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Hobby

  1. I am SC for GERD and IBS. I need to file for an increase on both. I already know about pyramiding, so I understand that I will just have one rating under gastrointestinal. Is there any strategy to filing for these? Would filing them together be different than filing them seperately?
  2. Good Morning, Attached is my Decision Letter. I think they may have made a mistake. Background: Retired 2014. Claimed IBS in 2015 but was denied due to no diagnosis. Didn’t fight it. Starting in 2017 to today started having more and more issues. Was diagnosed in 2017 with IBS by Doctors at Naval Hospital. Leads us to Decision letter Oct 29, 2020 – Requested IBS Service Connection via Gulf War Syndrome 38 C.F.R.3.17 1. Received Decision Letter today 13 Jan 2021. 2. A 10% evaluation is established for IBS and added to the previously established non-compensable evaluation for hiatal hernia/GERD (I did not ask for this or ask to be reevaluated for hiatal hernia. I realize they often combine the two. 3. Examiner provided opinion that current disability is at least as likely as not (50% or greater probability) incurred in or caused by the in-service Injury, event or illness. 4. Service Connection established. Huge Win However, I think they may have made a mistake. 1. On page 3 of decision letter: a. Paragraph 1 – Hiatal hernia warrants non-compensable evaluation b. Paragraph 2 – Irritable colon syndrome warrants 10% - Moderate symptoms c. Paragraph 3 – Additional symptoms – Alternating Diarrhea and Constipation d. Paragraph 4 – I don’t understand what this means e. Paragraph 5 – they agree and state that I do have alternating diarrhea and constipation in my records. I also have constant bloating and gas in my records as well. f. Paragraph 6 – Hiatal Hernia 0% I agree with, No argument. I wasn’t trying to get an increase. g. Paragraph 7 – A higher evaluation of 30 percent is not warranted for IBS unless there are severe symptoms demonstrated by diarrhea, OR alternating diarrhea AND constipation, with more or less constant abdominal distress. i. In Paragraph 5, they already agree and state that I do have alternating diarrhea and constipation. ii. Alternating diarrhea and constipation is the epitome definition of MORE OR LESS CONSTANT ABDOMINAL DISTRESS. h. Paragraph 8 – Deals solely with the Hiatal Hernia/GERD evaluation 2. I feel like when they combined the two 7319 & 7346 codes which they often do, I understand that however I clearly meet the Irritable Colon Syndrome of 30% evaluation in paragraph 7. See below as well. 3. But when they combined both codes they make it seem like I have to have the other Hiatal Hernia/GERD symptoms as well to qualify for the 30% 7319 IBS Rating. 4. Wanted to get some advice before I figure out how to proceed. 7319 Irritable colon syndrome (spastic colitis, mucous colitis, etc.): Severe; diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress 30 Moderate; frequent episodes of bowel disturbance with abdominal distress 10 Mild; disturbances of bowel function with occasional episodes of abdominal distress 0 7346 Hernia hiatal: Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health 60 Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health 30 With two or more of the symptoms for the 30 percent evaluation of less severity 10 Redacted.pdf
  3. 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!
  4. So, I am SC'd on GERD 10% and IBS 30% which they grant at a 30% combined rating since (according to the VA) codes 7319 and 7346 (Hiatal hernia is what they use for GERD) fall in the inclusive rating categories according to this: Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. I would argue that, that's not what that says.. It actually says codes 7301 - 7329 are inclusive and then 7331. 73342, and 7345 - 7348 are inclusive which would actually mean codes 7319 and 7346 are in their own categories and should be rated exclusively. However, my actual question is about code 7204 Esophagus, spasm (cardiospasm). I submitted a claim for this, but it was not rated separately. Instead, I was given: Evaluation of IBS and GERD with esophagus spasm of (cardiospasm) (claimed as esophageal condition): The evaluation of IBS and GERD with esophagus, spasm of (cardiospasm) (claimed as esophageal condition) is continued as 30 percent disabling. We have reviewed the evidence received and determined your service-connected condition(s) hasn't/haven't increased in severity sufficiently to warrant a higher evaluation. We have continued a 30% evaluation for your IBS and GERD with esophagus, spasm of (cardiospasm) based on: -Abdominal distress -Alternating diarrhea and constipation Additional Symptoms Include: -Disturbances of bowel function -Frequent episodes of bowel disturbance This is the highest schedular evalution allowed under the law for IBS. (38 CFR 4.114) A higher evaluation of 60% is not warranted unless there are symptoms of pain, vomiting, material weight loss, and hematemesis or melena with moderate anemia, or other symptom combinations productive of severe impairment of health. (38 CFR 4.112, 38 CFR 4.113, 38 CFR 4.114) A 10% evaluation would be warranted for your GERD with esophagus, spasm of (cardiospasm) (claimed as esophageal condition) based on: -Pyrosis (Heartburn and/or Reflux) -Substernal pain -Regurgitation -Persistently recurrent epigatric distress A higher evaluation of 30% is not warranted for hiatal hernia unless the evidence shows persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. (38 CFR 4.114) Ratings under diagnostic codes 7301 to 7329, inclusive, 7331,7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with the elevation to the next higher level evaluation where the severity of the overall disability warrants such evaluation. (38 CFR 4.114) So in reading that, I do not see how 7204 Esophagus, spasm of (cardiospasm). If not amenable to dilation, rate as for the degree of obstruction (stricture). falls in to that rating criteria. Does anyone have any experience in getting a separate rating for 7204? I'm now at 92.23% SC'd with 1 rating on appeal and an increase on remand. Both of which (if granted at what the reg actually says) would kick me to 95.29% (or rounded to 100). This one, I really expected to be at 30% on its own...so I'm confused as to why it was rolled in to another rating.
