Jim MAC

Opted for "informal DRO Hearing." No tape recording or transcription. DRO said we could go on record., record and transcription, at any time that I chose to do so. After approximately 30+ min. of back and forth, the DRO said he was granting my main NOD issue from 2010. And because we were doing an informal hearing, he would also address my TDIU NOD filed in 10/2011, if I was prepared to do so.
I was, we did, I won! The DRO awarded TDIU back to my original PTSD filing date. Hearing was completed by 9:50am. My VSO called at 3:30 same day, to advise me, he already had the DRO Award Letter on his desk.

It took a couple years to get my original NOD Hearing, but the wait was worth it. The work I did preparing, gave me the confidence to represent myself at the hearing. Saved me 20% of retro, for legal representation.

If you have access,Check your MyHealthevet, your medical records will have any updated SC%. Also check "Letters", at ebenefits, or download letters, it will reflect your current updated rating in the "Summary of Benefits" letter. All of this updated for me the same day they closed the claim.

Just a thought. Good Luck, I hope you received the decision you wanted.

Welcome. Just because you are now under VA healthcare and not under DOD healthcare does not mean they have the right to lower the standard of healthcare you are entitled to receive. Your PCP sounds like a jerk who should not be working in the VA healthcare system. Ask for a new PCP and tell them why you are requesting the change.

You need to formally file for PTSD.

"Also I plan to start seeing a personal physiologist, would their diagnosis be of any help?"

Probably not.

"Effective July 13, 2010, VA amended its adjudication regulations governing service connection for PTSD by liberalizing, in certain circumstances, the evidentiary standard for establishing the required in-service stressor. 75 Fed. Reg. 39843 (July 13, 2010). Specifically, the final rule amends 38 C.F.R. § 3.304(f)(3) as follows:

If a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of [PTSD] and that the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

See 75 Fed. Reg. 39843 -51 (July 13, 2010) and corrective notice at 75 Fed. Reg. 41092 (July 15, 2010)."

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp14/Files2/1414893.txt

If you do fit into the above criteria, the VA will surely diagnose you with PTSD. Also they will consider also any combat awards such as CIB, CAR, or PH on your DD 214 and, in that case ,would probably most definitely concede the stressor.

In this following BVA case it shows how difficult it can be for vets with private psychiatric care to get a PTSD diagnosis from the VA:

In part:
Private treatment records in April 2007 showed that the Veteran described the aforementioned in-service incident. The examiner diagnosed PTSD.

The Veteran was afforded a VA examination in March 2013 in which the claims file was reviewed. The VA examiner opined that the Veteran's symptoms did not meet the diagnostic criteria for PTSD under DSM-IV criteria. The VA examiner noted the above-referenced private diagnosis of PTSD and stated that the test results and diagnosis were not considered relevant as the method of testing used did not include any instruments that would have tested for malingering nor did the private examiner explain how PTSD symptoms materialized years after the identified trauma. The VA examiner stated that research indicated that delayed onset was rare; delayed onset with no prior symptomatology was ever rarer, and the combination of no symptoms for 40 years with then a full clinical presentation was almost unheard of. The VA examiner opined that the Veteran as not a credible historian."
And

"By contrast, the VA examination reflects a comprehensive evaluation prepared after reviewing the claims files and examining the Veteran to ascertain whether the he met the DSM-IV criteria for a diagnosis of PTSD. The VA examination noted that the Veteran experienced, witnessed or was confronted with an event that involved actual or threatened death or serious injury, but the traumatic event was not persistently re-experienced ("Criterion A and B", respectively); he did not meet "Criterion C," which pertains to persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness or "Criterion D," which pertains to persistent symptoms of increased arousal. Therefore, the VA examiner concluded that the Veteran did not meet the criteria for a diagnosis of PTSD."

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp13/Files4/1338861.txt

There is considerable info here on PTSD in our PTSD forum.

Also on what stressors are:




And info on how to get Buddy statements :

Today 1 day after getting the bank deposit i recieved the big brown envelope.
100% schedular was the final grant and chapter 35 , CHAMPVA FOR THE WIFE,AND ANYTHING ELSE THAT COMES WITH

WAY TO GO HADIT! YOU GUYS NEVER LET ME QUIT.

