diabetes Nexus In Smrs

[Former Member]

This is one of my local vets.

I got him awarded about two years ago-

mega retro-----long time case------

His rep brought him to my home. I had limited info but had managed to access this BVA case and fortunately it was his because he forgot to bring all of his stuff-

http://www.va.gov/vetapp00/files3/0029422.txt

This was for SC of diabetes but not AO diabetes.

The Nexus is in the BVA decision-

one single word that no one bothered to even look up to see what it meant.

I couldn't wait until they left to delve into this word and what it meant-a few hours later ---

it meant service connection!

I will buy the VBM for the very first person here who posts that they have found the nexus word.

My point is that even with his SMRs the veteran himself nor his rep nor his attorneys at CAVC even read the SMRs carefully or used a medical dictionary to understand them.

Edited May 17, 2007 by Berta (see edit history)

[Boats]

Berta

Here you go

Diabetes and Looking After Your Eyes

--------------------------------------------------------------------------------

WHY YOUR EYES NEED TO BE CHECKED

People with diabetes have the same chance of developing eye problems unconnected to their diabetes as anyone else.

However, diabetes can cause some additional eye problems.

TEMPORARY CHANGES IN YOUR EYE SIGHT

You may have noticed changes in your sight around the time you found out you had diabetes. Your sight may have become blurred at times due to higher than normal blood sugar levels affecting the lenses in your eyes. However

These changes settle once your treatment is established and your blood sugar levels return to near normal values.

You should wait for 2 to 3 months after diagnosis of diabetes before you visit your optician for a sight test and/or a change of glasses.

If your diabetes treatment is altered you may notice slight changes again as your blood sugar levels are lowered especially if they were quite high to start with. These will settle as you adjust to your new treatment.

Any sudden change in vision should be reported to your doctor immediately.

Yearly eye tests by an optician are free for people with diabetes.

OTHER EYE CHANGES

All people with diabetes have an additional risk of developing damage to their eyes as a result of poor blood glucose and blood pressure control.

This is called DIABETIC RETINOPATHY.

Diabetic retinopathy is the major cause of blindness in the 30-65 age group in the UK at the present time.

Development or progression of diabetic retinopathy can be prevented by good blood sugar control, and the detection and management of high blood pressure.

In the early stages, diabetic retinopathy does not cause any symptoms such as pain or loss of sight. Once symptoms are present , it may be more difficult or even impossible to treat the condition. Treatment is usually most successful before patients develop symptoms.

Regular eye screening checks are VITAL and should be done ONCE A YEAR.

Children with diabetes should start to have regular eye examinations at age 12 or, if developing diabetes after puberty, 3 years after diagnosis.

WHERE IS EYE SCREENING CARRIED OUT?

In Tayside:

If you live in Dundee or Broughty Ferry your eye screening will be carried out at a fixed clinic currently situated at the Diabetes Centre in Ninewells Hospital.

If you live in Perthshire, Angus, Tayport or Newport on Tay, there are two mobile eye vans that travel round GP surgeries in these areas.

Wherever you are screened, you will be sent an appointment for this.

WHAT HAPPENS AT EYE SCREENING?

Your eyesight is tested first; remember to bring your distance glasses with you!

Photographs are then taken of the back of your eyes, to check for any diabetic retinopathy.

This is done in a darkened room to allow the pupils of the eye to enlarge and enable a good photograph of the back of the eye to be obtained.

Most people will NOT require to have drops applied to their eyes. However, for a small percentage of people, the pupils will not dilate sufficiently. In this case, eye drops will then be used to make your pupils wider.

We may need to give you a separate appointment for this.

The drops may sting at first. They also affect your sight for a few hours. You will not be able to drive until your vision returns to normal and may need someone to take you home.

You may want to take sunglasses with you, as your eyes will be sensitive to light for a few hours following the eye drops.

WHAT HAPPENS AFTER EYE SCREENING?

These photographs are examined by an expert and are kept from year to year for comparison. You will be informed of the result by post in approximately 1 month.

If the eye photograph is abnormal or if there is uncertainty, you may be invited to attend a specialist eye clinic in Tayside and be seen by an Ophthalmologist.

If any changes due to diabetes are found in your eyes, early treatment in most cases will protect your sight.

The photographs form part of your Computer Diabetes Record, and you will be able to see these by asking your GP or Practice Nurse.

WHAT ELSE DO YOU NEED TO KNOW?

In addition to your yearly eye screening visit, you are entitled to a free sight check at your optician every year.

Inform your optician that you have diabetes.

Give your optician the name of your family doctor and details of where you receive your diabetes care.

