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Found 17 results

  1. Question: VA Form 21-526EZ page 8 section 13. Should all the items from the VA Problem list (medical records) be included on the form, including secondary problems and other items such as diabetes or ONLY the service connected problems? Post Vietnam, no AO My spouse's condition has deteriorated in the last 10 years and we need to be re-evaluated. Last year, the VA Rep submitted a claim and the Comp&Pen Doctor asked us for an MRI. From there it gets murky trying to get assistance for documentation.
  2. 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
  3. I am currently rated at 50% for PTSD and just had my C&P exam for an increase. Below is my current C&P results. Also I suffer from Major Depression and Erectile Dysfunction due to my medication. Could these two items be filed as secondary since the examiner did not list them in my C&P exam.Any input would be appreciated on to what my outcome may be. Thank you SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran now have or has he/she ever been diagnosed with PTSD? [X] Yes[ ] No 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD, moderate to severe, chronic Comments, if any: The trauamtic event was learning that a close friend of his killed two older female civilians. PTSD also causes secondary panic attacks 2-3 times per week. b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes[X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes[ ] No[X] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with reduced reliability and productivity b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes[ ] No[X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes[ ] No[X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes[ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes[X] No If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [X] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: b. Was pertinent information from collateral sources reviewed? [X] Yes[ ] No If yes, describe: On 11/25/2014, Dr. XXX conducted a C&P Initial Evaluation for PTSD and diagnosed the veteran with PTSD with panic attacks. 2. Recent History (since prior exam) ------------------------------------ a. Relevant Social/Marital/Family history: Mr. XX is currently married to his wife of 10 years. He describes the quality of his current marriage as, "loving - but my wife puts up with me." He reports his irritability and anger can stress his wife. He adopted his wife's 14 year old daughter. He reports he has no friends of his own, but he reports he is friendly with many of his wife's friends. He tends to avoid crowds and group social activities. He is quite close with his parents. His main hobby is drumming and working on computers. Overall his social support is limited. He reports that the primary effect of his psychiatric symptoms on his social relationships are tension and distance caused by irritability, rage (including yelling, swearing, and very occasional violence towards inanimate objects - like punching a hole in the door), withdrawal, and emotional numbing. b. Relevant Occupational and Educational history: Mr. XXX highest level of education is some college. He served in the Airforce. He is currently employed as a cyber security analyst at XXX a telecommunications company called XXX. He has worked at XXX since 2011. In 2012, he was written up for "going off on a customer." He reports he works from home or calls in sick 4-5 days a month due to feeling stressed. He reports during times of stress he impulsively loses his temper when talking with customers or makes careless mistakes. He is a lead, and he has five other analysists who report to him. c. Relevant Mental Health history, to include prescribed medications and family mental health: Mr. XXX denied history of psychiatric hospitalization, receiving out-patient therapy, receiving any type of psychopharmacological treatment, or prior suicide attempts. He has been referred to a psychiatrist by his PCP but he is not currently engaged in therapy. He receives medication management from his private PCP, and he is currently maintained on a regimen of Zoloft, hydroxyzine, prazosin and diazepam. d. Relevant Legal and Behavioral history: No arrests. Received an article 15 in the military after he learned of the murders. e. Relevant Substance abuse history: No response provided. f. Other, if any: No response provided. 3. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors.) Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #6 - "Other symptoms". Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Witnessing, in person, the traumatic event(s) as they occurred to others [X] Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic events(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related. Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. [X] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] The duration of the symptoms described above in Criteria B, C, and D are more than 1 month. Criterion G: [X] The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. 4. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Anxiety [X] Panic attacks more than once a week [X] Chronic sleep impairment [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships 5. Behavioral Observations: --------------------------- Mr. XXX was casually dressed, and was cooperative throughout the examination. His speech was fluent. His psychomotor behavior was appropriate. His affect was constricted and his mood was anxious. His insight was intact. Thought process was linear, goal directed, and future oriented. No reported hallucinations or delusions. No reported homicidal or suicidal ideation. 6. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes[X] No 7. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes[ ] No 8. Remarks, (including any testing results) if any: --------------------------------------------------- Veteran's PTSD and panic attacks currently cause moderate socio-occupational impairment.
