ptsd Raising 2 Or More Bases

[Berta]

I mention this here but maybe not often enough-

a veteran or widow can raise more than one potential claim for service connection.

http://www.va.gov/vetapp06/files2/0605222.txt

This is a BVA decision which is a good example-

the veteran's diagnosis seemed to be at one point depression and then a year later PTSD- but he also was even diagnosed as malingering.

The vet claimed depression in 1999 and then filed claim for PTSD in 2000.

"ORDER

Service connection for PTSD is denied.

Service connection for depression is granted."

A widow can do the same. I claimed that my husband had undiagnosed DMII which is what resulted in his CVA, CAD and death.

The VA had already granted wrongful death due to malpractice but still-3 years after his death, had not diagnosed him properly.

I raised this issue for direct SC with 2 IMOs and also I raised the issue of PTSD causing heart disease-as a VA C & P doctor, in a report clearly determined to go against my initial claim of 1995, stated that there was an obvious reason to assume a potential link- forget how he put that-

I also raised the issue of PTSD (service connected at 100% posthumously)and that this was still an open issue as I realised in 2004 that PTSD was in his Sec 1151 claim, and also in mine.

Meaning a direct SC disability contributing to death- warrants a direct SC death.

The veteran felt that his PTSD had been malpracticed on and this is why he actually filed his Sec 1151 charge.

He had good documentation on that but Rod threw in at the end of this claim- in that he feared the VA would kill him because they probably misdiagnosed him with other disabilties too and he could die of another stroke or even heart disease.

The OGC settlement and Section 1151 award stated that malpractice of "Multiple" disabilities had caused his death.

The VA never clarified that statement but I obtain a report that definitely confirmed that the heart disease (never rated nor mentioned in his med recs) had been malpractice on as the most significant cause of his death-but no etiology was ever given for his CAD.After researching his med recs very carefully and info on DMII- 3 doctors agreed that Rod had DMII and this untreated AO disability-symptoms evident in med recs back to 1988-was what caused his strokes and heart disease and death.

The VSM sent me a letter some time ago as I had written the RO to clarify my issues-

in that letter she stated that the PTSD issue under Sec 1151 had been resolved in the Sec 1151 award.

Yippee.

I immediately sent copy of this letter back and claimed this as support for the PTSD under Section 1151 malpractice claim I filed-as contributing to his death-

direct SC contributing to death-one more reason for VA to directly SC his death.

My long point here and as in with the BVA decision above is that

any claimant should raise any potential reason whatsoever for service connection.

If the above veteran had accepted and pursued the PTSD claim-assuming that diagnosis was correct he would have been denied on that claim-

as soon as VA diagnosed him with depression-he filed another claim-

We are not limited to one potential scenario for SC in many cases and it certainly pays to raise every potential possibility for SC.

Edited May 25, 2007 by Berta

[Charleese]

Hi Berta or anyone,

What is CVA, CAD that you speak about below? Is that something related to DMII?

Thanks!

[Testvet]

CVA is Coronary Vascular Accident (stroke) and CAD is Coronary Artery Disease

I had the VARO deny my claim for CAD on their C&P docs claim that literature shows no connection between PTSD and CAD because it didn't state Hyperstension and Artheriosclerosis like DR Boscarino's study shows they denied it I still have it on appeal I also have raised the point that the exposure to the 77 toxins in the drinking water and soil of Edgewood Arsenal may have caused the early onset of my heart disease at age 36 37 of the toxins are linked to cariovascular problems. The VARO said I can't prove I was exposed to the toxins I was there for 2 months I had to drink the water, coffe and kool aid sometime during the 2 months I don't know anyone that can go 2 months without drinking liquids and it is in everything. The EPA forced the Army to cap Edgewood Arsenals water wells in 1978 and they have been dumping the stuff since 1917 and I was there in 1974 the odds are more likely than not I was exposed to it. Also 40% of the veterans used there are already dead and 54% of the 4022 survivors are disabled a 74.43% death and disability rate a very high rate for men aged 45-65 at the time the last health study was done.

Yes, raise every issue you can.