  5. All, Taking everyone's advice, I put together my letter that I plan to submit with my claim. I think it would be a supplemental claim since they denied me in 2015 due to no diagnosis. I typed out my history and included notes from my medical records. If someone has time, can you read thru it and give me an honest opinion? I used Blast Daddys advice for the presumptive piece. Anything you would add or change or that I am missing? We don't have VSOs out here in Okinawa so working on this by myself. I redacted names. I also have to submit the medical records from 2014 to Present but the files are huge. Can you upload then electronically or will I have to use snail mail? Thank you Claim for IBS Presumptive to GW Redacted.docx
  6. I have a rating for 10% for:. right knee patellofemoral syndrome, claimed as gout and iliotibial band syndrome Is it common for VA to group conditions, can these be separated? Thanks for the assist...
  7. I am beyond frustrated right now!!!! My claim is now preparation for decision and my fear is that it will be denied and I will have to appeal. I filed for my non-service connected Fibro as caused or aggravated by the service connected IBS and/or service connected PTSD on an as likely as not basis. See my screen shot attached of my original claim in July 2018. I had my first C&P exam in September 2018 and it was negative based on the examiner stated there was no causation of my s/c PTSD to my Fibro. See the screen shot below. I will note that he did a separate C&P exam for Fibro and agreed I had Fibro. Never looked at aggravation and never looked at the possibility of IBS. I sent a statement in support of claim pointing this out to the rater. I get another C&P exam in December 2018 BUT by now I have THREE positive medical opinions from BOTH my RA and MH doctor. Both state my Fibro is aggravated by my PTSD and my MH doctor also states my Fibro is aggravated by my IBS. SEE ATTACHED 2 of the 3 letters. When I went to the second C&P exam, it was with the same doctor and he refused to look at the medical opinions. He also once again did not look at aggravation. Again a negative C&P exam. Then the rater asked for clarification/review of conflicting medical opinions. Here is what the rater asked, Per III.iv.3.D.3.a. and III.iv.3.D.3.d. We need clarification/review and reconciliation of conflicting evidence for claim for fibromyalgia secondary to SC PTSD. Negative MO received on 09/28/2018 (TAB A) stated that fibromyalgia was not secondary to PTSD. Received positive MO on 12/05/2018 (TAB B) relating fibromyalgia as secondary to SC PTSD and IBS. Negative MO received on 12/05/2018 (TAB D) stated that fibromyalgia was not secondary to IBS. Examination dated 12/05/2018 (TAB C) shows a diagnosis for fibromyalgia. Per reference please request clarification of conflicting MO for fibromyalgia as secondary to PTSD and IBS with rationale. This medical opinion was done last week w/o me present and once again the medical opinion was negative and doesn't address anything the rater asked. In fact, his statement is laughable. While he states he reviewed conflicting medical evidence, he sites PT notes and doesn't refute the positive medical opinions. Here is what it says: I HAVE REVIEWED THE CONFLICTING MEDICAL EVIDENCE AND AM PROVIDING THE FOLLOWING OPINION:All medical records were reviewed. Physical therapy note on 8/15/2018 by XXXXX documents diagnosis of fibromyalgia and PTSD. The exact cause of fibromyalgia isunknown but has associations with IBS, temporomandibular joint disorder, interstitial cystitis, vulvodynia, and tension headaches. Literature review reveals fibromyalgia along withits associated pain syndromes are clearly different and separable from depression and anxiety. The claimant's fibromyalgia is not secondary to the claimant's claimed PTSDcondition. The VA continues to miss the fact that I asked in my original claim either causation or aggravation. So on Monday, when I went to PFD, I sent the attached statement and uploaded in Ebenefits pointing out once again they are not looking at aggravation. My rep said if it comes back denied, which I am sure it will, we will file an NOD pointing out the fact that they are missing aggravation. MH positive opinion.pdf RA positive medical opinion.pdf
  8. Hi there! Long time member here but been MIA for awhile. Life has been busy and I have been dealing with health issues. Long story short, I went through a battery of tests to find out what is wrong with me. I did an ANA-TITER test, and it was positive for an auto immune disease. Was referred to the RA doctor for further testing to see if I had lupus. The RA doctor did blood tests and determined I don't have lupus. We did additionally physical exam at the VA back in May and he determined I had Fibromyalgia and diagnosed me with it. We discussed that my Fibromyalgia co-exists with PTSD/MST and IBS. We also discussed that Fibromyalgia can be secondary to my already service-connected PTSD/MST or even maybe my IBS. I discussed this with my representative and we decided to file a claim for Fibromyalgia (non-service connected disability) to an already service-connected disability. Either PTSD/MST or IBS and we asked that they evaluate either causation or aggravation. We filed in July and I had my C&P exam in September. The examiner was asked by the rater to give his medical opinion as to the Fibro being secondary to my PTSD/MST. The rater did not ask if it was possible to be secondary to my IBS like we requested. The examiner did a C&P DBQ for Fibro and that was positive. I do have Fibro, that isn't the issue. The medical opinion is what was disturbing. I was