If you can swing a tiny loan from your bank and then pay it off rapidly that will help your credit rating a lot. You do that a couple of times and your credit will start to smell sweet. Same with credit card with 1000 dollar max. Get it, and use it and pay off every month. Your credit recovers. Miss a payment and you are in the toilet. Get a gas card and pay every month. They just want to see that you pay your bills on time.

Well I was finally awarded my retro here a few weeks back sorry haven't posted that bit of good news. I just been too busy excited..

where did the va get this 123 day waiting time? I thought I saw that in some report? I think it is 123 years, not days..

Some guys on here got IU, and it took them over 5 years. We are all so tired of waiting. Every other article about how the VA is jammed up and not doing their job, it doesn't matter if the VA still takes their sweet time about our claims. Bad enough they low ball us in the beginning, and then we have to fight for years what we should have gotten from the start. Good luck and God Bless to all.

No fair. I hid that money from my wife.

I work sensitive 7 at varo along with four digits. Pretty much the info I gave you is why stuff is sensitive. Also I'm sensitive 7 being an employee. Jmho

Since when has the VA allowed Science to effect its policies.

Service Connected Sleep Apnea...Being a retired military medical person, there are many health problems that link back to Sleep Apnea, Reflux, snoring, high blood pressure, depression, PTSD, type 2 diabetes, heart problems, weight problems, and the list goes on. Weight problems are recorded in your service record as well as your medical record, and all branches of the service have had a weight program for the past 25 years, and if you were ever on this, I'm sure that is one of the causes of your sleep apnea, you don't find out that it caused sleep apnea until you get out and all the other bad medical problems start after discharge. When they do a discharge physical on you , they to the basis physical, they don't want to find any problems that will delay your discharge or retirement or require a medical board. They tell you most of the time, "Just go to the VA when you get out if you have a problem", to avoid your discharge delay. On my retirement physical I had a couple of medical problems I wanted addressed and written down on my physical, the senior medical officer had a fit when he saw them on my physical because it required medical consults and follow ups before my physical was complete, I also refused to sign off on my physical until it was to my satisfaction not his. Also I was in charge of the physical exam clinic at the time, helps to know people lol. Most people who have served in the military know it's all to easy for someone to tell you "NO", then it is for them to say "OK", so you go up the chain of command, everyone's got a boss higher then them, so when you get a "NO" answer, keep trying, if all else fails get you a Lawyer they will win the case for you. Keep on trying until you find that person who will say "Yes you have a disability" they owe that to you for your service to your country. To many Vets are forgotten once you get that discharge paper. I think the military should require a physical of it retired Vets every 5 years just to follow up on service related problems that get you when you leave the service. I think that would be a good preventive medicine and help those out on active duty to avoid things that will knock you down once discharged or retired. Why are we the forgotten ones, after our service?

Doc904

Everytime I think something can't be done some hard charging vet proves me wrong. Great work!!!!
I am very interested since my apnea is driving me crazy.

My sleep apena claim, started in Oct 2011 has been approved. My contention was that my apnea is aggravated by my weight caused by inactivity and drugs used for depression and chronic pain. When I get the decision I will analyze it and its relevant notes for the decision to see if I can identify anything that might be helpful to others. I was not diagnosed before discharge with apnea, nor was I receiving treatment in service. I didn't even get checked for it until September of last year, when a CPAP was issued. I've read so much on here about how difficult it is to get sleep apnea service connected, especially if you don't have an in service finding. Here's to hoping that my decision renders some insight into what their rationale was. Many others here and on VPN have tried to service connect apnea with varying degrees of success and failure, but the arrow seems to point more towards failure if there is no in service finding.

In True VA Fashion ™ it makes little sense. I submitted all sorts of documentation, because id read on here that it is such an uphill battle to get this service connected especially with no in service diagnosis.



My finding letter came, and despite the list of reviewed material, the actual Reasons and Basis is about 2 sentences long:

"We have assigned a 50 % evaluation for your obstructive sleep apnea based on:
0-Requires use of breathing assitance device such as continuous airway pressure machine."

