Dro Denial Received

[jmlo]

My husband received a denial for service connection of his fibromyalgia on Friday. It states that even though his doctor stated that the fibromyalgia is service connected, he didn't base his opinion on a review of his medical records. Also, he got out of the service in 98 and the fibro wasn't diagnosed until 2005. He is a gulf war veteran and served during the Southwest Asia Theatre. Wouldn't the service connection be granted under the presumptive period?

Where do we go from here? I really don't want him to have to wait years for the BVA. The RO said that we could request a hearing. Should he do that? Will they issue a SSOC after that? Also, his gulf war registry exam is in a week. VA cancelled the first one. Could this be why they didn't service connect it? Because they don't show it in the records yet? Everything they send us has on it that he is a gulf war vet but we just found out about the registry in July and he has been to va to determine that he is eligible and they scheduled his exam.

Should we close this claim and re-open another? We also want to include two other conditions but were trying to wait this out first.

Any help is appreciated.

[Cheri0310]

I'm sorry, I'm not so sure how much help I can be since my husband is in the same boat as yours and we are currently waiting on a decision. This is what I've read about presumed disability's relating to the Gulf war.

Served in the Southwest Asia Theater of Operations during the Gulf War with condition at least 10 percent disabling by 12/31/11. Included are medically unexplained chronic multi-symptom illnesses defined by a cluster of signs or symptoms that have existed for six months or more, such as:

· chronic fatigue syndrome

· fibromyalgia

· irritable bowel syndrome

· any diagnosed or undiagnosed illness that the Secretary of Veterans Affairs determines warrants a presumption of service connection

Signs or symptoms of an undiagnosed illness include: fatigue, skin symptoms, headaches, muscle pain, joint pain, neurological symptoms, respiratory symptoms, sleep disturbance, GI symptoms, cardiovascular symptoms, weight loss, menstrual disorders

When did you file? How long did it take for a denial? Did he have a C&P exam?

My husband received a denial for service connection of his fibromyalgia on Friday. It states that even though his doctor stated that the fibromyalgia is service connected, he didn't base his opinion on a review of his medical records. Also, he got out of the service in 98 and the fibro wasn't diagnosed until 2005. He is a gulf war veteran and served during the Southwest Asia Theatre. Wouldn't the service connection be granted under the presumptive period?

Where do we go from here? I really don't want him to have to wait years for the BVA. The RO said that we could request a hearing. Should he do that? Will they issue a SSOC after that? Also, his gulf war registry exam is in a week. VA cancelled the first one. Could this be why they didn't service connect it? Because they don't show it in the records yet? Everything they send us has on it that he is a gulf war vet but we just found out about the registry in July and he has been to va to determine that he is eligible and they scheduled his exam.

Should we close this claim and re-open another? We also want to include two other conditions but were trying to wait this out first.

Any help is appreciated.

[calnight]

dont give up and try to keep it at the ro. i was denied 2 times by the dro. try to get as much medical evidence as possible. if you have to pay for a imo then do it. make sure it states his conditions are more than likely from the gulf war. also if he is not working have the doctor state that he can no longer work becuase of his service connection. very important rembember medical evidence is what counts. if he is not working fill out the iu app now do not wait. you can get by calling the 1-800-827-1000 number. some doctors need to be told what you need. so dont be afraid to tell the doctor that this is what you need to prove your claim. i was denied 2 times until i had my doctor state the above. i believe if you can obtain the above you should not have a problem. and better yet the more doctors that you can state the above even better. try to keep it at the ro the bva is way to long in my opion it should be used as a last resort. you still can add new evidence to your claim while your waiting for a hearing and the ro must look at all new evidence. so the faster you can obtain more medical evidence the better. good luck

[Cheri0310]

Here is some more information I've dug up.

<H5 style="MARGIN: 0in 0in 0pt">b. Information Required to Decide the Issue of Service Connection for an Undiagnosed Illness</H5>The following information is required in order to determine whether service connection for an undiagnosed illness is in order:

· when the illness arose

· whether the illness was severe enough to warrant the assignment of a compensable evaluation at any time during the presumptive period, unless manifested while in the Southwest Asia theater, and

· whether the illness chronically persisted for at least six months.

<H5 style="MARGIN: 0in 0in 0pt">c. Relevancy of Medical Evidence</H5>When the object of service connection is identification of a diagnosed illness, medical evidence is of paramount importance because a physician specializes in identifying disabilities through diagnoses.

The concept of “objective indications” expressed in 38 CFR 3.317 makes clear that the evidence required for undiagnosed illnesses, or illnesses which are outside the scope of medical understanding, is not so dependent on formal medical evidence.

Check out this link....

http://www.warms.vba.va.gov/admin21/m21_1/...2/ch02_secd.doc

My husband received a denial for service connection of his fibromyalgia on Friday. It states that even though his doctor stated that the fibromyalgia is service connected, he didn't base his opinion on a review of his medical records. Also, he got out of the service in 98 and the fibro wasn't diagnosed until 2005. He is a gulf war veteran and served during the Southwest Asia Theatre. Wouldn't the service connection be granted under the presumptive period?

Where do we go from here? I really don't want him to have to wait years for the BVA. The RO said that we could request a hearing. Should he do that? Will they issue a SSOC after that? Also, his gulf war registry exam is in a week. VA cancelled the first one. Could this be why they didn't service connect it? Because they don't show it in the records yet? Everything they send us has on it that he is a gulf war vet but we just found out about the registry in July and he has been to va to determine that he is eligible and they scheduled his exam.

Should we close this claim and re-open another? We also want to include two other conditions but were trying to wait this out first.

Any help is appreciated.

[rdawg]

fibromyalgia is an undiagnosed illness. The double speak of the VA is, well there is a diagnoses of fibromyalgia, therefore it is a diagnosed illness not an undiagnosed illness.

I posted this BVA decision a while ago.ibs cue (click here) The experts here (Berta,etc.) said it was a correct decision. I still say it's wrong. Check out the double talk.

Your husband should not need a medical opinion. He served in SW Asia, correct? You said he served during the Gulf War. Service in SW Asia is required. A diagnoses is also required. No nexus. Presumption till 2011 is the nexus.

If he did not serve in SW Asia then he will need a nexus opinion. The doctor giving the opinion must review the entire claims folder and base his opinion on that. I went thru the same thing. I filed a claim without getting a copy of my SMR's first. Then I was denied. When I realized I needed a copy of the claims folder the VA told me my case was in the rating board and it would have to come out to get a copy and I was advised against doing that. So I wnet to the American Legion and made them my Service Officer so I could get a copy of the claims folder. They steered me wrong. The gave me some verbage to get my doctor to sign, which he did, I turned it in, denied again. Guess what, he didn't review my service medical records. So I finally got the records, got my IMO from Dr. Bash (very good), and I wait. They move quickly when they know thay can deny. Not so quick when they have to grant.

Bottom line. Get a copy of the calims folder, get a good IMO. They will beat everything else down with double talk and delay.

[john999]

Ask for a personal hearing and get the doctor to review your medical records and write another letter. This is one of the VA's favorite tactics. Do you have a complete copy of your SMR's? Don't let this claim get away from you and do as Cal says and keep it local. You can keep it local by asking for personal hearings and sending in new evidence. It takes time but it is better than shipping it off to the BVA and then having them remand it two years later.

[Pete53]

You need to provide to the Doctor copies of Medical Records and the Dr needs to say that they reviewed them. In my opinion after that there is no way to go but to award the claim.

Good Luck

By the way if you can do it quickly I would send it to the DRO and say that the claim was cured per his objection