with the examiner for less than 5 minutes. He stated he physically examined me when he did not and he seemed very unknowledgeable about Fibro/PTSD-MST/IBS as co-existing and determining either causation or aggravation. Of course the medical opinion stated, "less likely than not". I was floored, so I went to work for my claim. I contacted my RA doctor and we talked with my representative on the phone as well. By the end of the call he was confident enough to link my PTSD/MST as aggravation to my Fibromyalgia. He wrote a one/two paragraph letter on my behalf. We sent that to the rater. Then I spoke to my MH provider last week and she too wrote me a very good NEXUS letter. That was sent to the rater yesterday. Both my doctor's are at the VA and both stepped out on a limb for me. I am hoping their medical opinions outweigh the negative C&P medical opinion. I am attaching the C&P exams (redacted), the two medical opinions (redacted) - I am hoping I am successful because this will make me 100% scheduler. I am currently 94% overall rated. C&P _Redacted.pdf nexus 2_Redacted.pdf redacted.pdf redacted2.pdf
  9. Hey, I'm service connected for IBS, chronic migraines, anxiety, reynaud's syndrome, and lumbosacral and cervical strain. Upon coming home from Afghanistan and while in country was treated for insomnia and many of my symptoms above progressed in the first year after returning in 2011. I was treated and diagnosed while still on AD. My rheumatologist an AD Col diagnosed me with fibromyalgia end of 2016. I filed a VA claim and told my fibromyalgia was not service related. Is it worth appealing and if granted could the VA take away my other conditions saying they are just part of my fibromyalgia diagnose? My rheumatologist wrote a letter stating he felt my fibromyalgia was service related. Any guidance on how to proceed or do nothing? Any help would be most appreciated. Regards Herb
  10. Thank You in advance! (First question after reviewing this book I wrote here should probably be, do i need to separate all of these questions into the different subject forums or is this OK ?) I've been procrastinating now for almost 10 years (mainly because of denial, I volunteered, tough guy, I know guys that seen/did worse and horror stories with the VA) and have just this year decided to attack this VA Claims Process. Putting it off for too long and ready to get the information needed to hopefully (fingers crossed) have a smooth process. I have not filed for anything, have no medical records or injuries documented while active or since (I have just requested my military records from the right place after all these years, because I assumed the VA would have them and keep them safe, so I didn't need a copy. MISTAKE #1, Naive I know) and have not been to see a private doctor for anything. I medicate with over the counter and always have, but have never been officially diagnosed with anything. Just last month I made an appointment with advice from an amazing local veteran group with a psychologist outside of the VA and she diagnosed me with PTSD. It was extremely hard to even talk to her, I've never talked to anyone about it just denied it or pushed it back. (I know I'll still need a VA exam). I was also seen by an outside, but VA referred hearing specialist and was diagnosed with tinnitus in the 3k range and hearing loss. 6 months after release from active duty in 2007 I was seen at the local VA for hemorrhoids and treated. I have had issues with roids, constipation, diarrhea etc ever since. This is also the only thing I have ever been seen for at the VA. My wife has also complained for years about sleep apnea and me startling her in the middle of the night when I sleep, should I get an evaluation for sleep apnea. She doesn't remember ifI did it when active or not, but does that matter for service connection ? I have already made the intent to file as of last month and am wondering how I should proceed from the above mentioned. I have not been seen for IBS, by any professional but it reads like that is a high possibility, so do I need a diagnosis from outside of the VA or should I get one prior to filing? Should I file IBS, if diagnosed under "presumptive illness" (BALAD IRAQ 2005-2006) ? Should I get on the Burn Pit or Gulf War Registry (Is there anything I should know prior to going to these registry appts) ? Should I file for PTSD with just an outside evaluation (How are stressors confirmed, all mine are personal accounts and encounters) ? Should I file for hearing loss or tinnitus or both I served as a firefighter and have read that as being on some list hearing related jobs ? And finally, Should I file for all of these now at one time or should I wait and do them individually ? My main concern is going into this and not being fully prepared, if there is anything you believe would aid in the above filings please let me know. I know there is a long road ahead, but I don't see any point in going alone and appreciate you all. Thanks again!
  11. Hi everyone! Hope all is well. I just wanted to stop in and say hello. I haven't been on here since late last year. Life is going good. As most know my story and it was a doozy, I finally got everything I deserved! Overall 90% and I couldn't be happier. It took a lot of hard work and sleepless nights and a lot of C&P exams and fighting the VA but I prevailed. I was thankful for this sight b/c without it I would have never met a great guy that helped me with the final phase of my rating. I am now just waiting on an EED for my contentions but I am really not really worried about it and if it happens great and if not, I am good. Don't give up EVER!