Thats it, folks. No quoting my material, no quoting of things in my Dr's letter, not quoting of the record itself or the sleep tech's finding.

I claimed it secondary to weight gain, pain and inactivity due to chronic pain, depression, and intervertebral disc syndrome.

Ill post my Dr's letter below that was submitted. The rest of what I turned in was pretty standard. A statement from my wife, the sleep tech records, there was a C&P that was about 20 minutes long.

I had some treatment notes that had been submitted for ED that I mentioned my issues sleeping with her as well, but I can't find those.





Mr. Satterfield has been a patient of mine since October of 2000. The conditions that I examined him for are chronic lower back pain and sleep difficulties.

I personally reviewed Mr. Satterfield's medical history including his service medical records from April 2001 to February 2002; and his VA rating decision rating decision C-file and C & P final report for service connection for degenerative disc disease dated September July 2002. His contention today is that he is having difficulty sleeping and that his wife says that he stops breathing several times a night during sleep. Mr. Satterfield was prescribed Elavil (10Mg) for sleep difficulties after his injury by Kenner Army Health Clinic, Ft. Lee, VA, and continued to take them after his discharge from service, and also takes Ultram, Flexaril, and Ibuprofen for pain, as prescribed by the VA. Currently he is prescribed Hydrocodone, Meloxicam, Gabapentin, Temazepam, Seretraline, and Omeprazole.

It is my opinion that it is likely that Mr. Satterfield’s sleep difficulties are aggravated by his service connected degenerative disc disorder and chronic pain, and the weight gained because of it. I also feel that it is at least as likely as not that Mr. Satterfield’s continued obesity is aggravated by his service connected degenerative disc disorder and pain, since his continued efforts to consume fewer calories over several months have resulted in very little loss.

Sleep disruption caused by obstructive sleep apnea can certainly be exacerbated by certain narcotic pain medicines, SSRI’s, and increasing weight. Mr. Satterfield has no prior symptoms of thyroid or metabolic issues, and had no reported sleep difficulties or weight related health problems prior to enlisting into the Army in April of 2001. He has been eating below maintenance for his weight and build, but continues to have difficulty losing weight. Because of these things, and the observations of his spouse it is likely that Mr. Satterfield has undiagnosed obstructive sleep apnea with an onset that started after his service connected injury and the weight gained as a side effect.

