I owe or are a bit behind on paying. I only owe one bill that is past due besides my VA medicine co-pay and only three others that I am behind because of when my SSDI check comes in. But it is nice all the same to finally reach the light at the end of this tunnel at least. I guess I will celebrate with a sit down meal I don't have to cook myself. Maybe even some warm house slippers or boots to keep my feet warm this winter, if theirs enough left over. Just like to let you know so I can put a end to this posting about my increase claim for a Nasal Fracture with Deviated Septum due to Trauma. Now I can concentrate on my other claims. Rockhound Rider B) B) B)

If the retired Marine had HBP during service, then at the time of his discharge physical, the Marine Corps or in this case the Navy Dr's were responsible to see that he had at least an EKG run. Make sure that when she asks for his medical records, she also specifies a copy of his exit physical. The failure alone, not giving him an EKG at his age with HBP is like giving a child a loaded gun. My father was SC for his heart condition after he had a heart attack after he was discharged from the service, and he should have had a EKG, but they didn't do one, His claim was approved on this alone, since had they done the EKG, it would have shown an underlying heart condition. also if his heart condition was noted prior to the presumptive period for such condition, he probably was intitled to SC instead of a NSC Pension. Theirs a lot of info we don't know about that would help us narrow her options down and not be sending her in all directions hoping she will find something and then only to find out she had been looking in an intirely different direction.

I should have added that my VSO is going to go thru my evidence I have thus far to see what is of value and what isn't and what I need or should bet before she turns in the new claim. She feels strongly that I have a case for these two items, but she wants to make sure that the evidence is more specific or has less wiggle room than my award that led to these two knew items. She feels that secondary issues are scrutinzed more so than the basis claim that they derived from, since they can say that may appear on the surface as being the result of a SC problem, but since it didn't happen at the same time as the claim it was derived from, there is a difference in the standard of proof. I hope this makes sense. It did when she told it to me. Rockhound Rider :P

I was in seeing my VSO to see about setting up Direct Deposit of my new SC 10% award, while their we began to discuss certain secondary issues I felt should have been assessed and/or adjudicated on, for this award and she jumped on it before I had even finished explaining why I thought they should have done so. The two secondary issues deal with: (1) Pain I exibited when examined during the C&P exam for my SC fractured nasal bone and deviated septum, due to trauma claim. Superficial scas, analogus to Painful scaring. exibited by tenderness in the nasal region with repeated ulcerations. (A 10% evaluation may be assigned for superficial scars which are poorly nourished with repeated ulcerations, 38 CFR 4.118 DC 7803) (2) Chronic Sinusitis with non allergic and/or allergic Rhinitis, necessitating daily treatment of a corticosteroid nasal spray at it's highest allowable dosage per PCP and a antihistamine, taken once a day, in order to maintain an open air way through both nasal passages so that treatment for an unrelated breathing problem can be successfully accomplished. (A 10% evaluation may be assigned for a chronic disease that is Inactive, following repeated episodes, without evidence of active infection in past 5 years. However, 20% evaluation may be assigned is shown with a discharging sinus or other evidence of active infection within the past 5 years.CFR 4.71a DC 6311-6314). Rockhound Rider :P

jbasser: If you mean from the VA hospital I was transfered to, NO! I only have the Hospital Summery notes which only speaks in general terms, ( such as did neurological examination was essentially negative). They did not specify any specific types of tests the exam went into like my summery note from the Navy medical board did and the most resent neuropsychological tests I took. They explaind what tests were involved and their results. I was at the VA hospital today to talk with my VSO about my banking infor, not realizing I didn't have to fill out a form, that I only needed to call and give them the right information and such. While I was their I went to my medical team and put in a request for a neurologist consult, so I got that in the works. The only bad thing was when she asked me a question about my Dr/PCP assigned to me, it was a different DR. yet again and this time they gave me a male Dr. even after I made a formal request to only be assigned a female Dr. because I have a fetish, phobia or something when it comes to male Dr.'s poking and proding me. It only seems to be with male Dr's that I have to work with as closely as one would with a PCP and one such as a Psychiatrist. although I have had some bad time with some specialists, for the most part, I only see them maybe once or once a year, so I manage it ok. But It was upseting all the same, since I thought I had already been assigned a female Dr. when I had my followup from my Labor Day Hospital stay for a bacterial infection of the small colon. NO! the answer is no, I do not have any nursing notes that go back that far, even for sick call and similiar notes for during the time I was in the service. Rockhound Rider :P