  12. Filed a notice of intent in Feb 2016, filed claim in January 2017, C&P exam end of January 2017, decision March 2017 30% IBS. From all of the advice on this forum did this claim myself, made sure to attach all of the needed information and was the fastest claim I have ever had with the VA. Thanks to all of you that have shared your knowledge and experience on this forum. You have educated an old scout LT about this process. Your information armed me to be successful in providing all of the information needed the first time. By the way they backdated the effective date to the date I filed my notice of intent to file. Maybe a little topic about how that works might help someone out there. I did not know that piece of the puzzle.
  13. Looking at the results in my file from the C&P. Does this look favorable? I know the degree of anything awarded goes off other particulars ect. RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Is Veteran's sleep disturbance secondary to his stress related disorder? b. Indicate type of exam for which opinion has been requested: psychological TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] a. The condition claimed is at least as likely as not ( 50% or greater probability) proximately due to or the result of the Veteran's service connected condition. ******************************** Intestinal Conditions (other than surgical or infectious), including irritable bowel syndrome, Crohn's disease, ulcerative colitis and diverticulitis Disability Benefits Questionnaire 11. Remarks, if any: -------------------- GULF WAR STATEMENT: In reviewing electronic files in VBMS and CPRS in conjunction with today's examination, the Veteran has a diagnosable, but medically unexplained illness of unknown etiology. * The disability pattern most closely correlates with a diagnosed illness of unknown etiology. * He indicates he has intermittent episodes of diarrhea/constipation/bloating and pain. * It is my medical opinion that this condition at least as likely as not (50 percent or greater probability) qualifies as a presumptive condition from service in SouthWesttAsia per website http://www.publichealth.va.gov/exposures/gulfwar/medically- unexplained-il lness. *************************** RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CURRENT DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEA AT LEAST AS LIKELY AS NOT 950 PERCENT OR GREATER PROBABILITY) RELATED TO OR INCURRED DURING HIS MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: OSA TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ******************************* RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S ERECTILE DYSFUNCTION AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) PROXIMATELY DUE TO OR RELATED TO THE MEDICATION (PROZAC) USED TO TREAT HIS SERVICE CONNECTED MENTAL HEALTH CONDITION? b. Indicate type of exam for which opinion has been requested: ED TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] a. The condition claimed is at least as likely as not (50% or greater probability) proximately due to or the result of the Veteran's service connected condition. *************************************** RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CURRENT DIAGNOSIS OF SPERMATOCELE AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) RELATED TO THE TESTICULAR PAIN DURING ACTIVE MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: SPERMATOCELE TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ***************************************** RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CURRENT DIAGNOSIS OF PATELLOFEMORAL SYNDROME RIGHT KNEE AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) INCURRED IN OR RELATED TO HIS RIGHT KNEE PFS DURING ACTIVE MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: PATELLOFEMORAL PAIN SYNDROME RIGHT KNEE TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ******************************************* RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CHRONIC CERVICAL STRAIN AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) DUE TO OR THE RESULT OF HIS MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: CHRONIC CERVICAL STRAIN. TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ********************************************** 4. Erectile dysfunction ----------------------- Does the Veteran have erectile dysfunction? [X] Yes [ ] No If yes, complete the following section: a. Etiology of erectile dysfunction: prozac (medication used to treat service connected mental health condition) b. If the Veteran has erectile dysfunction, is it as likely as not (at least a 50% probability) attributable to one of the diagnoses in Section 1, including residuals of treatment for this diagnosis? [X] Yes [ ] No If yes, specify the diagnosis to which the erectile dysfunction is as likely as not attributable:prozac (treatment for service connected mental health condition) ***************************************** GULF WAR STATEMENT: In reviewing electronic files in VBMS and CPRS in conjunction with today's examination, the Veteran has a diagnosable condition (GERD), but medically unexplained illness of unknown etiology. The condition GERD is at least as likely than not (50 percent or greater probability) related to his military service in Southwest Asia. ********************************************
  14. Looking at the results in my file from the C&P. Does this look favorable? I know the degree of anything awarded goes off other particulars ect. RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Is Veteran's sleep disturbance secondary to his stress related disorder? b. Indicate type of exam for which opinion has been requested: psychological TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] a. The condition claimed is at least as likely as not ( 50% or greater probability) proximately due to or the result of the Veteran's service connected condition. ******************************** Intestinal Conditions (other than surgical or infectious), including irritable bowel syndrome, Crohn's disease, ulcerative colitis and diverticulitis Disability Benefits Questionnaire 11. Remarks, if any: -------------------- GULF WAR STATEMENT: In reviewing electronic files in VBMS and CPRS in conjunction with today's examination, the Veteran has a diagnosable, but medically unexplained illness of unknown etiology. * The disability pattern most closely correlates with a diagnosed illness of unknown etiology. * He indicates he has intermittent episodes of diarrhea/constipation/bloating and pain. * It is my medical opinion that this condition at least as likely as not (50 percent or greater probability) qualifies as a presumptive condition from service in SouthWesttAsia per website http://www.publichealth.va.gov/exposures/gulfwar/medically- unexplained-il lness. *************************** RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CURRENT DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEA AT LEAST AS LIKELY AS NOT 950 PERCENT OR GREATER PROBABILITY) RELATED TO OR INCURRED DURING HIS MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: OSA TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ******************************* RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S ERECTILE DYSFUNCTION AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) PROXIMATELY DUE TO OR RELATED TO THE MEDICATION (PROZAC) USED TO TREAT HIS SERVICE CONNECTED MENTAL HEALTH CONDITION? b. Indicate type of exam for which opinion has been requested: ED TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] a. The condition claimed is at least as likely as not (50% or greater probability) proximately due to or the result of the Veteran's service connected condition. *************************************** RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CURRENT DIAGNOSIS OF SPERMATOCELE AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) RELATED TO THE TESTICULAR PAIN DURING ACTIVE MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: SPERMATOCELE TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ***************************************** RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CURRENT DIAGNOSIS OF PATELLOFEMORAL SYNDROME RIGHT KNEE AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) INCURRED IN OR RELATED TO HIS RIGHT KNEE PFS DURING ACTIVE MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: PATELLOFEMORAL PAIN SYNDROME RIGHT KNEE TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ******************************************* RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: IS THE VETERAN'S CHRONIC CERVICAL STRAIN AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) DUE TO OR THE RESULT OF HIS MILITARY SERVICE? b. Indicate type of exam for which opinion has been requested: CHRONIC CERVICAL STRAIN. TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. ********************************************** 4. Erectile dysfunction ----------------------- Does the Veteran have erectile dysfunction? [X] Yes [ ] No If yes, complete the following section: a. Etiology of erectile dysfunction: prozac (medication used to treat service connected mental health condition) b. If the Veteran has erectile dysfunction, is it as likely as not (at least a 50% probability) attributable to one of the diagnoses in Section 1, including residuals of treatment for this diagnosis? [X] Yes [ ] No If yes, specify the diagnosis to which the erectile dysfunction is as likely as not attributable:prozac (treatment for service connected mental health condition) ***************************************** GULF WAR STATEMENT: In reviewing electronic files in VBMS and CPRS in conjunction with today's examination, the Veteran has a diagnosable condition (GERD), but medically unexplained illness of unknown etiology. The condition GERD is at least as likely than not (50 percent or greater probability) related to his military service in Southwest Asia. ********************************************
  15. My claim for ervice connection for Irritable Bowel Syndrome (IBS) as a presumptive service connected disability due to my service in the Gulf War per 38 C.F.R §3.317 was denied. Wondering how I can succesfully appeal. VA DENIAL LETTER “ Service connection is not permitted if there is affirmative evidence that the disability was unrelated to military service in the Gulf War. Service connection for unexplained chronic multi symptom illness to include irritable bowel syndrome is denied because evidence established that this disability result from poor diet and fitness. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We did not find a link between your medical condition and military service. On examination, the examiner indicated that your stated symptoms do not meet the criteria for a diagnosis for irritable bowel syndrome and are most likely the result of poor dietary and fitness habits.” SERVICE INFORMATION & MEDICAL DIAGNOSIS: I served in Southwest Asia during Operation Iraq Freedom. My unit did participate in ground combat in Iraq. I have been diagnosed with IBS from VA medical doctor. I currently take both RX & non-RX medication for IBS. This information was submitted in my claim but not listed as evidence considered C&P EXAM Examined at VA Loma Linda. Examiner is a physican assistant. Examiner did not ask about fitness or diet patterns. Blue Button says I am unable to view the exam notes.
  16. I recently submitted a claim, 09/28/16, for IBS (presumptive to Gulf WAR) and dysthymic disorder. Had C&P exam on 11/16/16 and EBenifits shows Claim Complete on 12/24/16. Received BBE on 01/02/17 only addressing dysthymic disorder (Denied, not SC). There was no mention of IBS and it does not show up at all in my Ebenefits. I should note that C&P exam results clearly note my IBS and referenced my Gulf War Service. Called 1-800 # on 01/02/17 and was informed information on IBS was mailed on 12/21/16 and had to wait 10 days to request copy. Called 1800# yesterday and the woman informed me that I was given incorrect information about the IBS decision being mailed on 12/21/16. She then went into what I will describe as a more technical mode, informing me that she was a VA employee authorized to give and receive claim info. something along those lines. She told me I would have to file an appeal to have it looked at again ( I have no decision to appeal). She then informed me that my best bet would be to file the IBS claim again but this time as secondary to my currently rated GERD. She stressed this strongly and would not answer any of my questions, stating it was my choice to appeal or re=file as secondary. It appeard she was trying to help me out by stressing the Secondary method, but she was very vague and suggested it was the consensus among who she was conversing while I was on hold that I undertake the Secondary path. My questions are does anyone know what occured here? Why was I not notified of a decision either way on IBS? I thought IBS was Presumptive! Is Secondary the best path?
  17. So I was given a 0% SC rating for IBS (which is BS BTW, the examiner botched the C&P). How do I go about submitting new evidence to increase my disability rating, while retaining the original claim date? Thank you!