People with diabetes can wear contact lenses including some disposable types. However, the disposable lenses that are only worn for 24 hours and then thrown away are not recommended because they do not allow your eyes to get as much oxygen as they need.

If your eyes need further treatment, you should be referred to an ophthalmologist (eye specialist) without delay.

[Guest jangrin]

Berta--here is my thinking

The word in the record is ....rhinorrhea-

rhinorrhea can be cause from an auto immune disorder-

One of the most common is DIABETES (especially juvenile diabestes)

They military misdiagnosed the rhinorrhea as allergies when it was really a symptom of diabetes while in service either caused or aggravated.

Jangrin

[Jack]

This is one of my local vets.

I got him awarded about two years ago-

mega retro-----long time case------

His rep brought him to my home. I had limited info but had managed to access this BVA case and fortunately it was his because he forgot to bring all of his stuff-

http://www.va.gov/vetapp00/files3/0029422.txt

This was for SC of diabetes but not AO diabetes.

The Nexus is in the BVA decision-

one single word that no one bothered to even look up to see what it meant.

I couldn't wait until they left to delve into this word and what it meant-a few hours later ---

it meant service connection!

I will buy the VBM for the very first person here who posts that they have found the nexus word.

My point is that even with his SMRs the veteran himself nor his rep nor his attorneys at CAVC even read the SMRs carefully or used a medical dictionary to understand them.

drusen

Macular Degeneration

Macular Degeneration Overview

Macular degeneration is a disorder that includes a variety of eye diseases that affect central vision. Central vision is what you see directly in front of you rather than what you see at the side (or periphery) of your vision.

Macular degeneration is caused when part of the retina deteriorates. The retina is the interior layer of the eye. The macula is the central portion of the retina and is responsible for detailed vision

[Boats]

went from needing glasses 20/200 back to not 20/20

Boats

[free_spirit_etc]

The word drusen

http://www.novartisnutrition.com/us/articleDetail?id=7161

The glycemic index study (1)

The existence of diabetes or a raised blood sugar has not been associated, to date, with the occurrence of AMD. The researchers therefore decided to investigate the quality of the dietary carbohydrate intake in AMD patients. They examined the eyes of over 500 participants in the Nurses Health Study who had not had AMD diagnosed. The presence and degree of any AMD, along with the presence of any drusen (2), was classified as either (a) Unaffected, ( Without AMD but with drusen, or © AMD, with or without drusen. Dietary information came from food-frequency questionnaires collected over 10 years before the eye exams. The women were divided into three groups, according to their dietary glycemic index (3) or their total carbohydrate intake. The dietary glycemic index was found to be related to AMD, while the total carbohydrate wasnt. The likelihood of developing AMD was over 2½ times greater in the highest glycemic index group than in the lowest. Neither the glycemic index nor total carbohydrate intake was linked to the presence of drusen. ..

Diagnosing early AMD

The study described above also found that the glycemic index was related to one of the two major earlier signs of AMD - the presence of pigment changes but not the other (the development of drusen).

Free

This is one of my local vets.

I got him awarded about two years ago-

mega retro-----long time case------

His rep brought him to my home. I had limited info but had managed to access this BVA case and fortunately it was his because he forgot to bring all of his stuff-

http://www.va.gov/vetapp00/files3/0029422.txt

This was for SC of diabetes but not AO diabetes.

The Nexus is in the BVA decision-

one single word that no one bothered to even look up to see what it meant.

I couldn't wait until they left to delve into this word and what it meant-a few hours later ---

it meant service connection!

I will buy the VBM for the very first person here who posts that they have found the nexus word.

My point is that even with his SMRs the veteran himself nor his rep nor his attorneys at CAVC even read the SMRs carefully or used a medical dictionary to understand them.

[free_spirit_etc]

The drusen that was noted in 1961 - was also in his left eye - the eye he later lost vision in.

Free

[free_spirit_etc]

http://www.ifond.org/dict_d.php3

Drusen, Macular~, Optic Nerve~ Extra cellular material deposited either between between the basal lamina of the retinal pigment epithelium and the inner collagenous layer of Bruch membrane or in the optic nerve head. Drusen are seen with the ophthalmoscope as small yellow-white retinal or optic disc reflections. Drusen may be associated with vascular abnormalities in the eye, low retinal nerve fibre layer axon counts, glaucoma, anterior ischemic optic neuropathy, retinal hemorrhage, and premature visual loss.

http://www.amd.org/site/PageServer?pagenam...nter_friendly=1

Diabetes Another Threat to Your Eyes

In observance of National Diabetes Month, the U.S. Department of Health and Human Services has launched "Small Steps, Big Rewards". The new national diabetes prevention campaign is an effort to stem the explosion of diabetes by emphasizing to millions of Americans that modest lifestyle changes can do much to prevent the onset of type 2 diabetes, the most common form of the disease.