[Berta]

These two disabilities are often caused by hyperlipidemia, and atherosclerosis as initially due to DMII.Cholestrol can cause aterial plaque and the blood can clot getting through the artery-if the clot stays in the heart it can cause myocardial infarction-if it travels to the brain it can cause brain ischemia and stroke.

I am oversimplifying the medical connection- but have done extensive medical research on why DMII can cause CVA and CAD-

and why CAD and CVA could be unrelated to DMII-

However the VA fully knows of the important relationship that DMII has as to being the most often medical etiology of DMII to these conditions-

And the ADA - about a year after I filed a claim on this basis started those commercials telling Americans that DMII is often not diagnosed until a person has a heart attack or stroke- and that diabetes is a leading cause of heart disease and stroke in America.

If they used Rods autopsy as the commercial it would have vividly proved their point.

Only at my daughters insistence did I file a claim for DMII.

Her point was that since the VA had committed malpractice on CVAs and CAD in the first place-it was "more then likely" that dad has diabetes which they also failed to diagnose too.

I didnt see the connection but filed the claim after many months of her insistence and then began the horrible review of those medical records.

She was right. With no diabetes in Rod's family I always overlooked the fact that he was

exposed to AO in Nam and that his exposure had been confirmed and that the VA could have misdiagnosed this conditon too. They did.

I studied some autopsies and found that certain types of both heart and brain trauma are directly linked to DMII-

this is usually only proven by ECHO and complete MRI findings.

I correlated this information with my husbands MRIs and autopsy and found the connect to undiagnosed DMII was obvious.

Dr. Bash agreed.

It certainly pays when dealing with diabetes to read all the medical literature available on the net-

The best literature comes from the ADA, Diabetologica, and the VA itself.

The DMII training letter that I posted here many times-can be found under srearch fully shows that the VA is aware of the complixations of diabetes-which are numerous---

not all DMII pts get CAD or CVAs- but if they do the link is often quite obvious in their medical records.

Diabetes doesnt kill anyone.

Its complications do.

Only ECHOs and MRIs and detailed medical records can support the evidence needed for many claims of secondary CVA and CAD due to DMII.

In many cases a C & P doctor will readily make the connection.

Other cases need detailed info and usually an IMO.

Edited May 25, 2007 by Berta

[free_spirit_etc]

This is a GREAT idea. On my husband's cancer claim - he raised 2 issues:

1. That his cancer was incurred in-service (that though his cancer was not diagosed until after his presumptive period - that it is more likely than not that a 3.1 cm tumor of adenocarcinoma did NOT develop in the 2 years between his discharge and diagnosis.)

2. That the asbestos exposure he expreinced during his 13 years as an electrician for the Air Force more likely than not contributed to the development of his lung cancer.

We also asked the VA to re-evaluate some of the evidence in the file.

The regs clearly state procedures for Post Service Initial diagnosis of disease. And they tell how to develop a claim in which a diagnosis is made after the presumptive period.

So just saying "You disease wasn't diagnosed until after your presumptive period" really isn't an adequate denial - unless they give a reason as to why that fact matters (since the regs on post-servie diagnosis clearly PRESUME the disease was NOT diagnosed until after service)

The VBM manual (Thanks Berta!) states that if they just use the excuse that your disease wasn't diagnosed until after service - they are making medical assumptions about the progression of the disease - and that needs to be followed up with MEDICAL EVIDENCE (by THEM) as to why merely being diagnosed post service would be relevant.

The regs do say that if a disease is diagnosed shortyl after the presumptive period -- that the VA must go back and re-evaluate evidence in light of the new information to see if the person had symptoms that initially were overlooked - but in light of the new information (definite diagnosis) now take on new meaning to show that the disease WAS manifest to the degree of 10% disability during the presumptive period.

We asked them to go back and evaluate my husband's reported fatigue. He had consistently reported fatigue to the VA (AT retirement -and DURING his presumptive period) -- but first they said his fatigue did not meet the criteria of chronic fatigue syndrome (but gae no opionion as to what was causing his fatigue)... and later said his fatigue was caused by depression.

We sent them medical information that shows that fatigue is actually the FIRST symptom of most lung cancers.

We pointed out that he first reported fatigue when discharged from the military (a time when his cancer was growing but un-detected) and that he next reported his fatigue in 2003 (when his cancer - which was thought to be surgically cured - was once again growing but not detected again until later that year).