  18. I am currently s/c for IBS, Anemia and an Eating Disorder. All of these have attributed to my issues I have to this day regarding my hemorrhoids and anal fissure. I have filed for secondary s/c for anal fissures. Since one of the known causes for this is chornic diarrhea, which is noted in my prior C&P exam for IBS s/c, I feel this warrants a secondary s/c. I have progress notes from two doctors indicating I have the anal fissure. I had surgery (twice) to remove my hemorrhoids and repair the anal fissure in one surgery. The anal fissure is still an issue and will be for the rest of my life. My current doctor states that Chronic Diarrhea is one of the causes. I am due to see my doctor this week for post op discussions from my surgery in July. Prior to filing, I read up on anal fissures and the causes for it, and one of the causes is the Chronic Diarrhea, and I also read that symptoms for anal fissure are commonly mistaken for hemorrhoids. I have suffered with hemorrhoids for years never realizing that they were associated or potential associated to my issues with IBS. Anemia, although rare from blood loss due to hemorrhoids, I have Anemia from my Gastro issues due to my Eating Disorder (also S/C for). I filed an FDC claim on July 20th, 2016 for anal fissure to be secondary s/c to my curent s/c IBS. I am sure it will turn into a traditional claim since my NOD is still in the "decision" stage but I was moderately surprised to see that I have a C&P exam ordered so quickly. On Ebennies I happened to be looking at my upcoming doctor's appointments and happened to check the calendar for C&P exams and boom there it was! That is super fast! I do not have any secondary s/c contentions so I have a few questions. When you file for a contention to be secondary to the already s/c contention do you need to bring up the prior evidence that s/c you in the first place? Meaning, I am s/c for IBS, do I need to bring that up? I did state in my FDC claim (VA21-4138) why I felt it should be secondary to IBS. CODE 7336: Hemorrhoids large are swollen veins inside or outside the body near the anus. They are created from a lot of pressure being used to pass feces and can be very painful. If the hemorrhoids cause constant bleeding that leads to significant blood loss and anemia, a decrease in the number of red blood cells, or f they cause fissures, it is rated 20%. If there are blood clots inside the swollen veins, the swelling can’t go down, and there is a lot of redundant tissue, it is rated 10%. If they are only moderate with occasional bleeding, it is rated 0%. If I stated that it should be secondary to IBS but maybe it should be secondary to Anemia or my Eating Disorder, do I need to add those comments to ensure that the secondary contention doesn't get denied? Obviously the secondary contention was not in-service related but is aggravated by the current s/c contention. Also, anyone who has had a C&P exam for this type of claim, can you tell me your experience with this exam? It's a bit embarrassing already but understand I have to go through it. Anyone with knowledge on secondary contentions? UPDATE: I filed for secondary to my IBS but I have since found documentation in my SMR's that I had medical notes indicating I had hemorrhoids in-service as well. I also had colonoscopies in-service that discovered hemorrhoids internal/external. I did not provide that evidence to the VA b/c I am going under the assumption it should be secondary to IBS. Now I am wondering if I should submit that SMR's evidence showing I also had hemorrhoids? All my SMR's for many years show chronic diarrhea and issues relating to all of this. I know I don't need to supply those SMR's b/c I am already s/c for Chronic diarrhea/IBS. I filed an FDC claim, but since I am under a DRO decision, I was told that it wouldn't be an FDC claim anyways, but rather a traditional claim so what do I have to lose right? I think I would rather submit the concrete evidence sooner than later.
  19. Here are my questions: 1. The pruritus ani is a symptom of the chronic diarrhea/IBS, whichI am s/c for. So would the pruritus ani be secondary s/c to my IBS? 2. The hemorrhoids which are mild/moderate will be 0% according to 7336 correct? 3. The anal fissure, will that be rated separately? I ask this becasue the rating of 7336 discusses the anal fissure as it be related to hemorrhoids, however, the C&P exmainer is indicating the anal fissure is related to my IBS. The rater asked for TWO opinions, one if my anal fissure was related to my IBS and the other question was if my hemmorrhoids were related to my IBS. The C&P examiner said "at least as likely as not" for both. Here is the C&P exam results: Rectum and Anus Conditions (including Hemorrhoids) Disability Benefits Questionnaire Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request?[X] Yes [ ] NoACE 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 1. Diagnosis Does the Veteran now have or has he/ she ever had any condition of the rectum or anus?[X] Yes [ ] No [X] Internal or external hemorrhoids ICD code: K64.8 Date of diagnosis: 09/ 15/ 1994 2. Medical History a. Describe the history (including onset and course) of the Veteran's rectumor anus conditions (brief summary):The Veteran is claiming sc for hemorrhoids and anal fissuresThis is a 45 year old Female Veteran with the hisory of external and internal hemorrhoids, anal fissure had EUA, external hemorrhoidectomy and botox injection at XXX Va on 03/ 10/ 2016. The Veteran reported some relief afterwards but presented again at WPB with recurrent anal pain and prolapsing of anal mass. She had again EUA, botox injection into internal anal sphincter and hemorrhoidectomy right and left posterior on 07/ 07/ 2016. She is exclusively followed by XXX VA- Gastroenterolgy for this condition. The Veteran continues to endorse symptoms of sharp perianal pain and itching with minimal bleeding on defecation. Surgery clinic follow up 8/8/16 On exam healing well but still tender. A/ P: recovering well but it appears that she has failed botox twice. Will ask XXX for a second opinion to consider sphincterectoly.09/ 15/ 1994: colonsoscopy- chronic diarrhea -STR small hemorrhoids. chronic use of laxatives2013:private doctors had colonoscopy done : external and internal hemorrhoids found.03/ 2016: first hemorrhoidectomy done at VA XXX one internal and external anal fissures: botox injection 07/ 07/ 2016: several external heamorrhoids removed and recieved one botox injection b. Does the Veteran's treatment plan include taking continuous medication forthe diagnosed conditions? [X] Yes [ ] No If yes, list only those medications used for the diagnosed conditions: calmoseptine ointment for the prurius Ani Dilitiazem 2% ointment for anal fissure 3. Signs and Symptoms Does the Veteran have any findings, signs or symptoms attributable to any of the diagnoses in Section 1?