Sincerely,




CLAIM: Sleep Apnea W/CPAP secondarily aggravated by medications, pain, obesity, and depression due to service connected lower back injury.
In Aug 2001 I was diagnosed with a lower back trauma that was LOD directly to an injury incurred during training at Ft. Jackson SC. At that time I was still actively serving, under profile with a weight of 192-195 lbs. I was transferred to Ft. Lee, VA for AIT to await a decision about a MEB/PEB. As I was under strict PT restrictions and duty restrictions, and in a state of constant (albeit treated) pain, my activity level plummeted and my weight started to increase. Being that I was in a training environment at Ft. Lee my diet and activities were still restricted as that of any other trainee. I left Ft. Lee in January of 2002, still just under 200 lbs.
In the later part of 2001 I was prescribed Elevil to help with sleep disturbance issues by either Doctor _________ (Kenner Army Health Clinic) or Dr. ________(Kenner Army Health Clinic). I was not diagnosed with sleep difficulties prior to this time-having been married before enlistment, this would have been noticed by my wife. This prescription for elavil was filled to excess before I processed out of Ft. Lee, VA so that I would have time to set up civilian or VA health care. I continued to take Elavil for sleep disturbances, along with Ultram, Flexaril and Ibuprofen for pain until my prescriptions ran out a few months later. In that time I received a C&P for my lower back injury which was ruled service connected. During this time my weight continued to increase due to inactivity and pain. In my initial C&P examination by PA-C J_______ I was noted to be obese 4/29 /02. In December of 2002 . I sawcivilian _________ Medical center (Dr. _____) to refill current medications for pain and sleep issues, including elavil. In a later examination by PA-C __________, Lincoln VAMC I was noted in January 2003 to weigh 257 lbs when I saw him about pain and medications for pain. I declined to add elavil to my VA medications at that time, hoping that my sleep issues would work themselves out with better pain management.
My psychology treatment records by Dr. R_______ indicate sleep disturbances, and my struggles with weight loss/gain as well, and they are incorporated into my overall rating for depression. Inactivity due to pain is also noted throughout, and prior history is established that I was active prior to military service (theater/music) and obviously during service until my injury. I currently weight (10/15/2011) 312 lbs.
Post service I have struggled with my weight due to inactivity or due to medications taken for pain that have side effects of weight gain. I may lose 5-10 lbs on a severely restricted diet, or an increase in activity, but pain, motivation issues, and depression issues cause me to gain it back. I take one medication, Hydrocodone, in a direct attempt to BECOME more active to try to lose weight but thus far it’s results are unquantifiable because of the myriad other issues contributing to my weight.
In October of 2011 I was diagnosed at the Omaha VA Hospital with Sleep Apnea, and, on the basis of the sleep study, issues a CPAP machine (thank you!) This has helped control my apneic sleep disturbances that I feel are a result of my weight gain from my medications, depression, and lower back injury. It may be that since Elavil was not prescribed until after my injury in 2001 that the beginnings of sleep apnea extend to that point where I started to gain weight before discharge from the Army, and have steadily increased since. PA-C D_______ (Omaha VAMC) opined during counseling that Sleep Apnea is a result of either genetics/physical jaw issues, medications, Psychological issues (PTSD, etc), or obesity, and that it can be caused by, or CAN contribute to obesity and depression, and that my issues with both most likely come at least in part, from this etiology. He also advised to “avoid etoh/sedative/narcotics (do not increase hydrocodone dosage)”. His advisement directly contravenes my attempts to be more active to lose weight, by reducing the options available to me for pain management. However, dying slowly in my sleep is not an attractive option, either, and so I am inclined to follow his reasoning. In doing so, however, I must limit my activity.

My psychology treatment records, military medical records, and treatment records from Lincoln VAMC are in my CFile. My consult from Johnson County Medical Center is in my CFile. My Omaha records from my sleep study are in VISTA. Please find and adjudicate accordingly. Per prior rulings by the DVA, with sufficient evidence, Sleep Apnea post discharge has been granted service connection in cases as secondary to obesity , MH issues, and medication when one or more of those are service connected.
Citation Nr: 0905272
Decision Date: 02/13/09 Archive Date: 02/19/09

DOCKET NO. 04-16 673A ) DATE
)
)

On appeal from the
Department of Veterans Affairs Regional Office in St.
Petersburg, Florida

Thank you. Here is what I filed:

It looks like you could get back pay bud. It is up to you if you want to fight the VA. I recently caught a CUE that the VA made, and it was worth $2500 worth of back pay. It was not worth it to fight the VA, as I recently submitted another FDC for 7 conditions, 5 that I reopened that the VA denied without C&P exams, and 2 new exams. Good luck to you and keep us posted bud. I am SC for Hearing Loss and Tinnitus as I was Naval Aviation for 10 years.

Yes, private pain doctors in Florida are afraid to prescribe necessary pain meds. I have federal worker's compensation claim. They are good at always demanding extra paperwork from doctors when you ask for anything besides cheap generics. I ask for Cymbalta from WC and they refuse and kick it back to my good WC doctor who then has to do paperwork for special authorization. He gets tired of that extra work. All insurance companies just mean to delay or deny treatment and medications to save money. The VA also acts like an insurance company. Private insurance is ruining medical care here. They are inbetween the doctor and patient. They only care about stockholders. Blue Cross is one of the worst and biggest. They just basically refuse to pay for psychiatric care via paperwork traps and mazes of rules. Half of the population is suffering from pain and/or mental disorders and insurance companies won't pay for care. Oxycontin would be good for me, but I can't get it from VA, and private docs just want to do procedures like injections and surgery. It is all about money. Doctors believe they all are entitled to be millionaires even if all they do is prescribe pills.