  4. 38 CFR Book B 3.310 mandates secondary service connection for certain disabilities associated with traumatic Brain Injuries (TBI) I have a couple of QUESTIONs since my MDD rating is still in limbo at the VARO: What does it mean by "...the secondary condition shall be considered a part of the original condition….” Does that mean MDD is to be rated separately as secondary service connected to TBI? OR,does that mean that MMD cannot be rated separately from TBI and receives just ONE rating? How can secondary service connected disabilities avoid the "pyramiding" accusation? §3.310 Disabilities that are proximately due to, or aggravated by, service-connected disease or injury. (a) General. Except as provided in §3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. (b) Aggravation of nonservice-connected disabilities. Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. However, VA will not concede that a nonservice-connected disease or injury was aggravated by a service-connected disease or injury unless the baseline level of severity of the nonservice-connected disease or injury is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the nonservice-connected disease or injury. The rating activity will determine the baseline and current levels of severity under the Schedule for Rating Disabilities (38 CFR part 4) and determine the extent of aggravation by deducting the baseline level of severity, as well as any increase in severity due to the natural progress of the disease, from the current level. (Authority: 38 U.S.C. 1110 and 1131) (c) Cardiovascular disease. Ischemic heart disease or other cardiovascular disease developing in a veteran who has a service-connected amputation of one lower extremity at or above the knee or service-connected amputations of both lower extremities at or above the ankles, shall be held to be the proximate result of the service-connected amputation or amputations. (d) Traumatic brain injury. (1) In a veteran who has a service-connected traumatic brain injury, the following shall be held to be the proximate result of the service-connected traumatic brain injury (TBI), in the absence of clear evidence to the contrary: (i) Parkinsonism, including Parkinson’s disease, following moderate or severe TBI; (ii) Unprovoked seizures following moderate or severe TBI; (iii) Dementias of the following types: presenile dementia of the Alzheimer type, frontotemporal dementia, and dementia with Lewy bodies, if manifest within 15 years following moderate or severe TBI; (iv) Depression if manifest within 3 years of moderate or severe TBI, or within 12 months of mild TBI; or (v) Diseases of hormone deficiency that result from hypothalamo-pituitary changes if manifest within 12 months of moderate or severe TBI. (2) Neither the severity levels nor the time limits in paragraph (d)(1) of this section preclude a finding of service connection for conditions shown by evidence to be proximately due to service-connected TBI. If a claim does not meet the requirements of paragraph (d)(1) with respect to the time of manifestation or the severity of the TBI, or both, VA will develop and decide the claim under generally applicable principles of service connection without regard to paragraph (d)(1). (3) (i) For purposes of this section VA will use the following table for determining the severity of a TBI: Mild Moderate Severe Normal structural imaging Normal or abnormal structural imaging Normal or abnormal structural imaging LOC = 0–30 min LOC > 30 min and < 24 hours LOC > 24 hrs AOC = a moment up to 24 hrs AOC > 24 hours. Severity based on other criteria PTA = 0–1 day PTA > 1 and < 7 days PTA > 7 days GCS = 13–15 GCS = 9–12 GCS = 3–8 Note: The factors considered are: Structural imaging of the brain. LOC—Loss of consciousness. AOC—Alteration of consciousness/mental state. PTA—Post-traumatic amnesia. GCS—Glasgow Coma Scale. (For purposes of injury stratification, the Glasgow Coma Scale is measured at or after 24 hours.) (ii) The determination of the severity level under this paragraph is based on the TBI symptoms at the time of injury or shortly thereafter, rather than the current level of functioning. VA will not require that the TBI meet all the criteria listed under a certain severity level in order to classify the TBI at that severity level. If a TBI meets the criteria in more than one category of severity, then VA will rank the TBI at the highest level in which a criterion is met, except where the qualifying criterion is the same at both levels. (Authority: 38 U.S.C. 501, 1110 and 1131) [44 FR 50340, Aug. 28, 1979, as amended at 66 FR 18198, Apr. 6, 2001; 71 FR 52747, Sept. 7, 2006; 78 FR 76208, Dec. 17, 2013]