Diabetes attacks the retina of the eye in the form of diabetic retinopathy. It is similar to wet AMD in that blood vessels invade the macula. Laser treatment can be effective against it, but early diagnosis is the key. If you have diabetes, regular dilated eye exams are essential.

The guy seemed kind of young to be showing the first signs of AGE RELATED Macular Degeneration in 1961

Free

[Boats]

And you have a IMO making the Nexus for it almost forgot that...

[Former Member]

Great job Jack and Free!- I will open my PM- please send me your address and I will order the VBM today for both of you----

year after year no one recognized this word -Drusen-and the fact that it was related to his diabetes-----

he is totally blind in one eye now due to cataracts- they VA paid him much retro but still owe him money-

for cataracts and heart disease- I thought he would die before he saw his SC award!

I think this is an example of the good detective work it takes to win VA claims-

[free_spirit_etc]

Woo Hoo!!! The runner up gets a prize too!

I looked up the info -- posted it - and then looked and said Dang! Jack Beat me! But I still was happy I figured it out. (Likes to be right! )

I actually had NO idea what a drusen was. SO I looked it up. Did a search for Drusen - to find out what it was - and found out but saw no connection to Diabetes -- So then I did a search for drusen AND diabetes to see if there was a connection. And then started putting the rest of it together. 1961 would be hard to connect it to age related - it was in the same eye that he lost vision in - etc.

I agree - it is the kind of detective work needed. And important that you SPELL IT OUT to the VA -- because they aren't going to see the connection.

Interesting that the REASON I looked the word up is that I didn't know what it was. Unfortunately - sometimes when we know SOMETHING about a condition - we think we know it ALL - and therefore don't research enough. But we might have a tendency to overlook an important connection because what we already know stops us from looking further.

For instance, had I known what a drusen was, and connected it in my mind to age related macular degeneration, I might NOT have looked any further (unless I caught that he was quite young when it was discovered). And I could have breezed right past an important piece of info.

My students get so aggravated when I have them do research on a topic before a group discussion. They think "I already KNOW about the topic --why do I have to look anything up?"

BECAUSE -- you can always learn MORE - you can always add to what you know, or even find important information that SUPPORTS what you already know!

Anyway -- The REAL winner was the veteran who benefitted because BERTA caught the nexus and made the connection!!!!!!!!!!!!!!!!!!!!!!!

Free

Great job Jack and Free!- I will open my PM- please send me your address and I will order the VBM today for both of you----

year after year no one recognized this word -Drusen-and the fact that it was related to his diabetes-----

he is totally blind in one eye now due to cataracts- they VA paid him much retro but still owe him money-

for cataracts and heart disease- I thought he would die before he saw his SC award!

I think this is an example of the good detective work it takes to win VA claims-

[huskerfanfl]

Research is so important. And Free is right, you do have to spell it out for the VA. For my claim on sleep apnea, I did hours of research on the affects that sleep apnea can have to include high blood pressure, weight gain, GERD, and fatigue, and when I wrote a letter to the VA for my claim essentially wrote a research paper and noted how this is one of the signs of sleep apnea, when that symptom was noted in my medical records. I have not been rated yet, but the AMVET rep looked at my file and commented on the presentation I made of the evidence. Since then, I have done searches on cases that have gone before the BVA regarding sleep apnea and I am confident that if I do not receive a favorable decision, I will be successful on appeal.

[Former Member]

If you dont receive the VBM in week to ten days-let me know free-I just ordered it and I await Jacks address too-----

I hope no one minded this contest I pulled-

It is just that something here triggered for me what this above vet went through-

and worse yet the VA withheld $8,000 bucks from his retro for a law firm registered with CAVC.

It was in my opinion $7,999.98 too much-

but I did prepare a NOD to get about $4,000 back for him-

I commend anyone who did what you did------

to take the time to wonder about one word and then check it out good-

this is the heart of good VA claims help----

think of that-this vet even had lawyers who didnt pick up on the nexus-

and then- he got a free IMO- but his doctor did not follow the IMO criteria and still VA denied the claim-

the doc did not fully understand how important it was for him to opine on the nexus in the SMRs.