[X] Yes [ ] No [X] a. Internal or external hemorrhoids If checked, indicate severity (check all that apply): [X] Mild or moderateIf checked, describe: History of hemorrhoids: internal and external. Had hemorrhoidectomy in March and July 2016. [X] With fissures [X] f. Pruritus ani If checked, indicate underlying condition and describe:The veteran has history of pruritus ani and currently is on treatment with topical creams 4. Exam Provide results of examination of rectal/ anal area: (check all that apply) [X] No external hemorrhoids; skin tags only 5. Other pertinent physical findings, complications, conditions, signs, symptoms and scars a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? [ ] Yes [X] No conditions or to the treatment of any conditions listed in the Diagnosis Section above?[ ] Yes [X] No c. Comments, if any: No response provided 6. Diagnostic testing a. Has laboratory testing been performed? [X] Yes [ ] No If yes, check all that apply: [X] CBC (if anemia due to any intestinal condition is suspected or present) Date of test: 08/ 05/ 2016 Hemoglobin: 12.8Hematocrit: 38.8Platelets: 266 b. Have imaging studies or diagnostic procedures been performed and are the results available?[ ] Yes [X] No c. Are there any other significant diagnostic test findings and/ or results? [ ] Yes [X] No 7. Functional impact Does the Veteran's rectum or anus condition impact his or her ability to work [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 MEDICAL OPINION SUMMARY RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Is the Veteran's anal fissures at least as likely as not (50 percent or greater probability) proximately due to or the result of irritable bowel syndrome? Is the Veteran's Hemorrhoids at least as likely as not (50 percent or greaterprobability) proximately due to or the result of irritable bowel syndrome? b. Indicate type of exam for which opinion has been requested: DBQ Gen anus and rectal TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] a. The condition claimed is at least as likely as not (50% or greater probability) proximately due to or the result of the Veteran's service connected condition. c. Rationale: Current medical literature support irritable bowel syndrome Veteran has chronic diarrhea) as a cause or risk factor for the development of Anal fissure. https:// www.www.mayoclinic.org/ diseases.../ anal-fissure/ symptoms-causes/ dxc-2 016823 Nexus between irritable bowel syndrome and Hemorrhoids well substantiated in the medical literature. Veteran has documented history of chronic diarrhea from IBS and Hemorrhoids.
  20. Hello everyone! First I want to introduce myself. I am a recent USN retiree, 6 years active duty, 14+ years reserve (with deployment), and a qualified submariner. I am a long time reader and first time poster. I want to give my sincere gratitude to everyone who posts here, the information in this forum is priceless! I will spare you all the medical details, the long and short is: I have a number of chronic service connected disabilities, chiefly IBS and Fibromyalgia, as well as chronic urticaria (hives), scaring secondary to hives, and chronic fissure due to IBS. Utilizing the knowledge I learned here and from shipmates, I worked with my private physicians and prepared a series of disability benefits questionnaires (DBQ) which the VFW submitted on my behalf. My claim process was unbelievably fast- it went from intent to file, to filing, to award in seven months. I was recently awarded the following: IBS 100%, Chronic Urticaria 60%, Fibromyalgia 40%, Facial Scars 30%, Anal Fissure 20%. I was awarded 100% total disability compensation with a Special Monthly Compensation (S-1). I have not yet received my letter, however I can see the benefits in benefits and my VFW rep called me to inform me of the award. I am very grateful for the award, and consider myself lucky based on the stories I have read here. I do have a couple of questions, and in advance, thank you for taking time to read this! 1. I have never heard of anyone being awarded 100% for IBS. I have chronic oscillating constipation and diarrhea, and constant abdominal pain, which is noted in the DBQ. I miss a few weeks of work over a year's time due to inability to eat, compounded with the aforementioned bowel issues. While I am grateful for the award, I do not understand how the VA awarded me 100%. I thought 30% was tops unless the veteran requested an extra-schedular award (which I did not). What do you make of this? Was I assigned a TDIU or something similar without applying for it? Will or can the VA provide an extra-schedular award without the veteran asking for it? 2. My award indicates that I was also awarded SMC S-1. What does this mean? I do not require a home health aid at this time, although my wife did leave her job to assist me with activities of daily living such as cleaning and cooking since at times, I am not able to complete those tasks due to either bowel issues or exhaustion from fibromyalgia. The SMC S-1 code indicates that the award was given due to having a 100% disability (IBS) and a second award of 60% (Urticaria). Is it just standard process to issue an SMC S-1 for someone suffering from two diseases that are over a certain percentage each? 3. Does any of the above legally impact my ability to seek and maintain employment? Again, I do not have my formal VA letter yet, however, the above mentioned awards seem to indicate that the VA issued a TDIU or something to that effect. While I am in constant moderate to severe pain, and the problems are chronic and debilitating, I strongly prefer to try to maintain employment because working and staying active as I can seems to help me, at least mentally. I am afraid that if I quit working and focus solely on my chronic illnesses, my overall life outlook would suffer. 4. Lastly, am I missing anything? Thank you so very much for you time. As I learn more, I will be glad to assist anyone here by sharing what I did (almost of it learned here). Thanks again everyone!