  5. Hello and TYIA for any responses and for reading my long post. BLUF: I would appreciate some insight or just plain ol speculatin on why the VA raters would submit me for a lumbar strain increase (that I didn’t submit for) while working on my current claim? Also, are secondary conditions disqualified in the 60% calculation for SMC Housebound? I know it says the 60% must be separate from the 100% condition, but how does this work if I’m on IU, with secondary conditions? I’m probably overthinking at 4am but why would they submit me for an increase for a condition when I didn’t ask them, and the increase has no bearing on the final rating due to VA math, unless it qualifies me for SMC, or they believe I should be qualified. I’ve never raised the issue of SMC and I’m still learning about it trying to figure out my claim, and I know they are supposed to do due diligence, but that’s not my first hunch since that’s why I’m still in this process. History: I filed a claim in 2015 for PTSD increase and TDIU, was granted increase in 2016 to 70% PTSD, denied TDIU. Combined, 80% with other SC conditions. BBE/VSO said I was denied increase to 100% even though I had a nexus statement from a psychologist saying total social and occupational impairment, at least as likely as not, etc., but they said because I was still employed (I was on long term disability leave but not yet “terminated” and yes they had the relevant evidence through my employer and insurance), and my VA treating provider’s opinion took precedence who didn’t feel my symptoms quite qualified me for total of course, though he‘s a CRNP versus a psychologist and I don’t think he even knows me. I thought they were supposed to take the rating and credentials that favor the Veteran but never mind me. I also survived and was approved for Social Security and life insurance premium waivers during this period without having to appeal, with the same medical information and evidence, with the same VA SC conditions, even coming from VA docs and providers. Of course I appealed the rating and TDIU denial (they can decide) in 2016. I also submitted a new claim for secondaries to PTSD, and in my fog, with that claim an increase for PTSD and TDIU, even though I already had those on appeal. I believe I read or was told somewhere (or maybe my brain made it up) that if I submitted new evidence, the raters could look back at the effective date and could EED to the original claim if the evidence shows and close the appeal. Or, they could approve me from the date of the new claim and the appeal could deal with the stuff before that. But what they did was what they are apparently supposed to do (according to Peggy and the VSOs): defer the appeal related claims to the appeal. DOH. Current Status: Early this month my claim progressed and I was granted an increase to 30% for IBS secondary to my 70% PTSD, and since I had a pre-existing 10% for nerve condition and 20% for lumbar strain, that brought me to 90%. My claim never went to complete and I never got the BBE, ebenefits bounced around from gathering of evidence to pending decision approval within days of my last C&P (I had one for PTSD and one for IBS). I’m not sure why they would give me a C&P for PTSD if they are deferring that part of my claim to appeal as I was told. Maybe they’re just giving me a checkup because my 30 appointments and inpatient stays and shock treatments over the past year weren’t enough medical evidence. I learned of the increase bc I got a small retro and my ebenefits letters and disabilities changed within days, but the claim stayed open. I found out by calling Peggy and VSO that it’s due to an increase for my lumbar strain that someone in the rating chain put in. I do have plenty of evidence in my medical records that show my back is also crap. I got sent to a C&P for my lumbar strain and now I wait in GOE. The C&P examiner, Peggy, VSOs specifically say I was submitted for an increase for my back, not a review. BTW, in ebenefiits in the disabilities section, the PTSD increase is still open, the TDIU disappeared, the IBS is rated, and the lumbar strain doesn’t appear. Yes, I know ebenefits is unreliable and I should find something else to do, but compulsively logging into ebenefits is an activity quite similar to playing a slot machine for me. Every 1 in 10000000 logins I might get a glimmer of hope, and it keeps me going lol. I Wonder: What difference does it make if I’m rated 20% or 30% for my lumbar strain? Why would this be raised since my overall rating won’t change from 90% either way? Trust me, I AM NOT COMPLAINING AND I AM GRATEFUL, anything they do (and they have been getting faster and more Vet-friendly it seems) positive for the Veteran that saves future agony and torture is an appreciated blessing. It would help in the future in qualifying for SMC, but I don’t qualify with the math now. Just wondering if they don’t have enough to do over there, because in the future I’d probably have to get another C&P. Also, I would have to have another condition at 30% for that math to work out, and I pray nothing else worsens enough for that to happen. Does “separate” mean it can’t affect the same body system or it can’t be a secondary condition? Because with secondaries, I could potentially qualify for SMC, and therefore the VA rater would be setting me up for success. Otherwise, it just seems like extra work for them when they could close my case and get their quota numbers and help another Vet...again, not complaining but whoever is on my file seems to be thorough regardless. I know they could be doing anything over there, and I’m glad they’re working on my claim, but just for s&g I’d appreciate any guesses or suggestions, and any help clarifying the SMC Housebound math thing please. Thank you all.