But that finally got squared away-

This bothers me too about the whole thing-

this man is an African American and told me of how discrimination affected him when he was serving

in the military in those days-

he had sick calls because he was really sick and his CO or someone kept telling him he was just lazy-

I am a civilian and not african American but I tried to relate to his situation and I sure realised that the mil did not really give him adequate care-then again they did not understand diabetes then like they do now-still- this veteran had one heck of an ordeal all around and I commend you both----

if only vet reps or SOs would take the time to do what you did here-

with every vet's claim.

PS -I won FTCA based a lot on one word too-diaphoretic-

long story there but it took me months to even figure out the chicken scratch handwriting it was in-but it proved my husband had a heart attack at the VAMC.

They sent him home with sudafed.

Diaphoretic consition- profuse sudden sweating- is a clear medical emergency and can be symptom of a sudden heart attack.

[Josephine]

Berta or Anyone,

Is Nervousness in your SMR Psychaitric Records a nexus to Anxiety ? Is this a KEY WORD?

Nervousness is an emotional reaction to all sorts of stresses, good or bad. A person may complain of being high-strung or jumpy. Feelings of nervousness can include:

* sweaty hands, dry mouth and rapid heartbeat,

* lack of concentration,

* muscle pains in the neck or back,

* restlessness and agitation,

* frequent need to use the bathroom for either diarrhea or urination, and

* an upset, jittery stomach.

All of us have been nervous, especially when we are anxious or afraid of new situations. It may be related to concerns about a relationship, job pressure, or a parenting issue. It usually resolves on its own. If it begins to interfere with our ability to perform our daily tasks, it is time to ask for help. Often talking to a friend, counselor or clergy person will help us find a solution, or a way of coping with our problem.

Other reasons for nervousness may be related to medical conditions, such as:

* withdrawal from alcohol or drugs,

* overuse of caffeine or other stimulants,

* medication side effects,

* medical conditions such as seizures, stroke, or thyroid or hormone imbalances, and* psychiatric conditions such as anxiety disorders.

Seek help if your nervousness is causing:

* Changes in your sleeping, eating, grooming or exercise habits.

* A hard time sustaining your relationships.

* Difficulty on the job.

Don't suffer. Get help. Medication, counseling and/or, medical treatment can make a difference.

Thanks,

Josephine

Edited May 17, 2007 by Josephine (see edit history)

[Pete53]

Josephine:

The answer would be yes to your question. Nervousness and the other stuff in your records should win your case.

Good Luck

[Josephine]

Pete,

Thanks as always. I am going to need it.

Josephine

[hayley3]

That was very inspiring! I got it right too, darnit!

At least I can kinda understand why they missed the word drusen. I laid it all out for them and they still didn't get it. I gave them every document I could find on the internet linking the infection and the arthritis. But I'm not a doctor so there ya go.

This is one of my local vets.

I got him awarded about two years ago-

mega retro-----long time case------

His rep brought him to my home. I had limited info but had managed to access this BVA case and fortunately it was his because he forgot to bring all of his stuff-

http://www.va.gov/vetapp00/files3/0029422.txt

This was for SC of diabetes but not AO diabetes.

The Nexus is in the BVA decision-

one single word that no one bothered to even look up to see what it meant.

I couldn't wait until they left to delve into this word and what it meant-a few hours later ---

it meant service connection!

I will buy the VBM for the very first person here who posts that they have found the nexus word.

My point is that even with his SMRs the veteran himself nor his rep nor his attorneys at CAVC even read the SMRs carefully or used a medical dictionary to understand them.

[free_spirit_etc]

Josephine -

I certainly would think so.

Diagnostic Criteria - Generalized Anxiety Disorder

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

The person finds it difficult to control the worry.

The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months).

Note: Only one item is required in children.

restlessness or feeling keyed up or on edge

being easily fatigued

difficulty concentrating or mind going blank

irritability

muscle tension

sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

I don't recall -- how long ago were you in the service?

I was thinking it was sometime back.

If your diagnosis is anxiety disorder NOW -- and you had nervousness listed in your SMR's back THEN (depending on when "back then" was) -- connecting the dots may even be easier.

Personally, I like to use government documents as much as possible - or actual medical journals, rather than basic lay person internet sites, as sources to back my arguments (as they are considered more credible and harder to debate). But the basic sites are a good starting point.

I ran across this:

http://anxiety-panic.com/dictionary/en-dictn.htm

Nerves - see nervous illness or neuron.

Nervous - the feeling of anxiety, or regarding the nervous system as studied in neurology.

Nervous Breakdown - a dated term referring to anxiety disorders that notably affect functionality.

Nervous Disease - a dated term for an anxiety disorder.