We also gave them the Cancer Fatigue PDQ which is used to diagnose cancer fatigue (from the national cancer institute)

And we pointed out that though the second C&P said his fatigue was caused by depression -- based on the BECK Depression Inventory -- he also gave a list of the answers that TRIGGERED the diagnosis of mild to moderate depression --

And the only answers that triggered the depression diagnosis were his reports of fatigue.

So he goes to them - says I am tired -- I have trouble gettng things done - I am fatigued - etc.

So they give him a depression inventory --on which he once again verifies that he is fatigued, tired, has trouble getting things done -- So his reports of fatigue trigger enough answers to diagnose him with DEPRESSION (because he IS FATIGUED!) And they make a diagnoses of depression - and then say it is more likely than not that hs fatigue is caused by his depression (which was ONLY diagnosed because of his FATIGUE) It was a real circular argument.

The exact same questions he answered yes to on the Beck Depression Inventory are ON the Cancer Fatigue PDQ. And he didn't trigger any of the questions on the BECK inventory that were NOT related to Fatigue.

So we asked that the VA go back and reconsider (in light of the later diagnosis) that his fatigue was just as likely as not related to his cancer as it was to depression)

I would think they would have to do this -- as we requested them to -- and the regs clearly state they have to go back and reconsider symptoms that at first did not seem signficant --but in light of the diagnosis might take on new meaning.

Free

I mention this here but maybe not often enough-

a veteran or widow can raise more than one potential claim for service connection.

http://www.va.gov/vetapp06/files2/0605222.txt

This is a BVA decision which is a good example-

the veteran's diagnosis seemed to be at one point depression and then a year later PTSD- but he also was even diagnosed as malingering.

The vet claimed depression in 1999 and then filed claim for PTSD in 2000.

"ORDER

Service connection for PTSD is denied.

Service connection for depression is granted."

A widow can do the same. I claimed that my husband had undiagnosed DMII which is what resulted in his CVA, CAD and death.

The VA had already granted wrongful death due to malpractice but still-3 years after his death, had not diagnosed him properly.

I raised this issue for direct SC with 2 IMOs and also I raised the issue of PTSD causing heart disease-as a VA C & P doctor, in a report clearly determined to go against my initial claim of 1995, stated that there was an obvious reason to assume a potential link- forget how he put that-

I also raised the issue of PTSD (service connected at 100% posthumously)and that this was still an open issue as I realised in 2004 that PTSD was in his Sec 1151 claim, and also in mine.

Meaning a direct SC disability contributing to death- warrants a direct SC death.

The veteran felt that his PTSD had been malpracticed on and this is why he actually filed his Sec 1151 charge.

He had good documentation on that but Rod threw in at the end of this claim- in that he feared the VA would kill him because they probably misdiagnosed him with other disabilties too and he could die of another stroke or even heart disease.

The OGC settlement and Section 1151 award stated that malpractice of "Multiple" disabilities had caused his death.

The VA never clarified that statement but I obtain a report that definitely confirmed that the heart disease (never rated nor mentioned in his med recs) had been malpractice on as the most significant cause of his death-but no etiology was ever given for his CAD.After researching his med recs very carefully and info on DMII- 3 doctors agreed that Rod had DMII and this untreated AO disability-symptoms evident in med recs back to 1988-was what caused his strokes and heart disease and death.

The VSM sent me a letter some time ago as I had written the RO to clarify my issues-

in that letter she stated that the PTSD issue under Sec 1151 had been resolved in the Sec 1151 award.

Yippee.

I immediately sent copy of this letter back and claimed this as support for the PTSD under Section 1151 malpractice claim I filed-as contributing to his death-

direct SC contributing to death-one more reason for VA to directly SC his death.

My long point here and as in with the BVA decision above is that

any claimant should raise any potential reason whatsoever for service connection.

If the above veteran had accepted and pursued the PTSD claim-assuming that diagnosis was correct he would have been denied on that claim-

as soon as VA diagnosed him with depression-he filed another claim-

We are not limited to one potential scenario for SC in many cases and it certainly pays to raise every potential possibility for SC.