John

When the VA prescribes addictive drugs to a vet for ten years and then suddenly decides this is a mistake this calls into question their entire system of medical care. You simply can't just abruptly stop taking benzos and opiates and many other drugs for anxiety and pain. There needs to be consultation between patient and doctor. The VA told me that I should go to in-patient pain program. However, to do this I must be off all opiates and benzos already. This is not rational or reasonable. I might consider a withdrawal program and then non drug pain program, but first I need real help getting off the pain meds and I need something to help me do it. Now I can go to private pain clinic and they have drugs that blunt effect of opiates. I don't know if the VA has anything like this and I sure don't trust them. I was hospitalized some years ago and the first thing they did was stop my pain meds cold turkey. I did not sleep until I could get my wife to get me out of there. The shrink did threaten me with jail if I acted up on the ward. I was there due to big problem at work where stress drove me into voluntary admission to psychiatric ward. I wanted OUT of there and would never go back as inpatient without serious ground rules.

Hey, Vern, what you're experiencing with eBenefits is absolutely normal! There was a rater who was active on this forum and he described how the process works - basically, there is an electronic checklist within the system that eBenefits feeds off of that says whether or not a requested document has been received. The rater knows that he or she gets the docs, knows that they're in the C-file, so they don't bother to check off the checklist. You've done the absolute right thing: check via IRIS. That's really the only way to get an accurate look into what they hold and don't hold because someone at the RO goes and looks in your file to answer.

I've gotten claim decisions that list all kinds of documentation but eBenefits says they were requested and never received. It's one of the major flaws in the system, and it drives you nuts because you don't know whether to trust it or not.

eBenefits isn't really even understood within the RO anyway, so they may not even realize the amount of angst a simple handful of clicks might solve.

Meanwhile, really sorry to hear your claim is stuck. Really hope it frees up fast. My last one did - they suddenly farmed it out to another RO which closed the claim within literally a few days. Of course, I'm drafting the NOD now...but that's beside the point. Hang in there!

1. back log of claims,

2. VA lack of personnel to do the job.

3. Denials. It took me 2 years to get my SC for Tinnitus, I had to fight the VA every step, I proved they made a CUE, I WON.

4. fast C&P, my statements changed or altered, even left out.

5. RO putting more weight to what the C&P Dr. wrote than my private Drs who have treated me for many years.

Hugh

In addition to the delays, shredding our documents, my biggest complaint is the VA LIES TO US:

No, I did not make it up. Shinseki said that Vets get an appointment in 24 days, the VAOIG says 115 days:
http://www.foxbusiness.com/markets/2014/05/28/phoenix-vets-waited-115-days-for-first-doctor-appointment-inspector-says/

VA officials need to be made held accountable for their words, and fired when a lie is discovered like this. This is not the only lie, its just one of many glaring obvious lies.

Claims and appeals, they take way too long to get completed. No claim even going through the appeal process should take over 10 years to be completed!

If you get proposal to reduce you have to file a NOD and ask for a hearing within 30 days. The VA cannot just reduce you after 17 years unless they show by clear and convincing evidence that you have improved. You have protection from 5 year rule that says after 5 years of being static at Total the VA must show by a complete review of the evidence that you are better. That does not mean one C&P exam.

I wonder why VA pulled this out of thier ass. . "

VA presumes certain chronic, unexplained symptoms existing for 6 months or more are related to Gulf War service without regard to cause. These "presumptive" illnesses must have appeared during active duty in the Southwest Asia theater of military operations or by December 31, 2016, and be at least 10 percent disabling. These illnesses include:

why are they trying to close the door on december 31 2016? what do they know that we dont? I wonder if the studies that they were caught trying to manipulate have anything to do with it. The only logical and reasonable explaination is that VA know that there are going to be long term health effects suffered by gulf war vets., and they DONT WANT TO TAKE CARE OF US/.
They take blood test from me like crazy. I know they are tracking something. They see the writing on the wall for gulf war vets and are trying to close the door. Why set a date " ilness has no respect for time or dates/. its all an attempt to deny us.

Most companies will make a desperate attempt to satisfy their customer by making immediate corrections to administrative errors.

Not that bunch in St Pete. They figure the more they abuse you, the more likely you are to "go-away".

I think that some serious firing needs to happen. Especially at the top. Also we need to vote out whomever is in office to show

that we do have some power. Unless we march on Washington, the only power we have is the vote.