Nervous Exhaustion - a dated term referring to anxiety disorders which seemed a product of stress.

Nervous Heart - a dated term for an anxiety disorder.

Nervous Illness - a dated term for an anxiety disorder.

Nervous Storm - a dated term for a panic attack.

Lightbulb time. Though I wouldn't use this source as THE source with the VA -- what clicked for me was that - Yes... You didn't used to hear of people having "Anxiety." Quite some time back the SAME condition was called a "Nervous condition." People had "Nervous breakdowns." They were put on medicine for their NERVES.

So -- depending on how far back your SMR's were -- Nervous WAS the term they USED for the disorders they now use the term anxiety for.

So rather than just trying to connect today's use of "nervous" with today's use of anxiety -- you could possibly build a case that they are one and the same CONDITION -- and it was the TERM USED that changed over time.

Just a thought,

Free

Berta or Anyone,

Is Nervousness in your SMR Psychaitric Records a nexus to Anxiety ? Is this a KEY WORD?

Nervousness is an emotional reaction to all sorts of stresses, good or bad. A person may complain of being high-strung or jumpy. Feelings of nervousness can include:

* sweaty hands, dry mouth and rapid heartbeat,

* lack of concentration,

* muscle pains in the neck or back,

* restlessness and agitation,

* frequent need to use the bathroom for either diarrhea or urination, and

* an upset, jittery stomach.

All of us have been nervous, especially when we are anxious or afraid of new situations. It may be related to concerns about a relationship, job pressure, or a parenting issue. It usually resolves on its own. If it begins to interfere with our ability to perform our daily tasks, it is time to ask for help. Often talking to a friend, counselor or clergy person will help us find a solution, or a way of coping with our problem.

Other reasons for nervousness may be related to medical conditions, such as:

* withdrawal from alcohol or drugs,

* overuse of caffeine or other stimulants,

* medication side effects,

* medical conditions such as seizures, stroke, or thyroid or hormone imbalances, and* psychiatric conditions such as anxiety disorders.

Seek help if your nervousness is causing:

* Changes in your sleeping, eating, grooming or exercise habits.

* A hard time sustaining your relationships.

* Difficulty on the job.

Don't suffer. Get help. Medication, counseling and/or, medical treatment can make a difference.

Thanks,

Josephine

[Josephine]

Free,

Thanks so much. I really appreiate your time to help me.

It took me some time to wise up and let the VA know that the terminology has changed not the illness.

My discharge was in 1964 and as you said, there was no such use of the word" Anxiety".

I typed up my enlistment physical for the VA and the term used them was " Nervousness of any sort" and " been insane".

I answered "No" to each of those questions.

Only after being in the military for a year did I know what these words meant and knew what they felt like.

With the two claims filing in 1978 and 2002, I never onced used the word" Anxiety". Only the VA has changed this word from " Nervousness" to " Anxiety" to " Acquired Psychiatric Disorder".

Dr. Joxxxx, Board Certiied Psychiatrist, U.S. Navy March 12, 1964, state that I was in consulation for " Nervousness", " Headaches" and " Irritability". Staff member dis-satisfied with " Working Conditons" and " Living in the barracks".

Dr. Mxxxxe Board Certified Psychiatrist for U. S Navy - March 24, 1964. States Staff member in consulation for symtoms of the same and makes note of the consultation with " Dr. Jxxxs". Recommeds dischage by reasons of " Unsuitability".

( Dr. Muzzzz) VAMC states " HE IS NOT TELLING THE VA ANYTHING THAT THEY DON'T ALREADY KNOW". Anxiety no otherwise Specified with Depression. " More Likely than not her Anxiety with Depression began in service".

The Board of Two Psychiatrist at the VAMC in their write up left out the key words " NERVOUSNESS".

I have brought this to the attention of The Appeals Management Center.

They state that I was in consulation with Dr. Jxxxxx and Dr Mxxxxx for " HEADACHES".

I hope to soon receive an answer from the Apeals Management Center. If I receive a denial, I will continue this claim with a lawyer.

Eventually, I am going to the License Board for the lies in the C&P by the Board of Two at the VAMC.

Thanks a bunch,

Josephine

Edited May 19, 2007 by Josephine (see edit history)

[hayley3]

Hey Josephine,

It sounds like we are having the same problem. The medical people have changed the name of my disease 3 times and the VA still doesn't have it listed. And sounds like your VA doctors are like mine as well. Best of luck to ya!

Susie

[Josephine]

Susie,

What are the names the VA has given your illness ? Maybe, I can help you make heads and tails out of what they are doing.

Josephine