  6. Filed a claim for Esophageal Stricture (DC 7203) Secondary to SC GERD. Below is result of C&P Exam. Seems pretty straight forward. VSRO asks if Stricture is at least as likely as not due to GERD. Examiner responds in the affirmative. Decision letter mentions nothing about esophageal stricture and continues disability rating for GERD for 30%. Viewed many BVA decisions where 7203 can be rated separately and is not considered pyramiding. Filed for Stricture Secondary to GERD after recent EGD Exam diagnosed me with Schatzki ring and Eosinophilic Esophagitis. Both of which cause narrowing of the esophagus. MMEDICAL OPINION SUMMARY ----------------------- DBQ GI Esophageal (including GERD & hiatal hernia): TYPE OF MEDICAL OPINION REQUESTED: Secondary Service connection. The Veteran's esophageal condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of GERD, currently rated as hiatal hernia. RATIONALE: EGD Report dated 9/8/17 supports esophagitis which has been linked to chronic reflux of GERD/hiatal hernia. Veteran has no other documented condition to which it could be related. supplemental data: https://my.clevelandclinic.org/health/articles/hiatal-hernia RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: DBQ GI Esophageal (including GERD & hiatal hernia): TYPE OF MEDICAL OPINION REQUESTED: Secondary Service connection. Is the Veteran's esophageal condition, stricture at least as likely as not (50 percent or greater probability) proximately due to or the result of GERD? POTENTIALLY RELEVANT INFORMATION: TAB A: Bedford VAMC Treatment Records, 02/06/2013 to present TAB B: EGD Report b. Indicate type of exam for which opinion has been requested: GI 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: Recent EGD with biopsies supports esophagitis which is mediaclly accepted as having a link to hiatal hernia. TYPE OF MEDICAL OPINION PROVIDED: [ OPINION REGARDING CONFLICTING MEDICAL EVIDENCE ] I have reviewed the conflicting medical evidence and am providing the following opinion: The Veteran's esophageal condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of GERD, currently rated as hiatal hernia.
  7. Have a question. I submitted a claim in E-Benefits for secondary for both my left hip and left foot (due to left discrepancy), which is SC. The plantar fasciitis in my foot was diagnosed by the VA and my hip was diagnosed by a civilian doctor. I uploaded all my VA medical and personal doctors medical evaluation and documents along with a copy of my service medical records. My question is why this was done so fast as my initial claim was put into E-Benefits on 08/02/2017 and now I see its already in the "Preparation for Notification" phase. Also under disabilities claimed it states "mqas review - recoupment adjustment (New)". I did get an SSB payment when I left the service that I have been paying back for years now. My question is this seems too fast for the VA.....and not a good sign. (E-Benefits yesterday) Status of Your Claim: Gathering of Evidence Submitted: 08/02/2017 (Compensation) Estimated Completion: 11/11/2017 - 02/03/2018 Estimated Completion Info Tooltip with additional information Disabilities Claimed: bursitis(secondary to: leg length discrepancy, left lower extremity) (Secondary), (secondary to: leg length discrepancy plantar fasciitis left lower extremity) (Secondary) Current Status: Gathering of Evidence (E-Benefits Today) Status of Your Claim: Preparation for Notification Submitted: 08/21/2017 (Regulatory or Procedural Review) Estimated Completion: 08/24/2017 - 08/28/2017 Estimated Completion Info Tooltip with additional information Disabilities Claimed: mqas review - recoupment adjustment (New) Current Status: Preparation for Notification Representative for VA Claims: VETERANS OF FOREIGN WARS OF THE US
  8. 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?
  9. I have asked a lot of questions and i continue to ask alot of questions to learn even more. I think this may be my final question before i file. So i am currently service connected at 80% 60% asthma 30% allergic rhinitus 10% carpal tunnel 10% cystic acne (due to jet fumes) Now here's my question. Back in 2009 i began seeing a shrink for depression. ive been on pills and have gone to a counselor very often ever since. It is believed that my depression came from the 3 plane crashes that i witnessed. And another 1 that i didnt witness, but i was apart of the HR (human remains) team that shipped the 6 recovered bodies home. It is also believed that my depression has come as a result of the severe asthma and allergy pains. Recent my therapist marked me down as bipolar I, fyi. My question is, do you think i would have a better chance claiming bipolar/depression as secondary to the asthma and allergies. Or should i just say that ive been depressed from the plane crashes and hr missions. Or should i just claim depression as its own issue. please help. Thanks.