  21. I just got the award letter over the weekend granting me 30% for Irritable Bowel Syndrome as secondary to PTSD. My better half is positive that I should have been awarded SMC-S statutory based on my new ratings: 100% IU P&T - 70% for PTSD; 30% for IBS secondary to PTSD; 10% LF residuals injury; 20% LF residuals with RSD & metatarsalgia; 10% RF plantar fasciitis with RSD - I researched some here on Hadit, and I found this in a thread from July : That was written by Asknod. So my first question, which was whether TDIU was good enough to count as 100% seems to be answered. My second question, as to where a condition rated as secondary can be counted... I'm not sure. I called my VSO this morning and she said she would research it for me. She apologized that she didn't know the info right off the top of her head, but the SMC's are confusing on a good day... I feel like a greedy bastard asking for more. Then my other half say stop thinking that way and remember all the years (25 +) that I didn't ask for anything from the VA, not even a vaccine or flu shot.
  22. Hi, I'm currently 60% disabled, having been recently diagnosed with Fibromyalgia though suffered with it "undiagnosed" for 6 years before I was actually given a diagnosis, Fibromyalgia is medically unexplained, I've done tons of research already on the disorder, my question now is can anyone point me in the right direction to validate my claim when it comes to Gulf War Syndrome, what evidence would be heavily weighted evidence in proving Gulf War Syndrome illness? My understanding is that no nexxus needs to be formed between service and the illness only pre-qualifying factors of whether I fit into the category of a Gulf War Vet which I in fact do.... More so where can I find Training Letters? And any information pertaining to the health effects on Gulf War Veterans and the use of Anthrax vaccine and Malaria pill both of which I was given amongst other vaccines. ANY information that would help me in filing my claim under the presumption of Gulf War Illness would be great. Thank you much, this is my last claim I will be filing with the VA and prayerfully no other illness pops up in light of all the crap and toxins I was exposed to in country...
  23. Hello all, got a question, I have been dealing with multiple issues that are stress related, for over 20 years. During my 2nd year on AD I began to develop sleep issues, and from there I had sinus infections seemingly on a monthly basis. My bowels also began to be grumpy, resulting in diahria 3-4 days a week and stomach cramps. I also started consuming mass quantities of alcohol, mostly Jim Beam, till I passed out. I even enjoyed a NJP courtesy of said Jim drinking. I'm sure my MH problems began shortly after I fell down a flight of stairs during Boot Camp, in November of 1992. I do have a printed list of all my VA prescriptions for various NSAIDs over the years, which are medically proven to cause or increase depression. I was looking on eBenefits, trying to figure out how to file for these contentions. So..my question is, should I speak to my local VAMC bennies counselor, and have him file the claims? He's been pretty good to me so far(got me bumped from 60-80%. Any guidance suggestions clues or hints would be most welcome and greatly appreciated! Thanks in advance. Semper Fi. Andyman
  24. Hi I am new here, and trying to sort through all of this, and it is a bit overwhelming. I have a C&P scheduled in a few months, and just received my appointments. C&P MHC C&P PSYCH TEST C&P Primary Care C&P Audiology So my question would be, I assume MHC = Mental health...So would it really be 4-hours of MH and psych testing? I am having a longer wait as it is because I need to see a female doctor for the MST part. I am really nervous about this whole process, and have read so many horror stories about the MST claim process (I understand it is PTSD via MST). I have a wonderful psychiatrist (private) that has helped me a lot, and she has submitted the Nexus. I guess I just feel like I am walking into an appointment where they will want to prove me wrong rather than help. I have been avoiding this whole situation for 17-years. Can anyone give me any advice that has been through this? Thank you in advance.
  25. So I went to my local Va and filed a 21-456EZ form for: Tinnitus Insomia memory problems Fibro(gulf war) Cfs(gulf war) Gastrointestinal disorders,hiatal hernia(gulf war) sleep disorders anxiety shingles/rashes and a few other things in my record I was honorably discharged from the USMC in 96 was dealing with this stuff then but, right or wrong I just dealt with it. I mean if I could get up and put my boots on in the morning and go to work thats's what I did. Only now it's taking longer to get going in the morning and so with the urging of my wife and fellow vets I went and filed. They took down my info and sent the form off. Also told my to go get a gulf war registry exam, which I am still waiting on. He didn't ask for med. records, x-rays, DBQ or anything. I told him about my PSTD symtoms and he put down anxiety. I'm just wondering what I'm in for and what to do next. So any advice , info, or help you guys can send my way is much appreciated. Semper Fi, Gadevildog
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