Another dead end I guess. I got a 0% from the Navy because they said the VA would take care of me, that is why they transfered me to a VA hospital for further treatment and observation, because I wasn't OK then and because it was closer to my mother and family members, since my father had just past away. The VA did nothing in the 12 days they said I spent as an inpatient except the normal intake procedure and I certainly didn't get any further treatment nor observation because most of the time I spent at home on convelescent leave to be with my greiving mother. So I recon this is another dead end. They didn't even do anything to assess any residuals for my head injury either. That's how the VA looked after the Veteran back then. Kick them to the street and hope they go away, which is pretty much what I did, because I had to survive. It was easy to just forget about my problems when you had a grieving mother to look after. God I get so angry when I have to look back to those times, I can honestly say now, it is time like this that my paranoia is most prevelent and the voices tell me it is time to do something so the VA will stop messing with my mind. I'm glad over the years I have been able to disapplen myself at times like this to seek help and/or that it triggers me to take the extra medication I am allowed to take. It's such a wonder how I made it this far when I didn't have the medication to help me, of course I wasn't doing much with my claims then and at least when things did start to get out of control I did seek out help and did get medication, even if it was for a short time then. Now I am a prisoner to my meds and to not take them could well end disastraously. I'm also glad it's one of those days I am going into the VA hospital, even though it is just to turn in the banking info for my award so I can get direct deposit for it. As you guessed it, not a good night last night, little or no sleep, I couldn't tell, maybe that person or persons unkown in my head would have known, if he wasn't so intent on wanting me to someone. Don't worry, not there yet. got to go Rockhound Rider :P :P

Berta: might you have an opinion as to the viability of a CUE claim for not considering and/or applying CFR 4.28? Rockhound Rider :P

I'm sure if you made any inquiry on getting this medication, someone who the information got to was on the ball and knew their was a possible malpractive issue, since a Dr who has never seen you cannot by any standard of medical practive, prescribe you any medication that needs a perscription. They are only covering their asses at this point, I might still however, send in a complaint to the AMA or Pharmacy Board listing this Dr by name for his mess up. Rockhound Rider :P

Wings: I could just kiss you for this find, but since I can't, I'll just have to say thank you very much. I think and feel if I presented this study to a neurologist, it might be the supporting information he would need to confirm the organic brain sysdrome Dx for depression and personality disorder and maybe even a basis for my adjustment disorder as well, although the study doesn't list or quantify it. But at least this is a big step in the right direction, each of the points in my neurological test results are covered in this study which would give definite support to any opinion by a neurologist and the neuropsychiatric test results. Thank you once again. Rockhound Rider :P :P B)

Below is a couple of excerps from the Summery & Recommendations of a Neuropsychiatric test I took and wonder if I need conformation from a Neurologist that their is brain damage consistant with these test results? That is, his findings are consistant with the test results and that the TBI I sustained while in the service is more likely than not or as likely as not the cause for my current problems listed in the stated excerps 1. "Mr. XXXX 's attention and memory abilities are basically intact. Test scores show significant executive dysfunction. 2. "Given the course of history, it is possible that the deficits found represent the sequaelae of the brain injury he sustained during the military service. Changes in mood and personality functioning may represent an Organic Personality Disorder stemming from the brain injury. Military records show that his performance prior to the injury was satisfactory. Also, would I need I a, "as likely as not" or better statement from this neurologist, that the Personality disorder, inadequate type, that was used to deny my original claim for a psychiatric disorder were one and the same and had no relationship to the psychiatric disorder, since it developt from the TBI as a organic personality disorder, and not as the VA Examiner opinioned it to be nor how the VA Rater later used it as his basis to deny my original claim? I'm just trying to get input so I can reopen my claim so that I can, first get my TBI SC and then possibly later, get my psychological problems from service also SC. Rockhound Rider :P p.s. sorry for the spelling errors. LoL :P

I have a lot of diagnosises and symptoms that are only being treated to alleviate the severity of them and not on the basis or idea of curing them. I'm sure that some of my many problems, if they were treated differently and with physical theripy could possibly be taken off my list of dx's and/or conditions. The VA's method of throwing medication at everything only provides maintenance for our problems and condition. It does not provide any cure or the likelyhood that their ever will be a day we will be cured of any of these things. I know this sounds like a cop out, but if I wasn't so messed up Psychologically, Physically, and with mental cognitive problems, I could and would be helping myself with some of these problems, but I am handicapped to the point that I need and must have the help of medical professionals to help me do what is needing done. The VA Hospital System is lacking in this respect and I don't have the financial resources to seek it elseware. I'm looking for recommendation and or sudjestions from everyone, as to how I might approach my concerns with my VHA PCP, Psychiatrist and the number of specialist I have been seen by. Rockhound Rider :P