  10. OK Experts, I am currently rated 30% under migraines for headaches NOS. Before i ever put in a claim, I was experiencing jumping of my left eye. I kept going to my family doctor and telling her about the issue and also at my year eye exams. Explained the issue with my optometrist. Kept being told it could be stress, eye strain, lack of sleep. As my headaches became more frequent due to the issue or thee issue made headaches that much worse and the jumping moved down the side of my face to my lips. Well this scared me so I made an appointment with an opthamology specialist, he ordered a cat scan. Diagnosed as hemificial spasms: hemifacial spasm by definition a disorder of the facial nerve characterized by unilateral involuntary paroxysmal contractions of the facial muscles,caused by high-frequency bursts of motor units lasting from a few msec to several seconds; reported causes include compression of the ipsilateral facial nerve near its exit from the 9pons by a vascular malformation, compression of theipsilateral facial nerve by a posterofossa neoplasm, and idiopathic derivations Condition is the same as having convulsive tics or terret syndrome. I was told by the opthamologist that I could have a surgery or do botox injections. This would help with the tics and the headaches. So I choose to do botox every 4 months. First few rounds went great no issues, now all of a sudden I have muscle weakness and a droopy left eye. Given eye drops to help raise the eye lid. This of course is affecting my vision in my left eye. I filed a claim with hemifacial spasms secondary to migraines, of course the claim was DENIED. VA says that this was not caused by headaches and I know it started when headaches increased and intensified. I was going to drop it and let it go, but now with these new issues and I am being told that they dont know if this will reverse it self or this will be my permanent look. I have until December to file for an appeal. Do I submit a new claim or do I file for muscle weakness, convulsive tics, droopy eye or all separate as secondary to migraines or secondary to botox that was treating the migraines? Thanks in advance
  11. Is it true that for secondary issues you DO NOT need your in service medical records reviewed in order to obtain a Nexus letter? And has anyone had any success in claiming secondary issues? For example I am looking at putting in a claim for neck and hip pain secondary to my service connected lower back pain. I'm being treated for both neck and hip pain by my VA doctor. By treated I mean given Pain killers and muscle relaxers..lol
  12. Hi everyone I saw my Doctor yesterday and I asked and received a IMO for carpal tunnel and cubital tunnel syndrome secondary to right shoulder injury. A little history I'm receiving 20% Rt shoulder, 20% Lt shoulder secondary due to over use 10% Lt Biceps due to over use I would like to know if this is enough to claim service connection for my hand and forearm due to over use ? Here goes nothing . Work Status: NOT ABLE to work at present. Estimated to be permanently disabled from this injury to the left shoulder. He has night symptoms which keep him up at night. Patient demonstrates weakness and numbness in the left hand and forearm consistent with carpal tunnel and cubital tunnel . This is causing him to be unable to utilize his upper extremity and this is related to overuse and repetitive actions.
  13. Hello everyone, I am exploring a situation where regarding potential informal claims fo secondary conditions found during C&P exams. Adding in BVA instructions, this might be a situation where the VA might have dropped the ball on manifesting them into actual claims. Please note that the time period for this is 1995-2000, but it might also apply to later exams. In addition, the identified conditions were SC years later after this claim was closed. Some might read this and think that it might be a long shot or impossible, but I have read various opinions about this and wanted to ask about this approach. It might seem a bit unusual given the circumstances, but I am pulling together ideas and concepts from various resources and am asking for granular answers to my granular questions. Given these parts: Part 1 http://www.hadit.com/veterans-affairs-claims-self-help-guide/ An Informal claim is some type of communication to your local regional office in which you state you intend to apply for disability compensation. This communication can be a written letter, or fax, a telephone call or even an email. The best way, however, is something in writing. When a claimant makes an informal claim with VA, they need to clearly identify the disability for which they intend to apply for, give the VA your SSN and dates and branch of service, and make sure you send it via certified mail with return receipt! After you have sent your informal claim to VA, you have up to one year to send the VA your Formal Claim. In this one year period, I would recommend that you get together all of your medical records and so forth that will support your claim. If you send the VA your formal claim within the one year time period of the informal claim and VA grants your claim, the effective date, or the day you start to receive disability compensation, is the date of your informal claim. This could mean a lot of money in retro! Part 2 38 CFR 3.155 - Informal claims (a) Any communication or action, indicating an intent to apply for one or more benefits under the laws administered by the Department of Veterans Affairs, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. If received within 1 year from the date it was sent to the claimant, it will be considered filed as of the date of receipt of the informal claim. Part 3 BVA instructions to the RO as follows: "The examination should include an evaluation of, but not limited to, the above forementioned disabilities. The examiner should be requested to assess any and all disabilities present and render an opinion as to whether they are etiology related to service. A complete rationale should be provided." Questions 1. The VA said "any communication". If a "telephone call" (part 1) assumed to be to 1-800-827-1000 constitutes "any communication", would statements from a veteran documented by a VA C&P examiner be included? 2. If an "informal claim must identify the benefit sought" and "any communication, indicating an intent to apply for one of more benefits" are required, already being in a C&P exam demonstrates an intent and actual filing of disability benefits. Is this sufficient to prove intent to seek additional direct or secondary disability benefits? 3. If additional disabilities are identified through subjective statements from the veteran and objective diagnosis by the C&P examiner - but an opinion regarding SC was never rendered either for or against SC (part 3, BVA instructions), would those conditions be still considered open or would the mere lack of opinion be assumed as a denial? 4. (similar to previous question) If a C&P examiner fails to follow specific BVA instructions regarding opining for/against additional diagnosed conditions, is there a CFR/CAVC rule that states those conditions are automatic denials? 5. If the reported/diagnosed additional disabilities were reported during a C&P exam meet the requirements of an informal claim, a formal claim was not on filed already, and if the veteran was never sent an application form, would an informal claim for secondary disabilities still be considered open? Sorry to bug everyone about this, but the gears in my head have been spinning about these questions. Thanks!
  14. Rated 10% (SC) painful joints/Arthritis. When filed for increase unaware, but last week! diagnosed with fibromyalgia. Explains why my pain is severe. I need information. A condition caused or worsened by a SC condition is rated secondary to the SC condition. I don't know how to address acquiring after service a condition that aggravates existing SC condition. Am I stuck at 10% rating for painful joints or can I get compensation for the disabling pain either for effects on arthritis or as a secondary diagnosis? BTW I have SC conditions (IBD,PTSD,Migraines) which are common with fibromyalgia,... still getting Fibromyalgia SC is unlikely. Fibromyalgia alone is painful, but co-existing with arthritis is unbearable. Is there precedent to allow increase above 10% or allow secondary diagnosis? ANY SUGGESTIONS!!!!! I'm in constant pain. My claim is in reviewing evidence and will be decided soon. Any good advice is appreciated. Thank You
  15. There are 5 ways of obtaining Service connection, and not 2 like most VSO's state. The ones most VSO's often state are Direct and presumptive. However, there are 5: 1. Direct 2. Presumptive (this means there was an "act of law" which means you get service connection if you meet the criteria for the law). 3. Secondary. This means your service connected condition somehow caused another illness/injury. 4. Aggravation. This means you while you may have already had an injury in service, your military service "aggravated" and made worse your condition. 5. 1151. This means you sought medical treatment and one or more of your VA treatments caused an injury or illness. If you like, please give your example of how you won your claim with one of these. For example, I think Berta won an 1151 claim as the Va apparently caused her late husband's illness or even death.
  16. Okay I hope I am in the right section..... I have been s/c for my Eating Disorder Anorexia Nervosa. Most recently on 11/16/14 I took a pretty good tumble/spill and fainted due to my eating disorder and the fall resulted in me cracking/chipping my front upper teeth. They are turning grey/black as we speak and it is evident I am going to need dental work. The ER noted the fall due to Anorexia Nervosa so I want to get the dental s/c secondary to my anorexia nervosa. Both consults presented to Dental were denied due to I don't have 100% dental s/c. The consults were put in by my PCP and my MH doctor. Here are my questions: 1) If I go to outside dentist to get the work done and pay for it out of pocket can I submit the payment request with an FDC? 2) Should I get both PCP and MH to type a letter up on this? 3) MyhealthyVet notes show the ER visit and the evidence of my teeth damage due to Anorexia Nervosa. I should submit this with FDC - is that enough? If not shoudl I; 4) Get a statement from the dentist I am going to see to get my teeth fixed? I can't wait to get s/c because of the condition/infection I would risk with my teeth in the state they are in.... 5) Do you think I could get the s/c for my teeth???? I think an FDC is warranted in this case?? Thoughts???
  17. I was dx yesterday with sleep apnea- moderate, at the VA Medical Center by a VA sleep doc. I want to consider filing a secondary claim for SA, secondary to my service connected Major Depressive Disorder which is secondary to my SC DJD and thigh rupture. I will get my private doc to give me a IMO connecting the event. What change I got to get my claim thru with a good IMO from Dr Bash? Right now I am 160% with a extra $300.00 per month.
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